AC 4386 BAT 26 Metropolitan Borough of Battersea. 3 REPORT ON THE HEALTH OF THE Metropolitan Borough of Battersea For the Year 1920, BY G. QUIN LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. Kent & Matthews, Ltd., Wandsworth Road and Clapham Junction. BAT 26 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1920. by G. QU1N LENNANE, F.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH. Health Committee As constituted 10th November, 1919. Chairman : Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor A. Winfield, j.p.) Councillor W. R. Croucher. „ G. Davis. ,, Mrs. E. H. D. Duval. „ P. P. Haythornthwaite. „ Mrs. J. Hockley. „ T. Jones. ” R. Moore. ” J. W. O'Brien. „ G. A. Saunders. „ E. E. Tomalin. „ A. Welsh. „ H. White. As constituted 9th November, 1920. Chairman: Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor A. Winfield, j.p ) Alderman Mrs. C. Dkspard. Councillor Mrs. E. H. D. Duval ,, P. P. Haythornthwaite. „ J. Hendrick. „ Mrs. J. Hockley. „ T. Jones. Alderman C. W. Martin. Councillor R. Moore. „ J. W. O'Brien. Alderman E. C. Reed. Councillor A. Welsh. „ H. White. Maternitg and Child Melfare Committe. . As constituted 10th November, 1919. Chtirman: Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor A. Winfield, j.p.) Councillor W. R. Croucher. „ G. Davis. „ Mrs. E. H. D. Duval. „ P. P. Haythornthwaite. „ Mrs. J. Hockley. „ T. Jones. „ R. Moore. ” J. W. O'Brien. ,, G. A. Saunders. „ E. E. Tomalin. „ A. Welsh. „ H. White. As constituted 9th November, 1920. Chairman : Councillor Mrs. C. S. Ganley, j.p. His Worship the Mayor (Councillor A. Winfield, j.p.) Alderman Mrs. C. Despard. Councillor Mrs. E. H. D. Duval. „ P. P. Haythornthwaite. ,, J. Hendrick. „ Mrs. J. Hockley. „ T. Jones. Alderman C. W. Martin. Councillor R. Moore. „ J. W. O'Brien. Alderman E. C. Reed. Councillor A. Welsh. ,, H. White. Co-opted Members: Mrs. A. Baker. Miss C. Heinemann. Mrs. A. Moore, m.b.e. (Nov., 1920). Mrs. F. B. Payne. Mrs. M. H. Rose. Miss L. Retallack. Mrs F. Young. Houstnq Commiitee As constituted 9th November, 1920. Chairman: Councillor H. Harling. His Worship the Mayor (Councillor A. Winfield, j.p.) Councillor A. Clist. „ W. R. Croucher. Alderman F. C. R. Douglas. Councillor J. Edwards. „ W. D. Garnsey. Alderman C. W. Martin. Councillor W. Nichols. Alderman T. Pocock. Councillor G. A. Saunders. „ E. S. Strange. „ H. G. White. „ C. H. Young. *As constituted 10th December, 1919. Chairman: Councillor C. H. Young. His Worship the Mayor (Councillor A. Winfield, j.p.) Councillor Capt. F. A. Abbott. „ W. S. Daniel. Alderman F. C. R. Douglas. Councillor Mrs. C. S. Ganley, j.p. „ D. W. Garnsey. „ A. H. R. Goodson „ H. Harling. „ R. H. Johnson. Alderman C. W. Martin ,, T. Pocock. Councillor G. A. Saunders. „ G. Wheeler. *The Housing Committee was appointed ioth December, 1919. Staff of the public Health Dpartment. (at Slat December, 1920.) Assistant Medical Officer. W. Nicoll, M.A., M.D. Chief Sanitary Inspector. I. Young, F.S.I.A. Women Sanitary Inspectors and Health Visitors. Miss A. E. moss, San. Insp. Board's Cert., C.M.B. Miss J. Round, „ ,, „ Health Visitors. Miss N. BOURDILLON, San. Insp. Board's Cert., C.M.B. Miss B. L. KAYE, ,, ,, ,, ,, Miss N. Playne, ,, ,, ,, ,, Miss M. H. Kaye (temporary), C.M.B. Food Inspector. A. chuter, Cert. San. Inst, and Meat Insp. Cert. Workshop Inspector. W. E. Benjamin, Cert. San. Inst. Sanitary Inspectors. No. 1 District J. HERRIN, Cert. San. Inst. and Meat Insp. Cert. ,,2 ,, j. j. burgess, San. Insp. Board's Cert. ,, 3 ,, J. lawrence, Cert. San. Inst.and Meat Insp. Cert. ,,4 ,, A. E. Purnell, Cert. San. Inst. ,, 5' ,, j. t. Baxter, Cert. San. Inst. ,, 6 ,, H. marrable, Cert. San. Inst. ,, 7 ,, A. odell, Cert. San. Inst. and Meat Insp. Cert. ,, 8 ,, H. H. May, Cert. San. Inst. — H. E. Wheeler (Housing), San. Insp. Board's Cert.and Meat Insp. Cert. Organising Rat Officer. H. RENHAM. Clerical Staff. Chief Clerk F. E. ward. Statistical Clerk J. W. Brown. Clerks E. Cole. W. Halstead. H. C. Godfrey, San. Insp. Board's Cert. (Four temporary junior clerks, and shorthand-typist.) Superintendent of Disinfecting Station. C. H. woodhouse. Mortuary Keeper. G. Streat. Matron—Maternity Home. Miss C. Dickson. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Ladies and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary state of the Borough of Battersea for the year 1920. The year has been characterised by the increasing activities of the Health Department and the large volume of work dealt with, especially in regard to Maternity and Child Welfare work and to Housing matters. The outstanding feature of the year's work has been, undoubtedly, the development of the Council's Maternity and Child Welfare Scheme. The municipal part of the scheme has been rapidly improved and extended by the provision of such necessary measures as adequate midwifery and nursing services, dental and ante-natal clinics, etc. These additional services are now nearly completed, and were for the most part functioning early this year. The work of the voluntary associations comprised in the Council's comprehensive scheme has also been more closely and effectively linked up with the work of the Health Department, and material assistance—financial and otherwise—to enable these bodies to carry out their useful functions with greater efficiency, has been given them by the Council. In regard to Housing matters, strenuous efforts were made during the year to carry out the provisions of the Housing Acts. So far as the provision of new working-class dwellings is concerned, only two small schemes (viz., Heathwall Street and Swaffield House) were being actively proceeded with, and it is anticipated that these tenements will be ready for occupation early in 1921. It is confidently expected that the larger scheme for the erection of 52 tenements on the vacant site of the Council's Latchmere Estate will also be proceeded with in the coming year. Notwithstanding the administrative difficulties met with in carrying out the provisions of the Housing Act, it is gratifying to note, in the section of the Report dealing with Housing, that at least in regard to the important question of the repair of insanitary property very successful progress was made. The vital and morbid satistics for this year are on the whole satisfactory, and compare favourably with those for past years. I desire to express my thanks to the Chairmen of the Health, Maternity, and Housing Committees, and to the Members of the Council, for their support and sympathetic consideration. To my colleagues, the Chief Officers of the Council, and to the staff of the Public Health Department, my thanks are also due for assistance always willingly rendered. G. QUIN LENNANE. July, 1921. 6 CONTENTS. page Vital Statistics—Summary 8 Births, Marriages and Deaths— Vital Statistics 9 Births 10-16 Marriages 10 Deaths 12 ,, (Age Periods) 14 ,, (In Public Institutions) 14 ,, (Senile) 14 ,, (Comparative Table) 16 Infant Mortality 17 otification of Births Act 20 Maternity and Child Welfare— Centres 20 Maternity Home 21 Dental Clinic 21 Hospital Accommodation 22 Nursing 22 Health Visitors 23 Milk—Supply to Mothers and Children 23 Ante-Natal Work 24 Infectious Diseases 25 Infectious Diseases— Summary 28 Contacts 31 Drainage Defects 31 Puerperal Fever 25 Ophthalmia Neonatorum 25 Polio-myelitis and Polio-encephalitis 26 Diarrhoea 26 Measles and German Measles 26 Whooping Cough 27 Small Pox 32 Scarlet Fever 32 Diphtheria 32 Enteric Fever 32 Erysipelas 33 Cerebro-Spinal Fever 33 Encephalitis Lethargica 33 T uberculosis— Summary 33 Battersea Dispensary 36 Contacts 37 Home and Institutional Treatment 37 Open-air School 37 Incidence 37 Localisation 39 Chicken-pox 41 Influenza 4l Rabies 43 Anthrax 43 Bacteriological Examinations 43 Deaths from Zymotic Diseases 44 7 page Sanitary Circumstances— Summary 45 Legal Proceedings 46-48 Common Lodging-houses 49 Drainage 49 Revenue Act (1903) Certificates 49 Licensed Premises Sanitary Conveniences 49 Smoke Nuisances 49 Van Dwellings 49 Water Supply 50 Rag Flock Act 50 Personal Cleansing Station 51 Disinfecting Department 51 Mortuary and Inquests 53 Rats and Mice (Destruction) Act 54 Protection of Food Supply— Unsound Food 57 Butchers' Shops 58 Cow and Slaughter-houses 58 Food Control Order 59 Sale of Food and Drugs Acts— Summary 59 Warranty Defence 61 Analyst's Reports 63 Legal Proceedings 48 Ice Cream 68 Milk Shops 68 Restaurant-Kitchens 68 Fish Shops 68 Milk and Cream Regulations 68 Factories, Workshops, Workplaces and Homework— Tabular Summary 70 Factories 71 Workshops 72 Homework 74 Bakehouses 75 Out-workers 75 Warehouses and Wharves 76 Summary of Legal Proceedings 76 Housing— Housing Problem 77 Repair of Unfit Houses 78 Insanitary Houses 80 Closing Orders 82 Unhealthy Areas 83 Increase of Rent, etc., Act, 1920 84 Statistics 84 Appendices— Table I.—Vital Statistics 89 ,, II.—Cases of Infectious Disease 90 ,, III.—Deaths (Causes and Ages) 91 ,, IV.—Infant Mortality 92 ,, V.—Deaths Registered 96 8 Summary of Vital Statistics for 1920. Area of Borough (excluding water) - 2,139 9 acres divided into three Registration Sub districts, two Parliamentary Divisions, and nine Wards. Population—Estimated 1920— For Births 166,093 For Deaths 165,664 Density 7742 Inhabited houses 24,926 Average number of persons per house 6.6 Marriages 1,644 Marriage-rate 19 8 Births 4,669 Birth-rate 281 Deaths 2,079 Death rate 12 5 Infant Mortality-rate 82 7 Deaths from Principal Infectious Diseases 188 Death-rate from ,, ,, ,, 113 CENSUS 1911. Population 167,743 Number of inhabited houses 24,321 Average number of persons per house 6 9 9 Births, Marriages and Deaths. Vital Statistics. The population of the Borough at the Census of April, 1911, was 167,743. The estimates of the population, according to the Registrar-General, of the Borough for the year 1920 are:— For the birth-rate 166,093 For the death rate 165,664 The estimated population (based upon the RegistrarGeneral's figures) for the registration sub-districts, and for each of the nine Wards is set out in the following table:— Registration Sub-District. For the purpose of the birth-rate. For the purpose of the death-rate. East Battersea 69,078 68,896 North-West Battersea 48,688 48,512 South-West Battersea 48,382 48,256 The Borough 166,093 165,664 Ward No. Ward. For the purpose of the birth-rate. For the purpose of the death-rate. 1 Nine Elms 27,107 27,037 2 Park 17,419 17,374 3 Latchmere 19,896 19,845 4 Shaftesbury 15,874 15,833 5 Church 19,186 19,137 6 Winstanley 20,048 19,996 7 St. John 8,136 8,114 8 Bolingbroke 18,312 18,265 9 Broomwood 20,115 20,063 The "birth-rate and marriage-rate population" includes all the elements of the population contributing to the birth and marriage rates. The "death-rate population," on the other hand, excludes all non-civilian males, whether serving at home or abroad. 10 The natural increase of population by excess of births over deaths during 1920 amounted to 2,590, as compared with 1,014 in 1919. In my Annual Report for 1919, it was pointed out that the estimate of the Registrar-General for the Borough was probably an under-estimate, and that, judging from the rationing returns and from the existing conditions as to housing in Battersea, it was probable that the population is at least equal to, if not greater than that enumerated at the Census of 1911. I am still of opinion that the figures supplied for 1920 are lower than the actual population. The result of the Census—due to be taken in 1921—will, however, clear up any doubt as to the correctness of the Registrar-General's estimate. Marriages. The marriages registered in Battersea during 1920 number 1,644. The marriage-rate, i.e., the number of persons married per 1,000 of the population, was 19 8. There were 1,677 marriages, and a marriage-rate of 20 2 in 1919. Births. The total number of births registered in Battersea during 1920 was 4,218, consisting of 2,120 males and 2,098 females— an excess of 22 males. The uncorrected birth-rate was therefore 25.4 per 1,000 population. The corrected number of births is obtained by adding the 528 births registered outside the Borough but relating to Battersea residents, and deducting 77 registered in the Borough but relating to non-residents. During the year, therefore, 4,669 births were registered as belonging to Battersea—2,340 males and 2,329 females (an excess of 11 males). The corrected births were 1,594 in excess of the number registered in 1919, and 1,969 in excess of the number registered in 1918. The births in the three registration sub-districts of the Borough were as follows:— Sub-district. Males. Females. Total. East-Battersea 1056 1002 2058 North-West Battersea 770 788 1558 South-West Battersea 514 539 1053 The Borough 2340 2329 4669 11 The corrected birth-rate was 28.1 par 1,000 of the population, as compared with 18'5 in 1919, 16.1 in 1918, and 17.7 in 1916. The large increase in the birth-rate for 1920, while a very satisfactory feature of the vital statistics of the Borough for the year under review, must, of course, be regarded only as a natural post-war increase which was to be anticipated. The decline, which has been steadily taking place in the birthrate of all civilised countries, will, it is to be feared, continue, notwithstanding the temporary increase, which is such a noteworthy incident of the post-war statistics of the nation as a whole The mean birth-rates in England and Wales and in London and Battersea for the quinquennia from 1877 to 1916, and the corresponding birth-rates for each subsequent year are shown in the following table:— Birth-rate per 1,000 Population. Years. England & Wales. London. Battersea. 1877-81 34•9 35•3 40•5 1882-86 33•3 34•0 40•0 1887-91 33•2 33•9 36•1 1892-96 30•1 30•6 32•4 1897-1901 29•0 29•5 30•8 1902-06 27•8 27•7 27•5 1907-11 25•5 25•5 24•8 1912-16 22•9 23•5 24•4 1917 17•8 17•9 17•7 1918 17•7 16•0 16•1 1919 18•5 18•3 18•5 1920 25•4 26•5 28•1 The following table shows the birth-rate per 1,000 of the population for each of the nine Wards of the Borough for the year 1920:— Ward. Estimated Population, 1920. Number of Births. Birth. rate. No. 1, Nine Elms 27,107 889 32•8 No. 2, Park 17,419 597 34•3 No. 3, Latchmere 19,896 541 27•2 No. 4, Shaftesbury 15,874 384 24•2 No. 5, Church 19,186 561 29•2 No. 6, Winstanley 20,048 717 35•8 No. 7, St. John 8,136 177 21•8 No. 8, Bolingbroke 18,312 429 23•4 No. 9, Broomwood 20,115 374 18•6 12 Table showing the birth-rates in the Borough and in the registration sub-districts in 1920, and for the previous decennium 1910-1919:— Birth-rate per 1,000 Population. Year. The Borough. East Battersea. North-West Battersea. South-West Battersea. 1910 23•7 26•6 30•5 14.8 1911 261 27•5 32•3 17•8 1912 25•4 28•4 28•9 17•6 1913 25•3 27•0 29•6 18•5 1914 25•7 27•9 30•9 17•2 1915 23•6 26•2 26•8 16•7 1916 21•8 23•0 25•0 16•8 1917 17•7 19•0 19•8 18•8 1918 16•1 17•7 17•8 12•0 1919 18•5 19•3 20•8 15•1 Average 1910-1919. 22•4 24•3 26•2 16•0 1920 28•1 29•8 32•0 21•8 Illegitimate Births. Of the total births registered in the Borough 'as belonging to Battersea 160 were of illegitimate children (i.e., 343 per cent.), as compared with 159 or 517 per cent. in 1919. Deaths. The total number of deaths registered in Battersea during the year 1920 was 2,393, as compared with 2,409 in 1919. Of the total deaths registered 1,206 were males and 1,187 females, showing an excess of 27 males. The crude registered death-rate for Battersea in 1920 is 14.6 per 1,000 population. This rate is, however, uncorrected, and, on analysing the 2,393 deaths registered, it is found that 700 represent deaths of non-residents. These deaths are to be deducted; but, on the other hand, there must be added 386 deaths of Battersea residents registered outside the Borough. The corrected number of deaths during 1920 is, therefore, 2,079 (1,073 males and 1,006 females), and the nett corrected death-rate 12.5 per 1,000 population as compared with 12'4 for London. 13 The following table shows the death-rates per 1,000 of the population for the Borough and the sub-districts for the ten years, 1910-1919 and the year 1920, respectively:— Death-rate per 1,000 Population. Year The Borough East Battersea North-West Battersea. South-West Battersea. 1910 11•3 11•9 13•9 8•3 1911 14•3 14•9 16•8 10•9 1912 12•2 12•8 13•5 10•1 1913 14•1 15•0 16•3 10•8 1914 13•2 14•0 14•4 10•9 1915 16•4 16•2 18•8 14•2 1916 13•9 14•5 14•7 12•4 1917 15•2 15•4 16•3 14•0 1918 18•7 19•2 20•2 16•6 1919 12.9 12.4 12.7 18.7 Average 1910-19. 