AC.4386 BAT 24 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1926. by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. WIGHTMAN & Co., Ltd., Printers, 101, Regency Street, S.W. 1. Battersea Borough Council. With the Compliments of the Medical Officer of Health. MUNICIPAL BUILDINGS. LAVENDER HILL, S.W. BAT 24 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1926. by G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. 1 Health Committee. As constituted 9th November, 1925. Chairman: Councillor J. Hendrick. His Worship the Mayor (Councillor C. H. Young, j.p.) Councillor Mrs. X. 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. As constituted 9th and 24th November, 1926. Chairman: Councillor J. Hendrick. His Worship the Mayor (Councillor W. H. Humphreys, j.p.) Councillor Mrs. T. Amphlett. Alderman J. R. Archer. Councillor J. A. Biss. „ H. W. Carpenter. „ E. W Coles. C. S. King. „ G. H. Lawther. „ R. Moore. ,, J. Morgan. Alderman Mrs. M. J. Robinson. Councillor Mrs. M. H. Rose. Maternity and Child Welfare Committee. 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. As constituted 9th and 24th November, 1926. Chairman: Councillor Mrs. M. H. Rose. His Worship the Mayor (Councillor W. H. Humphreys, j.p) The Health Committee, as above, and the following Co-opted Members: Mrs. K. S. D. Baker. Mrs. H. Bowler. Mrs. M. F. Douglas. Mrs. E. E. Kemp. Mrs. H. E. Mellor. Mrs. F. Young. Housing Committee. 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. As constituted 9th November, 1926. Chairman: Councillor H. Harling. His Worship the Mayor (Councillor W. H. Humphreys, j.p.) Councillor Mrs. T. Amphlett. „ C. Barrington. „ J. Bruce. „ C. S. Cooper. Alderman G. Fineran. Councillor W. Geard. ,, W. J. Mciver. Alderman C. J. Powell. Mrs. M. J. Robinson. Councillor E. S. Strange, j.p. H. G. White. 2 (Committee to issue Certificates and reports under the Rent and Mortgage Enterest Restrictions Act, 1920 and 1923, as to the condition of dwelling houses. 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. As constituted 9th November, 1926. Chairman: Councillor H. Harling. His Worship the Mayor. (Councillor W. H. Humphreys, j.p.) Alderman G. Fineran. Councillor W. Geard. „ E. S. Strange, j.p. H. G. White. Tuberrulosis Committee. As constituted 9th November, 1925. The Health Committee, as above. As constituted 9th November, 1926. The Health Committee, as above. Tuberculosis Care Committee. 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). As constituted 9th November, 1926. Chairman: Alderman J. R. Archer (Guardians). Alderman G. Fineran. Councillor J. Hendrick. „ R. Moore. „ Rev. A. G. Prichard. „ E. S. Strange, j.p. Other Member: Mrs. E. W. Coles. 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. George's Hospital (Miss Hamilton). Lady Almoner, St. Thomas's Hospital (Miss Cummins). After-Care Sister, Victoria Hospital (Miss Underwood). Representative of the London Insurance Committee (Mr. R. A. Hanson). Representative of the S.L. District Nursing Association (Miss A. M. Stanford). Representative of the British Red Cross Society (Mrs. C. E. Peach). Health Visitor and Sanitary Inspector (Miss J. Round). 3 Staff of public Health Department. (At 31st December, 1926). Tuberculosis Officer—G. MACDONALD, M.A., M.B., Ch.B., D.P.H. Assistant Medical Officer (Maternity and Child Welfare)— (Miss) M. L. HAMILTON, M.B., Ch.B., D.P.H. Do. (part-time)— (Miss) ALICE BLOOMFIELD, M.D., F.R.C.S. Public Analyst—C. HACKMAN, F.I.C. Women Sanitary Inspectors and Health Visitors— Miss A. E. Moss, San. Insp. Board's Cert., Cert. C.M.B. Miss J. Round, H.V. Diploma, San. Insp. Board's Cert. Health Visitors— Miss C. P. Armitage, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss M. Carr, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss B. L. Kaye, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss N. Playne, San. Insp. Board's Cert., Cert. C.M.B. Miss O. Baggallay, H.V. Diploma, San. Insp. Board's Cert., Cert. C.M.B. Miss D. Heap, H.V. Diploma (R.S.I.), San. Insp. Board's Cert. Miss F. B. Goodall, H.V. Diploma, Cert. C.M.B. Miss N. Bourdillon (temporary), San Insp. Board's Cert., Cert. C.M.B Sanitary Inspectors— Mr. J. Lawrence, Cert. San. Inst. and Meat Insp. Cert. (Sen. Insp.) 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. H. H. May, Cert. San. Inst. 4. Mr. F. H. Chuter, San. Insp. Board's Cert. & Meat Insp. Cert. 5. Mr. J. R. Holloway, San. Insp. Board's Cert. 6. Mr. H. Marrable, Cert. San. Inst. 8. Mr. J. T. Baxter, Cert. San. Inst. Mr. H. E. Wheeler (Housing) San. Insp. Board's Cert., and Meat Insp. Cert. Food Inspector—Mr. A. Chuter, Cert. San. Inst., and Meat Insp. Cert. Workshops Inspector—Mr. W. E. Benjamin, Cert. San. Inst. Organising Rat Officer—Mr. H. Renham. Clerical Staff— Chief Clerk—Mr. F. E. Ward. Mr. J. W. Brown (Statistical). Miss G. Newton. Mr. E. Cole. Mr. W. C. Turner Mr. W. Halstead. (One vacancy). Mr. H. C. Godfrey. Office youth. Mr. R. Graham. Miss M. A. Weller (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. Clerks—Miss C. Turner. Miss Brown. Disinfecting Station—Superintendent—C. Woodhouse. Mortuary—Keeper—W. Newman. 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit for your information my Annual Report on the health and sanitary state of the Borough of Battersea for the year 1926. The Annual Report for 1925, in accordance with the requirements of the Ministry of Health, was a "Survey" Report, i.e., the report should every fifth year be of a retrospective character and should include a survey of progress during the previous five years. The Report for 1926 is, therefore, of a more restricted character and is concerned mainly with matters dealt with in that year. The vital and morbid statistics for the year have on the whole been satisfactory and compare favourably with those of previous years. The birth-rate (i.e., 17.3 per 1,000) is the lowest recorded in the old Parish and Borough of Battersea. The steady decline which is taking place in the birth-rate in Battersea as elsewhere in England and Wales is becoming a serious menace to the future of the Nation. The general death-rate and infantile mortality rate for the Borough although slightly higher than in 1925 compare favourably with those of recent years. The Tuberculosis death-rate is the lowest yet recorded in Battersea. The outstanding feature of the year's work has been the development of Ante-Natal work in connection with the Midwifery Services (Hospital and District) included in the Council's Maternity and Child Welfare Scheme. The great increase in the number of patients admitted to the Maternity Hospital and to the District Service has rendered it necessary to provide increased facilities for the examination and medical supervision of the expectant mothers. A full account of this work will be found in the chapter dealing with Maternity and Child Welfare. 5 In regard to Housing matters, it is satisfactory to be able to report that considerable progress has been made with the Plough Road Area Improvement Scheme during the year notwithstanding the difficulties associated with the re-housing of the dispossessed tenants. This Scheme when completed will be found, as may be seen from photographs (vide p. 101), of some of the houses prior to demolition and the new tenements which have replaced them in Britannia Place, a useful illustration of the value of Slum clearances and should encourage the Council to press for an extension of this useful work in other areas of the Borough in which the need is equally or even more urgent. It is to be regretted that the serious over-crowding in some of the lower wards of the Borough has not been to any adequate extent abated, the lack of housing accommodation at rentals within the means of those most requiring it being an insuperable barrier to one of the elementary principles of sanitation and social betterment. In conclusion it is again my privilege to acknowledge the support and assistance so generously accorded me by the Mayor, the Chairman of the various Committees and the members of the Council. To the Chief Officers of Departments and the Staff of the Public Health Department my thanks are also due for assistance always willingly rendered and without which no Medical Officer of Health could efficiently carry on his duties. 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, 111 Population 9, 10 Marriages 10 Births and Birth-rates in Wards and Sub-districts 11-12 Illegitimate Births 12 Deaths in Borough 12 „ in Wards, and Age Periods 13 Death-rates in Sub-districts 14 Deaths in Public Institutions 14 „ Senile 14 „ Causes and Age Distribution 113 Comparative Table of Births, Deaths, &c. (1857-1926) 19 Infant Mortality 15-17, 20, 114-117 Illegitimate Infant Deaths 17 Comparative Statistics, Metropolitan Boroughs 18 Notification of Births Act 21 Maternity and Child Welfare. Maternity and Child Welfare Scheme 21 Centres 21,22 Hospital Provision 23 Nursing Facilities 23 Health Visitors 24,25 Test-feeding (St. Thomas's Cornwall Babies' Hostel) 26 Milk for necessitous persons 26 Ante-Natal Work 27-31 V.D. 31-33 Maternal Mortality 33-34 Maternity Hospital 34-37 District Midwifery Service 37 Dental Clinic 38 Infectious Diseases—(i.) Notifiable 40 Summary of Notifications 41 Bacteriological Examinations 56,64 Contacts 40 Small-pox 40 Scarlet Fever 42 Diphtheria 43 Enteric Fever, Cerebro-Spinal Fever 44 Encephalitis Lethargica, Puerperal Fever 44,45 Puerperal Pyrexia Regulations, 1926 45 Polio-Myelitis 46 Ophthalmia Neonatorum 47 Erysipelas 48 Measles 48, 49 Whooping-Cough 50 Tuberculosis 50-61, 118-120 Cases Notified 50,51 Localisation of Disease 51 Non-notification 52 Deaths from Tuberculosis 52-54 Public Health (Tuberculosis) Regs. 1924 52 Dispensary 54 ,, (Report of) 55 Institutional Treatment 55 Open-Air School (Day Sanatorium) 56 Tuberculosis Dental Clinic 57 Care Committee 57 Training and Employment 57 Non-Dispensary Patients 57-59 Summary Table of Notifications 60-61 „ ,, Tuberculosis Scheme (Dispensary) 118-120 7 Page Infectious Diseases—continued. Zymotic Deaths 62 (ii.) Non-Notifiable Diseases 62 Chicken-pox 62 Diarrhœa 63 Influenza 63 Cancer 63 Sanitary Circumstances. Summary Table 65 Legal Proceedings 66-71 Summary of ditto 71 Common Lodging Houses 71 Drainage Work 72 Revenue Act, 1903 72 Licensed Premises (Sanitary Conveniences) 73 Smoke and Effluvium Nuisances 73 Water Supply 73 Van Dwellings 73 Rag Flock Act 74 Rats and Mice Destruction Act 74 Personal Cleansing Station 74 Disinfecting Department 76 Coroner's Court and Mortuary 77 Staff 78 Protection of the Food Supply. Inspection and Supervision 79 Unsound Food 79 Cow-Houses and Slaughter-Houses 79 Butchers' Shops 80 Public Health (Meat) Regulation, 1924 80 Sale of Food and Drugs Acts 80 Analyst's Reports 80-85 Milk and Cream Regulations 86 Milk and Dairies (Amendment) Act, 1922 87 Milk and Dairies Order, 1926 87 Ice Cream Vendors 85 Milk (Special Designation) Order, 1923 88 Milk Shops 88 Public Health (Preservatives, &c., in Food) Regulations, 1925 89-91 Fish Shops, Restaurant Kitchens, Street Stalls 91 Food Poisoning 92 Factories, Workshops, &c.—General Tables 94 Factories 95 Workshops 96 Outworkers 97, 100 Bakehouses 99 Warehouses and Wharves 99 Housing. General 101 Overcrowding 104 New Tenements and Houses erected 102 Repair of Unfit Houses 102 Closing Orders 104 Underground Rooms 104 Increase of Rent, &c., Acts 104 Action under Section 5, Housing Act, 1925 104 Insanitary Areas 104 Houses Let in Lodgings—By-laws 105 Summary of Housing Work 108 Insanitary Houses 105-108 Statistics 108-110 Staff 110 Appendices. Table I. Summary of Vital Statistics 111 „ II. Infectious Disease Notifications 112 „ III. Causes of, and Ages at, Death 113 ,, IV. Infant Mortality 114-117 Tuberculosis Scheme of the Borough Council— Return of Work of the Dispensary 118-120 8 Summary of Statistics, 1926. 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 1926) 171,900 Structurally separate occupied dwellings (Census, 1921) 27,191 Rateable value £1,121,737 Sum represented by a penny rate £4,642 2. Extracts from Vital Statistics of the Year. Births— (Males,1567; females, 1,402) 2,969 Legitimate births (1,506 males, 1,352 females) 2,858 Illegitimate „ (61 males, 50 females) 111 Birth-rate 17.3 Deaths— (Males, 994, females, 966) 1,960 Death-rate 11.4 Number of women dying in or in consequence of childbirth— From sepsis 3 Other causes 7 Death-rate of infants under 1 year per 1,000 births. Legitimate 57.7 Illegitimate 162.2 61.6 Deaths from Measles (all ages) 43 „ Whooping-cough (all ages) 13 „ Diarrhœa (under 2 years of age) 28 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 is bounded on the North by the Thames and on the West, South and East by the adjoining Boroughs of Wandsworth and Lambeth. It has an area excluding water of 2,139 acres and a population of 171,900. There are 24,000 houses, including 27,000 separate tenements in the Borough. The rateable value is £1,121,737, and a penny rate yields over £4,642. Battersea is mainly a residential working-class district of London. The manufactures carried on are comparatively few, the larger element of the population being employed outside the Borough. The density of population varies in different areas of the Borough being highest in the North and Eastern districts, where the housing conditions are less satisfactory and overcrowding is more prevalent than in the Southern area, which, in the main, is inhabited by the more prosperous and better-housed inhabitants. The chief occupations of male workers in Battersea are transport work, building and allied trades, metal, clerks, draughtsmen, etc. Among female workers the principal employments are personal service, clerical, typists, dressmaking, embroidery, etc. According to the Census of 1921 there are 46,000 females over 12 "unoccupied" or "retired" mostly engaged in domestic duties at home. The Borough is well provided with open spaces. Battersea Park in the North with its fine river frontage and Clapham and Wandsworth Commons in the South, contribute to the healthiness and amenities of the Borough. The district is entirely built upon, there being now practically no land available for the erection of houses—especially for the needs of the working-classes. The congestion and even serious overcrowding since the War, have in consequence, especially in the lower Wards, been very marked. Population. The population of Battersea, as estimated by the Registrar General for the year 1926 is 171,900. 10 The estimated population based upon the Registrar-General's figures, for the registration Sub-districts and for the Nine Wards into which the Borough is divided, is set out in the following Table:- Registration Sub-District. Estimated Mid-Year Population, 1926. Males. Females. Total. East Battersea 34,198 37,035 71,233 North-West Battersea 23,787 25,373 49,160 South-West Battersea 22,625 28,882 51,507 Total 80,610 91,290 171,900 1. Nine Elms 13,617 14,369 27,986 2. Park 8,811 9,856 18,667 3. Latchmere 9,276 10,338 19,614 4. Shaftesbury 7,633 8,158 15,791 5. Church 9,285 9,670 18,955 6. Winstanley 10,210 10,918 21,128 7. St. John 3,682 5,100 8,782 8. Bolingbroke 8,697 10,751 19,448 9. Broomwood 9,399 12,130 21,529 Total 80,610 91,290 171,900 MARRIAGES. The marriages registered in Battersea during 1926 numbered 1,304. The marriage-rate (i.e., the number of persons married per 1,000 of the population) was 15.2. 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 1926 1,304 15.2 11 BIRTHS. The number of births registered in the Borough during 1926 was 3,198 (1,690 males, 1,508 females, an excess of 182 males). Of this number, 585 were transferred out, the premanent residence of the parents being outside the Borough and 356 were transferred here, giving on balance a total 2,969 births relating to Battersea residents, and a corrected birth-rate of 17.3 per 1,000 of the population. The following table gives the distribution of the births and the birth-rate per 1,000 population in the Sub Districts and in the Wards for the year 1926:— Estimated Population, 1926. Number of Births. Birthrate. Sub Districts. East 71,233 1,344 18.9 North-West 49,160 1,012 20.6 South-West 51,507 613 11.9 Wards. No. 1, Nine Elms 27,986 587 21.0 No. 2, Park 18,667 380 20.4 No. 3, Latchmere 19,614 398 20.3 No. 4, Shaftesbury 15,791 214 13.6 No. 5, Church 18,955 353 18.6 No. 6, Winstanley 21,128 454 21.5 No. 7, St. John 8,782 101 11.5 No. 8, Bolingbroke 19,448 256 13.2 No. 9, Broomwood 21,529 226 10.5 The birth-rate in 1926 was the lowest yet recorded, except in 1918. The birth-rates for the County of London and England and Wales were also the lowest previously recorded except in 1918. It is to be noted that the birth-rate in Battersea has declined during the year in the three Registration Sub-districts. The rate was highest in Winstanley Ward (21.5), and lowest in Broomwood Ward (10.5). The birth-rate in Battersea is 3.0 per 1,000 lower than the average for the previous decennium, 1916-1925. The next table shows the birth-rates in the Borough and in the registration sub-districts in 1926, and during the previous decennium 1916-1925:- 12 Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 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 1925 18.5 20.6 20.6 13.6 Average 1916-1925 20.3 21.9 23.1 15.3 1926 17.3 18.9 20.6 11.9 The steady decrease in the birth-rate is an unsatisfactory feature of the Vital Statistics of the Borough during 1926. Illegitimate Births. Of the total births registered as belonging to Battersea 111 or 3.74 per cent. were of illegitimate children as compared with 106 or 3.35 per cent. in 1925, 108 or 3.44 per cent. in 1924, 115 or 3.35 per cent. in 1923, and 128 or 3.49 per cent. in 1922. DEATHS. The number of deaths registered in the Borough during 1926 was 2,547. Of these 948 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were on the other hand, 361 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths of persons belonging to the Borough was 1,960 (males 994, females 966). This gives a recorded death rate of 11.4 compared with 11.6 for London and England and Wales respectively. The distribution of the deaths and the death-rate per 1,000 inhabitants for each of the Nine Wards is shown in the following Table. 13 Ward. Estimated Population 1926. Number of Deaths. Deathrate. No. 1, Nine Elms 27,986 330 11.8 No. 2, Park 18,667 210 11.2 No. 3, Latchmere 19,614 235 12.0 No. 4, Shaftesbury 15,791 164 10.4 No. 5, Church 18,955 198 10.4 No. 6, Winstanley 21,128 257 12.2 No. 7, St. John 8,782 108 12.3 No. 8, Bolingbroke 19,448 216 11.1 No. 9, Broomwood 21,529 242 11.2 The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1926:- Under 1 year. 1-5 5-10 10-15 15-25 25-45 45-65 65- Total. M 101 66 22 16 37 120 286 346 994 F 82 46 18 9 31 104 251 425 966 Ttls. 183 112 40 25 68 224 537 771 1,960 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 272 299 571 Second quarter 243 221 464 Third quarter 210 193 403 Fourth quarter 269 253 522 994 966 1,960 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 1926 was 11.0. The increase in the death-rate (10.5 to 11.4 as compared with 1925) has been slight and is accounted for by the increased deathrate in the first quarter of the year from respiratory disease and measles. The death-rate was lowest in the Shaftesbury and Church Wards (10.4), highest in St. John's Ward (12.3). The deaths of persons over 65 years numbered 771 or nearly 40 per cent. of the total deaths. The average age at death was 50.3 years, as compared with 51.2 in 1925. 14 Death-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 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 1925 10.5 10.5 11.0 10.0 Average 1916-25. 13.2 13.3 13.7 12.5 1926 11.4 11.5 11.4 11.3 The natural increase of population (that is the excess of births over deaths) was 1,009 in 1926, the lowest figure yet reached except in the War year 1918, when there was an adverse balance of 109. Deaths in Public Institutions. During 1926 the deaths of Battersea residents occurring in Public Institutions numbered 992. Of this number 696 occurred within and 296 outside the Borough. Of the total deaths in Public Institutions 665 occurred in Poor Law Institutions. Senile Mortality. During 1926 the deaths of 771 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 71 69 52 66 12 15 135 150 285 N.W. Battersea 62 53 39 47 3 9 104 109 213 S.W. Battersea 55 68 42 72 10 26 107 166 273 Borough of Battersea 188 190 133 185 25 50 346 425 771 15 Infant Mortality. During 1926 the deaths of 183 infants were registered as belonging to Battersea. The total number of births registered during the year was 2,969 giving an infant mortality rate of 61.6 per 1,000 births. The infant mortality-rate was slightly higher during 1926 than in the previous year. The main causes responsible for the rise were respiratory and to a lesser extent intestinal diseases. The distribution of the 183 infant deaths and the infant mortality-rates 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 Mortality per 1,000 births. M. f. total. East Battersea 1,344 39 41 80 59.5 North-West Battersea 1,012 47 27 74 73.1 South-West Battersea 613 15 14 29 47.3 The Borough 2,969 101 82 183 61.6 Ward. 1. Nine Elms 587 19 22 41 69.8 2. Park 380 8 8 16 42.1 3. Latchmere 398 14 7 21 52.8 4. Shaftesbury 214 7 7 14 65.4 5. Church 353 15 11 26 73.7 6. Winstanley 454 23 14 37 81.5 7. St. John 101 3 1 4 39.6 8. Bolingbroke 256 6 3 9 35.2 9. Broomwood 226 6 9 15 66.4 It will be noted that in the sub-districts the rate was highest in North West Battersea (73.1) and lowest in South-West Battersea (47.3). In the Wards, Winstanley showed the highest rate (81.5) and Bolingbroke the lowest (35.2). The infant mortality rate in the County of London and in England and Wales during 1926 was 64 and 70 respectively. 16 The number of infant deaths and the infant mortality in each quarter of the year was as follows : — Births registered. Infant deaths. Infant Mortality Rate. First quarter 725 48 66.2 Second quarter 799 34 42.6 Third quarter 750 38 50.6 Fourth quarter 695 63 90.6 During the first 9 months of the year the infant death-rate was 52.8. The unusually high mortality of the last quarter of the year accounted for the increased rate for the whole year as compared with 1925. There were 81 deaths of infants during the first four weeks of life (or 44.3 per cent. of the total infant deaths) as compared with 89 deaths (or 47.9 per cent.) in 1925 and an average percentage for the quinquennium 1921-1925 of 42.1. The main causes responsible for the increase in the infant deaths were Diarrhoea and Enteritis and respiratory diseases. Measles also accounted for some of these infant deaths. On the other hand it is satisfactory to record that the deaths from developmental diseases decreased from 88 to 72 as compared with 1925. The next tables show the incidence of mortality from the chief diseases of infancy in the first four weeks and during the four trimesters :— Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1921 to 1926. 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 1926 20 38 23 81 17 Certified Causes of Death. Months 0—3. Months! 