C I AC 4386 BAT 22 Metropolitan Borough of Battersea. REPORT on tub HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1924 by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. wightman & Co., Ltd., Print ere, 104, Regency Street, S.W. 1. Battersea Borough Council. With the Compliments of the Medical Officer of Health. MUNICIPAL BUILDINGS. LAVENDER HILL. S.W. BAT 22 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1924 by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. 1 Health Committee. As constituted 9th November, 1923. Chairman : Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor H. Harling, j.p.) Councillor Miss E. Brown. „ E. W. Coles. „ E. C. A. D. Duval. „ W. R. Early. „ A. P. Godfrey. „ J. Hendrick. Alderman C. W. Martin. Councillor R. Moore. „ Mrs. M. H. Rose. „ A. E. Samuels. „ S. C. Tarry. As constituted 10th November, 1924. Chairman : Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor C. E. Mason, j.p.) Councillor Miss E. Brown. „ E. W. Coles. „ E. C. A. D. Duval. „ W. R. Early. „ W. Geard. „ A. P. Godfrey. ,, J. Hendrick. „ G. H. Lawther. Alderman C. W. Martin. Councillor R. Moore. ,, Mrs. M. H. Rose. Maternity and Child Walfare Committee. As constituted 9th November, 1923. Chairman : Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor H. Harling, j.p.) The Health Committee, as above, and the following Co-opted Members : Mrs. K. S. D. Baker. Mrs. H. Bowler. Mrs. J. Hockley. Mrs. M. T. Varran. Mrs. F. Young. Mrs. E. E. Kemp. As constituted 10th November, 1924. Chairman. Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor C. E. Mason, j .p.) The Health Committee, as above, and the following Co-opted Members : Mrs. K. S. D. Baker. Mrs. H. Bowler. Mrs. J. Hockley. Mrs. E. E. Kemp. Mrs. M. T. Varran, j.p. Mrs. F. Young. * Appointed 27th February, 1924. Housing Committee As constituted 9th November, 1923. Chairman: Councillor W. D. Garnsey. His Worship the Mayor (Councillor H. Harling, j.p.) Councillor J. Bruce. „ D. Carmichael. „ W. R. Early. ,, W. Geard. „ J. W. Herd. „ T. R. Jones. Alderman T. Pocock. Councillor M. J. Prior. Alderman Mrs. M. J. Robinson. Councillor E. S. Strange, j.p. „ H. G. White. As constituted 10th November, 1924. Chairman. Councillor H. Harling. His Worship the Mayor (Councillor C. E. Mason, j.p.) Councillor J. Bruce. ,, W. R. Early. ,, W. D. Garnsey. ,, W. Geard. ,, T. R. Jones. Alderman T. Pocock. „ C. J. Powell. Councillor M. J. Prior. Alderman Mrs. M. J. Robinson. Councillor E. S. Strange, j.p. „ H. G. White. 2 Committee to issue certificates and reports under the Rent and Mortgage Interest Restriction Act, 1920 and 1925, as to the condition of dwelling houses. As constituted 28th May, 1924. Chairman: Councillor W. D. Garnsey. His Worship the Mayor. (Councillor H. Harling, j.p.) Councillor M. J. Prior. „ E. S. Strange, j.p. As constituted 10th November, 1924. Chairman : Councillor H. Harling. His Worship the Mayor. (Councillor C. E. Mason, j.p.) Councillor W. D. Garnsey. „ W. Geard. ,, E. S. Strange, j.p. H. G. White. Tuberculosis Committee. As constituted 9th November, 1923. The Health Committee, as above. As constituted 10th November, 1924. The Health Committee, as above. Tuberculosis care Committee. As constituted 9th November, 1923. Chairman—Mr. J. R. Archer. Councillor Mrs. C. S. Ganley, j.p „ J. Hendrick. „ R. Moore. „ Mrs. M. H. Rose. Other Members : Mrs. J. Hockley. Mr. T. Jones. Members of late Dispensary Committee : Mrs. Dermott. Mr. G. J. W. Gilder. Mr. B. R. Thorne. Members of late Voluntary Care Committee : Mrs. Causton. Miss B. Home. Miss Morris. Consultative Members: The L.C.C. District Organiser for Children's Care Committee Work. „ Representative of the War Pensions Committee. ,, Representative of the Invalid Children's Aid Association. „ Lady Almoner, St. Thomas's Hospital. „ After-Care Sister, Victoria Hospital. „ Tuberculosis Almoner, St. George's Hospital. „ Lady Almoner, King's College Hospital. „ Representative of the S. L. District Nursing Association. „ Representative of the London Insurance Committee. „ Lady Almoner, Brompton Hospital. ,, Representative of the British Red Cross Society. „ Health Visitor and Sanitary Inspector. As constituted 10th November, 1924. Chairman : Mr. J. R. Archer. Councillor Mrs. C. S. Ganley, j.p. ,, J. Hendrick. „ R. Moore. ,, Mrs. M. H. Rose, C. J. Wilkinson. Other Member : Mrs. J. Hockley. Members of the late Dispensary Committee : Mrs. Dermott. Mr. G. J. W. Gilder. Mr. B. R. Thorne. Members of the late Voluntary Care Committee : Mrs. Causton. Miss B. Home. Miss Morris. Consultative Members : L.C.C. District Organiser for Children's Care Committee Work (Miss Thomas) Representative of the Invalid Children's Aid Association. Representative of the War Pensions Committee (Mr. F. H. Richardson). Lady Almoner, Brompton Hospital (Miss Marx). Lady Almoner, King's College Hospital (Miss Edmonds). Tuberculosis Almoner, St. Georges Hospital (Miss Hamilton). Lady Almoner, St. Thomas's Hospital (Miss Cummins). After-Care Sister, Victoria Hospital (Miss Underwood). Representative of the London Insurance Committee (Mr. R. A. Hanson). Representative of the S.L. District Nursing Association (Miss A. M. Stanford). Representative of the British Red Cross Society (Mrs. C. E. Peach). Health Visitor and Sanitary Inspector (Miss J. Round). 3 Staff of Public Health Department. (At 31st December, 1924). Tuberculosis Officer—G. MACDONALD, M.A., M.B., Ch.B., D.P.H. Assistant Medical Officer (Maternity and Child Welfare). (Miss) M. L. HAMILTON, M.B., Ch.B., D.P.H. Do. (part-time). (Miss) ALICE BLOOMFIELD, M.D., F.R.C.S. Public Analyst—C. HACKMAN, F.I.C. Women Sanitary Inspectors and Health Visitors— Miss A. E. Moss, San. Insp. Board's Cert., Cert. C.M.B. Miss J. Round, H.V. Diploma, San. Insp. Board's Cert. Health Visitors— Miss C. P. Armitage, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss M. Carr, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss B. L. Kaye, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss N. Playne, San. Insp. Board's Cert., Cert. C.M.B. Miss'O. Baggallay,* H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss D. Heap, H.V. Diploma (R.S.I.), San. Insp. Board's Cert. Miss F. B. Goodall, H.V. Diploma, Cert. C.M.B. Miss A. Bannerman (temporary), H.V. Cert., Cert. C.M.B. Chief Sanitary Inspector— I. Young, F.S.I.A. District Inspectors. 1. Mr. J. Herrin, Cert. San. Inst, and Meat Insp. Cert. 2. Mr. J.J. Burgess, San. Insp. Board's Cert. 3. Mr. J. Lawrence, Cert. San. Inst. and Meat Insp. Cert. 4. Mr. A. E. Purnell, Cert. San. Inst. 5. Mr. J. T. Baxter, Cert. San. Inst. 6. Mr. H. Marrable, Cert. San. Inst. 8. Mr. H. H. May, Cert. San. Inst. Mr. H. E. Wheeler (Housing) San. Insp. Board's Cert., and Meat Insp. Cert. Food Inspector—Mr. A. Chuter, Cert. San. Inst., and Meat Insp. Cert. Workshops Inspector—Mr. W. E. Benjamin, Cert. San. Inst. Organising Rat Officer—Mr. H. Renham. Clerical Staff— Chief Clerk—Mr. F. E. Ward. Mr. J. W. Brown (Statistical). Mr. E. Cole. Mr. W. Halstead. Mr. H. C. Godfrey. Mr. W. F. Smith. Mr. J. R. Holloway. Mr. R. Graham. Miss G. Newton. Office youth. Miss F. M. Humphreys (temporary) Maternity and_Child Welfare Records. Tuberculosis Dispensary— Tuberculosis Nurses—Miss M. Schotburgh, Miss B. O Connor, Miss C. Thompson. Secretary and Clerk—Miss L. Wadham, Dispenser—Miss E. F. Davies. Typist—Miss C. Turner. Disinfecting Station—-Superintendent—C. Woodhouse. Mortuary—Keeper—W. Newman. Maternity Home— Matron—Miss C. Dickson, Cert. C.M.B. * Absent on special leave. 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Ladies and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary state of the borough for the year 1924. The birth-rate (18 4 per 1,000) is the lowest yet recorded in the old parish or borough of Battersea except in 1917 and 1918, during the war when conditions were abnormal. The death rate (11.8) and Infant mortality rate (62 4) were slightly higher than those for 1923. The increase in the mortality rate was mainly due to the prevalence of Influenza, respiratory diseases and Measles in the early months of the year, the number of deaths in the first quarter being nearly double that in each of the other quarterly periods. It is satisfactory to note that notwithstanding the unfavourable figures for the beginning of the year the mortality rates for the whole year were lower than in any previous year with the exception of 1923. There was a decline in the incidence of the principal infectious diseases except measles as compared with the previous year. The death-rate from Tuberculosis was very slightly higher than in 1923. On the other hand the number of notifications received was again lower than in any previous year, and it may be assumed, therefore, that the slight increase in the mortality figure from this disease was due to conditions affecting the general death-rate, to which allusion has already been made. The Health Services of the Council comprised in the Maternity and Child Welfare Scheme were carried on during the year with increased activity and success, and it has been necessary, owing to the development of the Ante-natal side of the work, to increase the medical staff by the appointment of a part-time woman medical officer. The reduction in the rate of Maternal Mortality has not kept pace with that of Infant Mortality and it is, therefore, of the highest importance that adequate provision should be made for the medical care and supervision of the expectant mother. It may confidently be anticipated that valuable results will follow from the improved Ante-natal service provided by the Council. In regard to housing matters the activities of the Council have been, of necessity, confined mainly to securing the repair of unfit houses and much useful work in that direction has been accomplished during the year under the provisions of Section 28 of the Housing Act, 1919. It is regrettable, however, that such 5 slow progress is being made in the provision of working-class houses. The extent of the overcrowding in many areas of the borough is so considerable as to be a serious menace to health apart from the other undesirable features associated with the evil. No relief, so far as Battersea is concerned, from this deplorable state of affairs can be hoped for until an adequate number of working-class tenements at reasonably low rentals are provided outside the Borough. I have again to express my appreciation of the consideration and support which have been so generously accorded me by the Chairmen of the Health, Maternity and Child Welfare and Housing Committees and the members of the Council. I have also to thank my colleagues, the Chief Officers of Departments and the staff of the Public Health Department for their loyal co-operation and assistance always willingly rendered. G. Quin LENNANE, Town Hall, Medical Officer of Heallh. Battersea, S.W. 6 CONTENTS. General. Page Constitution of Committees 1,2 Staff of Public Health Department 3 Introduction 4 Summary of Statistics 8 Births, Marriages and Deaths. Vital Statistics 8,9, 101 Acreage, Population and Dwellings 8, 9, 108 Marriages 9 Births 10 Illegitimate Births 11 Deaths in Borough and in Wards 12 „ in Age Periods 13 „ in Public Institutions 13 „ Senile 13 „ Causes and Age Distribution 103 Comparative Table of Births, Deaths, &c. (1857-1924) 14-15 Infant Mortality 15-18, 104-107 Illegitimate Infant Deaths 18 Notification of Births Act 19 Maternity and Child Welfare. Maternity and Child Welfare Scheme 20 Centres 20-23 Hospital Provision 23 Nursing Facilities 24, 25 Health Visitors 25 Milk Order 26 Ante-Natal Work 26 V.D 27-30 Maternity Hospital 30-33 District Midwifery Service 33 Dental Clinic 34 Infant Welfare Exhibition 35 Infectious Diseases 37 Summary of Notifications 38,102 Bacteriological Examinations 43,50 Contacts 37,48 Smallpox 37 Scarlet Fever and Diphtheria 39 Enteric Fever, Cerebro-Spinal Fever, Encephalitis Lethargica 40 Puerperal Fever 41 Polio-Myelitis, Erysipelas, Ophthalmia Neonatorum 41-42 Tuberculosis 44-55 Cases Notified 44,55 Deaths from Tuberculosis 45 Localisation of Disease 46 Dispensary 47 „ (Report of) 47-52 Institutional Treatment 48 Open-Air School (Day Sanatorium) 51 Care Committee 2,51 Non-Dispensary Patients 52,54 Tuberculosis Dental Clinic 52 Summary Table 55,56 Zymotic Deaths 57 Chicken pox 57 Diarrhcea 57 Influenza 58 Measles and Whooping-Cough 59 Cancer 61 7 Page Sanitary Circumstances. Summary Table 62 Legal Proceedings 63 66 Common Lodging Houses 67 Drainage Work 67 Revenue Act, 1903 67 Licensed Premises Urinals 67 Smoke and Effluvium Nuisances 67,68 Water Supply 68 Van Dwellings 68 Rag Flock Act 68 Rats and Mice Destruction Act 68 Personal Cleansing Station 69 Disinfecting Department 70 Mortuary 71 Staff 3,72, 100 Protection of the Food Supply. Unsound Food 73 Cow-Houses and Slaughter-Houses 73 Butchers' Shops 74 Sale of Food and Drugs Acts 74 75 Milk 75 Preservatives in Foods 75 Milk and Cream Regulations 79 Milk and Dairies (Amendment) Act, 1922 81 Ice Cream 81 Milk Shops 81 Fish Shops 82 Restaurant Kitchens 82 Street Stalls 82 Factories, Workshops, &c.—General Tables 83 Factories 84 Workshops 85 Outworkers 86,89 Bakehouses 88 Warehouses and Wharves 88 Housing. General 90 Overcrowding 91 New Tenements and Houses erected 91 Repair of Unfit Houses 91 Closing Orders 93 Underground Dwellings 93 Increase of Rent, &c., Acts 93 Houses Let in Lodgings—By-laws 94 Unhealthy Areas 94 Insanitary Houses 95 Statistics 98 Appendices. Table I. Summary of Vital Statistics 101 „ II. Infectious Disease Notifications 102 „ III. Causes of, and Ages at, Death 103 „ IV. Infant Mortality 104-107 Population of Battersea & County of London. Census return as to— I. Occupations 108 II. Age Distribution & Marital Condition 109 8 Summary of Statistics, 1924 1. General. Area of Borough. (Including land and inland water) acres 2,163 (Excluding water) acres 2,139.9 Population— (Census, 1921) 167,739 (Registrar-General's estimate, mid-year, 1924) 171,000 Structurally separate occupied dwellings (Census, 1921) 27,191 Rateable value £1,041,011 Sum represented by a penny rate £4,274 2. Extracts from Vital Statistics of the Year. Births— (Males, 1,658; females, 1,481) 3,139 Legitimate Births 3,031 Illegitimate Births 108 Birth-rate 18.4 Deaths— (Males, 989 ; females, 1029) 2,018 Death-rate 11.8 Number of women dying in or in consequence of child-birth:— From sepsis 4 Other causes 5 Death rate of Infants under 1 year per 1,000 births- Legitimate 59.4 Illegitimate 148.1 62.4 Deaths from Measles (all ages) 51 ,, Whooping Cough (all ages) 17 „ Diarrhoea (under 2 years of age) 23 Census, 1911— Population 167,743 Number of inhabited houses 24,321 9 Births, Marriages and Deaths. VITAL STATISTICS. Population. The population of the Borough as estimated by the RegistrarGeneral for the year 1924 is 171,000. The estimated population, based upon the Registrar-General's figures, for the registration sub-districts and for the nine Wards is set out in the following table:— Registration Sub-District. Estimated Mid-Year Population, 1924. Males. Females. Total. East Battersea 34,019 36,841 70,860 North-West Battersea 23,663 25,239 48,902 South-West Battersea 22,506 28,732 51,238 Total 80,188 90,812 171,000 1. Nine Elms 13,546 14,294 27,840 2. Park 8,764 9,805 18,569 3. Latchmere 9,227 10,284 19,511 4. Shaftesbury 7,593 8,115 15,708 5. Church 9,237 9,619 18,856 6. Winstanley 10,157 10,860 21,017 7. St. John 3,662 5,074 8,736 8. Bolingbroke 8,652 10,695 19,347 9. Broomwood 9,350 12,066 21,416 Total 80,188 90,812 171,000 Marriages. The marriages registered in Battersea during 1924 numbered 1,367. The marriage-rate (i.e., the number of persons married per 1,000 of the population) was 16-0. The steady decline which has taken place in the marriage-rate in the Borough during the past five years is shown in the following table:— Year. Marriages. Marriage-Rate. 1920 1,644 19.8 1921 1,482 17.5 1922 1,404 16.6 1923 1,352 15.8 1924 1,367 16.0 10 Births. The number of births registered in the Borough during 1924 was 3,180 (1,669 males, 1,511 females), an excess of 158 males. Of this number 305 were transferred out, the permanent residence of the parents being outside the Borough, and 264 births occurring elsewhere were transferred here, giving on balance a total of 3,139 births relating to Battersea residents and a corrected birth-rate of 18.4 per 1,000 of the population. The births in the registration sub-districts of the Borough were as follows:— Sub-district. Males. Females. Total. East Battersea 741 670 1,411 North-West Battersea 579 492 1,071 South-West Battersea 338 319 657 The Borough 1,658 1,481 3,139 The following table shows comparative average birth-rates for quinquennial periods from 1877-81 to 1917-1921, and birthrates for individual years from 1917 for England and Wales, London and Battersea:— Birth-rate per 1,000 Population. Years. England & Wales. London. Battersea. 1877-81 34.9 35.3 40.5 1882-86 33.3 34.0 40.0 1887-91 33.2 33.9 36.1 1892-96 30.1 30.6 32.4 1897-1901 29.0 29.5 30.8 1902-06 27.8 27.7 27.5 1907-11 25.5 25.5 24.8 1912-16 22.9 23.5 24.4 1917-21 20.4 20.2 20.5 1917 17.8 17.9 17.7 1918 17.7 16.0 16.1 1919 18.5 18.3 18.5 1920 25.4 26.5 28.1 1921 22.4 22.3 22.1 1922 20.5 21.0 21.7 1923 19.7 20.2 20.1 1924 18.8 18.7 18.4 11 The following table shows the birth-rate per 1,000 of the population for each of the nine Wards of the Borough for the year 1924:— Ward. Estimated Population, 1924. Number of Births. Birthrate. No. 1, Nine Elms 27,840 606 21.8 No. 2, Park 18,569 382 20.6 No. 3, Latchmere 19,511 381 19.5 No. 4, Shaftesbury 15,708 264 16.8 No. 5, Church 18,856 390 20.7 No. 6, Winstanley 21,017 484 23.0 No. 7, St. John 8,736 133 15.2 No. 8, Bolingbroke 19,347 280 14.5 No. 9, Broomwood 21,416 219 10.2 The next table shows the birth-rates in the Borough and in the registration sub-districts in 1924, and during the previous decennium 1914-1923:— Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 1914 257 27.9 30.9 17.2 1915 23.6 26.2 26.8 16.7 1916 21.8 23.0 25.0 16.8 1917 17.7 19.0 19.8 13.8 1918 16.1 17.7 17.8 12.0 1919 18.5 19.3 20.8 15.1 1920 28.1 29.8 32.0 21.8 1921 22.1 23.8 26.6 15.5 1922 21.7 23.0 24.8 16.8 1923 20.1 23.0 22.0 14.4 Average 1914-1923 21.5 23.3 24.6 16.0 1924 18.4 19.9 21 .9 12.8 Illegitimate Births. Of the total births registered as belonging to the Borough of Battersea 108 were of illegitimate children or 3.44 per cent., as compared with 115 or 3.35 per cent. in 1923, 128 or 3.49 per cent. in 1922 and 131 or 3.50 per cent. in 1921. 12 Deaths. The number of deaths registered in the Borough during 1924 was 2,506. Of these 858 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, on the other hand, 370 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths of persons belonging to the Borough was 2,018 (males 989, females 1,029). This gives a recorded death-rate of 11.8 as compared with 12.1 for London and 12.2 for England and Wales. The following table shows the death-rates per 1,000 of the population for the Borough and the registration sub-districts for the ten years 1914-1923 and the year 1924 respectively :— Death-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 1914 13.2 14.0 14.4 10.9 1915 16.4 16.2 18.8 14.2 1916 13.9 14.5 14.7 12.4 1917 15.2 15.4 16.3 14.0 1918 18.7 19.2 20.2 16.6 1919 12.9 12.4 12.7 13.7 1920 12.5 12.8 12.4 12.3 1921 12.2 12.3 12.7 11.5 1922 13.2 13.1 13.8 12.6 1923 10.8 11.2 10.4 10.6 Average 1914-23. 13.9 14.1 14.6 12.9 1924 11.8 11.9 12.5 11.0 The death-rate per 1,000 inhabitants for each of the nine Wards is shown in the next table:— Ward. Estimated Population 1924. Number of Deaths. Deathrate. No. 1, Nine Elms 27,840 333 12.0 No. 2, Park 18,569 238 12.8 No. 3, Latchmere 19,511 227 11.6 No. 4, Shaftesbury 15,708 173 11.0 No. 5, Church 18,856 228 12.1 No. 6, Winstanley 21,017 278 13.2 No. 7, St. John 8,736 102 11.7 No. 8, Bolingbroke 19,347 218 11.3 No. 9, Broomwood 21,416 221 10.3 13 The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1924:— Under 1 year. 1-5 5-10 10-15 15-25 25-45 45-65 65- Total. M 111 75 16 16 39 121 292 319 989 F 85 71 21 8 47 119 230 448 1,029 Ttls. 196 146 37 24 86 240 522 767 2,018 The corrected number of deaths of males and females registered in each quarter of the year is set out as follows:— Males. Females. Total. First quarter 364 421 785 Second quarter 208 193 401 Third quarter 187 190 377 Fourth quarter 230 225 455 Deaths in Public Institutions. During 1924 the deaths of Battersea residents occurring in Public Institutions numbered 955. Of this number 627 occurred within and 328 outside the Borough. Of the total deaths in Public Institutions 617 occurred in Poor Law Institutions. Senile Mortality. During 1924 the deaths of 767 persons aged 65 years and upwards were registered in the Borough of Battersea. The distribution of these deaths is set out in the following table:— District. 65 and under 75. 75 and under 85. 85 and upwards. Total over 65. Total. M. F. M. F. M. F. M. F. East Battersea 74 83 36 79 14 23 124 185 309 N.W. Battersea 48 57 34 56 8 11 90 124 214 S.W. Battersea 61 51 34 70 10 18 105 139 244 Borough of Battersea 183 191 104 205 32 52 319 448 767 14 COMPARATIVE STATISTICS OF BIRTHS, MORTALITY, &c. Year. Mean population for year. Births. Birth Rate. Deaths. Death Rate. Zymotic Deaths. Natural Increase. 1857 15,970 582 36.4 343 21 .4 46 239 1858 16,872 562 33.3 380 22.5 100 182 1859 17,774 685 38.5 394 22.1 96 291 1860 18,676 680 36.4 399 21.3 62 281 1861 19,582 750 38.3 505 25.7 112 245 1862 23,108 784 33.9 491 21.2 106 293 1863 26,635 1,042 39. 1 522 19.5 86 520 1864 30,161 1,140 87.8 669 22.1 129 471 1865 33,688 1,357 40.3 785 23.3 177 572 1866 37,145 1,386 37.3 1,002 26.9 244 384 1867 40,741 1,734 42.5 870 21.3 122 864 1868 44,267 1,975 44.6 1,046 23.6 194 929 1869 47,749 2,096 43.9 1,121 23.4 247 975 1870 51,320 2,170 42.2 1,375 26.7 404 795 1871 54,847. 2,220 40.4 1,472 26.8 463 748 1872 60,244 2,349 38.9 1,202 19.9 220 1,147 1873 65,614 2,659 40.5 1,307 19.9 205 1,352 1874 70,984 2,865 40.3 1,387 19.5 238 1,478 1875 76,354 3,080 40.3 1,724 22.5 307 1,356 1876 81,704 3,455 42.2 1,745 21.3 340 1,710 1877 87,094 3,481 39.9 1,725 19.8 280 1,756 1878 92,464 3,748 40.5 1,803 19.4 322 1,945 1879 97,834 4,001 40.8 1,980 20.2 355 2,021 1880 103,204 4,095 39.6 2,040 19.7 383 2,055 1881 108,342 4,452 41.8 2,033 18.7 381 2,419 1882 112,661 4,504 39.9 2,214 19.6 353 2,290 1883 116,980 4,711 40.2 2,344 20.0 369 2,367 1884 121,299 5,275 43.4 2,569 21.1 568 2,706 1885 125,618 4,654 37.0 2,566 20.4 432 2,088 1886 129,937 5,140 39.5 2,477 19.0 398 2,663 1887 134,256 5,186 38.6 2,451 18.2 502 2,735 1888 138,565 5,061 36.5 2,187 15.7 363 2,874 1889 142,884 5,161 36.1 2,240 15.6 366 2,921 1890 147,203 5,105 34.6 2,854 19.3 543 2,251 1891 150,880 5,237 34.7 2,697 17.9 398 2,540 1892 153,778 4,990 32.4 2,782 18.1 439 2,208 1893 156,719 5,225 33.3 2,974 18.9 614 2,251 1894 159,724 5,024 31.4 2,577 16.1 526 2,447 1895 162,787 5,264 32.3 2,961 18.1 460 2,303 1896 165,309 5,358 32.4 2,994 18.1 642 2,364 1897 166,059 5,266 31.7 2,737 16.4 486 2,529 1898 166,814 5,157 30.9 2,892 17.3 531 2,265 1899 167,570 5,179 30.9 2,905 17.3 418 2,274 1900 168,339 5,161 30.6 2,978 17.6 435 2,183 1901 169,100 5,025 29.7 2,766. 