14.2 14.6 15.8 12.2 1920 12.5 12.8 12.4 12.8 The death-rate per 1,000 inhabitants for each of the nine Wards is shown in the following table:— Ward. Estimated Population 1920. Number of Deaths. Deathrate. No. 1. Nine Elms 27,037 346 12.8 No. 2. Park 17,374 272 15.6 No. 3. Latchmere 19,845 228 11.5 No. 4. Shaftesbury 15,833 170 10.7 No. 5. Church 19,137 228 11.9 No. 6. Winstanley 19,996 260 13.0 No. 7. St. John 8,114 91 11.2 No. 8. Bolingbroke 18,265 232 12.7 No. 9. Broomwood 20,063 252 12.6 The position which the Borough occupies during 1920 in the Registrar-General's corrected returns among the twentynine Metropolitan Cities and Boroughs is satisfactory. The lowest mortality rate is recorded for Hampstead (9 0), and the highest for Shoreditch (15'4). There are fifteen with a higher general death-rate than Battersea. 14 Age Periods. The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1920:— Under 1 year. 1-5 5-10 10-15 15-25 25-45 45-65 65- Total. M 218 67 41 12 37 120 270 808 1,078 F 168 67 26 22 56 128 174 865 1,006 386 184 67 84 98 248 444 678 2,079 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 818 817 680 Second quarter 272 248 520 Third quarter 229 198 422 Fourth quarter 259 248 607 Deaths in Public Institutions. During 1920 the deaths of Battersea residents occurring in Public Institutions numbered 882. Of this number 516 occurred within and 366 outside the Borough. Of the total deaths in Public Institutions 494 occurred in Poor Law Institutions. Senile Mortality. During 1920 the deaths of 673 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. East Battersea 127 99 28 249 North-West Battersea 98 62 14 169 South-West Battersea 124 103 28 255 Borough of Battersea 344 264 65 673 15 The deaths over 65 in each year during the ten years 19101919 were:— 1910 510 1911 591 1912 570 1913 631 1914 604 1915 784 1916 724 1917 730 1918 730 1919 706 Aver. 1910-1919 658 1920 673 Comparative Statistics of Births, Mortality, &c. Year Mean population for year. Births. Birth Rate. Deaths. Death Rate. Zymotic Deaths. Natural Increase. 1857 15.970 582 364 343 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 18,676 680 364 399 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 2,217 132 142 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 21 5 188 2,590 *B = Population as estimated for purpose of the Birth-rate *D = Population as estimated for purpose of the Death-rate † Decrease. The years marked ... were census years. 17 Infant Mortality. During 1919 the deaths of 386 infants were registered as belonging to Battersea. The total number of births registered during the year was 4,669, giving an infant mortality rate of 82.7. A lower rate has only once been recorded, viz. in 1919, when the rate was 74T per 1,000 births. The infant mortality rates in Battersea and in London for the years which have elapsed since the formation of the Borough, as well as for the previous decennium, are set out n the following table:— Year. London. Battersea. 1891-1900 158 162 1901 148 163 1902 189 186 1903 180 185 1904 144 147 1905 129 181 1906 129 126 1907 116 115 1908 118 107 1909 108 107 1910 108 97 1901-10 126 126 1911 129 124 1912 91 88 1918 105 111 1914 104 92 1915 112 112 1916 89 84 1917 104 101 1918 108 99 1919 85 74 1920 74-9 82-7 1911-20 100 96 The infant mortality rate for the County of London was 74.9 per .1,000 births, which is lower than has hitherto been recorded. The lowest rate previously recorded was 85 per 1,000 births in 1919. 18 The distribution of the 386 infant deaths and the infant mortality rates, both for the registration sub-districts and for the wards, is shown in the following tables:— Registration Sub-Districts. Deaths of Infants under 1 year of age. Infantile Mortality per 1,000 births. M. F. TOTAL. East Battersea 105 82 187 90.9 North-West Battersea 72 55 127 81.5 South-West Battersea 41 81 72 68.4 The Borough 218 168 386 82.7 Ward. Births. Infant Deaths. Infant Mortality per 1000 births.[/##] M. F. TOTAL. 1. Nine Elms 889 48 87 85 95.6 2. Park 597 87 25 62 108.9 8. Latchmere 541 26 15 41 76.8 4. Shaftesbury 884 9 15 24 62.5 5. Church 561 28 19 47 88.8 6. Winstanley 717 29 27 56 78.1 7. St. John 177 9 7 16 90.4 8. Bolingbroke 429 15 18 28 65.8 9. Broomwood 874 17 10 27 72.2 The next table shows the incidence of mortality from the chief diseases of infancy in the first and second trimesters and the second six months of the first year of life:— 19 Certified Causes of Death. Months 0—3. Months 3—6. Months 6-12. Total. Diarrhoea and Enteritis 18 18 17 48 Prematurity 74 — — 74 Marasmus and Debility 21 8 2 81 Developmental Disease 6 2 2 10 Bronchitis 16 14 9 89 Pneumonia 19 16 21 56 Convulsions 18 2 — 15 Suffocation — — — — Measles 8 — 14 17 Whooping Cough 7 8 5 15 Tubercular Meningitis — 1 2 8 Meningitis — 1 8 4 Miscellaneous 50 10 14 74 227 70 89 886 An inspection of the above table shows that 227, or 59 per cent. of the total infant deaths during 1920, occurred during the first three months of life. Analysing the deaths during the first three months more closely—as will be seen from an inspection of Table IV. in the Appendix—11 per cent. of the total deaths occurred during the first twenty-four hours of life, while 24.6 per cent. did not survive the first week. Practically all these deaths were due to prematurity, marasmus, debility, and developmental diseases, and of the deaths at ages under four weeks the proportion due to those causes is 74 per cent. It is evident, therefore, that the greater proportion of the deaths of infants in the earlier weeks of life can be ascribed to influences which are largely pre-natal. To what extent these influences are preventable is, of course, one of the problems of maternity and child welfare work. The total infant mortality rate has fallen steadily during recent years, owing in part, no doubt to the preventive measures taken by sanitary authorities. This decrease mainly affects the other two principal groups of diseases—vie., respiratory and abdominal—which are more amenable to measures such as those that have been up to the present carried out. It should not be forgotten, also, that many of these children born suffering from the results of what are known as the " racial poisons," yet manage to survive the first year of life, only to grow up under the handicap of these inherited 20 poisons, weakly, stunted—both mentally and physically. These help to swell the ranks of the C3 population, which the medical inspection of vast numbers of men called up for military service during 1917 has shown to be such an alarming feature of the physique of the nation. The death-rate amongst illegitimate children under one year of age during 1920 was 175 per 1,000 births. 1 his is more than double the mortality rate of legitimate infants, which was 79.4. Notification of Births Act. The Notification of Births Act, 1907, was adopted throughout the Borough, and came into force early in 1908. During 1920 the number of notifications of births received was 4,259. The (corrected) number of births registered in Battersea was 4,669. The proportion of notified to registered births was, therefore, 912 per cent., compared with 95.2 in 1919 and 85.8 in 1918. There were 660 or 15.5 per cent. of the notifications made by medical practitioners, 2,223 or 52.2 per cent. by midwives, and 1,376 (32.3 per cent.) by other persons. Ninety-one still-births were notified during the year. Maternity & Child Welfare. The further development of the Maternity and Child Welfare Scheme continued to occupy the attention of the Council during 1920. The appointment of the Special Maternity and Child Welfare Committee, in November of 1919, did much to advance the progress of this most useful and farreaching feature of the Council's public health activities, and during the year the scheme included the following activities:— Maternity and Child Welfare Centres:— 1. Municipal:— (a) Latchmere Baths. (b) Battersea Tabernacle. (c) Plough Road Baths. (d) Dental Clinic (Plough Road Baths). 2. Voluntary:— (e) Battersea School for Mothers (55 Mundella Road). (f) Women's League of Service (111 Bridge Road West). 21 (g) Chislehurst Mission (St. James' Hall, Ponton Road). (h) St. Mary's Hostel for Unmarried Mothers and their children (Macaulay Road, Clapham). (i) St. Margaret's Creche and Hostel (10 and 12 Cambridge Road). For administrative purposes the Borough is sub-divided into six areas, in each of which a Maternity and Child Welfare Centre is established, either municipal or voluntary. Each Centre is presided over by a trained health visitor, and to each of them is attached a clinic, which is attended by a qualified medical woman. During the year the Council took over the Voluntary Centre at Plough Road Baths, hitherto run by the Battersea School for Mothers. This enabled the latter body to concentrate upon their Mundella Road Centre, while, at the same time, their district was enlarged by arrangement with the Medical Officer of Health. Towards the end of the year the Council had under consideration a proposal for the inclusion in their Borough Maternity and Child Welfare Scheme of the organisation at Nine Elms, conducted by a voluntary society (the Women's League of Freedom), part of whose welfare work is the provision of meals to expectant and nursing mothers and young children, as well as a Creche Hostel. It is hoped that it will be possible at an early date to link up this useful work with the Council's scheme. The proposals for the provision of an adequate midwifery service for the Borough were well advanced during the year, and in connection therewith the new Borough Maternity Hospital of twenty beds is expected to be ready for the reception of patients at the beginning of 1921.* Another useful addition to the Council's scheme was the establishment of a fully-equipped Dental Clinic at the Plough Road Centre. The clinic was opened in August, and has already proved a very greatly appreciated feature of the Maternity and Child Welfare Scheme. *The Maternity Home was opened for the admission of lying-in cases about the middle of February, 1981, the official opening ceremony taking place on the 5th March, 1921. 22 The informal arrangement for the hospital treatment of children attending the various Centres, comprised in the Council's Maternity and Child Welfare Scheme, made with the Victoria Children's Hospital, Tite Street, Chelsea, has been continued, and the Council, in view of the extended use made of the facilities granted to the patients sent from the clinics, increased their annual contribution to the funds of the hospital. It is to be hoped that a more permanent arrangement, under which one or two beds would be reserved for the use of patients from the Borough clinics, will be made with the hospital authorities. The development of the Council's scheme in this direction is bringing to light an increasing number of patients, for whom it is imperative that hospital treatment be provided. The early diagnosis and prompt surgical or other treatment, which can only be successfully and safely carried out at a well-equipped hospital, is a matter of the greatest importance, and frequently is the means of saving the little patients from permanent physical defects and their consequences. No maternity and child welfare scheme can be regarded as complete where adequate hospital facilities are not readily available. The proximity of such a well-known children's hospital, where modern surgical and medical treatment is available, is a distinct advantage to the Borough scheme. In connection with the Council's scheme, nursing attendance is now freely available, arrangements having been made with the South London District Nursing Association to provide nursing attendance at the homes of patients when required. The value of the work carried out in this direction cannot be overestimated, and the results must necessarily produce a marked effect upon the mortality rate amongst young children. During 1920 the total number of attendances made by the nurses was as follows:— Children's Diseases. Ophth. Neon. 3,886 Measles 583 Whooping Cough 278 Chicken Pox 40 Diarrhœa 28 Mumps 8 4,823 Others. Pneumonia 1,015 Influenza 705 Puerp. Fever 81 1,801 Children's Diseases 4,823 Grand Total 6,624 23 Health Visitors. The work carried out during 1920 by the Council's Health Visiting Staff, and by the Health Visitors of the voluntary organisations included in the Borough Maternity and Child Welfare Scheme, will be found summarised below:— Health Visitors' First Visits. Re-Visits. Total. Grand Total C'cil. Vol'y. C'cil. Vol'y. C'cil. Vol'y. Visits to Expectant Mothers 259 124 376 170 635 294 929 Visits to Notified Births 1876 599 4399 2196 6275 2795 9070 Visits to children aged 1-5 years 191 31 859 361 1057 392 1449 Visits to enquire into Infant Deaths 85 58 20 — 105 58 163 Visit to cases of Infectious Disease 1275 — 2827 — 4102 — 4102 Other Visits 452 50 — — 452 50 502 Totals 4145 862 8481 2727 12626 3589 16215 Health Visitors' Attendances at Maternity Centres. Council. Voluntary. Total. 736 176 912 Milk Orders The Milk (Mothers and Children) Order, 1918, and the Local Authorities (Food Control) Order (No. 1), 1918, were in force in the Borough of Battersea during the year 1920. These orders were administered mainly from the Town Hall Centre, but, in part, locally through the Council's Maternity and Child Welfare Centres, and through the Voluntary Associations' Centres linked up with the Council's scheme. The supply of milk under the Orders is not restricted to necessitous cases, but the quantity to be supplied is limited to 1½ pints daily to children under 18 months, and 1 pint daily to children from 18 months up to 5 years of age. For 24 expectant and nursing mothers the quantities allowed are at the discretion of the medical officer certifying. As was to be expected, the administration of the Milk Order threw much additional work on the staff of the Health Department. The total quantity of milk—dried and freshsupplied under the order was 77,578 lbs. of dried milk and 5,323½ pints of fresh milk, of which 15,588 lbs. of dried milk and the whole of the fresh milk were supplied to necessitous cases at an approximate cost of ,£3,330. The estimated. expenditure for the year was £350 (necessitous cases) for milk free of cost, or at reduced rates. Much time and care have been devoted to the administration of this most useful Order by the Borough Council, the value of which cannot be measured in terms of money. It is to be hoped that this most recent administrative measure will be continued by the Central Authority, and that financial considerations will not be permitted to interfere with one of the most valuable measures in connection with maternity and child welfare work which the Ministry of Health have yet sanctioned. The total number of necessitous mothers and children receiving milk under the provisions of the Orders during 1920 was 1,473. Ante Natal Work. The work carried out under this heading shows a distinct advance on that of the previous year. During the year there were 203 attendances of expectant mothers at AnteNatal Clinics (Municipal Clinics, 191; Voluntary Clinics, 12). The number of cases recorded in the books of the Municipal Clinics was 79. Of these 55 were sent in by the Council's Health Visitors, 12 were referred by local midwives, and 12 attended of their own accord. Fifteen cases were referred to hospital for more extended examination or appropriate treatment. Special attention is being directed towards this highly important feature of the Maternity and Child Welfare Scheme. Arrangements are being made to provide at the Borough Maternity Hospital a well-equipped Ante-Natal Centre, which will include provision for special cases referred from the various Centres in the Council's Scheme. There will be wards available for in-patients, as well as an out-patient department. It is expected that these arrangements will be completed early in 1921. The Mother-Craft Classes at the Centres continue to be largely attended, and the earlier pioneer efforts in this direction are now bearing fruit. The educational value of the classes 25 is seen by the increased interest taken by the mothers in the proper methods of cutting out and making up of suitable garments for the expectant mother and for her newly born infant. Many of the old prejudices and unhygienic customs are gradually giving way to this educational campaign, which must necessarily react with advantage to the