3—6. Months 6—9. Months 9—12. Total. % of Total. Scarlet Fever Diphtheria Erysipelas Measles Influenza Meningococcal Meningitis Whooping Cough Diarrhoea and Enteritis General Tuberculosis Tuberculous Meningitis Pulmonary Tuberculosis Pneumonia Bronchitis Other Respiratory Diseases Nephritis Prematurity Marasmus (Edema Neonatorum Congenital Malformation; Injury at Birth Suffocation (overlying) Convulsions Atelectasis & Asphyxia N Lack of Care Septic Parotitis Syphilis Miscellaneous Total Percentage of Total - - 1 - 2 - - 5 - - 8 2 45 5 2 10 1 13 2 1 3 1 101 55-2 1 9 1 1 8 1 6 1 28 15-3 2 7 8 1 2 1 21 11-5 1 6 1 4 1 1 15 3 1 33 18-0 1 1 6 2 4 25 1 1 2 39 5 47 13 2 10 1 13 2 1 3 4 183 100-0 0.55 0.55 3.28 1.09 2.19 13.66 0.55 0.55 1.09 21.31 2.73 25.68 7.10 1.09 5.46 0.55 7.10 1.09 0.55 1.64 2.19 100.0 Illegitimate Infant Deaths. The death-rate amongst illegitimate children during 1926 was 162 per 1,000 births, as compared with 113.2 per 1,000 births in 1925, 148.1 in 1924 and 179.7 in 1923. The corresponding deathrate of legitimate children in 1926 was 61.6, the ratio of the mortality-rate of illegitimate infants to that of legitimate being 2.8 to 1. 18 Table showing birth-rates, death-rates and infant mortalityrates in the 29 Metropolitan Cities and Boroughs for the year 1926:— Births per 1,000 Population. Deaths per 1,000 Population. Infant Mortality per 1,000 Births. 1. Shoreditch 23.3 1. Lewisham 10.0 1. Lewisham 40 2. Poplar 21.7 2. Hampstead 10.1 2. Woolwich 42 3. Bethnal Green 20.9 3. Woolwich 10.1 3. S. Newington 49 4 Bermondsey 20.8 4. Wandsworth 10.4 4. Lambeth 54 5. Finsbury 20.6 5. Hackney 10.6 5. Bermondsey 56 6. Southwark 20.2 6. Fulham 10.7 6. Deptford 56 7. Stepney 19.7 7. City of London 10.7 7. Hampstead 58 8. Islington 18.5 8. Greenwich 10.9 8. Hackney 60 9. Deptfcrd 18.2 9. S. Newington 11.0 9. Kensington 61 10. Greenwich 17.8 10. Camberwell 11.0 10. Battersea 62 11. Hackney 17.3 11. Deptford 11.1 11. City of Westminster 62 12. Battersea 17.3 12. City of Westminster 11.2 13. Lambeth 17.2 12. Greenwich 63 14. Woolwich 16.9 13. Hammersmith 11.3 13. Wandsworth 64 15. St. Pancras 16.8 14. Battersea 11.4 14. Camberwell 64 16. Camberwell 16.6 15. Poplar 11.4 15. City of London 65 17. Fulham 16.3 16. Lambeth 11.5 16. Stepney 65 18. Hammersmith 16.3 17. Bethnal Green 11.6 17. Chelsea 65 19. S. Newington 15.6 18. Stepney 11.7 18. Fulham 65 20. Lewisham 15.5 19. Holborn 11.7 19. Shoreditch 66 21. Paddington 15.4 20. Bermondsey 11.9 20. Finsbury 67 22. Kensington 15.1 21. Shoreditch 11.9 21. Hammersmith 67 23. Wandsworth 14.3 22. Islington 12.0 22. Islington 67 24. Chelsea 13.3 23. St. Pancras 12.2 23. Southwark 70 25. St. Marylebone 12.8 24. Paddington 12.3 24. Poplar 70 26. Holborn 12.4 25. Chelsea 12.4 25. Bethnal Green 72 27. Hampstead 12.2 26. Kensington 12.4 26. St. Pancras 76 28. City of Westminster 11.3 27. St. Marylebone 12.6 27. St. Marylebone 82 28. Southwark 12.7 28. Paddington 84 29. City of London 7.9 29. Finsbury 12.8 29. Holborn 90 London County 17.1 11.6 64 England and Wales 17.8 11.6 70 19 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 8,742 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 1926 171,900 2,969 17.3 1,960 11.4 119 1,009 * Population as estimated for purpose of (B) Birth-rate, (D) Death-rate. † Decrease. Census years in heavy type. 20 CHART showing the INFANTILE MORTALITY RATE (per 1,000 Registered Births) in Battersea from 1858 to 1926. 21 Notification of Births Act. During 1926 the number of notifications of live births received was 2,839. The corrected number of births registered during the year in Battersea was 2,969. The proportion of notified to registered births was, therefore, 95.6 per cent. The number of still births notified during the year was 71 or 2.4 of the total births. 245 births of Battersea children born in other districts were notified from the districts in which these births occurred. Notified births are visited and revisited by the Council's official Health Visitors and the visitors of the Voluntary organisations included in the Council's Maternity and Child Welfare Scheme. A weekly return of all births notified is forwarded 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 Maternity and Child Welfare Scheme of the Council includes both Municipal and Voluntary effort and the activities of both are fully co-ordinated. In order to enable the Voluntary Associations to keep their work efficient and in uniformity with that of the Municipal Centres and Clinics they receive, in addition to the grants from the Ministry of Health, an annual contribution from the Council. Maternity and Child Welfare Centres. The Centres, Municipal and Voluntary, are situate as follows :— 1 Municipal. (а) 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' Hall, Ponton Road, Nine Elms). Other 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, Cambridge Road. 22 Each centre is under the supervision of a trained Health Visitor and Voluntary Helpers assist in the work of these centres. At each centre there is a clinic in charge of a woman Medical Officer. The Voluntary Centres are managed on similar lines to those of the Municipal Centres. • The following table gives a summary of the work carried out at the Child Welfare Centres during 1926:— Summarised Statistics Relating to Municipal Infant Centres, 1925-1926. Latchmere Centre. Plough Road Centre. East Battersea Centre. Chatham Road Centre. Total 1925. Total 1926. 1925. 1926. 1925. 1926. 1925. 1926. 1925. 1926. Sessions held 145 146 100 98 102 98 115 142 462 484 Attendances 7,161 7,330 4,634 4,392 4,704 4,316 5,923 5,332 22,422 21,370 First attendances 488 480 370 382 321 276 354 341 1,533 1,479 Average attendances per session 49 50 46 45 46 44 52 38 49 44 Average ditto weekly 138 141 89 84 90 83 114 103 431 411 Doctor's attendances 100 96 43 45 49 47 50 49 242 237 Babies seen by Doctor 2,755 2,505 967 1,107 1,291 1,265 1,156 1,123 6,169 6,000 Average ditto per attendance 28 26 22 25 26 27 23 23 25 25 Weights recorded 6,205 6,197 3,804 3,750 4,367 3,924 5,016 4,561 19,392 18,432 Advice only 956 1,133 830 642 337 392 907 771 3,030 2,938 The following table summarises the work carried out during 1925 and 1926 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. 1926. 1925. 1926. 1925. 1926 1925. 1926. Sessions held 95 95 50 51 73 75 218 221 Attendances 3,541 4,392 1,112 1,248 2,120 1,941 6,773 7,581 First attendances 241 261 66 64 110 92 417 417 Averages attendance per session 37 46 22 24 29 26 31 34 Average weekly 68 84 22 24 41 37 130 146 Doctor's attendance 94 95 26 28 73 75 193 198 Babies seen by Doctor 2,653 3,099 303 374 1,633 1,414 4,589 4,887 Average do. per attendance 28 33 12 13 22 19 24 25 Weights recorded 3,541 4,357 1,040 1,161 1,925 1,794 6,506 7,312 Advice only - 35 72 87 195 147 267 269 23 Hospital Provision. In addition to the provision of Midwifery Services, Hospital and District, the Council have provided facilities for the needs of children requiring special Hospital treatment by arrangement with the Victoria Children's Hospital, Chelsea, and the Fulham Babies' Hospital (chronic debility and wasting diseases). The Council contribute an annual sum in the case of the former, and a per capita payment to the latter Institution in respect of these facilities. Women and children where necessary are referred from the AnteNatal and Child Welfare Centres to other appropriate Institutions. Number of cases referred to Hospitals and Institutions from the Maternity and Child Welfare Clinics during 1926 :— St. Thomas's Hospital 53 Victoria Hospital—Chelsea 254 St. James's Hospital 11 Bolingbroke Hospital 4 Borough Tuberculosis Dispensary 23 Fulham Babies' Hospital 10 St. Thomas's Cornwall Babies' Hostel 98 Humanity House 2 Nursing Facilities. During 1926 the total number of attendances made by the District Nursing Service in connection with the Council's Scheme was:— Nursing Service, 1926. Name of Disease. Age. Total. Under 5 years. Over 5 years. Cases. Visits. Cases. Visits. Cases. Visits. Ophthalmia Neon. & other Eye Aff'ns. 122 2,993 — — 122 2,993 Measles 88 817 22 232 110 1,049 Whooping Cough 11 154 2 40 13 194 Diarrhœa & Vomiting 22 107 — — 22 107 Chicken Pox 2 24 2 21 4 45 Pemphigus neonatorum — — — — — — Puerperal Fever — — — — — — Pneumonia 55 982 67 1,161 122 2,143 Influenza 4 39 18 185 22 224 Other Diseases — — 3 79 3 79 Totals 304 5,116 114 1,718 418 6,834 24 The cost of the Nursing Service in 1926 was £227 16s. as compared with £218 13s. 4d., in the previous year. Health Visitors. The Health Visiting Staff consists of 9 full time Health Visitors, two of whom are partly employed as women Sanitary Inspectors. During the year the Council granted facilities, on the request of the Ministry of Health, to students of recognised training bodies for practical training as Health Visitors. A syllabus for the training of these students has been drawn up to meet the requirements of the training bodies concerned. The serious outbreak of Measles at the end of 1925 which continued with increased severity into the early part of 1926, took up a good deal of the time of the Health Visitors. Notwithstanding this however, the other important duties of these officers did not suffer, the assistance in visiting and other work rendered by the students from the recognised Training Bodies undergoing practical training in the Council's Maternity and Child Welfare Scheme proving very useful in the emergency in maintaining and even increasing the record of the year's work. The work carried out during 1926 by the Council's Health Visitors and those of the voluntary organisations included in the Borough Maternity and Child Welfare Scheme is summarised in the table on page 25. 25 Summary of Visiting Work Carried out by Council's Visiting Staff and Voluntary Organisations included in the Borough Maternity and Child Welfare Scheme from 1922 to 1926. Health Visitors. 1922. 1923. 1924. 1925. 1926. 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 1,363 297 1,660 1,611 304 1,915 1,754 612 2,366 1,843 579 2,422 1,866 628 2,494 Visits to Notified Births 6,025 1,660 7,685 8,016 1,350 9,366 8,383 1,215 9,598 8,565 1,249 9,814 8,549 950 9,499 Visits to Still Births 33 — 33 60 4 64 88 18 106 83 11 94 86 6 92 Visits to children aged 1-5 years 942 1,117 2,059 1,394 1,459 2,853 2,539 1,447 3,986 2,775 1,438 4,213 3,017 1,118 4,135 Visits to enquire into Infant Deaths 174 30 204 117 32 149 205 24 229 164 33 197 151 28 179 Visits to cases of Notifiable Infectious Disease 5,611 712 6,323 5,074 354 5,428 5,060 589 5,649 4,367 318 4,685 7,480 912 8,392 Visits to cases of Non-Notifiable Disease 660 129 789 552 104 656 528 101 629 626 132 758 452 110 562 Visits re Summer Diarrhœa 1,847 652 2,499 1,713 400 2,113 1,361 655 2,016 471 243 714 1,251 120 1,371 Visits to Dental Cases 276 — 276 322 33 355 320 25 345 260 14 274 231 29 260 Visits to V.D. Cases 145 — 145 191 — 191 211 — 211 159 — 159 75 — 75 Other Visits 949 83 1,032 785 229 1,014 1,311 819 2,130 1,061 650 1,711 1,053 623 1,676 Totals 18,025 4,680 22,705 19,835 4,269 24,104 21,760 5,505 27,265 20,374 4,667 25,041 24,211 4,524 28,735 26 St. Thomas's Cornwall Babies' Hostel. During the year arrangements were temporarily made with St. Thomas's Cornwall Babies' Hostel, with the sanction of the Ministry of Health, for the provision of facilities for cases sent from the Borough Maternity and Child Welfare Clinics for test feeding and the encouragement of breast feeding amongst Battersea mothers. The results of the year's work have been very promising and are summarised below:— A. Test Feeds. Number of cases, 95, comprising: Mothers, 95; babies, 98. Number of attendances, 102. 7 cases received in-patient treatment. B. In-Patient Treatment. 28 Battersea cases received, made up of— 10 (mother and babe in each case) sent by Council. 8 (babies only) sent from other sources. Period of stay. 20 cases sent by Council— 9 mothers and babies, 184 days Average 1 mother 5 days, and baby 75 days 22.4 days 8 other cases—8 babies, 144 days. Average 18 days. A contribution of £50 was made by the Council towards the cost of this work, which was included in the estimates of the Maternity and Child Welfare Scheme. Milk for Necessitous Persons. Under the provisions of the Maternity and Child Welfare Act, 1918, Milk is provided by the Council for 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 bv those able in part to contribute :- 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 1926 609 30,762 699* 89,435 3,262 * Of these 469 also received dried milk. 27 In addition to the above, dinners to the number of 3,200 were supplied to necessitous mothers and children at a cost of £92 2s. 3d. On and after the 1st April, 1926, in place of dried milk hitherto mainly supplied under this head, Grade A (Tuberculin Tested) Milk only was given, except in a few cases where for medical reasons, dried milk was ordered. Ante-Natal Work. The work of the Ante-Natal Clinics during 1926 was very satisfactory as will be seen from an examination of the statistics shown on page 31. These Clinics are under the direction of Miss Alice Bloomfield, M.D., F.R.C.S., who has organised them with remarkable success. The importance of this branch of Maternity and Child Welfare Work cannot be over-estimated, not only in its effects in the reduction of maternal mortality, but also in the prevention of invalidity, suffering and other evil results which threaten the expectant and nursing mother. Owing to the increase in the attendances of patients at the Central Ante-Natal Clinic held at the Borough Maternity Hospital, it was found necessary to provide an extra session. This additional session was sanctioned by the Ministry of Health and was opened on the 1st April, 1926. The effect has been to greatly relieve the pressure on the Medical Officer and to increase the efficiency of the work. There are subsidiary Clinics held at the Latchmere, Plough Road, and All Saints' Hall Centres. With the exception of one fortnightly Ante-Natal Clinic held at the Women's League of Service Centre, 111 Bridge Road West, all Ante-Natal Cases are referred from the Voluntary Centres included in the Borough Maternity and Child Welfare Scheme to the Ante-Natal Clinics at one or other of the Municipal Centres. The increase in the number of patients admitted to the Borough Maternity Hospital and also in the District Midwifery Service has, of course, resulted in a corresponding increase in the attendances at the Ante-Natal Clinics. It is an inflexible rule that every expectant mother who applies for admission to the Maternity Hospital or for the services of the District Midwife, is required to attend for examination by the Medical Officer of the Clinic. Dr. Bloomfield reports : — During the year 1926 the Ante-Natal work in Battersea has grown considerably, the number of new cases attending the Battersea Pre-Natal Clinics being 906 as against 729 in 1925, while the total attendances have been 3,842 in 1926 as against 2,904 in 1925. These added cases are largely due to "out of the Borough" cases, the greater proportion of whom were primiparæ. 28 This increase in the work necessitated the institution of an extra Ante-Natal Clinic which is held on Thursday morning at the Borough Maternity Hospital, the existence of which has been more than justified by the amount of work undertaken at it. I am thus now responsible for the three Ante-Natal Clinics held at the Battersea Maternity Hospital, on Tuesday afternoon, Wednesday and Thursday mornings. To these last two clinics all cases expecting to be confined in the Hospital come during their last two months of pregnancy, thereby increasing the work enormously. On the whole, cases have attended the clinics at an earlier period than formerly, 453 attending before the sixth month, 356 between the sixth and eighth months and only 74 after the eighth month. As I pointed out in my 1925 report this is to be encouraged, as it permits of an examination of the patient's general health being made earlier in pregnancy when treatment can be effectively instituted for any deviation from the normal. Thirteen patients with cardiac disease have been examined in the last year, and advice given or treatment instituted, while in ten cases a further examination of the chest by a specialist in pulmonary diseases was recommended. The Tuesday Clinic shows a great increase in numbers, 691 new patients having attended during 1926 with 791 attendances in all. This is largely due to the increased number of patients attending for blood tests, the crowded condition of the ordinary Ante-Natal Clincs making it impossible to take specimens at these times. Out of 658 Wasserman Tests done, only 10 or approximately 1.5 per cent gave a positive reaction. There has been a considerable decrease in the number of patients attending the Clinic complaining of prolapse, vaginal discharge, etc., this being due, I think, to the very large number of primiparae in whom such symptoms are not so common. The Wednesday and Thursday Clinics have already been mentioned. They have been well attended with 87 Sessions showing an average attendance of 25 and 404 new patients. At the Friday Clinic at the Latchmere Centre, in spite of the fact that since about August, 1926, all cases attending this clinic and expecting to be confined in the Battersea Maternity Hospital, have been referred to the Hospital after the seventh month, the total attendances were 708 as against 630 the year before. The new patients were 198 in 1926 and only 148 in 1925, and the average attendance 14 per clinic as against 13 in the previous year, showing how this clinic has increased in size. With this report on the purely ante-natal or out-patient part of the work, must be placed an account of some of the results obtained in abnormal cases and others in patients entering the Hospital from the Clinics, and here I append a resumé of some of these which the Matron has kindly drawn up for me, showing the results. 29 I should like here to make some comments and suggestions about these results having a close connection and interest with these cases by reason of my Ante-Natal work. Albuminuria.—Although 64 cases of Albuminuria were seen at the Ante-Natal Clinics and there treated it was only necessary to admit 4 cases to the Hospital. Of these 3 became Albumenfree after in-patient treatment, and the other patient was transferred to St. Thomas's Hospital with grave Ophthalmic symptoms. In one case Eclampsia occurred. Breech Presentations.—I think it is a matter for congratulation to all concerned in the examination of the Ante-Natal patients that out of 906 new patients only 5 cases of breech presentation escaped diagnosis. Seventeen breech cases were admitted for a night to the Hospital for External Version under anaesthesia and in 7 of these version was successful. Of the remaining ten labour resulted in the birth of a living child in all but one case, i.e., 90 per cent., which is a matter for the warmest praise of the Matron who performed most of the deliveries in these often, in primiparae, very difficult cases. Inductions.—During 1926, 13 inductions were performed (one was followed by Caesarian Section with a live child, but unfortunately death of the mother 3 days afterwards—? cause) as against 3 inductions in 1925. This at first appears a large increase, but when the number of primiparae attending the clinics is taken into consideration I think this increase is relative only and that the actual ratio number of inductions will have altered little. number of primiparae These inductions resulted in the birth of 8 living children, of whom 2 died shortly after birth with convulsions, apparently arising from cranial injury. One mother died (? from Embolism), and one mother had for a time continued pyrexia. These results are disappointing and require further scrutiny. Of these 12 inductions, 6 were sent to St. Thomas's Hospital for a second opinion, in these cases some doubt being felt as to the best time to perform induction or as to the necessity and suitability of a case for induction. In all these cases its carrying out was advised, either at once or at a future date. These 6 cases resulted in 5 forceps deliveries with 2 still-births and 2 neo-natal deaths. The 6 remaining cases were seen by me only and resulted in 4 living children and 2 still-births, neither of the cases in these 2 last requiring assistance by forceps, therefore presumably labour was quite easy. Certain conclusions may be drawn from these data:— (1) It is a well-known fact that induction babies stand instrumental interference very badly, their prematurity and consequent lessened cranial ossification making them 30 poor subjects for pressure by forceps. Instrumental interference should therefore be avoided as far as possible. (2) The earlier in pregnancy induction is performed, the poorer the chances of a living and viable child, there being little prospect of this before the 36th week, therefore all cases should be left as long as possible and as is consistent with safety; the weight of the child in itself is of little real importance, the extent of ossification and size of the foetal head in relation to the maternal pelvis being the most important factors. It is now agreed by most modern Obstetricians that induction is a well recognised and very valuable form of treatment for minor degrees of disproportion between the foetal head and the maternal pelvis and that it should be done in preference to Caesarian Section in all primiparae where a reasonable chance of a living child exists. Each case is, however, a potential Caesarean Section and the most careful and skilled medical attention and repeated examination is required in certain cases to decide when an induction mother after being in labour for a few hours is likely to deliver herself successfully of a living child or whether Caesarian Section will be required. For this reason and for others the presence of a resident medical Officer who possesses some obstetric knowledge would be of great benefit. In any case of induction admitted to the Battersea Maternity Hospital, I should like to make the following suggestions. (1) That where a case is referred for a second opinion, the letter in reply should be sent direct to the Town Hall and acted on forthwith if necessary without the possible valuable time lost in awaiting my next attendance at the Battersea Maternity Hospital. (2) In the case of every induction the doctor who performed the operation should see the patient at an interval of not more than 12 hours after the commencement of labour, or sooner if need be. (3) That in every case of. induction, a form containing certain particulars should be filled in at the time of the case and a copy should be sent immediately after delivery to the Medical Officer of Health and myself. By these measures, I think much may be done to secure greater co-operation in the treatment of these cases with great advantage and, I hope, improvement in the results obtained. In closing I should like to draw attention to the almost complete absence of Sepsis of any kind in the cases attended in the Battersea Maternity Hospital, and in the homes of patients and congratulate all those concerned in this result. The report of Dr. Alice Bloomfield on the development of AnteNatal work in Battersea will give some idea of its magnitude and importance, especially in relation to the Maternity Services, Hospital and District, of the Council. The great increase in the number of admissions to the Maternity Hospital and of applications for the 31 district Midwife's Services during the year 1926—taxing the accommodation at the Hospital to its fullest extent, renders it imperative that a resident woman Medical Officer should be seriously considered. Not only in the direction indicated in Dr. Bloomfield's report, but in others as well—the appointment of such an Officer would, having regard to the growth of these services—be productive of greater security to the patients and by co-ordinating the Ante-Natal work with that of the Hospital and the Consultant Obstetrician, result in better team work. The total number of patients attending the Ante-Natal Clinics during 1926 was :— Central Clinic (Borough Maternity Hospital) 625 Latchmere Clinic 255 All Saints (East Battersea) 156 Plough Road (West Battersea) 172 Total 1,208* The numbers show an increase of 297 patients as compared with 1925. In addition to the Ante-Natal work carried out under the Maternity and Child Welfare Scheme, a considerable amount of visiting and reporting of cases is done for the Obstetric and Gynaecological Departments of the larger Hospitals in connection with Battersea patients attending these Institutions. The following is a summarised statement showing the Hospital and the visits carried out for them during 1926 :— Ante-natal and postnatal. Other. Total. St. Thomas's Hospital 417 227 644 General Lying-in Hospital 352 — 352 King's College Hospital 8 — 8 St. George's Hospital 26 3 29 Westminster Hospital 13 1 14 Victoria Hospital, Chelsea - 55 55 Gt. Ormond Street Hospital 3 2 5 Royal Waterloo Hospital Royal Free Hospital 819 288 1,107 Ante-Natal (V.D.) Clinic. This Special Treatment Clinic was established in connection with the Ante-Natal Out-patient Department at the Borough Maternity Hospital at the end of 1921. The Clinic is fully equipped with all modern requisites for diagnosis and treatment and is directed by Dr. A. C. Roxburgh, the Consultant Medical Specialist. The work carried out during 1926 is summarised in the table on page 32. * These figures do not include those of the special Gynaecological Clinic held on Tuesday. z?. 