16.3 491 2,259 1902 171,401 4,844 28.2 2,581 15.0 367 2,263 1903 173,422 4,973 28.6 2,476 14.2 347 2,497 1904 175,465 4,849 27.5 2,543 14.4 353 2,306 1905 177,532 4,843 27.3 2,561 14.4 375 2,282 1906 179,622 4,654 25.9 2,384 13.2 338 2,270 1907 181,736 4,574 25 .1 2,406 13.2 255 2,168 1908 183,873 4,629 25.1 2,272 12.3 238 2,357 1909 186,036 4,450 23.9 2,417 12.9 283 2,033 1910 188,222 4,489 23.7 2,124 11.3 242 2,365 1911 167,765 4,381 26.1 2,404 14.3 336 1,977 1912 167,589 4,255 25.4 2,052 12.2 138 2,203 1913 167,464 4,240 25.3 2,365 14.1 208 1,875 1914 167,338 4,303 25.7 2,217 13.2 142 2,086 1915 161,945 3,820 23.6 2,653 16.4 334 1,167 1916 B*173,432 3,774 21.8 — — — — D*159,402 — — 2,221 13.9 160 1,553 1917 B*167,233 2,960 17.7 — — — — D*150,023 — — 2,285 15.2 185 675 1918 B*168,014 2,700 16.1 — — — — D*149,951 — — 2,809 18.7 204 -109† 1919 B*165,960 3,075 18.5 — — — — D*159,316 — — 2,061 12.9 95 1,014 1920 B*166,093 4,669 28.1 - - - - D*165,664 - - 2,079 12.5 188 2,590 1921 169,200 3,742 221 2,060 12.2 173 1,682 1922 169,200 3,665 21.7 2,227 13.2 192 1,438 1923 170,600 3,434 20.1 1,839 10.8 114 1,595 1924 171,000 3,139 18.4 2,018 11.8 122 1,121 * Population as estimated for purpose of (B) Birth-rate, (D) Death-rate. † Decrease. The years marked were census years. 15 CHART showing the INFANTILE MORTALITY RATE (per 1,000 Registered Births) in Battersea from 1858 to 1924. 16 Infant Mortality. During 1924 the deaths of 196 infants were registered as belonging to Battersea. The total number of births registered during the year was 3,139, giving an infant mortality-rate of 62.4 per 1,000 births. There were only six Boroughs in the County of London with a lower infant mortality than Battersea. The infant mortality-rates in Battersea and in London for the years which have elapsed since the formation of the Borough, as well as for the previous decennium, are set out in the following table:— Year. London. Battersea. 1891-1900 158 162 1901 148 163 1902 139 136 1903 130 135 1904 144 147 1905 129 131 1906 129 126 1907 116 115 1908 113 107 1909 108 107 1910 103 97 1901-10 126 126 1911 129 124 1912 91 83 1913 105 111 1914 104 92 1915 112 112 1916 89 84 1917 104 101 1918 107 99 1919 85 74 1920 75 83 1911-20 100 96 1921 79.6 73.8 1922 74.4 69.3 1923 60.4 49.5 1924 69.0 62.4 The infant mortality-rate for the County ot London tor the year 1924 was 69 per 1,000 births. 17 The distribution of the 196 infant deaths and the infant mortality-rates, both for the registration sub-districts and for the Wards, are shown in the following table:— Registration Sub-Districts. Births. Deaths of Infants under 1 year of age. Infant Mortality per 1,000 births. m. f. total East Battersea 1,411 51 44 95 67.3 North-West Battersea 1,071 46 26 72 67.2 South-West Battersea 657 14 15 29 44.1 The Borough 3,139 111 85 196 62.4 Ward. 1. Nine Elms 606 22 19 41 67.7 2. Park 382 9 14 23 60.2 3. Latchmere 381 14 12 26 68.2 4. Shaftesbury 264 15 4 19 72. 0 5. Church 390 15 8 23 59.0 6. Winstanley 484 24 13 37 76.4 7. St. John 133 6 4 10 75.2 8. Bolingbroke 280 4 5 9 32.1 9. Broomwood 219 2 6 8 36.5 The effect of environment is well illustrated in the above table by the infant mortality rates for the lower wards which in the main are peopled by a less prosperous class of the community. The rates in all these lower wards during 1924 are, with the exception of Shaftesbury ward, much higher than in the previous year, partly due to the high incidence of influenza and respiratory diseases and partly, there is no doubt, to the serious overcrowding resulting from the housing shortage and its attendant evils. In the upper wards, Bolingbroke and Broomwood, there has only been a very slight increase as compared with 1923. The most marked increase is that shown in St. John Ward, where the infant mortality for 1924 is 75.2 per 1,000 births as against 25.6, or three times the rate in the previous year. It is satisfactory to note, however, that the infant mortality of the borough for 1924 is lower than in any previous year with the exception of 1923. The next table shows the incidence of mortality from the chief diseases of infancy in the first and second trimesters and during the ages 6 to 12 months:— 18 Certified Causes of Death. Months 0—3. Months 3—6. Months 6—9. Months 9—12. Total. % of Total. Scarlet Fever — — — — — — Diphtheria — — — — — — Erysipelas — — — — — — Measles — 2 2 6 10 5.1 Influenza 1 1 1 1 4 2.0 Meningococcal Meningitis — — — — — — Whooping Cough — 1 1 8 10 5.1 Diarrhoea and Enteritis 2 6 7 4 19 9.7 General Tuberculosis — — — 1 1 0.5 Tuberculous Meningitis — — — — — — Pulmonary Tuberculosis — — — 1 1 0.5 Pneumonia 8 8 9 10 35 17.9 Bronchitis 6 5 2 2 15 7.7 Other Respiratory Diseases — — — — — — Nephritis — — — — — — Prematurity 47 1 — — 48 24.5 Marasmus 10 3 1 — 14 71 Icterus Neonatorum 3 — — 3 1.5 CongenitalMalformations 6 1 — — 7 3.6 Injury at Birth 1 — — — 1 0.5 Suffocation (overlying) — — — — — — Convulsions 3 — — 1 4 2.0 Atelectasis &Asphyxia N. 7 — — — 7 3.6 Lack of Care 3 — — — 3 1.5 Syphilis 3 1 1 — 5 2.6 Miscellaneous 6 1 1 1 9 4.6 Total 106 30 25 35 196 100.0 Percentage of Total 54.1 15.3 12.8 17.8 100.0 — Illegitimate Infant Deaths. The death-rate amongst illegitimate children during 1924 was 148.1 per 1,000 births, as compared with 130.4 in 1923, 179.7 in 1922 and 183.2 in 1921. The corresponding death-rate of legitimate infants in 1924 was 59.4, the ratio of the mortality-rate of illegitimate infants to that of legitimate being 2.49 to 1. The following table shows (a) the legitimate and illegitimate births and deaths, (b) the ratio of illegitimate to legitimate births, (c) the deaths per 1,000 legitimate and illegitimate infant births respectively, and (d) the ratio of the illegitimate infant mortality rate to that of legitimate infants during the past 6 years:— 19 Year. Births. Ratio of Illeg. to Legit. Births. Deaths. (Infants under 1 year.) Deaths per 1,000 Births. Ratio of Illeg. I.M.R. to Legit. I.M.R. Legit. Illeg. Legit. Illeg. Legit. Illeg. 1919 2,916 159 .055 204 24 70.0 150.9 2.16 1920 4,509 160 .035 358 28 79.4 175.0 2.20 1921 3,611 131 .036 252 24 69.8 183.2 2.62 1922 3,537 128 .036 231 23 650 179.7 2.76 1923 3,319 115 .035 155 15 46.7 130 4 2.79 Average 19191923 3,578 139 .039 240 23 67.1 164.5 2. 45 1924 3,031 108 .036 180 16 59.4 148.1 2.49 The above table shows that the death-rate amongst illegitimate children, though slightly lower in 1924, shows little variation, while on the other hand the decline in the rate for legitimate infants has been steady and progressive. Notification of Births Act. The Notification of Births Act, 1907, was adopted in the Borough of Battersea and came into force in 1908. During 1924 the number of notifications of live births received was 3,117. The corrected number of births registered in Battersea was 3,139. The proportion of notified to registered births was 99 • 3 per cent. The number of still-births notified during the year was 79 or 2.5 per cent. of the corrected total births registered. 195 births of infants born outside the Borough, but children of Battersea residents, were notified from the districts in which these births occurred. Notified births are visited and re-visited by the Council's official Health Visitors and by the Health Visitors of the voluntary organizations linked up with the Council's Maternity and Child Welfare Scheme. The mothers are invited to bring their babies to the various Welfare Centres included in the Battersea Maternity and Child Welfare Scheme. A weekly return of all births notified is sent to the London County Council in accordance with the requirements of Sec. 5, subsec. 2 of the Notification of Births Act. 20 Table showing the Birth Rates, Death Rates and Infantile Mortality Rates in the 29 Metropolitan Cities and Boroughs. Births per 1,000 Population. Deaths per 1,000 Population. Infantile Mortality per 1,000 Births. 1. Shoreditch 25.1 Lewisham 10.4 Lewisham 47 2. Bermondsey 24.4 Woolwich 10.8 Hampstead 52 3. Poplar 23.1 Wandsworth 11.0 Stoke Newington 56 4. Southwark 22.5 Fulham 11.1 Wandsworth 56 5. Bethnal Green 22.3 Hackney 11.2 City of Westminster 58 6. Finsbury 21.6 Hampstead 11.4 Hackney 60 7. Stepney 21.4 S. Newington 11.4 Battersea 62 8. Deptford 20.7 Greenwich 11.4 Chelsea 63 9. Greenwich 20.2 Camberwell 11.4 Woolwich 65 10. Islington 20.0 City of London 11.5 Lambeth 66 11. Lambeth 19.2 City of Westminster 11.6 Islington 66 12. Camberwell 19.0 Battersea 11.8 Camberwell 70 13. St. Pancras 19.0 Deptford 11.9 Southwark 71 14. Hackney 18.7 Holborn 11.9 Poplar 71 15. Battersea 18.4 Poplar 12.0 Hammersmith 72 16. Fulham 18.4 Hammersmith 12.1 Fulham 72 17. Woolwich 18.1 Bethnal Green 12.2 St. Pancras 73 18. Hammersmith 18.0 Stepney 12.2 Greenwich 74 19. Paddington 17.1 Islington 12.3 Deptford 74 20. Lewisham 16.7 Lambeth 12.5 Kensington 75 21. Stoke Newington 16.6 Paddington 12.9 Stepney 75 22. Kensington 16.2 St. Pancras 12.9 Bermondsey 77 23. Wandsworth 14.9 Kensington 13.0 St. Marylebone 78 24. St. Marylebone 14.6 Chelsea 13.0 Paddington 78 25. Chelsea 14.4 St. Marylebone 13.1 Bethnal Green 78 26. Hampstead 13.6 Bermondsey 13.5 Finsbury 78 27. Holborn 13.4 Shoreditch 13.5 Holborn 83 28. City of Westminster 11.2 Southwark 14.0 Shoreditch 83 29. City of London 7.0 Finsbury 14.1 City of London 115 London County 18.7 12.1 69 England and Wales 18.8 12.2 75 Maternity and Child Welfare Scheme. The Battersea Maternity and Child Welfare Scheme, the revision and development of which, under the provisions of the Maternity and Child Welfare Act, 1918, was begun early in 1919, made useful progress during 1924. The various activities included in the Scheme— pre-natal, natal and post-natal—are now well co-ordinated, but special attention was given to the development of the pre-natal side of the work. Maternity and Child Welfare Centres. For administrative purposes the Borough is divided into six areas. In each of these areas a Maternity and Child Welfare Centre 21 —municipal or voluntary—has been established. The Centres are situate as follows:— 1. Municipal. (a) Latchmere Baths (Burns Road). (b) All Saints' Parish Hall (Prince of Wales Road). (c) Plough Road Institution. (d) Chatham Hall, Chatham Road. (e) Dental Centre and Clinics (Plough Road Institution). 2. Voluntary. (a) Battersea School for Mothers (55 Mundella Road). (b) Women's League of Service (111 Bridge Road West). (c) Chislehurst Mission (St. James' Parish Hall, Ponton Road, Nine Elms). In addition to the above, ancillary activities included in the Scheme comprise: (1) St. Mary's Hostel, Macaulay Road, Clapham Common, and (2) St. Margaret's Day Nursery and Resident Hostel, both of which Institutions are under voluntary control, but linked up with the Battersea Maternity and Child Welfare Scheme and in receipt of an annual grant from the Council. A new Maternity and Child Welfare Centre was opened in April at Chatham House, Chatham Road. This district, although it is populated in the main by a more prosperous class of inhabitant, yet contains a growing minority of less well-to-do families. Hitherto it had been necessary for mothers to travel a considerable distance to the nearest Centres—Plough Road and the Latchmere. The establishment of the Chatham Road Centre has, therefore, been a great boon to the inhabitants of the surrounding district, and moreover it has relieved to a considerable extent the congestion at Latchmere and Plough Road Centres, thereby contributing to greater comfort and efficiency at these latter Centres. The success which has followed the opening of this new Centre is shown in the statistical summary in the table on page 22. Each Child Welfare Centre is under the superintendence of a trained Health Visitor, and to each Centre is attached a clinic at which a woman medical officer is in attendance. The Voluntary Centres are managed on similar lines to those of the Municipal Centres. The Child Welfare work at two of the voluntary associations' Centres is under the superintendence of one of the Council's Health Visitors. The work carried out at the various Municipal Infant Welfare Centres during 1924 is summarised as follows:— 22 Summarised Statistics relating to Municipal Infant Centres, 1923-1924. Latchmere Centre. 1923. 1924. Sessions held 149 134 Attendances 11,459 8,297 First attendances 979 739 Average at tendances per session 77 62 Average attendances weekly 219 160 Doctor's attendances 102 74 Babies seen by Doctor 2,306 2,008 Average ditto per attendance 23 27 Weights recorded 10,053 7,216 Advice only 1,346 1,081 Plough Road Centre. Sessions held 101 100 Attendances 5,221 5,041 First attendances 611 488 Average attendances per session 52 50 Average attendances weekly 100 97 Doctor's attendances 55 48 Babies seen by Doctor 1,297 1,078 Average ditto per attendance 24 22 Weights recorded 4,673 4,319 Advice only 543 722 East Battersea Centre. Sessions held 102 100 Attendances 4,717 4,519 First attendances 371 404 Average attendances per session 46 45 Average attendances weekly 91 87 Doctor's attendances 54 47 Babies seen by Doctor 1,040 1,231 Average ditto per attendance 19 26 Weights recorded 4,217 4,012 Advice only 500 507 Chatham Road Centre.* Sessions held — 73 Attendances — 3,617 First attendances — 277 Average attendances per session — 49 Average attendances weekly — 98 Doctor's attendances — 35 Babies seen by Doctor — 738 Average ditto per attendance — 21 Weights recorded — 3,148 Advice only — 469 * Opened in April, 1924. 23 Summary of Statistics relating to Municipal Infant Centres. 1923. 1924. Sessions held 351 407 Attendances 21,397 21,474 First attendances 1,981 1,908 Average attendances per session 61 53 Average attendances weekly 411 413 Doctor's attendances 211 204 Babies seen by Doctor 4,643 5,055 Average number seen per session 22 25 Weights recorded 18,943 18,695 Advice only 2,389 2,779 The work carried out during 1924 at the Voluntary Child Welfare Centres linked up with the Council's Maternity and Child Welfare Scheme is summarised as follows:— Battersea School for Mothers, 55 Mundella Road. Chiselhurst (St. James's) Mission, Ponton Road Women's League of Service, 111 Bridge Road West. Total. 1923. 1924. 1923. 1924. 1923. 1924. 1923. 1924. Sessions held 95 99 51 49 67 73 213 221 Attendances 3,850 3,429 1,459 1,190 2,240 1,766 7,549 6,385 First Attendances 251 258 104 81 88 127 443 466 Average attendance per session 41 35 29 24 33 24 35 29 Average weekly 74 66 29 24 43 34 145 123 Doctor's attendances 94 97 27 29 67 73 188 199 Babies seen by Doctor 2,670 2,561 439 439 1,806 1,516 4,915 4,516 Average do. per attendance 28 26 16 15 27 21 26 23 Weights recorded 3,831 3,425 1,427 1,111 2,207 1,685 7,465 6,221 Advice only 19 4 32 79 33 81 84 164 Hospital Provision. Apart from the special provision for maternity at the Borough Maternity Hospital and the District Midwifery Service, facilities for the needs of children requiring hospital treatment are provided by the Council by arrangement with the Victoria Children's Hospital, Tite Street, Chelsea. The Council contribute an annual sum to the hospital funds for this service. Women and children are occasionally referred from the Child Welfare and Ante-natal clinics to other Hospitals and Institutions. 24 Number of cases referred to Hospitals from the Municipal Clinics during 1924:- St. Thomas's Hospital10 Victoria Hospital for Children 90 St. James's Hospital Bolingbroke Hospital 1 Borough Tuberculosis Dispensary 12 Mothercraft Training Centre (Trebovir Road, Earls Court) 12 Fulham Babies Hospital 0 Total 137 The number of cases referred to Hospitals in 1923 was 189. During the year arrangements were made with the Committee of the Fulham Babies' Hospital to admit children sent from the Battersea Child Welfare Clinics for treatment in the Hospital. The cases received in this Institution are mainly those suffering from malnutrition and deficiency diseases requiring prolonged dietetic and other appropriate treatment. A sum of £90 has been sanctioned by the Ministry of Health in the Maternity and Child Welfare estimates of the Council. The basis of payments is a per capita charge of £1 per week. Very useful results have followed from this new Hospital Service and there are indications that the requirements of the Welfare Centres will necessitate an extension of the Service. Nursing Facilities. In connection with the Council's Scheme, by arrangement with the South London District Nursing Association, free skilled Nursing attendance in their own homes is available under the provisions of the Maternity and Child Welfare Act when required for inhabitants of the Borough. Very valuable results have accrued from this useful provision, and, especially during the prevalence of epidemic disease, e.g., acute infective diarrhoea, measles, whoopingcough and other dangerous diseases of child life, the Nursing service has proved a very effective Public Health preventive measure. During 1924, the total number of attendances made by the Nurses was as follows:— 25 Nursing Service, 1924. Name of Disease. Age. Total. Under 5 years. Over 5 years. Cases. Visits. Cases. Visits. Cases. Visits. Ophthalmia Neon. & other Eye Aff'ns. 85 2,676 — — 85 2,676 Measles 93 1,059 17 211 110 1,270 Whooping Cough 11 167 — — 11 167 Diarrhoea & Vomiting 6 70 — — 6 70 Chicken Pox 1 4 3 15 4 19 Puerperal Fever — — — — — — Pneumonia 115 1,452 89 1,541 204 2,993 Influenza 16 108 58 577 74 685 Other Diseases — — 6 94 6 94 Totals 327 5,536 173 2,438 500 7,974 The cost of the Nursing Service, particulars of which are set out in the above table, was £265 16s. 0d. as compared with £182 10s. 8d. during 1923. Health Visitors. The work carried out during 1924 by the Council's Health Visiting Staff, and by the Health Visitors of the voluntary organisations included in the Borough Maternity and Child Welfare scheme, will be found summarised below:— Health Visitors. First Visits. Re-Visits. Total. Grand Total. C'cil. Vol'y. C'cil. Vol'y. C'cil. Vol'y. 1923 1924. Visits to Expectant Mothers 866 216 888 396 1,754 612 1,915 2,366 Visits to Notified Births 2,889 375 5,494 840 8,383 1,215 9,366 9,598 Visits to Still Births 61 18 27 — 88 18 64 106 Visits to Children aged 1-5 years 653 1,886 1,447 2,539 1,447 2,853 3,986 Visits to enquire into Infant Deaths 141 21 64 3 205 24 149 229 Visits to cases of Notifiable Infectious Disease 3,264 452 1,796 137 5,060 589 5,428 5,649 Visits to cases of Non-Notifiable Disease 384 74 144 27 528 101 656 629 Visits re Summer Diarrhœa 1,361 655 1,?61 655 2,113 2,016 Visits to Dental Cases 320 25 320 25 355 345 Visits to V.D. Cases 211 — — — 211 191 211 Gynæcological Visits 48 — — — 48 — — 48 Other Visits 1,263 799 — 20 1,263 819 1,014 2,082 Totals 11,461 2,635 10,299 2,870 21,760 5,505 24,104 27,265 26 Milk Order. During 1924, Milk, both fresh and dried, was supplied by the Council free or at reduced rates to Necessitous Expectant and Nursing Mothers and Children under 5 years of age. The following table gives particulars relating to the number of persons supplied, quantities distributed and cost after deducting payments made:— Year. Dried Milk. Fresh Milk. Cost (after deducting payments made). Persons Supplied. lbs. Supplied. Persons Supplied. Pints Supplied. £ 1920 1,473 15,588 233 31,894 3,330 1921 2,391 49,020 301 27,254 5,011 1922 2,469 61,511 260 23,879 5,279 1923 2,231 50,110 219 25,633 3,288 1924 1,840 51,837 178 17,654 2,533 Ante-natal Work. Very considerable progress was made in the development of the Ante-natal side of the Borough Maternity and Child Welfare Scheme. In April, 1924, a part-time Medical Officer (Dr. Alice Bloomfield, M.D., F.R.C.S.) specially skilled in the diseases of women was appointed by the Council, and her services were allocated to this branch of our Maternity work. She was given medical charge of the three principal clinics, two of which art held at the Borough Maternity Hospital (out-patient department) and one at the Latchmere Centre. In addition to these main ante-natal clinics subsidiary clinics are held at the All Saints' Parish Hall and Plough Road Centre under the direction of the Assistant Medical Officer (Maternity and Child Welfare), Dr. Martha Hamilton, M.B., and at 111, Bridge Road West (Women's League of Service) Centre. The latter alinic is under the supervision of the Medical Officer appointed by the Voluntary Organisation in charge of this centre, but the work is linked up with that of the Council's Scheme. A Health Visitor, a fully trained Nurse, is in attendance at each of these Clinics, and interviews the mothers prior to their being seen by the Doctor for medical examination. It is satisfactory to note that this important development of the Borough Maternity and Child Welfare Scheme has been much appreciated by the expectant and nursing mothers, and has already produced valuable results. Under the new arrangements above outlined, it is anticipated that still better results will accrue from the measures being taken to secure the reduction of maternal mortality. In the valuable report by Dame Janet Campbell recently issued by the Ministry of Health the necessity for such increased efforts is evident. The 27 neglect in the past of provision for the early diagnosis of conditions inimical to the health of mothers has resulted not only in a high maternal mortality rate but a considerable amount of suffering and invalidity among the survivors. On inspection of the figures for the year 1924 it will be seen that the largest attendance—55 per cent. of the total—at these Clinics was at the Borough Maternity Hospital Clinic, the remaining attendances being distributed between the three subsidiary clinics. All new cases are seen on the first visit at the Borough Maternity Hospital Clinic, as are also expectant mothers in the later months of pregnancy, who have booked for admission to the lying-in wards. It has been found necessary to consider a re-arrangement of the work of these clinics, the attendances at the principal Ante-natal Clinics at the Maternity Hospital having become too large to permit of the necessary time being given to individual cases. It is proposed therefore that, in future, all cases, with the exception of one visit at the Tuesday afternoon Clinic at the Maternity Hospital for the routine blood test, will be seen at their local clinics until the sixth and seventh months, and all cases expecting admission to the Maternity Hospital for their confinement will attend the Maternity Hospital Clinic for their last three monthly visits. It is felt that more reliable results will follow from these alterations and that moreover the congestion at the Tuesday and Wednesday clinics will be entirely avoided and better training facilities provided for the teaching of the pupil midwives undergoing training at the Borough Maternity Hospital. The total number of patients attending the Municipal Antenatal Clinics during 1924 was:— Central Clinic (Borough Maternity Hospital) 420 Latchmere Clinic 154 All Saints' Clinic (East Battersea) 85 Plough Road Clinic 101 760 Ante-natal (V.D.) Clinic. This special treatment clinic was established in connection with the Ante-natal Out-patient Department at the Borough Maternity Hospital, and was opened for the reception of patients late in 1921. The Clinic is fully equipped with all modern appliances and aids for diagnosis and treatment, and very useful work was carried out during 1924, which is summarised below. Owing to the increase in the numbers attending it was found necessary to institute another Session last year. This extra session is utilised as a preliminary clinic for the classification of cases, and those found to require special treatment are referred to the main clinic for treatment. 