health and comfort of both mothers and children. Among other matters, the question of the provision of home helps is not being overlooked. The comprehensive scheme of the Council is developing steadily and progressively under the direction of the Maternity and Child Welfare Committee, and it is confidently anticipated that by the end of 1921 the Borough Scheme will be a complete—if not model— one. In accordance with the instruction contained in the memorandum of the Ministry of Health as to contents and arrangement of annual reports of Medical Officers of Health, details of the incidence of puerperal fever, ophthalmia neonatorum, measles, whooping cough, epidemic diarrhœa, polio-myelitis, etc., are set out in this section of the report. Puerperal Fever. Thirty-one cases of puerperal fever were notified in Battersea during the year 1920, and 7 deaths were registered from the disease, giving a case-mortality of 22.6 per cent. The number of cases per 1,000 births was 6.64 in 1920, as compared with 358 in 1919; while the fatality from puerperal fever per 1,000 births was 1.5 in 1920 and 1.3 in 1919. The death-rate was 0.042 per 1,000 population. The 7 deaths from puerperal fever were distributed as follows: East Battersea, 1; North-West Battersea, 3; South-West Battersea, 3; the number of cases notified in each of the sub-districts being 12, 13 and 6, respectively. Ophthalmia Neonatorum. There were 105 cases of ophthalmia neonatorum notified in the Borough during 1920, as compared with 78 in 1919. The rate per 1,000 births was 22.5 in 1920, as compared with 25.4 in 1919. Visits are at once made, on receipt of notification, to the homes of children suffering from this serious infectious disease of the eyes. Steps are taken to see that nursing attendance is provided by arrangement with the South London District Nursing Association if the case is being treated at home. Four cases were removed to the Metropolitan Asylums 26 Board Hospital, 2 were treated in the Infirmary, and the majority of the other cases were attending as out-patients at General Hospitals. Acute Polio Myelitis and Polio Encephalitis. During 1920, one case of acute polio-myelitis was notified, and one case of polio-cncephalitis. The former was treated at home, the latter being removed to St. Thomas' Hospital. Both cases recovered. Six cases of polio-myelitis occurred in 1919, none of which were fatal. No case of polio-encephalitis was recorded during that year. Diarrhœa. Diarrhoea was not unduly prevalent in Battersea during 1920, the number of deaths recorded being 64. The deathrate was 0.39 per 1,000. The number of deaths of infants under 1 year of age from this cause (including enteritis) was 48. Special measures of precaution are taken by the Health Department to prevent epidemic diarrhœa, which is one of the chief causes of infant mortality. These measures are mainly set out in the work of the Health Visiting Staff, and include the following:— (1) Visiting of houses wherein births were notified under the Notification of Births Act, 1907, or wherein deaths have occurred from epidemic diarrhœa. (2) Distribution of leaflets setting out the danger to life from summer diarrhœa, and the precautions to be taken to prevent the contamination of food supplies (especially milk), the necessity for strict attention to domestic and personal cleanliness, the importance of ventilation, and the free admission of fresh air and sunlight to living rooms. (3) Teaching of proper feeding, especially breastfeeding, and the care and management of infants, which is carried on systematically at the Infant Welfare Centres throughout the Borough. (4) Supply of dried or fresh milk at cost price or at reduced rates or free in necessitous cases to children under 5 years and to nursing and expectant mothers. Measles and German Measles. During 1920, 1,290 cases, of measles and German measles were reported. Forty-five deaths occurred from measles, as 27 compared with 18 deaths in 1919 and 57 in 1918. The deathrates were .27, .11 and .38 for the Borough in these respective years, and .22, .08 and .42 for London. Measles and German measles were made compulsorily notifiable on January 1st, 1916, and remained so up to the end of 1919. Compulsory notification was rescinded as from the 1st January, 1920, by the Public Health (Measles and German Measles) Rescission Order, 1919. The number of cases reported from schools is not comparable with the number of notifications received during the period in which measles was notifiable. Cases of measles and German measles, when reported, are visited, and such measures of a precautionary character as are practicable are taken, especially in regard to the protection of the younger children. Nursing attendance is provided where required free of cost by the Borough Council. Whooping Cough. During 1920 there were 33 deaths registered from whooping cough in the Borough, the death-rate being 0.20. The corresponding figures for 1919 were 6 deaths and a deathrate of 0 04. The disease is not notifiable, and information as to its incidence is mainly derived from school reports. The number so reported in 1920 was 375. Precautionary measures are carried out so far as practicable; visits to the homes of children reported to be suffering from the disease are made, and advice given by the Health Visitors to the mothers, urging them to seek timely medical assistance, especially in regard to the younger children. Arrangements are also made for the provision of nursing attendance where required. 28 Notifiable Infectious Diseases. During 1920, under the Notification Clauses of the Public Health (London; Act, 1891, and the Orders and Regulations made thereunder, 1,831 cases of infectious diseases (excluding tuberculosis) were notified, including: cerebro-spinal fever, 7; acute polio-myelitis, 1; polio-encephalitis, 1; encephalitis lethargica, 6. The 2,077 cases notified during 1919 included 699 cases of measles and 100 of German measles. The compulsory notification of these diseases was rescinded as from January 1st, 1920. If the number of cases thus notified are deducted from the total of 2,077, there remain 1,278 cases notified in 1919 comparable with 1,831 notified in 1920, which therefore shows an increase of 43.3 per cent. 29 Number of Cases of Infectious Diseases Notified in Battersea. 1920. Wards. No. 1 Nine Elms. No. 2 Park. No. 3 Latchmere. No. 4 Shaftesbury. No. 5 Church. No. 6 Winstanley. No. 7 St. John. No. 8 Bolingbroke. No. 9 Broomwood. Totals. Small-pox ... ... ... ... ... ... ... ... ... ... Diphtheria and Membranous Croup 73 82 59 80 45 73 22 56 40 530 Erysipelas 13 9 9 8 12 22 3 4 9 89 Scarlet Fever 166 85 49 78 73 94 24 42 56 667 Typhoid or Enteric Fever 3 1 2 ... 3 ... ... ... 1 10 Ophthalmia Neonatorum 32 11 11 4 15 25 3 1 3 105 Puerperal Fever 6 4 1 2 4 7 3 2 2 31 Polio-myelitis ... 1 ... ... ... ... ... ... ... 1 Polio-encephalitis 1 ... ... ... ... ... ... ... ... 1 Encephalitis Lethargica 1 1 1 ... 1 1 ... ... 1 6 Cerebro-spinal Fever 2 1 2 1 ... 1 ... ... ... 7 Malaria 3 3 4 2 ... ... 1 2 6 21 Dysentery ... ... 1 ... ... ... 1 ... ... 2 Trench Fever ... ... ... ... ... ... ... ... ... ... Acute Primary Pneumonia 52 40 43 25 35 48 15 12 15 285 Acute Influenzal Pneumonia 6 15 18 3 11 8 2 5 8 76 358 253 200 203 199 279 74 124 141 1831 30 Table Showing Comparison of Prevalence of Sickness and Death from Infectious Diseases (Rates calculated per 1,000 persons on the population estimated to the middle of each year). Years. Small-pox. Erysipelas. Diphtheria and Membranous Croup. Scarlet Fever. Enteric and Continued Fever. Puerperal Fever. Cerebro-spinal Fever. Caserate. Deathrate. Caserate. Deathrate. Caserate. Deathrate. Caserate. Deathrate. Caserate. Deathrate. Caserate. Deathrate. Caserate. Death- rate 1910 0·00 0·00 0·90 0·04 1·10 0·06 2·33 0·03 1·21 0·03 0·08 0·03 0·02 0·02 1911 0·00 0·00 0·96 0·02 1·23 0·12 1·93 0·02 0·12 0·02 0·05 0·01 0·04 0·04 1912 0·00 0·00 0·79 0·02 1·25 0·10 2·54 0·03 0·12 0·01 0·03 0·005 0·00 0·00 1913 0·00 0·00 0·73 0·02 1·49 0·11 5·35 0·05 0·08 0·03 0·05 0·03 0·01 0·01 1914 0·00 0·00 0·93 0·03 1·46 0·10 5·55 0·06 0·10 0·01 0·07 0·02 0·005 0·005 1915 0·00 0·00 0·85 0·03 2·24 0·18 3·82 0·05 0·12 0·03 0·02 0·01 0·12 0·04 1916 0·00 0·00 1·20 0·01 2·01 0·17 2·01 0·04 0·14 0·01 0·3 0·04 0·14 0·03 1917 0·00 0·00 0·47 0·01 1·18 0·09 1·53 0·03 0·09 0·05 0·03 0·03 0·08 0·07 1918 0·00 0·00 0·50 0·01 1· 43 0·.15 1·64 0·03 0·04 0·00 0·01 0·01 0·06 0·05 1919 0·02 0·00 0·58 0·02 1·44 0·13 3·04 0·02 0·07 0·02 0·07 0·03 0·06 0·04 Average 1910-1919 0·002 0·00 0·79 0·02 1·48 0·12 2·97 0·036 0·21 0·02 0·05 0·02 0·05 0·03 1920 0·00 0·00 0·54 0·012 3·20 0·223 4·03 0·042 0·06 0·012 0·19 0·042 0·042 0·036 This table is recommended for use by the Society of Medical Officers of Health, as a record of "the frequency and mortality of infectious diseases in the whole district for a series of years." 31 The 1,831 cases occurred in 1,558 infected houses. Of these cases, 1,262 (i.e., 69 per cent.) were removed to hospital, and 569 (i.e., 31 per cent.) remained under treatment at home. The proportion removed to hospital in 1919 (deducting measles and German measles) was 57 per cent. Full particulars of all notifiable infectious diseases will be found in tabulated form in Table II. of the Appendix. The following table gives the drainage defects, etc., in houses in which cases of infectious disease were notified during 1919, and where inspections were found necessary:— DISEASE. No. of Houses invaded. Number showing defects as to— Percentage showing drainage defects. Percentage showing no drainage defects. Drains. Traps, fittings and appliances. Total. Diphtheria 463 15 43 58 12·5 87·5 Erysipelas 89 ... 2 2 2·2 97·8 Scarlet Fever 612 3 3 35 5·8 94·2 Typhoid 9 ... ... ... ... 100·0 Puerperal Fever 31 ... ... ... ... 100·0 Total 1204 18 77 95 7·9 92·1 Infectious Disease "Contacts." Many cases of "contacts" which were reported to the Medical Officer of Health were kept under observation in connection with various diseases as follows:— Small-pox, Plague, Dysentery, Malaria, Cerebro spinal fever, Enteric fever, Typhus, Other infectious diseases. 82 The above include civil as well as military cases. Contacts were also kept under observation in connection with cases of diphtheria in a civilian institution, viz., the St. James' Infirmary. Small-pox. There were no cases of small-pox notified in Battersea during 1920, and no deaths were registered from this disease. In a case which occurred outside the Borough, clothing had been sent to a laundry in the Borough, and steps were immediately taken to disinfect the clothing and premises thoroughly. All persons who came into contact with this soiled clothing were temporarily isolated and vaccinated. Scarlet Fever. 667 cases of scarlet fever were notified in Battersea during 1920, as compared with 484 in 1919. The case-rate per 1,000 of the population was 4.03, and 7 deaths were registered from the disease in the Borough, giving a death-rate per 1,000 population of 0.04. Of the cases notified 659 (i.e., 98.8 per cent.) were removed to hospital. Fifteen cases notified as scarlet fever were found not to be suffering from the disease. There was a greatly increased incidence of scarlet fever in London during the year, marking the commencement of one of the quinquennial waves of epidemicity which are typical of the more common infections. Diphtheria. Diphtheria was considerably more prevalent during 1920 than in the preceding year, the number of cases notified being 530, as compared with 229 in 1919. There were 516 cases (i.e., 97.4 per cent. of the total notified) removed to hospital. Thirty-seven deaths were registered from the disease in Battersea, giving a fatality of 0 22 per 1,000, as against 0.13 in 1919. The total number of houses invaded by diphtheria was 463. Twenty-nine cases notified as diphtheria and removed to hospital were found not to be suffering from the disease, and were discharged to their homes. Enterio Fever. During 1920 there were 10 cases of enteric fever notified in the Borough, as against 11 in 1919 and 6 in 1918. 33 Two deaths were registered from the disease, giving a case mortality of 20 per cent, and a death-rate per 1,000 of the population of 0 012. Erysipelas. Eighty-nine cases of erysipelas were notified during 1920, and 2 deaths were registered from the disease, as compared with 92 cases and 3 deaths in 1919. The case-mortality was 2 25 per cent., and the death-rate per 1,000 of the population was 0 012. Cerebro-Spinal Fever. During 1920 seven cases of cerebro-spinal fever (epidemic cerebro-spinal meningitis) were notified in Battersea, as compared with 9 cases in 1919 and 9 in 1918. Five cases were removed to hospital. Six of the cases ended fatally. Encephalitis Lethargica. This disease was made compulsorily notifiable on January 1st, 1919, by order of the Local Government Board. Six cases of the disease were notified in Battersea during 1920, five of which were removed to hospital. There was one death registered from this cause. Ophthalmia Neonatorum—Polio Myelitis—Puerperal Feyer. Particulars relating to cases of these compulsorily notifiable diseases will be found in the section relating to Maternity and Child Welfare (page 25 et. seq.) Tuberculosis. During 1920 there were 212 deaths from tuberculosis registered as belonging to the Borough of Battersea. Of this number 170 (i.e., 80"2 per cent.) were due to phthisis (tuberculosis of the lungs), 19 to tubercular meningitis, and 23 to other forms of the disease. The following table shows the death-rate from phthisis and other tubercular diseases in each year since 1901, and the average rates for the decennia 1901-1910 and 1911-1920:— 34 Year. Deaths from Phthisis per 100,000 persons. Deaths from other Tubercular Diseases per 100,000 persons. 1901 146 60 1902 129 44 1908 128 51 1904 139 41 1905 132 50 1906 122 48 1907 120 46 1908 119 46 1909 117 39 1910 104 30 1901-10 (aver.) 126 45 1911 129 43 1912 113 26 1913 114 32 1914 122 37 1915 143 31 1916 144 36 1917 168 25 1918 152 41 1919 107 23 1920 103 25 1911-20 (aver.) 129 32 The number of deaths from phthisis and other tubercular diseases and the death-rate per 1,000 population in each of the sub-districts are set out in the following table:— District. Phthisis. Other Tubercular Diseases. Total. No. of Deaths. Rate. No. of Deaths. Rate. No. of Deaths. Rate. East Battersea 74 1·07 17 0·25 91 1·32 Nth-West Battersea 49 1·01 13 0·27 62 1·28 Sth-West Battersea 47 0·97 12 0·25 59 1·22 The Borough 170 1·03 42 0·25 212 1·28 35 The deaths from tuberculosis were 10.2 per cent. of the total deaths. The death-rate from phthisis (the most common form of tubercular disease) was 103 in 1920. There were 498 cases of tuberculosis notified in Battersea during 1920. The number of notifications received, the number of deaths, and the death-rate from all forms of tuberculosis in each year since 1909 are shown in the following table:— Year 1909. 1910. 1911. 1912. 1913. 1914. 1915. 1916. 1917. 1918. 1919. 1920. No. of Notifications 257 166 314 542 743 616 613 565 523 601 514 498 No. of Deaths 289 252 289 233 245 267 282 287 289 289 208 212 Death-rates per 100.000 Pop. 155·3 133·9 172·3 139·0 146·3 159·6 174·1 180·0 192·6 192·6 130·6 128·0 During 1920 1,985 visits to homes where cases of tuberculosis had been notified were made by the Council's Sanitary and Health Visiting Staff, and 180 inspections were made by the Council's sanitary inspectors. The death-rate from tuberculosis is the lowest recorded during the past twenty years; the notifications in 1920 were also below the average for the previous ten years. The death-rates per 100,000 of the population from tuberculosis during the past twenty years are given in quinquennial averages in the following table:— Pulmonary. NonPulmonary. Total. 