BAT23 AC 4386 Metropolitan Borough of Battersea. REPORT ON THE HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1925 by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. wlghtman & Co., Ltd., Printers, 104, Regency Street, S.W. 1. Battetsea Borough Council With the Compliments of the Medical Officer of Health. MUNICIPAL BUILDINGS, LAVENDER HILL, S.W BAT 23 Metropolttan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1925 G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. 1 Health Committee. 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. As constituted 9th November, 1925. Chairman: Councillor J. Hendrick. His Worship the Mayor (Councillor C. H. Young, j.p.) Councillor Mrs. T. Amphlett. „ W. F. Andrews. Alderman J. R. Archer. Councillor F. A. Cazalet „ E. W. Coles. ,, C. S. King. „ G. H. Lawther. „ R. Moore. Alderman Mrs. M. J. Robinson. Councillor Mrs. M. H. Rose. „ G. Weadriff. Maternitp and Child Welfare Committer. 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. As constituted 9th November, 1925. Chairman: Councillor Mrs. M. H. Rose. His Worship the Mayor (Councillor C. H.Young, 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. Housing Committee. 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. As constituted 9th November, 1925. Chairman: Councillor H. Harling. His Worship The Mayor (Councillor C. H. Young, j.p.) Councillor Mrs. T. Amphlett. ,, J. Bruce. „ D. Carmichael. Alderman G. Fineran. Councillor W. Geard. ,, J. G. McIntyre. „ W. J. McIver. Alderman C. J. Powell. ,, A. E. Samuels, ll.b. Councillor E. S. Strange, j.p. „ H. G. White, 2 Committer to issue certificates and reports under the Kent and Mortgage Interest Restrictions Act, 1920 and 1923, as to the condition of dwelling houses. 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. As constituted 9th November. 1925. Chairman: Councillor H. Harling. His Worship the Mayor. (Councillor C. H. Young, j.p.) Councillor W. Geard. Alderman C. J. Powell. Councillor E. S. Strange, j.p. ,, H. G. White. Tuberculosis Committee. As constituted 10th November, 1924. The Health Committee, as above. As constituted 9th November, 1925. The Health Committee, as above. Tuberculosis Care Committee. 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). As constituted 9th November, 1925. Chairman—Mr. J. R. Archer. Councillor W. F. Andrews. „ J. Hendrick. „ R. Moore. „ J. Morgan. „ Mrs. M. H. Rose Other Member: Mrs. J. Hockley. 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: L.C.C. District Organiser for Children's Care Committee Work (Miss Thomas) Representative of the War Pensions Committee (Mr. F. H. Richardson). Representative of the Invalid Children's Aid Association. Lady Almoner, St. Thomas's Hospital (Miss Cummins). After-Care Sister, Victoria Hospital (Miss Underwood). Tuberculosis Almoner, St. George's Hospital (Miss Hamilton), Lady Almoner, King's College Hospital (Miss Edmonds). Representative of the S.L. District Nursing Association (Miss A. M. Stanford). Representative of the London Insurance Committee (Mr. R. A. Hanson). Lady Almoner, Brompton Hospital (Miss Marx). 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, 1925). I ubercutosis 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—Mi. 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, M. & C.W. Records. Maternity Home— Matron—Miss C. Dickson, Cert. C.M.B. 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. 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 1925. The Annual Report for 1925, in accordance with the requirements of the Order No. 648 issued by the Ministry of Health, is in the nature of a "Survey" Report, i.e., the report should deal every five years, not only with the health of the ISorough for the year under review, but should be retrospective in character and should include a survey of the progress made during the previous five years in the public health. Although the report for 1925 follows the lines of previous Annual Reports, so far as practicable the suggestions of the Ministry as to its compilation as a quinquennial record of the measure of progress achieved have been kept in view. There is no outstanding feature to be recorded in this "survey" report; nevertheless, the year under review has been from the standpoint of public health a satisfactory one for the Borough. The birth-rate (18∙5 per 1,000) for the year shows little change as compared with the two preceding years. It is at least satisfactory to note that the steady fall which has characterized this feature of the vital statistics of the Borough for the past two or three decades appears to have been arrested. The General death-rate (10∙5 per 1,000) is the lowest recorded in the Borough. The Infant Mortality-rate (58.0 per 1,000 births) was also lower than in 1924, and is the lowest rate (with the exception of 1923) yet recorded in Battersea. There was a decline in the incidence and in the death-rate from thp principal infectious diseases as compared with the previous year. The Health Services of the Council included in the Maternity and Child Welfare Scheme have produced excellent results which are reflected in the vital and morbid statistics for the year under review. There has been a considerable increase in the number of patients admitted to the Borough Maternity Hospital as compared with previous years, and the popularity and usefulness of this institution have increased. It is, moreover, most gratifying to note that notwithstanding the large increase in the number of beds occupied not a single maternal death has occurred in the Hospital during the year. From the administrative point of view, it is also satisfactory to record that the cost per bed has been substantially reduced. The development of Ante-Natal Supervision referred to in my last Annual Report has fully realised expectations during 5 the year, and even more useful developments may be expected to follow this and other activities of the Council's scheme when the new Maternity and Child Welfare Building is ready for occupation. Housing Activities during 1925 have had to be restricted chiefly to the repair of unfit houses, and the year's work in this direction has been satisfactory. Progress has been made with the Plough Road Improvement Scheme, and at least one block of the new tenements was occupied before the year ended. It is with regret that I have again to point out that the serious overcrowding and congestion in many parts of the Borough through lack of adequate housing accommodation have not been materially relieved, and many cases of serious hardship and even of dangerous overcrowding have come to the knowledge of the Health Department during the year, in regard to which, in most cases, little could be done to remedy the situation. The high position amongst the Metropolitan Cities and Boroughs, which Battersea has attained in regard to its health statistics, will be seen from an inspection of the table on page 21. In conclusion, I desire again to express my acknowledgments for the support given me by the Chairmen of the Health, Maternity and Housing Committees, and the Members of the Borough Council. I have also to acknowledge the invaluable assistance rendered to me by my colleagues, the Chief Officers of the Council. To the Outdoor and Clerical'Staffs of the Public Health Department, my thanks are also due for services always loyally and willingly rendered. G. Quin LENNANE, Medical Officer of Health. Town Hall, Battersea, S.W. 6 CONTENTS. General. Page Constitution of Committees 1, 2 Staff of Public Health Department 3 Introduction 4, 5 Births, Marriages and Deaths. Natural and Social Conditions 9 Vital Statistics 8, 9, 107 Population 10 Marriages 11 Births and Birth-rates in Wards and Sub-districts 11-13 Illegitimate Births 13 Deaths in Borough 13 „ in Sub-districts, Wards, and Age Periods 14 „ in Public Institutions 15 „ Senile 15 „ Causes and Age Distribution 109 Comparative Table of Births, Deaths, &c. (1857-1925) 16 Infant Mortality 17-20, 131-134 Illegitimate Infant Deaths 20 Comparative Statistics, Metropolitan Boroughs 21 Notification of Births Act 21 Maternity and Child Welfare. Maternity and Child Welfare Scheme 22 Centres 23,24 Hospital Provision 24, 25 Nursing Facilities 25, 26 Health Visitors 26, 27 Milk Order 28 Ante-Natal Work 29 V.D 30-35 Maternal Mortality 35 Maternity Hospital 37 District Midwifery Service 40 Dental Clinic 41 Infectious Diseases—(i.) Notifiable 42 Summary of Notifications 43 Bacteriological Examinations 61,68 Contacts 42 Small-pox 42 Scarlet Fever 44 Diphtheria 44 Enteric Fever, Cerebro-Spinal Fever 47 Encephalitis Lethargica, Puerperal Fever 48 Polio-Myelitis 49 Ophthalmia Neonatorum 50 Erysipelas 51 Measles 51 Whooping-Cough 53 Tuberculosis 54-66 Cases Notified 54,55 Localisation of Disease 56 Deaths from Tuberculosis 55,57 Public Health (Tuberculosis) Regs. 1924 and 1925 57 Cases on Register 58 Dispensary 59 „ (Report of) 60 Institutional Treatment 61 Open-Air School (Day Sanatorium) 61 Care Committee 62 Training and Employment 62 Tuberculosis Dental Clinic 62 Non-Dispensary Patients 63,64 Summary Table 65,66 7 Page Infectious Diseases—continued. Zymotic Deaths 67 (ii.) Non-Notifiable Diseases 67 Chicken-pox 67 Diarrhoea 68 Influenza 69 Cancer 70 Sanitary Circumstances. Summary Table 71 Legal Proceedings 72-78 Summary of ditto 78 Common Lodging Houses 78 Drainage Work.78 Revenue Act, 1903 79 Licensed Premises Urinals 79 Smoke and Effluvium Nuisances 79 Water Supply 79 Van Dwellings 80 Rag Flock Act 80 Rats and Mice Destruction Act 80 Personal Cleansing Station 81 Disinfecting Department 82 Mortuary 83 Staff 83 Protection of the Food Supply. Unsound Food 84 Cow-Houses and Slaughter-Houses 84 Butchers' Shops 85 Public Health (Meat) Regulation, 1924 85 Sale of Food and Drugs Acts 86 Analysts' Reports 87-91 Milk and Cream Regulations 92 Milk and Dairies (Amendment) Act, 1922 92 Ice Cream 91, 94 Milk (Special Designation) Order, 1923 94 Milk Shops 94 Fish Shops, Restaurant Kitchens, Street Stalls 95 Factories, Workshops, &c.—General Tables 96 Factories 97 Workshops 98 Outworkers 99, 102 Bakehouses 101 Warehouses and Wharves 101 Housing. General 103 Overcrowding 103, 123 New Tenements and Houses erected 103, 104 Repair of Unfit Houses 104 Closing Orders 106 Underground Rooms 106 Increase of Rent, &c., Acts 106 Action under Section 5 107 Insanitary Areas 107 Houses Let in Lodgings—By-laws 107 Summary of Housing Work 108 Insanitary Houses 109-111 Statistics 112-114 Appendices. Overcrowding Report 115-124 Chuter v. Wooding 124-126 Table I. Summary of Vital Statistics 127 „ II. Infectious Disease Notifications 128 ,, III. Causes of, and Ages at, Death 129 ,, IIIa. Causes of Death 1921-5 130 IV. Infant Mortality 131-134 8 Summary of Statistics, 1925 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 1925) 172,100 Structurally separate occupied dwellings (Census, 1921) 27,191 Rateable value £1,044,020 Sum represented by a penny rate £4,293 2. Extracts from Vital Statistics of the Year. Births— (Males,1677; females, 1,507) 3,184 Legitimate births 3,078 Illegitimate „ 106 Birth-rate 18∙5 Deaths— (Males, 911, females, 894) 1,805 Death-rate 10∙5 Number of women dying in or in consequence of childbirth— From sepsis 3 Other causes 3 Death-rate of infants under 1 year per 1,000 births. Legitimate 56∙5 Illegitimate 113∙2 58∙4 Deaths from Measles (all ages) 4 ,, Whooping-cough (all ages) 20 ,, Diarrhoea (under 2 years of age) 16 Census, 1911— Population 167,743 Number of inhabited houses 24,321 9 Births, Marriages and Deaths. VITAL STATISTICS. Natural and Social Conditions. The Metropolitan Borough of Battersea, created in November, 1900, under the provisions of the London Government Act, 1899, was formed from the old parish of Battersea after some re-arrangement between the two districts of Battersea and Wandsworth to define the boundary line. The origin of the name Battersea, according to the recently issued and scholarly history of the district, "Our Lady of Battersea" (I. G. Taylor, B.A.), is from the Saxon Bat rices Ege, Badorisheah or Badrices Ege—the Island of Badric. It is a historic locality, and its earliest reference by the chroniclers is in 693 a.d., and later it is mentioned in Domesday Book, and was given by William of Normandy to the Abbey of Westminster. The Manor of Battersea, with "the Burgh of Wandlesworthe," remained an appanage of the Abbey of Westminster up to the time of Henry VIII., when, with the spoliation of the churches during the reign of that Monarch, it passed to other hands. Up to comparatively modern times Battersea was a picturesque hamlet on the Thames. It was not until late in the nineteenth century that it began to emerge from its rural environment, and some idea of its rapid growth will be gathered when it is known that so late as 1850 the population was only 15,000. The Borough as now constituted is bounded on the north by the Thames and on the west, south and east by the neighbouring boroughs of Wandsworth and Lambeth. It has an area (excluding water) of 2,139 acres, and a population of 171,200. There are 24,000 houses, including 27,000 separate tenements. The rateable value is £1,044,020, and a penny rate yields over £4,290. There are two Parliamentary Divisions (North and South). Thestatus of the population is in the main working-class. The manufactures carried on are comparatively few, so that the larger element of the population goes to work outside the Borough, and it is, therefore, mainly a residential working-class district of London. In the north and east districts there is a considerably higher density of population, and overcrowding is more prevalent as compared with the south and south-west districts. The housing accommodation, moreover, in the first-mentioned areas is inadequate and of markedly inferior condition and, as is to be expected, the vital and morbid statistics exhibit less favourable results. The chief occupations of male workers in Battersea are transport, building and allied trades, metal works and clerks, draughtsmen, &c. Amongst female workers (excluding those engaged in domestic duties) the principal employments are personal service, clerical, typists, dressmaking, embroidery, &c. 10 According to the census of 1921, there are 46,000 females over 12 "unoccupied" or "retired" in Battersea, mostly engaged in domestic duties at home. The occupations involving risk to health are practically negligible. Battersea is fortunate in the possession of fine open spaces, Battersea Park in the north, and Clapham and Wandsworth Commons in the south and south-west contributing greatly to the healthiness and natural amenities of the district. The Borough is low-lying in the north, where in parts it lies below high-water mark of the river, and in the past this area has been much liable to flooding in times of heavy storm. On the south and south-west the ground rises to a considerable height towards Clapham and Wandsworth Commons to the Balham plateau. The soil is chiefly clay with outcrops of gravel and isolated banks of sand or sandy loam. Along the river front there is a belt of alluvium laid down by the river where it overflowed its banks, and what is now the site of Battersea Park was mainly marsh land. Population. The population of the Borough as estimated by the RegistrarGeneral for the year 1925 is 172,100. 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, 1925. Males. Females. Total. East Battersea 34,238 37,078 71,316 North-West Battersea 23,815 25,402 49,217 South-West Battersea 22,651 28,916 51,567 Total 80,704 91,396 172,100 1. Nine Elms 13,633 14,386 28,019 2. Park 8,821 9,868 18,689 3. Latchmere 9,287 10,350 19,637 4. Shaftesbury 7,642 8,167 15,809 5. Church 9,296 9,681 18,977 6. Winstanley 10,222 10,930 21,152 7. St. John 3,686 5,106 8,792 8. Bolingbroke 8,707 10,764 19,471 9. Broomwood 9,410 12,144 21,554 Total 80,704 91,396 172,100 11 Marriages. The marriages registered in Battersea during 1925 numbered 1,382. The marriage-rate (i.e., the number of persons married per 1,000 of the population) was 16∙1. The marriage-rate in the Borough during the past five years is shown in the following table:— Year. Marriages. Marriage-Rate. 1921 1,482 17∙5 1922 1,404 16∙6 1923 1,352 15∙8 1924 1,367 16∙0 1925 1,382 16∙1 Mean, 1921-25 1397∙4 16∙4 Births. The number of births registered in the Borough during 1925 was 3,264 (1,713 males, 1,551 females, an excess of 162 males). Of this number 394 were transferred out, the permanent residence of the parents being outside the Borough, and 314 births occurring elsewhere were transferred here, giving on balance a total of 3,184 births relating to Battersea residents and a corrected birth-rate of 18∙5 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 779 692 1,471 North-West Battersea 518 495 1,013 South-West Battersea 380 320 700 The Borough 1,677 1,507 3,184 The following table shows comparative average birth-rates for quinquennial periods from 1877-81 to 1917-1921, and 12 rates 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 22.1 22.1 1922 20.5 20.9 21.7 1923 19.7 20.1 20.1 1924 18.8 18.7 18.4 1925 18.3 18.0 18.5 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 1925:— Ward Estimated Population, 1925. Number of Births. Birthrate. No. 1, Nine Elms 28,019 635 22∙7 No. 2, Park 18,689 406 21∙7 No. 3, Latchmere 19,637 371 18∙9 No. 4, Shaftesbury 15,809 265 16∙8 No. 5, Church 18,977 386 20∙3 No. 6, Winstanley 21,152 449 21∙2 No. 7, St. John 8,792 152 17∙3 No. 8, Bolingbroke 19,471 279 14∙3 No. 9, Broomwood 21,554 241 11∙2 The next table shows the birth-rates in the Borough and in the registration sub-districts in 1925, and during the previous decennium 1915-1924:— 13 Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 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 1924 18∙4 19∙9 21∙9 12∙8 Average 1915-1924 20∙8 22∙5 23∙7 15∙6 1925 18∙5 20∙6 20∙6 13∙6 Illegitimate Births. Of the total births registered as belonging to the Borough of Battersea 106 or 3∙33 per cent. were of illegitimate children as compared with 108 or 3∙44 per cent. in 1924, 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. 14 Death-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 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 1924 11∙8 11∙9 12∙5 11∙0 Average 1915-24. 13∙8 13∙9 14∙5 12∙9 1925 10∙5 10∙5 11∙0 10∙0 The death-rate per 1,000 inhabitants for each of the nine Wards is shown in the next table:— Ward. Estimated Population 1925. Number of Deaths. Deathrate. No. 1, Nine Elms 28,019 290 10∙3 No. 2, Park 18,689 201 10∙7 No. 3, Latchmere 19,637 241 12∙3 No. 4, Shaftesbury 15,809 153 9∙7 No. 5, Church 18,977 196 10∙3 No. 6, Winstanley 21,152 230 10∙9 No. 7, St. John 8,792 90 10∙2 No. 8, Bolingbroke 19,471 206 10∙6 No. 9, Broomwood 21,554 198 9∙2 The following table shows the age and sex distribution ol the total deaths (corrected) in Battersea during 1925:— Under 1 year. 1-5 5-10 10-15 15-25 25-45 45-65 65- Total. M 118 36 9 18 51 108 254 317 911 F 63 31 10 14 42 98 207 424 894 Ttls. 186 67 19 32 93 206 461 741 1,805 15 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 235 264 499 Second quarter 200 187 387 Third quarter 192 178 370 Fourth quarter 284 265 549 911 894 1,805 According to the factor supplied by the Registrar General for correction of the rate in reference to age and sex distribution, the corrected death-rate for Battersea during 1925 was 10.1. Deaths in Public Institutions. During 1925 the deaths of Battersea residents occurring in Public Institutions numbered 875. Of this number 596 occurred within and 279 outside the Borough. Of the total deaths in Public Institutions 579 occurred in Poor Law Institutions. Senile Mortality. During 1925 the deaths of 741 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 56 62 44 67 15 31 115 160 275 N.W. Battersea 47 50 34 49 3 11 84 110 194 S.W. Battersea 58 74 48 58 12 22 118 154 272 Borough of Battersea 161 186 126 174 30 64 317 424 741 16 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 37∙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 22∙1 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 1925 172,100 3,184 18.5 1,805 10∙5 64 1,379 * Population as estimated for purpose of (B) Birth-rate, (D) Death-rate, † Decrease. Qensys years in heavy type. 17 CHART showing the INFANTILE MORTALITY RATE (per 1,000 Registered Births) in Battersea from 1858 to 1925. 18 Infant Mortality. During 1925 the deaths of 186 infants were registered as belonging to Battersea. The total number of births registered during the year was 3,184, giving an infant mortality-rate of 58-4 per 1,000 births. There were only four Boroughs in the County of London with a lower infant mortality than Battersea. The infant mortality-rates in Bsattersea 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. Year. London. Battersea. 1901 148 163 1916 89 84 1902 139 136 1917 104 101 1903 130 135 1918 107 99 1904 144 147 1919 85 74 1905 129 131 1920 75 83 1906 129 126 1921 79∙6 73∙8 1907 116 115 1922 74∙4 69∙3 1908 113 107 1923 60∙4 49∙5 1909 108 107 1924 69∙0 62∙4 1910 103 97 1925 67∙0 58∙4 1911 129 124 1912 91 83 1891-1900 158 162 1913 105 111 1901-10 126 126 1914 104 92 1911-20 100 96 1915 112 112 The infant mortality-rate for the County of London for the year 1925 was 67∙0 per 1,000 births. The distribution of the 186 infant deaths and the infant mortality-rates, both for the registration sub-districts and the Wards are shown in the following table:— Registration Sub-Districts Births. Deaths of Infants under 1 year of age. Infant tality per 1,000 births. M. F. total. East Battersea 1,471 56 31 87 59∙1 North-West Battersea 1,013 41 27 68 67∙1 South-West Battersea 700 21 10 31 44∙3 The Borough 3,184 118 68 186 58∙4 Ward. 1. Nine Elms 635 23 18 41 64∙6 2. Park 406 19 8 27 66∙5 3. Latchmere 371 14 13 27 72∙8 4. Shaftesbury 265 10 1 11 41∙5 5. Church 386 14 11 25 64∙8 6. Winstanley 449 18 7 25 55∙7 7. St. John 152 7 2 9 59∙2 8. Bolingbroke 279 8 4 12 43∙0 9. Broomwood 241 5 4 9 37∙3 19 The next tables show the incidence of mortality from the chief diseases of infancy in the first four weeks of life and during the four trimesters:— Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1921 to 1925. Year. Under 24 hrs. 1 to 7 days. 1 to 4 weeks. Total under 4 weeks. 1921 38 21 49 108 1922 32 41 35 108 1923 33 21 23 77 1924 21 29 27 77 1925 25 29 35 89 Total 1921-25 149 141 169 459 Mean do. 29∙8 28∙2 33∙8 91∙8 Certified Causes of Death. Months 0—3. Months 3—6. Months 6—9. Months 9—12. Total. % of Total. Scarlet Fever - - - - - - Diphtheria - - - - - - Erysipelas 1 — — — 1 0∙5 Measles - - - - - - Influenza - - - - - - Meningococcal Meningitis - - - - - - Whooping Cough 2 4 1 4 11 5∙9 Diarrhoea and Enteritis 7 3 2 2 14 7∙5 General Tuberculosis — — 1 1 2 1∙1 Tuberculous Meningitis — — — 1 1 0∙6 Pulmonary Tuberculosis — — 1 — 1 0∙5 Pneumonia 7 8 5 10 30 16∙1 Bronchitis 7 2 1 — 10 5∙4 Other Respiratory - - - - - — Diseases - - - - - - Prematurity 46 2 0 — 48 25∙8 Marasmus 10 8 2 — 20 10∙7 Icterus Neonatorum 2 — — — 2 1∙1 CongenitalMalformations 12 1 2 — 15 8∙1 Injury at Birth 3 — — — 3 1∙6 Suffocation (overlying) - - - - - - Convulsions 1 — — 1 2 1∙1 Atelectasis & Asphyxia N. 9 — — — 9 4∙9 Lack of Care 1 — — — 1 0∙5 Syphilis — — — — — — Miscellaneous 6 3 3 4 16 8∙6 Total 114 31 18 23 186 100∙0 Percentage of Total 61∙3 16∙6 9∙7 12∙4 100∙ 0 — 20 On analysis of the above tables it will be noted that over 60 per cent. of the total infant mortality occurred in the first three months of life. If these figures are more closely investigated it is found that of the total 186 deaths of infants under 1 year in 1925, 89, or 48 per cent., occurred in the first four weeks of life. It will be noted further that most of these infants deaths were due to prematurity, marasmus and congenital defects. These infants, therefore, were born with such a heavy handicap that their chances of survival were slight and, therefore, no post-natal care could have, in the majority of cases, averted the result. While it is satisfactory to note that much has been accomplished in reducing infant mortality, especially in the later months of the first year of life, and that no doubt a proportion of these neo-natal deaths (i.e., deaths of infants in the first few weeks of life) are inevitable, the causes responsible require further investigation, and more attention must be paid to conditions which are favourable to a high incidence of mortality in the early weeks of life, e.g., state of health, nutrition and general ante-natal supervision of the mother. Illegitimate Infant Deaths. The death-rate amongst illegitimate children during 1925 was 113.2 per 1,000 births, as compared with 148.1 in 1924, 130.4 in 1923, 179.7 in 1922 and 183.2in 1921. The corresponding deathrate of legitimate infants in 1925 was 56.5, the ratio of the mortalityrate of illegitimate infants to that of legitimate being 2.00 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:— 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. 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 65.0 179.7 2.76 1923 3,319 115 .035 155 15 46 .7 130.4 2.79 1924 3,031 108 .036 180 16 59.4 148 .1 2.49 Average 19201924 3,601 128 .036 235 21 65.3 165.1 2.53 1925 3,078 106 .034 174 12 56.5 113.2 2.00 The above table shows that the death-rate amongst illegitimate children, though much lower in 1925, is still twice the rate for legitimate infants. 21 Table showing Birth-rates, Death-rates and Infant Mortalityrates in the 29 Metropolitan Cities and Boroughs for the year 1925. Births per 1,000 Population. Deaths per 1,000 Population. Infant Mortality per 1,000 Births. 1. Shoreditch 24.7 Hampstead 10.1 Wandsworth 53 2. Poplar 22.7 Lewisham 10.2 Woolwich 54 3. Bermondsey 22.7 Wandsworth 10.4 Hampstead 55 4. Finsbury 22.6 Battersea 10.5 Lewisham 56 5. Bethnal Green 22.1 Fulham 10.6 Battersea 58 6. Southwark 21.4 Woolwich 10.7 Finsbury 59 7. Stepney 21.0 Camberwell 11.0 City of London 60 8. Islington 19.4 City of London 11.0 St. Marylebone 60 9. Deptford 18.9 Greenwich 11.2 Lambeth 62 10. Greenwich 18.8 Hackney 11.4 Deptford 62 11. Battersea 18.5 S. Newington 11.6 Islington 63 12. St. Pancras 18.1 Poplar 11 .7 S. Newington 63 13. Hackney 18.0 St. Marylebone 11.7 Camberwell 64 14. Lambeth 17.9 Paddington 11.8 Hackney 64 15. Woolwich 17.9 Hammersmith 11.9 Holborn 65 16. Camberwell 17.8 Deptford 11.9 Hammersmith 66 17. Hammersmith 17.5 Bethnal Green 12.0 Chelsea 66 18. Fulham 17.2 City of Westminster 12.1 City of Westminster 69 19. Paddington 16.0 Stepney 12.1 Greenwich 69 20. Kensington 15.9 Lambeth 12.2 St. Pancras 71 21. Lewisham 15.7 Islington 12.2 Paddington 73 22. Stoke Newington 15.5 Holborn 12.3 Stepney 75 23. Chelsea 14.5 Bermondsey 12.6 Bermondsey 75 24. Wandsworth 14.4 St. Pancras 12.6 Fulham 75 25. St. Marylebone 14.2 Kensington 12.9 Poplar 75 26. Hampstead 12.2 Southwark 13.1 Southwark 77 27. Holborn 12.2 Chelsea 13.3 Kensington 80 28. City of Westminster 10.7 Shoreditch 13.3 Bethnal Green 80 29. City of London 7.4 Finsbury 13.6 Shoreditch 88 London County 18.0 ... ... 11.7 ... ... 67 England and Wales 18.3 ... ... 12.2 ... ... 