28 Special Treatment Centres. I. Tests carried out by Pathologist—St. Thomas's Hospital. Wassermann. Dreyer's Sigma. Totals. Routine tests of expectant mothers Neg. Pos. Neg. Pos. Totals. 499 18 2 13 532 Tests taken at V.D. Clinic, Wednesday, p.m. 101 35 31 13 180 II. Pathological Tests carried out at Maternity Home Special Clinics. Negative. Positive. Total. Slides from eye discharge 22 2 24 „ „ vagina and urethra 126 3 129 Total 148 5 153 The positive results were obtained from:— Babies (eye discharge) 2 Mother of baby suffer from Ophthalmia 1 Expectant mothers (vaginal discharge) 2 The slides were obtained from:— Mothers (including 9 whose babies suffered from Ophthalmia Neonatorum) 98 Babies, suffering from Ophthalmia Neonatorum 9 III. Report of Treatment Clinic held on Wednesday at Borough Maternity Hospital. Consultant—Dr. A. C. Roxburgh. Assistant Medical Officer—Dr. Hamilton. Health Visitor—Nurse Carr. Total number of sessions held 51 Total number of cases seen 189 Total number of attendances made 516 The 189 cases attending were dealt with as under:— Discharged by Medical Officer (no evidence of V.D.) 110 Cured (Gonorrhœa) 3 Discharged temporarily 24 Transferred for other treatment elsewhere 17 Ceased to attend without permission 7 Died 1 Still under treatment at end of year 27 29 IV. Sources from which 189 patients were referred to the Treatment Clinic:— Borough Maternity Hospital 17 Municipal and Voluntary Welfare Centres 130 Health Visitors 28 Medical Practitioners 4 Privately practising midwives 2 Came independently 8 V.—Of the 18 cases (expectant mothers) shewing a positive Wassermann reaction (No. I. above):— 15 were treated during pregnancy with the following results- Babies shewing negative Wassermann re-action 11 Still-born—not macerated. (Post-mortem shewed Patent Foramen Ovale and Patent Ductus Arteriosus) 1 No test (removed from Borough) 1 Mother not yet confined 2 3 were not treated during pregnancy— Baby shewing negative Wassermann re-action 1 Babies born, no tests made 2 VI. Report of Preparatory Clinic held on Tuesday at Borough Maternity Hospital. Medical Officer in Charge—Dr. Bloomfield. Health Visitor—Nurse Carr. Total number of sessions held 52 Total number of cases seen 303 Total number of attendances made 525 The 303 cases attending were dealt with as under:— Discharged by Medical Officer (no evidence of V.D.) 172 Treated for minor ailments and discharged cured 46 Transferred for treatment elsewhere 55 Ceased to attend without permission 19 Still under treatment at the end of the year 11 Dr. Roxborough, M.D., M.R.C.P., Consultant of the V.D. Clinic, reports:— A striking feature of the year's work has been the fact that by having routine Wassermann tests done on the blood of all mothers attending the ordinary ante-natal clinics in the borough—a system which we started a little over a year ago, so that this is the first full year's working—we have been enabled to identify eighteen mothers suffering from unrecognised syphilis. The proportion, 30 18 out of 517 tested, which works out at only 3.4 per cent., is a low one, lower than the published statistics would have led one to expect, and speaks well for the morality of the borough. Of the eighteen expectant mothers thus discovered to have syphilis, three either refused treatment or came up so late in pregnancy that it was useless to start it. The other fifteen were treated during the remainder of their pregnancies. Of these fifteen, eleven had healthy babies with negative Wassermann tests, one had a baby stillborn, apparently due to a prolonged first labour lasting three days in a woman of 36, but it showed no signs of syphilis. One had a healthy baby whose blood could not be tested as it was removed from the Borough, and two of the mothers have not yet been confined. These results were remarkably good, and the practice of routine testing of the blood of all mothers attending the ordinary ante-natal clinics has thus strikingly proved its value. This does not exhaust the Ante-natal work carried out under the Maternity and Child Welfare Scheme. A very considerable amount of visiting and reporting of cases is carried out for the Obstetric and Gynaecological Departments of the larger Hospitals in connection with Battersea patients attending those Institutions. The following is a summarised statement showing the Hospitals and the work carried out during 1924:— Ante-natal. Post-Natal. Total. 1. St. Thomas's Hospital 77 49 126 2. General Lying-in Hospital, York Road 92 56 148 3. King's College Hospital 10 — 10 4. St. George's Hospital 7 — 7 186 105 291 Maternity Hospital. The Borough Maternity Home was opened early in 1921. The Hospital is situated at 19 and 20 Bolingbroke Grove, directly overlooking Wandsworth Common. In addition to being a Lying-in Hospital, it is a recognised training Institution for PupilMidwives, and a District Midwifery Service is also run in connection with the hospital (see page 33). 31 The Central Ante-natal and Special Clinics are also held at the Out-Patients Department of this hospital. Medical attendance, when required, is provided by a rota of local medical practitioners. The services of the Consultant to the Hospital, Dr. J. S. Fairbairn, M.D., F.R.C.S., F.R.C.P., Senior Obstetric Physician to St. Thomas's Hospital (or his deputy, Dr. A. C. Richardson, M.D., F.R.C.S.), are also available in cases of grave emergency. The staff of the hospital consists of a Matron, 1 Sister, and 4 Staff Nurses. There is also accommodation for 12 pupil-midwives. Particulars relating to the admissions during 1924 are set out as follows:— Total number of cases admitted 400 Average duration of stay 14 days Number of cases delivered by— (a) Midwives (nursing staff) 360 (b) Doctors (on rota) 37 Of the above 400 cases, 3 patients were admitted for antenatal treatment prior to re-admission at a later date for confinement. Number of cases in which medical aid was sought by the midwife, with reasons for requiring assistance. (a) Ante-Natal Pre-eclamptic condition 6 Albuminuria 4 Cerebral haemorrhage and renal disease 1 Pernicious vomiting 1 Hematuria 1 Contracted pelvis 2 Breech in primipara 1 Placenta prævia 1 17 (b) During labour. Ruptured perineum 16 Delayed second stage 4 p.p.h. 1 Retained placenta 1 Adherent and partially retained placenta 2 Placenta prævia 2 Foetal distress 8 Unreduced occipito position 4 Painless labour 2 Complicated breech 2 Breech presentation with hydrocephalus 1 Rigid os 1 Prolapse of cord 1 Presentation of cord 1 Contracted pelvis (Caesarean section performed) 1 Oedema of legs and albuminuria 1 48 32 (c) After labour. Post-partum eclampsia 1 Collapse 1 Sore throat 1 Pain in leg 1 Pain in breast 3 7 (d) For infant. Convulsions 1 Fits 1 Dangerous feebleness 2 Skin eruption 1 Pneumonia 1 Prematurity 1 Septic fingers 1 Obstetrically fractured thigh 1 Influenza 1 Abscess of neck 1 11 Number of cases in which temperature rose above 100.4 with rise of pulse 4 Number of cases notified as ophthalmia neonatorum with result of treatment 2 Cured before leaving the Hospital. Number of infants with discharge from eyes however slight 25 Number of foetal deaths (still-born or within 12 days of birth) and their causes 16 Congenital heart 2 Prematurity 2 Congenital debility 1 Hydrocephalus 1 Anencephalus 1 Macerated fœtus 2 a.p.h. prematurity 3 Atelectasis 1 Influenza 1 Pneumonia 1 Convulsions 1 16 The Medical Consultant was called in in 6 cases of grave emergency, particulars of which are set out below:— Post partum eclampsia 1 a.p.h. placenta prævia 2 Collapse after labour 1 Contracted pelvis (Cæsarean section) 1 Cerebral hæmorrhage and renal disease 1 6 Number of maternal deaths 3 *Cerebral hæmorrhage and renal disease 1 *Pernicious vomiting 1 Post-partum eclampsia 1 (*Both cases admitted in a very serious condition) Number of infants not entirely breast fed 3 Death of mother 1 Mother suffering from mastitis 2 I am indebted to the Borough Treasurer for the following statement of the cost of the Home during the financial year ended 31st March, 1925 33 Maternity Hospital, 1924-1925. Total beds, 30; total cases, 412; percentage of beds occupied 53 per cent. Item. Total. Per Patient Week. £ £ s. d. Salaries Medical 146 0 3 6 Nursing 501 0 12 2 Domestic and other 475 0 11 7 Provisions 895 1 1 9 Drugs and other Medical Requisites 281 0 6 10 Heating, Lighting and Cleaning 346 0 8 5 Laundry 400 0 9 8 Repairs and Renewals Domestic 253 0 6 2 Structural 464 0 11 3 Rates, Taxes and Insurance 159 0 3 10 Loan Charges 1,424 1 14 7 Miscellaneous 177 0 4 3 Gross cost £5,521 £6 14 0 Income Pupil Midwives 176 0 4 3 Inmates' Payments 1,572 1 18 2 Other 5 0 0 2 Net cost £3,768 £4 11 5 It will be noted that there is a satisfactory decrease in the cost per patient per week as compared with the previous year. The decrease would probably have been greater but for an increase in the item structural and domestic repairs, the chief item in which was the re-painting of the wards. District Midwifery Service. The District Midwifery Service for the attendance on maternity cases in their own homes, inaugurated at the close of 1921, continued to make progress during 1924. The service is directed from the Maternity Hospital, but accommodation has been provided for the District Midwife and her pupil at the Town Hall, which is very centrally situated for all parts of the borough. The Midwife's rooms are connected with the Maternity Hospital by telephone, and persons requiring her services at night can telephone to her from the Police Stations. Particulars relating to this service during 1924 are set out below:— Total number of cases attended on the district 152 Number of cases delivered by— (a) Midwife 144 (b) Doctors 8 34 Number of cases where medical assistance was called for, with reasons for requiring assistance— (a) After labour. Ruptured perineum 8 Post-partum hæmorrhage 2 10 (b) For infant. Dangerous feebleness 3 Skin eruption 1 Slight discharge from eyes 9 13 Number of cases notified as ophthalmia neonatorum, with result of treatment 1 (Attended St. Thomas's Hospital, subsequently discharged cured.) Number of infants with discharge from the eyes, however slight 9 Number of infants' deaths within 10 days 1 (Died three hours after birth) Number of still-births 1 (Prematurity). Number of cases of notified sepsis 1 (Puerperal sepsis, transferred to Fever Hospital subsequently discharged cured). Number of cases in which temperature rose above 100.4 with rise of pulse 4 Number of infants not entirely breast fed 2 (Insufficient breast milk). Dental Clinic. The work of the Dental Clinic during 1924 is summarised as follows:— Number of sessions held (62 morning, 52 afternoon) 114 Total number of patients (women 137, children 56) 193 Total attendances (women 1,296, children 56) 1,352 Work carried out:— Extractions— Ordinary 40 With local anæsthetic 128 „ general ,, 613 781 35 Scaling and polishing 43 Fillings (simple) 116 Upper dentures 37 Lower dentures 31 Dressings and treatment generally to gums 107 Impressions 46 Bites taken 27 Try-ins 46 Repairs 7 Prescriptions 45 Advice 434 Infant Welfare Exhibition. An Infant Welfare Exhibition was held by the Council in the Grand Hall of the Town Hall, on June 24th-27th. The Exhibition was opened on the first day by the Right Hon. Christopher Addison, M.D., F.R.C.S., ex-Minister of Health. His Worship the Mayor (Councillor H. Harling, J.P.) presided, and he was supported by a number of distinguished visitors and by members of the Council. There was a very large attendance of the public present, and Dr. Addison, referring to the occasion, said that what he saw that afternoon was something in the way of a return for what was done a good many years ago, and recalled the efforts he had made to secure the adoption of a Bill to provide that elder schoolgirls might have instruction in infant welfare. Now children were being taught all manner of things that would help them in after life. In connection with infant mortality he never expected to see it reduced to 50 per 1,000 births, but it had been so reduced in Battersea. He complimented the Council in their efforts to promote an effective comprehensive Scheme of Maternity and Child Welfare which had produced results such as those shown in the statistical returns prepared by the Medical Officer of Health, and which were not only reflected in the reduction of the mortality rate but in the improved standard of health and physique of the children as compared with former generations. He was surprised and delighted that when the economists came along in 1919 with the Geddes Axe, they had refrained from striking at the expenditure on this work. There were two reasons for this: firstly because of the magnificent results accomplished, and secondly that the cost was so small. Wonderful results had been obtained in the borough, and he hoped the Council would continue their efforts. After declaring the Exhibition open, a vote of thanks was proposed to Dr. Addison and carried with acclamation. On subsequent days the Exhibition was formally opened by Miss Lena Ashwell, Dr. L. Haden Guest, M.C., M.P., and Dame Janet Campbell, M.D. 36 The Exhibition, the first of its kind held in Battersea, was attended daily by large numbers of the citizens and attracted a large number of representatives of Health Authorities from other districts. During the four days it remained open from 11 a.m. to 10 p.m. The various activities of the Council in the comprehensive Scheme of Maternity and Child Welfare were represented and demonstrated by a series of stalls depicting Ante-natal and Postnatal work. Each stall was arranged and equipped to show the actual work carried on. Thus there were stalls illustrative of an ante-natal clinic-room, Dental Clinic, Maternity Hospital lying-in ward, labour room, post-natal welfare centre and clinic, &c. Lectures by well-known specialists in Health and demonstrations with lantern and films in hygiene and preventive medicine were also successful and instructive features of the Exhibition week. The activities of the Voluntary Associations linked up with the Council's Maternity and Child Welfare Scheme were represented at the Exhibition by stalls illustrating the ancillary work which they were individually carrying out in the Borough in co-ordination with the Council's Scheme. The success of the Exhibition was due to the determination of the Council to make it attractive and educational. The scope and extent of the Council's work in relation to Maternity and Child Welfare was brought to the notice of the general public in a way in which it could be readily understood and appreciated. No effort was spared by the Maternity and Child Welfare Committee of the Council to make the various exhibits instructive and practical, and that they succeeded in their object is fully borne out by the large attendance at the Exhibition on each of the four days it remained open. On the last day of the Exhibition very great interest was taken in the various competitions for mothers in Mothercraft and for fathers in domestic handicraft. Prizes and Certificates were presented by the Mayor and Mayoress to the successful candidates. The work of the competitors was of a high order and reflected great credit on them for their ingenuity and industry, as well as on the teachers and lecturers at the Welfare Centres. 37 Notifiable Infectious Diseases. During 1924, under the Notification Clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, 3,821 cases of infectious diseases (excluding Tuberculosis) were notified, including cerebro-spinal fever 4, acute poliomyelitis 9, encephalitis lethargica 12. The following is a list of the diseases compulsorily notifiable in Battersea Smallpox. Cholera. Diphtheria. Membranous croup. Erysipelas. Scarlet fever. Typhus fever. Typhoid or Enteric fever. Relapsing fever. Continued fever. Puerperal fever. Ophthalmia neonatorum. Cerebro-spinal fever. Acute polio-myelitis. Acute polio-encephalitis. Glanders. Anthrax. Hydrophobia. Acute Influenzal pneumonia. Acute primary pneumonia. Trench fever. Malaria. Dysentery. Plague. Acute encephalitis lethargica. Measles. Whooping cough. The distribution of the cases notified in the sub-districts and the nine wards is shown in the table on page 38. Excluding the cases of measles and whooping cough, there were 1,417 cases which occurred in 1,219 houses. Of these cases 926 (i.e., 65.3 per cent.) were removed to the Isolation Hospitals of the Metropolitan Asylums Board and 491 (i.e., 34.7 per cent.) remained under treatment at home. Full particulars of all notifiable infectious diseases will be found in the form required by the Ministry of Health (Table II.) in the Appendix. Infectious Disease Contacts. Many cases of "contacts," which were reported to the Medical Officer of Health were kept under observation in connection with various diseases as follows:— Small-pox. Plague. Diphtheria. Enteric fever. Malaria. Scarlet fever. Small-pox. No case of small-pox was notified in Battersea in 1924. During the year 4 cases occurred in London, a single case having been notified in each of the Metropolitan Boroughs of Chelsea, Kensington, St. Pancras and the City of Westminster. 38 Notifications of Infectious Diseases, 1924, in Wards and Sub-Districts. Notifiable Disease. Wards. Districts. Totals. 1 2 3 4 5 6 7 8 9 E N S Small-pox — — — — — — — — — — — — — Diphtheria and Membranous Croup 99 54 49 18 35 68 15 24 10 191 129 52 372 Erysipelas 16 10 9 9 4 14 2 4 7 41 21 13 75 Scarlet Fever 60 48 64 33 53 33 34 31 22 162 120 96 378 Enteric (Typhoid) Fever 2 — 1 1 — — — — - 2 4 — 2 6 Ophthalmia Neonatorum 7 3 5 4 6 10 — 2 4 13 21 7 41 Puerperal Fever 2 — — 2 1 6 1 2 1 3 7 5 15 Polio-myelitis 2 — 1 1 — 2 1 2 — 3 3 3 9 Encephalitis Lethargica 1 — 3 2 — 2 1 1 2 5 3 4 12 Cerebro-Spinal Meningitis 1 1 — — 1 1 — — — 2 2 — 4 Malaria 1 — — 1 — — — — — 2 — — 2 Dysentery — — — — — — — — — — — — Acute Primary Pneumonia 77 33 46 27 40 73 12 18 10 153 140 43 336 Acute Influenzal Pneumonia 21 24 24 6 16 43 9 10 14 62 73 32 167 Whooping Cough* 44 34 70 19 72 164 40 40 28 115 284 112 511 Measles* 452 284 143 101 257 207 66 224 159 932 504 457 1,893 Totals 785 491 415 224 485 623 181 358 259 1,688 1,307 826 3,821 * Notifiable in Battersea from 24th April, 1922. 39 Scarlet Fever. Scarlet fever was slightly less prevalent during 1924 than in the previous year, 378 cases having been notified as compared with 409 in 1923, 750 in 1922, and 1,374 in 1921. We are again at the base of the wave of cyclical epidemicity which commenced in 1919, reached its apex of maximal intensity in 1921, and then gradually declined. The case-rate per 1,000 of the population was 2.2, and three deaths were registered from the disease, giving a death-rate of .018 per 1,000 as compared with 6 deaths and a death-rate of .035 in 1923, and 13 deaths and a death-rate of .077 in 1922. Of the cases notified 352 (i.e., 93.1 per cent.) were removed to hospital. The infected houses numbered 326. In 25 of the notified cases (not included in the above total) the diagnosis of scarlet fever was not confirmed at hospital. Diphtheria. The number of cases of diphtheria notified during 1924 was 372 as compared with 374 in 1923, 670 in 1922, and 713 in 1921. The number of deaths registered from the disease was 25, giving a death rate of 0.15 as compared with 34 deaths and a death rate of 0.20 in 1923, and 58 deaths and a death rate of 0.34 in 1922. The following table shows the incidence and mortality during 1924 in the wards and sub-districts:— Ward. Cases. Deaths. Cases per 1,000 Popltn. Deaths per 1,000 Popltn. Percentage Case Mortality. 1 99 7 3.6 .25 7.1 2 54 2 2.9 .11 3.7 3 49 2 2.5 .10 4.1 4 18 3 1.1 .19 16.7 5 35 4 1.9 .21 11.4 6 68 2 3.2 .10 2.9 7 15 2 1.7 .23 13.3 8 24 2 1.2 .10 8.3 9 10 1 0.5 .05 10.0 Sub-District East. 191 11 2.7 .16 5.8 N.W. 129 8 2.6 .16 6.2 S.W. 52 6 1.0 .12 11.5 Boro' 372 25 2.18 .15 6.7 40 The case-rate per 1,000 population was 2.18 in 1924 as compared with 2.19 in 1923, 3.96 in 1922, and 4.21 in 1921. The case-mortality in 1924 was 6.7 per cent. as compared with 9.1 in 1923. The average case-mortality per cent. for the ten years 1914-1923 was 8.36 as compared with 7.97 for the previous decennium. The 372 cases of diphtheria occurred in 311 infected houses. All cases were removed to hospital. The incidence of the disease was highest in the Nine Elms, Winstanley and Park Wards, these three wards contributing 59.4 per cent. of the total cases notified. In 66 cases notified (not included in the above total) the diagnosis of diphtheria was not confirmed at hospital. The facilities provided by the Council under the Anti-toxin Order, 1910, for the bacteriological examination of swabs from suspected cases of diphtheria are largely availed of by medical practitioners practising in the Borough. Anti-toxin is also supplied free on personal or written application by doctors, and can be obtained by them at any hour of the day or night at the Town Hall. Enteric Fever. During 1924 there were 9 cases of enteric fever notified in Battersea as compared with 12 cases in 1923. There were 3 deaths from this cause as against 2 deaths in the previous year. Three of the cases notified were cancelled, the diagnosis of enteric fever not having been confirmed at hospital. The source of infection in the 6 definite cases of enteric fever was, in the main, conjectural. In one case, however, the infection was traceable to an outbreak in an adjoining borough involving 4 members of a family residing in that district and a relative living in Battersea. Cerebro-Spinal Fever. During 1924 four cases of epidemic cerebro-spinal meningitis were notified in Battersea as compared with 4 cases in 1923 and 2 cases in 1922. All the cases were fatal. Encephalitis Lethargica. There were 14 cases of encephalitis lethargica (sleepy sickness) notified in Battersea during 1924, as compared with 3 cases in 1923, 2 cases in 1922, and 12 cases in 1921. In two of these cases the diagnosis was not confirmed in hospital. On the other hand a death certified to be due to Acute Encephalitis was on investigation ascribed to Encephalitis Lethargica. No notification was received in respect of this case. This makes the total number of cases 13, and there were five deaths registered from the disease, giving a case-mortality of 38.4 per cent. 41 The following table gives particulars of all notified cases of Encephalitis Lethargica:— Identification. Age and Sex. Date notified. Date of Death. Progress. T. E. 39, M. 16.4.24 26.5.24 Died. E. M. 39, F. 17.4.24 — Recovered. J. C. 38, M. 28.4.24 — do. F. S. 50, M. 16.5.24 — do. H. G. 34, M. 30.5.24 — do. K. J. 45, F. 20.6.24 — do. L. B. 17, F. 8.7.24 — do. A. S. W. 53, F. 31.7.24. 