1901-1905 134·8 49·2 184·0 1906-1910 116·4 41·8 158·2 1911-1915 124·2 33·8 158·0 1916-1920 134·8 30·0 164·8 Average (20 years) 127·6 38·7 166·3 36 Sex and Age Distribution of Deaths from Tuberculosis. , 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35 45 45-55 55-65 65 upwards All ages Pulmonary m. - - 1 - 9 7 13 16 13 9 4 72 f. 3 3 1 2 10 9 21 24 9 10 6 98 Tubercular Meningitis M. 1 6 6 - - - - - - - - 13 f. 2 3 1 - - - - - - - — 6 OtherTubercular Disease M. 2 3 4 2 1 1 1 - - - - 14 f. 3 1 1 — — — 2 1 — 1 — 9 Total M. 3 9 11 2 10 8 14 16 13 9 4 99 f. 8 7 3 2 10 9 23 25 9 11 6 113 Grand Total 11 16 14 4 20 17 37 41 22 20 10 212 Battersea Dispensary for the Prevention of Consumption. The Battersea Dispensary for the Prevention of Consumption is controlled by a voluntary organisation, but is temporarily approved by the Ministry of Health as the Tuberculosis Dispensary for Battersea in the Council's Tuberculosis Scheme. The question of the control of the dispensary by the Council as the sanitary authority responsible for the administration of the Tuberculosis scheme for the Borough was still under consideration at the end of the year in connection with the renewal of the annual contract with the Dispensary Committee. The contract, at the request of the Ministry of Health, was renewed up to March 31st, 1921. The annual report of the Battersea Dispensary for the Prevention of Consumption for the year 1920 states that during the year 718 cases were referred to the dispensary for diagnosis and treatment, showing an increase of 26 cases over 1919. Ex-service men sent by the Local War Pensions Committee numbered 150. Of the 718 cases examined, 217 (i.e., 30.2 per cent.) were diagnosed as definitely tuberculous. Of the 217 definite cases 184 were adults and 33 children. Of the 184 adults 126 were insured and 58 non-insured persons. 149 were found not to be suffering from tuberculosis and were discharged. 37 Contacts. The number of contacts examined at the Dispensary during the year was 290. The Medical Officer (Dr. Macdonald) states that this most important work suffers owing, under existing circumstances, to lack of time to devote adequate attention to it. Twenty-eight "suspects" were definitely diagnosed during the year as tuberculous, and these added to the 217 new definite cases make a total of 245 cases notified, as compared with 266 during 1919. Home Treatment. During the year 159 patients received domiciliary treatment from the Dispensary Medical Officer, and 291 visits were made by him. 2,809 visits were paid by the Dispensary nurses during the year, and 971 by voluntary visitors. 218 houses were examined. Institutional Treatment. During 1920 there were 135 patients sent to Sanatoria or other Institutions, of whom 106 were insured persons. Day Sanatorium or Open Air School. The London County Council, having acquired Springwell House, Clapham Common North Side, transferred the Openair School held in Battersea Park, which had been found to be inadequate and unsuitable, to the new premises. The Medical Officer of the Battersea Dispensary for Consumption and a nurse from the dispensary supervise the health of the children attending the school. The majority of the children attending this school come from Battersea. The number on the roll is now 140, as compared with 100 at the end of 1919. Incidence of Tuberculosis. The following tables show the particulars as regards age and sex distribution of the cases notified of pulmonary and nonpulmonary tuberculosis, and the number notified in the various Wards and sub-districts respectively:— 38 Classification Age Periods. Totals. 0 to 1 l 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. Pulmonary Males — 3 15 8 19 22 43 34 29 17 3 193 Females — 2 12 14 26 14 43 43 12 5 3 174 Non-Pulmonary Males 4 8 27 12 6 3 3 - 1 — — 64 Females 3 10 18 8 3 2 8 5 4 4 2 67 Totals 7 23 72 42 54 41 97 82 46 26 8 498 Wards. Totals 1 2 3 4 5 6 7 8 9 Pulmonary 63 50 38 35 47 41 13 42 38 367 Non-Pulmonary 24 23 14 14 16 12 4 11 13 131 Totals 87 73 52 49 63 53 17 53 51 498 East Battersea. N.-W. Battersea. S.-W. Battersea. Borough. Pulmonary 164 105 98 367 Non-Pulmonary 69 33 29 131 Totals 233 138 127 498 39 Particulars are given in the table below of the localization of disease in the 498 cases notified. Localization of Disease. Pulmonary (368)— Skin, etc. (6)— Lungs 347 Skin 1 Lungs and Larynx 7 Lupus 3 Lungs and Spine 1 Skin of Neck 1 Lungs and Glands 3 Forehead and Cheek (L) 1 Pleura 3 Lungs and Brain 3 General (6)— Lungs and Skin 1 Miliary T uberculosis 2 Lungs and Peritoneum 1 General Tuberculosis 3 General T uberculosis and Meninges 1 Lungs, Hip and Spine 1 Bones (29)— Lungs and Wrist (R) 1 Legs 3 Chest (L) 1 Glands (68)— Spine 4 Glands 12 Hip 7 Mediastinum 15 Ankle and Skin 1 Cervical Glands 36 Knee 8 Mesenteric 5 Sterno - Clavicular (L Joint) 1 Abdominal (8)— Intestines 2 Elbow Joint and Sacro-Iliac (R) 1 Peritoneum 5 Ileo-cœcal 1 Foot (L) and Hand Urinary, etc. (1)— (R) 1 Fallopian Tube 1 Foot 2 Eyes (1)— Total 498 Both eyes 1 Brain, etc. (11)— Meninges 11 40 The number of notifications of tuberculosis received during the year, arranged according to source of origin, were as follows:- Classification. New Cases. Duplicates. Totals. A. 440 136 576 B. 8 4 12 C. Poor Law Institutions 12 40 52 Sanatoria 28 156 184 D. Poor Law Institutions 1 61 62 Sanatoria 9 141 150 Totals 498 538 1036 41 Non-Notifiable Infectious Diseases. Chicken pox. During 1920 there were 615 cases of chicken-pox voluntarily notified, as compared with 271 cases reported in 1919. Influenza The epidemic of influenza, which began in the late summer of 1918 and reached its height during the fourth quarter of that year, continued the first quarter of 1919, and then began to gradually decliae. There was a recrudescence of the disease in 1920, 57 deaths occurring from this cause—mainly in the first two quarters of the year. The number of deaths from the disease during 1920 are shown in the following table arranged in Wards:— Wards. Deaths from Influenza. Death-rate per 1000 Population No. 1 (Nine Elms) 8 .30 „ 2 (Park) 10 .58 „ 3 (Latchmere) 9 .45 „ 4 (Shaftesbury) 5 .32 „ 5 (Church) 5 .26 „ 6 (Winstanley) 4 .20 „ 7 (St. John) 2 .25 „ 8 (Bolingbroke) 2 .11 „ 9 (Broomwood) 12 .60 The Borough 57 .34 42 Seasonal Mortality. Period. E. N. S. Total. 1st quarter 17 5 7 29 2nd „ 9 5 8 22 3rd „ — 1 1 2 4th „ 1 2 1 4 Totals 27 13 17 57 Death-rates .39 .27 .35 .34 The next table gives the deaths from influenza, showing age and sex distribution:— Table showing Seasonal Mortality from Influenza with Age and Sex Distribution. Period. 0- 1— yr. 15— yrs. 25— yrs. 35yrs. 45— yrs. 55— yrs. 65— yrs. M. F. Total. 1st qr. M. 1 1 2 4 3 3 2 3 19 10 29 F. — 1 4 1 1 — 1 2 2nd qr. M. - 1 1 3 1 4 3 - 13 9 22 F. — — 3 — 3 1 2 — 3rd qr. M. — — — — — — 1 — 1 1 2 F. - - - - - - 1 — 4th qr. M. - - - 1 - 1 - 1 3 1 4 F. - - - - - - - 1 Totals M. 1 2 3 8 4 8 6 4 36 21 F. - 1 7 1 4 1 4 3 Grand Total 1 3 10 9 8 9 10 7 36 21 57 43 There were 77 cases of influenzal pneumonia notified during the year, compared with 131 in 1919. Twenty-two were notified in the first quarter, 35 in the second, and 3 and 17 in the third and fourth quarters respectively. The Public Health (Influenza) Regulations, 1918, and the Public Health (Influenza) Regulations (No. 2), 1918, which came into force on November 25th, 1918, were rescinded by order of the Local Government Board on May 6th, 1919. Bacteriological Examinations. During the year 1920, 1,305 bacteriological examinations of specimens sent in by medical practitioners practising in the Borough of Battersea have been made at the Clinical Research Association Laboratories at a cost of £163 14s. 1d., particulars of which are set out in the following table:— Suspected disease. Positive Results. Negative Results. Total. Diphtheria 241 808 1044 Enteric fever 3 15 18 Tuberculosis 44 199 243 Total 288 1017 1805 Rabies. There were no cases of rabies reported during the year. Anthrax. No case was notified during 1920. Information was, however, received from H.M. Medical Inspector of Factories that a man employed in the Goods Depot of the London and South Western Railway at Nine Elms Lane was suffering from this disease. The case was notified to the Medical Officer of Health for Lambeth, the man being resident in that Borough. On enquiry being made, it was found that the man, in the course of his employment, handled foreign skins and hides, and there would appear to be little doubt that the disease was contracted while engaged at his occupation. I am informed that positive evidence of the nature of the infection was found on bacteriological examination. The man ultimately recovered. I visited the depot and suggested additional precautions to those already carried out, particularly the provision of better facilities for the cleansing and disinfection of the hands of those engaged in this work. The company agreed to provide immediately additional ablutionary facilities, with a constant supply of hot water, which are now available for the use of the men employed at this depot. 44 Deaths from Zymotic Diseases. The principal zymotic diseases are smallpox, measles, scarlet fever, diphtheria (including membranous croup), whooping cough, enteric fever, and diarrhœa. The deaths from these causes in 1920 numbered 188, as compared with 95 in 1919, an increase of 98 per cent. The zymotic death-rate increased from .60 in 1919 to 1.13 in 1920. The mean death-rate from each of the principal zymotic diseases for the ten years 1900-1909 and for the ten years 1910-1919 are compared with the corresponding rates for 1919 and 1920 in the following table:— Disease. Mean Deathrate per 1000 population. Death-rate per 1000 population. Increase ( + )or decrease (- ) during 1920, over 1900 09. 191019. 1919. 1920. Previous year. Precdng 10 years. Small Pox .01 - - - - - Measles .46 .43 .11 .27 + .16 - .16 Scarlet Fever .08 .04 .02 .04 + .02 - Diphtheria .12 .12 .13 .22 + .09 + .10 Whooping Cough .37 .23 .04 .20 + .16 - .03 Enteric Fever .06 .02 .02 .01 - .01 - .01 Diarrhœa and Enteritis .66 .37 .28 .39 + .11 + .02 Total death-rate from above diseases 1.76 1.21 .60 1.13 + .53 - .08 It will be seen that, notwithstanding that the rate from the seven diseases is nearly double that of the preceding year, there is still a considerable decrease (6.6 per cent.) compared with the previous ten years. It is also worthy of note that the mean death-rate during the latter period compares very favourably with that for the ten years 1900-1909. 45 Sanitary Circumstances. SANITARY INSPECTION OF THE BOROUGH. Summary of Sanitary Operations for the Year 1920. Total Sanitary Operations 80,091 Houses supplied with water and fittings repaired 230 Number of house inspections 45,628 House to house inspections 1,739 Houses let in lodgings 89 Bakehouse inspections 295 No. of inspections 267 Bakehouse nuisances abated 58 Water Closets provided, supplied with water or supply disconnected from drinking water cisterns 120 Urinals—inspections 249 Do. altered, repaired or water laid on 105 Intimations served under Sec. 3 3,644 Cisterns covered, cleansed and repaired 151 Notices served under Sec. 4, &c. 884 Notices served under Secs. 62 & 65 1,382 Additional water supplies to upper floors 51 Complaints received & attended to 3,779 Number of premises disinfected 2,161 Keeping of animals in unfit state discontinued 45 Houses supplied with disinfectants 2,021 House drains flushed with disinfectants after infectious disease 1,742 Smoke observations 159 Certificates of disinfection granted 3,355 Overcrowding abated 12 Houses inspected and certificates granted (Sec. 48) 9 Premises improved, cleansed and repaired 2,751 Proceedings ordered by Council and Health Committee 3,692 Drains tested By smoke 703 Do. ,, water 1,349 Summonses issued 110 Drains cleansed aud repaired 258 Magisterial Orders obtained and enforced 28 Drains relaid 96 Frontage drains constructed or re-constructed 67 Factories, Workshops, &c., inspections 3,899 Soil pipes and drains ventilated 67 Sanitary conveniences provided or improvements effected in Factories & Workshops (Sec. 38) 100 Sink and rain-water pipes discon nected or repaired 314 Water Closets cleansed & repaired 498 Cesspools abolished 1 Underground sleeping rooms : Mews & Stables drained & paved 6 Use discontinued 2 Yards and forecourts paved and repaired 235 Defects remedied 6 Gipsy van inspections 55 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 18 Drains laid to new houses and tenements 9 Samples taken under the Sale of Food and Drugs Acts 1,000 Dust receptacles provided 752 Miscellaneous 2,088 Leaky house-roofs and gutters repaired 691 46 Legal Proceedings. Legal proceedings in connection with nuisances were taken by the Council in 12 cases during 1920. Particulars with regard to each case are set out below. Legal Proceedings under the Public Health (London) Act, 1891. Nature of Offence. Result of Proceedings. Nuisances at No. 15 to 25 (odd) Green Lane Nuisances having been abated, summonses withdrawn on payment of £5 5s. costs. Nuisances at Nos. 60 to 68 (even) Usk Road Nuisances having been abated, summonses withdrawn on payment of £3 3s costs. Nuisance at No. 74 Longhedge Street (a) Failing to comply with notice to abate (b) Failing to keep paved yard at ditto in proper repair (c) No water to w.c. at ditto Find £1 for each offence (£3 in all) and £10 10s. costs. Nuisance and no ashpit at No. 16 Rollo St Nuisances having been abated, dust-bin provided, and costs, £3 3s., paid, summonses withdrawn. No dust bin at No. 12 Este Road Dust-bin having been provided since issue of summons, ordered to pay 10s. costs. Nuisance at No. 9 Duffield Street Order to abate within 21 days and £1 1s. costs. Nuisance and no dustbin at No. 7 Musjid Road Order to abate nuisance within 21 days and 10s. costs. Dustbin provided since issue of proceedings. Nuisance at No. 6 Abyssinia Road Order to abate within 28 days. Nuisance and no dust-bin at No. 103 Lavender Hill Nuisance having been abated and dustbin provided, ordered to pay £1 7s. costs. Nuisance and no dust-bin at No. 20 Wroughton Road Nuisance having been abated and dust-bin provided, summonses withdrawn on payment of costs. Non-compliance with notice to provide dustbins at Nos. 36 and 55 Musjid Road Dust-bins having been provided, summonses ordered to be withdrawn on payment of £1 5s. costs. Nuisance and no sufficient dust-bin at No. 22 Sisters Avenue Dust-bin having been provided and nuisance abated, ordered to pay £1 7s. costs. 47 London County Council (General Powers) Act, 1908. Nature of Offence. Result of Proceedings. Occupier of 4a Grant Road, not observing due cleanliness in shop in which butcher's meat was deposited for sale Fined £3 and £3 3s. costs. Ditto. Fined £6 and £3 3s. costs, and given one week to pay, but warned of the consequences if a further offence occurred. Housing, Town Planning, &c., Act, 1919. Demanding or collecting rent of Nos. 20 and 22 Alfred Street without the name and address of the the Medical Officer of Health, and of the Landlord or the person directly responsible for keeping the premises fit for habitation having been inscribed in the rent book. Summonses withdrawn on payment of £2 2s. costs. The like offence in respect of No. 22 Alfred Street Summonses withdrawn on payment of £2 2s. costs. Default in payment of £229 17s. 9d. expenses incurred by the Council under section 28 in making No. 10 Arden Street, of which he was the owner, in all respects reasonably fit for human habitation Order for payment of £229 17s. 9d. and £5 5s. costs. The like default in payment of £229 3s. 5d. in respect of No. 11 Arden Street Order for payment of £229 3s 5d. The like default in payment of £217 12s. 2d. in respect of No. 18 Arden Street Order for payment of £217 12s. 2d. The like default in payment of £201 10s. 7d. in respect of No. 20 Arden Street Order for payment of £201 10s. 7d. The like default in payment of £200 3s. in respect of No. 28 Arden Street Order for payment of £200 3s. Milk Order, 1920. Knowingly selling milk to which colouring matter had been added One defendant ordered to pay £2 2s. costs. Aiding or abetting 48 Legal Proceedings under the Sale of Foods and Drugs Acts. Number of Sample. Article. Nature of Oflence, Adulteration, &c. Result of Proceedings. Extraneous Water. Fat Abstracted. Fine. Costs. 