75 Notification of Births Act. During 1925 the number of notifications of live births received was 3,046. The corrected number of births registered in Battersea was 3,184. The proportion of notified to registered births was 95.7 per cent. The number of still-births notified during the year was 87 or 2-7 per cent. of the corrected total births. 213 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 the voluntary organizations linked up with the Council's Maternity and Child Welfare Scheme. 22 A weekly return of all births notified is sent to the London County Council in accordance with the requirements of Sec. 5, sub-sec. 2 of the Notification of Births Act. Maternity and Child Welfare Scheme. The Borough Maternity and Child Welfare Scheme was revised early in 1919, on the coming into force of the Maternity and Child Welfare Act, 1918. This Act gave greatly increased powers to local authorities for the development of measures having for their object the welfare of women and of children under five years of age. These powers were at once welcomed by the Council, and a very extensive scheme of health services was inaugurated, which has continued year by year to develop in extent and scope to meet the needs of the population of the Borough. The scheme includes both municipal and voluntary effort and the activities of both are fully co-ordinated. Maternity and Child Welfare Centres. For administrative purposes the Borough is divided into seven areas. In each of these areas a Maternity and Child Welfare Centre —municipal or voluntary—has been established. The Centres are situated as follows :— 1. Municipal. (a) Latchmere Baths (Burns Road entrance). (b) All Saints' Parish Hall (Prince of Wales Road). (c) Plough Road Institution. (d) Chatham Hall (Chatham Road). (e)Dental Centre and Clinic (Plough Road). 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 services included in the Scheme are: (1) St. Mary's Hostel, Macaulay Road, Clapham Common, and (2) St. Margaret's Day Nursery and Hostel, institutions under voluntary control, but linked-up with the Borough Maternity and Child Welfare Scheme and in receipt of an annual grant from the Council. Each Centre is under the superintendence of an official Health Visitor, assisted by voluntary helpers and by students from recognised training bodies, e.g., Battersea Polytechnic, College of Nursing and International Red Cross. At each Centre there is a Clinic with a woman medical officer in attendance. The Voluntary Centres are managed on similar lines to those of the Municipal Centres; in fact, at two of the Voluntary Centres the Child Welfare work is under the superintendence of an official Health Visitor of the Council. 23 The following table gives a summary of the work carried out at the Infant Welfare Centres during 1921 to 1925. Summarised Statistics relating to Municipal Infant Centres, 1921-25. 1921. 1922. 1923. 1924. 1925. Latchmere Centre. Sessions held 151 151 149 134 145 Attendances 14,312 12,178 11,459 8,297 7,161 First attendances 1,373 1,812 979 739 488 Average attendances per session 94 81 77 62 49 Average ditto weekly 275 234 219 160 138 Doctor's attendances 101 101 102 74 100 Babies seen by Doctor 1,832 2,711 2,306 2,008 2,755 Average ditto per attendance 18 27 23 27 28 Weights recorded 13,769 11,062 10,053 7,216 6,205 Advice only 543 1,116 1,346 1,081 956 Plough Road Centre. Sessions held 100 101 101 100 100 Attendances 4,076 4,704 5,221 5,041 4,634 First attendances 442 769 611 488 370 Average attendances per session 41 46 52 50 46 Average ditto weekly 80 90 100 97 89 Doctor's attendances 48 51 55 48 43 Babies seen by Doctor 1,040 1,204 1,297 1,078 967 Average ditto per attendance 22 24 24 22 22 Weights recorded 3,734 4,226 4,673 4,319 3,804 Advice only 342 478 543 722 830 East Battersea Centre. Sessions held 103 103 102 100 102 Attendances 3,525 4,029 4,717 4,519 4,704 First attendances 314 549 371 404 321 Average attendances per session 34 39 46 45 46 Average ditto weekly 68 77 91 87 90 Doctor's attendances 51 48 54 47 49 Babies seen by Doctor 964 1,016 1,040 1,231 1,291 Average ditto per attendance 18 21 19 26 26 Weights recorded 3,338 3,912 4,217 4,012 4,367 Advice only 187 117 500 507 337 Chatham Road Centre. Sessions held — — — 73 115 Attendances — — — 3,617 5,923 First attendances — — — 277 354 Average attendances per session — — — 49 52 Average attendances weekly — — — 98 114 Doctor's attendances — — — 35 50 Babies seen by Doctor — — 738 1,156 Average ditto per attendance — — — 21 23 Weights recorded — — — 3,148 5,016 Advice only — — — 469 907 * Opened in April, 1924. 24 Summary of Statistics relating to Municipal Infant Centres. 1921. 1922. 1923. 1924. 1925. Sessions held 354 355 351 407 462 Attendances 21,913 20,911 21,397 21,474 22,422 First attendances 2,129 3,130 1,961 1,908 1,533 Average attendance per session 62 59 61 53 49 Average attendance weekly 421 402 411 413 431 Doctor's attendances 200 200 211 204 242 Babies seen by Doctor 3,836 4,931 4,643 5,055 6,169 Average do. per attendance 19 25 22 25 25 Weights recorded 20,841 19,200 18,943 18,695 19,392 Advice only 1.072 1,711 2,389 2,779 3,030 The following table summarises the work carried out during 1924 and 1925 at the Voluntary Centres, linked up with the Council's Maternity and Child Welfare Scheme :— Battersea School for Mothers, 55 Mundella Road. Chislehurst (St. James's) Mission, Ponton Road Women's League of Service, 111 Bridge Road West. Total. 1925. 1924. 1925. 1924. 1925. 1924. 1925. 1924. Sessions held 95 99 50 49 73 73 218 221 Attendances 3,541 3,429 1,112 1,190 2,120 1,766 6,773 6,385 First attendances 241 258 66 81 110 127 417 466 Average attendance per session 37 35 22 24 29 24 31 29 Average weekly 68 66 22 24 41 34 130 123 Doctor's attendances 94 97 26 29 73 73 193 199 Babies seen by Doctor 2,653 2,561 303 439 1,633 1,516 4,589 4,516 Average do. per attendance 28 26 12 15 22 21 24 23 Weights recorded 3,541 3,425 1,040 1,111 1,925 1,685 6,506 6.221 Advice only ~~~ 4 72 79 195 81 267 164 Hospital Provision. In addition to the 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, and the Fulham Babies Hospital (Chronic Wasting Diseases). The Council contribute an annual sum to the 25 hospital funds for this service. Women and children, where necessary, are also referred from the Ante-Natal and Child Welfare to other Hospitals and Institutions. Number of cases referred to Hospitals and Institutions from the Maternity and Child Welfare Clinics during 1925:— St. Thomas's Hospital 22 Victoria Hospital for Children 160 St. James's Hospital 2 Belgrave Hospital 1 Borough Tuberculosis Dispensary 29 Fulham Babies Hospital 13 Sunlight Clinic, Humanity House 8 Children's Hospital, Vincent Square 1 Royal Eye Hospital 1 Total 237 The following health services are carried on in the Borough by the Guardians of the Poor and voluntary bodies:— St. James's Hospital, Ouseley Road. St. John's Hospital, St. John's Hill. Bolingbroke Hospital, Wandsworth Common. Battersea General Hospital, Battersea Park. The two first-named are institutions maintained by the Wandsworth Board of Guardians. Nursing Facilities. In connection with the Council's Scheme, Nursing attendance in their own homes is, by arrangement with the South London District Nursing Association, provided when required for inhabitants of the Borough. Very considerable use of this valuable feature of Maternity and Child Welfare work has been availed of during the past few years, especially during the prevalence of epidemic disease, e.g., acute infective diarrhoea, measles, whooping-cough and other dangerous or disabling diseases of child life. 26 During 1925 the total number of attendances made by the Nurses was as follows :— Nursing Service, 1925. Name of Disease. Age. Total. Under 5 years. Over 5 years. Cases. Visits. Cases. Visits. Cases. Visits. Ophthalmia Neon. & other Eye Aff'ns. 108 3,056 - - 108 3.056 Measles 24 188 8 48 32 236 Whooping Cough 19 324 2 31 21 355 Diarrhoea & Vomiting 5 37 — — 5 37 Chicken Pox 3 33 1 9 4 42 Pemphigus neonatorum 5 139 — — 5 139 Puerperal Fever — — — — — — Pneumonia 60 1,038 66 1,376 126 2,414 Influenza 1 4 26 239 27 243 Other Diseases — — 2 47 2 47 Totals 225 4,819 105 1,750 330 6.569 The cost of the Nursing Service, particulars of which are set out in the above table, was £218 19s. 4d., as compared with £265 16s. Od. in 1924 and £182 10s. 8d. in 1923. Health Visitors. The work carried out during the quinquennium 1921 to 1925 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 in the table on page 27. 27 Summary of Visiting Work Carried out by Council's Visiting Staff and Voluntary Organisations included in the Borough Maternity and Child Welfare Scheme from 1921 to 1925. Health Visitors. 1921. 1922. 1923. 1924. 1925. Mean (1921-25). C'c'l. Vol. Total C'c'l. Vol. Total C'c'l. Vol. Total C'c'l. Vol. Total C'c'l. Vol. Total C'c'l. Vol. Total Visits to Expectant Mothers 1,733 418 2,151 1,363 297 1,660 1,611 304 1,915 1,754 612 2,366 1,843 579 2 422 1,661 442 2,103 Visits to Notified Births 6,378 2,460 8,838 6,025 1,660 7,685 8,016 1,350 9,366 8,383 1,215 9,598 8,565 1,249 9,814 7,473 1,587 9,060 Visits to Still Births 22 — 22 33 — 33 60 4 64 88 18 106 83 11 94 57 7 64 Visits to children aged 1-5 years 1,049 827 1,876 942 1,117 2,059 1,394 1,459 2,853 2,539 1,447 3,986 2,775 1,438 4,213 1,740 1,258 2,998 Visits to enquire into Infant Deaths 252 69 321 174 30 204 117 32 149 205 24 229 164 33 197 182 38 220 Visits to cases of Notifiable Infectious Disease 2,231 35 2,266 5,611 712 6,323 5,074 354 5,428 5,060 589 5,649 4,367 318 4,685 4,469 401 4,870 Visits to cases of Non-Notifiable Infectious Disease 1,901 308 2,209 660 129 789 552 104 656 528 101 629 626 132 758 853 155 1,008 Visits re Summer Diarrhœa 1,243 721 1,964 1,847 652 2,499 1,713 400 2,113 1,361 655 2,016 471 243 714 1,327 534 1,861 Visits to Dental Cases 282 — 282 276 — 276 322 33 355 320 25 345 260 14 274 292 14 306 Visits to V.D. Cases 31 — 31 145 — 145 191 — 191 211 — 211 159 — 159 148 — 148 Other Visits 760 — 760 949 83 1,032 785 229 1,014 1,311 819 2,130 1,061 650 1,711 973 356 1,329 Totals 15,882 4,838 20,720 18,025 4,680 22,705 19,835 4,269 24,104 21,760 5,505 27,265 20,374 4,667 25,041 19,175 4,792 23,967 28 A survey of the work carried out during the five years 19211925, as summarised in the above table, exhibits some interesting points for observation and comment. The Staff of Official Health Visitors has been increased from 7 in 1921 to 9 in 1925. The number of Child Welfare Centres has, during the same period, been increased by one (Chatham Road). The number of sessions held at the Centres has been increased from 354 in 1921 to 462 in 1925, and the attendances, exclusive of the Voluntary Centres, at these Centres has increased from 21,913 to 22,422. The total home visits paid by the Health Visitors (Official and Voluntary) during the 5 years increased from 20,720 to 25,041, an increase of 4,321. The number of home visits and re-visits paid by the Health Visitors in connection with notifiable infectious diseases increased during the quinquennium from 2,231 to 4,367. While this figure is, of course, affected by the fluctuations in individual years of notifiable infectious diseases, this is not the only explanation; the increased Staff has rendered it possible to devote greater attention to this important preventive measure and with better results, as shown by the vital and morbid statistics of the Borough. An analysis of the attendances of infants at the Welfare Centres in Battersea shows that 55.5 per cent. are of infants at the earlier weeks of life (under 2 months). This satisfactory feature points to the attention now given by the Health Visitors to the importance of home visiting from the earliest possible date after birth. Milk Order. During 19J5, Milk, both tresh 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 1925 1,620 44,805 222 26,079 2,631 In addition to the above dinners to the number of 1,277 were supplied to necessitous expectant and nursing mothers by arrangement with the Women's League of Service, at a cost of £36 10s. 2d. 29 As a result of the conference of Metropolitan Sanitary Authorities convened by Bermondsey Borough Council and attended by Battersea delegates, the Council on the report of the Maternity and Child Welfare Committee decided on a gradual substitution of Grade A (Tuberculin Tested) milk for dried and liquid milk hitherto supplied to necessitous expectant and nursing mothers and children under 5 years of age. Notice was accordingly sent to all milk retailers in the Borough that on and after the 1st April, 1926, orders for milk would only be given to milk retailers who were prepared to supply this milk. Ante-natal Work. The organisation of the Ante-natal side of the Maternity and Child Welfare Scheme only began in earnest with the appointment in April, 1924, of a part-time Assistant Medical Officer (Miss Alice Bloomfield, M.D., F.R.C.S.) specially skilled in the diseases of women. Since then the work has made rapid progress, and the attendances at the Central Out-patient Ante-natal Clinic at the Borough Maternity Hospital have increased to such an extent as to make it impossible for the Medical Officer to give the necessary time to individual cases. A re-arrangement of the work was therefore found to be imperative, and also the holding at this Centre of an extra session, and application was accordingly made by the Council to the Ministry of Health for sanction.* It is anticipated that the extra session will relieve the existing pressure and afford greater opportunity to the Medical Officer in charge for the more efficient examination of patients. There are subsidiary Clinics held at the Latchmere, Plough Road and All Saints Parish Hall Centres. At these Clinics the patients attend until the sixth and seventh months and, with the exception of one attendance at the Central Clinic for the routine blood test, all cases expecting admission to the Borough Maternity Hospital for their confinement will be required to attend the Central Clinic for their last three monthly visits. With the exception of one fortnightly Ante-natal Clinic held at the Women's League of Service Centre at 111 Bridge Road West, all ante-natal cases are referred from the Voluntary Centres included in the Council's Scheme to the Ante-natal Clinics at one or other of the Municipal Clinics. The increase in the number of patients admitted to the Maternity Hospital during 1925 has, of course, given rise to an increased attendance at the Ante-natal Centres. Every expectant mother who applies for admission to the Borough Maternity Hospital or for the services of the Midwife on the District Midwifery Service is required to attend for examination by the Medical Officer at the Ante-natal Clinic. * This extra session was sanctioned by the Ministry early in 1926, to take effect from 1st April, 1926. 30 As an integral part of the Maternity and Child Welfare Scheme there can be no question that the development of Ante-natal work in the Borough has been followed by the most gratifying results. Ante-natal work is largely preventative, and is the most effective weapon against the dangers, many of them avoidable, that threaten the expectant mother. During 1925 the salient features of the report of the year's work are: (1) A definite increase in the number of new patients, and (2) improved organisation for securing more efficient methods in dealing with the extension of the work. The latter includes the ancillary work of the instruction of expectant mothers in the care of their health during pregnancy, preparation for their confinement and the provision of suitable clothing for themselves and the expected child. Classes of instruction are conducted by the Health Visitor and are much appreciated by the mother, especially the young mothers, who are eager, willing and receptive. The total number of patients attending the Municipal Antenatal Clinics durine 1925 was :— Central Clinic (Borough Maternity Hospital) 489 Latchmere Clinic 201 All Saints Clinic (East Battersea) 98 Plough Road Clinic 123 911 The numbers show an increase of 151 patients as compared with 1924. Ante-natal (V.D.) Clinic. This special treatment Clinic was established in connection with the Ante-natal Outpatient Department at the Borough Maternity Hospital, and was opened for the reception of patients at the end of 1921. The Clinic is fully equipped with all modern appliances, etc., for diagnosis and treatment. The work carried out during 1925 is summarised below. During 1925 a total of 653 blood tests were made. Of these 37 were positive. Of these 37 positive results— 6 were from repeated tests. 14 were from expectant mothers. 2 were from infants under 1 year. 1 was from child of 2 years. 13 were from post-partum cases. 1 was from potential mother. 31 Of the 14 expectant mothers whose blood gave a positive Wasserman reaction— 5 were discovered before 7th month of pregnancy. 9 were discovered after 7th month of pregnancy. 8 were treated during pregnancy. 4 had no treatment during pregnancy. 2 failed to attend Clinic. 10 had normal confinements in the Borough Maternity Hospital. 1 had premature labour in the Borough Maternity Hospital. 1 had a still-born baby at home. 2 have not yet been confined. The mother of the still-born baby had no pre-natal treatment, the result of her blood test not being known until 8th month of pregnancy. The mother of the premature baby had had 2 previous stillborn (premature) babies and had been intermittently under treatment since January, 1924. Of the 12 babies born— 1 was still-born. 1 was premature but healthy. 9 were normal healthy infants. 1 infant gave a positive Wasserman. 7 infants gave a negative Wasserman. 4 infants not yet examined. The Consultant Specialist to the Clinic, Dr. Roxburgh, reports that a larger number of expectant mothers were tested by the Wasserman reaction in 1925 than in the previous year, but apart from this there has been a slight falling off in the Ante-natal work, partly owing to the smaller number of positive Wasserman discovered a satisfactory feature—but mainly owing to the fact that many of the mothers so discovered either failed to attend for Antenatal specific treatment or came so late in pregnancy that it was impossible to start treatment. This is an unsatisfactory feature and can only be remedied by the gradual education of the mothers in the Borough to the importance of attending the Ante-natal clinics early in pregnancy. The table on page 32 shows the number of mothers treated for svphilis ante-natallv in the complete years 1922, 1923, 1924 and 1925. 32 Year. Number of expectant mothers tested by W.R. Number giving positive W.R. Per cent. Number of expectant mothers with positive W.R. treated during pregnancy. Babies. Mothers not confined by end of year. Healthy Neg. W.R. Healthy looking Not yet tested. Positive W.R. Still-born. 1922 — — — 1 1 0 0 0 0 1923 — — — 8 4 0 1 0 3 1924 517 IS 3.5 15 11 1 0 1 Prolonged labour. Not syphilitic 2 1925 653 14 2.1 8 7 1 0 0 — 1925 — — — Not treated during Pregnancy 6 Came for W.R. too late in pregnancy or would not attend Clinic for treatment. 1 1 1 1 2 N.B.—This table does not shew cases treated post-partum, or babies or gonorrhœa cases. 33 The table shews the value of Ante-natal treatment for syphilis, particularly in the case of one of the eight mothers with positive Wasserman who were treated during pregnancy. She had previously had two still-born children and no live birth; she now has a healthy baby with negative Wasserman, although it was bom prematurely after the 8th month. The table further shews the value of the scheme started at the end of 1923 of taking a routine Wasserman test from every mother attending the ordinary Ante-natal clinics. It also shows that the percentage of positive Wasserman in expectant mothers in Battersea is much lower than the figure commonly supposed to represent the incident of syphilis in the urban population, namely about 10 per cent. At the bottom of the table is inserted for comparison the fate of the pregnancies of six mothers with positive Wassermans who, for one reason or another, were not treated during their pregnancies. It shews that out of four deliveries there was only one definitely healthy child and one possibly healthy whose blood has not yet been tested. Special Ante-natal Clinics are held at the Out-patient Department of the Borough Maternity Hospital on Tuesday and Wednesday afternoons. This development of the Council's Maternity and Child Welfare Scheme was begun in 1922. In 1924 the attendances increased to such an extent that it was found necessary to hold an extra session on Tuesdays. The Session held on Tuesday, though not exclusively devoted to the diagnosis and treatment of Venereal Disease, forms a very important part of the scheme for the treatment of V.D. in pregnant and post-parturient women. Dr. Bloomfield, who is in charge, reports:— This Clinic is held— A.—For the purpose of taking specimens for routine Wasserman blood test. These specimens until a few months ago were also taken at one of the ordinary Antenatal Clinics, but the pressure of work in the latter Clinics rendered it necessary to refer practically all patients for their blood test to the Maternity Hospital Clinic. In 1925, 653 routine tests were taken, of which 266 were taken at the "Special" Clinic, but the percentage of these latter will be much higher in 1926. In 653 cases, 37 gave positive results among whom were 14 expectant mothers. 34 Of these 14 positive results— 5 were discovered before the 7th month of pregnancy 9 were discovered after the 7th month. Thirteen post-parturient cases had positive results. B.—For the examination of pregnant and post-parturient women suffering from vaginal discharge and sores and irritation about the vulva. All pregnant patients suffering from more than a very slight vaginal discharge are referred to the "Special" Clinic and are there examined with the proper facilities and films are taken from urethra and cervix when necessary. Many patients are found to require no treatment. In 1925 19 films were taken from the cervix, gorococci being discovered in only two cases. These two patients received in addition to weekly inspection and treatment by the doctor, daily douching, etc., by a nurse and were discharged cured. Besides these two cases, any case showing a purulent or excessive vaginal discharge received treatment and among these were several cases of cervical erosion of probably infective origin. The work of this Clinic and its results may be summarised as follows :— 1. A routine Wasserman test is an extremely valuable and essential part of ante-natal examination. 2. The importance of an examination in all cases complaining of a possible purulent discharge during pregnancy. It is possible that some of these discharges originated in a Diplococcal infection, but the gonococcus is seldom found in pregnancy unless the infection is recent and acute. In films special attention should be paid to the number and staining re-actions of pus cells—large quantities of well staining pus cells being an absolute indication for treatment. Treatment should be started as early as possible in pregnancy, as local treatment, except in very severe and acute cases, is not usually desirable after the 8th month. For this reason, and in order that the routine Wasserman test may be carried out patients should be encouraged to report very early in pregnancy, e.g., the 3rd month, when this examination can be carried out. They could then be required to attend again 2-3 months later, when the usual examination, i.e., presentation of foetus measurements, etc., could be carried out. 35 That the Clinic is appreciated is shown by the large attendance, viz., 560 in 1925, of whom 308 were new cases, and its effectiveness is in part borne out by the few and mild cases of Ophthalmia which have occurred in the Borough Maternity Hospital and District Midwifery Services. The extremely low percentage of febrile puerperia during 1925 further points to some extent, at least, to the steady treatment of all purulent vaginal discharges during pregnancy. 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 1925:— Ante- and post-natal visits Other visits. T otal. 1. St. Thomas's Hospital 314 252 566 2. General Lying-in Hospital, York Road 127 - 127 3. King's College Hospital 32 3 35 4. St. George's Hospital 5. Westminster Hospital 6. Victoria Hospital 7. St. Bartholomew's Hospital 8. Gt. Ormond Street Hospital 9. Southwark and Newington Rescue Society 473 255 728 Maternal Mortality. During 1925 there were six deaths of women from diseases or accidents of child-birth, and this figure represents a death-rate per 1,000 births of 1.88. The causes of death and the mortality rates for the five years 1921-1925 are set out in the following table :— 36 Maternal Deaths in Child-birth (Puerperal Sepsis and other Causes). 1921. 1922. 1923. 1924. 