29.7.24 Died. L. P. 33, F. 1.9.24 — Recovered. A. W. R. 34, M. 18.9.24 — do. H. D. 41, F. 21.11.24 13.11.24 Died. C. A. P. 37, F. 31.12.24 29.12.24 do. In 1924 the numbers of notified cases of this disease in England and Wales was 5,068, and in London 620. Puerperal Fever. There were 15 cases of puerperal fever notified in Battersea during 1924 as compared with 7 cases in 1923 and 13 cases in 1922. There were 4 deaths from the disease. The number of cases per 1,000 births was 4.78 as compared with 2.04 in 1923 and 3.55 in 1922. The notified cases were distributed as follows:—East Battersea, 3 ; North West Battersea, 7 ; South West Battersea, 5. The case-mortality was 26.7 per cent., the mortality rate per 1,000 births 1.27, and the death-rate per 1,000 population .023. Acute Polio-Myelitis. There were 9 cases of acute polio-myelitis notified in Battersea during 1924, as compared with 8 in 1923 and 4 in 1922. Three cases were removed to hospital. There was no death from this disease in 1924 in Battersea. The following table gives particulars of the nine notified cases of the disease:— Name. Age and Sex. Date Notified. Result. M.H. 3—F. 12/8/24 Discharged cured. R.B. 3—M. 1/9/24 Improving. Still attending Hospital. M.W. 2—F. 6/9/24 Died 12/12/24. Death certified to be due to Tuberculous Meningitis (8 days). W.C.* 2—M. 8/11/24 Some improvement. J.M.* 10—M. 8/11/24 Left Borough. Slight improvement. Reported to be receiving institutional treatment. L.M.* 2—M. 8/11/24 No improvement noted. E.M.* 2—F. 8/11/24 Still attending Hospital. Improving. F.H.* 11/12—F. 8/11/24 Still attending Hospital. Improving. E.C. 1—F. 24/12/24 Improving. Now left Borough. * These cases in attendance at the Victoria Hospital for Children. 42 Erysipelas. There were 75 cases of erysipelas notified and 6 deaths were registered from the disease as compared with 84 cases and 3 deaths in 1923, and 66 cases and 2 deaths in 1922. The case-mortality was 8 per cent. and the death-rate per 1,000 of the population was .035. Ophthalmia Neonatorum. There were 41 cases of ophthalmia neonatorum notified in Battersea during 1924, as compared with 42 in 1923, 41 in 1922, 61 in 1921, and 105 in 1920. The rate per 1,000 births was 13.1, as compared with 12.2, 11.2, 16.3 and 22.5 in 1923, 1922, 1921 and 1920 respectively. The incidence of the disease and the rate per 1,000 births in the sub-districts and in the wards is shown in the following table:— Registration Sub-District. Cases. No. of Births. Rate per 1,000 births. East Battersea 13 1,411 9.2 North-West Battersea 21 1,071 19.6 South-West Battersea 7 657 10.7 Wards. No. 1. Nine Elms 7 606 11.6 „ 2. Park 3 382 7.9 ,, 3. Latchmere 5 381 13.1 „ 4. Shaftesbury 4 264 15.2 ,, 5. Church 6 390 15.4 „ 6. Winstanley 10 484 20.7 „ 7. St. John — 133 — ,, 8. Bolingbroke 2 280 7.1 ,, 9. Broomwood 4 219 18.3 Borough (1924) 41 3,139 13.1 Borough (1923) 42 3,434 12.2 Borough (1922) 41 3,665 11.2 Borough (1921) 61 3,742 16.3 Borough (1920) 105 4,669 22.5 43 Number of cases notified— By medical practitioners 33 By midwives or nurses 8 Number removed to hospital 5 All cases of ophthalmia neonatorum notified are at once visited by the Health Visitors, and every care is taken to see that they are receiving medical treatment either at home or at hospital. Nursing attendance is provided gratuitously where cases of ophthalmia neonatorum are being treated at home. The importance of securing hospital treatment in suitable cases in the special hospital provided for the purpose by the Metropolitan Asylums Board has been impressed upon medical practitioners by letter from time to time. Owing to the objection, in many cases, of the mother to go into hospital with her baby, or, alternatively, to be separated from it, the use made of the facilities provided at St. Margaret's Hospital is slight. The majority of cases are, therefore, treated at home or at the out-patient departments of General Hospitals. During 1924 the total number of visits paid by the Nurses supplied by the Council in cases of ophthalmia neonatorum or other forms of inflammation of the eyes in infants, was 2,676. In addition, 244 visits were made by the Health Visitors. These figures indicate the importance of the work the valuable results of which are shown in the, happily, very rare occurrence nowadays in Battersea of a case of permanent damage to the eyesight or even total blindness—a not infrequent sequel in the past. All cases notified during 1924 recovered without permanent damage to sight. Bacteriological Examinations. During 1924, the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 1,630. These specimens are examined at the laboratories of the Clinical Research Association, Watergate House, Adelphi, Strand, W.C., and include diphtheria, enteric, and other diseases. The cost of these examinations is defrayed by the Council The examination of Tuberculosis specimens is now carried out at the Tuberculosis Dispensary, that institution having been taken over by the Council from the Central Fund in 1921. 44 The following table gives particulars of the bacteriological examinations carried out during 1924. Suspected disease. Positive Results. Negative Results. Total. Diphtheria 147 1,472 1,619 Enteric fever 1 9 10 Tuberculosis 1 — 1 Other — — — Total 149 1,481 1,630 The cost of these examinations amounted to £211 0s. 9d. TUBERCULOSIS. During 1924, there were 351 cases of Tuberculosis (all forms) notified in Battersea, as compared with 364 in 1923, 411 in 1922, 466 in 1921 and 498 in 1920. In the following table is shown the distribution of the notified cases arranged in the Wards and Sub-Districts of the Borough:— Classification. Wards. Sub-districts. 1 2 3 4 5 6 7 8 9 E. N.W. S.W. Pulmonary 40 33 33 23 24 30 8 23 32 109 71 66 NonPulmonary 16 9 14 8 12 27 2 12 5 38 48 19 Totals 56 42 47 31 36 57 10 35 37 147 119 85 The Borough: Pulmonary 246 Non-Pulmonary 105 Total 351 The following table shows the age and sex distribution of the ca6es of Tuberculosis notified in each Ward and in the Registration Sub-Districts during 1924:— 45 Ward. Ages: Total, all ages. Grand Total. Rate per 100,000 population. Under 1 yr. 1-5 5-15 15-25 25-45 45-65 65 up M. F. 1 1 2 13 17 12 9 2 28 28 56 201 2 - - 10 10 15 6 1 21 21 42 226 3 - 2 10 14 13 8 - 30 17 47 241 4 - 1 5 9 10 6 - 19 12 31 197 5 - 7 6 4 8 9 2 18 18 36 191 6 - 13 15 8 19 2 - 31 26 57 271 7 _ _ 4 1 3 2 - 5 5 10 114 8 1 2 6 6 16 4 - 22 13 35 181 9 _ _ 3 12 14 8 _ 22 15 37 173 Boro' 2 27 72 81 110 54 5 196 155 351 205 E, 1 4 30 42 44 23 3 82 65 147 207 N.W. _ 21 29 19 32 16 2 63 56 119 243 s.w. 1 2 13 20 34 15 _ 51 34 85 166 Rate per 10 0,000 population in each age group Boro' 54 243 217 273 217 165 51 244 171 205 _ The death-rate from tuberculosis in 1923 was the lowest previously recorded in Battersea; the notifications received in that year were also lower than during any year since compulsory notification came into force. In 1924 there was however a slight increase in the death-rate. On the other hand, the number of primary notifications of tuberculosis received was again lower than in any previous year. The death-rates per 100,000 of the population from tuberculosis during the twenty years ended 1920, in quinquennial averages, and in 1921, 1922,1923 and 1924 are given in the following table :— Pulmonary. NonPulmonary. Total. 1901-1905 134.8 49.2 184.0 1906-1910 116.4 41.8 158.2 1911-1915 124.2 33.8 158.0 1916-1920 134.8 30.0 164.8 Average (20 years) 127.6 38.7 166.3 1921 100.5 27.2 127.7 1922 101.0 20.1 121.1 1923 81.5 21.1 102.6 1924 89.5 21.6 111.1 46 In the subjoined table are given deaths from Tuberculosis at various ages in each Ward and the registration sub-districts during 1924 :— Wards. Rate per 100,000 population. Ages :— Total, All Ages. Totals. Grand Total. Pulmon ary. NonPul monary. 0-1 1-5 5-15 15-25 25-45 45-65 65- M. F. 1 129 1 2 4 9 11 8 1 19 17 26 10 36 2 124 1 _ 1 7 10 4 – 16 7 20 3 23 3 102 _ – 2 5 7 5 1 13 7 17 3 20 4 89 _ – — 3 4 7 – 9 5 13 1 14 5 106 _ 3 1 5 3 5 3 8 12 14 6 20 6 133 _ 3 3 5 16 1 - 12 16 20 8 28 7 114 _ - 1 1 5 3 - 6 4 9 1 10 8 98 – 1 1 5 10 2 - 8 11 16 3 19 9 93 – – 1 4 7 8 - 11 9 18 2 20 E 108 2 2 6 19 29 18 1 46 31 62 15 77 N 127 – 6 5 15 22 10 4 29 33 46 16 62 S. 100 – 1 3 10 22 15 – 27 24 45 6 51 — 111 2 9 14 44 73 43 5 102 88 153 37 190 Rate per 100,000 popultn. 54 81 42 148 144 131 51 127 97 89 22 111 Particulars are given in the table below of the localization of disease in the 351 cases notified during 1924. Localization of Disease. Pulmonary (246) Abdominal (10) General (5) Lungs 230 Abdomen 2 Miliary 1 Lungs and Larynx 1 Peritoneum 8 Miliary and Meninges 1 Lungs and Spine 3 Lungs and Abdomen 1 Genito-Urinary (5) General 3 Lungs and Glands 3 Fallopian Tubes 1 Lungs and Intestines 1 Kidney 3 Lungs and Throat 2 Testicle 1 Bones and Joints (16) Spine 4 Lungs and Miliary 2 Lungs and Meninges 1 Brain (16) Hip and Hip Joint 5 Lungs, Kidney and Bladder 1 Meninges 16 Hip and Face 1 Knee 2 Lungs and Ulcer of Leg 1 Skin (3) Shoulder, Knee and Ankles 1 Face 1 Nose 1 Elbow 1 Glands (47) Unspecified 1 Ankle 2 Cervical 18 Abscesses (3) Total 351 Abdominal 3 Unspecified and Chest and Spine 1 Various 26 Neck 2 A copy of the official return to the Ministry of Health of the notifications on Forms A B and C, received during 1924, is set out on pages 55 and 56. During 1924 there were 190 deaths from Tuberculosis registered as belonging to the Borough of Battersea. Of this number, 153 47 (i.e. 80.5 per cent.) were due to Phthisis (tuberculosis of the lungs), 17 (8.9 per cent.) to tubercular meningitis and 20 (10.6 per cent.) to other forms of the disease. In 1923, the number of deaths from phthisis and other tubercular diseases was 175. Of the 190 deaths registered from Tuberculosis during the year, 19 were not notified until within one month before death; in 30 cases the notifications were received after death, and in 6 cases no notification was received. Of the 6 cases in which no notification was received 4 were recorded as due to tuberculosis after enquiry by the Coroner, 1 case was transferred from the Workhouse to the Infirmary, and in the remaining case death occurred at a lunatic asylum. Of the 30 cases notified after death 4 (2 pulmonary, 2 nonpulmonary) were notified by private doctors, 11 (6 pulmonary, 5 non-pulmonary) by Poor Law Institutions, and 15 (5 pulmonary, 10 non-pulmonary) by hospitals or asylums. Dispensary Treatment of Tuberculosis. The work of the Dispensary has been carried out with the usual routine during 1924, notwithstanding the unsuitability and inadequate accommodation referred to in previous Annual Reports. Plans and specifications for a new Tuberculosis Dispensary have been prepared and submitted to the Ministry of Health and only await sanction for the building to be proceeded with. The new Dispensary will be erected on the site given by the Council at Latchmere Road, facing the Latchmere Baths, and in addition to being more central will be more readily accessible than the present building—an adapted private house at 179 Battersea Bridge Road. Dr. Macdonald, Tuberculosis Medical Officer, reports The Dispensary Staff have remained the same as in the previous year, and the work is carried on in close co-operation with the local medical practitioners and with St. Thomas's Hospital. No alterations were made in routine work. Sessions are held to suit the circumstances of the different classes of patients. Home visiting is systematically carried out by the Nursing Staff, and insanitary conditions noted are reported to the Medical Officer of Health. The "following up" of patients is very diligently pursued to encourage, as far as practicable, regular attendance at the Dispensary, and to round up defaulters. The homes of patients undergoing treatment at the Sanatoria are kept under frequent inspection in order to keep in touch with the circumstances of the patient's family and to prevent, if possible, the premature return of the patient when, as occasionally happens, 48 he desires to leave the Institution against medical advice. The existing housing situation renders the prevention of infection in the home very difficult, and in many cases it is impossible for a patient to have a separate bed, and not infrequently families with a member suffering from Tuberculosis are living in one room. These unsatisfactory conditions make it difficult, if not impossible, to prevent spread of infection, and advice given in such circumstances as to precautions to be taken by patients is a counsel of perfection. Nevertheless all possible steps are taken to assist patients to take precautions and beds have been provided by the Dispensary, which are loaned out to patients whose circumstances are necessitous and urgent. All cases of Tuberculosis notified to the Medical Officer of Health are referred at once to the Dispensary, and steps are taken to secure, where possible, the attendance of patients at the Dispensary, the object aimed at being to see that every patient receives appropriate treatment and, by advice, to secure the observance of all precautions against the spread of infection. There has been a gratifying reduction in the waiting period in regard to patients requiring Institutional Treatment. The average waiting period during 1924 for admission to Institutions under the London County Council has been reduced from 29 to 18 days as compared with the previous year—and there has also been a satisfactory speeding up in regard to the admission of urgent cases. Advanced cases are removed to St. James's Hospital. This Institution fulfils a very useful purpose in receiving and caring for these cases, and in the opinion of the Tuberculosis Officer provides a more suitable environment than would—as has been frequently suggested for this type of case—Homes for Incurables in each authority's area. It is probable that a large proportion of patients themselves would object to enter such Homes owing to the depressing effect on their minds and temperaments. Other Institutions during the year to which advanced cases were sent were Colindale Hospital, Liverpool Road Hospital, St. Luke's Home, St. Joseph's Hospice and St. Columba's Home for the Dying. The work of the Care Committee and of those bodies doing philanthropic and social work represented on the Committee was of an extensive and valuable character. Details will be found summarised in the appended returns for the year 1924. The Committee, which meets weekly, is composed of members of the Borough Council and co-opted members, including consultative members from philanthropic and charitable Associations who are working in close co-operation with the Care Committee. The Committee also receives material assistance from the Emergency Help Fund of the British Red Cross Society and the Charity Organisation Society, &c., and from its small fund is, with the aid from these other bodies and private charitable donations, enabled to relieve many cases in urgent need of assistance. 49 Debilitated and weakly children who attend the Dispensary but are not definitely found to be tuberculous are in many cases, through the agency of the Invalid Children's Aid Association, sent to Convalescent Homes. On return they again attend the Dispensary for examination, when it is usually found that great improvement in health and physique has been effected. The results obtained by the change in environment is, in most cases, so marked as to emphasise the importance of dealing in this manner with all cases of debility in children following the common infectious diseases, e.g., measles, whooping-cough, scarlet fever, respiratory and gastro-intestinal disease, which so commonly predispose to subsequent infection by the tubercle bacillus. The Dental Clinic for tuberculous patients continues to serve a very useful need. Advice, extractions and fillings, &c., are provided free, and assistance towards the cost of dentures in the case of necessitous patients is obtained through various agencies. Patients readily attend for treatment when so advised by the Tuberculosis Officer. Co-operation with the School Medical Service continues to be carried out on lines described in previous Annual Reports and with useful results. During the year 1924 there were 594 new patients who attended the Dispensary. Of these, 189 were found to be suffering from Tuberculosis and 148 were regarded as "suspect" cases. The remaining 257 cases were not considered tuberculous. Of the 189 definite cases 47 were children and 142 were adults. Of the adult patients 106 were insured and 36 uninsured. There were 35 ex-service men amongst the tuberculous cases, or 6 less than in the previous year. During the year 271 "contacts" were examined—adults 69, children 202. Much more difficulty is experienced in getting the adult "contacts" to attend the Dispensary than is the case with the children. The latter are referred for observation to the School Medical Officer. During the year 17 patients in whom the diagnosis was at first doubtful were definitely found to be suffering from tuberculosis, and these, added to the 189 new cases, make a total of 206 notified cases. Of this number 85 had already been notified to the Medical Officer of Health, so that 121 were primary notifications from the Dispensary. The total number of attendances at the Dispensary during the year was 4,389—by insured persons 1,729, by non-insured 2,660. Insured persons attend the Dispensary periodically for observation, but only in exceptional circumstances is treatment given to this class of patient. 50 During the year 278 domiciliary visits were paid by the Tuberculosis Officer at the request of the Ministry of Pensions. These visits are paid, in consultation with the Medical attendant, where the ex-service pensioner is too ill to attend the Dispensary, and where the report of the Dispensary Nurse or the home conditions appear to call for such special action. The home visits by the Dispensary Nurses during 1924 numbered 6,534. 1. Average stay of patients in sanatorium 16 weeks 4 days 2. Number of patients improved 47 3. Number of patients who took their own discharge 18 1. Number of Dispensary patients who died during the year 1924 118 2. Number of patients discharged or cured or disease arrested during 1924 30 3. Number of patients recorded as ceasing to attend during 1924 27 4. Number of patients removed to other districts and transferred to the Medical Officer of Health of district concerned 40 During the year 114 patients were sent away to Institutions under the London County Council scheme—insured 79, uninsured 35. In addition 39 patients were, on the recommendation of the Tuberculosis Officer, admitted to St. James's Hospital. The number of sputum examinations made at the Tuberculosis Dispensary was 1,265. In 299 (23.6 per cent.) the result was positive. Of the total number of sputums examined 407 were sent in by Medical Practitioners practising in the borough, and 214 examinations were made for St. James's Hospital. The number of reports sent to public bodies during the year was 986. There was an increase in the number of new patients sent in by local medical practitioners, and, in addition, many old patients were referred back for further examination and opinion. Progress reports on insured patients are submitted to the Tuberculosis Officer by the patient's medical attendant. During 1924, consultations with medical practitioners at the homes of their patients, and reports on patients sent by them to the Dispensary, numbered 735. 89 patients were referred to hospitals and 71 difficult and doubtful cases were sent to St. Thomas's Hospital for X-ray 51 nations. The facilities provided by the Hospital are freely availed of by the Dispensary in such cases, and with valuable results. The medical supervision of children attending the open-air school at Springwell House is carried out by arrangement with the L.C.C. by the Dispensary staff. The following is a summary of the year's work :— Number on roll during 1924 147 „ admitted during 1924 48 „ discharged during 1924 48 Reasons for discharge:— (a) Fit for Elementary School 10 (b) Fit for work 28 (c) Transferred to Hospital or Sanatorium 7 (d) Removed from district 3 The average gain in weight per child was 2.65 kilogrammes during the year. Only one child lost weight or remained stationary. The Tuberculosis Care Committee. The Care Committee met weekly during the year, and much useful work was carried out in connection with the Borough Tuberculosis Dispensary Scheme. The constitution and membership of the Committee will be found set out on page 2. The details of the work of the Care Committee will be found summarised below:— In Need of Assistance. The following is a list of cases in need of assistance which were referred to various agencies for attention:— Battersea Borough Council—extra nourishment 75 Wandsworth Board of Guardians—for relief, 9; extra nourishment, 19; other forms of assistance, 14 42 Charity Organisation Society—financial assistance, 2; dentures, 5; bed and bedding, 12; other assistance, 6 25 British Red Cross Society—financial assistance, 7; clothing, 1; bed and bedding, 1 9 United Services Fund—financial assistance, 7; clothing, 2; bed and bedding, 1; convalescence, 1 11 Soldiers and Sailors' Families' Association—clothing, 1; extra nourishment and bedding, 1 2 52 London County Council—reimbursement of cost of railway fare and funeral expenses, 1; housing accommodation, 1; deferred payments of instalments for purchase of house, 1 3 National Society for Prevention of Cruelty to Children 1 Battersea Charity Trustees Educational grant 1 Southern Railway Company—grant for former employee, 1; transfer to country post, 1 2 British Legion Officers' Association—financial assistance, 1; home for child, 1 2 Other Agencies 2 Training and Employment. Former Employers or suitable agencies 9 Local Employment Exchange and Chief Area Officer re discharged ex-service men 9 British Legion—grant for tools 1 The contributions of patients who were sent away for appropriate Institutional treatment collected by the Dispensary, and remitted to the London County Council, amounted to £382 18s. l0d. Tuberculosis Dental Clinic. Total attendances 227 Sessions held 46 Average attendance per session 5 Extractions, 71; scalings, 8; fillings, 19; dentures, 10; repairs to dentures, 1; dressings, 28; advice, 62 (average 4.3) 199 NON-DISPENSARY CASES. In addition to the work carried out by the Staff of the Tuberculosis Dispensary, 1,421 visits to houses in which cases of Tuberculosis were notified, were made during 1924 by the Sanitary Inspectors to males and, in the case of women and children, by a Health Visitor. Women and Children. Women and children notified to be suffering from Tuberculosis and not attending the Dispensary are systematically visited by a Health Visitor. During 1924 the number of new cases notified was 129. Of these after correction and adjustment of the figures 53 in regard to cases not traced, transferred to other districts and cases in which no information could be obtained, there were 117 cases investigated—women 55; children 62. Of these 117 cases, 25 were dead when first visited and 9 cases died during the year. The following Table gives particulars of the 117 women and children, non-dispensary cases notified to be suffering from Tuberculosis (all forms) during 1924. Age and Sex Distribution. 