762 Milk 5.4% 30.7% £2 0 0 £1 1 0 807 „ 4.9% - Withdrawn on paying £1 1 0 851 „ 4.9% - £2 0 0 £1 1 0 (Warranty pleaded) 856 „ 7.3% - £2 0 0 £1 1 0 959 „ 10.1% - Dismissed—Warranty pleaded 883 „ 6.3% - No fine £5 5 0 884 „ 4.2% - 888 „ 8.7% - 892 „ 6.8% - 897 „ 6.3% - No fine £2 2 0 939 „ - 5.3% Withdrawn on paying £2 2 0 973 „ - 11.8% Dismissed—Warranty pleaded 997 „ 10.1% - £5 0 0 no costs or one month in default 16 Skimmed Milk 14.1% - £5 0 0 „ 17 „ 51.5% - £20 0 0 „ 30 Milk - 19.3% £5 0 0 £2 0 0 31 „ - 15.3% 32 „ - 18.0% 33 „ - 19.3% 42 „ — 14.0% £3 0 0 £1 1 0 107 Separated Milk 14.2% - £10 0 0 £3 3 0 182 „ 10.35% - £10 0 0 £3 3 0 110 Milk - 7.3% No fine £2 2 0 216 „ - 5.3% No fine £1 1 0 223 „ — 8.0% Withdrawn 226 „ - 30.66% £4 0 0 12 0 227 „ — 24.66% £4 0 0 12 0 239 „ — 5.3% Withdrawn on paying £2 2 0 248 „ — 25.3% Dismissed on defendant proving Warranty £2 2 0 310 „ 5.6% - Withdrawn on paying £1 1 0 316 ,, 6.4% — „ „ £2 2 0 352 Separated Milk 11.7% — No fine £1 1 0 353 „ 9.6% - 368 11-26% inclusive 386 „ 4.9% - Withdrawn 449 Milk - 9.3% Proceedings against Warrantor 450 „ - 14.0% 498 „ — 14.66% No fine £2 2 0 530 Separated Milk 5.6% — 5 0 602 Milk - 15.3% £1 0 0 £2 2 0 626 „ 13.4% - Dismissed—Warranty pleaded 630 Separated Milk 19.6% — No fine 14 0 650 „ 14.0% — £2 0 0 4 0 668 Milk 13.6% - £5 0 0 12 0 687 „ 9.6% - £3 0 0 12 0 711 „ 6.3% - Dismissed—Warranty pleaded 712 „ 12.0% — £5 0 0 12 0 (Warranty pleaded) - „ Giving false Warranty £2 0 0 £3 3 0 - „ „ „ £2 0 0 £3 3 0 - „ „ „ (2 summonses) Dismissed without costs — „ „ „ „ „ — „ „ „ „ „ — „ „ „ Withdrawn on Magistrate's suggestion 847 Vinegar 11.5% Extraneous Water No fine £1 1 0 849 „ 11.5% „ „ No fine £3 3 0 950 Sausages 19.831 grs. Boric Acid per lb. Withdrawn on paying £1 1 0 93 „ 30.989 „ „ „ £10 0 0 £2 2 0 49 Common Lodging Houses. The following table gives a list of the common lodging houses in the Borough:— Premises. Authorised No. of Lodgers. Whether Males or Females. 75 Falcon Road 81 Males 67 Winstanley Road 66 Females Drainage During 1920, 41 plans for the drainage of 55 new buildings, and 53 plans for the alteration and reconstruction of drains in 63 existing buildings, have been received and approved. During the year the drains of ten dwelling-houses have been reconstructed as sewers by the Council. Revenue Act, 1903. No certificate under the provisions of the above-mentioned Act was applied for during 1920. Sanitary Conveniences attached to Licensed Premises. During 1920 the number of public-house urinals under inspection was 117. In 82 instances the accommodation is accessible to the general public as well as the users of the houses, and in 35 cases the accommodation is. accessible to the customers only. As a result of the annual inspection of these conveniences 57 notices were served to remedy defects discovered. Smoke Nuisances. During the year 159 observations were made and 53 complaints received. Twenty preliminary and two statutory notices were served by the Council to abate smoke nuisances. No prosecutions were instituted. Van Dwellings The number of van dwellings in the Borough in 1920 was 51. In the following table are set out the situation and number of occupants:— 50 Situation of Vans. No. of Vans No. Occupants. M. F. Mill's Yard, adjoining 88 Sheepcote Lane 2* 2 4 Mill's Yard, adjoining 80 Sheepcote Lane 4* 3 1 Manley's Yard, Falcon Road 8 11 9 Manley's Yard, Cabul Road 21† 21 24 Mill's Yard Culvert Road 16* 20 22 * Including one shed. † Including one cottage. During the year 4 vans were found to be overcrowded, and notices were served, where necessary, to abate the nuisance. Water Supply. During 1920, 9 applications were received for certificates of water supply in accordance with Section 48 of the Public Health (London; Act, 1891. The certificates were granted in each instance. In 51 cases additional water supply to the upper floors of tenement houses, 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, were provided. Rag Flook Aot, 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. In Battersea the stuffing of bedding and furniture is carried on at 17 workshops. Rag flock is used at only 2 of these premises. During 1920, under the provisions of the Rag Flock Act, samples were taken at these 2 workshops, and submitted to the Public Analyst for the purpose of analysis. These were found to comply with the requirements of the standard laid down by the Act. The 15 remaining workshops are now using cotton flock, which is manufactured from raw cotton. In my Annual 51 Report for 1919, difficulties of administration were referred to in connection with the enforcement of the provisions of the Rag Flock Act. Personal Cleansing Station. During 1920, 4,213 children and 419 adults were cleansed at the Council's Personal Cleansing Station, Sheepcote Lane. Of the total children who attended 1,749 were suffering from scabies, a contagious skin affection due to the animal parasite known as the Acarus Scabies. The remaining 2,464 children were verminous. These children attended from the public elementary schools in the Borough by arrangement with the London County Council as Education Authority, who have entered into a contract with the Borough Council for the use of their personal cleansing station for the cleansing of children attending the Battersea public elementary schools. The treatment and cleansing of the children is carried out under the supervision of officers of the staff of the London County Council's Public Health Department, while the disinfection of the clothing and of the homes is dealt with by the Borough Council's sanitary staff. Plans and estimates for the erection of a new Personal Cleansing Station were approved by the Council, but at the end of the year the matter was still in abeyance. In view of the inadequate and otherwise unsuitable character of the premises in which this important and necessary hygienic work is at present being carried out, it is earnestly to be hoped that the Council will, at an early date, be in a position to provide better accommodation. At the request of the London County Council Education Authority, the Council agreed to provide cleansing facilities for 8,000 children per annum, an increase of 4,000 over the number in the existing contract, a corresponding addition to the contribution paid for this service being guaranteed by the London County Council. Disinfecting Department. During 1920, 2,161 premises were disinfected by the Council's Disinfecting Staff. A total of 1,640 cases of compulsorily notifiable infectious diseases was dealt with during the year. In addition to these, a large amount of disinfection was carried out in connection with non-notifiable infectious diseases, reported by school teachers and others. Verminous rooms, bedding and articles of clothing, were also dealt with. 52 Summary of Work carried out by the Disinfecting Department during 1920. Premises disinfected 2,161 Rooms disinfected 3,610 Drains flushed 1,742 Staircases disinfected 187 Schools disinfected 105 Number of articles laundered 36,507 Number of articles destroyed 942 Number of verminous persons 4,632 Number of infectious disease contacts 656 Number of Library books collected 246 Number of visits to ambulances 914 Toted Articles. Number. Weight. tons cwts. qrs. lbs. Bedding, etc. 70,547 150 16 1 6 Bedding, etc., lent 1,956 6 11 0 0 Verminous, etc., clothing 46,320 12 18 3 10 Total 118,823 170 6 0 16 53 Mortuary. Details as to the number of bodies received into the Mortuary and as to inquests held thereat are set out in the following table:— Bodies of Persons received into the Mortuary during 1920. Formerly resident in Battersea. Wandsworth. Elsewhere. Total. No. of bodies received 96 48 30 174 Post-mortem examinations held at Mortuary 57 16 11 84 Inquests held 80 47 27 154 Removed to Wandsworth for inquest 4 — 3 7 Bodies received for sanitary reasons 9 — — 9 Other bodies on which no inquest held 3 1 — 4 96 48 30 174 Verdicts at Inquests held:— Natural Causa 46 20 8 74 Accidental Death. Drowning 1 — 1 2 Burns and Scalds 3 2 — 5 Coal Gas Poisoning — 1 — 1 Falls 6 5 5 16 Run over 6 11 4 21 Other means 1 3 2 6 Open Verdict. Want of attention at birth 2 3 — 5 Suffocation 1 — — 1 Injuries (Blow or Fall) 1 — — 1 Found Dead 1 — 1 2 Found Drowned 1 — — 1 Stillborn 1 — — 1 Suicide. Cut Throat 3 — — 3 Coal Gas Poisoning 2 — 1 3 Drowning — 1 3 4 Hanging 2 1 1 4 Other Injuries 2 — 1 3 Homicide. Abortion 1 — — 1 Totals 80 47 27 154 54 Rats and Mice (Destruction) Act, 1919. This Act, which became operative on January 1st, 1919, imposes upon local authorities and occupiers of premises additional responsibilities in connection with rat repression. The Council delegated their powers under the Act to the Health Committee, who decided to appoint an Organising Officer to carry out the provisions of the Act under the direction and supervision of the Medical Officer of Health. The attention to the inhabitants of the Borough was drawn to the provisions of the Act by posters, and they were invited to co-operate with the Council in taking all practicable steps to destroy rats and to prevent their premises becoming infested. The following letter was, on the instruction of the Health Committee, sent td the occupiers of factories, warehouses and large business premises, in the Borough:— Enclosure. Dear , Rats and Mice (Destruction) Act, 1919. The Borough Council have recently engaged an experienced Organising Officer to direct measures for the destruction of rats and mice in their district under the powers conferred upon them under the Rats and Mice (Destruction) Act, 1919, and the attention of the inhabitants of the Borough has already been called to the provision of the Act by public posters. I would remind you, however, that Section 1 provides— "that any person who fails to take such steps as may, from time to time, be necessary and reasonably practicable for the destruction of rats and mice on or in any land of which he is the occupier, or for preventing such land from becoming infested with rats or mice, shall be liable, on summary conviction, to a fine not exceeding five pounds (£5), or, where he has been served with a notice under this Act requiring him to take such steps, not exceeding twenty pounds (£20)." (N.B.—The expression "land" includes any buildings and any other erection on land, and any cellar, sewer, drain or culvert in or under land). The Health Committee of the Council are now considering a scheme for administering the provision of the Act, and I am instructed to inform you that, although the liability to 55 carry out effective means to rid premises of rats rests with the occupier, they are prepared to place the services of the Organising Officer at the disposal of the inhabitants, and to provide such measures—e.g., poisons, traps, etc.—as may be required on terms to be agreed. It is hardly necessary to point out the extreme importance of securing that effective steps are taken for the extermination of these destructive vermin. Apart from the danger to public health that may arise from rats acting as carriers of dangerous disease, the damage done to food-stuffs by these rodents is most formidable, and it is estimated that the country suffers a loss in this respect of fifteen million pounds annually. If you desire to avail yourself of the facilities provided by the Council, on hearing from you to this effect I will arrange for the Organising Officer to call upon you. Enclosed will be found a scale of charges which the Committee propose to recommend the Council to adopt. Yours faithfully, Medical Officer of Health. The response to this letter was encouraging and satisfactory. Many of the principal manufacturers and business firms in the Borough readily decided to make use of the scheme which the Council had prepared, with a view to securing that the best means available for the systematic destruction of rats and mice should be at the disposal of the inhabitants generally. The scheme, it was hoped, would be self-supporting, and a scale of fees, based upon the size of the premises to be cleared of rats, was approved by the Health Committee. During 1920, 27 firms and business premises had entered into a contract with the Council for the use of the services of the Organising Rat Officer and his staff. The results obtained for the first few months' working of the scheme have been interesting and promising, and many firms have already written to the Medical Officer of Health, expressing their satisfaction at the successful methods adopted by the Organising Officer's staff. Most of the successful measures for the destruction of rats and mice were utilised by the Organising Rat Officer's staff, the most successful being poisons (mainly those harmless to man and domestic animals), traps, gas, etc. 56 Traps have also proved very efficient for the destruction of rats. Various types of traps have been used, the most successful being the break-back trap and the platform cage trap. As many as 21 rats at one time have been caught in the latter type of trap. Varnish traps have also been found very useful, but these deteriorate rapidly if kept, and were therefore found too expensive for general use. The following is a summary of the work carried out by the Rat Officer's staff during the last six months of the year 1920:— Number of contracts entered into 27 Premises visited 1,358 Number of poison bait laid 23,697 Rat runs traced to house drains 21 Traps lent out to occupiers 56 The amount of £312 14s. was paid to the Council by occupiers of factories and other premises for the services of the Organising Rat Officer's staff. A Rat Week Campaign was carried out in Battersea from 1st to 6th November, and proved very successful. During the week 18,500 poison baits were issued by the Rat Officer to householders, and from the very large number of dead rats picked up, thousands and thousands of these rodents must have been accounted for. 57 Protection of the Food Supply. Unsound Food. The following is a tabulated return of unsound food seized or voluntarily surrendered during 1920:— Food Quantity. Apples 41 cases Bacon 296¼ lbs. Baked Beans 1 tin Beef (Scotch) 25½ stone Butter 135 lbs. Chaps 1 box Cheese 56 lbs. 13 oz. Codfish 2 boxes Condensed Milk 146 tins Cooked Ham 3 10/16 lbs. Corned Beef 20 1-lb. tins 8 6-lb. tins Eels 1 box Eggs 2481 Fish Paste 1 tin Herrings 3 boxes 3 trunks Kippers 16 boxes Lard 1½ lbs. Mackerel 5 boxes Mandarins 240 Mutton 51 lbs. Peaches 3 tins Pears 6 boxes Pineapple 8 tins Pork & Beans 1 tin Potatoes 305 bags Potted Meat 4 small jars Rabbits 139 lbs. Roe 1 box Salmon 6 tins 84 1-lb. tins Sardines 1 tin Sausages 17 lbs. Sheep 3 whole Skate 1 trunk „ wings 4 stone Spaghetti 1 tin Tomatoes 55 bundles 13 boxes 12 tins 11 baskets Walnuts 3 bags Winkles 1½ bushels 1 bag Witches 1 box 58 Unsound Foreign Flour. A complaint was received from a local baker of the condition of a large consignment of Chinese flour which he had received from two wholesale firms. On investigation, this flour—a percentage of which is used with other flour in the baking of bread—was found to be both maggotty and weevilly, and, in my opinion, unfit for human food. The Food Department of the Ministry of Food was communicated with, and, at the same time, I notified the Ministry of Health, and one of their medical inspectors (Dr. Hamill) came to Battersea and inspected the flour with me. It was agreed that the flour was unfit for human food, but was capable of being used for animal feeding. Eventually, after some considerable delay and apparent reluctance to agree with the views of the Medical Officer of Health, the flour was removed and disposed of for other purposes. The quantity of flour involved amounted to 5,600 lbs. Butchers' Shops. The number of butchers' shops in the Borough is 78. These premises are usually well kept, only one serious complaint (either as to the condition of the meat sold, or to the manner in which it was kept free from risk of contamination) was reported. In that case, a man had recently opened a butchers' shop in a poor quarter of the Borough, and was doing a roaring trade in cheap mutton. The Inspector found that he had not taken steps to make the premises (sanitarily) suitable for the business. As he refused to comply with the requirements of the London County Council (General Powers) Act, 1908, when called upon to do so, proceedings were taken against him in the Police Court under that Act. He was convicted and fined. Notwithstanding the conviction and fine he continued to carry on his business without taking steps to comply with the requirements of the Act. He was again summoned, and was convicted and fined with costs. The Magistrate, at the same time, warned the defendant that if he appeared before him again he would be sent to prison. This action had the desired effect, and the premises were made fit under the supervision of the Council's Inspectors. A systematic inspection of all butchers' shops is carried out by the Food Inspector, and during the year 950 inspections were recorded. 