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 date of report. 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 18 3.5 15 11 1 0 1 2 1925 653 14 2.1 8 7 1 0 0 0 1926 658 10 1.5 9 6 3 0 0 0 * Not syphilitic. 33 The Consulting Specialist to the Clinic, Dr. Roxburgh, reportsCompared with 1925 there was an increase of 5 in the number of Wasserman Tests carried out on pregnant women attending the Ante-Natal Clinics (vide Table p. 32). Of these the results were positive (showing the presence of syphilis) in only 10 (1.5 per cent.) as opposed to 14 (2.1 per cent.) in 1925. It is satisfactory to find the percentage of syphilis among the mothers attending the Ante-Natal Clinics falling year by year (see Table). Another satisfactory feature this year is that the syphilitic mothers have been discovered earlier in their pregnancies. The average duration of pregnancy when they came for Test was 5.7 months this year, whereas in 1925 the majority had passed the seventh month. The average number of injections which each received was between seven and eight, which was higher than usual. Of the ten syphilitic mothers discovered all ten had treatment during pregnancy, this being the first time we have succeeded in getting 100 per cent. treated. One at her husband's request was transferred to a General Hospital for treatment. Her pregnancy unfortunately ended in a miscarriage at 6 months. All the 9 treated in the Borough Maternity Ante-Natal Clinic had healthy babies. Six of the babies have been tested and found to have negative Wasserman's, the other three have not yet been tested as the mothers failed to bring them up. This reluctance to bring the babies up for test is an unsatisfactory feature. It is interesting to note the results of the 25 previous pregnancies in these 9 women, some of which no doubt occurred before the women became infected. These 25 pregnancies resulted in 7 miscarriages, 2 still-births, 5 children who are already dead and only 11 now living. Of these some must be syphilitic, while others are probably healthy as being born before their mothers acquired syphilis. Comparison of these figures with the results of treated pregnancies (see Table) shows the great value of ante-natal treatment in syphilitic pregnant women. Maternal Mortality. During 1926 there were ten deaths of women from diseases or accidents of child-birth, which is equivalent to a fatality-rate of 3.37 per 1,000 births. The causes of death and the mortality-rate for the five years 1921-25 and in 1926 are set out in the following table:— 34 Maternal Deaths in Child-birth (Puerperal Sepsis and other Causes). 1921. 1922. 1923. 1924. 1925. 1926. Deaths from Puerperal Sepsis 4 3 - 4 3 3 Deaths from other causes connected with child-birth 10 6 10 5 3 7 Total Maternal Deaths connected with child-birth 14 9 10 9 6 10 Rate per 1,000 births— Puerperal Sepsis 1.07 0.82 - 1 .27 0.94 1.01 Other Maternal deaths 2.67 1.64 2.91 1 .59 0.94 2.36 Rate per 1,000 all Maternal deaths 3.74 2.46 2.91 2.86 1.88 3.37 Rate per 1,000 population— Puerperal Sepsis .024 .018 - .023 .017 .017 Other Maternal deaths .059 .035 .059 .029 .017 .041 Rate per 1,000 population all Maternal deaths .083 .053 .059 .052 .034 .058 The figures for 1926, while not so satisfactory as those for the previous year, are on the whole encouraging, and it is hoped that when the effects of the measures now being taken for the provision of ante-natal facilities throughout the Borough (vide pp. 36-37 of the Annual Report for 1925) are completed and co-ordinated that still better results will follow. Borough Maternity Hospital. The Borough Maternity Hospital was opened for the reception of maternity patients in February, 1921. The Hospital is situated at 19 and 20 Bolingbroke Grove, directly overlooking Wandsworth Common. Accommodation is provided for 30 patients at one time. 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 held at the Out-patient Department of the Hospital. The Nursing Staff of the Hospital consists of a Matron (Miss C. Dickson), one Sister and four Staff Nurses. There is accommodation in the Hospital for 12 pupil-midwives undergoing training. 35 During 1926, 625 cases were admitted to the Hospital as compared with 560 cases in 1925 and 400 cases in 1924. Medical attendance, when required, is provided by a rota of local 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. H. Richardson, F.R.C.S.) are also available in cases of grave emergency. It was found necessary to call in the services of the Consultant Obstetrician in 10 cases during the year as compared with 5 cases in 1925. Particulars relating to the admissions during 1926 are set out as follows:— Total number of cases admitted 625 Average duration of stay 14 days Number of cases delivered by midwives 570 Number of cases delivered by doctors 41 Of the above 625 cases, 14 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. Albuminuria 4 Version 7 Hæmatemesis 1 Œdema 1 Induction for contracted pelves 12 Ante partum hæmorrhage 5 30 (b) During Labour. Foetal distress 16 Eclamptic fits 1 Prolapse of cord 2 Retained placenta 3 Face presentation 1 Complicated breech 4 27 (c) After Labour. Rupture of perineum 8 Sore throat and rheumatism 1 Influenza 2 Pain in breast 2 Collapse after labour 2 Vaginal lacerations 1 Rise of temperature 1 Bronchitis 1 Abscess of buttock 1 Pneumonia 1 Recto-vaginal fistula 1 — Pleurisy 1 22 36 (d) For Infant. Prematurity 5 Mastitis 1 Feebleness 2 Discharge from ear 1 Aspiration pneumonia 1 ? Meningeal 1 Abscess of face 1 Ascites and general oedema 1 Vomiting 1 Meloena neonatorum 1 Asphyxia pallida 1 Acute parotitis 1 Fractured femur 1 Ophthalmia neonatorum 2 Fractured humerus 1 Slight discharge from eyes 21 Convulsions 2 Skin eruption on arms 1 45 Number of maternal deaths 3 Myocarditis 1 Post operation Cæsarean section after induction 1 Fatty degeneration of the heart 1 Number of cases in which temperature rose above 100.4° F. for 24 hours with rise of pulse rate 8 Number of cases notified as Ophthalmia neonatorum with result of treatment 7 (All cured. No permanent damage to eyes. 1 transferred to St. Margaret's Hospital for treatment.) Number of cases with discharge from eyes ever slight 21 Number of infants not entirely breast fed 5 Anæmia of mother 1 Death of mothers 2 Insufficient secretion 2 Number of cases notified as puerperal sepsis Nil Number of foetal deaths (still-born or within 10 days of birth) and their causes 26 Placenta not fully developed 1 Cause unknown 1 Placenta prævia 2 Triplets (premature) 3 Prolapse of cord 1 Prematurity 3 Macerated foetus (2nd twin) 3 Feebleness at birth 1 Complicated breech 2 Convulsions after Head injury—forceps—cases of duction 3 induction 4 General oedema and ascites 1 Anencephalus 1 The Medical Consultant was called in in 10 cases of grave emergency, particulars of which are set out below:— A.P.H. 2 Albuminuria with loss of eyesight 1 Cesarean section 2 Complicated breech 1 Pyrexia with no apparent cause 1 Continued pyrexia 1 Myocarditis 1 Meloena neonatorum 1 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, 1927 :— 37 Maternity Hospital, 1927-1927. Total beds, 30; total cases, 635; percentage of beds occupied 81.4 per cent. Item. Total. Per Patient Week. £ £ s. d. Salaries Medical 168 0 2 8 Nursing 590 0 9 4 Domestic and other 497 0 7 10 Provisions 1,134 0 17 10 Drugs and other Medical Requisites 234 0 3 8 Heating and Lighting 468 0 7 4 Laundry 380 0 6 0 Repairs and Domestic 294 0 4 8 Renewals Structural 288 0 4 6 Taxes and Insurance 81 0 1 3 Loan Charges 1,408 1 2 2 Miscellaneous 164 0 2 7 Gross cost £5,706 £4 9 10 Income Pupil Midwives 166 0 2 7 Patients' Payments 2,641 2 1 7 Other 12 0 0 2 Net cost £2,887 £2 5 6 District Midwifery service. During 1926 there were 152 cases attended in their own homes by the District Midwife as compared with 119 in the previous year, an increase of 33 cases. Particulars relating to this Service during the year are set out below :— Total number of cases attended in the district 152 Average number of visits to each case 17 Number of cases delivered by :— (a) Midwife 144 (b) Doctors 8 Number of cases where medical assistance was called for, with reasons for requiring assistance :— (a) Ante-Natal. A.P.H. at 28th week 1 « 38 (b) During Labour. Delayed 2nd stage 3 Malpresentations 2 Adherent placenta 2 Post partum hæmorrhage 2 Influenza 1 10 (c) After Labour. Ruptured perineum 1 Heart disease 1 2 (d) For Infant. Eruption on skin 2 Prematurity 5 Weak heart 1 Slight discharge from eyes 6 14 Still-births 6 Died within 10 days (prematurity) 4 Dental Clinic. During 1926 the work carried out at the Dental Clinic and Child Welfare Centre was satisfactory. The Clinic was established as for an integral part of the Council's Scheme for Maternity and Child Welfare for providing facilities for the dental treatment of Expectant and Nursing Mothers and children under 5 years of age. It has been found necessary during the year to provide an additional Session for the separate (dental) treatment of young children—it having been found impossible to give these little patients at the ordinary sessions the time and attention requisite. The Ministry of Health sanctioned this extra Session which was expected to be opened early in 1927. The Dental Clinics are available for. patients recommended by the Medical Officers of the Maternity and Child Welfare Clinics of the Voluntary Associations linked up with the Council's Scheme. The work of the Dental Clinic during 1926 is summarised as follows :— Number of sessions held 153 Total number of patients (women 254, children 40) 294 Total attendances (women 1,929, children 90) 2,019 39 Work carried out:— Extractions— Ordinary 19 With local anaesthetic 941 „ general anæsthetic 327 1,287 Scaling and polishing 36 Fillings 92 Upper dentures 71 Lower dentures 73 Denture visits 591 Dressings and treatment to gums 80 Repairs to dentures 27 Advice 627 The estimated cost of dental treatment (Maternity and Child Welfare) in the financial year 1926-7 was £599 10s. This sum includes £261 2s. 5d. paid for dentures supplied, the cost of which was distributed as under :— £ s. d. Contributed by patients 124 6 5 Grant from British Dental Hospital 31 0 6 Grants from Saturday and Sunday Hospital Funds 56 3 6 Grants from other philanthropic agencies 24 17 0 Grant by Guardians 6 0 0 Health Insurance 4 0 0 Contribution by the Council 14 15 0 £261 2 5 The nett cost to the Council during 1926 for this service was £353 2s. 7d. 40 Notifiable Infectious Diseases. During 1926 under the Notification Clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, 5,712 cases of infectious diseases (excluding tuberculosis) were notified, including cerebro-spinal fever 1, acute poliomyelitis 6, encephalitis lethargica 4. 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. Puerperal pyrexia Acute encephalitis lethargica. Ophthalmia neonatorum. Measles. Cerebro-spinal fever. Whooping cough. The distribution of the cases notified in the registration subdistricts and the wards is shown in the table on p. 41. Excluding measles and whooping cough, there were 1,640 cases which occurred in 1,382 houses. Of these cases 1,300, or 79.3 per cent., were removed to the Isolation Hospitals of the Metropolitan Asylums' Board or to other Institutions and 340, or 20.7 per cent., remained under treatment at home. Full particulars of all notifiable infectious diseases will be found in the form required by the Ministry of Health (Table II.) in the Appendix. Infectious Disease Contacts. Cases of " Contacts" which were reported to the Medical Officer of Health were kept under observation in connection with various diseases. Small-Pox. No case of small-pox occurred in Battersea during 1926. During the year 5 cases of this disease were recorded in London, 2 in St. Marylebone and 1 each in Lambeth, St. Pancras and Islington. In England and Wales, 10,205 cases of small-pox were notified during 1926. 41 Notifications of Infectious Diseases, 1926, 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 147 57 92 21 94 79 8 23 19 256 232 52 540 Erysipelas 8 12 10 10 10 10 3 7 2 34 26 12 72 Scarlet Fever 110 59 63 75 76 82 22 47 47 249 208 124 581 Enteric (Typhoid) Fever — 1 1 — — — — — 1 2 — 1 3 Ophthalmia Neonatorum 11 1 5 — 4 9 1 2 2 13 17 5 35 Puerperal Fever 1 4 3 — 1 2 1 — — 7 4 1 12 †Puerperal Pyrexia 1 3 1 1 1 — — — 2 6 1 2 9 Polio-myelitis — 1 1 1 2 1 '— — — 3 3 — 6 Encephalitis Lethargica — — — 2 2 — — 4 4 Cerebro-Spinal Meningitis — 1 — — — — — — — 1 — — 1 Malaria 1 — 1 — — 1 — — — 1 2 — 3 Dysentery 1 — — — — — — — — 1 1 Trench Fever — 1 — — — — — — — 1 — — 1 Acute Primary Pneumonia 73 39 43 26 34 48 13 9 11 154 108 34 296 Acute Influenzal Pneumonia 14 12 7 5 8 15 3 8 4 32 28 16 76 *Whooping Cough 113 155 94 67 48 68 16 100 48 383 154 172 709 *Measles 758 421 311 312 417 334 138 373 299 1,666 868 829 3,363 Totals 1,238 767 632 518 695 649 205 571 437 2,809 1,651 1,252 5,712 * Notifiable in Battersea from 24th April, 1922. Notifiable from 1st October, 1926. 42 Scarlet Fever. Scarlet Fever was somewhat more prevalent during 1926, and 581 cases were notified as compared with 497 in the previous year. The case-rate per 1,000 of the population was 3.4 and 2 deaths were registered from the disease giving a death-rate of 0.012 per 1,000 as compared with 8 deaths and a death-rate of 0.046 in 1925. Of the cases notified 577 or 99.3 per cent. were removed to hospital. The infected houses numbered 492. In 39 of the notified cases (not included in the above total), the diagnosis of Scarlet Fever was not confirmed at Hospital. The following table shows the incidence and mortality of scarlet fever during 1926 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. 1 110 3.93 2 59 — 3.16 — — 3 63 1 3.21 005 1.59 4 75 — 4.75 — — 5 76 — 4.01 — — 6 82 1 3.88 005 1.22 7 22 — 2.51 — — 8 47 — 2.42 — — 9 47 — 2.18 — — E. 249 3.50 N.W. 208 2 4.23 004 0.96 S.W. 124 — 2.41 — — Boro' 581 2 3.38 0012 0.34 Incidence and Mortality, 1895-1926. Period. Mean Quinquennial Rates. Case mortality per cent. Mean No. of Cases per annum. Mean Case rate Mean No. of deaths per annum. Mean deathrate 1895-1899 1018.4 6.14 29.8 0.18 2.93 1900-1904 566.8 3.31 12.6 0.07 2.22 1905-1909 907.0 4.99 20.0 0.12 2.21 1910-1914 603.4 3.54 7.2 0.04 116 1915-1919 381.8 2.41 5.4 0.03 1.41 1920-1924 715.6 4.24 7.0 0.04 0.98 Year 1925 497 2.89 8 0.05 1.61 „ 1926 581 3.38 2 0.01 0.34 43 Diphtheria. The number of cases of Diphtheria notified in Battersea during 1926 was 540 as compared with 396 in 1925, 372 in 1924, 374 in 1923 and 670 in 1922. The number of deaths registered from the disease was 20, giving a death-rate of 0.116 as compared with 10 deaths and a death-rate of 0.06 in 1925. Of the 540 cases notified 533 or 98.7 per cent. were removed to hospital. The infected houses numbered 472. In 64 cases notified (not included in the above total) the diagnosis of Diphtheria was not confirmed at hospital. The case-rate per 1,000 population was 3.14 as compared with 2.30 in 1925, 2.18 in 1924, 2.19 in 1923, and 3.96 in 1922. The case-mortality was 3.70 as compared with 2.53 in 1925, 6.72 in 1924, and 9.09 in 1923. The incidence of the disease was highest in the Nine Elms, Latchmere and Church Wards. . The following table shows the incidence and mortality of diphtheria during 1926 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. 1 147 11 5.25 .39 7.48 2 57 1 3.05 .05 1.75 3 92 1 4.69 .05 1.09 4 21 1 1.33 .06 4.76 5 94 3 4.96 .16 3.19 6 79 3 3.74 .14 3.80 7 8 — 0.91 — — 8 23 — 1.18 — — 9 19 — 0.88 — — E. 256 13 3.59 .18 5.08 N.W. 232 7 4.72 .14 3.02 S.W. 52 — 1.01 — — Boro' 540 20 3.14 .116 3.70 44 Incidence and Mortality, 1895-1926. Period. Mean Quinquennial Rates. Case mortality per cent. Mean No. of cases per annum. Mean case rate Mean No. of deaths per annum. Mean deathrate. 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 „ 1926 540 3.14 20 .116 3.70 Enteric Fever. During 1926 six 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 disease as compared with 1 death in 1925 and 3 deaths in 1924. Cerebro-Spinal Fever. During 1926 only 1 case of this disease was notified in Battersea, which proved fatal. Encephalitis Lethargica. Eight cases of Encephalitis Lethargica (sleepy sickness) were notified in Batersea during 1926, as compared with 8 in 1925 and 14 in 1924. In 4 of the cases the diagnosis was not confirmed. Three deaths were recorded from the disease (one being of an un-notified chronic case in a mental hospital) giving a death-rate of 0.017. The following table gives particulars of the cases notified during 1926:— Identification. Age and Sex. Date notified. Date of Death. Progress. M.G.F 46 M 8 Jan — Mild case E.M.M.L 65, F. 26 Apl. 11 May — E.M.L 61, F. 10 May 9 July — D.B. 37, F. 31 Dec. — Progressing favourably 45 In 1926 the number of notified cases of this disease in England and Wales was 2,273, and in London 230. Puerperal Fever. There were 12 cases of Puerperal Fever notified in Battersea during 1926, as compared with 6 cases in 1925 and 15 cases in 1924. There were 3 deaths from the disease. The number of cases per 1,000 births was 4.04, as compared with 1.88 in 1925. The notified cases were distributed as follows:—East Battersea, 7 ; North West Battersea, 4 ; South West Battersea, 1. The case mortality was 25.0 per cent., and the death-rate per 1,000 births was 1.01. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926. These Regulations which were issued by the Ministry of Health and came into force on the 1st October, 1926, prescribe the form in which medical practitioners are required to notify cases of Puerperal Fever and also of Puerperal Pyrexia. Puerperal Pyrexia is defined in the Regulations as any febrile condition (other than puerperal fever) which is required to be notified under the Infectious Diseases (Notification) Acts occurring in a woman within 21 days after child-birth or miscarriage in which a temperature of 100.4° Fahrenheit has been sustained during a period of 24 hours or has recurred during that period. The Council are required to enforce and administer the Regulations and to cause to be sent to all medical practitioners resident or practising in the Borough notice of the Regulations and of the duties imposed upon them. A supply of the prescribed forms of notification is also required to be sent to each medical practitioner and the Medical Officer of Health is required by the Regulations to forward a copy of every notification received by him to the County Medical Officer within 24 hours of receipt and to the .Metropolitan Asylums Board within 12 hours. 