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 upwards All ages Pulmonary M 1 2 2 2 1 – – – – – – 8 f. — 3 2 4 5 8 14 6 8 4 1 55 Tuberculous Meningitis M. – 2 5 – – – – – – – – 7 F. — 3 2 1 — — — — 1 — — 7 Other Forms M. 1 5 6 5 1 – – – – – – 18 f. — 2 5 8 2 1 2 1 1 — — 22 Total M. 2 9 13 7 2 – – – – – – 33 f. — 8 9 13 7 9 16 7 10 4 1 84 Grand Total 2 17 22 20 9 9 16 7 10 4 1 117 The home condtions of these 117 cases were carefully investigated. The sanitary state of the dwellings was in the majority of cases satisfactory, the average number of persons per room being 1.44. In 13 instances, however, the patient's family was found to be living in one room. During the year 52 cases were undergoing hospital, sanatorium or other form of institutional treatment. At the end of 1924 there were 508 women and children patients, including new cases notified during the year, not in attendance at the Dispensary on the Tuberculosis Register, and 803 visits were made by the Health Visitor to the homes of these patients. Efforts are made in all cases to induce these patients to attend periodically at the Dispensary. Thirty-one cases were transferred to the Dispensary during the year. Adult Male Patients. There were 245 adult male non-dispensary cases on the register at the end of 1924 and 80 were new cases notified during the year. Of these new cases, 28 died during the year. 54 The following table gives particulars of the non-dispensary new cases notified in 1924. Age Distribution. All ages. 16/20 20/25 25/30 30/35 35/45 45/55 55/65 65 up Pulmonary 2 10 10 10 14 14 9 2 71 Tuberculous Meningitis — 1 — 1 — — — — 2 Other Forms 3 — 1 1 1 1 — — 7 Total 5 11 11 12 15 15 9 2 80 The Homes of all these patients were systematically visited during the year by the District Sanitary Inspectors, and 618 visits, including 78 first visits to new cases, were made. Eleven of the new cases notified were found dead on first visit. The sanitary condition of the homes was in the main satisfactory. Of the new cases 20 received institutional treatment and 28 were transferred to the Dispensary. 55 Summary of Notifications during the period from the 30th December, 1923, to the 3rd January, 1925, in the Metropolitan Borough of Battersea. Age Periods. Notifications on Form A. † Notifications on Form B. No. of Notifications on Form C. * Number of Primary Notifications. Total No. on Form a. * No. of Primary Notifications. Total No. on Form B. Poor Law Institutions Sanatoria. 0 to 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 and over. Total. Under 5 5 to 10 10 to 15 Total Primary Notifications Pulmonary— Males – 2 4 2 14 24 28 25 19 10 3 131 190 – – 1 1 1 59 110 Females – 2 3 7 14 15 24 14 12 4 1 96 137 — — — — — 36 45 N on-Pulmonary— Males 2 9 15 10 5 – 3 2 – – – 46 50 1 – – 1 1 1 26 Females — 9 12 9 3 2 2 2 2 – – 41 46 – — 2 2 2 – 18 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11 (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) In filling up the form the following notes should be carefully observed— Patients notified as suffering from both pulmonary and non-pulmonary disease should be included among the "pulmonary" returns only. All notifications on Form D should be disregarded in preparing this return. • Primary notifications relate to patients who have not previously been notified in this or former years, either on Form A or on Form B, in the area to which the return relates. Any additional notification of a case which has previously been notified in the area is to be regarded as duplicate. (Note.—No primary notifications should be made on Form C.) † A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, should be included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification occurs on Form A, and all notifications on Form A, whether duplicate or not, should be included in this column. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A, or on Form B, should be included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area, or not, either on Form A or on Form B, should be included in this column. Col. 21. If in the case of any institution belonging to the Council, formal notifications on Form C have not been made, the totals of the weekly admissions during the year of patients proper for notification on Form C should be shewn (according to the classification in Column 1) in brackets in Column 21. 56 Supplemental Return. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from the 30th December, 1923, to the 3rd January, 1925, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods 0 to 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 and upwards Total Cases. Pulmonary Males 1 — — 1 — 1 9 — 2 — — 14 „ Females — — 1 — 2 — 3 2 — 3 2 13 Non-pulmonary Males — 2 4 — — 1 2 1 1 — — 11 „ Females — 3 1 — — — 1 — 1 2 — 8 57 Deaths from Zymotic Diseases. The principal zymotic diseases are small-pox, measles, scarlet fever, diphtheria (including membranous croup), whooping cough, enteric fever, and diarrhoea. The deaths from these causes in 1924 numbered 122, as compared with 114 in 1923, an increase of 7.0 per cent. There was a corresponding increase in the zymotic death-rate from 0.67 in 1923 to 0.71 in 1924. The mean death-rate from each of the principal zymotic diseases for the ten years 1904-1913, and for the ten years 1914-1923 are compared with the corresponding rates for 1923 and 1924 in the following table:— Disease. No. of Deaths. Mean Deathrate per 1,000 population. Death-rate per 1,000 population. Increase (+) or decrease ( - ) during 1924, over 1924. 1923. 1904- 13. 1914- 23. 1924. 1923. Previous year. Prec'd'ng 10 years (average) Small Pox ... 1 ... .001 ... .006 — .006 — -001 Measles 51 24 .442 .321 .298 .141 + .157 — .023 Scarlet Fever 3 6 .073 .042 .018 .035 — .017 — .022 Diphtheria 25 34 .104 .195 .146 .199 — .053 — .049 Whooping Cough Enteric Fever 17 2 16 1 .277 .003 .203 .016 .099 .012 .094 .006 + .005 + .006 — .104 — .004 Diarrhoea & Enteritis 24 32 .519 .324 .140 .188 — .048 — .204 Total deaths 122 114 ... ... ... ... + 8 — 57 Total death-rate 0.71 0.67 1.418 1.102 .713 .669 + .044 — .389 NON-NOTIFIABLE INFECTIOUS DISEASES. Chicken-Pox. During 1924 there were 541 cases of chicken-pox reported as compared with 617 in 1923, 259 in 1922 and 400 in 1921. Diarrhœa. The great decline in the incidence of acute infective enteritis, which has been such a marked feature of the morbid and vital statistics of the Borough in recent years, was again manifest in 58 1924. The total number of deaths under 2 years of age caused by diarrhoea in Battersea during the year was 23, giving a fatality-rate of .13 as compared with 26 deaths and a fatality-rate of .15 in 1923. The great advance that has taken place in the development of health services by Sanitary Authorities, assisted as such measures have been by increased legislative powers and by grants in aid from the National Exchequer, has materially contributed to the remarkable decrease in this and other scourges of child life, and to an improved standard of health and physical soundness of children since the War. The educational efforts of trained and experienced Health Visitors, provision of milk and other assistance, e.g., hospital, dental and nursing, are also factors which undoubtedly have played a most important part in this desirable result. Deaths of Infants under 2 years of age from Diarrhœa and Enteritis in Battersea. Year. Under 1 year. 1-2 years. Total under 2 years. Rate per 1,000 births. 1911 186 39 225 51.4 1912 38 10 48 11.3 1913 91 27 118 27.8 1914 98 21 119 27.7 1915 60 19 79 20.7 1916 51 5 56 14.8 1917 38 7 45 15.2 1918 36 4 40 14.8 1919 28 3 31 10.1 1920 48 6 54 11.6 1921 51 11 62 16.6 1922 15 3 18 4.9 1923 18 8 26 7.6 1924 19 4 23 7.3 Influenza. Influenza was very prevalent during 1924, especially in the first quarter of the year. There were 84 deaths caused by the disease as compared with 31 in 1923 and 110 in 1922. The mortality rate was .49 as against .18 in 1923, and .66 in 1922. The deaths from influenza, which numbered 23 in January and 28 in February, declined to 15 in March. There were 167 cases of influenzal pneumonia notified during the year as against 70 in 1923 and 196 in 1922. The death-rate was .29 as compared with .10 in 1923 and .41 in 1922. 59 Systematic visitation was carried out by the Sanitary and Health Visiting Staffs, and free nursing assistance, where required, was provided under the arrangement made by the Council with the South London Nursing Association. MEASLES AND WHOOPING-COUGH. Measles. There was a considerable increase in the incidence of measles during 1924. This disease and whooping-cough are compulsorily notifiable in Battersea under regulations made by the Ministry of Health. The regulations—Battersea (Measles and Whooping-Cough) Regulations,—1922, are dated 8th April, 1922, and came into force on 24th April, 1922. During the year there were 2,423 cases of measles notified or otherwise reported to the Medical Officer of Health*. The incidence of the disease, as measured by these notified and reported cases, was equivalent to a rate of 78 cases in every 1,000 of the population under 10 years of age. In the previous year 1,688 cases were notified or otherwise reported. Of the cases notified or reported during the year 1924 there were 1,893 cases notified under the Regulations as compared with 1,319 cases in 1923, showing that the obligation of notification (restricted to the first case occurring in a house) is being observed. There were 530 cases in addition to those notified under the Regulations reported from the Public Elementary Schools and other sources. The annual incidence and mortality since 1911 is shown in the following table:— Year. Cases notified or reported. Deaths. Death-rate. Case Mortality per cent. 1911 1,068 111 .66 10.4 1912 706 55 .33 7.8 1913 815 90 .53 11.0 1914 718 49 .29 6.8 1915 1,459 158 .97 10.8 1916 1,154 27 .17 2.3 1917 2,176 74 .49 3.4 1918 1,724 57 .38 3.3 1919 699 18 .10 2.6 1920 1,290 46 .27 3.6 1921 138 2 .01 1.4 1922 3,060 66 .39 2.2 1923 1,688 24 .14 1.4 1924 2,423 51 .30 2.1 60 The average annual death-rates from measles for each of the quinquennia from 1874 to 1923 are shown in the following table :— Quinquennium. Average Death-rate. 10 years Average. • 1874-1878 • .45 .57 1879-1883 .69 1884-1888 .75 .70 1889-1893 .64 1894-1898 .77 .69 1899-1903 .61 1904-1908 .41 .45 1909-1913 .49 1914-1918 .46 .32 1919-1923 .18 1924 .30 — The deaths caused by measles during 1924 numbered 51, giving a total mortality-rate at all ages of .30, as compared with 24 deaths and a death-rate of .14 in 1923 and 66 deaths and a deathrate of .39 in 1922. The disease was most prevalent in the first quarter of 1924, 41 of the 51 deaths occurring in that period of the year. The fatal cases, with one exception, were of children under 5 years. The special precautionary measures described in previous annual reports were systematically carried out. These included visits by the Health Visitors to the houses of all cases notified, advice to mothers as to the importance of early medical assistance, nursing assistance where required, and removal of cases to hospital where the home conditions rendered it advisable. During 1924 the number of cases removed to the Metropolitan Asylums Board's Hospital was 176. Whooping-Cough. During 1924, 511 cases of whooping-cough were notified under the Battersea (Measles and Whooping-Cough) Regulations, 1922, to the Medical Officer of Health, and 305 additional cases were reported from the public elementary schools and other sources. There were 17 deaths registered from the disease, the death-rate being 0.099, as compared with 16 deaths and a death-rate of 0.095 in 1923, 22 deaths and a mortality-rate of 0.13 in 1922, and 30 deaths and a death-rate of 0.18 in 1921. The total number of cases notified or otherwise reported during 1924 was 816, as compared with 1,024 in 1923, a decrease of 25 per cent. 61 Cancer. During 1924 the number of deaths from cancer of persons belonging to Battersea was 231 (male 107, females 124), as compared with 242 in 1923 and 225 in 1922. The death-rate from the disease per 1,000 of the population was 1.35 as compared with 1.42 in 1923, 1.33 in 1922, and 1.12 in 1921. The following table gives the comparative average death-rate from cancer in Battersea for quinquennial periods since 1899:— Cancer Deaths, 1899-1924. Quinquennium. Deaths per 1000 population. Quinquennium. Deaths per 1,000 population. 1899-1903 .71 1919-1923 1.26 1904-1908 .96 1909-1913 1.00 1924 1.35 1914-1918 1.28 The increase in the death-rate from cancer is a disturbing feature of the vital statistics of recent years. To what extent this may be due to improved methods of diagnosis it is not easy to determine. That there is an increase in the incidence of this disease there can be no doubt. Our knowledge of the origin or causes of cancer is still, however, very obscure, notwithstanding the patient study and persistent research which is taking place in this and other countries. 62 Sanitary Circumstances. SANITARY INSPECTION OF THE BOROUGH. Summary of Sanitary Operations for the Year 1924. Total Sanitary Operations 67,096 Dust receptacles provided 624 Number of house inspections 36,606 Leaky house-roofs and gutters repaired 977 House to house inspections 848 Bakehouse inspections 278 Houses supplied with water and fittings repaired 262 Bakehouse nuisances abated 36 Urinals—inspections 159 Houses let in lodgings registered 85 Do. altered, repaired or water laid on 72 No. of inspections of do. 125 Water Closets provided, supplied with water or supply disconnected from drinking water cisterns 246 Intimations served under Sec.3 3,216 Notices served under Sec.4,&c. 744 Notices served under Secs. 62 & 65 1,719 Cisterns covered, cleansed and repaired 141 Complaints received and attended to 3,626 Additional water supplies to upper floors 17 Number of premises disinfected Houses supplied with 1,879 Keeping of animals in unfit state discontinued 25 infectants 1,463 Overcrowding abated 3 Smoke observations 119 Premises improved, cleansed and repaired 3,280 Certificates of disinfection granted 2,012 Drains tested By smoke 488 Houses inspected and certificates granted (Sec. 48) 15 Do. ,, water 1,229 Drains cleansed and repaired 298 Proceedings ordered by Council and Health Committee 3,354 Drains relaid 86 Frontage drains constructed or re-constructed 31 Summonses issued 53 Magisterial Orders obtained and enforced 21 Soil pipes and drains ventilated 135 Sink and rain-water pipes disconnected or repaired 489 Factories, Workshops, &c., inspections 5,084 Water Closets cleansed and repaired 500 Sanitary conveniences provided or improvements effected in Factories and Workshops (Sec. 38) 107 Cesspools abolished — Mews and Stables drained and paved 3 Underground sleeping rooms: Yards and forecourts paved and repaired 196 Use discontinued 2 Defects remedied 3 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 6 Gipsy van inspections 53 Drains laid to new houses and tenements 15 Samples taken under the Sale of Food and Drugs Acts 1,200 Miscellaneous 1,949 63 Legal Proceedings. Legal proceedings in connection with nuisances were taken by the Council in 11 cases during 1924. Particulars with regard to each case are set out below. Legal Proceedings under the Public Health (London) Act, 1891. Nature of Offence or Claim. Result of Proceedings. Nuisance from black smoke Summons withdrawn on defendants' undertaking to abate nuisance and payment of £5 5s. costs. Dirty condition of top floor front room and contents at 47 Simpson Street Order to abate within 7 days, with 2/- costs. Choked sink in basement, leaky roof, dirty and dilapidated ceilings and walls of top floor rooms, staircase and passage at 259 Battersea Park Road—also failure to provide dustbin Order to abate within 14 days and £2 2s. costs. Abated Foul walls and no water supply or sparge pipe to urinal. Battersea Empire, York Road Order by consent to abate within one month and £2 2s. costs. Ditto—failure to comply with order of Court. Fined £5 and £2 2s. costs. Defective roof, stoves, windows and water fittings at 97 Latchmere Grove Order for necessary work to be done within 28 days. Nuisance from choked drain at 6 Alfred Street Nuisance having been abated, defendant ordered to pay £1 1s. costs. Dirty condition of ceilings and walls of staircases and hall at 111 to 120 Albert Palace Mansions Order to abate in 14 days and £3 3s. costs. Nuisance from overcrowding at 2 Meyrick Road Order to abate within one month. Summonses against occupiers of rooms adjourned one month. Failure to comply with notice to fix sufficient water closets and flushing apparatus at 43 St. Johns Road Proceedings still pending at end of year. Selling quantity of jam wholesale in unsound condition Defendant absconded—summons not served. Failure to pay £47 15s. 1d. expenses incurred in repairs to defendant's premises. No. 112 Wycliffe Road Order for payment of debt with £3 3s. costs, 64 Sale of Food and Drugs Acts. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 751 Milk 18% deficient in fat Fined £20 or one month. Dismissed—warranty defence. (Samples taken in course of delivery.) 843 Milk 6% deficient in fat 844 Milk 15% deficient in fat 845 Milk 11 % deficient in fat Milk Giving false warranty in writing Dismissed on payment of £5 5s. 0d. costs. 44 Sponge Cake The equivalent of 13.3 grains crystallised boric acid per 1b. cake Fined £3. 58 Milk 6% extraneous water and at least 31.5% deficient in fat Dismissed on payment of £1 1s. 0d. costs on each summons, together £2 2s. 0d. 59 Milk 5% extraneous water and 16% deficient in fat (Samples taken in course of delivery.) 151 Milk 18% deficient in fat Dismissed on payment of £5 5s. 0d. costs. (Sample taken in course of deliverv). 197 Milk Selling milk from a can which did not have vendor's name conspicuously inscribed thereon On defendant stating he had now put the matter in order, summons dismissed on payment of £2 2s. 0d. costs. 250 Margarine Selling margarine by retail without a paper wrapper on which the word "margarine" was printed Defendant ordered to pay £1 1s. 0d. costs. 270 Milk Formaldehyde preservative amounting to 0.0975 parts formaldehyde in each 100 parts of sample Defendant who took responsibility fined £30; proceedings against second defendant abandoned. 381 Fairy Cakes 24.5 grains per lb. boric acid Proceedings still pending at end of year. 459 Milk 43% deficient in fat Fined £5 and £2 2s. 0d. costs (sample taken in course of delivery). 460 Milk 33% deficient in fat Fined £5 and £2 2s. 0d costs (sample taken in course of delivery). 65 Public Health (Milk & Cream) Regulations, 1912. Public Health (Milk & Cream) Regulations, 1912, Amendment Order, 1917. Nature of Offence. Result of Proceedings. Delivering preserved cream to a purchaser in an unlabelled receptacle. Dismissed on payment of Two guineas costs. Milk and Dairies (Amendment) Act, 1922. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 720 Milk 5½% extraneous water Fined £2. 772 Milk 9% extraneous water Dismissed on payment of £1 1s. 0d. costs. 819 Milk 9% extraneous water Each defendant fined £20 and allowed 28 days to pay. 208 Milk 13.5% extraneous water Summons withdrawn on payment of £2 2s. 0d. costs. 219 Milk 12% extraneous water Summons dismissed on payment of £2 2s. 0d costs; summons against second defendant withdrawn. 416 Milk 9½% extraneous water First defendant fined 20/and £2 2s. 0d. costs. 483 Milk 9% extraneous water First defendant fined £3 and £1 1s. 0d. costs, and second defendant fined £2. 569 Milk 9½% extraneous water Fined £4 and £1 1s. 0d. costs; summons against employee dismissed. 638 Milk 12% extraneous water Fined £5 and £2 2s. 0d. costs. Milk Acting as a purveyor of milk without being registered Withdrawn on payment of £3 3s. 0d. costs. 66 Housing, Town Planning, &c., Acts. Nature of Offence or Claim. Result of Proceedings. Failure to comply with notice requiring him to state from whom the premises 41 Weybridge Street were held Fined 1 /- and £2 2s. costs. Non-compliance with Closing Order (146 St. John's Hill) Order made, suspended for two months. Recovery of £178 1s. 4d. expenses incurred in making No. 173 Lavender Road in all respects reasonably fit for human habitation The claims having been satisfied on terms approved by the Council, summonses withdrawn. The like of £180 12s. 7d. as to No. 177 Lavender Road Summary of Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 41 cases during the year 1924:— Persons prosecuted (including employees). Convictions. Fines. Costs. £ s. d. £ s. d. Factory & Workshop Act, 1901 – – – – Milk & Dairies (Amendment) Act, 1922 17 8 57 0 0 14 14 0 Public Health (Milk and Cream) Regulations, 1912, Amendment Order, 1917 1 – – 2 2 0 Public Health (London) Act, 1891, and the Bylaws made thereunder 13 9 5 0 0 19 0 0 Sale of Food and Drugs Acts 13 5 63 0 0 19 19 0 Housing Acts 3 2 0 1 0 2 2 0 Total 47 24 125 1 0 57 17 0 67 Common Lodging Houses. The following table gives a list of the common lodging houses in the Borough:— Premises. Authorised No. of Lodgers. Whether Males or Females. 75 Falcon Road 81 Males 134 High Street 54 Males 67 Winstanley Road 66 Females Drainage Work. During the year new drains were constructed to 47 new buildings, or additions to existing buildings, and the drains of 86 old buildings were partially or entirely reconstructed, under the supervision of the Officers of the Department. The drains of the following premises, being "sewers" in respect of the maintenance of which liability was recognised by the Council, were repaired or reconstructed during 1924 at the cost of the Council:— Corunna Road. 54 (with No. 55, &c.). Ingrave Street, 116 & 118. Grant Road, 89, 91, 93. Mendip Road, 31 & 33. New Road, 97, 99, 101, 103 & 105. The expenditure incurred on these "sewers" amounted to £305 5s. Revenue Act, 1903. During 1924 no application for the certificate of the Medical Officer of Health under the provisions of the Revenue Act, 1903, was received. Sanitary Conveniences attached to Licensed Premises. During 1924 the number of public-house urinals under inspection was 118. In 80 instances the accommodation is accessible to the general public as well as the users of the houses, and in 38 cases the accommodation is accessible to the customers only. As a result of the annual inspection of these conveniences, 37 notices were served to remedy defects discovered. Smoke Nuisances. During the year 119 observations were made and 17 complaints received. Eight preliminary and 2 statutory notices were served by the Council to abate smoke nuisances. Proceedings were instituted against one firm, the summonses being withdrawn on payment of 5 guineas costs, the defendants by their solicitors undertaking to use the best practical steps to prevent further nuisances arising. 