1925. Mean 1921-5 Deaths from Puerperal Sepsis 4 3 — 4 3 2.8 Deaths from other causes connected with child-birth 10 6 10 5 3 6.8 Total Maternal Deaths connected with Child-birth 14 9 10 9 6 9.6 Rate per 1,000 births— Puerperal Sepsis 1.07 0.82 — 1.27 0 .94 0.82 Other Maternal deaths 2.67 1.64 2.91 1.59 0.94 1.98 Rate per 1,000 all Maternal deaths 3.74 2.46 2.91 2.86 1.88 2.80 Rate Der 1.000 population— Puerperal Sepsis .024 .018 .023 .017 .016 Other Maternal deaths .059 .035 .059 .029 .017 .040 Rate per 1,000 population all Maternal deaths .083 .053 .059 .052 .034 .056 The figures are very encouraging, showing as they do a decline in maternal mortality since 1921. In view of the attention which has been drawn in the memorandum by Sir George Newman, issued by the Ministry of Health in 1919, and by the more recent report by Dame Janet Campbell to the high rate of maternal mortality still prevailing, and the necessity for more active steps by local authorities, the Borough Council has, during the past 5 or 6 years, made special efforts in their Maternity and Child Welfare Scheme, details of which are set out in this section of the Report, to provide an efficient midwifery service in conjunction with the other measures which have been carried on in Battersea for many years. Most of the measures suggested in Sir George Newman's admirable memorandum have been in operation in the Borough for the past 5 or 6 years, and include:— (1) An adequate midwifery and nursing service. (2) Arrangements for securing the nutrition of the expectant and nursing mother. (3) Provision of Maternity Centres and ante-natal supervision. That these measures have produced the results anticipated, as shown in the above table, is a satisfactory feature of this year's 37 Annual Report. The development of ante-natal supervision during the past two or three years has played an important part in the success which has already been obtained through the Council's Maternity and Child Welfare Scheme. It should not be forgotten in this connection that the reduction in maternal mortality is not the only gain. There is also the diminished incidence in the suffering, invalidity and incapacity which, in the case of the survivors, as Sir George Newman pointed out, is exerting a serious effect upon the well-being of the community. Borough Maternity Hospital. The Borough Maternity Hospital 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. The Central Ante-natal and Special Treatment Clinics are also held at the Out-patients Department of the Hospital. Medical attendance when required is provided by a rota of local medical practitioners. The services of the Consultant Obstetrician to the Hospital, Dr. J. S. Fairbairn, M.D., F.R.C.S., F.R.C.P., Senior Obstetric Physician to St. Thomas' 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 the training of 12 pupil-midwives. During 1925, 560 cases were admitted to the Hospital (30 beds), an increase of 150 cases compared with 1924. The increase in the number of patients admitted during 1925 is a very satisfactory feature of the year's work, indicating (a) that the popularity of the Institution is increasing, and (b) that the cost of maintenance per bed has been reduced. An even more satisfactory feature is that notwithstanding the greatly increased number of patients admitted, not a single maternal death occurred. No case of puerperal sepsis occurred during the year. The number of infant deaths was 6 less than in 1924. It was found necessary to call in the services of the Consultant Obstetrician in 5 cases of grave emergency during the year, as compared with 6 cases in 1924. Particulars relating to the admissions during 1925 are set out as follows:— Total number of cases admitted 560 Average duration of stay 14 days Number of cases delivered by— (a) Midwives (nursing staff) 508 (b) Doctors (on rota) 39 38 Of the above 560 cases, 13 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. Retention of urine 1 Version under anaesthetic 2 Contracted pelvis 3 Ante-partum haemorrhage 2 Albuminuria 12 Neurotic condition 1 Debility 1 Cases 25 Threatened miscarriage 1 Heart disease 1 Threatened eclampsia 1 (b) During labour. Foetal distress 16 Eclampsia 1 Miscarriage—Hydramnios with twins 1 Collapse after birth of twins 1 Heart disease 1 Prolapse of cord 2 Retained placenta P.P.H. 1 Delayed labour 1 Collapse during 3rd stage of labour 1 A.P.H. Premature labour 1 Contracted pelvis 1 Post-partum haemorrhage 1 Placenta praevia 1 Cases 31 Hour glass contractions 1 Adherent placenta 1 (c) After labour. Ruptured perineum 10 Collapse 1 Engorged breast 1 Cases 16 Bronchitis 2 Broncho-Pneumonia 1 Subinvolution 1 (d) For infant. Watery eyes 27 Dangerous feebleness 1 Ophthalmia 2 Cyanosis 1 Prematurity 2 Cases 37 Distressed breathing 1 Convulsions 2 Microcephalus 1 Number of maternal deaths Nil. Number of cases in which temperature rose above 100-4 for 24 hours with rise of pulse 4 Number of cases notified as ophthalmia neonatorum with result of treatment 2 (Attended St. Margaret's and St. Thomas's Hospitals: Discharged cured.) Number of infants with discharge from eyes however slight 27 Number of infants not entirely breast fed 3 Anaemia of mother 2 Going to foster-mother 1 39 Number of foetal deaths (still-born or within 10 days of birth) and their causes 10 Cord tightly round neck 1 Ante-partum haemorrhage in mother 2 Macerated foetus 1 Prolapse of cord 1 Prematurity 4 Microcephalus 1 The Consultant Obstetrician to the Council was called in in 5 cases of grave emergency, particulars of which are set out below:— Ante-partum haemorrhage 1 Albuminuria 1 Eclampsia 1 Collapse after labour 2 I am indebted to the courtesy of the Borough Treasurer for the following statement of the cost of the Home during the financial year ended 31st March, 1926 :— Maternity Hospital, 1925-1926. Total beds, 30; total cases, 571; percentage of beds occupied 73 per cent. Item. Total. Per Patient Week. £ £ s. d. Salaries Medical 153 0 2 8 Nursing 550 0 9 8 Domestic and other 499 0 8 9 Provisions 1,150 1 0 2 Drugs and other Medical Requisites 206 0 3 7 Heating and Lighting 448 0 7 10 Laundry 416 0 7 3 Repairs and Renewals Domestic 213 0 3 9 Structural 216 0 3 9 Taxes and Insurance 158 0 2 9 Loan Charges 1,427 1 5 0 Miscellaneous 117 0 2 1 Gross cost £5,553 £4 17 3 Income Pupil Mid wives 156 0 2 9 Inmates' Payments 2,403 2 2 1 Other 10 0 0 2 Net cost £2,984 £2 12 3 40 It will be noted that there is a satisfactory reduction in the cost per patient per week (£2 12s. 3d.) as compared with £4 1 Is. 5d. in 1924, £4 17s. 4d. in 1923, and £4 7s. Od. in 1922. This satisfactory financial result has been due to the increased percentage of beds occupied, and the reduction in the cost of structural and domestic repairs and other miscellaneous charges. These reductions are the more satisfactory as electric cooking was substituted for gas during the year. District Midwifery Service. The District Midwifery Service for the attendance of patients in their own homes was inaugurated at the close of 1921. During 1925 there were 119 cases attended by the District Midwife, a decrease of 33 as compared with 1924. This may partly be due to the transfer of 17 cases for reasons of health or other unsuitable conditions for admission to the Borough Maternity Hospital. Particulars relating to this Service during 1925 are set out below:— Total number of cases attended 119 Number of cases delivered by— (a) Midwife 114 (b) Doctors 5 Number of cases where medical assistance was called for, with reasons for requiring assistance— (a) Ante-Natal. Ante-partum haemorrhage 1 lb) During labour. Delayed labour 5 (c) After labour. Post-partum haemorrhage 3 Retained placenta 2 Torn perineum 4 (d) For infant Dangerous feebleness 6 Number of maternal deaths Nil. Number of cases notified as ophthalmia neonatorum, with result of treatment 3 (Attended St. Thomas's Hospital, subsequently discharged cured.) Number of infants with discharge from the eyes, however slight 8 Number of infants not entirely breast-fed (Insufficient breast milk.) 2 Number of foetal deaths 6 Congenital heart 2 Prematurity 1 Pyloric Stenosis 1 Stillborn 1 Anencephalus 1 41 Dental Clinic. The work carried out at the Dental Clinic during 1925 for the treatment of expectant and nursing mothers and children under 5 years of age was satisfactory. Under the provisions of the Maternity and Child Welfare Act, as part of the comprehensive scheme of the Council for Maternity and Child Welfare, dental facilities were provided in August, 1920. Arrangements were made for this service with the British Dental Hospital, who furnished the necessary equipment and the services of a Dental Surgeon (Mr. J. Rhys Herbert, L.D.S., R.C.S.(Eng.), the Council providing accommodation at the Plough Road Centre. The Dental Clinic began with cne session weekly, but the attendance of patients in a few months had increased to such an extent that a second session and, later, a third session, had to be provided weekly. The popularity of thig health service has steadily increased, and there can be no question that it has produced excellent results. The Dental Clinic is available for expectant and nursing mothers and children attending the Voluntary Association's Clinics included in the Council's scheme, on the recommendation of the Medical Officers in charge, as well as for those attending the Council's Municipal Clinics. The work of the Dental Clinic during 1925 is summarised as follows:— Number of sessions held 149 Total number of patients (women 244, children 50) 294 Total attendances (women 1,601, children 64) 1,665 Work carried out:— Extractions— Ordinary 25 With local anaesthetic 352 „ general anaesthetic 987 1,364 Scaling and polishing 52 Fillings (simple) 65 Upper dentures 44 Lower dentures 39 Dressings and treatment to gums 52 Repairs to dentures 18 Prescriptions given 52 Advice 535 The estimated cost of dental treatment (Maternity and Child Welfare) in 1925 was £459 2s. 5d. This sum includes £167 7s. 9d. paid for dentures supplied, the cost of which was distributed as under:— £ s. d. Contributed by patients 97 16 0 Grants from Saturday and Sunday Hospital Funds 47 8 6 Grants from other philanthropic agencies 16 1 0 Grant by Guardians 1 14 6 Contribution by Council 4 7 0 £167 7 9 The nett cost to the Council during the year was £296 Is. 8d. 41 Notifiable Infectious Diseases. During 1925 under the Notification Clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, 2,770 cases of infectious diseases (excluding tuberculosis) were notified, including cerebro-spinal fever 1, acute poliomyelitis 2, encephalitis lethargica 8. The following is a list of the diseases compulsorily notifiable in Battersea:— Small-pox. Acute polio-myelitis. Cholera. Acute polio-encephalitis. Diphtheria. Glanders. Membranous croup. Anthrax. Erysipelas. Hydrophobia. Scarlet fever. Acute influenzal pneumonia. Typhus fever Acute primary pneumonia. Typhoid or enteric fever. Trench fever. Relapsing fever. Malaria. Continued fever. Dysentery. Puerperal fever. Plague. Ophthalmia neonatorum. Acute encephalitis lethargica. Cerebro-spinal fever. Measles. Whooping cough. The distribution of the cases notified in the registration subdistricts and the wards is shown in the table on p. 43. Excluding measles and whooping cough, there were 1,300 cases which occurred in 1,116 houses. Of these cases 1,002, or 77.1 per cent., were removed to the Isolation Hospitals of the Metropolitan Asylums Board and 298, or 22.9 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. Enteric fever. Plague. Malaria. Diphtheria. Scarlet fever. Small-pox. No case of small-pox was notified in Battersea during 1925, and'only 1 case (fatal haemorrhagic small-pox, notified in September, 1923) occurred in the Borough during the past 5 years. During the year 13 cases were recorded in London, 11 in Bethnal Green and 2 in Lambeth. In addition, 4 cases were notified to the Port of London Authority. In England and Wales 5,341 cases of small-pox were notified during 1925. 43 Notifications of Infectious Diseases, 1925, 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 69 36 68 38 64 79 11 18 13 153 199 44 396 Erysipelas 13 10 11 5 6 9 3 6 4 33 21 13 67 Scarlet Fever 94 47 58 37 80 91 19 35 36 207 198 92 497 Enteric (Typhoid) Fever 2 1 2 1 - - - - - 5 1 — 6 Ophthalmia Neonatorum 10 3 7 2 3 5 — 1 1 16 14 2 32 Puerperal Fever 2 — — — — 2 — 2 — 2 2 2 6 Polio-mvelitis - - - - - - - 1 1 — — 2 2 Encephalitis Lethargica 4 1 1 1 — — — — 1 6 1 1 8 Cerebro-Spinal Meningitis - - - - - - - 1 - - - 1 1 Malaria - - - - - - - - - - - - - Dysentery — - - — — — — — — — — — — Acute Primary Pneumonia 43 27 33 16 17 62 4 5 6 100 95 18 213 Acute Influenzal Pneumonia 16 11 7 6 10 11 2 4 5 38 23 11 72 Whooping Cough* 91 110 128 61 117 131 40 57 42 309 326 142 777 Measles* 26 25 120 48 71 313 29 41 20 117 474 102 693 Totals 370 271 435 215 368 703 108 171 129 986 1,354 430 2,770 * Notifiable in Battersea from 24th April, 1922. 44 Scarlet Fever. Scarlet fever was more prevalent during 1925 than in the previous year, and 497 cases were notified, as compared with 378 in 1924, 409 in 1923, 750 in 1922, and 1,374 in 1921. It is therefore to be anticipated in accordance with epidemiological experience that we may be on the upward curve of a wave of cyclical epidemicity which characterises this and other common infections. The case-rate per 1,000 of the population was 2.9, and 8 deaths were registered from the disease, giving a death-rate of .046 per 1000, as compared with 3 deaths and death-rate of .018 in 1924, 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 489; or 98.4 per cent., were removed to hospital. The infected houses numbered 425. In 54 of the notified cases (not included in the above total) the diagnosis of scarlet fever was not confirmed at hospital. Scarlet fever of late years has become a mild disease. Indeed, the very mildness of the clinical manifestations which, in the majority of cases the disease has shown, has rendered it difficult, in many instances, to diagnose, and in a number of cases children are found in the desquamative or "peeling" stage before the nature of the disease is recognised. It is therefore a difficult matter to control the incidence of the disease, and the effect of removal to the Isolation Hospitals of the Metropolitan Asylums Board as a precaution against the spread of infection appears to be of doubtful value from this standpoint. Except where the environmental circumstances are unsatisfactory, rendering hospital treatment necessary or desirable, it becomes a question whether the accommodation of the Board's Hospitals should not be utilised to a greater extent for other diseases, e.g., measles and whooping cough, which are much more dangerous to young children. Diphtheria. The number of cases of diphtheria notified in Battersea during 1925 was 396, as compared with 372 in 1924, 374 in 1923, 670 in 1922, and 713 in 1921. The number of deaths registered from the disease was 10, giving a death-rate of 0.58, as compared with 25 deaths and a death-rate of 0.15 in 1924, 34 deaths and a death-rate of 0.20 in 1923, and 58 deaths and a death-rate of 0-34 in 1922. Of the 396 cases notified, 392 or 99.0 per cent, were removed to hospital. The infected houses numbered 337. In 61 cases (not included in above total), the diagnosis of diphtheria was not confirmed at hospital. 45 The following table shows the incidence and mortality of diphtheria during 1925 in the Borough, the sub-districts and the wards:— Ward. Cases. Deaths. Cases per 1,000 Popltn. Deaths per 1,000 Popltn. Percentage Case Mortality. 1 69 4 2.46 .14 5.80 2 36 — 1.93 — — 3 68 1 3.46 .05 1.47 4 38 1 2.40 .06 2.63 5 64 2 3.37 .11 3.12 6 79 1 3.73 .05 1.27 7 11 — 1.25 — — 8 18 1 0.92 .05 5.55 9 13 — 0.60 — — E. 153 6 2.15 .08 3.92 N.W. 199 3 4.04 .06 1.51 S.W. 44 1 .85 .02 2.27 Boro' 396 10 2.30 .06 2.53 Incidence and Mortality, 1895-1925. Mean Quinquennial Rates. Mean deathrate. Case mortality per cent. Mean No. of cases per annum. Mean case rate Mean No. of deaths per annum. 1895-1899 569.6 3.43 93.4 .564 17.02 1900-1904 265.2 1.57 22.6 .134 8.34 1905-1909 267.4 1.58 22.2 .131 8.18 1910-1914 224.4 1.34 17.4 .104 7.74 1915-1919 261 .0 1.66 22.4 .143 8.56 1920-1924 531.8 3.15 43.4 .257 8.06 Year 1925 396 2.30 10 .058 2.53 The case-rate per 1,000 population was 2.30, as compared with 2.18 in 1924, 2.19 in 1923, 3.96 in 1922, and 4.21 in 1921. The case-mortality was 2.53, as compared with 6.7 in 1924, and 9.1 in 1923. The average case-mortality for the 5 years 1921-1925 was 7.18 per cent. 46 The incidence of the disease was highest in the Latchmere, Church and Winstanley Wards, where the standard of living and the housing accommodation are generally much below the average for the Borough, these wards contributing 53.3 of the total cases notified. The facilities provided by the Council for the bacteriological examination of swabs from suspected cases of diphtheria are freely availed of by medical practitioners practising in the Borough. Anti-toxin is also supplied free of charge, and may be obtained on personal or written application by doctors at any hour of the day or night at the Town Hall. In the chart facing this page are shown the incidence and mortality from diphtheria annually from 1893 to 1925. It will be noted that in 1921 the incidence curve has attained as high a maximum almost as in 1893, and that the mortality curve had also reached a higher maximum than in any year since 1898. While it is satisfactory to note that the mortality from diphtheria in Battersea was low during 1925, there is no doubt that this disease is still a very formidable menace to child life, and that its toll of lives is greater than it should be, in spite of the fact that there is at our disposal a most potent preventive measure. The Schick test, which has so far only been tried on a very small scale in this country, has already proved its value, and it is to be regretted that more extensive use is not being made of this powerful immunising agent. Moreover, such use as has already been made has been mainly in children of school age. It is in the case of children of pre-school age that the best results from immunisation are to be obtained. Even on the very small scale that it has been already carried out in various elementary and secondary schools in this country, Schick testing has amply proved its value. In these schools it is stated some 5,000 children were immunised after a positive result had been obtained, and with the exception of one or two specially susceptible cases none of these children even when exposed to risk of infection had subsequently contracted the disease. It is obvious therefore that an extended use should be made of this preventive agent. Infant Welfare Clinics are the most appropriate places to carry out the necessary treatment, dealing, as they do, with children of pre-school age One Metropolitan borough has already adopted the Schick test, and the immunisation of positively re-acting cases at one of its Infant Welfare Clinics. During the year 82 children under 12 years of age at the Royal Masonic Institute for Girls were Schick tested, with the following results:— 60 gave a positive result. 22 were negative to the test. 47 Of the 60 children who reacted positively— 3 were immunised after 2 injections 35 ,, ,, ,, 3,, 2 ,, ,, ,, 4 ,, 12 ,, ,, ,, 5 ,, 5,, ,, ,, 6 ,, 3 ,, ,, ,, 7 ,, Enteric Fever. During 1925, 9 cases of enteric fever were notified in Battersea. Of these 3 cases were cancelled, the diagnosis not being confirmed at hospital. There was 1 death from this cause as against 3 deaths in 1924. The source of infection in 2 cases, there was reason to believe, was traceable to infection while travelling in France and Italy. In 3 cases there was no definite evidence obtainable as to the probable source of infection. The following table gives particulars of the cases notified in 1925:— Enteric Fever Cases Notified 1925. Identification. Sex. Age. Diagnosis. Result. Probable Source of Infection. L.G. (1 Jan.) M. 6 Confirmed Vidal Positive B. Typhos. (St. Thomas's 31-3-25). Recovered. Discharged about 10-5-25. Not known. C. E. (4 Apr.) M. 14 Confirmed Recovered. Discharged Hospital 14-l-26 Do. M.C. (22 Jun.) F. 13 Confirmed Convalescence uneventful. Discharged Victoria Hospital before 17-10-25. Probably contracted at Naples. Another case reported. C.C. (20 Aug.) M. 55 Confirmed Discharged 16-10-25. Unknown. R.D. (5 Oct.) F. 38 Confirmed "Paratyphoid B." Discharged 10-11-25. Visited France, returned 15-9-25—unwell 17-9-25. S.M. (24 Oct.) M. 43 Confirmed. Died 28-10-25 Jellied eels, Shell fish or Fried fish. Cerebro-Spinal Fever. During 1925 only 1 case of cerebro-spinal fever was notified in Battersea, as compared with 4 cases in 1924, 4 cases in 1923, 2 cases in 1922 and 3 in 1921. There were no deaths from this disease in Battersea during 1925. 48 Encephalitis Lethargica. There were 12 cases of encephalitis lethargica (sleepy sickness) notified in Battersea during 1925, as compared with 14 cases in 1924 and 3 cases in 1923. In 4 of these cases the diagnosis was not confirmed. Two deaths were recorded from this disease as compared with 5 in 1924. The following table summarises particulars of the cases notified in Battersea during 1925:— Identification. Age and Sex. Date notified. Date of Death. Progress. F.P. 16, M. 21 Jan. - Recovered H.M. 38, M. 7 Feb. — In mental hospital W.B. 9, M. 9 „ — Recovered R.T. 20, F. 24 Mar. — Progressing favourably M.A.L. 48, F. 10 June 8 June — J.V.G. 36, M. 21 July — Recurring case (nearly well) M.G. 19, F. 14 Sept. — Still under treatment W.F.S. 20, F. 14 Dec. 10 Dec. — There was also a fatal case (unnotified) in Battersea, the patient having been removed to hospital notified suffering from Scarlet Fever, and dying the following day, death being certified as due to Encephalitis Lethargica. In 1925 the numbers of notified cases of this disease in England and Wales was 2,676, and in London 302. Puerperal Fever. There were 6 cases of puerperal fever notified in Battersea during 1925, as compared with 15 cases in 1924, 7 cases in 1923 and 13 cases in 1922. There were 3 deaths from the disease. The number of cases per 1,000 births was 1.88, as compared with 4.78 in 1924. The notified cases were distributed as follows:—East Battersea, 2 ; North West Battersea, 2 ; South West Battersea, 2. The case-mortality was 42.9 per cent., and the death-rate per 1,000 births was 0.94, and per 1,000 of the population .017 respectively. One fatal case was not notified, the death being ascribed to puerperal fever following miscarriage. The following table summarises the particulars of incidence of puerperal fever in Battersea from 1892-1925 49 Puerperal Fever Statistics, 1892-1925. Notifications. Mean No. per annum. Mean Rate per 1,000 population. Mean Rate per 1,000 births. 1892-1901 10.9 .067 2.11 1902-1911 11.8 .066 2.53 1912-1921 10.4 .063 2.77 1921 15 .089 4.01 1922 13 .077 3.55 1923 7 .041 2.04 1924 15 .088 4.78 1925 6 .035 1.88 Mean 1921-5 11.2 .066 3.25 Deaths. Case mortality % Mean Number. Rate per 1,000 population. Rate per 1,000 births. 1892-1901 69.8 8 .049 1.54 1902-1911 54.2 5 .037 1.39 1912-1921 47.0 4 .025 1.06 1921 26.7 4 .024 1.07 1922 23.0 3 .018 0.82 1923 0 — — 1924 26.7 4 .023 1.27 1925 42.9 3 .017* 0.94* Mean 1921-5 24.6 2.8 .016 0.82 * An unnotified fatal case is included for the purpose of these columns. Acute Polio-Myelitis. There were 2 cases of acute polio-myelitis notified in Battersea during 1925, as compared with 9 in 1924, 8 in 1923, 4 in 1922, and 2 in 1921. Both cases were removed to hospital, and there were no deaths from the disease. At the end of the year there were still under treatment 17 cases, including 15 cases notified prior to 1925. Of these 17 cases, 12 were of children under 5 years of age when notified. All cases were carefully enquired into during the year. 50 The following table gives particulars of the cases notified in Battersea during the year:— Name. Age and Sex. Date Notified. Result. S.P. 1½—F. 9 Jan. At Carshalton. Progress reported good. B.T. 29—M. 9 Sept. At Convalescent Home, Osborne, I.O.W. Much improved. Ophthalmia Neonatorum. There were 32 cases of ophthalmia neonatorum notified in Battersea during 1925, as compared with 41 cases in 1924, 42 in 1923, 41 in 1922, 61 in 1921, and 105 in 1920. The rate per 1,000 births was 10.0, as compared with 13.1, 12.2, 11.2, 16.3 and 22.5 in 1924, 1923, 1922, 1921 and 1920 respectively. The incidence of the disease and the rate per 1,000 births in the Borough, sub-districts and the wards is shown in the following table:— Registration Sub-District. Cases. No. of Births. Rate per 1,000 births. East Battersea 16 1,471 10.9 North-West Battersea 14 1,013 13.8 South-West Battersea 2 700 2.9 Wards. No. 1. Nine Elms 10 635 15.7 „ 2. Park 3 406 7.4 ,, 3. Latchmere 7 371 18.9 ,, 4. Shaftesbury 2 265 7.5 „ 5. Church 3 386 7.8 ,, 6. Winstanley 5 449 11.1 ,, 7. St. John 152 ,, 8. Bolingbroke 1 279 3.6 „ 9. Broomwood 1 241 4.1 Borough (1925) 32 3,184 10.0 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 Mean 1920-1924 58 3,730 15.5 51 Number of cases notified— By medical practitioners 32 By midwives or nurses Nil. Number removed to hospital 2 All notified cases of ophthalmia neontorum or of inflammation of the eyes of the newly-born are at once visited by the Health Visitors, and steps are at once taken to secure medical treatment at home or at hospital. Nursing attendance is provided free of charge when cases are retained at home for treatment. During 1925 the total number of visits paid by Nurses supplied by the Council in cases of ophthalmia neonatorum or other inflammatory conditions of the eyes of infants was 3,056. In addition, 237 visits of enquiry and supervision were made by the Health Visitors. No case of permanent damage to the eyes of new-born infants was recorded in 1925. Erysipelas. There were 67 cases of erysipelas notified, and 1 death was registered from the disease during 1925, as compared with 75 cases and 6 deaths in 1924, 84 cases and 3 deaths in 1923, and 66 cases and 2 deaths in 1922. The case-mortality was 1.5 per cent., and the death-rate per 1,000 of the population was .006, as against a case-mortality of 8 per cent. and a death-rate of .035 per 1,000 of the population in 1924. Measles. There was a considerable increase in the incidence of measles during the last quarter of 1925. 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 794 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 29 cases in every 1,000 of the population under 10 years of age. In the previous year 2,423 cases were notified or otherwise reported. Of the 794 cases notified or reported during the year 1925 there were 693 cases notified under the Regulations, as compared with 1,893 cases in 1924, showing that the obligation of notification 52 (restricted to the first case occurring in a house) is being observed. There were 101 cases in addition to those notified under the Regulations reported from the Public Elementary Schools and other sources. Measles Incidence and Mortality, 1921-5. 1921. 1922. 1923. 1924. 1925. Mean. 1921-5. Cases notified 1,496* 1,319 1,893 693 1,350 (4 yrs) „ Reported 149 1,564 369 530 101 543 (5 yrs) Total 149 3,060 1,688 2,423 794 1,623 (5 yrs) Case-rate per 1,000 popln. 0-10 yrs. 4.87 103.30 58.64 86.46 29.02 56.52 Deaths 2 66 24 51 4 29.4 D.R. per 1,000 popln.(all ages) .012 .390 .141 .298 .023 .173 D.R. per 1,000 popln. (0-10) .065 2.228 .834 1.820 .146 1.019 Mortality per 100 cases (Total) 1 .345 2.157 1.422 2.105 .516 1.809 * Measles was made notifiable in Battersea under the Battersea (Measles and Whooping Cough) Regulations, 1922, which came into force on April 24th of that year. The disease became very prevalent during the last quarter, and had assumed the proportions of a characteristic epidemic during the last few weeks of the year. The mortality was however compared with previous epidemics, remarkably low. This may be accounted for by a less virulent type of infection, but so far as this Borough is concerned, it is probably, in part at least, due to the special precautionary measures carried out in conjunction with notification. These are similar to those in operation in respect of other forms of notifiable disease, and include, in addition to a modified form of notification, systematic home visiting of notified cases, removal to the Metropolitan Asylums Board's Hospitals, where the home conditions are unsatisfactory, securing the provision of medical treatment and nursing attendance of cases under treatment in their homes, and in necessitous cases such other appropriate assistance as may be needed. The London County Council School Medical Service works in co-operation with the Public Health Department of the Borough Council in measles outbreaks with satisfactory results, so far as the recent scheme of co-operation arranged between the County and Borough Medical Officers of Health has been in operation in Battersea. 53 As the outbreak of measles which began late in 1925 was, during the early part of 1926, exhibiting signs of a severe epidemic, it will be of interest in the next annual report to record the effects of notification and the precautionary measures taken in conjunction therewith on the mortality-rate from this formidable disease of child life. 