46 The object of these Regulations is to secure the more effective control of Puerperal Fever. This disease has, of course, been made a notifiable infectious disease for many years past. Unfortunately, mainly no doubt owing to the ill-defined character of this disease, which is not a specific disease comparable, for example, with Scarlet Fever and Diphtheria, experience has shewn that many cases are not notified. Failure to notify has given rise not only to lack of accurate knowledge of its incidence and mortality, but has also prevented the securing of more effective administrative preventive measures against the disease. The new Regulations should be found to a great extent to secure improved and more accurate statistical data as to this dangerous disease and consequently more efficient measures of prevention and treatment. Provision can be made by the Sanitary Authority with the sanction of the Ministry of Health for (1) Assistance in diagnosis by the appointment of a Consultant Specialist; (2) Institutional treatment ; (3) Special treatment of cases of Puerperal Pyrexia and (4) Skilled nursing. The Ministry of Health in the circular letter accompanying the Regulations impressed upon Sanitary Authorities the necessity of making suitable provision on these lines, and in Battersea, the Council have made all adequate provision for the purpose. These summarised briefly include The appointment of a consultant (Mr. A. H. Richardson, F.R.C.S., of St. Thomas's Hospital) to assist medical practitioners, when required, in the diagnosis of doubtful cases. Facilities for the examination of lochia or specimens from patients. Removal of patients to the hospitals of the Metropolitan Asylums Board. Arrangements with the South London District Nursing Association for the nursing of notified cases. The number of cases of puerperal pyrexia notified during 1926, after the Regulations came into force, was nine. Acute Polio-Myelitis. There were 6 cases of acute Polio-Mvelitis notified in Battersea during 1926. There was 1 death from the disease.. At the end of the year there were still under treatment 21 cases, including 16 cases notified prior to 1926. Of these 21 cases 19 cases were of children under 5 years of age when notified. All these cases were carefully enquired into and kept under observation during the year. 47 The following table gives particulars of the cases notified in Battersea during the year :— Identification. Age & Sex. Notified. Result. C. H. 3 M. 29 May In receipt of out-patient treatment daily at Tite Street Hospital. Improving. D. P. 7 F. 7 Sept. Fatal, 7.12.26. E. L. 13 F. 13 Oct. Under own doctor, having massage. Improving. R. D. 4 M. 21 Oct. In receipt of out-patient treatment at Tite Street Hospital. I. S. 3 F. 11 Dec. In receipt of out patient treatment at St. Thomas's Hospital. A. B. 5 M. 16 Dec. In receipt of out-patient treatment at Tite Street Hospital. Ophthalmia Neonatorum. There were 35 cases of Ophthalmia Neonatorum notified in Battersea during 1926 as compared with 32 cases in 1925,41 cases in 1924 and 42 cases in 1923. The rate per 1,000 births was 11.8, as compared with 10.0, 13.1, and 12.2 in 1925, 1924 and 1923 respectively. The disease was most prevalent amongst the less prosperous districts of the Borough, East Battersea and North West Battersea contributing 85.7 per cent. of the total cases notified. Number of cases notified— By medical practitioners 34 By midwives 1 Number removed to hospital 4 During 1926 the number of visits paid by nurses supplied by the Borough Council in cases of Ophthalmia Neonatorum or other inflammatory condition of the eyes of the newly-born, was 2,993. In addition 220 visits of enquiry and supervision were made by Health Visitors. There were only two severe cases amongst the 35 notified and no permanent damage to the eyes of infants suffering from Ophthalmia Neonatorum or other inflammatory condition of the eyes was recorded during the year. 48 The Public Health (Ophthalmia Neonatorum) Regulations 1926, made by the Ministry of Health, came into force on the 1st October. The new Regulations revoked the previous Regulations of 1914, but re-enacted the principal provisions thereof. The chief alteration made by the new Regulations was to remove from the midwife the obligation of notifying a case upon which she was in attendance. The Council were required to notify all Medical Practitioners practising in the Borough, of the provisions of the new Regulations, and in the accompanying circular, the Ministry made various suggestions as to preventive measures to be taken. The suggestions of the Ministry have been anticipated in the routine steps already taken in the Borough to deal with cases of this disease. Erysipelas. There were 72 cases of Erysipelas notified and 2 deaths were recorded from the disease during 1926 in Battersea. The casemortality was 2.78 per cent. and the death-rate per 1,000 population was 0.012. Measles. Measles, which had become very prevalent in the last quarter of 1925, had early in 1926 assumed the proportions of a characteristic epidemic, and 4,206 cases were notified or otherwise reported to the Medical Officer of Health. The incidence of the disease as measured by these notified and reported cases were equivalent to a rate of 156 cases in every 1,000 of the population under 10 years of age. In 1925 there were 794 cases notified or otherwise reported, the great majority occurring in the last quarter of the year. Of the 4,206 cases notified or reported from the Schools or other sources, 3,363 were notified under the Regulations—the Battersea (Measles and Whooping-Cough) Regulations, 1922. These Regulations were made by the Minister of Health on the application of the Council and are dated 8th April, 1922, and came into operation on 24th April, 1922. The obligation of notification under the Regulations is restricted to the first case occurring in a house. In addition to the notified cases 843 were reported from the Public Elementary Schools and other sources. The deaths caused by Measles during 1926 numbered 43, giving a total mortality-rate at all ages of 0.25 as compared with 4 deaths and a death-rate of 0.023 in 1925 and 51 deaths and a death-rate of 0.30 in 1924. Notwithstanding the high incidence of the disease in Battersea during 1926 the death-rate was, as compared with previous outbreaks, relatively low. During the past 25 years outbreaks of this 49 disease have occurred in the Borough as elsewhere—with characteristic regularity, usually every second year. During the first 15 years of this period notification was not compulsory and we relied for our knowledge of the prevalence of the disease mainly upon the reports from the public Elementary Schools. During this period the average annual death-rate from Measles was 51.63 per 100,000 of the population. In 1916, Regulations were made under the Public Health Act making the disease compulsorily notifiable. The Regulations were rescinded at the end of 1919. During this period the average annual mortality was 28.87 as compared with 53.35 in the preceding quinquennium, a reduction of 44 per cent. It is reasonable to infer therefore, that the introduction of compulsory notification was responsible to some extent at least, for the decline in the death-rate from this formidable infectious disease of child life, which accounts for more deaths, especially amongst the age group under 5 years, than all the other common infections. The main reason given for the rescinding of the Regulations in 1919 was that notification per se was in the special clinical circumstances associated with Measles, useless, and that only where notification was combined with a definite co-ordinated scheme for promptly dealing with outbreaks was the expenditure involved justifiable. The Ministry were, however, prepared to make an order making the disease notifiable by Regulations made by the Minister of Health in the district of a local authority prepared to carry out an approved scheme for dealing with Measles. The Council took advantage of this attitude of the Ministry, and in 1922 the disease was made compulsorily notifiable in the Borough. The effect of this decision of the Council would appear from the statistical evidence relating to Measles in Battersea during the period 1922-1926, to have been fully justified, and while there has been no diminution in incidence in epidemic years, there undoubtedly has been a decline in mortality. For example the average annual mortality which had decreased during the period 1916-1919 to 28.87 per 100,000 from 53.35 as compared with the previous 5 years, had still further fallen in the 4 years 1922 to 1926 to 22.04 per 100,000. It is probable, however, that decreasing virulence, which, in recent years, has been a feature in this, as in the case of other diseases, e.g., Scarlet Fever, has been a factor in the reduction of the death-rate. There can, I think, be no doubt that notification, combined with the other precautionary measures which have been taken in Battersea, has contributed to this satisfactory result, and that, as a system of notification is a necessary preliminary to active measures for limiting the disastrous effects of outbreaks on the child population, such action has been fully justified, 50 The precautions adopted in Battersea for dealing with Measles include notification, home visiting and the securing of such isolation, especially of the younger children, as is practicable, early medical attention and provision of nursing attendance and removal to the Hospitals of the Metropolitan Asylums' Board, where the home conditions are unsuitable and unsatisfactory, etc. Whooping-Cough. During 1926 there were 709 cases of Whooping-Cough notified under the Battersea (Measles and Whooping-Cough) Regulations, 1922 to the Medical Officer of Health and 501 additional cases were reported from the public elementary Schools and other sources. There were 13 deaths registered from this disease, the deathrate being 0.076, as compared with 20 deaths and a death-rate of 0.116 in 1925, 17 deaths and a death-rate of 0.099 in 1924, 16 deaths and a death-rate of 0.095 in 1923 and 22 deaths and a deathrate of 0.13 in 1922. The total number of cases notified or otherwise reported during 1926 was 1,210 as compared with 1,320 in 1925, 816 in 1924 and 1,024 in 1923, the decrease in 1926 compared with 1925 being 8.33 per cent. The disease, with measles, was made compulsorily notifiable in Battersea in 1922, and the precautionary measures taken against the disease are similar to those in connection with the latter disease, in view of the danger to life in the younger children. TUBERCULOSIS. During 1926 there were 344 cases of Tuberculosis (all forms) notified in Battersea as compared with 335 in 1925. In the following table is shown the distribution of the notified cases in the Sub-Districts and Wards of the Borough:— Classification. Wards. Sub-districts. 1 2 3 4 5 6 7 8 9 E. N.W. S.W. Pulmonary 44 32 20 28 27 30 14 26 25 111 68 67 NonPulmonary 27 7 8 13 12 10 8 9 4 54 23 21 Totals 71 39 28 41 39 40 22 35 29 165 91 88 The Borough : Pulmonary 246 Non-Pulmonary 98 Total 344 51 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 1926:— Ward. Ages : Total, all ages. Grand Total. Rate per 100,000 population. Under lyr. 1-5 5-15 15-25 25 45 45-65 65 up M. F. 1 — 3 20 14 22 9 3 40 31 71 254 2 — — 7 8 18 5 1 24 15 39 209 3 — — 5 8 12 3 — 17 11 28 143 4 — 2 7 15 10 7 — 29 12 41 260 5 _ 3 6 9 13 8 — 17 22 39 206 6 2 2 3 11 15 7 — 24 16 40 189 7 — 2 3 3 11 2 1 13 9 22 251 8 — 3 4 7 14 7 — 22 13 35 180 9 — 1 2 7 10 7 2 16 13 29 135 Boro' 2 16 57 82 125 55 7 202 142 344 200 E. — 5 38 40 56 22 4 103 62 165 232 N.W. 2 5 10 24 33 17 — 47 44 91 185 s.w. — 6 9 18 36 16 3 52 36 88 165 Rate per 10 0,000 population in each age group Boro' 68 182 173 267 238 162 69 251 155 200 — In the table on pp. 60-61 is shown the information required by the Ministry of Health in regard to notifications. The localisation of the disease in the 344 cases notified in 1926 is summarised below :— Localisation of Disease. Pulmonary (246) Bones and Joints (30) Abdominal (10) Lungs 238 Ankle 1 Peritoneum 6 Lungs and Larynx 3 Heel 1 Peritoneum and enteric glands 1 Lungs and Shoulder 1 Hip and Chest 1 Lungs and Glands 3 Hip and Hip Joint 7 Stomach 1 Pleural Effusion 1 Hip and Left Ulna 1 Unspecified 2 Knee 4 Brain (5) Legs 1 Genito-urinary (3) Meninges 5 Ribs 1 Kidney 1 Sacro-iliac 1 Renal Tract 1 Glands (46) Shoulder and Cheek 1 Testicle and Bladder 1 Cervical 20 Sinus of Neck 1 Ear (left) 1 Abdominal 1 Spine 8 Unspecified and Various 25 Wrist 2 Skin 3 52 The following table gives particulars in regard to non-notification of Tuberculosis for the 5 years 1922-1926 :— Non-Notification of Tuberculosis. Year. Not notified (dead). Notified after Death. Primarily Notified on Form C or D. Other Sources Total. 1922 7 41 35 3 86 1923 3 33 8 — 44 1924 6 30 3 7 46 1925 19 18 4 4 45 1926 13 10 4 7 34 From an examination of the above table giving particulars of non-notification of the disease, it will be noted that there has been an improvement in 1926 as compared with previous years. In accordance with the suggestions contained in the Circular letter of the Ministry of Health, dated 22nd December, 1924, with reference to the requirements of notification, in all cases where the obligation of notification is not complied with the attention of the Medical Practitioner concerned is drawn to the omission, and an explanation requested. It was not found necessary to take any legal action during 1926. Deaths from Tuberculosis. The death-rate from Tuberculosis was considerably lower in 1926 than in any previous year. The lowest death-rate previously recorded from the disease was in 1923. The death-rate for 1926 was 96.6 per 100,000 population. 53 In the subjoined table are given deaths from Tuberculosis at various ages in each Ward and the registration sub-districts during 1926:- 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. 1 125 1 — 4 10 12 7 1 18 17 28 7 35 2 102 2 — 1 4 7 3 2 12 7 17 2 19 3 71 — — — 1 8 5 — 9 5 14 — 14 4 89 — 1 — 1 7 5 — 11 3 13 1 14 5 69 — — 1 4 4 3 1 7 6 12 1 13 6 133 1 — 1 5 11 9 1 21 7 24 4 28 7 68 — 1 1 1 3 — — 5 1 4 2 6 8 93 — 2 1 2 9 4 — 8 10 13 5 18 9 88 — — — 4 9 2 4 14 3 16 3 19 E. 104 3 1 5 16 29 17 3 44 30 64 10 74 N. 98 1 _ 2 9 19 15 2 33 15 43 5 48 S. 85 — 3 2 7 22 6 4 28 16 34 10 44 — 97 4 4 9 32 70 38 9 105 61 141 25 166 Rate per 100,000 popultn. 136 45 27 104 133 112 89 130 67 82 15 97 The death-rates per 100,000 of the population during the 25 years ended 1925 in quinquennial averages and in individual years from 1921 to 1926 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 1926 82.0 14.6 96.6 54 During 1926 there were 166 deaths from Tuberculosis registered as belonging to the Borough of Battersea. Of this number 141 (i.e. 84.9 per cent.) were due to pulmonary tuberculosis, 9 (i.e. 5.4 per cent.) to tubercular meningitis and 16 (i.e. 9.7 per cent.) to other forms of the disease. In 1925 the number of deaths from tubercular diseases was 199. Of the 166 deaths registered from Tuberculosis during the year 28 cases were not notified until one month before death ; in 10 cases the notifications were received after death, and in 13 cases no notification was received. Of the 13 cases in respect of which no primary notification was received 5 were patients who died in hospitals, infirmaries or nursing homes. Of the remaining cases 7 were under treatment by private medical practitioners, and of these 2 had been certified to the Medical Officers of Health of other districts, while one was certified by the coroner after inquest. Of the 10 cases notified after death 1 (pulmonary) was notified by a private medical practitioner, 6 (3 pulmonary, 3 non-pulmonary) from Poor Law Institutions and 3 (2 pulmonary and 1 non-pulmonary) by hospitals or asylums. Tuberculosis Dispensary. The work of the Battersea Tuberculosis Dispensary, which has been under the direct control of the Council as part of their scheme for the prevention of tuberculosis since 1921, was carried on with the usual routine during 1926. It is anticipated, now that part of the buildings at Southlands College is available for conversion and adaptation for the purpose of a modern and well-equipped Tuberculosis Dispensary, that the work will soon be proceeded with, as the existing dispensary building is quite inadequate for the needs of the Borough. The Dispensary is affiliated to St. Thomas's Hospital, which provides facilities in difficulties arising in diagnosis—e.g., X-ray examinations and for cases needing artificial pneumothorax refills, &c. Co-operation with other hospitals is maintained and patients attending the Dispensary and found to be suffering from conditions other than Tuberculosis requiring treatment are referred to appropriate institutions. The staff of the Dispensary consists of a Tuberculosis Medical Officer, 3 Nurses, Secretary, Typist-and two Junior Clerks. There are also Caretakers (man and wife) living on the premises. The Dispensary treatment of school children is carried on in close co-operation with the School Medical Service, and the Springwell House Open Air School on Clapham Common North Side, has, in this connection, carried on useful work during the year, particulars of which will be found on p. 56. 55 The Tuberculosis Care Committee, the composition of which will be found on p. 2, met weekly at the Tuberculosis Dispensary during the year, and details of the work of the Committee will be found set out on p. 57. Dental facilities for tuberculosis patients were provided by the Council in 1922. A weekly session is held at the Dental Centre, Plough Road, and patients requiring treatment or the provision of dentures are referred to the Clinic by the Tuberculosis Medical Officer. Institutional treatment is provided by the London County Council for Battersea patients; this form of treatment being arranged for in the majority of cases through the Tuberculosis Dispensary. Dr. Macdonald, Tuberculosis Medical Officer, reports : — During 1926, 660 new patients attended the Dispensary for examination. In addition 11 patients were transferred from other areas and attended the Dispensary for the first time during the year. Of the 660 patients 427 were adults and 233 were children. The "Contacts" examined at the Dispensary numbered 212, 84 adults and 128 children. Of the new patients and " Contacts " 209 were found to be suffering from Tuberculosis, 165 adults and 44 children. During the year 7 patients in whom the diagnosis was at first doubtful were found to be suffering from Tuberculosis, and these added to the 209 new cases made a total of 216 notified cases. Of this number 100 had already been notified to the Medical Officer of Health, so that 116 were primary notifications from the Dispensary. The total number of attendances at the Dispensary during 1926 numbered 4,686. During the year 180 visits were paid to the homes of patients by the Tuberculosis Officer and 5,294 by the Dispensary Nursing Staff. During 1926, 131 patients received institutional treatment under the London County Council's Tuberculosis Scheme. The average stay of patients in institutions was 104 days, and the average period of waiting between recommendation and admission was 19 days. Of the number admitted 53 had definitely improved as a result of institutional treatment —31 patients discharged themselves. In addition to admissions to institutions provided by the London County Council 46 patients were admitted to St. James' Hospital. 56 Number of Dispensary patients who died during 1926 100 Number of Dispensary patients discharged 57 Number of Dispensary patients who ceased to attend 25 Number of Dispensary patients removed to other districts (and transferred to the Medical Officer of Health of the districts concerned) 64 The number of sputum examinations at the Tuberculosis Dispensary during 1926 was 1,504, 313 (20.8 per cent.) of which were positive. Of the total number of specimens examined 548 were sent by medical practitioners and 359 specimens were examined for St. James' Hospital. The number of reports sent to public bodies during 1926 was 1,157. Consultations with Medical practitioners at the homes of their patients and reports on their patients sent to the Dispensary numbered 879. The number of reports received during the year in respect of insured persons was : — (a) Form G.P. 17 2 (b) Form G.P. 36 247 Ninety-five patients were referred to hospitals, 78 of whom were sent to St. Thomas's Hospital for X-ray examination. Open Air School. The particulars relating to the work carried out during 1926 at Springwell House Open-Air School are summarised as follows : — Number on roll, 31st December, 1926 148 Number admitted during 1926 47 Number discharged during 1926 46 Reasons for Discharge — (a) Fit for Elementary School 8 (b) Fit for work 23 (c) Transferred to Hospital or Sanatorium 10 (d) Removed from district 4 (e) Death 1 Gain or loss in weight of children who have been in the School for more than 12 months:— Children who have gained weight 102 Average gain in kilos 3.5 Children who lost weight or whose weight was stationary Nil. 57 Tuberculosis Dental Treatment. Total attendances 399 Sessions held 51 Average attendance per session 7.8 Extractions 277 ; scalings, 10; fillings, 39 ; dentures supplied—whole sets 11, partial sets 4; repairs to dentures, 7; dressings, 31; advice, 128 (average per session, 9.9) 507 In the Appendix (pages 118 to 120) will be found Form T. 53, which contains the returns required by the Ministry of Health of the work of the Dispensary during the year 1926, and Form T. 56, which shows in a summarised form the condition of all patients whose case records were in possession of the Dispensary at the end of 1926, arranged according to the years (from 1921 to 1926) in which the patients first came under public medical treatment for pulmonary and non-pulmonary tuberculosis. The Tuberculosis Care Committee. The Care Committee met weekly during 1926, and the following is a summary of the work carried out by the Committee: — Battersea Borough Council,—extra nourishment, 166 ; housing, 3 ; arrears of rates, 1 170 Wandsworth Board of Guardians financial assistance, 13; dentures, 1 ; clothing, 10; other assistance, 18 42 British Red Cross Society—financial assistance, 2; clothing, 1 ; bed and bedding, 1 4 United Services Fund- financial assistance, 9; clothing, 5 ; boarding out of children, 1 15 London County Council—housing, 5 ; travelling expenses, 2 7 Charity Organisation Society—dentures, 7 ; financial assistance, 6; bed and bedding, 2; clothing, 2 17 Other Agencies 10 Training and Employment. Former Employers or suitable agencies 6 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 £640 5s. 7d. 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 district Sanitary Inspectors during 1926 to male patients, and by a woman Sanitary Inspector (Miss J. Round) to women and children. 58 Women and Children. During 1926 the number of new cases of Tuberculosis notified amongst women and children and not attending the Tuberculosis Dispensary was 150. Of this number, 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 142 cases investigatedwomen, 88 ; children, 54. Of these 142 cases 19 were found to have died on the first visit, and 9 cases died subsequently during the year. The home conditions of these 142 patients were carefuly 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 1.4. In 18 cases, however, the patient's family was found to be living in a single room, as compared with 19 families living under similar housing conditions in 1925. During the year 59 cases were undergoing hospital, sanatorium or other appropriate institutional treatment. At the end of 1926 there were 464 women and children nondispensary patients (a decrease of 30 as compared with 1925), including new cases notified during the year, on the Tuberculosis Register, and 1,022 visits were paid by the Woman Sanitary Inspector to the homes of these patients. Efforts were made in as many cases as possible to induce these patients to attend the Tuberculosis Dispensary, and during the year 48 cases were transferred. The following table gives particulars of the 142 women and children non-dispensary cases notified to be suffering from Tuberculosis (all forms) during 1926. 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 1 — — — — — — — 3 f. 1 — 1 3 6 8 26 16 2 8 4 75 Tubercular M. 2 2 — — — — — — — — 4 Meningitis f. 1 1 1 2 — — 1 — — — — 6 M 2 7 11 8 — — — — — — — 28 Forms f. 1 2 3 3 3 2 5 3 2 2 — 26 M 2 9 15 9 — — — — — — — 35 Total f. 3 3 5 8 9 10 32 19 4 10 4 107 Grand Total 5 12 20 17 9 10 32 19 4 10 4 142 59 Adult Male Patients. There were 267 adult male patients not on the Dispensary roll on the register at the end of 1925, and 93 were new cases notified during 1926. Of these new cases 33 died during the year. The following table gives particulars of the non-dispensary new cases notified in 1926 :— Age Distribution. All ages. 16-20 20-25 25-30 30-35 35 -45 45-55 55-65 65up Pulmonary 5 10 2 11 18 14 13 3 76 Tubercular Meningitis — — — — — — — — — Other tubercular Diseases 4 4 3 3 1 1 1 — 17 Total 9 14 5 14 19 15 14 3 93 The homes of all these patients were systematically visited during the year by the District Santiary Inspectors, and 578 visits, including 93 first visits to new cases were paid. Five of the new cases notified were found to have died on the first visit. Of the new cases 26 received institutional treatment and 34 were transferred to the Dispensary. 60 Summary of Notifications during the period from the 3rd January, 1926, to the 1st January, 1927, in the Metropolitan Borough of Battersea. Age Periods. Notifications on Form A. Total No. on Form A. Notifications on Form B.‡ No. of Notifications on Form C.