68 Effluvium Nuisance. During 1924 no complaint of effluvium was established. Water Supply. During 1924, fifteen applications were received for certificates of water supply in respect of 15 houses in accordance with Section 48 of the Public Health (London) Act, 1891. The certificates were granted in each instance. In 17 cases additional water supply to the upper floors of tenement houses, required by the Council under the provisions of Section 78 of the London County Council (General Powers) Act, 1907, and Section 48 of the Public Health (London) Act, 1891, was provided. Van Dwellings. The number of van dwellings in the Borough in 1924 was 62. In the following table are set out the situations of the dwellings and number of occupants:— Situation of Vans. No. of Vans. No. Occupants. m. f. Mill's Yard, adjoining 88 Sheepcote Lane 3 2 2 Mill's Yard, adjoining 80 Sheepcote Lane 4 7 6 Manley's Yard, Falcon Road 8 10 8 Manley's Yard, Cabul Road 28† 27 26 Mill's Yard, Culvert Road 19* 22 42 During the year 5 vans were found to be overcrowded, and notices were served to abate the nuisance. Nine vans were unoccupied. Rag Flock Act, 1911. This Act was passed to prevent the use of material known as rag flock, unless such material complies with the standard of cleanliness laid down in the Act. No proceedings were taken under the Act in Battersea during 1924. Rats and Mice (Destruction) Act, 1919. This Act, which became operative on the 1st January, 1920, imposes on local authorities and occupiers of premises additional responsibilities in connection with rat repression. * Including one shed. † Including one cottage. 69 During 1923 the work carried out under the Council's Rat Repression Scheme is summarised as follows :— Premises visited 2,128 Poison baits used 47,560 Dead rats found 2,554 Contracts renewed 12 Value of contracts £164 10 0 Cash for poison bait £42 10 4 Drains were tested at 65 premises in connection with this work, and in 30 cases were found to be defective. Most of these defective drains were in private houses. As the presence of rats in houses is usually regarded as prima facie evidence of drain defects, the work of the Rat Officer therefore is carried on in close co-operation with that of the district Sanitary Inspectors. The methods employed under the Rat Repression Scheme have been described in previous Annual Reports. It is only necessary, therefore, to state that as an inspection of the summarised figures shows, the work done during the year under this head has been as satisfactory as in previous years. Personal Cleansing Station. The new Personal Cleansing Station, opened on the 3rd November, 1923, was fully described in my Annual Report for that year. The new premises have greatly facilitated the work of the officers responsible for the cleansing and treatment of children infested with vermin and of those suffering from scabies and other contagious skin affections. During the year 1924, there were 5,394 children and 311 adults cleansed and treated at the station. Of the 5,394 children attending, 381 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. These children attended from the Public Elementary Schools in the Borough by arrangement with the London County Council, who have entered into a contract with the Borough Council for the use of their Personal Cleansing Station. The cleansing and treatment of the School children is carried out under the supervision of Officers of the London County Council while the disinfestation of the clothing and of the homes is carried out concurrently by the Borough Council's Sanitary staff. There was a considerable increase in the number of children cleansed, &c., in 1924 as compared with the previous year. The increased numbers dealt with are probably the result of the improved facilities provided by the new Station enabling large numbers of children to be attended to and with greater comfort and efficiency. It is probable also that the increased prevalence of overcrowding which is such a regrettable result of the housing shortage is in part responsible for the rise in the numbers cleansed in 1924. The following table shows the numbers of persons cleansed and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun. 70 Number of Baths, &c. Year. Adults Children. Cost of Station. Amount Contributed. Verminous. Verminous and Scabies. £ £ 1906 141 2 29 — 1907 504 113 42 — 1908 1,011 656 82 — 1909 1,373 321 91 — 1910 1,583 341 88 — 1911 1,459 191 93 13 1912 1,351 841 237 65 1913 1,323 1,090 118 69 1914 1,050 1,602 132 78 1915 648 1,273 125 78 1916 475 1,773 143 94 1917 320 2,620 169 140 1918 291 3,179 237 187 1919 366 3,214 287 169 1920 419 4,213 456 331 1921 340 4,607 561 400 1922 274 4,444 584 400 1923 212 4,949 985 400 1924 311 5,394 1,172* 400 13,451 40,823 £5,631 £2,824 * Estimated. Disinfecting Department. Summary of work carried out by the Disinfecting Department during 1924. Premises disinfected 1,879 Rooms disinfected 3,089 Staircases disinfected 182 Schools disinfected 62 Number of articles laundered 28,544 „ „ destroyed 837 „ verminous persons (including 5,063 school children) 5,394 „ infectious disease contacts 605 „ Library books collected 182 Total Articles. No. Weight. Tons. cwts. qrs. lbs. Bedding, &c., disinfected 49,584 115 16 0 15 „ lent 1,256 4 2 0 16 Verminous clothing, &c. 6,285 2 5 1 4 Articles from Welfare Centres 4,389 (not weighed) Total 61,514 122 3 2 7 71 Mortuary. Details as to the number of bodies received into the Mortuary and as to inquests held thereat are set out in the following:— Usual Place of Residence. Total. Battersea. Wands -worth Elsewhere. Residence unknown Inquest and post-mortem held at Mortuary 79 5 6 6 96 Inquest at Mortuary; post-mortem elsewhere 13 32 6 — 51 Inquest at Mortuary; no post-mortem 10 19 2 — 31 Total inquests held Battersea Mortuary 102 56 14 6 178 Post-mortems without inquest,Battersea Mortuary 7 — 1 1 9 Total post-mortems held at Battersea Mortuary 86 5 7 7 105 Bodies received for sanitary reasons 4 — — — 4 Other bodies on which no inquest held at Mortuary — 1 — — 1 Total bodies received 113 57 15 7 192 VERDICTS AT INQUESTS HELD— Natural causes 63 4 4 — 71 Accidental Death Asphyxia 1 — — — 1 Bathing — — 1 — 1 Burns and scalds 2 4 — — 6 Deaths under anaesthetic 1 1 — — 2 Drowning 1 — — — 1 Fall 14 16 1 — 31 Railway and street accidents 8 18 3 — 29 Septicæmia — 4 — — 4 Struck head against wall — 1 — — 1 Open Verdict— Found drowned — — — 2 2 Stillborn 3 — — 1 4 Want of attention at birth — — — 3 3 Suicide— Cut throat 1 2 — — 3 ,, ,, and poisoning 1 — — — 1 Drowning — 1 2 — 3 Firearms 1 2 — — 3 Hanging 2 1 — — 3 Jump from high place — 1 — — 1 Poisoning—Coal gas 2 — — — 2 „ Drugs, etc 1 1 1 — 3 Railway — — 1 — 1 Homicide. Blow (manslaughter) 1 — — — 1 Firearms (wilful murder) — — 1 — 1 Grand Total 102 56 14 6 178 72 Sanitary Staff. The personnel of the staff of the Health Department will be found fully set out on page 3. During 1924 the following changes occurred:— In view of the development of the Maternity and Child Welfare Scheme the Council on 28th May appointed, after public advertisement, Dr. Alice Bloomfield, M.D., F.R.C.S., as part time Assistant Medical Officer, to relieve the Assistant Medical Officer (Maternity and Child Welfare) in the attendance at certain of the Maternity and Child Welfare Clinics. The work of Dr. Bloomfield is referred to on page 26. Miss O. Baggallay, Health Visitor, was granted leave of absence for one year, from 1st September, without pay, in order that she might undertake a tour of Canada and the United States on behalf of the Florence Nightingale Fund, to study the nursing services in those countries. Miss A. Bannerman was appointed temporary Health Visitor in Miss Baggallay's absence. 73 Protection of the Food Supply. Unsound Food. The following is a tabulated return of unsound food seized or voluntarily surrendered during 1924 Food Condemned. Food. Quantity. Food. Quantity. Fish. Fruit & Vegetables (fresh). Chats 1 trunk. Apples 2 barrels. Haddock 1 trunk. Bananas 2 crates. 12 stones. Potatoes 3 bags. Haddock roes 14 lbs. Tomatoes 19 bundles. Herrings 4 boxes. Kippers 5 boxes. Meat. Mussels 1 large bag. Corned Beef 8 6-1b. tins. Plaice 1 box. Lamb 1. Whelks 1 bag. Pigs 3 (small). Whiting 1 trunk. Rabbits 36. Winkles 2 bags. Miscellaneous. Cakes 25 lbs. and 198 small. Jam 4 gross jars. Wheat 522 lbs. A quantity of unsound jam, amounting to four gross 1-lb. jars, was brought to the Public Health Department and surrendered by the retailer. The jam was condemned at the South-Western Police Court as unfit for human food, and proceedings were taken against the wholesale vendor, but the summons could not be served as the defendant had abscorided. Cow-houses. There is only one licensed cow-house remaining in the Borough, situate at 17 Wiseton Road. Slaughter-houses. There are now only two slaughterhouses remaining in the Borough. These premises are kept under systematic inspection, and during the year 1924, 333 inspections were made by the Council's inspector. The carcases of 1,075 animals (oxen 112, calves 27, sheep 571 and pigs 365 were examined after slaughter. 74 Butchers' Shops. The number of butchers' shops in the Borough at the beginning of the year 1924 was 88. Two new shops were opened during the year, making a total of 90 butchers' premises carrying on business at the end of the year. All butchers' shops in the Borough are systematically inspected, and, in the main, they are well kept and provided with cold storage facilities. During the year 1,206 inspections of these premises were carried out by the Council's Food Inspector. Sale of Food and Drugs Acts. The total number of samples taken under the Acts during 1924 was 888, of which 35 or 3.9 per cent, were certified by the Public Analyst to be adulterated. In addition to the foregoing, 312 informal samples were procured, of which 36 or 11.5 per cent, were reported by the Public Analyst as adulterated, not up to standard, or as containing preservatives in varying amounts. The following tables give details of the articles of which samples were obtained for the purpose of analysis. Main Statement. TABLE I. Nature of Sample. Examined. Adulterated. Formal. Informal. Total. Formal. Informal. Total. Butter 16 96 112 0 2 2 Cheese 15 — 15 0 — 0 Cocoa 20 — 20 0 — 0 Coffee 5 13 18 0 0 0 Cream 2 2 4 1 1 2 Cream, Preserved 17 12 29 0 0 0 Flour — 2 2 — 0 0 ,, Self-raising — 5 5 — 0 0 Margarine 6 19 25 0 0 0 Milk 721 — 721 25 0 25 ,, Condensed (Full Cream) - 4 4 - 0 0 ,, ,, (Machine Skimmed) 11 11 0 0 „ Dried — 4 4 — 0 0 ,, Separated 2 — 2 0 — 0 Mustard — 6 6 — 0 0 Sugar — 7 7 — 0 0 Vinegar 10 — 10 0 — 0 Drugs — 20 20 — 0 0 Other Articles 74 111 185 9 33 42 Total 888 312 1200 35 36 71 75 TABLE II. Drug (Informal). Nature of Sample. Examined. Adulterated. Borax, Powdered 4 0 Camphorated Oil 4 0 Cream of Tartar 12 0 Total 20 0 TABLE III. Other Articles. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Arrowroot 2 12 14 0 0 0 Baking Powder — 4 4 — 0 0 Cordials — 8 8 — 7 7 Fairy Cakes 2 13 15 2 11 13 Fish Paste 8 8 16 3 8 11 Honey 15 — 15 0 — 0 Lard 20 — 20 0 — 0 Olive Oil 10 — 10 0 — 0 Peas, Tinned (Preserved) — 7 7 — 1 1 Pepper — 6 6 — 0 0 Rice — 26 26 — 0 0 Sausages 9 — 9 2 — 2 Sausages (Luncheon) 7 — 7 1 — 1 Sponge Cake 1 24 25 1 4 5 Sponge Sandwich — 2 2 — 1 1 Swiss Roll — 1 1 — 1 1 Total 74 111 185 9 33 42 Milk. Of the 721 whole milk samples, 25, or 3.4 per cent. were certified as adulterated. Eight samples were reported against as being deficient in milk fat, 14 as containing extraneous water, 2 as being deficient in milk fat and containing extraneous water, and 1 as containing preservative. The average composition of the 696 samples reported as genuine proved to be as under:— Total milk solids 12.58% Milk fat 3.70% Non-fatty solids 8.88% 76 The content of fat in these 696 samples ranged as follows:— 4.0% and over 117 samples or 16.8% Between 3.9 and 4.0% 49 „ „ 7.0% „ 3.8 „ 3.9% 74„ „ 10.6% „ 3.7 „ 3.8% 101 „ „ 14.5% „ 3.6 „ 3.7% 86 „ „ 12.4% „ 3.5 „ 3.6% 105 „ „ 15.1% „ 3.4 „ 3.5% 66 „ „ 9.5% „ 3.3 „ 3.4% 46 „ „ 6.6% „ 3.2 „ 3.3% 28 „ „ 4.1% „ 3.1 „ 3.2% 16 ,, ,, 2.3% „ 3.0 „ 3.1% 8 „ „ 1.1% All samples are systematically tested for the presence of preservatives. In one case only, referred to above, was a positive result obtained, a whole milk being found to contain a formaldehyde preservative to the extent of no less than 975 parts formaldehyde per million of the sample. In this case proceedings were taken against the vendor, who was convicted and fined £30. Milk sampling was carried out on 16 Sundays during the year, and 80 samples were purchased for analysis on these occasions. Samples of milk in course of delivery by wholesale firms to the, number of 87 were taken during the year. The bulk of these samples was taken at Clapham Junction or South Lambeth Railway Stations. Samples of milk to the number of 76 were taken in course of delivery to elementary schools in the borough. Proceedings with regard to adulteration were taken in 19 instances (fat abstraction 7; extraneous water 9; both fat abstracted and added water 2; containing preservative 1), particulars relating to which will be found set out in the tables on pages 64 and 65. Warranty was pleaded in defence in one case (three samples) and was successful. Proceedings were instituted against the warrantor in this instance, but the summons was dismissed on payment of five guineas costs. Preservatives found in Foods during 1924. Formal Samples. Nature of Sample. Nature and amount of Preservative. Milk 0.0975% formaldehyde. Cream 26.6 grains boric acid per lb. Sausages 4.7 „ „ „ ,, 5.6 „ „ „ Luncheon Sausage 3.2 „ „ „ Fish Paste 10.5 ,, ,, ,, „ 11.7 „ „ „ „ 8.2 „ „ „ Fairy Cakes 24.5 „ „ „ „ 13.3 „ „ „ Sponge Cake 13.3 „ „ „ 77 Informal Samples. Nature of Sample. Nature and amount of Preservative. Cream 25.9 grains boric acid per lb. Fish Paste 3.4 ,, ,, ,, ,, 3.8 ,, ,, ,, ,, 7.7 ,, „ ,, ,, 27.3 ,, ,, ,, ,, 7.77 „ „ „ ,, 6.02 ,, ,, ,, ,, 16.0 ,, ,, ,, ,, 8.19 ,, ,, ,, Sponge Cakes 10.5 ,, ,, ,, ,, 18.2 ,, ,, ,, ,, 4.7 ,, ,, ,, ,, 4.3 ,, ,, ,, Fairy Cakes 19.5 ,, ,, ,, ,, 24.5 „ ,, „ 14.0 ,, ,, ,, ,, 9.8 ,, ,, ,, ,, 16.1 ,, ,, ,, ,, 11.2 ,, ,, ,, ,, 4.9 ,, ,, ,, ,, 4.2 ,, ,, ,, ,, 7.0 ,, ,, ,, ,, 8.4 ,, ,, „ ,, 14.2 ,, ,, ,, Swiss Roll 5.6 ,, ,, ,, Jam Sandwich 9.5 ,, ,, ,, Cordial 8.5grains salicylic acid per pint ,, 2.5 ,, „ ,, ,, 6.0 „ ,, „ ,, 8.5 ,, ,, ,, ,, 7.4 ,, ,, ,, ,, 7.4 ,, ,, ,, ,, 8.1 ,, ,, ,, Tinned Peas (Preserved) 3.0 grains crystallised copper sulphate per lb. The Departmental Committee's report on preservatives in food was issued in November. The main conclusions arrived at were, inter alia, that preservatives should be prohibited in all articles of food or drink offered or exposed for sale, except in a few definite and specific cases. Only two preservatives should, in the view of the Committee, be permitted, viz., benzoic acid and sulphurous acid and their salts. 78 The main exceptions in respect of which preservatives might be permitted are sausages, jam, dried fruits, fruit pulp, beer, cyder, wines, cordials and fruit juices and the preservative used, it is suggested, should be sulphur dioxide or, alternatively, benzoic acid in prescribed quantities. The nature and quantity of the preservative used should be disclosed. The Report of the Committee is of the greatest importance and value from the public health standpoint and the result of the action taken by the Government upon the recommendations of the Committee will be awaited with interest by Sanitary Authorities. Sponge Cakes, Fairy Cakes, &c. During the year 43 samples in all were submitted to the Public Analyst, 25 consisting of Sponge Cakes, 15 of Fairy Cakes, 2 of Sponge Sandwich and 1 of Swiss Roll. One sample of sponge cakes and 2 of fairy cakes were procured formally and reported against as containing a boron preservative, the quantities present expressed as crystallised boric acid being respectively 13.3, 24.5 and 13.3 grains per lb. Of the informal samples, 4 of the sponge cakes, 11 of the fairy cakes, 1 of sponge sandwich and 1 of Swiss roll were reported as containing a boron preservative ranging from 24.5 to 4.2 grains crystallised boric acid per lb. Butter. During the year 112 samples of butter were submitted for examination. Of these 16 were taken in the form prescribed by the Acts, the remaining 96 samples were purchased informally. Two of the 96 informal samples were reported by the Public Analyst as containing margarine. Of the 112 samples submitted 9, or 8.0 per cent. contained no preservative other than common salt; whilst 103, or 92.0 per cent., contained a boron preservative. Excluding the two (informal) samples reported as adulterated, the average content of boron preservative expressed in terms of crystallised boric acid, proved to be 0.22 per cent., equivalent to 15.4 grains per lb. butter. The maximum permissible quantity of this preservative in butter is 35 grains per lb. Margarine. Twenty-five samples of margarine were purchased and submitted to the Public Analyst for examination. Of these 6 were procured formally and 19 informally, and were all reported as genuine. A boron preservative was present in each of the 25 samples, the average amount present expressed as crystallised boric acid being 0.30 per cent., equivalent to 21 grains per lb. 79 Sausages, Preserved Meats, &c. Nine samples of sausages and 15 samples of preserved meats were procured in the form prescribed by the Acts and submitted to the Public Analyst. Two of the sausages and 4 of the preserved meats, &c., were reported as containing a boron preservative in quantities ranging from 3.2 to 11.7 grains per lb. expressed as crystallised boric acid. Rice. Twenty-six samples of rice were procured informally and submitted to the Public Analyst and all were reported as genuine. Sixteen samples were "polished," four by means of oil and 12 with the aid of talc. In the latter the foreign matter (talc coating) ranged from 0.42 per cent. to 0.10 per cent., which was below the permissible limit of 0.5 per cent. The average amount for these 12 samples proved to be 0.24 per cent. In view of the risk to health which may arise from the consumption of rice, even in small amounts, so treated, a practice which has grown up owing to the preference shown by the public for "polished" rice, the presence of foreign mineral matter shown on analysis of these samples points to the advisability of washing all whole rice prior to cooking. The practice in no sense adds to the dietetic value of rice, while, on the other hand, it is objectionable bearing in mind that this article of food is consumed largely by children and invalids and may, even in the case of small quantities of this foreign mineral matter, give rise to risk of injury to health. If the practice of "facing" or "polishing" within the permissible limit of .5 per cent. is considered essential in trade interests, it certainly should be made an obligation upon the trader to disclose its presence and quantity in rice to the purchaser. Milk and Cream Regulations, 1912-17. 1. Milk and cream not sold as preserved cream:— (a) (b) Number of Samples examined for the presence of a preservative. Number of Samples in which a preservative was reported to be present. Milk 723 1 Cream 4 2† † One of these was an informal sample. 80 2. Cream sold as preserved cream:— (a) Samples submitted for analysis to ascertain if the statements on the labels as to preservatives were correct:— 1. Correct statements made 29* 2. Statements incorrect Nil. Total 29 (b) Determinations made of milk fat in cream sold as preserved cream:— 1. Above 35 per cent 29* 2. Below 35 „ Nil. Total 29 (c) Instances where (apart from analysis) the ments as to labelling or declarations of preserved cream in Article V. (1) and the proviso in Article V. (2) of the Regulations have not been observed 2† (d) Particulars of each case in which the Regulations have not been complied with, and action taken:— 1. Informal.—Sold as "Cream" without a declaratory label. No verbal declaration was made at time of purchase. A declaratory label was, however, affixed to the receptacle in which the cream was stored. 2. Formal.—Sold as "Cream." Same dor as No. 1 above. Precisely same circumstances. Vendor summoned. No fine. £2 2s. 0d. costs. 3. Formal.—Milk (Sample No. 270) tained Formaldehyde .0975 parts per 100 parts of milk. Vendor summoned and fined £30. (Proceedings taken under Sale of Food and Drugs Acts) 3. Thickening substances:— Any evidence of their addition to cream or to preserved cream and action taken when found Nil. 4. Other observations (if any) Nil. * Twelve of these were informal samples, † One of these was an informal sample. 81 Milk and Dairies (Amendment) Act, 1922. (Vide Circular 360 of the Ministry of Health.) 5. Action taken under Section 4 of the Milk and Dairies (Amendment) Act, 1922:— (a) No. of samples of milk certified by Public Analyst to contain colouring matter Nil. (b) Number of samples of milk certified by Public Analyst to contain extraneous matter 14 Action taken thereon— In 9 cases (added water) Vendor summoned Convictions (fines and costs) 6 Summons withdrawn on payment of costs 1 Summonses dismissed on payment of costs 2 In 5 cases (added water) Vendor cautioned Ice Cream. There are 190 premises in the borough from which ice cream is sold, 8 of these being occupied by Italian vendors by whom this article of food is sold from barrows. All the premises, stalls, barrows, &c., from which the trade is carried on are kept under daily inspection during the season. During 1924, 12 ice cream premises were removed from the register and 40 were added. There was, therefore, an increase of 28 in the number of premises compared with 1923. During the year 258 inspections were made and 20 notices were served to remedy defects found on inspection. In addition, during the same season a daily inspection of street barrows and the utensils, glasses, towels, &c., used thereon was carried out. The sale of this article during recent years has practically passed from the hands of the less desirable class of purveyor and ice cream is now being sold largely throughout the borough during the season from box tricycles, the article being packed in clean paper packets and stored in the tight chambers provided on the tricycle. There is, therefore, a distinct improvement in the conditions under which ice cream is now sold. Milk Shops. The number of premises from which milk is sold in Battersea is 128, as compared with 130 last year. All milk shops are kept under inspection and during the year 520 inspections were carried out and 8 notices were served to remedy defects found on inspection. These mainly referred to dirty and unsuitable premises and other minor defects. In one case it was necessary to take proceedings to enforce compliance with the statutory notice requiring certain alterations of the premises. 