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 1921 .01 .17 (5 years 1921-5) 1922 .39 1923 .14 1924 .30 1925 .02 The deaths caused by measles during 1925 numbered 4, giving a total mortality-rate at all ages of -02, as compared with 51 deaths and a death-rate of -30 in 1924, 24 deaths and a death-rate of • 14 in 1923 and 66 deaths and a death-rate of -39 in 1922. Whooping-Cough. During 1925, 777 cases of whooping-cough were notified under the Battersea (Measles and Whooping-Cough) Regulations, 1922, to the Medical Officer of Health, and 545 additional cases were reported from the public elementary schools and other sources. There were 20 deaths registered from the disease, the death-rate being 0.116, as compared with 17 deaths and a death-rate of 0.099 in 1924, 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 1925 was 1,320, as compared with 816 in 1924, and 1,024 in 1923, an increase of 61.8 per cent, over 1924. 54 Incidence and Mortality, 1921-5. 1921. 1922.* 1923. 1924. 1925. Mean. (1921-5). Cases Notified 285* 580 511 777 538 (4 yrs.) ,, Reported 576 143 444 305 543 403 (5 yrs.) Total 576 428 1,024 816 1,320 833 (5 yrs.) Case-rate per 1,000 population (0-10 yrs) 18.83 14.45 35.57 29.12 48.24 29.24 Deaths 30 22 16 17 20 21 D.R. per 1,000 population (all ages) .177 .130 .094 .099 .116 .123 D.R. per 1,000 population (0-10 yrs.) .981 .741 .556 .607 .731 .723 Case-mortality per 100 cases (Total) 5.21 5.14 1.56 2.08 1.52 2.52 *Whooping Cough was made notifiable in Battersea under the Battersea (Measles and Wooping Cough) Regulations, 1922, which came into force on April 24th of that year. TUBERCULOSIS. During 1925 there were 335 cases of Tuberculosis (all forms) notified in Battersea, as compared with 351 in 1924, 364 in 1923, 411 in 1922, and 466 in 1921. In the following table is shown the distiibution 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 43 29 21 30 28 29 9 25 24 113 66 59 NonPulmonary 15 14 15 7 16 8 1 10 11 42 32 23 Totals 58 43 36 37 44 37 10 35 35 155 98 82 The Borough : Pulmonary 238 Non-Pulmonary 97 Total 335 55 The following table shows the age and sex distribution of the cases of Tuberculosis notified in each Ward and in the Registration Sub-Districts during 1925:— 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 13 18 14 9 2 32 26 58 207 2 1 2 9 11 8 12 - 26 17 43 230 3 _ 4 7 6 12 6 1 23 13 36 183 4 _ 2 6 13 13 3 _ 17 20 37 234 5 _ 2 8 11 20 2 1 23 21 44 232 6 1 1 3 10 14 8 - 25 12 37 175 7 - - 1 2 6 1 _ 7 3 10 114 8 _ _ 3 14 12 6 - 11 24 35 180 9 - 1 5 10 15 4 - 19 16 35 162 Boro' 2 14 55 95 114 51 4 183 152 335 195 E. 1 8 31 46 41 26 3 86 69 155 217 N.W. 1 5 15 22 39 14 1 60 38 98 199 s.w. - 1 9 27 34 11 — 37 45 82 159 Rate per 100,000 popul ation in each age group Boro' 66 154 170 310 217 150 39 230 164 195 - The death-rate fiom Tuberculosis was slightly higher than in the previous year. The lowest death-rate from the disease hitherto recorded in Battersea was during 1923. The death-rate for 1925 was 115.6 per 100,000 population, equal to the mean rate for the 5 years 1921-25. 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 ol the population during the twenty-five years ended 1925 in quinquennial averages, and in 1921, 1922, 1923, 1924, and 1925 are given in the following table:— Years. 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 1921-1925 92.6 23.0 115.6 Average (25 years) 120.5 35.6 156.1 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 1925 90.6 25.0 115.6 56 In the subjoined table are given deaths from Tuberculosis at various ages in each Ward and the registration sub-districts during 1925:- Wards. Rate per 100,000 population. Ages:— Total, All Ages. Totals. Grand Total. 0-1 1-5 5-15 15-25 25-45 45-65 65- M. F. Pulmon ary. NonPul monary. 1 118 2 - 2 10 10 7 2 19 14 28 5 33 2 150 1 1 1 5 11 8 1 17 11 23 5 28 3 153 - 2 3 12 10 1 2 15 15 20 10 30 4 120 - 1 1 5 7 5 _ 9 10 16 3 19 5 100 _ _ 2 5 6 6 _ 8 11 15 4 19 6 128 1 1 2 5 12 5 1 18 9 22 5 27 7 80 - 1 - 2 2 2 - 4 3 5 2 7 8 134 — 1 1 3 12 9 - 15 11 19 7 26 9 46 - - 3 1 4 2 - 5 5 8 2 10 E. 133 3 2 6 27 31 21 5 54 41 76 19 95 N. 122 1 3 5 14 25 11 1 32 28 47 13 60 S. 85 - 2 4 7 18 13 - 24 20 33 11 44 — 116 4 7 15 48 74 45 6 110 89 156 43 199 Rate per 100,000 popultn. 132 77 46 157 141 133 59 136 97 91 25 116 The localisation of the disease in the 335 cases notified in 1925 is summarised below:— Localization of Disease. Pulmonary (238) Genito-Urinary (3) General (2) Lungs 234 Fallopian Tubes 1 Generalized 2 Lungs and Larynx 2 Kidney 1 Lungs and Abdomer 1 Testicle 1 Bones and Joints (22) Lungs and Glands 1 Spine 8 Brain (5) Hip and Hip Joint 3 Glands (50). Meninges 5 Knee 2 Cervical 22 Foot 3 Abdominal 4 Skin (2) Ankle 2 Unspecified and Various 24 Elbow 1 Nose i Trochanter 2 Abdominal (12) Unspecified 1 Wrist 1 Abdomen 3 Peritoneum 9 Eye 1 Total 335 A copy of the official return to the Ministry of Health of the notifications on Forms A B and C, received during 1925, is set out on pages 65 and 66. During 1925 there were 199 deaths from Tuberculosis registered as belonging to the Borough of Battersea. Of this number, 156 (i.e. 78.4 per cent.) were due to pulmonary tuberculosis, 16 (8.0 per cent.) to tubercular meningitis and 27 (13.6 per cent.) to other forms of the disease. 57 In 1924, the number of deaths from tubercular diseases (all forms) was 190. Of the 199 deaths registered from Tuberculosis during the year, 27 were not notified until within one month before death; in 18 cases the notifications were received after death, and in 19 cases no notification was received. Of the 19 cases of which no primary notification was received 14 were patients who died in hospitals, infirmaries or nursing homes, 2 in mental hospitals, and two elsewhere, while one death was recorded by the coroner as due to tuberculosis after enquiry. Of the 18 cases notified after death 2 (1 pulmonary, 1 nonpulmonary) were notified by private doctors, 9 (4 pulmonary, 5 non-pulmonary) by Poor Law Institutions, 6 (3 pulmonary, 3 nonpulmonary) by hospitals or asylums, and one was notified after Inquest. In all cases where notification was not received in accordance with the requirements of Public Health (Tuberculosis) Regulations, 1912, the explanations received were considered satisfactory, and in no case was it found necessary to take legal proceedings. A circular letter, dated 22nd December, 1924, was issued by the Ministry of Health, drawing the attention of Local Authorities, inter alia, to the importance of securing strict compliance with the requirement of the Public Health (Tuberculosis) Regulations as to notification. On the instructions of the Health Committee the Medical Officer of Health addressed a circular letter to all medical practitioners practising in the Borough reminding them of the obligation of notification imposed on them by the Regulations and of the facilities for diagnosis, etc., provided under the Council's Tuberculosis scheme through the Tuberculosis Dispensary. The number of notifications received after the death of the patient in 1925 was 18 as compared with 30 in 1924. It would appear, therefore, from these figures that the action of the Council has been followed by a more careful observation of the requirements of notification. The Public Health (Tuberculosis) Regulations, 1924, require the Medical Officer of Health to furnish quarterly to the County Medical Officer of Health returns of cases (a) on the register at the beginning of the quarter, (b) notified during the quarter, (c) removed during the quarter, (d) remaining on the register at the end of the quarter; the figures being separated for males and females and for pulmonary and non-pulmonary cases. The Public Health (Tuberculosis) Regulations, 1925, wen. issued in July, and prohibited any person suffering from Tuberculosis of the respiratory tract from entering upon any employment or occupation in connection with a dairy, involving the milking of cows, the treatment of milk or the handling of milk vessels. 58 Powers were given to the Local Authority under proper safeguards to require persons engaged in handling milk who were suffering from tuberculosis to discontinue their employment.* One such case occurred during 1925, but the patient, a milk roundsman, after examination at the Dispensary and Hospital, was certified to be cured and was allowed to continue his occupation. The notification register is regularly revised, and in all cases of deaths, removals from the Borough, etc., the names of the patients are forthwith removed from the register. A number of cases are also removed after medical examination by the Tuberculosis Officer, the disease being found to be arrested or cured. The result of the revision of the register during 1925 is shown in the following table:— Pulmonary. Non-Pulmonary. Grand Total. M. F. Total M. F. Total On register 1st January, 1925 622 554 1,176 333 300 633 1,809 Additions— New cases 140 116 256 67 56 123 379 Removals into Borough 2 2 4 3 2 5 9 Restored to register 4 5 9 1 1 2 11 768 677 1,445 404 359 763 2,208 Deletions. Deaths 86 70 156 24 19 43 199 Removals from Borough 48 51 99 12 28 40 139 Cured or disease arrested 82 85 167 36 30 66 233 Diagnosis not confirmed 1 _ 1 - 1 1 2 Other causes 11 25 36 - — — 36 228 231 459 72 78 150 609 On register 1st January, 1926 540 446 986 332 281 613 1,599 Divided between :— Dispensary 343 254 597 138 104 242 839 Male Inspectors 180 — 180 86 — 86 266 Female Inspectors 17 192 209 108 177 285 494 540 446 986 332 281 613 1,599 *The Council empowered the Medical Officer of Health to serve such notices where necessary. 59 Battersea Tuberculosis Dispensary. The Battersea Tuberculosis Dispensary, taken over in 1921 from the Voluntary Organisation, is situated at 179 Bridge Road. The premises there are, however, regarded as unsuitable, and a new Dispensary building, for which the plans and specifications have been prepared, and after some modifications have been approved by the Ministry of Health, is to be erected. It is hoped that the new building will be completed in the Autumn of 1926. It is very badly needed as the existing Dispensary, an adapted private house, is inadequate and otherwise unsuitable for the purpose. The new Dispensary has been planned to meet all the requirements of a modern tuberculosis dispensary, and when ready for the admission of patients will prove a most useful addition to the provision already made by the Council for health services in the Borough. The Dispensary is affiliated to St. Thomas's Hospital, which provides facilities for difficulties in diagnosis, e.g., X-ray examination, cases necessitating artificial pneumothorax refills, &c. Cooperation with other hospitals is maintained, and patients attending for examination at the Dispensary and found to be suffering from conditions requiring treatment other than tuberculosis, are referred to appropriate institutions. The staff of the Dispensary consists of a Tuberculosis Medical Officer, 3 Nurses, Secretary, Typist, Dispenser and Caretakers (man and wife). Dental facilities for Tuberculosis patients attending the Dispensary were provided by the Council in 1922. A weekly session is held at the Dental Clinic, Plough Road, and patients requiring treatment or the provision of dentures are referred to the Clinic by the Tuberculosis Medical Officer. The London County Council is responsible for the Institutional treatment of tuberculosis in the County of London (hospital, sanatorium, &c.), and arrangements are made for the Institutional treatment of Battersea patients through the Dispensary. Advanced cases are removed to St. James' Hospital under the Guardians of the Wandsworth Union or other appropriate institutions. Co-operation with medical practitioners has been maintained, and increasing use is being made by Medical men practising in the Borough of the facilities provided at the Tuberculosis Dispensary for diagnosis in difficult and doubtful cases. As far as possible the Dispensary follows its main role, viz., that of a centre for diagnosis. Cordial co-operation between the Tuberculosis Dispensary Medical Staff and local medical practitioners is regarded as a matter of prime importance in any efficient dispensary scheme for the prevention of Tuberculosis, and the relations shown in the following figures to exist between the Dispensary Staff and local doctors is most satisfactory. During 1925 the consultations with Medical practitioners numbered 898, and during the 4 years 1921-1924, the numbers were 1921, 460, 1922, 625, 1923, 574, and 1924, 736. 60 During 1925, 99 Dispensary patients were referred to hospitals for various causes. Of these 75 were sent to St. Thomas's Hospital for X-ray examination. The Dispensary treatment of school children is carried on in close co-operation with the School Medical Service. In this connection the Borough is fortunate in having the Springwell House Open-air School in its district, under the direction of the London County Council. The Tuberculosis Medical Officer and one of the Dispensary Nurses, by arrangement with the London County Council, are in medical charge of the School, which is located at Clapham Common North Side. The School is not exclusively attended by Battersea children, the majority of the children are, however, resident in the Borough. The results of the year's work will be found on p. 61. Work of the Tuberculosis Dispensary. The work of the Dispensary was carried out with the usual routine during 1925. Dr. Macdonald, Tuberculosis Medical Officer, reports:— During the year 629 new patients attended the Dispensary. Of these 128 were found to be suffering from Tuberculosis and 158 were "suspect" cases, and were kept under observation at the Dispensary for a period. The remaining 276 were considered nontuberculous. For the 5 years 1921-25, the number of new patients who attended the Dispensary, showing the number found to be tuberculous, were:— Year 1921. 1922. 1923. 1924. 1925. New patients 746 624 662 594 629 Tuberculous 197 188 202 189 195 During the year 1925, 233 contacts were examined—adults 80, children 153. In 1925, 37 patients in whom the diagnosis was at first doubtful were definitely found to be suffering from Tuberculosis, and these were added to the 195 new cases, making a total of 232 notified cases. Of this number 103 had already been notified to the Medical Officer of Health, so that 129 were primary notifications from the Dispensary. The total number of attendances at the Dispensary during the year was 5,177, insured 1,753, non-insured 3,824. For the years 1921-25 the attendances were:— 1921. 1922. 1923. 1924. 1925. 6,010 4,910 5,436 4,389 5,177 During the year 223 domiciliary visits were paid by the Tuberculous Officer. The home visits by the Dispensary Nurses during the year numbered 5,670. Year 1921. 1922. 1923. 1924. 1925. Doctor 269 264 188 278 223 Nurses 5,599 7,048 6,942 6,534 5,670 61 During the year 128 patients were sent away to institutions under the London County Council's Tuberculosis Scheme—insured 87, non-insured 41. In addition, 42 Dispensary patients were admitted to St. James' Hospital. 1. Average stay of patients in Sanatorium during the year 1925 101 days 2. Average waiting-period between tion and admission 24 days 1. Number of patients recorded as ceasing to attend during 1925 74 2. Number of patients removed to other districts and transferred to the Medical Officer of Health of district concerned 45 The number of sputum examinations made at the Dispensary during 1925 was 1,422. In 294 (i.e., 20-7 per cent.) the result was positive. Of the total number of specimens examined 566 were sent by Medical practitioners practising in the Borough and 248 by St. James' Hospital. The number of specimens examined during the quinquennium 1921-1925 was:— Year 1921. 1922. 1923. 1924. 1925. Specimens of sputum examined 691 925 1,132 1,265 1,422 The number of reports sent to public bodies during the year was 1,240, as compared with 986 in 1924. The particulars relating to the work carried out during 1925 at Springwell House Open-Air School are summarised as follows:— Number on roll 31st December 147 „ admitted during 1925 52 „ discharged during 1925 52 Reasons for Discharge:— Fit for Elementary School 10 Fit for work 23 Transferred to Hospital or Sanatorium 10 Removed from district 7 Transferred to Special School Nil Discharged for other reasons 2 Gain or loss in weight of children who have been in the School for more than 12 months:— Children who have gained weight 101 Average gain in kilos. 3.401 Children who have lost weight or whose weight was stationary 2 Average loss in kilos. .5 kg. 62 The Tuberculosis Care Committee. The Care Committee met weekly during 1925, and the following is a summary of the work carried out by the Committee:— In Need of Assistance Battersea Borough Council—extra nourishment 88 Wandsworth Board of Guardians—for relief, 15; extra nourishment, 14; other forms of assistance, 14 43 Charity Organisation Society—financial assistance, 6; dentures, 9; bed and bedding, 10; other assistance, 2 27 British Red Cross Society—financial assistance, 4; bed and bedding, 1 5 United Services Fund—financial assistance, 4; clothing, 4; bed and bedding, 1; other assistance 1 10 London County Council—housing accommodation, 3; re-imbursement of cost of funeral expenses, 2; extension of period of deferred payments of instalments of purchase of house, 1 6 National Society for Prevention of Cruelty to Children 1 Royal Naval Benevolent Fund—financial assistance 1 British Legion—financial assistance 1 Battersea Charity Trustees—Educational grant 1 Other Agencies 5 Training and Employment Former Employers or suitable agencies 9 Local Employment Exchange and Chief Area Officer for discharged Ex-service men 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 £324 19s. 8d. Tuberculosis Dental Treatment Total attendances 302 Sessions held 47 Average attendance per session 6.4 Extractions 240; scalings, 18; fillings, 24; dentures, 13; repairs to dentures, 1; dressings, 19; advice, 92 (average, 8.7) 407 63 NON-DISPENSARY CASES. In addition to the work carried out by the staff of the Tuberculosis Dispensary visits to houses in which cases of Tuberculosis were notified were paid by the Sanitary Inspectors during 1925 to male patients, and in the case of women and children patients by a woman Sanitary Inspector (Miss J. Round). Women and Children. Women and children notified to be suffering from Tuberculosis and not attending the Borough Tuberculosis Dispensary are systematically visited by a woman Sanitary Inspector. During 1925 the number of new cases notified was 149. Of these, after correction and adjustment of the figures as to cases not traced, transferred to the Dispensary and to other districts, and cases in regard to which no information could be obtained, there were 136 cases investigated—women 78, children 58. Of these 136 cases, 33 were found to be dead on first visit, and 9 cases died subsequently during the year. The following table gives particulars of the 136 women and children non-dispensary cases notified to be suffering from tuberculosis (all forms) during 1925:— 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. 2 - - 2 - - - - - - - 4 f. — 3 1 4 5 15 15 9 8 2 2 64 Tuberculous Meningitis M. 2 1 3 2 - - - - - - - 8 f. — 4 1 1 — 2 - - - - - 8 Other Forms M. 1 6 11 2 - - - - - - - 20 F. — 3 4 6 5 6 4 3 — 1 — 32 Total M. 5 7 14 6 - - 32 F. — 10 6 11 10 23 19 12 8 3 2 104 Grand Total 5 17 20 17 10 23 19 12 8 3 2 136 The home conditions of these 136 cases were carefully investigated. In the majority of cases the sanitary state of the home was found to be satisfactory, the average number of persons per room being 1.32. In 19 cases, however, the patient's family was found to be living in a single room, as compared with 13 families living under the same conditions in 1924. During the year 65 cases were undergoing hospital, sanatorium or other Institutional treatment. 64 At the end of 1925 there were 494 women and children nondispensary patients (a decrease of 14 as compared with 1924), including new cases notified during the year on the Tuberculosis register, and 1,173 visits were paid by the Woman Sanitary Inspector to the homes of these patients. Efforts are made in as many cases as possible to induce nondispensary patients to attend the Tuberculosis Dispensary, and during the year 13 cases were transferred. It is satisfactory to record that the efforts to secure precautions against infection of other members of the family appear to have met with considerable success, e.g., separate room or separate bed were found to be in use in over 90 per cent, of the cases, as compared with 78 per cent, in 1924, and 68 per cent, in 1923. It should be borne in mind, however, in this connection, that a larger number of these patients were receiving Institutional treatment in 1925 than in previous years. Adult Male Patients. There were 266 adult male non-dispensary cases on the register at the end of 1925, and 88 were new cases notified during the year. Of these new cases 24 died during the year. The following table gives particulars of the non-dispensary new cases notified in 1925:— Pulmonary Age Distribution. All ages. 16-20 20-25 25-30 30-35 35 -45 45-55 55-65 65up 4 8 9 8 10 24 6 2 71 Tubercular Meningitis - - - - - - - - — Other tubercular Diseases 5 3 3 2 1 — 3 — 17 Total 9 11 12 10 11 24 9 2 88 The homes of all these patients were systematically visited during the year by the district Sanitary Inspectors, and 610 visits, including 88 first visits to new cases, were made. Ten 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 42 received institutional treatment, and 30 were transferred to the Dispensary. 65 Summary of Notifications during the period from the 4th January, 1925, to the 2nd January, 1926, 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. *No. of Primary Notifications. 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. Total No. on Form A. Under 5 5 to 10 10 to 15 Total Primary Notifications Total No. on Form B. Pulmonary— Males I 4 12 21 31 26 27 9 2 133 193 - - - - - 54 118 Females — 2 — 5 15 24 26 15 10 3 2 102 142 - - - - - 35 52 Non-Pulmonary— Males 2 6 22 5 4 5 6 2 1 53 58 — — — 2 19 Females — 5 6 12 7 7 4 3 — — - 44 47 — — — - - - 26 (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 ou 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. 66 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 4th January, 1925, to the 2nd January, 1926, 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 3 3 1 — 11 „ Females - 2 - - 1 1 3 1 1 2 1 12 Non-pulmonary Males 2 2 1 1 2 — — 1 — 2 — 11 „ Females — 3 1 3 - 3 1 — — — — 11 67 Deaths from Zymotic Diseases The principal zymotic diseases are small-pox, measles, scarlet fever, diphtheria (including membranous croup), whooping-cough, enteric fever and diarrhœa. The deaths from these causes in 1925 numbered 64, as compared with 122 in 1924, a decrease of 48.0 per cent. There was a corresponding decrease in the zymotic death-rate from 0.71 in 1924 to 0.37 in 1925. The mean death-rate from each of the principal zymotic diseases for the ten years 1905-1914, and for the ten years 19151924, are compared with the corresponding rates for 1924 and 1925 in the following table:— Zymotic Diseases. Number of Deaths from each of the principal Zymotic Diseases in 1924 and 1925, with corresponding Death Rates for those years and for the 10 years 1905-14 and 1915-1924. No. of Deaths. Death-rate per 1,000 population. Mean Death-rate per 1,000 population. Increase ( + ) or Decrease (—), 1925 over 1924. 1925. 1924. 1925. 19051914. 19151924. Previous year. 19151924. Small Pox - - - - - .001 - -.001 Measles 51 4 .298 .023 .446 .325 -.275 -.302 Scarlet Fever 3 8 .018 .046 .081 .038 +.028 +.008 Diphtheria 25 10 .146 .058 .116 .200 -.088 -.142 W hooping-cough 17 20 .099 .116 .273 .201 +.017 -.085 Enteric fever 2 1 .012 .006 .031 .015 - .006 -.009 Diarrhoea and enteritis 24 21 .140 .122 .466 .313 -.018 -. 191 Total 122 64 .713 .371 1.413 1.093 -.342 -.722 NON-NOTIFIABLE INFECTIOUS DISEASES. Chicken-Pox. During 1925 there were 853 cases of chicken-pox reported, as compared with 541 in 1924, 617 in 1923, 259 in 1922, and 400 in 1921. 68 Bacteriological Examinations. During 1925, the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 1,725. 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. The following table gives particulars of the bacteriological examinations carried out during 1925 :— Suspected disease. Positive Results. Negative Results. Total. Diphtheria 196 1,509 1,705 Enteric fever 6 14 20 Total 202 1.523 1,725 The cost of these examinations amounted to £221 3s. 11d. Diarrhoea. During 1925 the total number of deaths from diarrhoea of children under 2 years of age was 16. This is the lowest incidence ever recorded, and was equal to a fatality-rate of .09, as compared with 23 deaths and a fatality-rate of .13 in 1924. The remarkable decline in the incidence and mortality from this erstwhile formidable disease of infant life, is one of the most satisfactory features of modern sanitary progress. The reasons advanced for this great improvement in our vital statistics has been referred to in previous annual reports, and it is gratifying to note that infantile diarrhoea continues to decline, and that we may look forward confidently to the death-rate under this heading of the Registrar General's returns as no longer a serious cause of child mortality. 69 The following table summarises the incidence and mortality under 2 years of age, of diarrhoea and enteritis from 1911 to 1925 :— Year. Deaths under 1 yr. of age. 1-2 yrs. 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 1925 14 2 16 5.0 Mean Deaths in Quinquennial Periods. 1911-1915 94.6 23.2 117.8 27.8 1916-1920 40.2 5.0 45.2 13.3 1921-1925 23.4 5.6 29.0 8.3 Influenza. There were 36 deaths caused by influenza during 1925, as against 84 in 1924, 31 in 1923 and 110 in 1922. The mortality-rate was .21, as compared with .49 in 1924, .18 in 1923, and .66 in 1922. Influenza was not very prevalent in 1925, and no special action was needed to deal with the disease. Influenzal pneumonia was also less prevalent during 1925. There were 72 cases notified, as compared with 167 in 1924, 70 in 1923, and 196 in 1922. The death-rate was .09 per 1,000 population, as against .29 in 1924, 1 in 1923, and .41 in 1922. 70 Cancer. During 1925 the number of deaths from cancer of persons belonging to Battersea was 236 (male 105, female 131), as compared with 231 in 1924, 242 in 1923, and 225 in 1922. The death-rate from the disease per 1,000 of the population was 1-37 in 1925, as compared with 1.35 in 1924, 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 1901 :— Cancer Deaths, 1901-1925. Mean Annual Death-rate per 1,000 population. 