‡ * Number of Primary Notifications. * No. of Primary Notifications. Total No. on Form B. Poor Law Institutions Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and over. Total. Under 5 5 to 10 10 to 15 Total Primary Notifications Pulmonary— Males — — 2 4 12 21 28 31 24 15 3 140 197 — — — — — 47 121 Females — 1 3 2 18 16 26 23 5 6 4 104 138 — — — — — 36 59 Non-Pulmonary— Males 1 11 20 10 5 3 7 1 — 1 — 59 68 — — — — — — 36 Females 1 4 9 5 4 3 6 1 2 2 37 45 — — — — — 1 13 (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.) t A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, should be included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification occurs on Form A, and all notifications on Form A, whether duplicate or not, should be included in this column. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A, or on Form B, should be included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area, or not, either on Form A or on Form B, should be included in this column. Col. 21. If in the case of any institution belonging to the Council, formal notifications on Form C have not been made, the totals of the weekly admissions during the year of patients proper for notification on Form C should be shewn (according to the classification in Column 1) in brackets in column 21. ‡ 4 Notifications (primary) on Form C not included here, but in Supplemental return. 61 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 3rd January, 1926, to the 1st January, 1927, 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 3 3 3 1 2 14 Females — — — — — 2 3 2 — — — 7 Non-pulmonary Males 1 1 2 1 — — — — — — — 5 „ Females 1 — 1 — — 1 2 1 — — 2 8 62 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 1926 numbered 119, as compared with 64 in 1925, an increase of 85-9 per cent. There was a corresponding increase in the zymotic death-rate from 0.371 in 1925 to 0.692 in 1926. The mean death-rate from each of the principal zymotic diseases for the ten years 1906-1915, and for the ten years 19161925, are compared with the corresponding rates for 1925 and 1926 in the following table:— Zymotic Diseases. Number of Deaths from each of the principal Zymotic Diseases in 1925 and 1926, with corresponding Death Rates for those years and for the 10 years 1906-15 and 1916-1925. No. of Deaths. Death-rate per 1,000 population. Mean Death-rate per 1,000 population. Increase (+) or Decrease (—), 1926 over 1925. 1926. 1925. 1926. 19061915. 19161925. Previous year. 19161925. Small Pox — — — — — .001 — — 001 Measles 4 43 .023 .250 .471 .230 + .227 + .020 Scarlet Fever 8 2 .046 .012 .072 .037 — .034 — .025 Diphtheria 10 20 .058 .116 .129 .187 + .058 — .071 Whooping-cough 20 13 .116 .076 .291 .331 —.040 — .255 Enteric fever 1 1 .006 .006 .032 .011 — .005 Diarrhoea and enteritis 21 40 .122 .232 .775 .293 + .110 — .061 Total 64 119 .371 .692 1.770 1.090 + -321 — .398 NON-NOTIFIABLE INFECTIOUS DISEASES. Chicken-Pox. During 1926 there were 375 cases of chicken-pox reported as compared with 853 in 1925, 541 in 1924, 617 in 1923, 259 in 1922, and 400 in 1921, 63 Diarrhœa. During 1926 the total number of deaths from diarrhoea of children under 2 years of age was 28, and was equivalent to a fatality-rate of .16. In 1925 there were 16 deaths and a fatalityrate of .09. Influenza. There were 25 deaths due to Influenza during 1926, as against 36 in 1925, 84 in 1924, 31 in 1923 and 110 in 1922. The mortalityrate was .15 as compared with .21 in 1925, .49 in 1924, .18 in 1923 and .66 in 1922. Influenzal Pneumonia was slightly more prevalent in 1926 than in the previous year, 76 cases being notified as against 72 in 1925. The death-rate was .07 per 1,000 of the population. Cancer. During 1926 the number of deaths of Battersea residents from Cancer was 263 (males 120, females 143) as compared with 236 in 1926, 231 in 1924, 242 in 1923, and 225 in 1922. The death-rate from the disease per 1,000 of the population was 1.53 as compared with 1.37 in 1925, 1.35 in 1924, 1.42 in 1923 and 1.33 in 1922. The following gives the comparative average death-rates from Cancer in Battersea for quinquennial periods since 1901 :— 1901—5 0.88 1916-20 1.28 1906-10 0.95 1921-25 1.33 1911-15 1.11 1926 1.53 The following table shews the localisation of the disease in the case of the 263 deaths recorded in 1926. Localisation. No. of deaths. Total. Male Female Buccal cavity 13 2 15 Stomach, liver, etc. 45 22 67 Peritoneum, intestines and rectum 29 38 67 Female genital organs 1 32 32 Breast 1 37 38 Skin 1 1 2 Other and unspecified organs 31 11 42 Total 120 143 263 64 Bacteriological Examinations. During 1926 the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 2,012. This number is exclusive of the Tuberculosis specimens, the examination of which was carried out at the Tuberculosis Dispensary. The following table gives particulars of the bacteriological examinations carried out during the year :— Suspected disease. Positive Results. Negative Results. Total. Diphtheria 272 1,722 1,994 Enteric fever 1 16 17 Tuberculosis — 1 1 Total 273 1,739 2,012 The cost of these examinations amounted to £258 13s. 7d., and is borne by the Council. 65 Sanitary Circumstances. SANITARY INSPECTION OF THE BOROUGH. Summary of Sanitary Operations for the Year 1926. Total Sanitary Operations 62,418 Number of house inspections 32,594 House to house inspections 676 Bakehouse inspections 273 Bakehouse nuisances abated 63 Urinals—inspections 130 Do. altered, repaired or water laid on 52 Intimations served under Sec.3 3,006 Notices served under Sec.4,&c. 750 Notices served under Secs. 62 & 65 6,478 Complaints received and attended to 3,341 Number of premises disinfected 2,516 Houses supplied with disinfectants 1,102 Overcrowding abated 5 Premises improved, cleansed and repaired 2,484 Drains tested By smoke 621 Do. ,, water 1,132 Drains cleansed and repaired 268 Drains relaid 110 Frontage drains constructed or re-constructed 22 Soil pipes and drains ventilated 120 Sink and rain-water pipes disconnected or repaired 413 Water Closets cleansed and repaired 522 Cesspools abolished — Mews and Stables drained and paved 4 Yards and forecourts paved and repaired 288 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 22 Dust receptacles provided 502 Leaky house-roofs and gutters repaired 756 Houses supplied with water and fittings repaired 170 Houses let in lodgings registered 85 No. of inspections of do. 44 Water Closets provided, supplied with water or supply disconnected from drinking water cisterns 184 Cisterns covered, cleansed and repaired 118 Additional water supplies to upper floors 31 Keeping of animals in unfit state discontinued 4 Smoke observations 59 Certificates of disinfection granted 3,224 Houses inspected and certificates granted (Sec. 48) 31 Proceedings ordered by Council and Health Committee 3,044 Summonses issued 53 Magisterial Orders obtained and enforced 12 Factories, Workshops, Sec., inspections 4,909 Sanitary conveniences provided or improvements effected in Factories and Workshops (Sec. 38) 94 Underground sleeping rooms : Use discontinued — Defects remedied — Gipsy van inspections 35 Drains laid to new houses and tenements 31 Samples taken under the Sale of Food and Drugs Acts 1,200 Miscellaneous 1,786 66 Legal Proceedings. Legal proceedings in connection with nuisances were taken by the Council in 6 cases during 1926. 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 abate nuisance at 21 Belfour Street Work required by notice having been completed, summons withdrawn subject to payment of £2 2s. costs. Failure to comply with notice to abate nuisance at 103 High Street Work required by notice having been completed, summons withdrawn subject to payment of £1 1s. costs. Nuisance at 52 Elspeth Road Nuisance having been abated and defendant's Solicitor having undertaken to pay £1 1s. costs, summons withdrawn. Nuisance at 27 Rosenau Road Order for abatement within 21 days and for payment of £1 1s. costs Nuisance at 40 Benfield Street Nuisance having been abated summons dismissed on payment of 10s. 6d. costs. Nuisance at 9 Ponton Street Nuisance having been abated and defendant having paid 2s. cost of summons, summons withdrawn. Sale of Food and Drugs Acts. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 869 Milk 7½% extraneous water Defendant by his Solicitor having pleaded guilty and offered to take responsibility for both defendants, summons against employee withdrawn. Defendant discharged on payment of £2 2s. costs. 874 Milk 6% deficient in milk fat Fined 20s. and £1 1. costs. 939 Milk 15½% extraneous water Dismissed on payment of £3 3s. costs. 241 Vinegar 16% deficient in acetic acid Summons dismissed on payment of £1 1. costs; that against second defendant withdrawn. 67 Sale of Food and Drugs Acts—continued. No. of Sample Article. Nature of Offence. Adulteration, &c. Result of Proceedings. 252 Preserved Cream Containing 0.58% boric acid Summons against first defendant dismissed on payment of £1 l1s. 6d. costs and that against second defendant withdrawn. 381 Vinegar 4% deficient in acetic acid Defendant having paid 5s. costs, summons withdrawn on instructions of Health Committee. 388 Preserved Cream Containing 0.5% boric acid Summons dismissed on payment of of £3 3s. costs; that against second defendant withdrawn. 399 400 Milk Milk 6% added water 4% Summons dismissed under Probation of Offenders Act, 1907 and defendant Ordered to pay £1 1s. costs. 522 Milk 17% deficient in fat Summons dismissed on warranty defence; that against second defendant withdrawn. 531 Milk 16% deficient in fat Dismissed on payment of £2 2s. costs (Samples taken at place of delivery). 532 Milk 8% deficient in fat 666 Milk 12% deficient in fat Dismissed; defendant satisfying the Court that the milk was sold exactly as it came from the cow. 687 Milk 12% deficient in fat At Magistrate's suggestion summons against employer withdrawn and that against employee dismissed on payment of £1 1s. costs. Milk and Dairies (Amendment) Act, 1922. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 15 Milk Selling milk containing an added colouring matter Discharged on payment of £1 1s. costs. 86 Milk 5% added water, also an added colouring matter Defendant having paid 15s. costs, summons withdrawn on instructions of Health Committee. 68 Milk and Dairies (Amendment) Act, 1922—continued. No. of Sample. Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 94 Milk 6.5% extraneous water Defendant having paid £2 2s. costs, summons withdrawn on instructions of Health Committee (Samples taken in course of delivery). 95 Milk 7% extraneous water 96 Milk 7½% extraneous water 157 Milk 11 % added water Fined £10 and £3 3s. costs or in default one months imprisonment (one month in which to pay) 228 Milk 18.5% added water In view of special cir cumstances of case, summons dismissed on payment of 2s. costs. 256 Milk 15% added water Fined £5 and £3 3s. costs; summons against second defendant withdrawn. 570 Milk 3% added water Summons against first defendant not served; that against second dismissed. 590 594 Milk Milk 15% added water 13% added water Fined £2 and £1 1s. costs ; summons against second defendant withdrawn. 599 Milk 11% added water Fined £5 and £2 2s. costs 600 Milk 13.5% added water 601 Milk 13.5% added water 602 Milk 14.5% added water 653 Milk 13% added water Defendant dealt with on above summonses. Summons against employee dismissed on payment of £1 1s. costs which employer promised to pay. Milk and Dairies (Consolidation) Act, 1915. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. — Milk Not having name and address on milk barrow Fined 10s. 69 Dairies, Cowsheds and Milkshops Order, 1885. Nature of Offence. Result of Proceedings. Carrying on trade of purveyor of milk without being registered Fined 20s. and £3 3s. costs. Margarine Act, 1887. No. of Sample Article. Nature of Offence, Adulteration, &c. Result of Proceedings. 699 Margarine Exposing margarine for sale without proper label Dismissed on payment of £1 1s. costs. Maternity and Child Welfare Act, 1918. Nature of Claim. Result of Proceedings. Balance of fees due in respect of accommodation of defendant's wife at Council's Maternity Hospital Judgment by consent for debt (£1 15s.) and costs (4s. 6d) payable in instalments of 10s. per month. Metropolis Management Acts. Nature of Offence. Result of Proceedings. Failure to deposit plans, &c., in connection with re-construction of drains at 162 and 164 Stewarts Road Plans, &c., having been deposited, fined 2s. 6d., and £1 1s. costs. Housing Act, 1925. Nature of Offence or Claim. Result of Proceedings. Failure to have name and address of landlord and of Medical Officer of Health in rent book of 135 Meyrick Road Rent book having been put in order and £2 2s. costs having been paid before hearing, summons withdrawn. 70 Housing Act, 1925—continued. Nature of Offence or Claim. Result of Proceedings. Failure to furnish name and address of person from whom defendant held 53 Eccles Road Defendant having given required information in Court, summons withdrawn at Magistrate's suggestion. The like in respect of premises at 18 Woodgate Street The like at 19 Woodgate Street Defendant not appearing, but her father attending at Court on her behalf and giving required information summons withdrawn at Magistrate's suggestion. * Plaintiffs' claim as freeholders was for determination of leases of 18 and 20 Basnett Road, on failure by defendant to comply with Council's notices to repair the premises Order made on terms of claim; plaintiff to pay £180 compensation to defendant and to comply with Council's notices in place of defendant under the supervision of the Council. (Council waived their costs.) £1 3s. unpaid costs on Police Court summons re 20 Basnett Road £1 3s. and 3s costs paid into Court before hearing. Claim by Council for £200 17s. 10d. cost of repairing defendant's premises at 47 John Street and interest at 5% from 16th April, 1926 Defendant by her Solicitor admitting claim, order made in terms thereof with £1 1s. costs. The like for £261 8s. 10d„ at 48 John Street The like. The like for £295 0s. 2d., at 49 John Street. The like. Claim by Council for £195 12s. cost of repairing 18 Belfour Street and interest at 5%from30th December, 1925 The like for £268 15s. 6d. at 19 Belfour Street The like for £247 16s. 7d. at 20 Belfour Street Proceedings incomplete at end of year. Failure to pay £3 12s. debt and 6s. costs in respect of repairs to 18 Woodgate Street (Judgment summons) The like—£11 16s. 2d. debt and £4 Is. 6d. costs—19 Woodgate Street Debt and costs having been paid before hearing, summonses withdrawn. * Proceedings by freeholders against leaseholder. Council being joined as defendants. 71 Summary of Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 54 cases during the year 1926:— Persons prosecuted (including employees). Convictions. Fines. Costs. £ s. d. £ s. d. Metropolis Management Acts 1 1 0 2 6 1 1 0 Public Health (London) Act, 1891, and the Bylaws made thereunder 7 1 - 5 17 6 Housing Acts 7 1 - 5 8 0 Factory & Workshop Act, 1901 - - - - Sale of Food and Drugs Acts 18 1 1 0 0 16 10 6 Margarine Act, 1887 1 — - 1 1 0 Milk & Dairies (Consolidation) Act, 1915 1 1 0 10 0 - Milk & Dairies (Amendment) Act, 1922 15 5 22 0 0 14 10 0 Dairies, Cowsheds & Milkshops Order, 1885 1 1 1 0 0 3 3 0 Public Health (Milk and Cream) Regulations, 1912, Amendment Order, 1917 - - - - Maternity & Child Welfare Act, 1918 1 1 - 0 4 6 Total 52 12 £24 12 6* £47 15 6* 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 * The disproportion between the fines and costs imposed is accounted for by the fact that the Court in some 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. 72 These are frequently inspected and any defects noted are referred to the London County Council, who are the authority responsible. Drainage Work. During the year new drains were constructed to 62 new buildings, or additions to existing buildings, and the drains of 110 old buildings were partially or entirely reconstructed, under the supervision of the Officers of the Department. The drains of the following premises, being combined drains for the maintenance of which liability was recognised by the Council, were repaired or reconstructed during 1926 at the cost of the Council:— Auckland Road, No. 26 ; Currie Road, Nos. 11 & 13 ; Castle Street, Nos. 50 & 52 ; Lockington Road, No. 42 ; Tyneham Road, No. 13. The expenditure incurred by the Council under this head amounted to £188 14s. 4d. The total number of plans of proposed drainage work deposited during 1926, as compared with 1925, was as under :— 1926 1925 Re-construction or repair of existing drains 64 74 New buildings or additions to existing buildings 43 48 107 122 In four cases, drainage work was found to have been carried out in contravention of the provisions of the drainage by-laws, as under:— 1. W.C. pan and trap fixed without notice. 2. Water waste preventer fixed without notice. 3. W.C. pan fixed without notice. 4. Plan of works executed not deposited within specified period. In the first three cases, a cautionary letter was addressed to the offender, and in the fourth case, legal proceedings were instituted, fine and costs being inflicted. Revenue Act, 1903. During 1926 no application for the certificate of the Medical Officer of Health under the provisions of the Revenue Act, 1903, was received. 73 Sanitary Conveniences attached to Licensed Premises. During 1926 the number of public-house urinals under inspection was 117. In 80 instances the accommodation is accessible to the general-public as well as the users of the houses, and in 37 cases the accommodation is accessible to the customers only. As a result of the annual inspection of these conveniences, 34 notices were served to remedy defects discovered. Smoke Nuisances. During the year 59 observations were made and 2 complaints received. Two preliminary notices were served by the Council to abate smoke nuisances, which were duly complied with. During the year, the Public Health (Smoke Abatement) Act, 1926, was passed by Parliament, but will not come into force until the 1st July, 1927. In this Act, increased powers are given to Local Authorities to prevent the pollution of the atmosphere by smoke. Effluvium Nuisance. Three complaints of effluvium nuisance were received during 1926, but in only one case was nuisance established, and in this case the works having closed it was not necessary to institute legal proceedings. Water Supply. During 1926 applications were received for certificates of water supply in respect of 31 houses in accordance with Section 48 of the Public Health (London) Act, 1891. The certificates were granted in each instance. In 31 cases additional water supply was provided to the upper floors of tenement houses, as required by the Borough 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. Van Dwellings. The number of van dwellings in the Borough in 1926 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. f. Mill's Yard, adjoining 88 Sheepcote Lane 3 2 4 Mill's Yard, adjoining 80 Sheepcote Lane 5 7 7 Manley's Yard, Falcon Road 8 9 8 Manley's Yard, Cabul Road 30 † 32 33 Mill's Yard, Culvert Road 19* 18 24 * Including one shed. †Including one cottage. 74 Van dwellings are frequently inspected, and during the year 4 vans were found to be overcrowded, and notices were served to abate the nuisance. Three 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 1926. 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 1926 the work carried out under the Council's Rat Repression Scheme is summarised as follows:— Premises visited 2,015 Contracts renewed 14 Poison baits used 405,000 Value of contracts £187 5 0 Dead rats found 2,029 Cash for poison bait £32 17 0 Total expenditure (financial year 1926-7) £568 5 6 Income (financial year 1926-7) £210 10 6 Net cost £357 15 0 Drains were tested at 63 premises in connection with this work, and in 30 cases were found to be defective. Most of these defective drains were in private houses. As the presence of rats in houses is usually regarded as prima facie evidence of drain defects, the work of the Rat Officer therefore is carried on in close co-operation with that of the district Sanitary Inspectors. The methods employed under the Rat Repression Scheme have been described in previous Annual Reports. It is only necessary, therefore, to state that as an inspection of the summarised figures shows, the work done during the year under this head has been as satisfactory as in previous years. Personal Cleansing Station. The new Personal Cleansing Station, opened on the 3rd November, 1923, was fully described in my Annual Report for that year. 75 During the year 1926, there were 4,371 children and 229 adults cleansed and treated at the station. Of the 4,371 children attending, 164 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. Of these children 4,315 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. Number of Baths, &c. Year. Adults. Children. Expenditure. 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 4,724 879 459 1926 229 4,371 917* 450* 13,941 49,918 £6,961 £3,908 * Estimated. 76 Disinfecting Department. Summary of work carried out by the Disinfecting Department during 1926. Total Premises disinfected 2,516 Rooms disinfected 3,697 Staircases disinfected 185 Schools disinfected 76 Number of articles laundered 28,504 ,, „ destroyed 723 „ verminous, etc., persons (including 4,315 school children) 4,600 ,, infectious disease contacts 943 „ Library books collected 219 Total Articles. No. Weight. Tons. cwts. qrs. lbs. Bedding, &c., disinfected 61,132 147 8 0 22 „ lent 1,241 3 18 0 0 Verminous clothing, &c. 3,089 1 1 2 13 Articles from Welfare Centres 2,973 (not weighed) Total 68,435 152 7 3 7 77 Coroner's Court and Mortuary. Details as to the number of inquests held at the Coroner's Court, and bodies received into the Mortuary during 1926 are set out in the following table:— Usual Place of Residence. Total Battersea. Wands -worth Elsewhere. Residence unknown Inquest at Coroner's Court; postmortem at Mortuary 120 69 11 2 202 Inquest at Coroner s Court; postmortem elsewhere 35 47 10 92 Inquest at Coroner's Court; no postmortem 15 16 7 — 38 Total inquests held at Battersea Coroner's Court 170 132 28 2 332 Post-mortems without inquest,Battersea Mortuary 9 1 1 — 11 Total post-mortems held at Battersea Mortuary 129 70 12 2 213 Bodies received for sanitary reasons 2 — — — 2 Other bodies received at Mortuary on which no inquest held 3 2 1 1 7 Total bodies received 184 135 30 3 352 VERDICTS AT INQUESTS HELD— Natural causes 90 60 5 — 155 Accidental Death— Asphyxia 3 2 — — 5 Burns and scalds 3 7 1 — 11 Deaths under anaesthetic — 1 2 — 3 Drowning 1 — 1 — 2 Fall 17 14 8 — 39 Food poisoning — 1 — — 1 Railway and street accidents 24 19 7 — 50 Septicaemia following injury — 3 — — 3 Tetanus following injury 4 — — — 4 Other accidents — 3 — — 3 Open Verdict— Found drowned — — 1 — 1 Stillborn 6 — — 1 7 Want of attention at birth 1 1 2 Suicide— Cut throat 1 1 — — 2 Drowning — 1 1 — 2 Firearms — 1 — — 1 Hanging 7 2 — — 9 Jump from high place — — 1 — 1 Poisoning—Coal gas 7 8 — — 15 „ Drugs, etc. 3 8 1 — 12 Homicide. Blow (manslaughter 1, murder 1) 2 — — — 2 Abortion 1 1 — — 2 Infanticide — — — — — Grand Total 170 132 28 2 332 78 Staff of Public Health Department. The personnel of the staff of the Health Department will be found fully set out on page 3. Several changes occurred in the staff of the Department during the year. Sanitary Inspectors. The Chief Sanitary Inspector, Mr. Isaac Young, retired owing to ill-health after 37 years' service as District and Chief Sanitary Inspector in the service of the Council and its predecessor the Vestry. The loss of the services of this very efficient and experienced officer is much regretted. Mr. A. E. Purnell, District Sanitary Inspector, No. 4 District, retired owing to ill-health after 33 years' service in March. Mr. James Lawrence, District Sanitary Inspector, No. 3 District, was appointed Senior Sanitary Inspector. Mr. F. H. Chuter and Mr. J. R. Holloway were appointed district Sanitary Inspectors for districts Nos. 3 and 5 to fill vacancies created by resignations. Mr. Saunders was appointed temporary Sanitary Inspector during the illness of Mr. H. Marrable. Health Visitors. Miss A. Bannerman, who had been appointed temporary Health Visitor in 1925, resigned the appointment in May, 1926. Miss N. Bourdillon was appointed temporary Health Visitor in December owing to illness among the Health Visiting Staff. Clerical Staff. Mr. W. F. Smith, Grade A Clerk, resigned his appointment in April to take up an appointment in another Metropolitan borough council. Mr. W. C. Turner was appointed to fill the vacant clerkship and took up duty in July. Miss F. M. Humphreys, record clerk in the Maternity and Child Welfare Department, resigned her appointment in May, and Miss M. A. Weller was appointed to the vacant post in July. 79 Protection of the Food Supply. INSPECTION AND SUPERVISION OF FOOD. Unsound Food. The following is a tabulated return of unsound food which, under the provisions of Section 47(8) of the Public Health (London) Act, 1891, were brought to the notice of the Sanitary Inspectors and voluntarily surrendered during 1926:- Food. Quantity. Food. Quantity. Fish Fruit & Vegetables (fresh). Codlings 2 boxes. Apples 101 barrels. Do. (dried) 3 boxes. Beet-roots 4½ bags. Dog Fish 1 box. Cherries 32 boats. Haddock 1 trunk. Currants, black 7 boats. 