82 Two unregistered milk vendors were discovered during the year and reported to the Health Committee. In one case a summons was taken out and in the other the vendor was cautioned. Thirteen cases occurred during 1924 in which a milk business changed hands, the register of milk purveyors being amended accordingly. In three cases new purveyors were registered in respect of premises not previously used for the purpose. In two of these the premises were used for the sale of dairy produce only and in one case for the sale of milk in sealed bottles only. In five cases the sale of milk was discontinued. Fish Shops. Fish shops in the Borough in which fish, either cooked or uncooked, is sold, or in which the curing of fish intended for sale is carried on number 68. Five new premises were opened during the year which are included in this total. All these premises are kept under systematic inspection. During 1924, 320 inspections were made and 4 notices were served for various defects found on inspection. Restaurant Kitchens. The number of restaurant kitchens and eating houses on the register at the end of 1924 was 93, an increase of 2 as compared with 1923. During the year 369 inspections were carried out, and in 11 cases it was found necessary to serve notices to remedy defects which were mainly of a minor character. Street Stalls for the Sale of Food. There are in the Borough a large number of street vendors of foodstuffs of varied character, namely—fruit 42; vegetables 44; fish 21; meat and rabbits 4; sweets 7; other foods 8. There has been a decrease in the number of street stalls in which meat is sold, probably owing to the cheaper prices charged in some of the shops. Eight notices were served for defective and insanitary conditions of premises used by the street vendors for the storage of their stock. 83 Factories, Workshops, Workplaces and Homework 1.—Inspections of Factories, Workshops and Workplaces (including Inspections made by Sanitary Inspectors or Inspectors of Nuisances). Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 1,006 104 - Workshops (including Workshop Laundries) 1,228 83 1 Workplaces (other than Outworkers' premises included in the Table on page 89) 2,340 79 - Total 4,574 266 1 2.—Defects found in Factories, Workshops and Workplaces Particulars. Found on Inspection. Remedied. Referred to H.M. Inspector. Number of Prosecutions. 1 2 3 4 5 Nuisances under Public Health Act — Want of Cleanliness 29 29 Nil. - Want of Ventilation 3 3 - Overcrowding - - - Want of drainage of floors - - - Other nuisances 71 71 - Sanitary accommodation Insufficient 15 15 - Unsuitable or defective 82 82 - Not separate for the sexes 12 10 1 Offences under the Factory and Workshop Act— Illegal occupation of underground bakehouse (Sec. 101) - - - Other Offences (excluding Offences relating to Outworkers which are included in the Table on page 89) - - - Total 212 210 - 1 84 3.—Registered Workshops. Workshops on Register (Section 131) at end of 1924:— Bakehouses 27 Bootmakers 35 Dressmakers 21 Laundries 5 Milliners 10 Tailors 42 Other Trades 193 Total number of workshops 333 4.—Other Matters. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Section 133) 6 Notified by H.M. Inspector 1 Underground Bakehouses (Section 101), in use at end of the year 27 Factories and Workshops. Factories. The following is a list of the factories on the register at the end of 1924:— Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons. Barge builder 2 26 4 — — Baker 50 213 19 — — Bootmaker 15 27 2 — — Builder 4 105 — — — Butter blender 1 48 24 11 10 Chemical works 4 227 5 62 14 Chaff & forage 5 59 1 8 — Coach 3 27 — — — Cycle maker 3 4 5 — — Dyer 2 44 — 23 — Engineer 30 691 7 — — Flour mills 2 150 — 12 — Firewood cutter 10 43 5 24 — Foundry 1 30 — — — Lift maker 2 16 — — — Mason 5 346 2 — — Mineral water 2 25 — 23 — Motor repairs 17 226 4 4 — Printer 18 92 9 15 — Steam laundry 17 66 10 530 74 Other trades 89 3,770 381 967 449 Total 282 6,235 478 1,679 547 85 The duties of sanitary authorities in relation to the sanitation of factories are few, and are limited mainly to the enforcement of suitable and sufficient sanitary accommodation for factory employees. Fifteen new factory premises were added to the register during the year, dealing with various trades. During the year 90 preliminary and 12 Statutory notices were served under the Public Health (London) Act, 1891, for defects found on factory premises, for the most part relating to defective or insufficient sanitary accommodation, all of which were duly remedied. Workshops. The following is a list of the workshops on the register at the end of 1924:— Trade. No. of Workshops. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Young Persons. Baker 27 36 41 1 — — Blind maker 2 3 3 2 — — Bootmaker 35 35 52 3 — — Carpenter 4 5 8 — — — Coach builder 9 14 30 — — — Cycle maker 7 11 8 — — — Dressmaker 21 28 — — 55 9 Embroiderer 2 3 1 — 24 1 Farrier & smith 13 13 30 — — — Firewood cutter 2 2 2 — — — Laundry 5 13 2 1 17 — Mason 3 3 15 — — ,— Milliner 10 12 — — 26 11 Motor repairs 11 11 31 1 — — Musical instrument 3 6 45 1 — — Photographer 2 5 4 — 1 — Picture framer 3 3 3 1 — — Rag sorter 14 14 22 3 7 — Saddler 2 2 2 — — — Tailor 42 59 52 6 61 2 Upholsterer 16 20 30 2 4 — Other trades 100 120 228 37 54 19 Totals 333 418 609 58 249 42 86 Twenty-three new workshops were added to the register, dealing with:— Baking 1 Motor repairs 1 Boot-making 5 Rag sorting 2 Dressmaking 4 Tailoring 2 Millinery 1 Miscellaneous 7 The following table gives particulars relating to new workshops in which "protected persons" were employed, notices of which were duly sent to H.M. Inspector during 1924:— Trade. No. of Workshops. Protected Persons employed. Women. Young Persons. Total. Bootmaker 1 — 1 1 Florist 1 1 — 1 Milliner 1 1 7 8 Tailor 3 4 1 5 Totals 6 6 9 15 Outworkers. During 1924, 661 names and addresses of out-workers were received in 136 lists sent in by employers and by the Medical Officers of Health of Metropolitan Boroughs and District Councils. 201 names and addresses relating to 129 out-workers, sent in by employers, were found to refer to other districts, and were accordingly forwarded to the Medical Officers of Health of those districts. Male. The following table shows the number of male out-workers premises registered in the Borough, together with the trades and the number of persons employed:— Trade. Number on Register. Persons Employed. Premises. Workrooms Bootmaking 36 36 36 Glovemaking 1 1 1 Tailoring 56 56 84 Other Trades 4 4 4 Totals 97 97 125 87 Seventeen new male out-workers (out-workers not previously registered) were registered during the year. There were 128 inspections made of male out-workers' premises during 1924, and it was found necessary to serve notices under the Public Health (London) Act, 1891, in 3 cases to remedy sanitary defects found on inspection, as follows:— Defective w.c., want of proper hood and shaft to gas fire, want of separate sanitary accommodation for male and female workers. No case of infectious disease was notified during 1924 from premises occupied by male outworkers. Female. The following is a list of the female out-workers registered in the Borough, together with the trades and the number of persons employed:— Trade. Number on Register. Persons Employed. Premises. Workrooms Blousemaking 8 9 15 Boxmaking 15 15 15 Dressmaking 35 37 59 Embroidery 39 39 40 Fancy goods 10 10 10 Fine needlework 7 7 9 Glovemaking 2 2 2 Knitting and crochet 17 17 18 Tailoring 37 37 51 Underclothing 6 6 9 Other trades 23 23 24 Total 199 202 252 Sixty-one new female out-workers (out-workers not previously registered) were registered during the year. 382 inspections of female out-workers' premises were made by the woman workshops' inspector (Miss Round). It was not found necessary to serve any notices under the Public Health (London) Act, 1891, to remedy defects. Two cases of infectious diseases, viz.: diphtheria 1, and erysipelas 1, were notified from female out-workers' premises. In both cases such precautionary measures as were required were taken to prevent spread of infection. 88 Bakehouses. There were 77 bakehouses on the register at the end of 1924. Of these 50 use power, and are therefore factories. Fifty of the bakehouses are above ground, and 27 are under ground. Three bakehouses were re-opened during the year. On the other hand one above ground and one below ground bakehouse were discontinued during the year, the premises being used for other businesses. 278 inspections were made during the year, and 36 intimation and 12 statutory notices were served, mainly for failure to carry out the half-yearly lime-whiting of the bakehouses within the statutory period. Warehouses and Wharves. At the end of 1924, there were 42 premises on the register, including railway yards. These premises were systematically inspected during the year, and 57 inspections were made. Five notices were served to remedy nuisances found on inspection. 89 Home Work. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Outwork in Unwholesome Premises, Sec. 108. Outwork in Infected Premises, Secs. 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110) Prosecutions (Secs. 109, 110) Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel- (1) Making 60 38 250 4 — 11 66 — — 1 1 — 1 — — (2) Cleansing & Washing — — — — — — — — — — — — — — Furniture and Upholstery 2 — 3 — — — 2 — — — — — — — — Other Trades 6 24 1 — 7 8 — — — — — 1 — — Total 68 38 277 5 — 18 76 — — 1 1 — 2 — — 90 Housing. The activities of the Council in housing matters were, with the exception of the Plough Road Improvement Scheme as described in my Annual Report for 1923, confined to the repair of unfit house property. There is still, unfortunately, a serious amount of overcrowding in the lower wards of the Borough, and cases have come to light of families of seven, eight or nine persons occupying a single room. The conditions in such gross instances are little short of appalling both from the health and moral standpoints. These insanitary conditions are incapable of being remedied until the housing shortage has been abated by the provision of an adequate number of working-class dwellings let at rents which are within the means of those requiring them. It is to be regretted that the economic situation and other difficulties have prevented a more rapid provision of houses, especially working-class dwellings, to relieve the distressing and dangerous conditions which are such an unsatisfactory feature of the housing situation since the War. It is to be hoped, therefore, that the recent legislative measure passed by Parliament, viz., the Housing (Financial Provisions) Act, 1924, which came into force on August 7th last, will result in a speeding up of the building of houses in adequate numbers and capable of being let at reasonably low rentals. The Act is primarily intended to establish continuity in dealing with the housing problem and by a co-ordination of all the resources of the building industry to ensure the production of houses on a sufficient scale to meet the exigencies of the moment and to make provision for the growth of the population and for the replacement of unsatisfactory accommodation. The Act provides for a programme extending over 15 years and aims at the production at a gradually increasing annual rate of approximately two and a half-million houses in Great Britain. The Act further provides for a subsidy from the Exchequer of £9 per annum for 40 years (£12 in the case of agricultural parishes) in respect of houses built for letting, under certain specified conditions as to fair wages and as to the letting of the houses when built. In the case of houses not subject to these special conditions the subsidy is at the rate of £6 per annum for 20 years. These financial proposals should stimulate the mass production of houses both by Municipalities and by private enterprise, and there should be, given public-spirited co-operation between the various interests concerned in the production of houses, a progressive annual improvement in the existing deplorable housing situation. Overcrowding. The extent and prevalence of serious overcrowding in certain of the lower wards of the Borough has been referred to in previous Annual Reports. There is, unfortunately, little, if any, 91 ment to be recorded in this respect in the Annual Report for 1924. As there is no available building land in Battersea relief from the present congestion and overcrowding can only be obtained by the provision of an adequate number of working-class dwellings outside the Borough. In this connection, in order to assist the Borough Councils in alleviating cases of special hardship and overcrowding, the London County Council proposed, in a letter dated 30th October, as an experiment for the period of one year, to apportion among the Metropolitan Borough Councils a certain number of new dwellings on the basis of the number and proportion of inhabitants in each borough living more than two persons per room according to the census of 1921. The number of new dwellings to be allocated to applicants from Battersea under this scheme is to be at the rate of 15 per 1,000 houses in the Housing Estates in course of development by the County Council. It is estimated that Battersea's share in this allocation will be only 20 dwellings. Advantage has been taken by the Borough Council, so far as it goes, of this proposal, and selected applications were on the instructions of the Housing Committee sent to the London County Council. Unfortunately, this concession to the needs of the housing situation in Battersea will have little effect in the relief of overcrowding. New Houses Provided by the Borough Council. No new houses were erected by the Borough Council during 1924. New Houses Erected by Private Enterprise. During 1924 fifteen new houses were erected by private enterprise ; six on what is known as the Battersea Rise Estate (Chatto and Wisley Roads); four in Sudbrooke Road; four in Ramsden Road ; and one in Nightingale Lane. New dwellings, as under, were in course of erection but were not completed at the end of the year:— Battersea Rise 4 flats. Grandison Road 2 houses. Nightingale Lane 3 houses. Sudbrooke Road 2 houses. Repair of Unfit Houses. The repair of unfit houses was rigorously enforced during 1924, as in the four preceding years, and the large number of houses found on inspection to be more or less seriously defective or insanitary were reported to the Housing and Health Committees for action under the Housing, Town Planning, etc., Act, 1919, or the Public Health (London) Act, 1891. The policy of dealing with the more seriously defective houses under Section 28 of the 1919 Housing Act, and the procedure 92 carried out in relation thereto has been fully described in previous Annual Reports and a summarised statement of the work carried out under Section 28 during the year will be found on page 98 The powers under this section have proved a very potent factor in securing effective compliance with the requirements of the Council in badly dilapidated properties. Only in a relatively small number of cases is it found necessary to serve notices under the Section, and even where such action is required, it is in comparatively few instances that, in default of the owner, the powers of the Council have to be enforced by direct action. The majority of owners appreciate the consideration extended to them by the Housing Committee in allowing them to submit proposals for the repair of their properties by informal negotiation without recourse to the service of notices. During 1924 the number of cases in which it was found necessary for the Council to exercise their powers in default was 25, and the total expenditure incurred was £2,857 4s. 8d. The difficulties associated with the recovery of expenses incurred in the, fortunately infrequent, cases where the Council, in default of compliance with notices served under Section 28, have found it necessary to instruct the Works Department to enter and carry out the necessary works of repair, have been referred to in previous annual reports. Unfortunately the extent of the work required to put this type of house even into a reasonable state of fitness for habitation is so considerable as to render it practically impossible to recover the whole of the expenditure incurred in carrying out the repairs. In order to avoid or reduce the loss which may be incurred in carrying out their obligations in such cases the Council have made representations to the Ministry of Health as to the need for amendment of the Housing Acts so as to:— (i.) Facilitate proceedings to recover expenses incurred by a local authority under Section 28 of the Housing, Town Planning, &c., Act, 1919, where the "owner" cannot be found or ascertained. (ii.) Make it clear that any proceeding under such section is in order if taken against the person who is owner at the date of such proceeding. (iii.) Enable the local authority to deal more effectively with individual insanitary houses by repealing the words "and a closing order has in consequence been deemed to have become operative in respect thereof" in Section 10 (2) (d) of the Housing, &c., Act, 1923, and to substitute the words "and whether or no the owner has given the notice referred to in the proviso to such sub-section." (iv.) Amend Section 10 (2) (e) of the Housing, &c., Act, 1923, so as to enable the local authority when exercising their power of sale to convey the legal estate. 93 The Council were successful in securing amendments dealing with defects in the administrative procedure in other directions under this section, which, as stated in the Annual Report for 1923, were incorporated in the 1923 Housing Act. It is hoped that similar effect will be given to the representations now submitted for the further amendment of the Act. Closing Orders. No Closing Orders were made during 1924 under Sec. 17 (ii.) of the Housing, &c., Act, 1909. Underground Dwellings. During 1924, on the representation of the Medical Officer of Health under Section 17 (vii.) of the Housing, etc., Act, 1909, the Council made Closing Orders in respect of the following underground rooms which were illegally used for sleeping purposes:— Premises. Date Order made. 330 Battersea Park Road (front room) 27th February. 26 Leathwaite Road (front room) do. 146 St. John's Hill (front room) 30th April. In the case of No. 146 St. Johns Hill, in view of the risk to health, steps were taken in a court of summary jurisdiction to make the order operative. The Court made an order that this room should not be used for sleeping purposes but suspended its operation for two months. Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920 and 1923. During the year 1924, applications for the certificate of the Sanitary Authority under Section 2 of the Act of 1920 were received in respect of 27 premises. Of this number in 25 cases the certificates were granted and 2 applications were refused. In addition, 6 applications for the report of the Sanitary Authority under this section were received from owners, all of which were granted. The main provision of the amending Act of 1923 is to require particulars of the necessary repairs to accompany the certificate of the Sanitary Authority. The Council, on the recommendation of the Housing Committee, on May 28th, 1924, appointed a Special Committee to deal with applications for certificates and reports under the Increase of Rent, etc., Acts. 94 Action under Sec. 29 of Housing, &c., Act, 1919. During the year, 49 cases, relating to 73 houses, have been reported to the Housing Committee of owners who have collected rent in contravention of this section which prescribes that— "the name and address of the Medical Officer of Health for the district, and the name and address of the landlord or other person who is directly responsible for keeping the house in all respects reasonably fit for habitation, shall be inscribed in every rent book, or where a rent book is not used, shall be delivered in writing to the tenant at the commencement of the tenancy and before any rent is demanded or collected." In each case the requirement of the Section having been complied with, the Committee directed that cautionary letters were to be sent to the offenders. Insanitary Areas. No additional insanitary areas were represented during 1924. With regard to the Plough Road Scheme, as reported in last year's Annual Report, the formal order of the Ministry of Health was made on 7th January, 1924. During the year negotiations were carried on with a view to the acquisition of the land comprised in this area. It was later in the year decided to proceed at once with the erection of a block of six tenements on the vacant plot of land in the area, each tenement containing three rooms, scullery, bathroom, etc. It is expected that this block, the cost of which is estimated to be £4,394 5s., will be completed early in 1925. The accommodation in these tenements will be utilised to re-house the occupants of the next block of houses to be demolished, and it is intended in this way, by proceeding block by block, to deal with the re-housing of the displaced tenants. By-Laws—Houses-Let-in-Lodgings. Reference was made in the Annual Report last year to the Bylaws which the London County Council were required to make under section 94 of the Public Health (London) Act, 1891, as amended and extended by section 26 of the Housing, Town Planning, &c., Act, 1919. By-laws were made by the London County Council in 1920 for confirmation by the Ministry of Health, but have not yet been confirmed. The County Council, however, gave notice that they were seeking powers under the Housing Bill (No. 2), 1923, to amend section 26 of the 1919 Housing Act under which these bylaws were required to be made, before completing the revision of the draft by-laws. Draft by-laws under Section 94 of the Public Health (London) Act, as amended and extended by Section 26 of the 1919 Housing Act and Section 14 of the 1923 Housing Act, were made by the London County Council and submitted to the Borough Councils 95 for their observations. The Council decided to approve the by-laws, but exception was taken to the words " as far as practicable" at the commencement of By-law No. 9, dealing with the separation of the sexes. Insanitary Houses. The following is a list of streets in the Borough in which houses were found, on inspection, to be insanitary, and were dealt with by the Council under the provisions of the Housing Act of 1919, either informally or by the service of notice under Section 28 of the Act, during 1924 :— Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. No. 1 District. Belfour Street 3 Patmore Street I Wadhurst Road 4 Chalmers Street 1 Power Street 2 Woodgate Street 1 Gonsalva Road 1 Savona Street 4 Total :—8 streets, 17 houses. No. 2 District. Abercrombie St. 26 Gaines Cottages 2 Orkney Street 2 Alfred Street 1 Gladstone Terrace 3 Oulton Street 6 Arthur Street 4 Henley Street 55 Raywood Street 2 Austin Road 2 Kersley Street 1 Sheepcote Lane 1 Blondel Street 1 Longhedge Street 3 Stewarts Lane W. 1 Total :—15 streets, 110 houses. No. 3 District. Balfern Street 1 Elcho Street 3 Hyde Lane 1 B'sea Bridge Road 3 Frances Street 2 Inworth Street 3 Bolingbroke Rd. 9 Goulden Street 2 Orbel Street 1 Bullen Street 1 Granfield Street 2 Park Road 1 Castle Street 2 Henry Street 1 Rosenau Road 1 Church Road 3 High Street 2 Surrey Lane 4 Colestown Street 1 Home Road 1 Winstead Street 18 Total21 streets, 62 houses. No. 4 District. Andoe Road 1 Kambala Road 1 Newcomen Road 1 Barmore Street 1 Kerrison Road 3 Shillington Street 14 Benfield Street 11 Khyber Road 4 Simpson Street 2 Cabul Road 2 Knox Road 1 Stain forth Road 3 Candahar Road 1 Latchmere Grove 5 Totteridge Road 2 Creek Street 3 Lavender Road 4 Urswick Road 1 Duffield Street 3 Lithgow Street 2 Verona Street 2 Este Road 2 Lombard House 1 Way ford Street 2 Gwynne Road 13 Lubeck Street 3 Winstanley Road 4 Harroway Road 3 Mantua Street 1 Wye Street 1 High Street 2 Meyrick Road 5 Yelverton Road 2 Ingrave Street 41 Musjid Road 9 York Road 1 Total :—36 streets, 157 houses. 