1901-1905 .88 1906-1910 .95 1911-1915 1.11 1916-1920 1.28 1921-1925 1.33 1925 1.37 It will be noted from these figures that there is again to be recorded a slight increase in cancer mortality in 1925. The progressive increase in the death-rate from this cause is still a matter of serious concern, and although research continues to take place into the nature and origin of the disease, so far no definite advance appears to have been obtained. The following table shows the localisation of the disease in the case of the 236 deaths recorded for 1925 :— Localisation. No. of deaths. Total. Male Female Buccal cavity 15 1 16 Stomach, liver, etc. 38 39 77 Peritoneum, intestines and rectum 18 30 48 Female genital organs — 16 16 Breast — 26 26 Skin 2 — 2 Other and unspecified organs 32 19 51 Total 105 131 236 71 Sanitary Circumstances. SANITARY INSPECTION OF THE BOROUGH. Summary of Sanitary Operations for the Year 1925. Total Sanitary Operations 65,400 Dust receptacles provided 582 Number of house inspections 34,744 Leaky house-roofs and gutters repaired 858 House to house inspections ... 644 Bakehouse inspections 280 Houses supplied with water and fittings repaired 210 Bakehouse nuisances abated 38 Urinals—inspections 140 Houses let in lodgings registered 85 Do. altered, repaired or water laid on 47 No. of inspections of do. 46 Water Closets provided, supplied with water or supply disconnected from drinking water cisterns 208 Intimations served under Sec.3 3,059 Notices served under Sec.4, Ac. 762 Notices served under Sees. 62 & 65 2,854 Cisterns covered, cleansed and repaired 81 Complaints received and attended to 3,294 Additional water supplies to upper floors 33 Number of premises disinfected 1,999 Houses supplied with disinfectants 1,154 Keeping of animals in unfit state discontinued 23 Overcrowding abated 6 Smoke observations 86 Premises improved, cleansed and repaired 2,668 Certificates of disinfection granted 3,086 Drains tested By smoke 501 Houses inspected and certificates granted (Sec. 48) 21 Do. water 1,179 Drains cleansed and repaired 255 Proceedings ordered by Council and Health Committee 3,347 Drains relaid 101 Frontage drains constructed or re-constructed 26 Summonses issued 85 Magisterial Orders obtained and enforced 26 Soil pipes and drains ventilated 152 Sink and rain-water pipes disconnected or repaired 499 Factories, Workshops, &c., inspections 5,611 Water Closets cleansed and repaired 479 Sanitary conveniences provided or improvements effected in Factories and Workshops (Sec. 38) 46 Cesspools abolished — Mews and Stables drained and paved - Underground sleeping rooms: Use discontinued - Yards and forecourts paved and repaired 324 Defects remedied — Accumulations of manure and other obnoxious matter removed or proper receptacles provided 6 Gipsy van inspections 67 Drains laid to new houses and tenements 21 Samples taken under the Sale of Food and Drugs Acts 1,221 Miscellaneous 1,715 72 Legal Proceedings. Legal proceedings in connection with nuisances were taken by the Council in 14 cases during 1925. 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. * Failure to comply with notice to provide sufficient water closets and flushing apparatus at premises No. 43 St. Johns Road Order made with £1 1s. costs. Nuisance at No. 55 Stainforth Road arising from defective drains Adjourned sine die on defendant's undertaking to carry out the work. Non-compliance with nuisance orders 507 Battersea Park Road Work commenced, 10s. 6d. costs paid. Case withdrawn. Failure to abate nuisance at 18 Basnett Road Order for abatement made with £1 1s. costs. Failure to abate nuisance at 40 Almeric Road Adjourned sine die £1 1s. costs paid. Failure to abate nuisance at 20 Marmion Road Work done. Withdrawn on payment of £1 1s. costs. Keeping dogs at 168 Tyneham Road in such a manner as to be a nuisance Fined £5. Non-compliance with notice to abate nuisance at 21 Stormont Road Nuisance abated. Summons withdrawn on payment of £1 1s. costs. The like at 116 Wycliffe Road The like, on payment of £2 2s. costs. Nuisance at 109 Livingstone Road —offensive condition of rooms and cats kept in such manner as to be a nuisance Order for abatement and prohibiting recurrence, defendant to pay £1 1s. costs—14 days allowed for payment. Nuisance at 70 York Road arising from defective condition of roof causing dampness The nuisance having been abated, defendant discharged under Probation of Offenders Act, but ordered to pay £2 2s. costs. Overcrowding of first floor front room at No. 2 Meyrick Road Adjourned sine die for defendant to find other premises, the L.C.C. having intimated their willingness to assist. Failure to comply with notice to abate nuisance at 83 Sterndale Road Defendant having executed the necessary work to abate nuisance, summons withdrawn subject to payment of £2 2s. costs. Nuisance at 11 Woodgate Street and no sufficient dustbin at 38 Woodgate Street Work having been done and £1 1s. costs paid, summonses withdrawn. Nuisance at 65 Livingstone Road Ditto. • Proceedings instituted in 1924. 73 Sale of Food and Drugs Acts. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. *381 Fairy Cakes 24.5 grains per lb. boric acid Summons dismissed. No order as to costs 695 Milk 16% deficient in fat Fined £5 5s. 0d. and £1 1s. 0d. costs. Sample taken in course of delivery at Clapham June. Obstructing Food Inspector in course of his duties On conflict of prosecution's evidence, summons dismissed. 17 Milk 35% deficient in fat Fined £5 and £1 1s. 0d. costs. Summons against second defendant dismissed. 85 Milk 9% deficient in fat Dismissed—Warranty defence. 157 Milk 8% extraneous water and 11% deficient in fat 186 Milk The like 10% and 14½% Defendant absconded. 187 Milk The like 4½% and 15½% Summonses not served. 188 Milk The like 3½% and 9½% 189 Milk The like 6½% and 16% 190 Milk The like 10% and 16½% 113 Vinegar 7% deficient in acetic acid Withdrawn on payment of 10s. 6d. costs. - Milk False warranty in respect of sale of milk Dismissed on defendant proving to the satisfaction of the Court that when the warranty was given there was reason to believe that the statements or descriptions contained therein were true. 273 Milk 13% deficient in fat Withdrawn in accordance with instructions of the Health Committee on payment by the defendant of £3 3s. 0d. costs. Sample taken in course of delivery at Clapham Junction. 356 Milk 42% deficient in fat Dismissed. Defendant to pay £10 10s. 0d. costs. 373 Milk 13% deficient in fat Dismissed. Defendant to pay £3 3s. 0d. costs. Sample taken in course of delivery at Clapham Junction. * Proceedings instituted in 1924. 74 Sale of Food and Drugs Acts—continued. No. of Sample. Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 381 Milk 22% deficient in fat Dismissed. Defendant to pay £6 6s. 0d. costs. Samples taken in course of delivery at Clapham Junction. 383 Milk 4% deficient in fat 384 Milk 13% deficient in fat 516 Milk 14% extraneous water Fined £10 and £2 2s. 0d. costs. Sample taken in course of delivery at S. Lambeth Station. 621 Milk 8% extraneous water Fined £5 and ordered to pay £3 3s. 0d. costs. 688 Milk 8% extraneous water Discharged under Probabation of Offenders' Act on payment of £1 1s. 0d. costs by each defendant on each summons (2 summonses). 689 Milk 8% extraneous water 698 Milk 12% extraneous water Each defendant fined £2 and £2 2s. 0d. costs or in default one month's imprisonment. Milk and Dairies (Amendment) Act, 1922. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 696 Milk Coloured with annatto Fined £5 5s. 0d. and £1 1s. 0d. costs. Sample taken at Clapham Junction in course of delivery. 705 Milk 14% extraneous water First defendant fined £3 and £1 1s. 0d. costs. 747 Milk 11½% extraneous water Each defendant fined £2 10s. 0d. 752 Milk Coloured with annatto Summons dismissed against first defendant with £1 1s. 0d. costs. Second defendant fined £1 and £2 2s. 0d. costs. 777 Milk Coloured with annatto 3rd sample analysed by Government Chemist shewed no annatto. Case withdrawn in Court. No order as to costs. 815 Milk Coloured with annatto Fined £1 and 10s. 6d. costs. 75 Milk and Dairies (Amendment) Act, 1922—continued. No. of Sample. Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 834 Milk 11% extraneous water Fined 30s. and £2 2s. 0d. costs. Case against employee dismissed. 883 Milk 11 % extraneous water Fined £3. 906 Milk 11 % extraneous water and containing added colouring matter First offence. Dismissed on payment of 10s. 6d. costs in each case. 265 Milk 6½% extraneous water Each case dismissed on payment of 12s. 6d. costs. 266 Milk 6 ½% extraneous water 314 Milk 7½% extraneous water Dismissed on payment of £1 1s. 0d. costs. 317 Milk 15½% extraneous water Dismissed on first defendant paying £1 1s. 0d. costs and the second defendant, 10s. 6d. costs. 400 Milk 16½% extraneous water Dismissed, defendants to pay £2 2s. 0d. costs. 581 Milk 13% extraneous water Defendant fined £5 with £1 1s. 0d. costs, or in default one month and summons against the other defendant withdrawn. 711 Milk 6.5% extraneous water Defendant fined £3 and ordered to pay £1 1s. 0d. costs. Employee discharged under Probation of Offenders Act. Housing Act, 1925. Nature of Offence or Claim. Result of Proceedings. A declaration that the Council were entitled to a first charge on the premises 18 Sheepcote Lane and the freehold interest therein for £94 Is. 2d. the costs of executing works to the premises and also for interest and costs and for a sale and other relief Judgment for the Council. Recovery of 12s. 6d. expenses incurred in executing work to No. 17 Woodgate Street Orders made. Total costs in three summonses £3 15s. 6d. The like £3 12s. Od.—18 Woodgate Street The like £11 16s. 2d.—19 Woodgate Street 76 Housing Act, 1925—continued. Nature of Offence or Claim. t of Proceedings. Failure to comply with notice under Section 10 of 1923 Act in respect of 16 Gladstone Terrace Withdrawn on payment of £1 1s. costs and compliance with notice. A declaration that the Council are entitled to a joint Charge on No. 67 Stainforth Road and the freehold interest therein for £152 1s. 6d., the costs of executing works to the premises and also interest and costs, and for a sale and other relief. Judgment for the Council in terms of minutes signed by defendants. Like claim for £158 13s. 6d. in respect of No. 58 Ascalon Street Terms of settlement having been agreed for payment of claim and costs, action adjourned sine die. Like claim for £140 15s. 7d. in respect of No. 64 Ascalon Street The like. Like claim for £73 19s. 7d. in respect of No. 147 New Road The like. A declaration that the Council are entitled to a first charge on the premises No. 12 Wayland Road for £452 19s. 11d. and interest at £5 per cent. per annum, and for an Order for sale Judgment for the Council in accordance with the claim. Failure to furnish name and address of person from whom the defendant held No. 20 Basnett Road Defendant by her Solicitor having given the names of the Solicitors to whom she paid the ground rent and stated she did not know the persons entitled to such rent, summons withdrawn on undertaking to pay £1 3s. costs. Collecting rent of 34 Austin Road, the rent book not being inscribed with the names and addresses of the Medical Officer of Health and the landlord Defendant fined altogether 12s. 6d. and ordered to pay £1 0s. 6d. costs. Default in payment of £21 14s. 6d. arrears due under an Order of the Council of the 25th February, 1925 (No. 38 Woodgate Street) The money and costs of the summons, 4s. having been paid, summons withdrawn. Failure to pay £5 2s. 5d. expenses incurred by the Council in works to defendant's premises, No. 7 Newcomen Road Defendant having paid amount of debt with 3s. costs of summons, case withdrawn. 77 Housing Act, 1925—continued. Nature of Offence or Claim. t of Proceedings. Failure to have name and address of landlord and of Medical Officer of Health in rent book of 20 Basnett Road Defendant having by her Solicitor given undertaking to put rent book in order forthwith and to pay £2 2s. costs, summons withdrawn. Default in payment of £4 2s. 3d. arrears due under an order of the Council dated 22nd July, 1925, for work done by them at defendant's premises 76 Knowsley Road Order for payment of debt and 3s. costs of summons forthwith. Default in payment of £9 3s. 6d., arrears due under an order of the Council dated 25th February, 1925 for work done at defendants premises 38 Woodgate Street Debt and 4s. costs of summons having been paid before hearing, case withdrawn. Default in payment of £30 19s. 10d. arrears due under an order of the Council dated 23rd July, 1924, for work done by them at 27 Darien Road Debt and 3s. costs of summons having been paid before hearing, case withdrawn. Factory and Workshop Act, 1901. Nature of Offence or Claim. t of Proceedings. Using an underground bakehouse at 31 Battersea Bridge Road contrary to Section 101 of the above Act Fined £1 and £3 3s. costs. 78 Summary of Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 74 cases during the year 1925:— Persons prosecuted (including employees). Convictions. Fines. Costs. £ s. d. £ s. d. Factory & Workshop Act, 1901 1 1 1 0 0 3 3 0 Milk & Dairies (Amendment) Act, 1922 27 10 27 15 0 15 19 0 Public Health (Milk and Cream) Regulations, 1912, Amendment Order, 1917 - - - - - - - - Public Health (London) Act, 1891, and the Bylaws made thereunder 16 2 5 0 0 15 4 6 Sale of Food and Drugs Acts 20 6 29 5 0 39 7 6 Housing Acts 21 7 0 12 6 9 19 0 Total 85 26 £63 12 6* £83 13 0* 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 50 new buildings, or additions to existing buildings, and the drains of 101 old buildings were partially or entirely reconstructed, under the supervision of the Officers of the Department. *The disproportion between the fines and costs imposed is accounted for by the fact that the Court in several instances dealt with defendants under the Probation of Offenders Act, discharging them on payment of costs, and that cases against employees were withdrawn where the employers took responsibility. 79 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 1925 at the cost of the Council:— Basnett Road, 26 and 28. Simpson Street, 27-34. The expenditure incurred on these "sewers" amounted to £86 10s. In the five years 1921-5, claims relating to combined drains were admitted in 23 instances (60 premises), the estimated expenditure incurred by the Council being £1,318 10s. Revenue Act, 1903. During 1925 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 1925 the number of public-house urinals under inspection was 117. In 81 instances the accommodation is accessible to the general public as well as the users of the houses, and in 36 cases the accommodation is accessible to the customers only. As a result of the annual inspection of these conveniences, 42 notices were served to remedy defects discovered. Smoke Nuisances. During the year 86 observations were made and 7 complaints received. Four preliminary notices were served by the Council to abate smoke nuisances, which were duly complied with. Effluvium Nuisance. During 1925 no complaint of effluvium was established. Water Supply. During 1925, 21 applications were received for certificates of water supply in respect of 21 houses in accordance with Section 48 of the Public Health (London) Act, 1891. The certificates were granted in each instance. In 33 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. 80 Van Dwellings. The number of van dwellings in the Borough in 1925 was 65. 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. #] Mill's Yard, adjoining 88 Sheepcote Lane 3 3 3 Mill's Yard, adjoining 80 Sheepcote Lane 4 6 6 Manley's Yard, Falcon Road 8 9 8 Manley's Yard, Cabul Road 33† 32 29 Mill's Yard, Culvert Road 17* 15 18 During the year 4 vans were found to be overcrowded, and notices were served to abate the nuisance. Eight 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 1925. 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. During 1925 the work carried out under the Council's Rat Repression Scheme is summarised as follows :— Premises visited 2,155 Contracts renewed 13 Poison baits used 65,800 Value of contracts £197 0 0 Dead rats found 2,584 Cash for poison bait £48 19 4 Total expenditure (financial year 1925-6) £543 8 9 Income (financial year 1925-6) £188 19 0 Net cost £354 9 9 Drains were tested at 68 premises in connection with this work, and in 35 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. *Including one shed. †Including one cottage. 81 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 1925, there were 4,724 children and 261 adults cleansed and treated at the station. Of the 4,724 children attending, 145 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 has been a decrease in the number of infested children and adults treated at the station as compared with the previous year. The following table shows the numbers of persons cleansed and treated at the Personal Cleansing Station and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun. 82 Number of Baths, &c. Year. Adults. Children. Cost of Station. Amount Contributed. Verminous and Scabies. 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 4,949 779 487 1924 311 5,394 912 488 1925 261 4,724 918* 465* 13,712 45,547 £6,083 £3,464 *Estimated. Disinfecting Department. Summary of work carried out by the Disinfecting Department during 1925. Total Premises disinfected 1,999 Rooms disinfected 3,243 Staircases disinfected 208 Schools disinfected 59 Number of articles laundered 29,370 „ „ destroyed 648 „ verminous, etc., persons (including 4,717 school children) 4,985 „ infectious disease contacts 933 „ Library books collected 234 Total Articles. No. Tons. Weight. lbs. cwts. qrs. Bedding, &c., disinfected 60,241 128 19 0 14 „ lent 1,256 3 18 3 20 Verminous clothing, &c. 4,523 1 10 3 8 Articles from Welfare Centres 3,809 (not weighed) Total 69,829 134 8 3 14 83 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 92 29 9 5 135 Inquest at Mortuary ; post-mortem elsewhere 16 36 19 _ 71 Inquest at Mortuary; no post-mortem 1 10 5 — 16 Total inquests held Battersea Mortuary 109 75 33 5 222 Post-mortems without inquest,Battersea Mortuary 9 - - - 9 Total post-mortems held at Battersea Mortuary 101 29 9 5 144 Bodies received for sanitary reasons 2 2 Other bodies on which no inquest held at Mortuary 3 2 1 — 6 Total bodies received 123 77 34 5 239 VERDICTS AT INQUESTS HELD— Natural causes Accidental Death— 64 28 7 1 100 Asphyxia 2 — 2 Bathing — 1 — — 1 Burns and scalds 3 6 — — 9 Deaths under anaesthetic 1 3 — — 4 Drowning 1 1 Fall 8 11 11 — 30 Railway and street accidents 9 15 11 — 35 Septicaemia 4 2 - — 6 Tetanus following injury — 1 - — 1 Other accidents 1 1 1 — 3 Open Verdict— Found drowned 1 1 Stillborn 5 — - 2 7 Want of attention at birth — 1 - 1 2 Suicide— Cut throat 2 1 3 Drowning 1 3 4 Hanging — 1 — — 1 Jump from high place 1 — — — 1 Poisoning—Coal gas 2 1 — — 3 „ Drugs, etc. 1 3 — — 4 Homicide. Blow (manslaughter) I - - - 1 Abortion 2 - - - 2 Infanticide 1 — — — 1 Grand Total 109 75 33 5 222 Sanitary Staff. The personnel of the staff of the Health Department will be found fully set out on page 3. No change in the personnel took place during 1925. 84 Protection of the Food Supply. INSPECTION AND SUPERVISION OF FOOD. Unsound Food. The following is a tabulated return of unsound food seized or voluntarily surrendered during 1925 :— Food Condemned. Food. Quantity. Food. Quantity. Fish. Fruit & Vegetables (fresh). Coal Fish 5 stones. Apples 20 boxes. Cod 1 trunk. Brussels Sprouts 1 bag. 1 case. Cherries 16 crates. 3 boxes. 5 boats. Codlings 3 boxes. Cocoanuts 3 bags. Dog Fish 6 stones. Mandarins 10 punnets. Eels 2 drafts. Potatoes 8 bags. Haddock 1 trunk. Tomatoes 31 boxes. 2 cases Kippers 4 boxes. Meat & Poultry. Roes 1 box. Fowls 18 Whelks 1 bag. Pork Pies 3 Winkles 1 bag. Rabbits 106 Cow-houses. There is only one licensed cow-house remaining in the Borough, situate at 17 Wiseton Road. Slaughter-houses. There are only two slaughterhouses remaining in the Borough. These premises are kept under systematic inspection, and during the year 1925, 319 inspections were made by the Council's inspector. The carcases of 669 animals (oxen 38, calves 5, sheep 295 and pigs 331) were examined after slaughter. The average number of animals examined after slaughter in the licensed slaughter-houses within the Borough during the 5 years 1921-25 was 1,102. 85 The provisions of the Public Health (Meat) Regulations, 1924, have been brought to the notice of the occupiers of these slaughterhouses. The provisions of the by-laws as to the marking of carcases, which, in my opinion, should have been made obligatory, have not been adopted by the proprietors. The requirements as to giving notice of intention to slaughter have, however, been rigidly enforced. Butchers' Shops. The number of butchers' shops in the Borough at the beginning of the year 1925 was 90. Four new shops were opened during the year and one closed, making a total of 93 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 1,173 inspections of these premises were carried out by the Council's Food Inspector. Public Health (Meat) Regulations, 1924. These Regulations, made under the Public Health (Regulations as to Food) Act, 1907, came into force on the 1st April, 1925. The principal part of the Regulations deals with slaughter-houses and slaughtering, and is designed to secure the inspection, by competent officials, of all animals slaughtered. This part of the Regulations, so far as Battersea is concerned, is not of great importance, as there are only two slaughter-houses now remaining in the Borough, and in only one of these is any regular slaughtering carried on. Part III. of the Regulations deals with the marking of carcases, and is not obligatory on slaughter-house proprietors. Part IV. deals with matters relating to the cleanliness of meat stalls. Part V. deals with cleanliness, &c., of shops and stores. Part VI. deals with transport and handling. It is with Parts IV., V. and VI. that the Council are mainly concerned. The object is to protect meat stored or in course of transit or exposed for sale in stalls, shops and stores from risk of contamination. On the issue of the Regulations steps were taken by the Council with a view to enforcing compliance by all meat retailers in the Borough. Owing, however, to the opposition of the Trade to the interpretation placed on the Regulations by the Sanitary Authority, administrative difficulty has been experienced in carrying them into effect. The Ministry of Health, after conferences with the Trade representatives, issued a circular in which it was stated (inter alia) that the provision of glass fronts to butchers' shops 86 was not, in their view, in all cases contemplated by the Regulations. Although it was anticipated that administrative difficulties might be raised by the interpretation placed upon the Regulations by the Ministry, it was, nevertheless, decided to enforce this requirement of the Regulations where necessary. Subsequently the Committee received a deputation of the local butchers at their request and the points of objection raised by the deputation were discussed. Most opposition appeared to be centred round the question of the provision of a glass window in all butchers' shops, notwithstanding that some 70 to 80 per cent. of these shops in Battersea were already provided with glass windows, and that it is chiefly in the cheaper class of shops that meat is found openly exposed to contamination from dust, dirt and other impurities in the crowded thoroughfares of the Borough. The Council, on the recommendation of the Committee, reiterated their decision to enforce the provisions of the Regulations in all cases in which it was reported to them that they were not being complied with. At the end of the year, in the majority of cases, an improvement was apparent in the manner in which the Regulations were being generally complied with, and it is probable that in due course the determination of the Council to secure the protection of meat from contamination in shops, stalls and during transit will be followed by strict observance of the Regulations. Sale of Food and Drugs Acts. The total number of samples taken under the Acts during 1925 was 973, of which 43 or 4.4 per cent. were certified by the Public Analyst to be adulterated. In addition to the foregoing, 248 informal samples were procured, of which 7 or 2.8 per cent. were reported by the Public Analyst as adulterated, not up to standard, or as containing preservatives in varying amounts. The percentage of samples reported by the Public Analyst to be adulterated during the 5 years 1921-25, was as follows :— Year. Formal Samples. Informal Samples. 1921 8.3% 1922 8. 0% 7.9% 1923 7.2% 7.4% 1924 3.9% 11.5% 1925 4.4% 2.8% Mean 6.4% 7.4% 87 The following tables give details of the articles of which samples were obtained for the purpose of analysis:— Main Statement. TABLE I. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Bread - 7 7 - 0 0 Butter 16 72 88 0 1 1 Cheese 18 — 18 0 — 0 Cocoa 22 — 22 0 — 0 Coffee 18 — 18 0 — 0 Cream 5 2 7 0 0 0 Cream, Preserved 10 1 11 0 0 0 Flour Self-raising — 7 7 — 0 0 Jam — 4 4 — 0 0 Margarine 5 18 23 0 0 0 Milk 808 1 809 40 1 41 „ Condensed (Full Cream) - 8 8 - 0 0 „ „ (Machine Skimmed) 4 4 0 0 „ Dried — 6 6 — 0 0 Mustard — 10 10 — 0 0 Sugar — 12 12 — 0 0 Vinegar 16 — 16 1 — 1 Drugs — 27 27 — 0 0 Other Articles 55 69 124 2 5 7 Total 973 248 1221 43 7 50 TABLE II. Drugs. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Acid, Citric - 2 2 - 0 0 Acid, Tartaric — 2 2 0 0 Bicarbonate of Soda — 2 2 0 0 Borax, Purified — 4 4 — 0 0 Camphorated Oil — 8 8 — 0 0 Milk of Sulphur — 6 6 — 0 0 Tincture of Quinine (Ammoniated) — 3 3 — 0 0 Total — 27 27 — 0 0 88 TABLE III. Other Articles. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Apples - 2 2 - 2 2 Arrowroot — 14 14 — 0 0 Baking Powder — 7 7 — 0 0 Barley, Pearl — 4 4 — 0 0 Confectionery (Sweets) — 4 4 — 0 0 Fairy Cakes — 1 1 — 1 1 Honey 9 — 9 0 — 0 Ice Cream — 6 6 — 0 0 Lard 23 — 23 0 — 0 Olive Oil 16 — 16 0 — 0 Pepper — 10 10 — 0 0 Rice — 11 11 — 0 0 Rice (Ground) — 3 3 — 0 0 Sausages 4 1 5 1 0 1 Sponge Cake 3 6 9 1 2 3 Total 55 69 124 2 5 7 Milk. Of the 808 formal samples 40 or 4.95 per cent. were certified as adulterated. Eleven samples were reported against as being deficient in milk fat, 17 as containing extraneous water, 6 as being deficient in milk fat and containing extraneous water, 4 as containing colouring matter and 2 as containing both colouring matter and extraneous water. One informal sample of milk was submitted and reported upon as containing extraneous water. In the 5 years 1921-25 the percentage of adulterated (formal) samples of milk was as under:— Year. Samples taken. Adulterated. No. Percentage. 