69 } Cow houses. There is now only 1 licensed cow-house in Battersea, situate at 17 Wiseton Road. Slaughter houses. There were three slaughter-houses on the register at the end of the year, and the number of inspections carried out was 472. Food Control Order. During the year a sample of milk, purchased under the provisions of the Sale of Food and Drugs Act by the Food and Drugs Inspector, was submitted to the Public Analyst, and was reported by him to be "artificially coloured." Proceedings were ordered to be taken by the Health Committee against the vendor of the sample under the provisions of the Milk Order (Food Control), 1920. At the request of the Food Commissioner for London, to whom the case was referred by the Borough Solicitor, the proceedings were undertaken by the Council. The defendant was ordered by the Court to pay £2 2s. costs. Sale of Food and Drugs Acts. The total number of samples taken under these Acts during 1920 was 1,000. Of this number 73 (i.e., 7.3 per cent.) were certified by the Analyst to be not of the nature, substance and quality demanded by the purchaser. Five samples were, in addition, reported as beine of inferior quality. The following table gives details of the articles of which samples were procured for purpose of analysis:— 60 Description of Article. Total No. taken. Genuine. Adulterated. Inferior. Arrowroot 6 6 - - Butter 68 63 — 5 Cheese 17 17 - — Cocoa 18 18 — — Coffee 28 23 - — Cream 9 1 8 — Drugs 10 10 — — Honey 5 5 — — Lard 18 18 — — Margarine 11 11 — — Milk 717 678 39 — Milk (Evaporated) 4 4 - - Milk (Separated) 19 8 11 — Mustard 2 2 — - Oatmeal — — - - Olive Oil 4 4 - - Pepper 10 10 — - Preserved Meats, &c. 22 15 7 - Rice 15 12 3 - Sugar 6 6 — - Vinegar 16 11 5 - Totals 1,000 922 73 5 Of the samples taken the bulk, viz. 717, were of whole milk, 19 samples were of skimmed or separated milk, and four were of evaporated milk. Of the 717 whole milk samples analysed, 39 or 5.4 per cent. were certified as being adulterated. No less than 11 or 58 per cent. of the 19-skimmed or separated milk samples were certified to contain extraneous water, in one case to the extent of 51.5 per cent. Another sample, taken from the same milk vendor, showed, on analysis, 14.1 per cent. of extraneous water. The vendor was summoned in respect of these 2 samples, and of a previous sample, showing, on analysis, added water. He was convicted and fined £30. Another vendor of separated milk, from whom two samples were purchased by the Food and Drugs Inspector, 61 which were found, on analysis, to contain 14.2 per cent. and 10.35 per cent. respectively of added water, was convicted and fined £20 and £3 costs. Milk sampling was carried out on 19 Sundays during the year, and 96 samples were purchased for purposes of analysis on these occasions. Samples of milk in course of delivery to the retailers to the number of 76 ware taken during the year. The bulk of these samples were taken at Clapham Junction railway station. Twenty-three samples of milk were taken in course of delivery to public elementary schools in the Borough. Warranty Defence. Warranty as a defence was pleaded in connection with proceedings under the Sale of Food and Drugs Acts on eight occasions, and was successful in four of the cases. In one case the Magistrate was not satisfied, and the defendant was convicted and fined £2 and £1 Is. costs. In the remaining three cases the proceedings are still pending. In connection with proceedings under the Sale of Food and Drugs Acts, taken by the Wandsworth Borough Council, the Magistrate (Mr. Bankes, K.C.) referred to a similar case previously heard by him at the instance of the Battersea Council, in which he convicted the defendants, which conviction was reversed on appeal. The remarks of the Magistrate are of interest, and are set out hereunder: — I must dismiss this case. In a similar case to this I convicted, and the Sessions said I was wrong. The consequences to London are serious. Pure milk is of the utmost importance to all, particularly to children. They will not get it whilst things remain as they are. The farmer in the country warrants that his milk will arrive pure in London. He cannot, of course, see to it or control it. He cannot be convicted if he sends it off all right; that is the decision of the Sessions. The retailer cannot be convicted if he sells it as he receives it. The result is, milk with 50 per cent, of water may be sold and no conviction follow. I thought if the farmer warranted that which he could not perform he should be convicted, but the Sessions say he cannot be. If so, the position is hopeless, and the matter requires legislation. In my opinion, the Borough 62 Councils of London will never get things right till they one and all intimate that it is useless to prosecute until the law is put into a reasonable shape in this matter. I should like to add that the Vice-Chairman of the Sessions, in giving his decisions, said the case resembled that of a passenger who was not to be expected to look after his luggage and see that it was safe in transit. But I am afraid there is an analogy here which is quite unsound, as the passenger does not warrant the safety of the luggage, and if that is the ground of the decision, although I shall follow it, I do not agree with it. Two cases, in which convictions had been obtained at the Police Court, were appealed against, and the decisions were reversed at Quarter Sessions, costs being given against the Council amounting to £78 8s. 7d. The following tables and report from the Public Analyst give full information with regard to samples delivered to him for analysis and report:— 63 Articles submitted for Analysis. State whether the Sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority. Result of Analysis Showing whether the Sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Observations. First Quarter. 168 Milk Council's Inspector Genuine — 15 Milk ,, Adulterated, as understated:— ,, (1) 5•4 per cent. extraneous water and 30•7 per cent. of the required fat deficient — ,, (2) 11•3 per cent. of the required fat deficient — ,, (3) 10•3 per cent. of extraneous water "Informal sample" ,, (4) 10•1 per cent. of extraneous water — ,, (5) 10•1 per cent. of extraneous water — ,, (6) 8•7 per cent. of extraneous water — ,, (7) 7•3 per cent. of extraneous water — ,, (8) 6•8 per cent. of extraneous water — ,, (9) 6•3 per cent. of extraneous water — ,, (10) 6•3 per cent. of extraneous water — ,, (11) 6•0 per cent. of the required fat deficient — ,, (12) 5•3 per cent. of the required fat deficient — ,, (13) 4•9 per cent. of extraneous water — ,, (14) 4•9 per cent. of extraneous water — ,, (15) 4•2 per cent. of extraneous water — 12 Coffee ,, Genuine — 8 Butter ,, Genuine — 6 Lard ,, Genuine — 6 Cocoa ,, Genuine — 6 Cheese ,, Genuine — 6 White Pepper ,, Genuine — 6 Arrowroot ,, Genuine — 4 Evaporated Milk ,, Genuine — 2 Vinegar ,, Genuine — 3 Vinegar ,, Adulterated, as understated :— ,, (1) 11•5 per cent. of extraneous water — ,, (2) 11•5 per cent. of extraneous water — ,, (3) 1•0 per cent. of extraneous water — 64 Articles submitted for Analysis. State whether the Sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority. Result of Analysis Showing whether the Sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Observations. 2 Sausages Council's Inspector. Genuine 2 Sausages „ Adulterated, as understated:— „ (1) 19•831 grains of Boric Acid per pound — „ (2) 8•302 grains of Boric Acid per pound — 3 Luncheon Sausages „ Genuine — 1 Pork Brawn „ Genuine — Second Quarter. 167 Milk „ Genuine — 12 Milk „ Adulterated, as understated :— „ (1) 30•66 per cent. of the required fat deficient — „ (8) 25•3 per cent. of the required fat deficient — „ (3) 24•66 per cent. of the required fat deficient — „ (4) 19•3 per cent. of the required fat deficient — „ (5) 19•3 per cent. of the required fat deficient — „ (6) 18•0 per cent. of the required fat deficient — „ (7) 15•3 per cent. of the required fat deficient — „ (8) 14•0 per cent. of the required fat deficient — „ (9) 8•0 per cent. of the required fat deficient — „ (10) 7•3 per cent. of the required fat deficient — „ (11) 5•3 per cent. of the required fat deficient — „ (12) 5•3 per cent. of the required fat deficient — 10 Butter „ Genuine Boric Acid present (under 0•5 per cent. in each case) 1 Butter „ Genuine — 1 Butter „ Inferior Actual adulteration could not be certified 6 Preserved „ Adulterated, as understated:— Cream „ (1) 24•794 grains of Boric Acid per pound — „ (2) 23•548 grains of Boric Acid per pound — „ (3) 23•548 grains of Boric Acid per pound — 65 Articles submitted for Analysis. State whether the Sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority. Result of Analysis Showing whether the Sample was Genuine or Adulterated, and, if Adulterated, what was the nature and extent of the Adulteration. Observations. 6 Preserved Cream (cont.) Council's Inspector. (4) 23•548 grains of Boric Acid per pound — „ (5) 22•982 grains of Boric Acid per pound — „ (6) 11•97 grains of Boric Acid per pound — 1 Preserved Cream „ Genuine — 6 Lard „ Genuine — 6 Margarine „ Genuine Boric Acid present (under 0•5 per cent. in each case) 6 Coffee „ Genuine — 6 Cocoa „ Genuine — 6 Cheese „ Genuine — 1 Sausages „ Adulterated, as understated:— „ (1) 30•989 grains of Boric Acid per pound — 2 Sausages „ Genuine — 1 Veal Brawn „ Genuine — 1 Fish Paste „ Genuine — 5 Vinegar „ Genuine — 1 Vinegar „ Adulterated, as understated „ (1) 1•5 per cent. of extraneous water — 4 Olive Oil „ Genuine — 2 Separated Milk „ Adulterated, as understated:— „ (1) 14•2 per cent. of extraneous water — „ (2) 10•35 per cent. of extraneous water and artificially coloured — 2 Separated Milk „ Genuine — 2 Skimmed Milk „ Adulterated, as understated:— „ (1) 51•5 per cent. of extraneous water and artificially coloured — „ (2) 14•14 per cent. of extraneous water — 1 Luncheon Sausage „ Genuine — Third Quarter. 185 Milk „ Genuine — 5 Milk „ Adulterated, as understated:— „ (1) 14•66 per cent. of the required fat deficient — „ (2) 14•0 per cent. of the required fat deficient — 66 Article submitted for Analysis. State whether the Sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority. Result of Analysis Showing whether the Sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Observations. 5 Milk (cont.) Council's Inspector (3) 9•3 per cent. of the required fat deficient — „ (4) 6•4 per cent. of extraneous water — „ (5) 5•6 per cent. of extraneous water — 20 Butter „ Genuine — 4 Butter „ Genuine Boric Acid present (under 0•5 per cent. in each case) 2 Butter „ Inferior Actual adulteration could not be certified 6 Lard „ Genuine — 3 Separated Milk „ Genuine — 4 Separated Milk „ Adulterated, as understated:— „ (1) 11•7 per cent. of extraneous water — „ (2) 11•26 per cent. of extraneous water and artificially coloured — „ (3) 9•6 per cent. of extraneous water — „ (4) 4•9 per cent. of extraneous water — 4 Rice „ Genuine — 1 Rice „ Adulterated, as understate:— „ (1) 9•8 grains per pound extraneous mineral matter Powdered Talc. 2 Luncheon Sausage „ Genuine — 1 Luncheon „ Adulterated, as understated:— Sausage „ (1) 10•409 grains of Boric Acid per pound — 3 White Pepper „ Genuine — 1 Brawn „ Genuine 1 Brawn „ Adulterated, as understated:— „ (1) 14•875 grains of Boric Acid per pound — 2 Mustard „ Genuine — 1 Fish Paste „ Adulterated, as understated:— „ (1) 14•504 grains of Boric Acid per pound — 1 Spiced Beef „ Genuine — 1 Sausages „ Adulterated, as understated:— „ (1) 9•541 grains of Boric Acid per pound — 2 Preserved „ Adulterated, as understated:— Cream „ (1) 23•80 grains of Boric Acid per pound — „ (2) 14•126 grains of Boric Acid per pound — Black Pepper „ Genuine — 67 Articles submitted for Analysis. State whether the Sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority. Result of Analysis Showing whether the Sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Observations. Fourth Quarter. 158 Milk Council's Genuine — 7 Milk Inspector. Adulterated, as understated:— „ (1) 5•3 per cent. required fat deficient — „ (2) 13•6 per cent. of extraneous water — „ (3) 13•4 per cent. of extraneous water — „ (4) 12•0 per cent. of extraneous water — „ (5) 9•6 per cent. of extraneous water — „ (6) 6•3 per cent. of extraneous water — „ (7) 3•0 per cent. of extraneous water — 3 Separated Milk „ Genuine — 3 Separated „ Adulterated, as understated:— Milk „ (1) 19•6 per cent. of extraneous water — „ (2) 14•0 per cent. of extraneous water — „ (3) 5•6 per cent. of extraneous water — 10 Butter „ Genuine — 10 Butter „ Genuine Boric Acid present (under 0•5 per cent. in each case) 2 Butter „ Inferior Actual adulteration could not be certified. Boric Acid present 0•5 per cent. in each case 8 Rice „ Genuine — 2 Rice „ Adulterated, as understated:— „ (1) 8•4 grains of extraneous mineral matter per pound Powdered Talc. „ (2) 7•7 grains of extraneous mineral matter per pound Powdered Talc. 6 Cocoa „ Genuine — 6 Sugar „ Genuine — 5 Margarine „ Genuine Boric Acid present (under 0•5 per cent. in each case) 5 Coffee „ Genuine — 5 Honey „ Genuine — 5 Cheese „ Genuine — 4 Vinegar „ Genuine — 1 Vinegar „ Adulterated, as understated:— „ 1•0 per cent. of extraneous water — 5 Camphorated Oil „ Genuine — 5 Bicarbonate of Soda „ Genuine — Note.—The term "Genuine" means that the composition of the samples so described was in accordance with the scientific definitions which can at present be given to the various articles dealt with, and that adulteration could not be certified in regard to them. The term " Inferior " means that the samples so described were of low quality, or of doubtful character, and that actual adulteration could not be certified in regard to them. 68 Ice Cream. There are 66 premises in the Borough from which ice cream is sold. Eight of these premises were occupied by Italians, of whom 7 carried on a trade in this article of food from street barrows. During the year 366 inspections of ice cream premises and street barrows were made, and 3 notices were served to remedy insanitary defects, which were duly complied •with. Milk Shops. There are 134 premises in Battersea where milk is sold. These are kept under systematic inspection by the Council's inspector, and during the year 465 inspections were made, and 26 notices were served to remedy insanitary conditions, all of which were complied with. Restaurant-Kitchens. The total number of restaurant-kitchens and eating-houses on the register at the end of 1919 was 89. These premises were all kept under systematic inspection during the year 1920. It was found necessary to serve 18 notices to remedy 27 defects found on inspection. Fish Shops. There are 59 premises in the Borough at which fish is sold. At some of them fish alone is vended. At others fried fish, cooked on the premises, is sold, and at a few premises the curing of fish is carried on as well. All premises, where the business of a fishmonger, fried fish vendor, or fish curer is carried on, are kept under systematic inspection. During 1920, 164 inspections were carried out, and notices were served to remedy 18 defects found on inspection. Milk and Cream Regulations, 1912. All samples of milk are examined by the Public Analyst for the presence of preservatives, but in no case of the 717 samples taken was a preservative certified as being present. Owing to the high price and scarcity of cream, there has been great difficulty in obtaining samples for analysis during 1920. 69 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 717 — Cream — — 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 8 *2. Statements incorrect 1 Total 9 * In this instance the sample was labelled Preserved Cream, but no preservative was found upon analysis. (b) Determinations made of milk fat in cream sold as preserved cream:— 1. Above 35 per cent 9 2. Below 35 per cent Nil Total 9 (c) Instances where (apart from analysis) the require- 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 Nil 3. Thickening substances:— Any evidence of their addition to cream or to preserved cream and action taken when found Nil 4. Other observations (if any) Nil 70 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) 689 48 _ Workshops (including Workshop Laundries) 1,071 107 - Workplaces (other than Outworkers' premises included in the Table on page 74) 1,407 86 — Total 3,167 241 — 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 6 Nuisances under Public Health Act:— Want of Cleanliness 71 71 NIL. NIL. Want of Ventilation — — Overcrowding — — Want of drainage of floors 1 1 Other nuisances 105 105 Sanitary accommodation Insufficient 7 7 Unsuitable or defective 92 92 Not separate for the sexes 1 1 Offences under the Factory and Workshop Act :— Illegal occupation of underground bakehouse (Sec. 101) — — Lack of Special Sanitary Requirements to Bakehouses (Sees. 97 to 100) 51 51 Other Offences (excluding Offences relating to Outworkers which are included in the Table on page 74) — — Total 328 328 — — 71 3.