96 No. 5 District. Basnett Road 1 Elsley Road 1 Shellwood Road 1 Beaufoy Road 6 Knowsley Road 5 Tyneham Road 1 Dorothy Road 1 Latchmere Road 1 Wickersley Road 1 Eland Road 1 Mossbury Road 2 Wycliffe Road 12 Total :—12 streets, 33 houses. No. 6 District. Abyssinia Road 2 Hope Street 39 Plough Road 1 Cairns Road 1 Knox Road 1 Sewell Road 1 Didcot Street 4 John Street 1 Speke Road 4 Eldred Place 1 Linda Street 27 Stockwood Street 18 Grant Road 16 Livingstone Road 4 Usk Road 3 Harbut Road 5 Mendip Road 1 Winstanley Road 3 Hibbert Street 67 Middleton Road 3 York Road 1 Total :—21 streets, 203 houses. No. 7 District. St. John's Road I Stormont Road 1 No. 8 District. Darley Road 1 Summary. No. 1 District 8 streets 17 houses. „ 2 „ 15 „ no „ ,, 3 ,, *21 „ 62 „ „ 4 „ *36 „ 157 „ „ 5 „ 12 „ 33 „ „ 6 „ *20 „ 203 „ ,, 7 „ 2 „ 2 „ „ 8 „ 1 „ 1 „ Totals *111 streets 585 houses •High Street included in both 3 and 4 Districts. Knox Road, Winstanley Road and York Road included in both 4 and 6 Districts. The following is a list of streets in the Borough in which houses were the subject of action, either informally or by the service of notice, under section 28 of the Housing Act of 1919, but the necessary works of repair had not been completed during 1923. Street. Houses dealt with Street. Houses dealt with. Street. Houses dealt with. No. 1 District. Ascalon Street 5 Dashwood Road 14 Sterndale Road 36 B'sea Park Road i Linford Street 1 Stewarts Road 12 Belfour Street 24 New Road 1 Stockdale Road 24 Corunna Road 1 Patmore Street 1 Tweed Street 13 Currie Street 4 Savona Street 1 Woodgate Street 12 Total:—15 streets, 150 houses. 97 No. 2 District. Alfred Street 2 Henley Street 6 Lockington Road 1 Anerley Street 2 Kennard Street 1 Palmerston Street 9 Arthur Street 1 Kilton Street 1 Rollo Street 1 Brougham Street 1 Latchmere Road 1 Weybridge Street 1 Culvert Road 4 Total :—13 streets, 31 houses. No. 3 District. Castle Street 1 Orville Road 17 Randall Street 1 Church Road 3 Parkham Street 2 Surrey Lane 1 Green Lane 6 Total :—7 streets, 31 houses. No. 4 District. Benfield Street 1 Latchmere Grove 1 Newcomen Road 1 Currie Road 1 Lavender Road 4 Shillington St. 1 Gwynne Road 1 Lubeck Street 1 Stainforth Road 1 Heaver Road 1 Meyrick Road 1 Urswick Road 12 Ingrave Street 7 Musjid Road 1 Winstanley Road 2 Khyber Road 1 Total :—16 streets, 37 houses. No. 5 District. Nil. No. 6 District. Abyssinia Road 2 Eldred Place 6 Livingstone Road 6 Aliwal Road 1 Grant Road 2 Tritton Street 16 Britannia Place 8 John Street 3 Way land Road 8 Darien Road ... 1 Total :—10 streets, 53 houses. No. 7 District. Nil. No. 8 District. Nil. Summary. No. 1 District 15 streets 150 houses. „ 2 ,, 13 „ 31 „ „ 3 „ 7 „ 31 „ „ 4 „ 16 „ 37 „ „ 6 10 „ 53 „ Totals 61 streets 302 houses 98 Statistics for the Year ending 31st December, 1924. 1. General. (а) Estimated population 171,000 (б) General death rate 11.8 per 1,000 (c) Death rate from tuberculosis 1.11 per 1,000 (d) Infantile mortality rate 62.4 per 1,000 (e) Number of premises used as habitations by all classes 27,844 (/) Estimated number of working-class dwelling- houses 24,953 (g) Number of new working-class dwellings erected 15 2. Unfit Dwelling-Houses. (a) Inspection— (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,609 (b) Number of dwelling-houses which were spected and recorded under the Housing (Inspection of District) Regulations, 1910 3,669 (c) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (d) Number of dwelling-houses (exclusive of those referred to under the previous heading) not found to be in all respects reasonably fit for habitation 3,547 (b) Remedy of defects without service of formal notice— Number of dwelling-houses rendered fit in consequence of informal action by the local authority or their officers 522 (c) Action under Statutory Powers— (I.) Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919— (a) Number of dwelling-houses in respect of which notices were served requiring repairs 81 (b) Number of dwelling-houses which were rendered fit— (i.) By owners 130 (ii.) Work commenced by Local Authority but workmen subsequently withdrawn and work completed by owner 12 99 (iii.) Work commenced by owner but workmen subsequently withdrawn and work completed by Local Authority 5* (iv.) By Local Authority in default of owners 8 (a) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil (II.) Proceedings under Public Health Acts— (a) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,961 (b) Number of houses in which defects were remedied— (i.) By owners 2,969 (ii.) By Local Authority in default of owners 1 (III.) Proceedings under Sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909— (a) Number of representations made with a view to the making of Closing Orders Nil (b) Number of dwelling-houses in respect of which Closing Orders were made Nil (c) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil (id) Number of houses in respect of which Demolition Orders were made Nil (e) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 3. Unhealthy Areas. Areas represented to the Local Authority witfi a view to improvement schemes under (a) Part I. or (b) Part II. of the Act of 1890:— Nil. *In addition there was one house at which the local authority entered to complete the work, but the repairs were not finished in 1924. 100 4. New Houses. Number of houses not complying with the building by-laws erected with the consent of the Local Authority under Section 25 of the Housing, Town Planning, etc., Act, 1919:— 15 5. Staff. Staff engaged on Housing work, with briefly the duties of each officer:— 1. Medical Officer of Health. 2. Chief Sanitary Inspector. Housing Inspector. Seven District Sanitary Inspectors. 3. Two Clerks (mainly engaged on matters relating to Housing work). 101 TABLE I. (Required by the Ministry of Health to be used in the Annual Report of the Medical Officer of Health.) Vital Statistics of Whole District during 1924 and Previous Years. Year. Population estimated to middle of each Year. Births. Total Deaths registered in the district. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Number. Rate. * of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate.* Number Rate per 1,000 Net Births. Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13[/###} 1914 167,338 4,080 4,303 25.7 2,470 14.4 685 432 397 92 2,217 13.2 1915 161,945 3,604 3,820 23.6 2,992 18.5 798 459 428 112 2,653 16.4 19161 173,432 B.† 159,402 D.† 3,523 3,774 21.8 2,502 15.7 705 424 318 84 2,221 13.9 1917 167,233 B.† 150,023 D.† 2,709 2,960 17.7 2,567 17.1 727 445 299 101 2,285 15.2 1918 168,014 B.† 149,951 D.† 2,407 2,700 16.1 3,195 21.3 857 471 267 99 2,809 18.7 1919 165,960 B.† 159,316 D.† 2,765 3,075 18.5 2,409 15.1 730 382 228 74 2,061 12.9 1920 166,093 B.† 165,664 D.† 4,218 4,669 28.1 2,393 14.4 700 386 386 83 2,079 12.5 1921 169,200 3,580 3,742 22.1 2,445 14.5 800 415 276 74 2,060 12.2 1922 169,200 3,577 3,665 21.1 2,679 15.8 864 412 254 69 2,227 13.2 1923 170,600 3,415 3,434 20.1 2,368 1.0 874 345 170 49 1,839 10.8 1924 171,000 3,180 3,139 18.4 2,506 14.7 858 370 196 62 2,018 118 Area of District in acres (land and inland water), 2,163 acres. Total population at all ages, 167,739 ; number of occupied separate dwellings, 27,191 ; average number of persons per occupied separate dwelling, 6.17 (Census Report 1921). * Rates calculated per 1,000 of estimated population. t Registrar General's estimated population for purposes of calculating:—(B), birth-rate ; (D), death-rate. 102 TABLE II. (Required, by the Ministry of Health to be used in the Annual Report of the Medical Officer of Health.) Cases of Infectious Disease notified during the Year 1924. Notifiable Disease. Cases Notified in the Borough of Battersea. Total Cases Notified in each Sub-District No. of Cases Removed to Hospital from each Sub-District. At all Ages. Under 1 year. 1 to 5 years. 5 to 15 years. 15 to 25 years. 25 to 65 years. 65 years and upwards. E. N.W. S.W. E. N.W. S.W. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 372 3 130 190 33 16 ... 191 129 52 191 129 52 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 75 ... 5 9 6 45 10 41 21 13 11 3 3 Scarlet Fever 378 2 121 212 29 14 ... 162 120 96 162 119 71 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 6 ... ... 1 1 4 ... 4 ... 2 3 ... 1 Puerperal Fever 15 ... ... ... 8 7 ... 3 7 5 3 7 4 Cerebro-Spinal Fever 4 1 3 ... ... ... ... 2 2 ... 1 2 ... Ophthalmia Neonatorum 41 41 ... ... ... ... ... 13 21 7 1 2 2 Polio-myelitis, &c. 9 1 7 1 ... ... ... 3 3 3 1 1 1 Encephalitis Lethargica 12 ... ... ... ... 12 ... 5 3 4 3 2 4 Polio-encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria 2 ... ... ... ... 2 ... 2 ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Influenzal Pneu. 167 7 26 9 17 94 14 62 73 32 19 13 13 Acute Primary Pneu. 336 41 115 41 22 88 29 153 140 43 55 31 16 Totals 1,417 96 407 463 116 282 53 641 519 257 450 309 167 T uberculosis— Pulmonary 246 ... 4 19 70 148 5 109 71 66 ... ... ... Non-Pulmonary 105 2 23 53 11 16 ... 38 48 19 ... ... ... Totals (Tuberculosis) 351 2 27 72 81 164 5 147 119 85 ... ... ... Totals 1,768 98 434 535 197 446 58 788 638 342 450 309 167 Whooping Cough* 511 75 335 95 1 5 ... 115 284 112 9 4 5 Measles* 1,893 107 1,058 671 42 15 ... 932 504 457 103 62 11 Grand totals 4,172 280 1,827 1,301 240 466 58 1,835 1,426 911 562 375 183 * Notifiable in Battersea from 24th April, 1922. 103 TABLE III Causes of, and Ages at Death during the Year 1924. CAUSES OF DEATH. All Ages. Nett Deaths at subjoined ages of " Residents" whether Occurring within or without the District. Total Deaths of " Residents " and " NonResidents " in Institutions in the District. 0-1 year. 1-2 years. 2-5 years. 5-15 years. 15-25 years. 25-45 years. 45-65 years. 65 years upward. 1. Enteric Fever 2 ... ... ... ... ... 1 1 ... ... 2. Small-pox ... ... ... ... ... ... ... ... ... ... 3. Measles 51 10 26 14 1 ... ... ... ... 39 4. Scarlet Fever 3 ... 2 1 ... ... ... ... ... ... S. Whooping-cough 17 10 1 6 ... ... ... ... ... 11 6. Diphtheria 25 ... 1 15 8 ... 1 ... ... ... 7. Influenza 84 4 3 5 1 1 11 33 26 31 8. Encephalitis Lethargica 5 ... ... ... ... ... 4 1 ... 6 9. Meningococcal Meningitis 3 ... 1 2 ... ... ... ... ... ... 10. Tuberculosis of Respiratory System 153 1 ... ... 4 39 69 35 5 93 11. OtherXuberculous Disease 37 1 6 3 10 5 4 8 ... 29 12. Cancer 231 ... ... ... ... 2 24 112 93 194 13. Rheumatic Fever 7 ... ... ... 4 2 1 ... ... 5 14. Diabetes 9 ... ... ... ... 1 ... 8 ... 9 15. Cerebral Haemorrhage, etc. 75 1 ... ... ... ... 2 25 47 82 16. Heart Disease 348 ... ... ... 4 8 17 94 225 297 17. Arterio-Sclerosis 54 ... ... ... ... ... 2 13 39 13 18. Bronchitis 183 15 3 ... 2 ... 8 36 119 58 19. Pneumonia (all forms) 159 35 27 10 4 ... 17 35 31 89 20. Other Respiratory Diseases 20 ... ... ... ... ... 6 7 7 17 21. Ulcer of Stomach or Duodenum 19 ... ... ... ... ... 8 9 2 20 22. Diarrhoea, Ac. 24 19 4 ... ... ... • • • ... 1 18 23. Appendicitis and Typhlitis 13 ... ... 1 2 4 2 3 1 15 24. Cirrhosis of Liver 11 ... ... ... ... ... ... 8 3 9 25. Acute and Chronic Nephritis 53 ... ... ... 1 1 10 19 22 51 26. Puerperal Sepsis 4 ... ... ... ... 4 ... ... ... 9 27. Other diseases of Pregnancy 5 ... ... ... ... 1 4 ... ... 8 28. Congenital Debility and Malformation, Premature Birth 77 73 2 ... 1 ... 1 ... ... 28 29. Suicide 18 ... ... ... ... 1 8 8 1 10 30. Other Deaths from Violence 54 ... 1 3 4 7 15 8 16 72 31. Other Defined Diseases 273 27 4 5 15 10 24 59 129 242 32. Causes ill-defined or unknown 1 ... ... ... ... ... 1 ... ... ... All cases { M. 989 111 46 29 32 39 121 292 319 731 {F 1029 85 35 36 29 47 119 230 448 724 Totals 2018 196 81 65 61 86 240 522 767 1455 104 East Battersea. TABLE IV. Infant Mortality, 1924. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 1 ... 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Bronchitis ... ... ... ... ... ... ... ... ... 1 ... 1 2 ... 2 2 1 1 ... 1 5 5 Pneumonia (all forms) ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 3 1 4 ... 3 4 12 5 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... 2 2 ... 1 5 3 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 5 5 1 4 i 2 1 1 ... ... 8 12 2 2 1 ... ... ... ... ... 11 14 Congenital Malformation ... ... 2 ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... 3 ... Congenital Debility 1 ... ... 1 ... 1 ... ... ... ... 1 2 ... 2 2 ... ... ... ... ... 3 4 Icterus Neonatorum ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis & Asphyxia Neonatorum 1 2 ... 1 ... ... ... ... ... ... 1 3 ... ... ... ... ... ... ... ... 1 3 Lack of Care 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Convulsions ... ... 1 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 ... 2 1 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... 1 ... ... 1 ... ... ... ... 1 1 ... 1 ... 1 ... ... ... 1 1 4 8 7 6 7 1 4 1 1 3 1 19 20 6 5 11 6 8 4 7 9 51 44 Totals 15 13 5 2 4 39 11 17 12 16 95 Nett Births in the year. Legitimate. Illegitimate. Total. 1369 42 1411 Nett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. 89 6 95 105 North-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1924. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 2 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... T uberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 2 ... Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... 3 2 3 1 3 1 2 1 11 5 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... 3 ... 1 1 9 1 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 3 ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 1 ... 4 5 ... 2 ... 1 ... ... 5 8 3 ... 1 ... ... ... ... ... 9 8 Congenital Malformation ... ... ... ... ... ... 1 ... ... 1 1 1 ... ... ... ... ... ... ... ... 1 1 Congenital Debility ... ... ... 1 ... ... 1 ... ... ... 1 1 2 1 1 ... ... ... ... ... 4 2 Icterus Neonatorum ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis and Asphyxia Neonatorum ... ... 1 1 ... ... ... 1 ... ... 1 2 ... ... ... ... ... ... ... ... 1 2 Lack of Care ... 2 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... 2 1 Totals 1 2 5 8 2 2 2 2 ... 1 10 15 11 3 11 2 8 1 6 5 46 26 3 13 4 4 1 25 14 13 9 11 72 Nett Births in the year. Legitimate. Illegitimate. Total. 1027 44 1071 Nett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. 65 7 72 106 South-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1924. Nett Deaths from stated causes at various ages under 1 year. causes of death. age periods. Under 24 hours. 1-7 clays. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-3 6-9 9-12 M. F. M. F. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. f. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 i 2 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 3 1 4 Diphtheria & Croup... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 2 1 Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 2 ... Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Gastritis ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Syphilis ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 3 ... 1 ... ... 1 ... 1 ... ... 4 2 ... ... ... ... ... ... ... ... 4 2 Congenital Malformation ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 2 ... Congenital Debility ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Icterus Neonatorum. ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Injury at Birth ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Atelectasis & Asphyxia Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 3 ... 2 ... 1 2 1 3 ... ... 7 5 3 1 1 ... 1 3 2 6 14 15 3 2 3 4 ... 12 4 1 4 8 29 Nett Births in the year Sfett Deaths in the year(Infants under 1 year) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 635 22 657 26 3 29 107 Borough of Battersea. TABLE IV.—(contd.) Infant Mortality, 1924. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 w eeks. Months. Total deaths under 1 year. Percentage of Total. 1-2 2-3 3-1 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 4 2 4 6 5.1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 6 3 7 5.1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 1 ... ... 1 1 3 2.0 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 0.5 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 0.5 Bronchitis ... ... ... ... 1 ... ... ... ... 1 1 1 4 ... 3 2 1 1 ... 2 9 ... 7.7 Pneumonia (all forms) ... ... ... ... ... ... ... ... 1 ... 1 ... 5 2 6 2 8 1 5 5 25 10 17.9 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 6 ... 5 2 1 3 14 5 9.7 Gastritis ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 0.5 Syphilis ... ... ... ... ... ... 1 ... 1 ... 2 ... 1 ... 1 ... 1 ... ... ... 5 ... 2.6 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 9 5 7 9 1 5 1 3 ... ... 18 22 5 2 1 ... ... ... ... ... 24 24 24.5 Congenital Malformation ... ... 2 ... 1 ... 1 ... ... 1 4 1 l ... 1 ... ... ... ... ... 6 1 3.6 Congenital Debility 1 ... ... 2 ... 1 1 ... ... ... 2 3 2 3 3 ... ... 1 ... ... 7 7 7.1 Icterus Neonatorum ... ... 1 ... 1 ... ... ... ... ... 2 ... ... 1 ... ... ... ... ... ... 2 1 1.5 Injury at Birth ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 0.5 Atelectasis & Asphyxia Neonatorum 1 2 1 2 ... ... ... 1 ... ... 2 5 ... ... ... ... ... ... ... ... 2 5 3.6 Lack of Care 1 2 ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... 1 2 1.5 Convulsions ... ... 2 1 ... ... ... ... ... ... 2 1 ... ... ... ... ... ... 1 ... 3 1 2.0 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... 1 1 ... 1 ... ... ... ... 1 2 1 1 ... 1 1 ... ... 1 3 5 4.1 12 9 14 15 4 8 4 6 3 2 37 40 20 9 22 8 17 8 15 20 111 85 100.0 Totals 21 29 12 10 5 77 29 30 25 35 196 — Percentage of Total 10.7 14.8 6.1 5.1 2.6 39.3 14.8 15.3 12.7 17.9 100.0 - M. 56.6% F. 43.4% Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate Total. Legitimate. Illegitimate. Total. M. 1,597 61 1,658 101 10 111 F. 1,434 47 1,481 79 6 85 Totals 3,031 108 3,139 180 16 196 108 POPULATION OF BATTERSEA AND COUNTY OF LONDON—I. OCCUPATIONS. Proportions of Males per 1,000 aged 12 years and upwards engaged in the following occupations. Proportions of Females per 1,000 aged 12 years and upwards engaged in the following occupations. Battersea. London. Battersea. London. Pr'p'n per 1,000. Number engaged. Pr'p'n per 1,000. Number engaged. Pr'p'n per 1,000. Number engaged. Pr'p'n per 1,000. Number engaged. 1 Fishermen 0 1 0 46 - - 0 1 2 Agricultural 3 170 5 7,732 0 4 1 435 3 Mining and Quarrying 0 23 0 477 0 1 0 6 4 Workers in Non-Metallic Products 0 26 0 617 0 4 o 150 5 Makers of Bricks and Pottery, &c. 4 255 1 1,109 3 72 2 585 ,, Glass and Glassware 2 108 3 4,449 12 1,097 6 Chemical Processes 8 498 5 7,717 11 258 4 3,277 7 Metal Workers, not Precious 81 4,882 72 115,674 8 200 11 8,562 8 Workers in Precious Metals and Electro Plate 2 146 3 5,482 1 21 1 1,017 9 Electrical Apparatus Workers 16 986 15 24,171 2 38 6 4,622 10 Watches, Clocks and Scientific Instruments 2 147 3 5,348 0 9 1 448 11a Furriers, Tanners, Leather Dressers 1 48 5 7,238 43 3,998 116 Makers of Leather and Leather Substitute Goods 2 147 4 5,630 3 37 10 4,434 12 Textile Workers 1 42 2 2,750 5 129 5 3,974 13 Makers of Textile Goods and Dress 17 1,016 33 52,909 128 3,134 145 113,056 14 (1) Makers of Food 16 978 12 19,177 607 12,100 (2) ,, Drink 3 201 4 5,965 33 87 24 2,039 (3) „ Tobacco, &c. 1 58 1 2,045 122 4,918 15 (1) Woodworkers 36 2,160 40 64,709 8 90 9 4,088 16 (2) Upholsterers, &c. 3 170 3 5,434 116 2,775 (1) Papermakers 0 23 0 489 33 412 (2) Printers, Binders and Photographers 20 1,202 24 38,970 28 318 40 17,001 17 (3) Workers in Paper Goods, Stationery, &c. 1 63 2 3,082 330 13,715 Builders, Stoneworkers, &c. 41 2,455 29 45,565 0 10 o 165 18 Painters and Decorators 30 1,799 23 36,609 1 25 1 633 19 Workers in other materials 2 150 3 5,075 6 148 7 5,699 20 ,, mixed „ 7 399 8 13,641 15 370 12 9,590 21 Gas, Water and Electricity Workers 6 379 4 6,014 0 5 0 64 22 (1) Railway Workers 39 2,347 19 30,145 11 183 (2) Road Transport 64 3,826 66 104,811 24 36 16 667 (3) Water Transport 8 463 26 41,011 7 269 (4) Other Transport and Communications 50 3,005 48 77,042 545 11,729 23 Commerce, Finance and Insurance 93 5,571 102 163,292 93 2,282 80 62,481 24 (1) Public Administration 36 2,160 34 53,834 35 854 23 17,817 (2) Defence 6 388 12 18,442 - - - - 25 Professional occupations 24 1,442 29 46,412 69 1,694 65 50841 26 Entertainments and Sports 8 456 9 13,991 8 184 10 7,495 27 Personal Service 36 2,169 48 77,384 290 7,079 357 278,747 28 Clerks, Draughtsmen and Typists 72 4,349 64 102,087 166 4,052 125 97,565 29 Warehousemen, Storekeepers and Packers 25 1,491 28 44,753 40 967 32 25,258 30 Stationary Engine, Dynamo and Motor Attendants 10 589 7 10,785 0 2 31 Other and Undefined Workers 87 5,227 71 113,588 23 518 13 8,896 32 Unoccupied or Retired 137 8,204 133 214,383 — — — — Occupied persons over 12 1,000** 52,015* 1,000** 1,385,701* 1,000* 24,452* 1,000* 780,511* Unoccupied persons over 12 — 8,204 — 214,383 — 46,005 — 1,165,317 Persons under 12 — 18,439 — 471,495 — 18,624 - 467,116 Census Population Males 78,658 2,071,579 89,081 2,412,944 Females 89,081 2,412,944 TOTAL 167,739 4,484,523 *Not including unoccupied persons. **Including unoccupied males. 109 II—AGE, DISTRIBUTION AND MARITAL CONDITION. Residents of Average Age. Age Distribution per 1,000 of the Population. Number of Females to every 1,000 Males. Males. Females. M. F. 0/4 5/19 20/39 40/up 0/4 5/19 20/39 40/up County of London 30.0 31.4 92 286 304 318 77 259 339 325 1,165 Battersea M.B. 29.6 31.1 91 299 300 310 83 271 320 326 1,133 Marital Condition per 1,000 of the Population. Married Women under 45 years of age per 1,000 Females of all Ages. Males. Females. Single. Married. Widowed or Divorced. Single. Married. Widowed or Divorced. County of London 547 418 35 542 364 94 228 Battersea M.B. 536 431 33 522 387 91 238