1921 714 36 5.0 1922 726 36 4.9 1923 702 43 6.1 1924 721 25 3.4 1925 808 40 4.9 Mean 734 36 4.9 89 The average composition of the 768 samples reported as genuine proved to be as under :— Total milk solids 12.52% Milk fat 3.69% Non-fatty solids 8.83% The content of fat in these 768 samples ranged as follows :— 4.0% and over 108 samples or 14.1% Between 3.9 and 4.0% 53 „ „ 6.9% „ 3.8 „ 3.9% 73 „ „ 9.5% „ 3.7 „ 3.8% 98 „ „ 12.8% 3.6 „ 3.7% 124 „ „ 16.1 % „ 3.5 „ 3.6% 126 „ „ 16.4% „ 3.4 „ 3.5% 82 „ „ 10.7% „ 3.3 „ 3.4% 62 „ „ 8.1% 3.2 „ 3.3% 20 „ „ 2.6% 3.1 „ 3.2% 15 „ „ 1.9% „ 3.0 „ 3.1% 7 „ „ 0.9% All samples are systematically tested for the presence of preservatives. In no case, however, was a positive result obtained. Milk sampling was carried out on 18 Sundays during the year, and 94 samples were purchased for analysis on these occasions. Samples of milk in course of delivery by wholesale firms to the number of 77 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 71 were taken in course of delivery to elementary schools in the borough. Proceedings with regard to adulteration were taken in 36 instances (fat extraction, 9 (one of these being also artificially coloured)*; extraneous water, 17 (one of these containing added colouring matter); both fat abstracted and added water, 6; added colouring matter, 4), particulars relating to which will be found set out in the tables on pages 73 to 75. Warranty was pleaded in defence in one case and was successful. Proceedings were instituted against the warrantor in this instance, but the summons was dismissed without costs. Preservatives found in Foods during 1925. Formal Samples. Nature of Sample. Nature and amount of Preservative. Sausages 25.9 grains boric acid per lb. † Sponge Cake 91 ,, ,, ,, *Proceedings in respect of fat deficiency only, † Summons not served. 90 Informal Samples. Nature of Sample. Nature and amount of Preservative. Sponge Cakes 9.8 grains boric acid per lb. ,, 8.4 Fairy Cakes 11.8 ,, ,, ,, Sponge Cakes, Fairy Cakes, &c. During the year nine samples of sponge cakes and one of fairy cakes were submitted to the Public Analyst. Of these 3 samples were procured formally and the rest informally. Of the formal samples one was reported upon as containing a boron preservative amounting to 9.1 grains of crystallised boric acid per lb., whilst 2 of the informal (sponge cake) samples contained 9.8 and 8.4 grains per lb. of the same preservative. The informal sample of fairy cakes was reported by the Public Analyst to contain a boron preservative equivalent to 11.8 grains per lb. In view of the small amount of preservative present in the formal sample, and having regard to the decision in the case which was the subject of proceedings last year (vide p. 73 sample 381), it was decided not to take out summonses against the vendor. A report of the result of the proceedings in this case will be found in the Appendix (page 124). Butter. During the year 88 samples of butter were submitted for examination. Of these 16 were taken in the form prescribed by the Acts, the remaining 72 samples were purchased informally. One of the 72 informal samples was reported by the Public Analyst as containing margarine. Of the 88 samples submitted 19, or 21.6 per cent. contained no preservative other than common salt; whilst 69, or 78.4 per cent., contained a boron preservative. Excluding the one (informal) sample 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. 91 Margarine. Twenty-three samples of margarine were purchased and submitted to the Public Analyst for examination. Of these 5 were procured formally and 18 informally, and all were reported as genuine. A boron preservative was present in each of the 23 samples, the average amount present expressed as crystallised boric acid being 0.18 per cent., equivalent to 12.6 grains per lb. Ice Cream. Six samples of ice cream were purchased and submitted to the Public Analyst for analysis, and his report showed that these had been prepared from milk, cane sugar and starch, and that no preservatives were present in the samples. The analytical data obtained showed that in 5 cases whole milk had been employed in their manufacture, whilst in 1 case milk diluted with about 10 per cent. water had been utilised. At present there is no standard as to the composition of this article in respect to milk fat or total solids. Apples. Attention was drawn by the Ministry of Health (Circular 659, dated 21st December, 1925) to the fact that two cases of arsenical poisoning had been traced to the consumption of imported Jonathan apples. Accordingly two samples of imported apples were procured informally, and submitted to the Public Analyst, who reported the presence of arsenic on the surface of both samples of the fruit to the extent of l/1000th grain and 1/100th grain per lb. of apples respectively. Sausages, Preserved Meats, &c. Five samples of sausages were examined during the year, of which 4 were procured with the necessary formalities prescribed by the Acts. Of these 4 were reported by the Public Analyst as free from preservatives, whilst 1 contained a boron preservative equivalent to 25.9 grains per lb. expressed as crystallised boric acid. Rice. Eleven samples of rice and 3 of ground rice were procured informally and submitted to the Public Analyst and all were reported as genuine. Five of the 11 samples of whole rice proved to be polished, the talc coating ranging from 0.43 per cent. to 0.06 per cent., the average quantity for the 5 samples amounting to 0.25 per cent. 92 Milk and Cream Regulations, 1912-17. 1. Milk and cream not sold as preserved cream :— (a) Number of Samples examined for the presence of a preservative. (b) Number of Samples in which a preservative was reported to be present. Milk 809* Nil. Cream 7† Nil. 2. Cream sold as preserved cream :— (а) Samples submitted for analysis to ascertain if the statements on the labels as to preservatives were correct:— 1. Correct statements made 11* 2. Statements incorrect Nil. Total 11* (б) Determinations made of milk fat in cream sold as preserved cream:— 1. Above 35 per cent 11* 2. Below 35 „ Nil. Total 11* (c) Instances where (apart from analysis) the requirements 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 Nil. 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. 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 :— * One of these was an informal sample, † Two of these were informal samples. 93 (a) (1) Number of samples of milk certified by the Public Analyst to contain colouring matter 6 (2) Action taken thereon— Three cases added colouring matter only— Vendors summoned. (1) Summons against first defendant missed with £1 1s. 0d. costs; second defendant fined £1 and £2 2s. 0d. costs. (2) Fined £1 and 10s. 6d. costs. (3) Third portion of sample referred to Somerset House. Result negative. Summons withdrawn. Two cases added colouring matter and extraneous water Vendors summoned. (1) First offence. Dismissed on payment of 10s. 6d. costs in each case. (2) Proceedings in respect of extraneous water only (included under (b) below). One case added colouring matter and slight fat deficiency. Vendor summoned and fined £5 5s. 0d. and £1 1s. 0d. costs (proceedings in respect of colouring matter only). (b) (1) Number of samples of milk certified by Public Analyst to contain extraneous water (including 2 referred to above) 26* (2) Action taken thereon— Vendor summoned 23† Convictions (fines with or without costs) 7† Dismissed on payment of costs 8† Included under heading of colouring matter above 1 Summons not served, defendant having absconded 6 Referred to Government Analyst—proceedings pending † Vendor cautioned 2 Informal sample 1 * One of these was an informal sample. † In certain of these cases proceedings were taken under Sale of Food and Drugs Acts. ‡ Case since settled—vendor convicted and fined. 94 Ice Cream Vendors. There are 201 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 1925, 1 of the ice cream premises was removed from the register and 12 were added. There was, therefore, an increase of 11 in the number of premises compared with 1924. During the year 336 inspections were made and 17 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 improvement in the manner in which this commodity is now sold, referred to in a previous report, is being maintained. Milk (Special Designations) Order, 1923. Under this Order the Council are authorised to issue licences to others than producers (i.e., persons producing milk for sale from herds over which they have control). The licences so granted are available for a period up to the end of the year in which they were issued. There is a scale of fees payable to the Licensing Authority by applicants for licences. During 1925 licences were issued as follows:— Certified milk 13* Grade A (Tuberculin tested) milk 5* Grade A milk 7* Pasteurised milk 4* Milk Shops. The number of premises from which milk is sold in Battersea is 147, as compared with 128 last year. Three new premises were registered during the year for the sale of milk. All milk shops are kept under inspection and during the year 818 inspections were carried out and 12 notices were served to remedy defects found on inspection. These mainly referred to dirty and unsuitable premises and other minor defects. Included in the above are 16 new premises in which sterilised milk in sealed bottles only is sold, and these were informally registered. It is questionable whether these premises come within the provisions of the statutory requirements as to registration. In view of the fact, however, that there is a risk in small shops that the bottles may be opened and portions of the contents sold, it would appear to be desirable that the occupiers of these premises should not be excluded from the statutory obligation to be registered as purveyors of milk. * Including one "supplementary" licence. 95 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. Two new premises were opened during the year, and in two cases the premises were no longer used for the sale of fish. All these premises are kept under systematic inspection. During 1925, 331 inspections were made and 30 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 1925 was 97, an increase of 4 as compared with 1924. During the year 499 inspections were carried out, and in 5 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 8; sweets 7; other foods 8. Six notices were served for defective and insanitary conditions of premises used by the street vendors for the storage of their stock. 96 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) 909 81 1* Workshops (including Workshop Laundries) 1,059 40 - Workplaces (other than Outworkers' premises included in the Table on page 102) 3,232 73 _ Total 5,200 194 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 69 69 Nil. - Want of Ventilation 4 4 _ Overcrowding 2 2 _ Want of drainage of floors _ Other nuisances 98 98 _ Sanitary accommodation Insufficient 7 7 - Unsuitable or defective 36 36 _ Not separate for the sexes 3 3 - Offences und.er the Factarv and. Worlshop Act— Illegal occupation of underground bakehouse (Sec. 101) 1 - 1* Other Offences (excluding Offences relating to Outworkers which are included in the Table on page 102) - Total 220 219 — 1 * Prosecution not concluded at end of 1925. 97 3.— Registered Workshops. Workshops on Register (Section 131) at end of 1925:— Bakehouses 25 Bootmakers 35 Dressmakers 25 Laundries 4 Milliners 10 Tailors 46 Other Trades 197 Total number of workshops 342 4.—Uther Matters. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Section 133) 9 Notified by H.M. Inspector 4 Underground Bakehouses (Section 101), in use at end of the year 26 Factories and Workshops. Factories. The following is a list of the factories on the register at the end of 1925:— Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons. Barge builder 2 26 2 - - Baker 50 213 19 — — Bootmaker 15 26 2 — — Builder 4 107 — — — Butter blender 1 48 24 12 9 Chemical works 4 237 5 61 14 Chaff & forage 5 59 1 8 — Coach 2 20 — — — Cycle maker 3 4 5 — — Dyer 2 45 — 23 — Engineer 30 689 7 — — Flour mills 2 150 — 12 — Firewood cutter 10 42 5 22 — Foundry 1 30 — — — Lift maker 2 16 — — — Mason 6 356 2 — — Mineral water 2 25 — 23 — Motor repairs 17 230 4 — — Printer 18 94 9 15 — Steam laundry 17 62 11 532 74 Other trades 92 3,800 382 984 464 Total 285 6,279 478 1,692 561 98 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. Four new factory premises were added to the register during the year, dealing with various trades. During the year 58 preliminary and 23 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 1925:— Trade. No. of Workshops. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Young Persons. Baker 25 34 37 1 - - Blind maker 2 3 3 2 — — Bootmaker 35 35 51 2 — — Carpenter 4 5 10 — — — Coach builder 9 14 29 — — — Cycle maker 8 12 10 — — — Dressmaker 25 32 1 — 67 7 Embroiderer 1 2 — — 15 — Farrier & smith 13 13 30 — — — Firewood cutter 2 2 4 — — — Laundry 4 8 3 — 15 1 Mason 3 3 15 — — — Milliner 10 13 1 — 27 8 Motor repairs 12 12 33 — — — Musical instrument 3 6 45 1 - - Photographer 2 5 4 — 1 — Picture framer 3 3 3 1 — — Rag sorter 14 14 23 4 7 — Saddler 2 2 2 — — — Tailor 46 55 59 4 61 4 Upholsterer 18 21 30 2 8 — Other trades 101 109 223 17 46 18 Totals 342 403 616 34 247 38 99 In certain of these trades in which female labour is mainly used, the inspection of the workshops is carried out by a female sanitary inspector. During 1925 69 workshops were visited by this female inspector, the number of inspections amounting to 99. Thirty-four intimation and six statutory notices were served during the year for various defects in workshops found on inspection, all of which were complied with. Of these, 5 intimation notices were served by the female inspector. Thirteen new workshops were added to the register, dealing with:— Builder 1 Millinery 2 Cycle maker 1 Motor repairs 1 Dressmaking 4 Tailoring 3 Engineer 1 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 1925:— Trade. No. of Workshops. Protected Persons employed. Women. Young Persons. Total. Baker 1 - 1 1 Dressmaker 5 8 4 12 Milliner 2 4 — 4 Motor repairer 1 — 1 1 Totals 9 12 6 18 Outworkers. During 1925, 556 names and addresses of out-workers were received in 127 lists sent in by employers and by the Medical Officers of Health of Metropolitan Boroughs and District Councils. 211 names and addresses relating to 130 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:— 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:— 100 Trade. Number on Register. Persons Employed. Premises. Workrooms Bootmaking 35 35 35 Glovemaking 1 1 1 Tailoring 54 54 82 Other Trades 4 4 4 Totals 94 94 122 No new male out-workers (out-workers not previously registered) were registered during the year. There were 142 inspections made of male out-workers' premises during 1925, and it was found necessary to serve notices under the Public Health (London) Act, 1891, in 2 cases to remedy sanitary defects found on inspection, as follows:— Want of cleansing ; defective apparatus to w.c. One case of infectious disease was notified during 1925 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 5 5 5 Boxmaking 11 11 11 Dressmaking 25 25 27 Embroidery 36 36 39 Fancy goods 12 12 12 Fine needlework 9 9 9 Glovemaking 2 2 2 Knitting and crochet 7 7 7 Tailoring 33 33 35 Underclothing 6 6 9 Other trades 18 18 18 Total 164 164 174 101 Twenty-seven new female out-workers (out-workers not previously registered) were registered during the year. 269 inspections of female out-workers' premises were made by the woman workshops' inspector (Miss Round). It was found necessary in one case to serve a notice under the Public Health (London) Act, 1891, to remedy defects. One case of infectious disease, viz.: scarlet fever, was notified from female out-workers' premises. Such precautionary measures as were required were taken to prevent spread of infection in this case. Bakehouses. There were 75 bakehouses on the register at the end of 1925. Of these 50 use power, and are therefore factories. Forty-nine of the bakehouses are above ground, and 26 are under ground. One above ground and one below ground bakehouse were discontinued during the year, the premises being used for other businesses. 280 inspections were made during the year, and 38 intimation and 16 statutory notices were served, mainly for failure to carry out the half-yearly lime-whiting of the bakehouses within the statutory period. During 1925 proceedings were taken by the Council against the occupier of a bakehouse in the Borough who had used an underground room as an ancillary part of his business for the baking of crumpets contrary to the provisions of Sec. 101, Factory and Workshop Act, 1901. At the hearing of the case in the South Western Police Court, the solicitor for the defendant contended that the process of manufacture of this article of food was not "baking" and that therefore the basement room used for the purpose was not a bakehouse within the meaning of the Factory Act. The magistrate (Mr. T. Scanlan) held that the manufacture of crumpets was a baking process and that the room in which the baking was carried on was an underground bakehouse, and was being used in contravention of Sec. 101 of the Factory and Workshop Act, 1901. The defendant was convicted, and fines and costs amounting to £4 3s. were imposed. Warehouses and Wharves. At the end of 1925, there were 42 premises on the register, including railway yards. These premises were systematically inspected during the year, and 64 inspections were made. Three notices were served to remedy nuisances found on inspection. 102 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 38 304 3 — 14 67 — — 3 3 — 2 — — (2) Cleansing & Washing Furniture and Upholstery Other Trades — — — — — — — — — — — — — — — 2 — 2 — — _ 2 — — — — — — — — 8 — 24 1 — 7 8 — — — — — — — — Total 70 38 330 4 — 21 77 — — 3 3 — 2 — — 103 Housing. During 1925 the work of the Council in regard to housing matters has been mainly directed towards securing the repair of insanitary houses—either under the Housing Act or Public Health (London) Act, 1891. The results of the systematic inspections under the provisions of the Housing (Inspection of District) Regulations will be found set out on pp. 109-13, from which it will be seen that much useful work in this direction has been accomplished. In addition progress was made with the Plough Road Improvement Scheme. It cannot be said that the housing situation in Battersea during 1925 has been materially relieved. There is still in many areas of the Borough serious overcrowding, reference to which has been made in previous annual reports. So far as Battersea is concerned, relief from this insanitary and otherwise undesirable state of affairs can only be obtained by the provision of sufficient housing accommodation outside the Borough, and at rents which are within the financial resources of those most needing dwellings. Although some progress has been made by the London County Council and other Metropolitan Authorities in the building of houses, the demand is still largely in excess of the supply. It is to be feared, therefore, that until more ambitious housing schemes have been launched, and less regard is paid to the question of economic rents, the appalling conditions under which numbers of Battersea families are now living will remain unabated. During the five years 1921-1925 the question of over-crowding has been dealt with in the annual reports of the Medical Officer of Health, and in April, 1923, a Special Report was presented to the Council (vide Appendix p. 115). In the survey of housing requirements in Battersea made in 1919 to meet to some extent the unsatisfactory conditions prevailing. the Council secured all available building sites in the Borough, and during the quinquennium the following working-class dwelling accommodation has been provided:— Situation. Tenements. Swaffield House (Wandsworth Borough) (converted buildings) 12 Heathwall Street 6 Latchmere Estate Extension 52 Savona Street 4 Disused Fire Station, Chatham Road 12 In addition to the accommodation provided by the Council, 90 new houses were erected by private enterprise as follows:— Situation. Houses or Flats. Battersea Rise Estate 60 Sudbrooke Road 9 Roseneath Road 3 Ethelburga Street 1 Ramsden Road 4 Nightingale Lane 4 Battersea Rise 4 Upper Tooting Park 3 Grandison Road 2 104 During 1925 no new houses were erected by the Council. Fourteen new houses were erected by private enterprise in the South-west area of the Borough. These, strictly speaking, do not come within the category of what can be called " working class dwellings," being houses of the villa type let at quarterly rentals or for sale. Plans for the erection of six more houses in this area and six flats in North-west Battersea were submitted, but these premises were not completed at the end of 1925. Repair of Unfit Houses. During 1925 the repair of unfit houses under the Housing and Public Health Acts continued to be, as in previous years since the conclusion of the War, the main housing activity of the Council. The work carried out in this direction under the provisions of section 28 of the Housing Act, 1919 (now section 3 of the Housing Act, 1925) and under the nuisance clauses of the Public Health (London) Act, 1891, will be found summarised on pp. 109-13. So far as this aspect of the housing problem in Battersea is concerned the results during the past five years have proved very satisfactory. In the early days, i.e., on the passing into law of the 1919 Housing Act, the application of the powers of the Council contained in section 28 (now embodied in section 3 of the consolidated Housing Act, 1925) gave rise to administrative and legal difficulties. The Council were fortunate in securing an early decision of the Courts in their favour, dealing with the power of recovery of the expenditure incurred by the Council in carrying out works of repair to insanitary house property in default of compliance by the owner or owners concerned, reference to which will be found in previous annual reports of the Medical Officer of Health (vide Annual Report, 1921, pp. 119 et seq.). It is however inevitable that some financial loss is incurred by reason of the fact that the cost of the repairs carried out by the Council's Works Department has been in excess of the sum recovered by the sale of the property in the relatively few cases in which it has been found necessary to resort to the administrative procedure in enforcing the powers of the section. The effect, however, of the Council's persistent yet discriminating use of the powers contained in section 28 has been followed by the most satisfactory administrative results and, in the great majority of cases, the necessary repairs in accordance with the detailed specifications sent in for submission to the Housing Committee are carried out by the owners concerned without the service of statutory notices, and it is rarely necessary either to serve notices or, even when notice has been served, for the Council to require to make use of their powers in default. The practice of giving notice to all owners concerned, where notice under section 3 of the Housing Act, 1925, has been served, has resulted in securing greater expedition in compliance with the notice, the superior landlord or freeholder exercising his powers under section 30 or under the covenants of his lease, requiring the leaseholder to carry out the necessary repairs. 105 During 1925 the number of cases in which it was found necessary to act in default of the owner was six, the expenditure incurred amounting to £850 13s. 3d. During the five years 1921-1925 the total number of houses repaired by the Council in default was 66, involving an expenditure of £10,199 14s. 2d., as shewn in the following table :— Year. No. of premises. Expenditure. £ s. d. 1921 Nil. Nil. 1922 1 84 10 2 1923 34 6,407 6 1 1924 25. 2,857 4 8 1925 6 850 13 3 Total 66 10,199 14 2 The right of appeal to the Ministry of Health provided by the section has in a few instances been made use of by owners of property who have objected on various grounds to the requirements of the Council. The results of these appeals have invariably been in favour of the Council. During 1925 the following appeals were made:— 20, Basnett Road—against notice served. Result.—Appeal dismissed for want of diligent prosecution. 47, 48 and 49 John Street—against demand for payment of £807 6s. 10d. Result.—After a Local Enquiry at which the Appellant contended that the value of the work done was £533 7s. 1d., the Ministry of Health issued an order, dated 6th May, 1925, that the amount payable by the appellant shall be £757 6s. 10d. By section 129 of the Land Registration Act, which came into force in 1925, in addition to the powers given under section 10 (3) of the Housing Act, 1923, to require an owner to state the name and address of the person from whom he holds the property, the Registrar may furnish to local authorities such particulars and information in regard to land and charges as they are by law entitled to require owners of property to furnish to them direct. On the 1st July, 1925, the Housing Act, 1925, came into force. This Act is a consolidating act and reproduces under different sections the powers already possessed in previous Housing Acts. 106 Closing Orders. During 1925 a Closing Order under section 11 (1) of the Housing Act, 1925, was made on the 30th September by the Council in respect of No. 39, Tidemore Street. During the past five years, owing to the shortage of houses, it has not been considered advisable to make closing orders in respect of insanitary dwelling houses, and in such cases action has been taken under section 28 of the Housing Act, 1919 (now section 3 of the Housing Act, 1925), requiring such modified repairs as may be necessary to render the premises, which ordinarily would have been dealt with under closing orders, temporarily fit for habitation. In only three cases have closing orders been made during the five years 1921-1925 on inhabited houses. Prior to 1921 closing orders were made in respect of Nos. 16, 17, 19 and 27 Arden Street, 118 Usk Road and 38 Winstanley Road, which were empty and in a more or less derelict condition. These houses were subsequently repaired and, having been made in all respect reasonably fit for habitation, the Closing Orders were determined during the period 1921-1925. Underground Rooms. No underground rooms were represented by the Medical Officer of Health under section 17 (7) of the Housing Act, 1909 (now section 18 of the Housing Act, 1925) during 1925. Six rooms have been so represented during the period 1921-1925. Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920 and 1923. The following is a summary of the action taken under section 2 of the Increase of Rent Act, 1920, as amended by section 5 of the Increase of Rent, etc., Act, 1923:— Year. Certificates. Reports. Applied for Granted Refused Applied for Granted Refused 1921 65* 58 7 13 10 1 1922 28 23 5 3 4 1 1923 21 15† 6 4 4 — 1924 27 25 2 6 6 — 1925 18 16 2 8‡ 7 — Total 159 137 22 34 31 2 Average No. per year 31.8 27.4 4.4 6.8 6.2 .4 * Includes 6 cases under consideration at end of 1920. † Includes 2 cases in which the certificate was not issued the necessary repairs having been completed. ‡ One case under consideration at end of 1925. 