—Registered Workshops. Workshops on Register (Section 131) at end of 1920:— Bakehouses 36 Bootmaker 37 Dressmaker 20 Laundries 4 Milliners 10 Tailors 36 Other Trades 196 Total number of workshops 339 4.—Other Matters. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Section 133) 28 Notified by H.M. Inspector Underground Bakehouses (Section 101), in use at end of the year 27 Factories and Workshops. Factories. The following is a list of the lactones on the register at the end of 1920:— Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons Barge Builder l 12 — — — Baker 48 210 31 30 33 Bootmaker 11 18 10 — — Builder 6 150 13 2 — Butter Blender 1 61 15 15 8 Chemical Works 4 221 15 65 14 Chaff & Forage 6 52 1 7 — Cycle Maker 4 7 3 — — Dyer 1 87 3 18 2 Engineer 88 527 82 31 1 Flour Mills 2 148 — 40 — Firewood Cutter 12 44 1 34 — Foundry 8 70 6 — — Lift Maker 2 16 4 2 — Mason 5 313 6 — — Mineral Water 2 22 — 18 — Motor Repairs 16 309 15 1 — Printer 17 85 21 18 2 Steam Laundry 17 77 14 511 90 Other Trades 82 4660 531 1869 657 Total 268 7034 771 2661 807 72 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. Twenty-nine new factory premises were added to the register during the year, dealing with: (a) builders, 2; (b) engineering, 11; (c) furniture, 2; (d) motor works, 5; (e) miscellaneous, 9. During the year 43 preliminary and 5 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 1920:— Trade. No. of Workshops No. of Workrooms. Persons Employed. Males. Females. Adults Young Persons. Adults. Young Persons. Baker 36 36 64 3 — — Blind maker 3 3 6 — — — Bootmaker 37 37 62 7 — — Carpenter 3 3 4 1 — — Coach builder 8 11 20 1 — — Cycle 6 6 8 2 — — Dressmaker 20 27 5 1 82 5 Embroiderer 3 4 1 — 17 3 Farrier & Smith 13 13 32 1 — — Firewood cutter 9 9 9 — 4 — Laundry 4 12 — — 14 — Mason 2 2 8 1 — — Millinery 10 12 — — 11 25 Motor repairs 14 14 57 11 — — Photographer 2 4 5 — 6 — Picture framer 1 1 2 — — — Rag sorter 18 20 50 2 34 — Saddler 4 4 7 — — — Tailor 36 39 49 2 47 — Upholsterer 10 11 14 2 10 — Other Trades 100 112 342 100 121 39 Totals 339 380 745 134 346 72 73 Fifty-five new workshops were added to the register, dealing with (a) boot-making, 2; (b) builders, 3; (c) cabinetmaking, 4 (d) dressmaking, 2; (e) fitters, 4; (/) millinery, 2; (g) motors, 7 ; (h) rag sorter, 2; (i) tailor, 5; (j) toy-making, 2 . (k) miscellaneous, 22. The following table gives particulars relating to new workshops in which "protected persons" were employed, notices of which were duly sent to H.M. Inspector during 1920:— Trade. No. of Workshops. Protected Persons employed. Women. Young Persons. Total. Bootmaker 2 — 2 2 Cycle maker 2 — 2 2 Dressmaker 4 8 — 8 Motor repairs 2 — 2 2 Tailor 5 5 1 6 Miscellaneous 13 12 19 31 Totals 28 25 26 51 74 Home Work. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Outwork in Unwholesome Premises, Sec. 103. 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 30 14 247 1 — 3 69 — — 20 20 — — — — (2) Cleansing and Washing — — — — — — — — — — — — — — — Furniture and Upholstery 1 1 3 — — — 1 — — — — — — — — Other Trades 3 1 6 — — — 3 — — — — — — — — Total 34 16 256 1 — 3 73 — — 20 20 — — — — 75 Bakehouses. There were 79 bakehouses on the register at the end of 1920. Of these 43 use power and are therefore factories. Fifty-two of the bakehouses are situated above ground, and 27 are under ground. 295 inspections were made during the year, and notices were served to remedy various defects, mostly for failure to carry out the bi-yearly limewhiting of the bakehouses within the statutory period. Out-Workers. During 1920 the names and addresses of 718 out-workers were received. 128 lists were sent in by employers and by the Medical Officers of Health of Metropolitan Borough and District Councils. The names and addresses of 130 out-workers, which were sent in by employers, were found to refer to other districts, and were accordingly forwarded to the Medical Officer of Health of these districts. The following table shows the number of out-workers premises registered in the Borough, together with the trades and the number of persons employed:— Trade. Number on Register. Persons Employed. Premises Workrooms. Males. Females. Blousemaking 10 10 — 10 Bootmaking 35 35 35 — Boxmaking 10 10 — 10 Dressmaking 25 25 — 25 Embroidery 49 49 — 52 Glovemaking 5 5 1 5 Tailoring 83 83 49 37 Underclothing 2 2 — 5 Other trades 43 43 2 44 Totals 262 262 87 188 225 new out-workers (out-workers not previously registered) were registered during the year. 76 During 1920, 732 out-workers premises were inspected. It was found necessary to serve notices under the Public Health (London) Act, 1891, in 20 cases to remedy dirty condition of premises and defective sanitary accommodation. Warehouses and Wharves. At the end of 1920 there were 44 premises on the register, including railway yards. Firty-three inspections were made, and 5 notices were served in respect of the following matters:— Accumulation of manure, Defective paving. The absence of proper ablutionary facilities for the workmen employed in the workshops of several of the large railway goods-yards in the Borough was brought to the notice of the railway companies concerned by order of the Health Committee. It is satisfactory to note that the representations of the Committee have resulted in the provision of satisfactory and adequate accommodation for the needs of the men employed by important industrial works. Summary of Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 110 cases during the year 1920:— Prosecutions. Convictions. Fines. Costs. Housing, Town Planning, &c., Act, 1919 9 £ s. d. £ s. d. — 9 9 0 London County Council (General Powers) Act, 1908 2 2 9 0 0 6 6 0 Milk Order, 1920. 2 — — 2 2 0 Public Health (London) Act, 1891, and the By-laws made thereunder 29 8 3 0 0 28 11 6 Sale of Food & Drugs Acts 68 28 98 9 0 49 9 0 Total 110 28 £110 9 0 £95 17 6 77 Housing. It cannot be said that the urgency of the Housing problem had appreciably diminished during 1920. The unsatisfactory conditions as to overcrowding and congestion—especially in the lower Wards of the Borough—referred to in the Annual Report for 1919 were still, so far as the provision of new housing is concerned, unabated. Active measures to provide new working-class houses, as far as the land available in the Borough permitted, were being undertaken by the Council; and the restrictions as to building on the vacant land on the Latchmere Estate were, after some difficulty, overcome by the insertion of a clause in the London County Council (General Powers) Bill, which passed into law on the 4th August, 1920. Up to the end of the year the new tenements, for which plans and lay-outs were prepared, or those already in course of construction, were not yet advanced enough for occupation. By far the most profitable work undertaken by the Council during the year was the repair of unfit working-class houses under the Public Health and Housing Acts, especially by means of Section 28 of the Housing Act of 1919, and the results obtained in that respect were most satisfactory. The acute condition of the housing question—the result largely of the difficulties arising out of the war—rendered it inexpedient (except in very exceptional circumstances, e.g., where the houses were empty and derelict, and the owner or owners concerned failed to render them fit for human habitation) to represent dwelling-houses to the Council for Closing Orders under Section 17 of the Housing Act, 1909. The early and vigorous application of the powers of the Council under the 1919 Housing Act was therefore carried out systematically in connection with all seriously defective house property. The work of systematic inspection of insanitary dwellinghouses, which, on the return to pre-war conditions, was begun early in the summer of 1919, and became gradually more active after the rapid survey of the housing needs of the Borough called for by the Ministry of Health on the coming into force of the 1919 Housing Act, was pushed forward with much energy and thoroughness during 1920. The Housing Committee appointed by the Council on 10th December, 1919, spared no effort to see that the powers delegated to them by the Council under the Housing Acts were utilised fully in securing that the housing conditions in their district might be, as far as possible, improved. 78 Unfortunately, the early promise which the passing into law of the 1919 Housing Act foreshadowed, as a powerful factor in remedying existing unsatisfactory conditions in regard to housing generally in the Borough, began gradually to fade away. As the year progressed, it became increasingly evident that the schema which the Housing Committee had prepared under the new powers was unlikely to materialise, at least to anything like the extent which the needs of the Borough required. The scheme outlined included provision for the erection of new working-class houses; the scheduling of groups of insanitary house property as small insanitary areas for reconstruction or improvement schemes under Section 38 of Part II. of the principal Act, with a view to the gradual clearance of slum areas; the systematic inspection of insanitary housing property in the Borough to see that all seriously defective houses, capable of being repaired, were made reasonably fit for habitation, and the raising of the less seriously defective houses to a reasonable standard of fitness for habitation. It is to be regretted that the scheme, as originally outlined, has had to be so curtailed, mainly owing, it is understood to financial considerations, rendering it impossible for the early promises made to local authorities capable of fulfilment. The result has been, so far as Battersea is concerned, that the activities of the Council in respect to their Housing proposals have had to be restricted, for the most part, to action under Section 28 of the 1919 Housing Act and the Public Health Act dealing with repairs to unfit houses. Repair of Unfit Houses. Under the Public Health and Housing Acts the systematic inspection of dwelling-houses, which had been considerably interrupted by the war, was actively resumed in 1919, and was pressed vigorously forward during 1920. The results of these house inspections were periodically submitted to the Housing and Health Committees. Seriously defective houses, or groups of houses, were dealt with by the Housing Committee under the provisions of the Housing Acts, the less seriously defective houses being referred to the Health Committee for action under the nuisance clauses of the Public Health (London) Act, 1891. For the most part, seriously insanitary houses were dealt with under the provisions of Section 28 of the 1919 Act. The housing shortage, as already stated, rendering it inexpedient and practically impossible for the Medical Officer of Health 79 to represent to the Council, except in, very exceptional circumstances, unfit dwelling-houses for Closing Orders. Notwithstanding this difficulty, very useful work was carried out in getting seriously defective houses made reasonably fit for habitation under the provisions of the 1919 Act, and reference to the Summary on page 80 et seq. will show the extent to which the powers under that Section were made use of by the Council during 1920. It is satisfactory to record that in about ninety per cent. of the houses it was found unnecessary to have to resort to the actual service of Section 28 notices, as by informal arrangement with the owners, the Housing Committee were able to secure that the requirements of the Council in respect of the repairs necessary to remedy the insanitary condition of their houses were carried out by the owners themselves. The procedure usually employed was to enter into informal negotiations with the owner or owners of houses, or groups of houses, the state of which, on inspection, was found sufficiently serious to require action being taken under the Housing Acts. As a preliminary measure, the owner was requested to submit proposals, in the form of a detailed specification, as to the steps he was prepared voluntarily to take to render the dwellinghouses in all respects reasonably fit for habitation, for the consideration of the Housing Committee. These if found, on examination, to be reasonably adequate and satisfactory were approved, and the owner was notified to that effect and requested to proceed with the work. Some difficulty was at first experienced in getting a certain type of owner of insanitary property to fall in with this informal arrangement. The service of notice under Section 28 as a last resort was, however, usually found sufficient to remove any doubt in the minds of such recalcitrant owner or owners as objected to the attitude of the Housing Committee in regard to the enforcement of the powers of the Council in relation to insanitary house property. It is only fair to state, however, that, in the main, owners of property rapidly fell into line with this informal procedure, and the fact that it was found necessary actually to serve notices under Section 28 in only about ten per cent. of the large number of houses dealt with in 1920 is sufficient evidence of the willingness of the majority of owners to fulfil their obligations in this respect. It is further satisfactory to note that even in the minority of cases where the service of notices was found necessary, the repairs (as set out in the schedule of repairs served with the notice upon the owner or owners concerned) were in most cases carried out by the owners themselves under the supervision of the sanitary inspectors. 80 It was, however, found necessary in a few instances to put into force the powers of the Council under the Section where the owner failed to comply with the requirements of the notice within the prescribed period. In such cases the Borough Surveyor was instructed to enter the premises and to carry out the repairs necessary to render the house or houses reasonably fit for habitation. In such cases the works of repair were carried out by the Council's Works Department. The total number of houses in respect of which it was considered necessary by the Council—in default of the owner, under the notice served upon him—to enter and do the works of repair, was 17. Insanitary Houses. The following is a list of streets in the Borough in which houses were found, on inspection, to be insanitary, and were dealt with by the Council under the provisions of the Housing Act of 1919, either informally or by the service of notice under Section 28 of the Act, during 1920:— Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. No. 1 District— Acre Street 2 Corunna Road 1 Portslade Road 1 Ægis Grove 21 Corunna Terrace 7 Roundell Street 1 Arden Street 17 Currie Street 1 Savona Place 7 Ascalon Street 16 Dashwood Road 58 Savona Street 1 Battersea Park Rd. 2 Everett Street 2 Sterndale Road 67 Belfour Street 1 Gonsalva Road 10 Stewarts Road 38 Bognor Street 2 Linford Street 69 Stockdale Road 74 Bramwell Street 17 New Road 19 Wadhurst Road 2 Ceylon Street 3 Patmore Street 2 William Street 26 Cherwell Street 8 Ponton Road 9 Woodgate Street 30 Total : 30 streets—514 houses. No. 2 District— Abercrombie St. 2 Gladstone Terrace 1 Palmerston Street 1 Alfred Street 45 Havelock Terrace 15 Park Grove 8 Arthur Street 38 Henley Street 4 Parkside Street 1 Austin Road 15 Kennard Street 4 Raywood Street 1 Battersea Park Rd. 3 Latidseer Street 1 Rollo Street 5 Blondel Street 1 Latchmere Street 3 Roydon Street 1 Brougham Street 31 Lockington Road 1 Sheepcote Lane 6 Chatham Street 13 Longhedge Street 3 Southolm Street 1 Culvert Road 13 Millgrove Street 1 Warsill Street 1 Gaines Cottages 2 Orkney Street 2 Weybridge Street 1 Total: 30 streets 219 houses. No. 3 District— Ashton Buildings 1 Goulden Street 2 Orville Road 3 Banbury Street Battersea Bridge 5 Gran field Street . 20 Parkham Street... 27 Green Lane 5 Radstock Street 1 Road 3 Henry Street 4 Randall Street 1 Bullen Street 2 Home Road 6 Spencer Street 1 Castle Street 1 Howie Street 18 Stanmer Street 1 Church Road 2 Hyde Lane 5 Surrey Lane 2 Elcho Street 15 Inworth Street 6 High Street 3 Freeland Street 1 Orbel Street 3 Total: 25 streets—138 houses. 