1 chat. Do. red 4 bushels. 2 boxes. Onions 2 bags Herrings, fresh 1 box. Pears 1 bushel. Mixed Fish 1 trunk. Pomegranates 1 box. Plaice 1 box. Potatoes 450 bags. Roker wings 1 box. Tomatoes 4 bundles. Skate 2 boxes. Skate wings 5 stones. Meat & Poultry. 1 box. Beef 11 stones. Whiting 1 box. Pigs' kidneys 46 lbs. Winkles 4 bags. Miscellaneous. Eggs 360 8 cwt. 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 1926, 271 inspections were made by the Council's inspector. The carcases of 127 animals (oxen 6, calves 1, sheep 72 and pigs 48) were examined after slaughter. 80 The provisions of the Public Health (Meat) Regulations, 1924, have been brought to the notice of the occupiers of these slaughterhouses. Butchers' Shops. The number of butchers' shops in the Borough at the beginning of the year 1926 was 93. Four new shops were opened during the year and two closed, making a total of 95 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 1,302 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 slaughtering regularly carried on. Proceedings were ordered for breaches of the Regulations in 4 cases, but were withdrawn by order of the Health Committee. Sale of Food and Drugs Acts. The total number of samples taken under the Acts during 1926 was 984, of which 42 or 4·3 per cent, were certified by the Public Analyst to be adulterated. In addition to the foregoing, 216 informal samples were procured, of which 8 or 3·7 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, and in 1926, 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% 1926 4·3% 3·7% 81 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 — 11 11 — 0 0 Butter 22 81 103 1 2 3 Cheese 24 — 24 0 0 Cocoa 25 — 25 0 0 Coffee 21 — 21 0 — 0 Cream 2 2 0 0 Cream, Preserved 11 — 11 2 2 Flour, Self-raising — 8 8 — 0 0 Jam — 3 3 — 0 0 Margarine 16 12 28 0 0 0 Milk 738 — 738 32 — 32 „ Condensed (Full Cream) - 9 9 _ 0 0 „ „ (Machine Skimmed) 2 2 0 0 „ Dried - 4 4 - 0 0 „ Skimmed 1 — 1 0 0 Mustard — 6 6 — 0 0 Sugar — 4 4 — 0 0 Tea — 4 4 — 0 0 Vinegar 30 - 30 3 — 3 Drugs 4 22 26 0 0 0 Other Articles 90 50 140 4 6 10 Total 984 216 1200 42 8 50 TABLE II. Drugs. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Bicarbonate of Soda — 6 6 — 0 0 Camphorated Oil — 4 4 — 0 0 Cream of Tartar 4 3 7 0 0 0 Milk of Sulphur — 3 3 — 0 0 Ointment, boric — 3 3 — 0 0 „ zinc — 3 3 — 0 0 Total 4 22 26 0 0 0 82 TABLE III. Other Articles. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Apples 1 9 10 0 4 4 Arrowroot — 7 7 0 0 Baking Powder — 4 4 0 0 Brawn 1 — 1 0 - 0 Custard Powder 6 6 0 - 0 Fish Paste 9 9 4 4 Honey 10 — 10 0 0 Lard 25 — 25 0 0 Olive Oil 15 15 0 0 Pepper — 7 7 — 0 0 Rice 10 10 20 0 0 0 Sausages 8 — 8 0 - 0 breakfast 3 — 3 0 0 luncheon 1 1 0 - 0 Sherbet 1 1 0 0 Sponge Cake — 13 13 - 2 2 Total 90 50 140 4 6 10 Milk. Of the 738 formal samples 32 or 4.34 per cent, were certified as adulterated. Nine samples were reported against as being deficient in milk fat, 22 as containing extraneous water, (one of these being coloured), and 1 as containing colouring matter. In the 5 years 1921-25 and in 1926, 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 1926 738 32 4·3 83 The average composition of the 706 samples reported as genuine proved to be as under:— Total milk solids 12.47% Milk fat 3.66% Non-fatty solids 8.81% The content of fat in these 706 samples ranged as follows :— 4.0% and over 86 samples or 12.2% Between 3.9 and 4.0% 44 „ 6.2% „ 3.8 „ 3.9% ... 72 „ „ 10.2% „ 3.7 „ 3.8% 86 „ 12.2% „ 3.6 „ 3.7% 95 „ „ 13.5% „ 3.5 „ 3.6% 117 „ 16.6% „ 3.4 „ 3.5% 89 „ „ 12.6% „ 3.3 „ 3.4% 63 „ „ 8.9% „ 3.2 „ 3.3% 31 „ „ 4.4% 3.1 „ 3.2% 12 „ „ 1.7% 3.0 „ 3.1% 10 „ „ 1.4% Under 3.0% 1 „ „ 0.1% 706 100.0% All samples were systematically tested for the presence of preservatives. In no case, however, was a positive result obtained. Milk sampling was carried out on 17 Sundays during the year, and 102 samples were purchased for analysis on these occasions. Samples of milk in course of delivery by wholesale firms to the number of 73 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 77 were taken in course of delivery to elementary schools in the borough. Sixteen samples were also taken in course of delivery at the request of the Medical Officers of Health of neighbouring boroughs under the provisions of the Milk and Dairies (Consolidation) Act, 1915, which permits the vendor to require (within 60 hours) the Council to take samples from a corresponding delivery or milking. Proceedings with regard to adulteration were taken in 26 instances—fat abstraction, 6; extraneous water, 19 (one of these containing added colouring matter); added colouring matter 1— particulars relating to which will be found set out in the tables on pages 66 to 68. Warranty was pleaded in defence in one case and was successful. 84 Preservatives found In Foods during 1926. Formal Samples. Nature of Sample. Nature and amount of Preservative. Fish Paste 11·2 grains boric acid per lb. „ 1·3 ,, ,, ,, „ 3·04 ,, ,, ,, „ 5·6 ,, ,, ,, Informal Samples. Nature of Sample. Nature and amount of Preservative. Sponge Cakes 6·5 grains boric acid per lb. ,, 6·9 ,, ,, ,, Sponge Cakes, Fairy Cakes, &c. During the year 13 samples of sponge cakes were submitted to the Public Analyst. All these samples were procured informally. Two of the samples contained 6.5 and 6.9 grains per lb. of crystallised boric acid respectively. Butter. During the year 103 samples of butter were submitted for examination. Of these 22 were taken in the form prescribed by the Acts, the remaining 81 samples were purchased informally. Of these 1 formal and 2 informal samples were reported by the Public Analyst as containing margarine. Of the 100 samples reported as genuine, 24 contained no preservative other than common salt, whilst 75 contained a boron preservative. The maximum quantity of this preservative permitted in butter is 0.5 per cent, or 35 grains to the lb., but in no case was an excess found present, the average amount contained in the 100 samples amounting to 0.26 per cent or 18.2 grains to the lb. of butter. The average moisture content for all the samples (103) was found to be 13.9 per cent. Margarine. Twenty-eight samples of margarine were purchased and submitted to the Public Analyst for examination. Of these 16 were procured formally and 12 informally, and all were reported as genuine. 85 A boron preservative was present in each of the 28 samples, the average amount present expressed as crytallised boric acid being 0.345 per cent., equivalent to 24.1 grains per lb. The average moisture content for all samples (28) proved to be 13.7 per cent. Apples. In December, 1925, attention was directed by the Ministry of Health (Circular 659, dated December 21st) to the presence of arsenic on certain imported apples. Consequently fruiterers' samples for analysis were obtained during the year 1926 and submitted to the Public Analyst, comprising in all 1 formal and 9 informal samples. Of these the formal sample was reported as genuine whilst of the informal samples 4 were reported against as containing traces of arsenic varying from 1/100th to l/172nd of a grain per lb. of apples. Sausages, Preserved Meats, &c. Twelve samples of sausages (including 3 of breakfast sausage and 1 of luncheon sausage), and 1 sample of brawn and 9 of fish paste were examined during the year, all of which were procured with the necessary formalities prescribed by the Acts. All were reported as genuine with the exception of 4 of fish paste, which were found to contain a boron preservative varying from 1.3 to 11.2 grains per lb. expressed as crystallised boric acid. Rice. Twenty samples of rice (10 formal and 10 informal) were procured and submitted to the Public Analyst and all were reported as genuine. One formal and 6 informal samples proved to be polished, while the talc coating on 4 informal samples ranged from 0.32 per cent, to 0.22 per cent., with an average of 0.29 per cent. In no case was the maximum permissible amount of 0.5 per cent. reached or exceeded. Ice Cream Vendors. There are 148 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 1926, 66 of the ice cream premises were removed from the register and 13 were added. There was, therefore, a decrease of 53 in the number of premises compared with 1925. During the year 451 inspections were made and 32 notices were served to remedy defects found on inspection. In addition, during the summer 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. 86 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 739* Nil. Cream 2 Nil. 2. Cream sold as preserved cream :— (a) Samples submitted for analysis to ascertain if the statements on the labels as to preservatives were correct:— 1. Correct statements made 9 2. Statements incorrect 2 Total 11 (b) 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 ments as to labelling or declarations of preserved cream in Article V. (1) and the proviso in Article V. (2) of the Regulations have not been observed Nil. (d) Particulars of each case in which the Regulations have not been complied with and action taken. (1) Sample contained 0.18 per cent, excess of boric acid over declared quantity (0.4 per cent.). Vendor summoned. No fine, £1 11s. 6d. costs. (2) Sample contained 0.1 per cent, in excess of permissible quantity (0.4 per cent.). Vendor summoned. No fine, £3 3s. 0d. costs. [In both cases proceedings taken under Sale of Food and Drugs Acts.] * One of these was a sample of skimmed milk. 87 3. Thickening substances :— Any evidence of their addition to cream or to pre- served 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 :— (a) (1) Number of samples of milk certified by the Public Analyst to contain colouring matter 2 (2) Action taken thereon— One case added colouring matter only - Vendor summoned. Defendant discharged, on payment of £1 1s. 0d. costs. One case added colouring matter and extraneous water ... Vendor summoned. Summons withdrawn on payment of 15s. costs.. (b) (1) Number of samples of milk certified by Public Analyst to contain extraneous water (including 1 referred to above) 22 (2) Action taken thereon— Vendor summoned 19† Convictions (fines with or without costs) 9 Dismissed on payment of costs 8† Included under heading of colouring matter above 1 Summons not served 1 Vendor cautioned 3 Milk and Dairies Order, 1926. This Order, which came into operation on the 1st October, 1926, revoked the Dairies, Cowsheds and Milkshops Order of 1885, and the amending Orders of 1886 and 1899, so far as they applied to England and Wales. The Order, made under the Powers conferred on the Minister of Health by the Milk and Dairies (Consolidation) Act, 1915, enacts anew many of the provisions of the preceding Order with alterations and additions, but modified in accordance with the development † In 4 of these cases proceedings were taken under Sale of Food and Drugs Acts. 88 of modern hygienic knowledge in connection with the production of milk, greater stress being now laid upon the handling and protection from contamination than upon the structure of buildings. It provides for the registration both of persons carrying on the trade of cowkeeper or dairyman, and all farms and premises used as dairies, and that before commencing to use as a cowshed, or as a place for keeping milk a building not previously used for that purpose, the occupier is required to give one month's notice to the Sanitary Authority of his intention so to do. The Order also makes provision for County Councils and County Borough Councils to inspect cattle and deal with specified diseases found among them. Provision is also made for the cleanly condition of dairies, etc., and for protecting milk from infection and contamination. For this purpose regulations are made prescribing the ventilation of places used for keeping milk, sufficiency of water supply, cleanliness of vessels, etc., and power is given to the Medical Officer of Health where he has evidence that any person is suffering from infectious disease caused by the consumption of milk supplied from any registered premises to prohibit the sale of milk from such premises. The Order also deals with the conveyance of milk and its distribution, and among other things, prohibits the filling of milk vessels in the streets. The operation of certain provisions of the Order is deferred until the 1st October, 1928, and in regard to cowsheds, the enforcement of certain provisions involving structural alterations is postponed until 18 months after service of notice by the Sanitary Authority. 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 1926 licences were issued as follows :— Certified milk 19* Grade A (Tuberculin tested) milk 48* Grade A milk 5* Pasteurised milk 6* Milk Shops. The number of premises registered in Battersea for the sale of milk is 131. Three new premises were registered during the year * Including two "supplementary" licences. 89 for the sale of milk, and in 2 cases the sale of milk from registered premises was discontinued. In 13 cases registration was transferred on account of change of proprietorship. All milk shops are kept under inspection and during the year 731 inspections were carried out and 24 notices were served to remedy defects found on inspection. These mainly referred to dirty and unsuitable premises and other minor defects. In addition to the above are 22 premises in which sterilised milk in sealed bottles only is sold. It is the practice to register informally these premises, but it is doubtful whether they come within the provisions of the statutory requirements as to registration. It is understood that legal proceedings are pending in another Borough to test this question. In view of the fact, however, that there is a risk in small shops that bottles may be opened and portions of the contents sold, it would appear to be desirable that the occupiers of all premises where milk is sold in sealed bottles should be subject to the statutory obligation to be registered as purveyors of milk. The Public Health (Preservatives, &c„ in Food) Regulations, 1925. These Regulations, made on 4th August, 1925, were amended by the Public Health (Preservatives, &c., in Food) Amendment Regulations, 1926. Preservatives. The Regulations, as amended, provide, that no person shall manufacture for sale, or sell any article of food which contains any added preservative, with the following exceptions :—* (a) The Regulations shall not apply until 1st July, 1927, in respect of bacon, ham, egg yolk, and articles of food containing preservatives necessarily introduced by the use in their preparation of preserved margarine. (b) The Regulations shall not apply until 1st January, 1928, in respect of butter, cream, and articles of food containing preservatives necessarily introduced by the use in their preparation of preserved bacon, preserved ham, preserved egg yolk, or preserved cream. (c) The Regulations shall not apply until 1st July, 1928, in respect of articles of food containing preservatives necessarily introduced by the use in their preparation of preserved butter. (d) In regard to food mentioned in the following table, there will be no offence under the Regulations in respect of the presence of either sulphur dioxide, or benzoic acid, provided that the preservative is not present in a proportion greater than that shown in the table. * The Regulations have since been further amended in regard to the dates upon which certain of the prohibitions come into force and other articles have been added to the schedule. 90 Food. Preservative. per Million. 1. Sausages and sausage meat containing raw meat, cereals and condiments Sulphur Dioxide 450 2. Fruit and fruit pulp, not dried, for conversion into jam or crystallized glace or cured fruit as defined in items 6 and 7:— (a) Cherries Do. 3,000 (b) Strawberries and raspberries Do. 2,000 (c) Other fruit Do. 1,500 3. Dried fruit- (a) Apricots, peaches, nectarines, apples and pears Do. 2,000 (b) Raisins and sultanas Do. 750 4. Unfermented grape juice and nonalcoholic wine made from such grape juice if labelled in accordance with the rules Contained in the Second Schedule to these Regulations Benzoic Acid. 2,000 5. Other non-alcoholicw ines, cordials and fruit juices, sweetened or unsweetened Either Sulphur 350 Dioxide or Benzoic Acid 600 6. Jam (including marmalade and fruit jelly prepared in the way in which jam is prepared) Sulphur Dioxide 40 7. Crystallized glace or cured fruit (including candied peel) Do. 100 7a. Fruit and fruit pulp not otherwise specified in this schedule Do. 350 8. Sugar (including solid glucose) Do. 70 9. Corn syrup (liquid glucose) Do. 450 10. Gelatine Do. 1.000 11. Beer Do. 70 12. Cider Do. 200 13. Alcoholic wines Do. 450 14. Sweetened mineral waters Either Sulphur 70 Dioxide or Benzoic Acid 120 15. Brewed ginger beer Benzoic Acid 120 16. Coffee extract Do. 450 17. Pickles and sauces made from fruit or vegetables Do. 250 The presence of these added preservatives, in the prescribed quantities in sausages, sausage meat, coffee extract, pickles, sauces, and (where the proportion of benzoic acid exceeds 600 parts per million) in grape juice, and wine, must be declared in a printed label of the prescribed pattern, affixed to the container. If any dealer sells a preservative for use by traders the product must bear a label with a printed declaration in the prescribed form. Colouring Matter and Thickening Substances. From 1st January, 1927, no person shall manufacture for sale, or sell any article of food which contains any of the following matter:— 91 (a) Compounds of any of the following metals : Antimony, arsenic, cadmium, chromium, copper, mercury, lead, zinc. (b) Gamboge. (c) Coal tar colours, such as picric acid, Victoria yellow, Manchester yellow, aurantia, aurine. The addition of thickening substances to cream is also prohibited. A thickening substance is defined as sucrate of lime, gelatine, starch paste, or any other substance which, when added to cream is capable of increasing its viscosity, but does not include cane or beet sugar. There is a penalty, not exceeding £100, and in a case of a continuing offence, a daily penalty not exceeding £50. The effect of these Regulations should be to put an end to the sophistication and drugging of food stuffs. Sanitary authorities, including Battersea, for years past have urged the Central Authority to promote legislation, prohibiting the use of substances euphemistically called preservatives, in food stuffs. The addition of such drugs may not only be injurious to health, but by inhibiting incipient decomposition, which may be present in food stuffs, enable the sale of foods unfit for human consumption. Their use further had the disadvantage from the consumers' point of view, of allowing the manufacturer of food stuffs to disregard the necessity for scrupulous cleanliness in the preparation and storage of food. It will be noted that in regard to certain preserved articles of food, a time limit is allowed to enable traders to adjust their businesses to the new conditions. 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. All these premises are kept under systematic inspection. During 1926, 326 inspections were made and 12 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 1926 was 99, an increase of 2 as compared with 1925. During the year 295 inspections were carried out, and in 31 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—coffee, 10; vegetables and fruit, 106; fish and poultry, 12; meat and rabbits, 6; sweets, 3; other foods, 1. Six notices were served for defective and insanitary conditions of premises used by the street vendors for the storage of their stock. 