107 Action under section 29 of the Housing Act, 1919 (now section 5 of the Housing Act, 1925). During 1925, 24 cases relating to 26 houses were reported to the Housing Committee for contravention of section 29 of the Housing Act, 1919 (now section 5 of the Housing Act, 1925), which requires the rent book to be kept in a prescribed form. In two cases proceedings were taken, and in the remainder the Committee directed cautionary letters to be sent to the respective owners. During the period 1921-1925, 107 cases relating to 169 houses have been reported to the Committee for contravention of this section. Insanitary Areas. No additional insanitary areas were represented during 1925. During the year considerable progress was made with the Improvement Scheme in the Plough Road area. Owing to the difficulty of re-housing the tenants the demolition of the existing houses had to be proceeded with block by block, i.e., as soon as the first block of tenements (which were erected on a vacant site) were completed and ready for occupation the tenants of the succeeding block were transferred to the new tenements and the vacated houses demolished in turn. This necessarily gave rise to considerable delay, as well as increasing the cost of the scheme, but in view of the requirements of the Housing Act and the absence of alternative accommodation no other course was practicable. The first block (six tenements) was completed in July, 1925, and the second block (six tenements) was well advanced by the end of the year. Each block consists of six tenements, which are approached by a common staircase, and each tenement contains three rooms and scullery. On the recommendation of the Housing Committee, it was decided, in addition to electric light, that electric cooking and heating apparatus be installed in all rooms except the living room, in which an "inter-oven" stove was provided. The charge made to the tenant was fixed at the rate of one shilling per week and one penny per unit for all electricity consumed for all purposes. This additional proposal was sanctioned by the Ministry of Health on condition that no part of the cost of the installation should rank for financial assistance. Byelaws—Houses Let in Lodgings. The draft byelaws made by the London County Council under section 94 of the Public Health (London) Act, 1891, as amended and extended by Section 26 of the Housing Town Planning Act, &c., 1919, and Section 14 of the Housing Act, 1923, were still the subject of discussion between the County Council, Ministry of Health and the Borough Councils at the end of 1925.* * These Byelaws came into force March, 1926. 108 A summary of the work carried out during the years 1919 to 1926 under the Housing Acts and the nuisance clauses of the Public Health (London) Act, 1891, is shown in the following table:— Total No. for the Years Grand Total. 1919-1920. 1921-1925. No. of cases in which notice under section 3 of the Housing Act, 1925 (or section 28 of the Housing Act, 1919) has been served 211 622 833 Average per year 105.5 124.4 119 No. of cases dealt with under the Housing Acts in which it was not necessary to serve notices 1,578 1,556 3,134 Average per year 789 311.2 447.7 * Total No. of houses dealt with under the Housing Acts (exclusive of Closing Orders) 1,789 2,178 3,967 Average per year 894.5 435.6 566.7 No. of Closing Orders made 11 3 14 No. of cases dealt with under the Public Health (London) Act, 1891 7,019 16,038 23,057 Average per year 3,509.5 3,207.6 3,293.9 Total number of cases in which defects were found 8,819 18,219 27,038 Average per year 4,409.5 3,643.8 3,862.6 No. of cases in which it was necessary for the Council's Works Department to enter and carry out work in default of compliance by the owners with notice under section 3 of the Housing Act, 1925 (or section 28 of the Housing Act, 1919) 17 66 83 £ s. d. £ s. d £ s. d Cost of such work 2,891 15 6 10,199 14 2 13,091 9 8 * The Housing, etc., Act, 1919, came into operation on 31st July, 1919. 109 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 Acts, either informally or by the service of notice under Section 28 of the Housing Act, 1919 (now Section 3 of the Housing Act, 1925), during 1925:— Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. No. 1 District. Belfour Street 2 New Road 1 Seymour Street 9 Everett Street 1 Ponton Street 13 Sterndale Road 1 Gonsalva Road 3 Savona Street 1 Stockdale Road 1 Total:—9 streets, 32 houses. No. 2 District. Abercrombie St. 33 Gladstone Terrace 2 Sheepcote Lane 1 Alfred Street 24 Landseer Street 31 Southolm Street 1 Anerley Street 1 Lockington Road 1 Stewarts Lane W. 1 B'sea Park Road 1 Longhedge Street 3 Weybridge Street 1 Berkeley Street 1 Rollo Street 3 Total:—14 streets, 104 houses. No. 3 District. B'sea Bridge Rd. 2 Goulden Street 1 Orville Road 27 Bridge Road W. 1 Green Lane 3 Randall Street 1 Bullen Street 4 Henry Street 1 Spencer Street 2 Castle Street 1 Home Road 3 Surrey Lane 4 Church Road 3 Hyde Lane 1 Yarmouth Cotts. 4 Frances Street 3 In worth Street 4 Total:—17 streets, 65 houses. No. 4 District. Andoe Road 1 Latchmere Grove 6 Rowena Crescent 5 Barmore Street 1 Lavender Road 7 Shillington Street 2 Benfield Street 5 Lavender Terrace 2 Simpson Street 1 Este Road 1 Lithgow Street 2 Stainforth Road 7 Falcon Terrace 2 Lubeck Street 1 Totteridge Road 1 Grant Road 1 Patience Road 2 Urswicke Road 13 Gwynne Road 5 Pearson Street 12 Verona Street 1 Harroway Road 1 Mantua Street 1 Wayford Street 2 High Street 1 Meyrick Road 6 Winstanley Road 2 Ingrave Street 28 Newcomen Road 1 Yelverton Road 4 Kambala Road Khyber Road 1 Newman Street 2 York Road 4 2 Total:—34 streets, 133 houses. No. 5 District. Basnett Road 2 Poyntz Road 1 Wickersley Road 2 Beaufoy Road 19 Shirley Grove 1 Wycliffe Road 2 Mossbury Road 1 Total:—7 streets, 28 houses. No. 6 District. Didcot Street 1 Maysoule Road 8 Strathblaine Rd. 1 Grant Road 2 Plough Road 5 Tritton Street 1 Harbut Road 2 St. Johns Hill Gr. 1 Usk Road 13 Hope Street 16 Speke Road 1 Winstanley Road 2 Livingstone Road 15 Total:—13 streets, 68 houses. 110 No. 7 District. Leathwaite Road 1 |Limburg Road 1 Marney Road 1 Total:—3 streets, 3 houses. No. 8 District. Chatham Road 1 Darley Road 1 Total:—2 streets, 2 houses. Summary. No. 1 District 9 streets 32 houses 2 „ 14 „ 104 „ „ 3 „ 17 „ 65 ,, „ 4 „ *34 „ 133 „ ,, 5 ,, 7 „ 28 „ „ 6 ,, *13 „ 68 ,, ,, 7 „ 3 „ 3 „ ,, 8 „ 2 „ 2 „ Totals *98 streets 435 houses * Winstanley Road included in both 4 and 6 Districts. The following table shows the number of houses dealt with under this section during the period 1921-1925:— Year. No. of houses dealt with. 1921 605 1922 359 1923 194 1924 585 1925 435 Total 2,178 Average per year 435.6 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 (now section 3 of the Housing Act, 1925), but the necessary works of repair had not been completed during 1924. Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. Belfour Street No. 1 District. 3 Gonsalva Road 1 Savona Street 1 Total:—3 streets, 5 houses. 111 No. 2 District. Abercrombie St. 18 Henley Street 5 Oulton Street 6 Blondel Street 1 Kersley Street 1 Raywood Street 2 GladstoneTerrace 1 Orkney Street 2 Total:—8 streets, 36 houses. No. 3 District. B'sea Bridge Rd. 1 High Street 2 Orbel Street 1 Bolingbroke Road 4 Hyde Lane 1 Surrey Lane 2 Elcho Street 1 In worth Street 3 Winstead Street 2 Frances Street 1 Total:—10 streets, 18 houses. No. 4 District. Benfield Street 9 High Street 2 Newcomen Road 1 Creek Street 1 Ingrave Street 7 Shillington Street 1 Duffield Street 1 Latchmere Grove 2 Urswicke Road 1 Gwynne Road 12 Lavender Road 2 Winstanley Road 1 Harroway Road 3 Lubeck Street 2 Total:—14 streets, 45 houses. No. 5 District. Elsley Road 1 Mossbury Road 1 Wickersley Road 1 Knowsley Road 1 Tyneham Road 1 Total:—5 streets, 5 houses. No. 6 District. Aliwal Road 1 Harbut Road 3 Linda Street 1 Cairns Road 1 Hibbert Street 37 Middleton Road 1 Didcot Street 4 Hope Street 39 Usk Road 1 Grant Road 9 John Street 1 Winstanley Road 2 Total:—12 streets, 100 houses. No. 7 District. St. Johns Road 1 No. 8 District. Nil. Summary. No. 1 District 3 streets 5 houses. „ 2 „ 8 „ 36 „ „ 3 „ *10 „ 18 „ „ 4 ,, *14 „ 45 „ „ 5 „ 5 „ 5 „ „ 6 „ *12 „ 100 „ „ 7 ,, 1 „ 1 „ ,, 8 ,, - „ - „ Totals *51 streets 210 houses *High Street included in 3 and 4 District. Winstanley Road included in 4 and 6 District. 112 Statistics for the year ending 31st December, 1925. 1. General. (a) Estimated enumerated population 172,100 (b) General death rate 10.5 per 1,000 (c) Death rate from tuberculosis 1.16 per 1,000 (d) Infantile mortality rate 58.4 per 1,000 (e) Number of premises used as habitations by all classes 27,848 (/) Estimated number of working-class dwellinghouses 24,956 (g) Number of new working-class dwellings erected *20 2. Unfit Dwelling-Houses. (a) Inspection— (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,641 (b) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 † 3,355 (c) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (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 3,289 (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 397 (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 53 (b) Number of dwelling-houses which were rendered fit— (i.) By owners 57 * Includes six tenements erected under Plough Road Improvement Scheme. † Now Part IV. of the Housing Consolidated Regulations, 1925 (S.R. & O. 860/1925). ‡ Now Section 3 of the Housing Act, 1925, which came into force 1st July, 1925. 113 (ii.) Work commenced by Local Authority but workmen subsequently withdrawn and work completed by owner 1 (iii.) Work commenced by owner, but workmen subsequently withdrawn and work completed by Local Authority 2 (iv.) By Local Authority in default of owners 3 (c) 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 2,854 (b) Number of houses in which defects were remedied— (i.) By owners 2,868 (ii.) By Local Authority in default of owners Nil (III.) Proceedings under Section 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 1 (b) Number of dwelling-houses in respect of which Closing Orders were made 1 (c) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit Nil (d) 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 with a view to improvement schemes under (a) Part I. or (b) Part II. of the Act of 1890 † Nil. * Now Secs. 11 and 14 of Housing Act, 1925. † Now Part II. of the Housing Act, 1925. 114 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 14 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). APPENDIX. Reports and Tables. 115 Report of the Medical Officer of Health on Overcrowding. The population of the Metropolitan Borough of Battersea, as enumerated at the Census of 1921, was 167,739, as compared with 167,743 in 1911 and 168,907 in 1901. From these figures it would appear that there has been a slight decline. It must be borne in mind, however, that while this is no doubt true as regards the Census for 1911, the decline then recorded for Battersea amounting to 5 per cent., the lowest for the inner and middle group of Metropolitan Boroughs, was due to the movement to the "outer ring," which during the inter-censal period was such a marked feature of the County of London returns. At the census of 1921 the enumeration which was planned to have been taken on the 24th April was, because of the industrial unrest prevailing, postponed until the 19th June following. Owing to the remarkably fine weather prevailing during the summer of that year, the holiday movement started earlier than usual, and this was reflected in the population statistics for the country generally. It was necessary, therefore, as explained in the preliminary report of the RegistrarGeneral, to make an adjustment of the enumerated figures for different areas. So far as London is concerned, the adjustment was small, the estimate of the resident population being only 9 per 1,000 in excess of the census figure in each of the Metropolitan Boroughs. The revised figure, as estimated by the RegistrarGeneral for Battersea, was 169,200, showing a slight excess over the figures for the previous census returns. It is evident, therefore, that the population of Battersea for the past two decades has remained stationary, and that, having regard to the fact that within the Borough boundaries there remains no building land available, there is, therefore, no further opportunity for expansion. This is not wholly a matter for regret, the density of population as measured by the number of persons per acre, i.e., 78, being, in my opinion, already greater perhaps than is desirable, and when contrasted with other Metropolitan Boroughs, especially its next door neighbour, Wandsworth, with its density of 17 persons per acre, the comparison is interesting and instructive. In considering the housing question in relation to housing and overcrowding it will be of interest to give a few of the principal features of the census returns for the County of London and for Battersea. In view of its vital importance at the present time, this side of the census inquiry was very carefully organised in advance, and the result is that particulars are available giving number and type of buildings, the number of structurally separate dwellings, of rooms in dwellings, of private families occupying them, and of persons in families. The term "structurally separate dwelling" is defined as any room or set of rooms having separate access either to a street or to a common landing or staircase. 116 For the county as a whole, with regard to the proportion of families to structurally separate dwellings, it is shown that while the number of families has increased by 9.5 per cent, during the decennium, the growth in the number of occupied dwellings has been at less than half of this rate, i.e., 4.1 per cent. As a result the average number of families per occupied dwelling has increased from 1.51 in 1911 to 1.59 in 1921. At the same time the number of empty dwellings has decreased from 47,260 to 18,969, a decline of 28,291. It should be noted, however, that these figures include both unoccupied dwellings and those merely empty through the temporary absence of the occupiers. The excess of 1921 ratio of 1.59 over the 1911 ratio of 1.51 is approximately equivalent to a deficiency of 36,000 dwellings. This number is small in comparison with the total number of dwellings (nearly 300,000) which are at present shared by two or more families each. Analysing the dwellings occupied by private families according to the number of rooms contained in them, the table shows that 18 per cent, contained three rooms or less, 27.2 per cent, four to five rooms, 42.3 per cent, six to eight rooms, and 12.4 per cent, nine rooms or more. The average number of rooms per structurally separate dwelling in the county is 5.85. In the County of London the average size of families has been reduced from 4.15 persons in 1911 to 3.79 persons in 1921—a drop of 9 per cent. This reduction is not local, and may be expected to be disclosed for other parts of England and Wales. It is pointed out that while the reduction in the size of families may not abate the demands of individual families for separate dwellings, it obviously justifies a review of the general position by reference to the requirements of families in point of accommodation. It is shown that whereas the average size of families has dropped by about 9 per cent., the average unit of occupation has decreased from 3.56 rooms per family in 1911 to 3.38 in 1921, a decrease of only about 5 per cent., with the consequence that the average number of occupied rooms per person has improved from .88 in 1911 to .91 in 1921. Disregarding, therefore, difference in type of accommodation and size of rooms (on which the census returns are of course silent), the London population is, on a general average of rooms per person, less densely housed than in 1911. Further evidence of improvement is also given by a comparison of families living under the "overcrowded" condition of two or more persons per room. The number of private families each living more than two persons per room was 110,495 (i.e., 16.1 per cent.) in 1921, compared with 121,591 (i.e., 17.8 per cent.) in 1911. The population in such families was 683,488 in 1921 and 758,439 in 1911. Some further examination of the "rooms per person" ratio, it is noted, is, however, necessary before the general average can 117 be utilised as a basis for the consideration of housing conditions in any given area. The actual unit of distribution is neither the person on the one side nor the room on the other, since in practice it is always a group of persons, classified in the census as a "private family," who share in common a group of rooms here denominated the "unit of occupation." Hence the ratio of rooms to persons, while forming a simple basis of comparison, is incomplete as a measure of conditions relating not to the individual, but to the family as a composite whole; and it is to the movements in the size and accommodation of families that attention must be directed for a more definite knowledge of the changes in the standards of housing. The inferior condition of housing in London, as compared with other large towns or of England and Wales as a whole, is shown by a table (VI.) giving the average number of rooms per person for each size of family. The position in the towns in 1911 was generally slightly worse than that of the whole country; but in the case of London in 1911 the densities stood at a lower level for the smaller families, while the comparison was noticeably unfavourable to the county for all families of 10 persons or less. The columns in the table showing the densities in London for 1911 and 1921 provide some expression of the changes in housing conditions in the county during the past decade. It is shown that it is only in families numbering one or two persons, where the density was already lowest, that an improvement has been recorded, while a deterioration has taken place for all other sizes of families, including the larger families whose density was already approaching the region of overcrowding. Dealing with housing in the Metropolitan Boroughs, the report shows that with regard to external characteristics, the most diverse types of distribution are found in the City and in Woolwich respectively. In the latter 89 per cent, of the dwellings are private houses, while in the former 67 per cent, are attached to, or form part of, business premises. Flats, tenements, etc., predominate in Holborn (61 per cen.) Westminster (43 per cent.), and St. Marylebone (44 per cent ) They are also numerous in Finsbury (42 per cent.), Southwark (40 per cent.), and Chelsea (39 per cent.). In respect of room accommodation Hampstead claims the first place with a general average of 7.96 rooms per dwelling, while immediately following are Paddington (7.53), Kensington (7.09), Stoke Newington (6.73), and St. Pancras (6.57). At the other end of the scale the City stands lowest (3.70), followed by Holborn (4.35), and the Eastern Boroughs—Bethnal Green (4.49), Southwark (4.52), Finsbury (4.67), Bermondsey (4.80), and Shoreditch (4.82). Measured in terms of families per dwelling, housing pressure might appear to be greatest in St. Pancras, where there are on an average 2-3 families to each dwelling, and where only 17.6 per 118 cent, of the families are in undivided occupation of separate dwellings. Islington is the only other borough with more than two families per dwelling (2.12) on the average. In both boroughs, however, the dwellings are larger and the families smaller than in the rest of the county, the combination of these factors improving their relative positions as evidenced by the ratio of rooms to persons. The average size of families in the several Boroughs varies from 4.26 to 3.12 persons. The biggest are found in the poorer boroughs in the following order: Stepney (4.26 persons per family), Poplar (4.19), Bethnal Green (4.14), Greenwich (4.10), and Bermondsey (4.08); the smallest is Holborn (3.12), City (3.31), Westminster (3.31), St. Marylebone (3.33), Paddington (3.43), and St. Pancras (3.45). In every Borough the families of 1921 are smaller than they were in 1911, the reductions varying from about 6 per cent, to 14 per cent. As compared with 1911, the density figure shows an improvement in every borough with the exception of Greenwich. Hammersmith and Stoke Newington. The particulars contained in the Census Returns relating to buildings, dwellings, rooms and families in Battersea as compared with the County of London will next be found of interest. The total number of structurally separate occupied dwellings in the Borough according to the recent census is 27,191, containing 157,323 occupied rooms, with an average of .96 rooms per person. The buildings are classified into five different groups as follows:— I. Undivided private houses 21,211 II. Structurally divided houses 724 III. Flats, tenements, &c 3,518 IV. Shops 2,144 V. Others, including shops, factories, workshops, wash-houses, public institutions, places of worship, amusements, &c. 117 27,714 Of the nine institutions containing dwellings the population at date of census was 2,778. The number of unoccupied dwellings was 523 containing 2,863 rooms. Analysing the dwellings occupied by private families in Battersea, it is shown that slightly more than half the total dwellings (15,297) contain six to eight rooms, 8,648 four to five rooms, 1,931 one to three rooms, and 1,740 have nine or more rooms. 119 In Battersea the average size of families is shown as 3-82 in 1921, as compared with 4.17 in 1911, the corresponding figures for the county being 3.79 and 4.15 respectively. The total number of private families is 42,988. There are 3,899 families of one person 8,755 of two persons, 9,511 of three persons. There are 931 families of ten or more persons, and 10 of fifteen or over. In the latter group there is one family of fifteen persons occupying three rooms. The return of the dwellings occupied by private families in Battersea shows there are 11,385 (about 25 per cent.), families living in three rooms, 9,958 (22.3 per cent.) living in four rooms (approximately half the private families occupying three or four rooms). Twenty-five per cent, of the families occupy one or two rooms, and the remaining 25 per cent, occupy five or more rooms. The census returns further show that there has been a marked increase during the decade in the number of families occupying less than five rooms each. In 1911, 70.4 per cent, of families were living in less than five rooms each, while in 1921 the number of families occupying four rooms or less was 75.3 per cent, of the total families. The average density in Battersea, as measured by the number of rooms per person (a more reliable index of overcrowding) is .96, and is exactly equal to the average for the county. The density varies, as might be expected, in the different wards, ranging from .73 in Winstanley Ward to 1.4 in Broomwood. Following Winstanley, Nine Elms Ward shows next highest density (.78), and then, in decreasing ratio, Church (.82), Park (.88), Latchmere (.90), and Shaftesbury (.97). It will be noted, therefore, that a comparison of the census returns for 1921 for the county and for Battersea shows that, taken as a whole, overcrowding, while not so acute as in some of the Eastern Boroughs, nevertheless exists, but is, in the main, confined to the lower wards and to a varying degree in these wards. Particulars relating to house inspections carried out during 1922-23 of nearly 1,000 houses in North-West and East Battersea are of interest in their bearing on the existence and extent of the overcrowding at present prevailing in certain areas of the Borough. Taking the "rooms per person" ratio, the density is found on these 1,000 houses to be .74 rooms per person, which is about equal to that in the Winstanley Ward as recorded in the census returns. There is little doubt, therefore, that the housing question is still very acute in the Borough. It is difficult on existing data to compare the conditions recorded in other Metropolitan Boroughs with those prevailing in Battersea. For example, in Finsbury the deficiency of rooms is shown to be greatest, but, on the other hand, the number of private families of one person each is greatest in that borough". Again, it has been already mentioned that in St. Pancras and Islington where the housing pressure measured by terms of families per dwelling might appear to be heaviest, the dwellings are larger and the families smaller than in the rest of the county. 120 It is interesting to note that in order to simplify the comparison suggested by the density of distribution, and to obtain an index of the aggregate effect of the intercensal variation, the 1911 ratios have been applied to the families of various sizes returned in 1921 for London, with a view to ascertaining the number of rooms which would have been required in 1921 according to the 1911 ratios, the comparisons, as before, being limited to families living in one to nine rooms only. The result is, that for the number of families of different sizes returned in 1921, 3,754,500 rooms would have been required to maintain the London 1911 ratios for families of these respective sizes. This number exceeds the actual number of rooms returned in 1921 (3,696,142) by 58,400 representing 1.6 per cent, on the latter figure. The conclusions to be drawn from an analysis of the housing conditions in Battersea from the data supplied in the recent census returns and from the results of a survey of a large number of houses in the Borough, are:— 1. That, taking the Borough, as a whole, the conditions as to housing are fairly comparable to the average of those for the County of London. 2. That it is difficult to make a comparison as regards housing conditions in the Borough with other individual Metropolitan Boroughs. 3. That in the lower wards of the Borough there is ample evidence of housing insufficiency, giving rise in certain areas to serious congestion and overcrowding. 4. That, although in Battersea, as elsewhere, there has been a marked decrease in the size of families during the intercensal period, leading to an improvement in the unit of accommodation, this improvement has only effected the small family group of one or two persons. Thus, as the census report shows, although, as compared with 1911, more of the population is now grouped in the smaller families housed at a density, e.g., of over one room per person, and less in the larger families housed below that standard, the redistribution has been accompanied by a lowering of the 1911 density standards for families of every size save those of one or two persons. Finally, it is only necessary to point to the statement in the report as to the inferior character of housing in London as compared with that of other large towns or of England and Wales as a whole to show that the housing conditions in certain areas of Battersea are little better than the worst in some of the Eastern Boroughs. The survey prepared by the Council in 1919 and submitted to the Ministry of Health, inter alia, estimated the housing insufficiency in the Borough at 500 houses. The results of the census returns 121 and of the surveys of large areas of working-class houses carried out since the original survey of the Borough appear to indicate that this estimate of the housing needs of Battersea was, if anything, an under-estimate, and that the requirements would be more closely met by a considerable increase in this figure. It is probable that at least 700 or 800 dwellings are needed to remedy the overcrowding in Battersea, and that until provision is made in this direction this evil, which is so fertile a source of unsatisfactory social and insanitary conditions, will continue. G. QUIN LENNANE, 28th April, 1923. Medical Officer of Health. ADDENDUM. Appended will be found tables showing details extracted from the census report and from the result obtained from the records of inspection Of houses in the Borough during 1922-23. METROPOLITAN BOROUGH OF BATTERSEA. CENSUS, 1921. Details as to Number of Families, Population of Private Families, Number of Separate Dwellings and Rooms occupied in each Ward. (Extract from Table III., Census Report, Vol. 1.) Ward. Area in Acres. No. ol Private Families. Population of Private Families. Separate Dwellings occupied. Rooms occupied. Average Rooms per Person. Average Persons per Room. Average Persons per Acre. Average Persons per Family. 