92 Food Poisoning. During the year four cases of suspected food poisoning were reported and exhaustively investigated. (1) R.A.B., aged 18, a domestic servant employed in the adjacent borough of Wandsworth, was admitted to St. James's Hospital on the 1st June with a history of diarrhoea and abdominal pain which had started two days previously. The patient's condition became worse and she died in the institution on the 9th June. Post-mortem examination revealed the presence of acute gastro-enteritis. On investigation it was ascertained that the patient had visited her home, at Rochester, for the week-end on Friday, May 28th. Almost immediately she, in common with other members of her family, ate some tinned salmon, but none of them shewed any evidence of illness after this meal. Enquiries were made at the shop where the salmon was purchased, and it was ascertained that several tins of the same brand had been sold to other customers without complaint; that there was only one tin left which shewed no signs of deterioration. For supper the same day fish and chips were eaten by the family without ill effect. On Saturday the whole family had for dinner a boiled meat pudding, part of which was uneaten and was put away on an uncovered plate on a shelf in the scullery in which there was a sink and copper. These shelves were also used for uncooked vegetables, &c. On Saturday the deceased and others ate some fish paste for tea without ill effects. For Sunday breakfast the deceased and her mother and a sister ate the remains of the meat pudding. These three were all taken ill with diarrhoea and sickness, but other members of the family who did not eat the warmed-up meat pudding, showed no symptoms of illness. The post-mortem material from the organs of the deceased was examined at the Government Laboratory, and was reported to contain bacillus aertryche in large numbers. The evidence therefore pointed to this being a case of true food poisoning of which the warmed-up meat pudding was probably the cause. Unfortunately none of this pudding remained for examination. (2) A.J.C., aged 13, became ill on 24th July, and died in St. James's Hospital on 25th July, after partaking of an imported egg for tea and a small quantity of fried potato chips for supper. Enquiries instituted in this case established that the boy had visited the East End of London two days previously, where he had had icecream and lemonade from a street stall. Bacteriological examination of post-mortem material from the organs of the deceased established the presence of bacillus aertryche, a germ belonging to the Salmonella group, invariably associated with true food poisoning cases. After the fullest enquiries in this case, there appeared to be no evidence incriminating the food consumed by the deceased 93 in Battersea, as such food had been eaten (so far as can be ascertained) in common with other members of the family, who were not affected. Nor was there any definite evidence against the icecream or lemonade consumed in the East End of London, no other cases of food poisoning in that locality having been discovered. (3) W.G.F., aged 45, was admitted to St. James's Hospital on the 13th September, and died the same evening. On the 9th and 10th September he had partaken of fish at a restaurant in a neighbouring borough and became ill on the evening of the 10th September. Full enquiries were instituted into the circumstances, but the bacteriological evidence and the subsequent evidence at the inquest led to the conclusion that death in this case was not due to food poisoning. (4) Mrs. B., and two children, G. and J., the two former having been admitted to St. Thomas's Hospital, suffering from acute gastroenteritis suspected to be due to food poisoning, and the latter into St. James's Hospital in November. On enquiry at St. James's Hospital, it was ascertained that in the case of the boy admitted to that Institution food poisoning was not suspected. All three had eaten imported preserved duck eggs fried in mutton dripping from the Sunday joint. Bacteriological tests of ducks eggs purchased from the same consignment failed to detect the presence of any of the bacillary group associated with food poisoning. All the patients made a good recovery. These isolated instances of food poisoning, though of special interest and importance from the point of view of investigation, present considerable difficulty in tracing the source of infection. 94 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) 763 57 1* Workshops (including Workshop Laundries) 1,185 94 — Workplaces (other than Outworkers' premises included in the Table on page 100) 2,541 115 — Total 4,489 266 1* 2.—Defects found in Factories, Workshops and Workplaces. Particulars. Found on Inspection. Remedied. Referred to H. M. Inspector. Number of Prosecutions. 1 2 3 4 5 Nuisances under Public Health Act — Nil. Want of Cleanliness 116 116 _ Want of Ventilation 11 11 _ Overcrowding 2 2 _ Want of drainage of floors — — — Other nuisances 112 112 _ Sanitary accommodation Insufficient 4 4 — Unsuitable or defective 84 84 _ Not separate for the sexes 6 6 — Offences under the Factory and Workshop Act— Illegal occupation of underground bakehouse (Sec. 101) 1 1 1* Other Offences (excluding Offences relating to Outworkers which are included in the Table on page 104) — — Total 336 336 — 1* * Prosecution instituted in 1925. 95 3.—Registered Workshops. Workshops on Register (Section 131) at end of 1926:— Bakehouses 23 Bootmakers 35 Dressmakers 20 Laundries 4 Milliners 17 Tailors 44 Other Trades 194 Total number of workshops 337 4.—Other Matters. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Section 133) 16 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 1926:— Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons. Barge builder 2 26 2 — — Baker 53 216 — 1 — Bootmaker 15 26 2 — — Builder 4 107 — — — Butter blender 1 48 24 12 9 Chemical works 4 237 5 61 14 Chaff & forage 4 53 — — — Coach 2 20 — — — Cycle maker 3 4 5 — — Dyer 2 45 — 23 — Engineer 29 686 7 — — Flour mills 2 150 — 12 — Firewood cutter 9 39 5 20 — Foundry 1 30 — — — Lift maker 2 16 — — — Mason 6 356 2 — — Mineral water 2 25 — 23 — Motor repairs 15 222 — — — Printer 18 94 9 15 — Steam laundry 17 62 11 532 74 Other trades 82 3,731 338 1,004 462 Total 273 6,193 410 1,703 559 96 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. Five new factory premises were added to the register during the year, dealing with various trades and 18 were removed. During the year 44 preliminary and 13 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 1926 :— Trade. No. of Workshops. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Young Persons. Baker 23 32 35 — — — Blind maker 2 3 3 2 Bootmaker 35 35 51 2 Carpenter 4 5 10 — — — Coach builder 9 14 29 — — Cycle maker 8 10 10 — — — Dressmaker 20 28 — — 62 2 Embroiderer 1 2 — — 15 1 Farrier & smith 13 13 30 — Firewood cutter 3 3 5 — 1 Laundry 4 12 3 — 11 — Mason 3 3 16 Milliner 17 21 1 60 2 Motor repairs 13 13 38 —. — — Musical instrument 3 6 48 1 — — Photographer 1 2 2 — — — Picture framer 3 3 4 1 Rag sorter 14 14 25 4 8 Saddler 2 2 2 — Tailor 44 55 66 4 71 5 Upholsterer 17 20 28 2 8 — Other trades 98 112 223 31 58 16 Totals 337 408 629 47 294 26 97 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 1926, 66 workshops were visited by this female inspector, the number of inspections amounting to 139. Eighty-seven intimation and 7 statutory notices were served during the year for various defects in workshops found on inspection, all of which were complied with. Of these, 14 intimation notices were served by the female inspector. Twenty-four new workshops were added to the register, dealing with :— Baker 1 Lamp-shade maker 1 Builder 1 Machine ruler 1 Cabinet maker 1 Millinery 10 Coffin maker 1 Motor repairs 2 Dressmaker 3 Tailor 3 The following table gives particulars relating to workshops in which "protected persons" were employed, notices of which were duly sent to H.M. Inspector during 1926 :— Trade. No. of Workshops. Protected Persons employed. Women. Young Persons. Total. Dressmaker 3 10 1 11 Machine ruler 1 — 1 1 Milliner 10 28 — 28 Tailor 2 2 3 5 Totals 16 40 5 45 Outworkers. During 1926, 682 names and addresses of out-workers were received in 118 lists sent in by employers and by the Medical Officers of Health of Metropolitan Boroughs and District Councils. 232 names and addresses relating to 129 out-workers, sent in by employers, were found to refer to other districts, and were accordingly forwarded to the Medical Officers of Health of those districts. Male. The following table shows the number of male out-workers' premises registered in the Borough, together with the trades and the number of persons employed:—. 98 Trade. Number on Register. Persons Employed. Premises. Workrooms Bootmaking 33 33 35 Glovemaking 1 1 1 Tailoring 57 57 85 Other Trades 4 4 4 Totals 95 95 125 No new male out-workers (out-workers not previously registered) were registered during the year. There were 153 inspections made of male out-workers' premises during 1926, and it was found necessary to serve notices under the Public Health (London) Act, 1891, in 6 cases to remedy sanitary defects found on inspection, as follows:— Want of cleansing; defective apparatus to w.c; dilapidations. No case of infectious disease was notified during 1926 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 4 4 9 Boxmaking 7 7 7 Dressmaking 23 23 37 Embroidery 23 23 23 Fancy goods 10 10 10 Fine needlework 4 4 5 Glovemaking 1 1 1 Knitting and crochet 4 4 4 Tailoring 25 26 39 Underclothing 4 4 8 Other trades 13 13 13 Total 118 119 156 99 Sixty-three new female out-workers (out-workers not previously registered) were registered during the year. 267 inspections of female out-workers' premises were made by the woman workshops' inspector (Miss Round). It was found necessary in six cases to serve a notice under the Public Health (London)-Act, 1891, to remedy defects. One case of infectious disease, viz.: diphtheria, 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 76 bakehouses on the register at the end of 1926. Of these 53 use power, and are therefore factories. Fifty of the bakehouses are above ground, and 26 are under ground. One above ground bakehouse was opened during the year. 273 inspections were made during the year, and 63 intimation and 10 statutory notices were served, mainly for failure to carry out the half-yearly lime-whiting of the bakehouses within the statutory period. Warehouses and Wharves. At the end of 1926, there were 43 premises on the register, including railway yards. These premises were systematically inspected during the year, and 84 inspections were made. Nine intimation and one statutory notices were served to remedy nuisances found on inspection. 100 Home Work, 1926. 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 54 12 157 2 l l 72 — — 11 11 — 1 — — (2) Cleansing & Washing — — — — — — — — — — — — — — — Furniture and Upholstery 4 1 6 — — — — — — — — — — — — Other Trades 4 — 3 2 — 4 5 — — l l — — — — Total 62 13 166 4 1 5 81 — — 12 12 — l — — Note.—Of the 185 names included in this table, only 56 were of work people residing in Battersea, the remaining names being those of workers residing outside the Borough. The names of 166 additional Battersea outworkers were included in the lists furnished by Medical Officers of Health of other Boroughs. There were therefore 222 Battersea home-workers named in the lists. Plough Road Area Improvement Scheme—Houses Demolished. (Britannia Place—South Side.) Plough Road Area Improvement Scheme. Houses Demolished (Britannia Place—North Side.) Plough Road Area Improvement Scheme—Houses Demolished. (Britannia Place—North Side.) Plough Road Area Improvement Scheme- New Working-Class Dwellings Erected by Council's Works Department. (Britannia Place—North Side.) 101 Housing. During 1926 the housing question in Battersea underwent little change, so far as the scarcity of housing accommodation is concerned. There is still considerable overcrowding to be recorded, especially in the lower Wards, and until adequate housing provision is made for the needs of the working classes, and at rentals which are within the means of the class of the community which is most urgently in want of suitable housing accommodation, this insanitary state of affairs will continue to exist as a reproach to our civilisation. It is distressing to receive the constant heartrending appeals for housing accommodation from families in the Borough who are living under seriously overcrowded and otherwise insanitary conditions, and yet be incapable, except in a very small proportion of cases, to assist them. It is true, of course, that the London County Council, and some of the Metropolitan Boroughs, including Battersea, have to some extent attempted to overcome the serious housing shortage; but such efforts have so far proved quite inadequate to abate overcrowding and its attendant evils in workingclass areas. The difficulties associated with the housing shortage in London Boroughs, especially those centrally situated, are either that the new houses provided by the London County Council are too remote, or too highly rented to enable the working class to avail themselves of housing accommodation at such distant localities as Becontree and Downham, and unless, therefore, the Government and local authorities are prepared to deal with these difficulties and apply the appropriate remedy, it is to be feared that for some years to come the present unhappy housing conditions in certain areas of the Borough, and similar districts elsewhere in London will not be removed. The Borough Council, with praiseworthy zeal, have so far as their opportunities permitted, provided housing accommodation by securing all available building sites in the Borough and erecting thereon working-class tenements, or acquiring for conversion premises capable of being used as tenements; and since the war 86 new working-class dwellings have been provided by them. Unfortunately, these efforts have been quite insufficient to meet the needs of the Borough. During the year, the Council acquired Southlands College, a large training college with three acres of ground. It is proposed by them to adapt the buildings for various health services, including a Tuberculosis Dispensary, a Central Maternity and Child Welfare Centre, &c. The acquisition of this property will set free the site in another part of the Borough which was already allocated for these purposes. Accordingly there will be available for housing accommodation either by the erection of new dwellings or by conversion of existing buildings— (1) The site in Latchmere Road on which it was proposed to erect a new Tuberculosis Dispensary and a Central Maternity and Child Welfare Centre. 102 (2) The Principal's House and the Caretaker's Lodge at Southlands College. (3) The premises now used as a Voluntary Welfare Centre and Women's Dining Room at 111 Bridge Road West, the activities carried on there to be transferred to the Southlands College buildings. On the sites so set free for building purposes it is proposed— (1) To erect 18 tenements on the Latchmere site* and tions were entered into with the Ministry of Health, who were asked to consent, under Section 65 of the Housing Act, 1925, to (a) the appropriation of the site in question for the purpose of Part III. of the Act, and (b) to the grant of a subsidy under the Housing (Financial Provisions) Act, 1924. In view of the fact that the Housing Subsidy is subject to revision in October, 1927, it was urgently desirable to secure the erection of the tenements by that date. (2) The Principal's house and the Caretaker's lodge, separate buildings in the grounds of the College, were considered capable of conversion into working-class dwellings. In the first-mentioned building it is proposed to provide five tenements, the Caretaker's lodge providing an additional tenement. (3) The premises at 111 Bridge Road West at present used as a Maternity and Child Welfare Centre, to provide 3 or 4 separate dwellings. These new dwellings it is fexpected will be proceeded with early in the new year, and will provide a useful addition to those already erected by the Council, and relieve, in some degree, the serious shortage of housing accommodation for the working classes in the Borough. New Houses. Apart from the Plough Road Improvement Scheme, no new houses were erected by the Council during 1926, but 10 houses or flats were erected by private enterprise as follows:— Totteridge Road 6 tenements. Sudbrooke Road 1 house. Blenkarne Road 2 houses. Upper Tooting Park 1 house. In addition to the above, plans for the development of an estate at Nightingale Lane which will provide sites for the erection of 64 houses and for 2 houses in Sudbrooke Road were submitted, but these dwelling-houses were not completed by the end of the year. Repair of Unfit Houses. During 1926, the repair of unfit houses under the Housing and Public Health Acts, continued to be the main housing activity of the Council and the work carried out in this direction under the * These tenements are in course of erection and are expected to be ready for occupation by the end of the summer. 103 Housing Act and under the nuisances clauses of the Public Health (London) Act, 1891, will be found summarised on pp. 106-110. During 1926 it was only found necessary for the Council, to a very slight extent, to carry out works of repair to comply with notices served under Section 3 of the Housing Act, 1925, in default of the owner, the expenditure incurred in this connection amounting to £8 4s. 8d. In view of the heavy expenditure incurred by the Council in previous years in enforcing their powers under the Housing Act in default of the owners, it is satisfactory to note that the vigorous action taken by them in this respect has proved effective in securing greater and more expeditious compliance with the obligations imposed on owners of property by the Housing Act, with correspondingly reduced expenditure of time and money. During 1926 the right of appeal to the Minister of Health provided in the Section has been made use of in 4 instances by owners of property who objected on various grounds to the requirements of notices under Section 3 served upon them by the Council. The following are summarised statements in regard to these appeals, the results of the appeals in all but one case, which is still sub judice, being in favour of the Council. 6 Cairns Road. Against notice served. Result. - The notice having been complied with except in regard to the repair of the roof, the Council concurred with a suggestion of the Ministry of Health that, in view of the time that had elapsed since the service of the notice, action under the notice served be abandoned and any defects which may still exist be dealt with under a fresh notice. 53 Eccles Road. Against notice served. Result. Appeal dismissed for want of diligent prosecution. 10 Este Road. Against notice served. Result. A Local Inquiry was held when the appellant raised objection to the requirements of the provision of adequate light and ventilation to the staircase and the provision of additional air space to window of front basement room. He contended, inter alia, that the house came within the definition of a "Lodging House," and that it should, therefore, be dealt with under the by-laws relating to "Houses divided into separate tenements, etc.," made by the London County Council, the application of which in respect of structural requirements is postponed until six months after the expiry of the Rent and Mortgage Interest (Restriction) Acts. The appeal was, however, dismissed by the Minister of Health. 58 Winstanley Road. Against notice served. This appeal is still sub judice, the Local Inquiry not having been held by the end of the year. 104 Closing Orders. No Closing Orders under Section 11, (1) of the Housing Act, 1925, were made by the Council during 1926. The Closing Order made by the Council in 1925, under the Housing Act, 1925, in respect of the dwelling-house No. 39 Tidemore Street was determined by the Council in July, 1926, the necessary works of repair to render the house in all respects fit for human habitation having been carried out by the owner. Underground Rooms. During 1926, in view of the housing shortage, no action was taken under Section 18 of the Housing Act, 1925, in respect of underground rooms. Increase of Rent, &c., Acts. During 1926, 14 applications were received from the tenants for the certificate and 8 from the owners for the report of the Sanitary Authority under the above-mentioned Acts. The applications for Certificates were refused in 5 cases, those for reports were granted in all cases. Action under Section 5 of the Housing Act, 1925. During 1926, 89 cases relating to 119 houses were reported to the Housing Committee for contraventions of Section 5 of the Housing Act, 1925, which requires the rent book (if such is provided) to be kept in the prescribed form. In 87 cases the Committee directed that cautionary letters were to be sent to the offenders and in the other 2 cases that proceedings be taken. Insanitary Areas. No additional insanitary areas were represented to the Council during 1926. During the year considerable progress was made with the Plough Road Improvement Scheme. The second, third and fourth blocks were completed and the fifth block was well-advanced by the end of the year. Assistance towards the re-housing of the people residing in this area was provided by the offer under certain conditions of the London County Council, to allot eight tenements on their East Hill Estate. In addition the County Council agreed to provide housing accommodation in three empty houses belonging to them in Culvert Road to accommodate other suitable families who were being de-housed in this area. The Borough Council decided to accept both offers. Overcrowding. To relieve to some extent the overcrowding prevailing in some of the Metropolitan Boroughs, the London County Council allocated a certain proportion of the housing accommodation on their Housing Estates towards the relief of overcrowding and hardship in Metropolitan Boroughs on the recommendation of the Medical Officer of Health. 105 During 1926, 112 cases were referred to the London County Council, and 54 families were accommodated. In 10 cases the offer was declined by the tenant, and in 10 cases the recommendation was not accepted by the County Council. The remaining cases were still under consideration at the end of the year. By-Laws—Houses-Let-in-Lodgings. These By-Laws were made by the London County Council on 17th November, 1925, under Section 94 of the Public Health (London) Act, 1891, as amended and extended by Section 26, of the Housing Act, 1919, and Section 14 of the Housing Act, 1923, and were confirmed by the Minister of Health on the 5th March, 1926, with respect to houses intended or used for occupation by the working classes and let in lodgings or occupied by members of more than one family. Some Metropolitan Sanitary Authorities had raised objection to the definition of " lodging-houses " in the draft by-laws, and representations were made at the Conference between the London County Council and the Metropolitan Boroughs in July, 1925, that the definition should be amended so as to require registration in the case only of those houses which the Borough Council resolved should be registered. The London County Council refused to agree to the suggested amendment. The objections raised were, however, met to some extent by the Minister of Health, who when confirming the by-laws did so with the reservation that, " except in so far as they apply to any lodging-house in which the tenant resides and not more than one family is lodged." The effect of such exception is to exclude from the operation of the by-laws a large proportion of houses which would otherwise have come within the definitiod " lodging-house " in the by-laws. The Minister in explanation of his action was of opinion that this exception would to some extent meet the objections raised against the by-laws, but that the alteration was not necessarily final and did not preclude the London County Council from requesting him at some future date to remove this restriction if experience showed this to be necessary or desirable. The Health Committee considered the new by-laws and gave instructions as to the administrative action to be taken in putting them into operation. Steps are being taken to put into effect the duties imposed by the by-laws. The full effect of the by-laws will however, not be operative until 6 months after the Rent and Mortgage Interest (Restrictions) Acts cease to operate, and the result of the experience of their working may therefore, prove useful in regard to the necessity for their further amendment. 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 3 of the Housing Act, 1925, during 1926. 106 Street. Houses dealt with Street. Houses dealt with. Street. Houses dealt with. No. 1 District. Ascalon Street I Motley Street 1 Stewarts Road 2 Corunna Terrace 2 New Road 1 Wadhurst Road 2 Currie Street 4 Roundell Street 1 Woodgate Street 6 Everett Street 1 Total:—10 streets, 21 houses. No. 2 District. Alfred Street 39 Gladstone Terr 2 Park Grove 2 Anerley Street 1 Kilton Street 36 Sheepcote Lane 1 Arthur Street 55 Lockington Road 2 Warsill Street 1 Austin Road 1 Longhedge Street 1 Weybridge Street 2 B'sea Park Road 1 Meath Street 1 Total:—14 streets, 145 houses. No. 3 District. Banbury Street 3 Home Road 2 Parkham Street 2 Goulden Street 1 Hyde Lane 6 Randall Street 1 Granfield Street 1 Orbel Street 1 Stanmer Street 2 High Street 1 Park Road 1 Total:—11 streets, 21 houses. No. 4 District. Afghan Road 4 Heaver Road 1 Pearson Street 1 Barmore Street 5 Ingrave Street 43 Rowena Crescent 2 Benfield Street 5 Kambala Road 1 Shillington Street 5 Cabul Road 2 Kerrison Road 1 Speke Road 3 Candahar Road 3 Knox Road 2 Stainforth Rd. 6 Currie Road 2 Latchmere Grove 40 Thibet Street 1 Darien Road 1 Lavender Road 9 Totteridge Road 2 Duffield Street 5 Lithgow Street 1 Urswicke Road 4 Este Road 3 Lombard House 1 Verona Street 4 Falcon Grove 2 Lubeck Street 2 Wayford Street 1 Falcon Terrace 1 Mantua Street 6 Winstanley Road 2 Grant Road 3 Meyrick Road 8 Wye Street 2 Gwynne Road 2 Musjid Road 5 Yelverton Road 3 Harroway Road 2 Newman Street 3 Total:—41 streets, 199 houses. No. 5 District. Basnett Road 30 Hanbury Road 3 Shell wood Road 2 Beaufoy Road 1 Knowsley Road 7 Shirley Grove 1 Culvert Place 3 Latchmere Road 1 Wickersley Road 1 Dorothy Road 1 Morrison Street 1 Wycliffe Road 1 Eversleigh Road 1 Poyntz Road 6 Total:—14 streets, 59 houses. No. 6 District. Abyssinia Road 22 Livingstone Road 1 Tritton Street 1 Darien Road 1 Middleton Road 1 Wilson Street 2 Didcot Street 4 Sewell Road 1 York Road 1 Linda Street 2 Speke Road 2 Total:—11 streets, 38 houses. No. 7 District. Beauchamp Road 1 Sugden Road 1 Taybridge Road 1 Eccles Road 7 Total:—4 streets, 10 houses. No. 8 District. Chatham Road 1 Total:—1 street, 1 house. 107 Summary. No. 1 District 10 streets 21 houses. ,, 2 ,, 14 „ 145 „ ,, 3 ,, 11 ,, 21 „ „ 4 „ *41 ,, 199 „ ,, 5 ,, 14 ,, 59 „ ,, 6 ,, *11 38 „ ,, 7 ,, 4 ,, 10 „ ,, 8 ,, 1 „ 1 „ Totals *104 streets 494 houses The following is a list of streets in the Borough in which houses were the subject of action during the previous year, either informally or by the service of notice, under section 3 of the Housing Act, 1925, but to which the necessary works of repair had not been completed during 1925. Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. No. 1 District. Belfour Street 1 New Road 1 Stockdale Road 1 Gonsalva Road 3 Sterndale Road 1 Total:—5 streets, 7 houses. No. 2 District. Alfred Street 24 Gladstone Ter i Longhedge Street 1 Berkeley Street 1 Landseer Street 6 Sheepcote Lane 1 Total:—6 streets, 34 houses. No. 3 District. B'sea Bridge Rd. 1 Green Lane 3 Surrey Lane 4 Bullen Street 3 Home Road 1 Yarmouth Cott. 4 Church Road 2 Orville Road 6 Frances Street 2 Spencer Street 2 Total:—10 streets, 28 houses. No. 4 District. Benfield Street 3 Lavender Road 3 Simpson Street 1 Falcon Terrace 1 Newcomen Road 1 Stainforth Road 5 Gwynne Road 2 Newman Street 2 Totteridge Road 1 Harroway Road 1 Patience Road 2 Urswicke Road 12 I ngrave Street 6 Pearson Street 12 Winstanley Road I Khyber Road 1 Rowena Crescent 1 Yelverton Road 1 Latchmere Grove 1 Shillington St. 2 York Road 3 Total:—21 streets, 62 houses. No. 5 District. Basnett Road 2 Poyntz Road 1 Wycliffe Road 2 Beaufoy Road 8 Wickersley Road 2 Total:—5 streets, 15 houses. * Darien Road and Speke Road included in both 4 and 6 Districts. 108 No. 6 District. Cairns Road 1 Livingstone Rd 10 Plough Road 3 Grant Road 6 Maysoule Road 7 Usk Road 8 Harbut Road 1 Total:—7 streets, 36 houses. 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 5 streets 7 houses „ 2 „ 6 ,, 34 „ ,, 3 ,, 10 „ 28 „ „ 4 „ 21 „ 62 „ ,, 5 ,, 5 „ 15 „ ,, 6 „ 7 „ 36 ,, ,, 7 ,, 3 „ 3 „ ,, 8 „ 2 „ 2 „ Totals 59 streets 187 houses Statistics for the year ending 31st December, 1926. 1. General. (a) Estimated population 171,900 (b) General Death Rate 11.4 per 1,000 (c) Death rate from tuberculosis 0.97 per 1,000 (d) Infantile mortality rate 61.6 per 1,000 (e) Number of premises used as habitations by all classes 27,847 (/) Estimated number of working class dwelling- houses 24,956 (g) Number of new working class dwellings erected *28 2. Unfit Dwelling-Houses. (a) Inspection— (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,728 (b) Number of dwelling-houses which were inspected and recorded under Part IV of the Housing Consolidated Regulations, 1925 3,265 * Includes 18 tenements erected under Plough Road Improvement Scheme. 109 (c) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for habitation Nil. (d) Number of dwelling-houses (exclusive of those referred to under the previous heading) not found to be in all respects reasonably fit for habitation 3,173 (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 476 (c) Action under statutory powers— (I.) Proceedings under section 3 of the Housing Act, 1925 (a) Number of dwelling-houses in respect of which notices were served requiring repairs 60 (b) Number of dwelling-houses which were rendered fit:— (i.) By owners 61 (ii.) Work commenced by local authority but workmen subsequently withdrawn and work completed by owner Nil (iii.) Work commenced by owner but workmen subsequently withdrawn and work completed by local authority 2 (iv.) By local authority in default of owners Nil (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 2,679 (b) Number of houses in which defects were remedied. (i.) By owners 2,773 (ii.) By local authority in default of owners Nil (III.) Proceedings under sections 11, 14 & 18 of the Housing Act, 1925 :— (a) Number of representations made with a view to the making of Closing Orders Nil 110 (b) Number of dwelling-houses in respect of which Closing Orders were made Nil (c) Number of dwelling-houses in respect of which Closing Orders were determined the dwelling-houses having been rendered fit 1 (d) Number of dwelling-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 Part II. of the Housing Act, 1925 Nil 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 (now section 99 of the Housing Act, 1925) 28 5. Staff. Staff engaged on Housing work with briefly the duties of each officer :— 1. Medical Officer of Health. 2. Senior Sanitary Inspector. Housing Inspector. Seven District Inspectors. 3. Two Clerks (mainly engaged on matters relating to housing work). 1ll 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 1926 and Previous Years. Year. 1 Population estimated to middle of each Year. 2 Births. Total Deaths registered in the district. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. 3 Nett. Number. 6 Rate. * 7 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 10 Rate per 1,000 Net Births. 11 Number. 12 Rate.* 13 1916 173,432 B. † 3,523 3,774 21.8 2,502 15.7 705 424 318 84 2,221 13.9 159,402 D. † 1917 167,233 B. † 2,709 2,960 17.7 2,567 17.1 727 445 299 101 2,285 15.2 150,023 D. † 1918 168,014 B. † 2,407 2,700 16.1 3,195 21.3 857 471 267 99 2,809 18.7 149,951 D. † 1919 165,960 B. † 2,765 3,075 18.5 2,409 15.1 730 382 228 74 2,061 12.9 159,316 D. † 1920 166,093 B. † 4,218 4,669 • 28.1 2,393 14.4 700 386 386 83 2,079 12.5 165,664 D. † 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 1926 171,900 3,198 2,969 17.3 2,547 14.8 948 361 183 62 1,950 11.4 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. 112 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 1926. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 540 3 186 290 42 19 ... 256 232 52 251 232 50 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 72 2 3 6 5 50 6 34 26 12 11 10 3 Scarlet Fever 581 4 140 363 41 33 ... 249 208 124 248 208 121 Trench Fever 1 ... ... ... ... 1 ... 1 ... ... ... ... ... Enteric Fever 3 ... ... ... 1 2 ... 2 ... 1 2 ... 1 Puerperal Fever 12 ... ... ... 2 10 ... 7 4 1 6 3 1 Puerperal Pyrexia † 9 ... ... ... 3 6 ... 6 1 2 1 ... 1 Meningococcal Meningitis 1 ... 1 ... ... ... ... 1 ... ... 1 ... ... Ophthalmia Neonatorum 35 35 ... ... ... ... ... 13 17 5 2 1 1 Polio-myelitis, &c. 6 ... 3 3 ... ... ... 3 3 ... 1 ... ... Encephalitis Lethargica 4 ... ... ... ... 3 1 ... ... 4 ... ... 1 Polio-encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria 3 ... ... ... 1 2 ... 1 2 ... ... ... ... Dysentery 1 ... ... ... ... 1 ... 1 ... ... ... ... ... Acute Influenzal Pneu 76 2 7 8 15 39 5 32 28 16 14 11 2 Acute Primary Pneu 296 27 90 47 27 87 18 154 108 34 62 47 8 Totals 1,640 73 430 717 137 253 30 760 629 251 599 512 189 Tuberculosis- Pulmonary 246 ... 1 11 67 160 7 111 68 67 ... ... ... Non-Pulmonary 98 2 15 46 15 20 ... 54 23 21 ... ... ... Totals (Tuberculosis) 344 2 16 57 82 180 7 165 91 88 ... ... ... Totals 1,984 75 446 774 219 433 37 925 720 339 599 512 189 Whooping-cough* 709 79 383 240 4 2 1 383 154 172 18 16 ... Measles* 3,363 145 1,637 1,525 36 20 ... 1,666 868 829 131 78 27 Grand Totals 6,056 299 2,4S6 2,539 259 455 38 2,974 1,742 1,340 748 606 216 * Notifiable in Battersea from 24th April, 1922. † Notifiable from 1st October, 1926. 113 TABLE III Causes of, and Ages at, Death during the Year 1926. CAUSES OF DEATH. 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. All 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. Small-pox ... ... ... ... ... ... ... ... ... ... 3. Measles 43 6 22 13 2 ... ... ... ... 42 4. Scarlet Fever 2 ... 1 ... 1 ... ... ... ... ... 5. Whooping-cough 13 4 7 2 ... ... ... ... ... 12 6. Diphtheria 20 1 2 4 13 ... ... ... ... 2 7. Influenza 25 2 ... 2 ... 1 1 6 13 11 8. Encephalitis Lethargica 3 ... ... ... ... ... ... 2 1 3 9. Meningococcal Meningitis 1 ... 1 ... ... ... ... ... ... ... 10. Tuberculosis of Respiratory System 141 2 ... ... 2 28 66 37 6 109 11. Other Tuberculous Disease 25 2 1 3 7 4 4 1 3 26 12. Cancer 263 ... ... ... 1 1 17 133 111 218 13. Rheumatic Fever 7 ... ... ... 2 1 1 3 ... 3 14. Diabetes 21 ... ... ... ... 1 2 8 10 16 15. Cerebral Hæmorrhage, etc. 100 ... ... ... ... ... 1 31 68 98 16. Heart Disease 338 ... ... ... 7 9 22 67 233 405 17. Arterio-Sclerosis 59 ... ... ... ... ... 1 20 38 8 18. Bronchitis 131 5 4 1 ... 1 7 38 75 45 19. Pneumonia (all forms) 148 39 24 9 1 1 15 34 25 90 20. Other Respiratory Diseases 14 ... ... 3 ... ... 2 4 5 13 21. Ulcer of Stomach or Duodenum 23 ... ... ... ... ... 3 15 5 27 22. Diarrhœa, &c. 40 25 3 1 3 ... 2 1 5 20 23. Appendicitis and Typhlitis 9 ... ... ... 1 ... 5 2 1 19 24. Cirrhosis of Liver 13 ... ... ... ... ... ... 10 3 17 25. Acute and Chronic Nephritis 61 ... ... ... 3 3 5 26 24 50 26. Puerperal Sepsis 3 ... ... ... ... ... 3 ... ... 5 27. Other diseases of Pregnancy 7 ... ... ... ... 1 6 ... ... 5 28. Congenital Debility and Malformation, Premature Birth 72 72 ... ... ... ... ... ... ... 44 29. Suicide 22 ... ... ... 1 1 5 10 5 9 30. Other Deaths from Violence 67 ... 2 2 9 4 10 18 22 68 31. Other Defined Diseases 288 25 1 4 12 12 45 71 118 249 32. Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... All Causes M. 994 101 38 28 38 37 120 286 346 813 F. 966 82 30 16 27 31 104 251 425 801 Totals 1960 183 68 44 65 68 224 537 771 1614 114 East Battersea TABLE IV. Infant Mortality, 1926. 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 8-9 9-12 m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... 1 2 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Bronchitis ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 Pneumonia (all forms) ... ... 1 ... ... 1 ... ... ... ... 1 1 1 1 ... 4 ... 1 4 1 6 8 Tonsillitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Diarrhœa & Enteritis ... ... ... ... 2 ... ... ... ... ... 2 ... 1 1 3 2 ... 3 1 1 7 7 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 1 2 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 3 2 7 1 ... 1 ... 1 1 ... 1 1 5 ... ... ... ... ... ... ... ... 11 5 Congenital Malformation 1 1 ... ... ... ... ... 2 1 ... 2 3 ... 1 ... ... ... ... ... ... 2 4 Congenital Debility ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... 2 1 1 ... ... ... 3 2 Œdema Neonatorum ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis & Asphyxia Neonatorum 1 1 ... 3 ... ... ... ... ... ... 1 4 ... ... ... ... ... ... ... ... 1 4 Lack of Care 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 2 ... 6 4 8 6 3 2 ... 3 2 1 19 16 4 7 6 8 2 5 8 5 39 41 Totals 10 14 5 3 3 35 11 14 7 13 80 Nett Births in the year. Legitimate. Illegitimate. Total. 1302 42 1344 Nett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. 71 9 80 115 North-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1926. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M F Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 3 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 1 3 1 Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 4 2 4 4 9 9 Tonsillitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 2 2 1 2 ... 7 3 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 1 ... 7 6 3 ... 2 ... ... ... 13 6 1 ... ... ... ... 1 ... ... 14 7 Congenital Malformation ... ... 1 ... ... 1 ... ... ... ... 1 1 1 ... ... ... ... ... ... ... 2 1 Congenital Debility ... ... 1 ... ... 1 ... ... ... ... 1 1 ... ... 1 2 1 ... ... ... 3 3 Œdema Neonatorum ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis and Asphyxia Neonatorum 1 ... 2 ... ... ... 1 ... ... ... 4 ... ... ... ... ... ... ... ... ... 4 ... Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 2 1 11 6 4 2 3 ... ... ... 20 9 4 1 5 6 7 5 11 6 47 27 3 17 6 3 ... 29 5 11 12 17 74 Nett Births in the year. Legitimate. Illegitimate. Total. 970 42 1012 Nett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. 67 7 74 116 South-West Battersea. TABLE IV.-(contd.) Infant Mortality, 1926. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 1 ... 1 1 1 2 5 Tonsillitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 3 1 2 2 ... 1 ... ... ... ... 5 4 ... ... 1 ... ... ... ... ... 6 4 Congenital Malformation ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Congenital Debility ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 Œdema Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis & Asphyxia Neonatorum 1 1 2 ... ... ... ... ... ... ... 3 1 ... ... ... ... ... ... ... ... 3 1 Lack of Care ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 2 ... Totals 4 3 5 2 1 2 ... ... ... ... 10 7 1 3 2 1 ... 2 2 1 15 14 7 7 3 ... ... 17 4 3 2 3 29 Nett Births in the year. Legitimate. Illegitimate. Total. 586 27 613 Nett Deaths in the year(Infants under 1 year) Legitimate. Illegitimate. Total. 27 2 29 117 Borough of Battersea. TABLE IV.-(contd.) Infant Mortality, 1926. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. ACE 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 M. F. M. F. M. F. M. F. M. F M. F M F M F M F M F M F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 1 5 1 3.3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 ... 1 3 2.2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 0.5 Influenza ... ... ... ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 1 1.1 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 0.6 Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 1 1.1 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 0.5 Other Tuberculous disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 0.6 Bronchitis ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... 2 1 3 2 2.7 Pneumonia (all forms) ... ... 1 ... ... 1 ... ... ... ... 1 1 9 4 1 7 4 4 9 6 17 22 21.3 Tonsillitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 0.5 Diarrhœa & Enteritis ... ... ... 2 ... ... ... ... ... 2 ... 2 1 5 4 2 5 3 1 14 11 13.7 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Svphilis ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 1 2 1.6 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 7 3 16 9 3 2 2 1 1 ... 29 15 1 ... 1 ... ... 1 ... ... 31 16 25.7 Congenital Malformation 1 1 2 ... ... 1 ... 2 1 ... 4 4 1 1 ... ... ... ... ... ... 5 5 5.5 Congenital Debility ... ... 1 1 ... 2 ... ... ... ... 1 3 ... 1 3 3 2 ... ... ... 6 7 7.1 Œdema Neonatorum ... 1 ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 1.1 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis & Asphyxia Neonatorum 3 2 4 3 ... ... 1 ... ... ... 8 5 ... ... ... ... ... ... ... ... 8 5 7.1 Lack of Care 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 1.1 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.5 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... 2 ... ... ... ... ... 2 ... ... ... 1 ... 1 ... ... ... 4 ... 2.2 12 8 24 14 8 6 3 3 2 1 49 32 9 11 13 15 9 12 21 12 101 82 100.0 Totals 20 38 14 6 3 81 20 28 21 33 183 — Percentage of Total 10.9 20.8 7.7 3.3 1.6 44.3 10.9 15.3 11.5 18.0 100.0 — M. 55-2% F. 44-8% Nett Births in the year. Legitimate. Illegitimate. Total. M. 1,507 60 1,567 F. 1,351 51 1,402 Totals 2,858 111 2,969 Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. 92 9 101 73 9 82 165 18 183 118 Form T53. TUBERCULOSIS SCHEME OF THE BATTERSEA METROPOLITAN BOROUGH COUNCIL. Return showing the work of the Dispensary (or Dispensaries) during the year 1926. Diagnosis. Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 89 58 2 4 6 9 19 4 95 67 21 8 (b) Doubtfully tuberculous — — — — — — — — 38 56 39 34 (c) Non-tuberculous — — — — — — — - 68 103 72 59 B.—Contacts examined during the year:— (a) Definitely tuberculous 2 1 1 1 — 1 1 — 2 2 2 1 (6) Doubtfully tuberculous — — — — — — — — 2 7 5 7 (b) Non-tuberculous — — — — — — — — 27 44 54 59 C.—Cases written off the Dispensary Register as (a) Cured 9 16 — 3 3 1 6 1 12 17 6 4 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) — — — — — — — — 143 220 161 155 D.—Number of Persons on Dispensary Register on December 31st (a) Diagnosis completed 311 226 70 88 19 18 94 50 330 244 164 138 (b) Diagnosis not completed — — — — — — — — 70 97 41 35 1. Number of persons on Dispensary 9. Number of patients to whom Dental Register on January 1st 1,144 Treatment was given, at or in connection with the Dispensary 70 2. Number of patients transferred from other areas and of "lost sight 10. Number of consultations with medical of" cases returned 11 practitioners;— (a) At Homes of Applicants. 38 (b) Otherwise 841 3. Number of patients transferred to other areas and cases " lost sight 11. Number of other visits by Tuberculosis Officers to Homes 142 4. Died during the year 100 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary 5. Number of observation cases under purposes 5,294 A (b) and B (b) above in which 13. Number of period of observation exceeded 2 months 92 (a) Specimens of sputum, &c., examined 1,504 6. Number of attendances at the Dis(b)X-ray examinations made 78 pensary (including Contacts) ... 4.686 in connection with Dispensary work 7. Number of attendances of non-pul14- Number of Insured Persons on monary cases at Orthopa?dic Out- pensary Register on the 31st stations for treatment or super- December 499 vision - 15. Number of Insured Persons under 8. Number of attendances, at General Domiciliary Treatment on the Hospitals or other Institutions 31st December 1 95 approved for the purpose, of patients for 16. Number of reports received during the year in respect of Insured (а) Light treatment 6 Persons (б) Other special forms of treatment 119 (a) Form G.P. 17 2 {b) Form G.P. 36 247 119 TUBERCULOSIS SCHEME OF THE METROPOLITAN BOROUGH COUNCIL OF BATTERSEA. Form T56. (a) Pulmonary Tuberculosis. Annual Return showing in summary form the condition of all Patients whose case records are in the possession of the Dispensary (or Dispensaries) at the end of 1926, arranged according to the years in which the patients first came under Public Medical Treatment for pulmonary tuberculosis, and their classification as shown on Form A. Condition at the time of the last record made during the year to which the Return relates. 1921. 1922. 1923. 1924. 1925. 1926. Class T.B minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Class T.B. minus. Class T.B. plus. Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total (Class T.B. plus). Group 1. Group 2. Group 3. Total(Class T.B. plus.) alive. Discharged as cured. Adults M. 1 1 — — 1 1 — — — — — — — — — — — — — — — — — — — — — — — — F. 3 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Children M. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — F. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Disease arrested. Adults M. 5 2 — — 2 3 1 2 — 3 2 1 — — 1 3 — — — — 2 — — — — — — — — — F. 7 — 1 — 1 1 1 — 1 2 3 1 — — 1 3 — — — — — — — — — — — — — — Children M. 2 — — — — 2 — — — — 1 — — — — 1 1 — — 1 — — — — — — — — — — F. 3 — — — — 3 — — — — — 1 — — 1 — — — — — — — — — — — — — — — Disease not arrested. Adults M. — 1 8 — 9 1 4 8 — 12 2 2 10 1 13 3 5 14 3 22 5 9 19 6 34 10 8 33 20 61 F. — — 3 1 4 — 4 2 — 6 1 4 2 — 6 5 1 5 3 9 6 3 11 4 18 11 5 20 18 43 Children M. 1 — — — — — — — — — — — — — — — — — — — — — 2 — 2 4 — — — — F. 1 — 1 — 1 1 — 1 — 1 — — — — — 5 — — — — 1 — 2 — 2 4 — — 1 1 Condition not ascertained during the Year. 4 2 1 — 3 2 2 2 — 4 4 2 2 — 4 — 2 1 — 3 2 1 2 2 5 — — — — — Lost sight of or otherwise removed from Dispensary Register. 17 4 18 3 25 21 4 15 9 28 2 10 14 4 28 5 1 6 5 12 5 4 7 5 16 2 — 6 — 6 dead. Adults M. 9 2 20 29 51 4 4 17 16 37 2 4 18 22 44 3 4 13 24 41 — — 11 28 39 1 — 6 13 19 F. 4 1 7 24 32 — 3 8 17 28 1 4 14 14 32 — 2 9 16 27 1 — 2 14 16 1 — 1 4 5 Children M. — — — 1 1 1 — — — — — — — — — 1 — — 1 1 1 — — 1 1 — — — — — F. 1 — — — — 2 — — — — — — 2 1 3 1 — — — — 1 1 — — 1 — — — 1 1 TOTALS 58 13 59 58 130 42 23 55 43 121 18 29 62 42 133 30 16 48 52 116 24 18 56 60 134 33 13 66 57 136 120 (b) Non-Pulmonary Tuberculosis. Form T56 Annual Return showing in summary form the condition of all Patients whose case records are in the possession of the Dispensary (or Dispensaries) at the end of 1926, arranged according to the years in which the Patients first came under Public Medical Treatment, and their classification as shown on Form A. Condition at the time of the last record made during the year to which the Return relates. 1921. 1922. 1923. 1924. 1925. 1926. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. Bones and Joints. Abdominal. Other Organs. Peripheral Glands. Total. ALIVE. Discharged as cured. Adults M. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — f. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Children M. — — — 3 3 1 1 — — 2 — — — — — — — — — — — — — — — — — — — — f. — — — 4 4 — — — 2 2 — — — — — — — — — — — — — — — — — — — — Disease arrested. Adults M. — — 2 1 3 — — — — — 1 — 1 — 2 2 — — — 2 — 1 — — 1 — — — — — f. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Children M. — — — 1 1 — 2 — 5 7 1 1 — 13 15 1 2 — 5 8 2 — 1 2 5 — — — — — f. — — — 5 5 1 — — 8 9 3 1 — 2 6 2 1 — 2 5 — 1 — 1 2 — — — — — Disease not arrested. Adults M. — — — — — — — — — — — — — — — — — 1 1 2 — 1 1 — 2 4 1 1 — 6 f. — — — — — — — 1 — 1 1 — 2 — 3 — 1 — 2 3 — 1 1 1 3 2 1 2 5 10 Children M. 1 — — — 1 — — — 2 2 1 — — 9 10 2 — 1 10 13 2 2 — 6 10 5 3 2 12 22 f. — — — 1 1 1 2 — — 3 — — — 1 1 — — — 5 5 1 — 1 4 6 2 — 1 8 11 Transferred to Pulmonary — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Condition not ascertained during the Year. 2 — 2 — 4 3 — — 1 4 — 1 1 4 6 — — — — — 2 — — — 2 — — — — — Lost Sight of or otherwise removed from Dispensary Register. 2 — 2 6 10 1 — 2 8 11 3 — — 4 7 3 — — 3 6 3 — — 5 8 — 1 — 2 3 DEAD. Adults M. 1 — — — 1 1 — — — 1 — — — — — 2 — — — 2 — — — — — — — — — — f. — — 1 — 1 — 1 — — 1 — — 1 — 1 — — — — — — — — 1 1 — — — — — Children M. — — — — — — — — — — 1 — — — 1 — — — 1 1 — — — — — — — 1 — 1 f. — — — 2 2 — 1 — — 1 — — — — — — — — — — — — — — — — — — — — totals 6 — 7 23 36 9 7 3 26 45 12 3 5 33 53 13 4 2 29 48 10 6 4 20 40 13 6 7 27 53