1 407 6,484 27,194 4,098 21,143 .78 1.29 67 4.2 2 316 4,619 18,194 2,896 15,993 .88 1.14 58 3.9 3 182 5,093 18,916 3,190 17,029 .90 1.11 105 3.7 4 140 4,023 15,130 2,742 14,600 .97 1.04 110 3.8 5 171 4,566 17,854 2,771 14,549 .82 1.23 108 3.9 6 126 4,850 20,545 2,889 14,981 .73 1.37 164 4.2 7 117 1,972 7,524 1,211 8,288 1.10 .91 73 3.8 8 205 5,641 18,851 3,349 22,543 1.20 .84 93 3.3 9 499 5,740 19,962 4,045 28,197 1.41 .71 42 3.5 Borough 2,163 42,988 164,170 27,191 157,323 .96 1.04 78 3.82 County of London 74,850 1,120,897 4,243,838 701,035 4,057,271 .96 1.04 60 3.79 122 The following table gives particulars of the inspection of 969 houses during 1922-23:— Information obtained from House Inspection during 1922 and 1923. Ward. No. of Houses Inspected. No. of Families. No. of Rooms. Occupants. Average Number of Adults. Children. Persons per Room. Rooms per per Person. 1 151 242 842 708 359 1.27 79 2 306 441 1,239 1,287 672 1.58 .63 3 62 106 306 314 118 1.41 .71 4 34 69 236 204 134 1.43 .70 5 181 258 845 689 336 1.21 .82 6 119 142 521 471 234 1.35 .74 7 60 64 108 141 172 1.3 .77 8 24 24 108 67 16 .77 1.30 9 32 48 202 130 21 .75 1.34 — 969 1,394 4,539 4,011 2,062 1.34 .74 * These figures relate to a street partly in Ward 6. Ward. Houses Inspected (1922-3). Occupied Separate Dwellings in Ward. Estimation based on House-to-house Inspection of the number of Houses in which the average Number of Rooms per person in each Ward is Less than .5. .5 to . 66. .66 to 1. 1 or more. 1 151 4,098 190 896 1,547 1,465 (4.6) (21.9) (37.7) (35.8) 2 306 2,896 634 634 814 814 (21.9) (21.9) (28.1) (28.1) 3 62 3,190 206 926 1,286 772 (6.5) (29.0) (40.3) (24.2) 4 34 2,742 403 726 968 645 (14.6) (26.6) (35.3) (23.5) 5 181 2,771 122 506 934 1,209 (4.4) (18.2) (33.7) (43.7) 6 119 2,889 243 607 1,068 971 (8.4) (21-0) (37.0) (33-6) 7 ... 60 1,211 81 242 484 404 (6-7) (20.0) (40.0) (33.3) 8 24 3,349 — — 279 (8.3) 3,070 (91.7) .9 32 4,045 - 126 (3.1) 759 (18.7) 3,160 (78.2) Total 969 27,191 1,879 4,663 8,139 12,510 (6.91) (17.15) (29-93) (46-01) Note.-—The figures in brackets are tne percentages calculated on the number of houses inspected in the respective Wards. It will be noted in the above table details are given as to the numbers and percentages of inspected houses, but containing more extended particulars of the accommodation for each Ward than that in the preceding table. Considerable range of variation was found to exist, as might be expected, in the various Wards. The percentages so obtained were applied to the total number of occupied dwellings in each Ward (extracted from the census returns) on the assumption that the distribution of accommodation in the inspected houses would be found to approximate to that 123 existing in the total houses in their respective Wards, and with a view to ascertaining whether this assumption could be sustained, both as regards the individual Wards and the Borough. The results showed that the percentages of the different standards of accommodation, although varying within a relatively wide range in individual Wards, agreed fairly closely with those obtaining throughout the Borough calculated from the number of families in the census returns found to be living under similar conditions. The next table gives similar details as to families in relation to accommodation:— Estimated Number of Private Families in each Ward (based on house-to-house Inspection) having accommodation per Average No. of Persons per Family. Ward. Total No. of Families. No. of Families in Houses inspected. person. Less than 5 rooms. .5 to .66 rooms. .66 to 1.0 rooms. 1.0 or more. In the inspected Houses. In the whole Ward. 1 6,484 242 562 (8.7) 1,715 (26.4) 1,474 (22.7) 2,733 (42.2) 4.4 4.2 2 4,619 441 1,005 (21.8) 1,079 (23.3) 901 (19.5) 1,634 (35-4) 4.4 3.9 3 5,093 106 480 (9.4) 1,345 (26.4) 1,201 (23.6) 2,067 (40.6) 4.1 3.7 4 4,023 69 408 (10.1) 991 (24.7) 1,050 (26.1) 1,574 (39.1) 4.9 3.8 5 4,566 258 265 (5.8) 814 (17.8) 1,115 (24.4) 2,372 (52.0) 4.0 3.9 6 ... 4,850 142 649 (13.4) 752 (15.5) 1,605 (33.1) 1,844 (38.0) 5.0 4.2 7 1,972 64 154 (7.8) 400 (20.4) 709 (35.9) 709 (35.9) 4.9 3.8 8 5,641 24 — — 470 (8.3) 5,171 (91.7) 3.5 3.3 - 9 5,740 48 - 359 (6.2) 598 (10.5) 4,783 (83.3) 3.1 3.5 Borough 42,988 1,394 3,523 7,455 9,123 22,887 4.36 3.82 Percentage of total fami lies (8.19) (17.34) (21.22) (53.25) Note.—The figures in brackets are tne percentages calculated on the number of families living in the houses inspected in the respective Wards. In the above table details are shown of the percentages of the families living in the inspected houses in similar conditions as those recorded in the previous table with regard to room accommodation. These percentages were similarly applied to the total families in each of the Wards. The results showed a relatively close correspondence with the totals for the Borough as shown in the next table calculated from Census data. The following percentages have been calculated from information extracted from Table 11 of Census Report, 1921 (Part 1). Total No. ot Families in Borough. No. of Families with under . 3 rooms per person. No. of Families with .3 and undef -5 rooms per person. No. of Families with .5 and under .7 rooms per person. No. of Families with .7 and under 1 room per person. No. of Families with 1 room or more per per person. 42,988 473 2,154 7,821 (18.19) 11,918 (27.72) 20,622 (47.98) (6.11) 124 It will be seen that these percentages show a fairly close approximation with those in the table above, the principal variations being in the last two groups. The inference to be drawn from the study of these tables would appear to support the conclusions arrived at in the Report as a result of inspections of houses and of the conditions known to exist in other areas of the Borough. CHUTER v. WOODING. Report of the Medical Officer of Health. The defendant, a local tradesman, was summoned under Section 6 of the Sale of Food and Drugs Act, 1875, at the instance of the Borough Council for selling an article of food for human consumption—to wit, Fairy Cakes—which contained boron preservative expressed as Boric Acid to the extent reported by the Public Analyst of 24.5 grains per lb. After a protracted hearing the case was dismissed, the Magistrate (Mr. T. Scanlan) holding that the presence of the boron preservative in the quantity found on analysis was not, mixed with food, injurious to health. An application for costs against the Borough Council was refused by the Court, the Magistrate stating that the prosecution was very properly brought by the Council and was in the public interest. It will be of interest to remind the Health Committee of the circumstances in which these proceedings were instituted. In the fourth quarter of 1923, a summons was issued against a tradesman in the borough for selling sponge cakes reported by the Public Analyst to contain 23.8 grains of boric acid per lb. of cakes. A conviction was obtained and the seller was fined £2 and £1 1s. 0d. costs. As a result, probably, of this conviction it became evident that the sale of the cheaper varieties of sponge cake in Battersea had declined and that the use of one of the principal ingredients, liquid egg, which contains a considerable quantity of boron preservative, had been prohibited, owing to an arrangement made by the Bakers' Allied Trades Association, after discussion with the Ministry of Health. Under this arrangement, the Association had, in 1923, resolved that its members should sign a bond that in future the sale of liquid whole egg should be under the following conditions:— 125 (1) Sale only to be made on the understanding that liquid whole egg must not be used in the manufacture of sponge fingers, sponge biscuits and l½d., 1d. and 2d. sponge cakes. (2) That all invoices should bear a statement to the buyer that liquid egg must not be used in the manufacture of sponge fingers and l½d., 1d. and 2d. plain sponge cakes. The effect of these resolutions was, inter alia, conveyed to Sanitary Authorities by a circular (381) issued by the Ministry of Health on the 20th March, 1923. In the circular referred to attention was drawn to the object of this trade arrangement, viz., that the varieties of sponge cakes were those most likely to be used by infants and invalids, and that, if effect were given to the decision of the Trade Association, the danger of the presence of excessive preservatives in cake would be substantially reduced. Local Authorities, it was further pointed out, would, of course, be able, as at present, to take proceedings under Sec. 3 or Sec. 6 of the Sale of Food and Drugs Acts, 1875, when they considered that the amount of boric acid found in a sample of cake (whether within the scope of the Association's Resolution or not) was excessive. In July and August of 1924, a series of informal samples was taken of a variety of cake which enquiries had elicited was being sold in place of the cheaper kinds of sponge cakes. The reports of the Public Analyst of the results of his analyses of these samples (13) shewed that eleven contained boric acid varying from 4.2 to 24.5 grains per lb. of cake, and that two were free from this or other preservative. Two of the adulterated samples contained 24.5 grains per lb. of cake and formal samples were subsequently taken from the sellers. In one case the quantity of the preservative present was still the same (24.5 grains per lb.) but in the other the amount found on analysis was only about half that present in the informal sample. These facts were duly reported to the Health Committee and proceedings were ordered by them in respect of the formal sample containing 24.5 grains, a summons being served upon the local tradesman from whom the sample was purchased by the Food Inspector. The case was taken up by the Trade Association, whose solicitors applied to the Council to have the summons adjourned sine die to await the report of the Departmental Committee appointed by the Ministry of Health to enquire into the use of preservatives which it was expected would soon be issued. The Committee agreed to this request. The Departmental Committee's report was issued in November, 1924, and, inter alia, definitely recommended that boric acid should be prohibited for use as a preservative in human food. 126 On the issue of the Departmental Committee's Report, the case was restored by order of the Committee. On the application of the defendant's solicitors, the third portion of the sample was submitted to the Government Analyst, who reported the quantity of boric acid found by him on analysis to be 20.3 grains per lb. Counsel for the prosecution (Mr. Done) contended that the quantity of boric acid present in these cakes was excessive and injurious to health, especially in the case of invalids and of children, by whom these cakes were commonly consumed, and that they were further to the prejudice of the purchaser in that the cakes were sold without a disclosure of the presence of the chemical preservative. Medical evidence in support of the Council's case was given by Professor Kenwood and by the Medical Officer of Health. The defendant was represented by Sir H. Curtis Bennett, K.C., and Mr. Frampton. Medical evidence for the defence was given by Dr. Panton, Professor of Clinical Pathology, London Hospital, who stated that, in his opinion, the amount of boric acid present in these cakes mixed with food was not injurious to health. The Magistrate, in giving his decision, appeared to have been influenced by two points, (a) that the ingredients used in the manufacture of these cakes, including the liquid egg and the margarine, both of which contain boric acid, were obtained in the ordinary course of commerce, and (b) that no special case was shown in evidence where any adult or child had suffered injury to health by eating cakes such as these. He therefore accepted the medical evidence given for the defence. The case is of much interest having regard to the circumstances surrounding the taking of these samples of fairy cakes, and to the recommendations in the Departmental Committee's report as to the prohibition of preservative, including boric acid, in food. The decision of the Court in this case serves mainly to emphasise one of the recommendations, viz., that relating to the need for legislation or regulations prohibiting or limiting the use of preservatives, &c., which would be binding on the Courts in proceedings taken under the Sale of Food and Drugs Acts. The present position admittedly is highly unsatisfactory to all concerned, the Authority, the Trade and the Consumer. It is to be hoped, therefore, that the draft regulations made by the Ministry of Health, which are intended to implement the recommendations of the Departmental Committee's Report, will be found, when issued with Statutory authority to local Authorities, to remove the administrative difficulties at present associated with proceedings under the Sale of Food and Drugs Acts. (Signed) G. QUIN LENNANE, 8th April, 1925. Medical Officer of Health. 127 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 1925 and Previous Years. Year 1 Population estimated to middle of each Year. 2 Birth Total Deaths registered in the district. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. 3 Nett. of Nonresidents registered in the District. 8 of Residents not registered in the District. 9 Under 1 Year of Age. At all Ages Number. 4 Rate.* 5 Number. 6 Rate. * 7 Number 10 Rate per 1,000 Net Births. 11 Number. 12 Rate.* 13 1915 161,945 3,604 3,820 23.6 2,992 18.5 798 459 428 112 2,653 16.4 1916{ 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 14.0 874 345 170 49 1,839 10.8 1924 171,000 3.180 3,139 18.4 2,506 14.7 858 370 196 62 2,018 11.8 1925 172,100 3,264 3,184 18.5 2,397 13.9 920 328 186 58 1,805 10.5 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. † Registrar General's estimated population for purposes of calculating:—(B), birth-rate; (D) death-rate. 128 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 1925. 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 395 4 126 214 32 19 ... 153 198 44 151 198 43 Membranous Croup 1 1 ... ... ... ... ... 1 ... ... ... Erysipelas 67 4 2 10 5 38 ... 33 21 13 10 5 1 Scarlet Fever 497 4 144 298 36 15 ... 207 198 92 205 197 87 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 6 ... ... 3 ... 3 ... 5 1 5 1 ... Puerperal Fever 6 ... ... ... 2 4 ... 2 2 2 2 2 1 Meningococcal Meningitis 1 1 ... ... ... ... ... ... ... 1 ... ... l Ophthalmia Neonatorum 32 32 .. ... ... ... ... 16 14 2 ... 2 ... 2 ... 1 ... ... 1 ... ... ... 2 ... ... 2 Encephalitis Lethargica 8 ... ... 1 4 3 ... 6 1 1 6 ... ... Polio-encephalitis ... ... .. ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Acute Influenzal Pneu 72 3 8 6 10 36 9 38 23 11 6 3 1 Acute Primary Pneu 213 19 68 36 17 64 9 100 95 18 43 24 6 Totals 1,300 67 350 568 106 183 26 560 554 186 428 432 142 Tuberculosis— Pulmonary 238 - 3 10 12 149 4 113 66 59 ... ... ... Non-Pulmonary 97 2 11 45 23 16 42 32 23 ... ... ... Totals (Tuberculosis)• 335 2 14 55 95 165 4 155 98 82 ... ... ... Totals 1,635 69 364 623 201 348 30 715 652 268 428 432 142 Wooping cough* 777 98 485 186 2 6 ... 309 326 142 16 31 6 Measles* 693 38 314 328 11 2 ... 117 474 102 7 50 5 Grand Totals ... 3,105 205 1,163 1,137 214 356 30 1,141 1,452 512 451 513 153 * Notifiable in Battersea from April 24th, 1922. 129 TABLE III. Causes of, and Ages at, Death during the Year 1925. 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. CAUSES OF DEATH. Al! Ages. 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 1 ... ... ... ... ... 1 ... 2 2. Small-pox ... ... .. ... ... 3. Measles 4 ... 2 ... 2 1 i ... 2 4. Scarlet Fever 8 ... 5 2 ... 19 5. Whooping-cough 20 11 7 2 ... ... ... 6. Diphtheria 10 ... 3 4 3 7. Influenza 36 ... 2 2 5 15 12 20 8. Encephalitis Lethargica 2 ... ... 1 ... 1 4 9. Meningococcal Meningitis ... ... ... 3 10. Tuberculosis of Respiratory System 156 1 1 ... 6 37 64 41 6 119 11. OtherTuberculous Disease 43 3 1 5 9 11 10 4 • •• 41 12. Cancer 236 ... 1 ... 17 100 118 218 13. Rheumatic Fever 4 ... 3 ... 1 ... 1 14. Diabetes 17 ... ... ... 1 9 7 10 15. Cerebral Hæmorrhage. etc. ... 80 ... 1 ... 5 22 52 88 16. Heart Disease ... 335 ... 3 12 17 83 220 333 17. Arterio-Sclerosis 51 ... ... ... 1 7 43 15 18. Bronchitis 148 10 ' 3 2 5 36 92 53 19. Pneumonia (all forms) ... 107 30 7 11 4 15 24 16 73 20. Other Respiratory Diseases 14 ... 1 2 3 8 13 21. Ulcer of Stomach or Duodenum ... 24 ... 1 5 14 4 25 22. Diarrhoea, &c. ... 21 14 2 1 2 ... 2 7 23. Appendicitis and Typhlitis 7 ... 2 3 2 15 24. Cirrhosis of Liver 3 ... ... ... 1 2 8 25. Acute and Chronic Nephritis 56 ... ... ... 3 5 5 20 23 49 26. Puerperal Sepsis 3 ... ... ... ... 9 ... 5 27. Other diseases of Pregnancy 3 ... ... ... ... ... 3 ... ... 6 28. Congenital Debility and Malformation, Premature Birth 88 88 ... ... ... ... ... ... ... 42 29. Suicide 15 ... ... ... 1 ... 2 9 3 4 30. Other Deaths from Violence 49 2 ... 1 4 8 12 11 11 61 31. Other Defined 262 27 5 6 7 12 27 58 120 251 Diseases 32. Causes ill-defined or unknown 2 ... ... ... ... ... ... 2 ... ... M. 911 118 15 23 26 51 107 254 317 785 All Causes F. 894 68 16 15 24 42 98 207 424 702 Totals 1805 186 31 38 50 93 205 461 741 1487 130 TABLE IIIa. Causes of Death during Five Years, 1921-5. causes of death. 1921. 1922. 1923. 1924. 1925. Mean. 1921-5. No. ot Deaths Rate per Million Pop'n No. of Deaths Rate per Million Pop'n No. of Deaths Rate per Million Pop'n No. ot Deaths Rate per Million Pop'n No. of Deaths Rate per Million Pop'n No. of Deaths Rate per Million Pop'n 1. Enteric Fever 1 6 1 6 1 6 2 12 1 6 1.2 7.2 2. Small-pox — — 1 6 — — — — 0.2 1.2 3. Measles 2 12 66 390 24 141 51 298 4 23 29.4 172.8 4. Scarlet Fever 6 35 13 77 6 35 3 18 8 46 7.2 42.2 5. Whooping-cough 30 177 22 130 16 94 17 99 20 116 21.0 123.2 6. Diphtheria 63 372 58 343 34 199 25 146 10 58 38.0 223.6 7. Influenza 45 266 110 650 31 182 84 491 36 209 61.2 359.6 8. Encephalitis Lethargica 2 12 1 6 2 12 5 29 2 12 2.4 14.2 9. Meningococcal Meningitis 3 18 1 6 2 12 3 18 1.8 10.8 10. Tuberculosis of Respiratory System 170 1,004 171 1,010 139 815 153 895 156 906 157.8 926.0 11. Other Tuberculous Disease 46 272 34 201 36 211 37 216 43 250 39.2 230.0 12. Cancer 189 1,117 225 1,330 242 1,418 231 1,351 236 1,372 224.6 1,317.6 13. Rheumatic Fever 5 30 13 77 6 35 7 41 4 23 7.0 41.2 14. Diabetes 10 59 13 77 10 59 9 53 17 99 11.8 69.4 15. Cerebral Haemorrhage, etc. 87 514 90 532 91 534 75 439 80 465 84.6 496.6 16. Heart Disease 299 1,767 365 2,157 334 1,958 348 2,035 335 1,947 336.2 1,972.8 17. Arterio-Sclerosis 44 260 42 248 35 205 54 316 51 296 45.2 205.0 18. Bronchitis 137 810 167 987 133 780 183 1,070 148 860 153.6 901.4 19. Pneumonia (all forms) 156 922 169 999 100 586 159 930 107 622 138.2 811.8 20. Other Respiratory Diseases 36 213 25 148 22 129 20 117 14 81 23.4 137.6 21. Ulcer of Stomach or Duodenum 15 89 22 130 23 135 19 111 24 140 20.6 121.0 22. Diarrhœa. &c. 71 420 32 189 32 187 24 140 21 122 6.0 211.6 23. Appendicitis and Typhlitis 15 89 5 30 8 47 13 76 7 41 9.6 56.6 24. Cirrhosis of Liver 13 77 14 83 8 47 11 64 3 17 9.8 57.6 25. Acute and Chronic Nephritis 55 325 63 372 55 322 53 310 56 325 56.4 330.8 26. Puerperal Sepsis 4 24 3 18 — 4 23 3 17 2.8 16.4 27. Other diseases of Pregnancy 10 59 6 35 10 59 5 29 3 17 6.8 39.8 28. Congenital Debility and Malformation, Premature Birth 109 644 100 591 72 422 77 450 88 511 89.2 523.6 29. Suicide 8 47 11 65 21 123 18 105 15 87 14.6 85.4 30. Other Deaths from Violence 58 343 63 372 43 252 54 316 49 285 53.4 313.6 31. Other Defined Diseases 371 2,192 322 1,903 302 1,770 273 1,597 262 1,523 306.0 1,797.0 32. Causes ill-defined or unknown - - - - - - 1 6 2 12 .6 3.6 All Causes {M. 1,012 12,738 1,131 14,255 930 11,625 989 12,334 911 11,288 994.6 12,448 {F. 1,048 11,677 1,096 12,197 909 10,033 1,029 11,331 894 9,782 995.2 11,004 Totals 2,060 12,175 2,227 13,162 1,839 10,780 2,018 11,801 1,805 10,488 1,989.8 11,681 131 East Battersea. TABLE IV. Infant Mortality, 1925. 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 Small-pox M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. m. F. Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 ... ... 1 1 3 2 Diphtheria & Croup ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... .. ... ... ... ... ... ... ... ... .. ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... Bronchitis ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... 1 ... ... ... 3 1 Pneumonia (all forms) ... ... ... ... 1 ... ... ... ... ... 1 ... 3 1 3 1 1 1 2 3 10 6 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... 1 1 ... 1 ... ... 3 •2 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 8 3 3 2 4 1 3 1 ... ... 18 7 ... 2 ... 1 ... ... ... ... 18 10 Congenital Malformation ... 2 1 ... 1 ... ... ... ... 2 2 ... 1 1 ... 1 ... ... ... 4 3 Congenital Debility ... ... ... ... ... ... 1 ... ... 1 1 1 ... ... 4 ... ... 1 ... ... 6 2 Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Injury at Birth ... ... ... ... 1 ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 ... Atelectasis & Asphyxia Neonatorum ... 1 ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... 1 ... ... 1 ... 1 1 ... ... 2 ... ... l 2 ... 5 2 Totals 8 4 5 4 7 3 5 1 2 1 27 13 7 6 11 4 5 4 6 4 56 31 12 9 10 6 3 40 13 15 9 10 87 Nett Births in the year. Nett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1423 48 1471 80 7 87 132 North-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1925. 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 Small-pox M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... 1 1 1 1 2 ... 1 ... ... ... ... ... 4 1 Pneumonia, all forms ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 1 2 2 ... 2 3 5 7 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Enteritis ... ... ... ... ... ... 2 ... ... ... 2 ... 2 ... ... 1 1 ... 1 1 6 2 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 2 ... 2 2 1 2 ... ... ... ... 5 4 ... 1 ... ... ... ... ... ... 5 5 Congenital Malformation ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 1 1 Congenital Debility ... ... 1 2 1 ... 1 ... ... ... 3 2 2 ... 3 ... 1 ... ... ... 9 'J Icterus Neonatorum ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 Injury at Birth ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Atelectasis and Asphyxia Neonatorum 1 1 2 1 ... ... ... ... 1 ... 4 2 ... ... ... ... ... ... ... ... 4 ? Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 1 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 2 Totals 3 1 7 6 2 3 3 2 2 17 12 7 2 7 5 5 2 5 6 41 27 4 13 5 3 4 29 9 12 7 11 68 133 South-West Batteraea. TABLE IV.—(contd.) Infant Mortality, 1925. 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 Small-pox M. F. M. f. M. F. M. f. M. F. M. f. M. F. M. F. M. F. M. F. M. F. Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... PulmonaryT uberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 1 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Enteritis ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 3 ... 2 1 ... ... 1 1... 1 ... 7 2 ... ... ... 1 ... ... ... ... 7 3 Congenital Malformation 2 1 1 1 ... ... ... ... ... ... 3 2 ... ... ... ... ... ... ... ... 3 2 Congenital Debility 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 1 Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... Atelectasis & Asphyxia Neonatorum ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Lack of Care ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Homicide 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... 1 ... ... ... ... ... ... 1 ... 2 ... ... ... .. ... 1 ... 4 ... Totals 7 2 5 2 ... 2 1 1 15 5 3 ... 2 2 ... 2 1 1 21 10 9 7 ... 3 1 20 3 4 2 2 31 Nett Births in the year. Nett Deaths in the year(Infants under 1 year) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 675 25 700 29 2 31 134 Borough of Battersea. TABLE IV.—(contd.) Infant Mortality, 1925. 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. Percentage of Total. 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Small-pox M. F. M. F M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 2 1 2 2 6 5 5.9 Diphtheria and Croup Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.5 Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 0.5 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 0.6 Other Tuberculous disease. ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... 1 ... 1 ... ? ... 11 Bronchitis. ... ... ... ... ... ... ... ... 2 1 2 1 3 1 2 ... 1 ... ... ... 8 2 5.4 Pneumonia (all forms) ... ... ... ... 1 1 ... ... ... 1 1 3 2 5 3 3 2 4 6 16 14 161 Pulmonary Congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Enteritis ... ... ... ... 1 ... 3 ... ... ... 4 ... 3 ... 1 2 1 1 1 1 10 4 7.5 Gastritis. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 0.5 Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.6 Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 13 3 7 5 5 3 4 2 1 30 13 ... 3 ... 2 ... ... ... ... 30 18 25.8 Congenital Malformation 2 1 4 2 ... 1 ... ... ... 6 4 1 1 1 ... 1 1 ... ... 9 6 81 Congenital Debility 1 ... 1 2 1 ... 2 ... ... 1 5 3 2 ... 7 1 1 1 ... ... 15 5 10.7 Icterus Neonatorum ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... ... 1 .1 Injury at Birth ... ... ... 1 1 ... 1 ... ... ... 2 1 ... ... ... ... ... ... ... ... 2 1 1.6 Atelectasis & Asphyxia Neonatorum Lack of Care 1 2 1 3 ... 2 ... ... ... ... ... 1 ... 5 4 ... ... ... ... ... ... ... ... 5 4 4.9 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 0.5 Convulsions ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 1 1.1 Homicide 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 0.6 Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 0.5 Other Causes Totals ... ... 1 ... ... 1 ... ... 1 ... 2 1 1 ... 2 1 ... 1 3 1 8 4 6.4 18 7 17 12 9 6 10 2 5 3 59 30 17 8 20 11 10 8 12 11 118 68 100-0 25 29 15 12 8 89 25 31 18 23 186 Percentage of Total 13.4 15.6 8.1 6.4 4.3 47.8 13.4 16.7 9.7 12.4 100.0 M. 63.4% f. 36.6% Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. M. 1,620 57 1,677 112 6 118 F. 1,458 49 1,507 62 6 68 Totals 3,078 106 3,184 174 12 186