81 Street. Houses dealt with. Street. Houses dealt with. Street. Houses dealt with. No. 4 District— Barmore Street 21 Ingrave Street 20 Pearson Street 2 Benfield Street 11 Kambala Road 6 Rowena Crescent 2 Cabul Road 2 Kerrison Road 7 Shillington Street 12 Candahar Road 1 Khyber Road Latchmere 2 Simpson Street 1 Creek Street 2 Stainforth Road 19 Darien Road 1 Grove 4 Thibet Street 11 Duffield Street 3 Lavender Road Lavender 15 Totteridge Road 6 Este Road 11 Urswicke Road 23 Falcon Grove 4 Terrace 3 Verona Street 3 Falcon Terrace 3 Lithgow Street 16 Wayford Street 8 Grant Road 17 Lubeck Street 9 Winders Road 1 Gwynne Road 7 Mantua Street 4 Winstanley Road 3 Harroway Road 1 Meyrick Road 24 Wye Street 8 Heaver Road 1 Musjid Road 3 Yelverton Road 32 High Street 5 Patience Road 2 York Road 4 Total: 43 streets —340 houses. No. 5 District— Acanthus Road 1 Eversleigh Road 4 Tyneham Road 1 Basnett Road 1 Grayshott Road 1 Shirley Grove 2 Beaufoy Road 1 3 Knowsley Road 3 Wickersley Road 4 Culvert Place 10 Mossbury Road 1 Wycliffe Road 78 Dorothy Road 1 Tipthorpe Road 1 Total: 14 streets—126 houses. No. 6 District— Abyssinia Road 3 Hibbert Street 11 St. John's Hill Grove 1 Aliwal Road 1 Hope Street 3 Auckland Road 1 John Street 3 Sewell Road 43 Battersea Rise 1 Knox Road 3 Speke Road 88 Brussels Road 1 Livingstone Road 78 Steelworks Road. 2 Cairns Road 3 Maysoule Road 1 Tritton Street 8 Cologne Road 1 Mendip Road 8 Usk Road 6 Darien Road 6 Newcomen Road 1 Wayland Road 7 Didcot Street 29 Oberstein Road 3 Winstanley Road 20 Grant Road 111 Plough Road 3 York Road 5 Total: 29 streets—451 houses. No. 7 District— Lavender Hill 1 house. Total: 1 street—1 house. SUMMARY. No. 1 District 30 streets 514 houses. No. 2 District *30 streets 219 houses. No. 3 District 25 streets 138 houses. No. 4 District †43 streets 340 houses. No. 5 District 14 streets 126 houses. No. 6 District ‡29 streets 451 houses. No. 7 District 1 street 1 house. Total 166 streets 1,789 houses. • Includes Battersea Park Road, also included in No. 1 District. † Includes High Street, also included in No. 3 District. ‡ Includes York, Grant, Darien, and Winstanley Roads, also included in No. 4 District. In order to cope with the increased pressure of work the staff of the Health Department was increased by the appointment of an Assistant Medical Officer and a Housing Inspector. 82 Closing Orders. During 1920, on the representation of the Medical Officer of Health under Section 17 of the Housing, Town Planning, etc., Act, 1909, the Council made Closing Orders in respect of each of the following dwelling houses:— Premises. State. Date of Order. 172-174 New Road The dwelling houses being generally dirty, damp, dilapiidated, worn out, and with defective sanitary fittings, etc. 25/2/20 74 Longhedge Street The dwelling house being generally dirty, damp, and dilapidated throughout and with defective sanitary fittings, etc. 25/2/20 15a, 16, 17, 19 & 27 Arden Street The dwelling houses being generally dirty, damp, dilapidated and worn out, and with defective sanitary fittings,etc. 25/2/20 88 Winstanley Road The dwelling house being generally dirty,damp, dilapidated and worn out,and with defective sanitary fittings, etc. 26/5/20 7 Darien Road The dwelling house being generally dirty, damp, dilapidated and worn out, and with defective sanitary fittings, etc. 26/5/20 118 Usk Road The dwelling house being generally dirty, damp and dilapidated, and with defective sanitary fittings, etc. 26/5/20 The above-mentioned dwelling-houses, with the exception of No. 74 Longhedge Street, were unoccupied when represented for Closing Orders. 83 Three dwelling-houses—Nos. 172 and 174 New Road and No. 74 Longhedge Street—were repaired and made fit in all respects for human habitation, and the Closing Orders were determined by the Council on the 23rd June and the 22nd December respectively. With regard to the dwelling-houses Nos. 16, 17, 19 and 27 Arden Street, the owners gave an undertaking to make the houses in all respects fit for human habitation. The dwelling-house No. 118 Usk Road was under repair at the end of the year, but not completed. With regard to No. 38 Winstanley Road, negotiations were being carried on with the owners with reference to the repairs. With regard to the remaining houses—Nos. 7 Darien Road and 15a Arden Street—the owners failing within the Statutory period to render them in all respects fit for human habitation, or to give an undertaking to do so, Demolition Orders were made by the Council on the 24th November and the 21th October respectively. Unhealthy Areas. A list of small areas scheduled for consideration as Unhealthy Areas under Part II. of the Housing Act, 1890, were set out in the Annual Report of the Medical Officer of Health for 1919. Six of these areas were surveyed, and were represented by the Medical Officer of Health to the Council during 1920. Resolutions adopting the report of the Housing Committee thereon were passed by the Council, who directed schemes to be prepared for improvement of the said areas under Part II. of the Housing Act of 1890. The Ministry of Health were informed of the Council's resolutions, and after several conferences and interviews with officials at the Ministry, it was suggested that the Council should begin with the Plough Road area. This area comprised houses in York Road, Plough Road, Britannia Place, Field's Place, and Holtby Place (a total of 109 dwelling houses, with an acreage of 2.39 acres, a population of 553, density 231 persons to the acre). Plans for reconstruction under a Part II. scheme were duly submitted to the Ministry, who wrote stating that consideration would be deferred pending a local enquiry. 84 Up to the end of the year no further progress had been made with this or the other areas represented to the Council and submitted to the Ministry, viz.—Didcot Street, Lothair Street, Gosling's Yard, Savona Street and Ponton Street—and it would appear that there is very little prospect of any of these schemes being proceeded with in the immediate future. Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. Under the provisions of this Act landlords are permitted to make certain increases of rents, and tenants are given an opportunity of applying to the Sanitary Authority for a certificate if the house is not in all respects reasonably fit for human habitation, or is otherwise not in a reasonable state of repair. The Act came into force on 2nd July, 1920, and up to the end of the year 19 certificates were applied for. Of this number 9 were granted, 4 not granted, and the remaining 6 cases were under consideration. Statistics for the year ending 31st December, 1920. 1. General. (a) Estimated Population— For birth rate 166,093 For death rate 165,664 (b) General death rate 12.5 per 1,000 (c) Death rate from tuberculosis 1.28 per 1,000 (d) Infantile mortality rate 82.7 per 1,000 (e) Number of dwelling houses of all classes 26,118 (f) Number of working-class dwelling houses 23,246 (g) Number of new working-class dwellings erected 9 2. Unfit Dwelling Houses. (a) Inspection— (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 5,595 (b) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 1,739 85 (c) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (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 5,433 (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 463 (C) Action under Statutory Powers— (I.) Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919- (a) Number of dwelling houses in respect of which notices were served requiring repairs 211 (b) Number of dwelling houses which were rendered fit— (i.) By owners 47 (ii.) By Local Authority in default of owners 17 (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 3,644 (b) Number of houses in which defects were remedied— (i.) By owners 3,725 (ii.) By Local Authority in default of owners Nil 86 (III.) Proceedings under Section 17 and 18 of the Housing, Town Planning, etc., Act, 1909— (a) Number of representations made with a view to the making of Closing Orders 11 (b) Number of dwelling houses in respect of which Closing Orders were made 11 (c) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit 3 (d) Number of houses in respect of which Demolition Orders were made 2 (e) Number of dwelling houses demolished in pursuance of Demolition Orders Nil 3. Unhealthy Areas. Areas represented to the Local Authority with a view to improvement schemes under (a) Part I. or (b) Part II. of the Act of 1890:- Name of Area 1 Acreage (approx). 2 No. of working class houses in area. 3 No. of working class persons to be displaced (approx.) 4 Savona Street 1.00 acre 26 192 Lothair Street .27 acres 9 52 Didcot Street .62 acres 29 156 Goslings Yard .15 acres 8 48 Ponton Street .57 acres 25 157 Plough Road 2.39 acres 109 550 Totals 5.00 acres 206 1155 4. New Houses. Number of houses not complying with the building bye-laws erected with the consent of the Local Authority under Section 25 of the Housing, Town Planning, etc., Act, 1919 9 5. Staff. Staff engaged on Housing work, with briefly the duties of each officer:— 1. Medical Officer of Health. 2. Chief Sanitary Inspector. Housing Inspector. Eight District Sanitary Inspectors. 3. Two Clerks (mainly engaged on matters relating to Housing work). APPENDICES. 89 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 1920 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 Nett Births 11 Number. 12 Rate.* 13 1914 167,338 4,080 4,303 25.7 2,470 14.4 685 432 397 92 2,217 13.2 1915 161,945 3,604 3,820 23.6 2,992 18.5 798 459 428 112 2,653 16.4 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 12.5 165,864 D.† * Rates calculated per 1,000 of estimated population. Area of District in acres (land and inland water), 2,307 acres. Total population at all ages, 167,743; number of inhabited houses, 24,321; average number of persons per house 6.9 (Census Report 1911). † B. = Registrar General's estimated population for purpose of calculating birth-rate. † D. = Do. do. death-rate. 90 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 1920. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. East Battersea. N.-West Battersea. S.-West Battersea. East Battersea. N.-West Battersea. S.-West Battersea. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 530 8 117 336 41 28 ... 272 135 123 267 133 116 Membranous Croup Erysipelas 89 2 4 9 7 56 11 33 39 17 7 6 2 Scarlet Fever 667 5 113 476 46 26 1 350 194 123 349 194 116 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 10 ... ... 3 3 4 ... 5 4 1 5 4 1 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 31 ... ... ... 6 25 ... 12 13 6 10 6 5 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever 7 2 1 2 1 1 ... 6 1 ... 5 ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 105 105 ... ... ... ... ... 52 46 7 3 1 2 Polio-myelitis, &c. 1 ... ... 1 ... ... ... 1 ... ... ... ... ... Encephalitis Lethargica 6 ... ... 4 ... 2 ... 2 3 1 2 3 ... Polio-Encephalitis 1 ... ... 1 ... ... ... 1 ... ... 1 ... ... Malaria 21 ... ... ... 5 16 ... 11 1 9 ... ... ... Dysentery 2 ... ... ... 1 1 ... ... l 1 ... ... ... Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Influenzal Pneu 76 ... 1 6 12 53 1 33 27 16 2 1 2 Acute Primary Pneu 285 43 67 43 22 83 27 139 104 42 10 6 3 Tuberculosis— Pulmonary. 367 ... 5 49 81 226 6 164 105 98 ... ... ... Non-pulmonary 131 7 18 65 14 25 2 69 33 29 ... ... ... *Totals 1,831 165 303 881 144 295 43 917 568 346 661 354 247 * The Tuberculosis figures are not included in the totals. 91 TABLE III. Causes of, and Ages at, Death during the Year 1920. causes of death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of " Residents "or" NonResidents" in Institutions in the District. All Ages. 1 Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. Enteric Fever 2 ... ... ... ... 1 ... 1 ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Measles 45 17 10 15 3 ... ... ... ... 32 Scarlet Fever 7 1 ... 2 4 ... ... ... ... ... Whooping-cough 33 15 ... 9 2 ... ... ... ... 11 Diphtheria and Croup 37 ... 4 13 16 3 1 ... ... 3 Influenza 57 1 1 ... 2 10 17 19 7 28 Erysipelas 2 ... ... ... ... ... 1 1 ... 3 Phthisis (Pulmonary Tuberculosis) 170 3 1 2 4 35 74 41 10 81 Tuberculous Meningitis 19 3 2 7 7 ... ... ... ... 7 Other Tuberculous Diseases 23 5 3 1 7 2 4 1 ... 9 Cancer, malignant disease 196 ... 1 ... ... 3 12 87 93 138 Rheumatic Fever 15 ... ... ... 8 4 3 ... ... 3 Meningitis 10 4 2 ... 1 2 1 ... ... 2 Organic Heart Disease 308 ... ... ... 6 8 21 80 193 289 Bronchitis 152 39 2 1 ... 2 7 22 79 20 Pneumonia (all forms) 147 57 9 8 2 4 15 30 22 58 Other diseases of respiratory organs 25 2 1 1 1 ... 6 5 9 10 Diarrhoea and Enteritis 64 48 6 1 1 ... 1 6 1 28 Appendicitis and Typhlitis 8 ... ... 1 3 2 1 1 ... 7 Cirrhosis of Liver 8 ... ... ... 1 ... ... 5 2 4 Alcoholism 1 ... ... ... ... ... 1 ... ... ... Nephritis and Bright's Disease 38 1 ... ... 2 1 7 15 12 24 Puerperal Fever 7 ... ... ... ... ... 7 ... ... 10 Other accidents and diseases of Pregnancy and Parturition 6 ... ... ... ... 1 5 ... ... 2 Congenital Debility and Malformation, including Premature Birth 120 118 1 ... 1 ... ... ... ... 43 Violent Deaths, excluding Suicide 57 2 4 4 11 4 11 14 7 47 Suicide 22 ... ... ... ... 1 7 12 2 4 Other Defined Diseases 498 70 7 7 19 10 46 104 235 322 Diseases ill-defined or unknown 2 ... 1 ... ... ... ... ... 1 1 Totals M. 1073 218 35 32 53 37 120 270 308 591 Totals F. 1006 168 27 40 48 56 128 174 365 595 Grand Totals 2079 386 62 72 101 93 248 444 673 1186 92 East Battersea. TABLE IV. Infant Mortality, 1920. Nett Deaths from stated causes at various ages under 1 year. causes of death. age periods. Under 24 hrs. 1 day-1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 8 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. 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 ... 2 ... ... ... 1 1 3 2 7 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 1 1 4 2 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Miliary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... 3 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 1 ... 3 1 Convulsions ... ... 1 2 1 ... 1 1 ... 1 3 4 1 ... ... 1 ... ... ... ... 4 5 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... 1 ... ... 1 1 ... 1 1 3 1 6 4 3 5 ... 2 1 13 13 Pneumonia, all forms ... 1 ... ... ... ... 1 1 1 ... 2 2 5 3 5 2 3 1 2 4 17 12 Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... 1 ... 4 Enteritis ... ... ... ... 1 ... ... ... 1 ... 2 ... 2 4 4 1 ... 3 2 ... 12 8 Gastritis ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 2 ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 2 2 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Lack of Care ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Atelectasis & Asphyxia Neon 3 3 1 1 ... ... ... ... ... ... 4 4 ... ... ... ... ... ... ... ... 4 4 Congenital Malform ations 1 ... 1 ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... ... ... 3 ... Premature Birth 8 3 5 7 2 1 1 ... ... ... 16 11 1 2 1 ... ... ... ... ... 18 13 Congenital Debility ... ... ... 1 ... ... 1 ... ... 1 1 2 4 2 1 2 2 ... ... ... 8 6 Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... 1 ... ... 1 ... ... ... ... 1 1 1 ... ... ... ... 1 ... ... 2 2 Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 12 8 9 13 4 2 7 3 2 3 34 29 18 18 19 14 18 11 16 10 105 82 Totals 20 22 6 10 5 63 36 33 29 26 187 Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1980 78 2058 178 9 187 93 North-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1920. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hrs. 1 day-1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months 8 under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths, under 1 year. 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 2 1 1 2 3 Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... 1 ... ... ... 1 2 4 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... 1 ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... ... 2 1 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 2 1 ... ... ... 5 3 Pneumonia, all forms ... ... 1 ... ... ... 1 ... ... ... 2 ... 3 2 5 1 3 2 2 2 15 7 Congestion of Lungs ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... 2 1 Enteritis ... ... ... ... ... 2 ... ... 1 ... 1 2 3 1 3 ... ... 1 ... 3 7 7 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... 1 3 1 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth 1 ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 Lack of Care 1 2 ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... 1 2 Atelectasis & Asphyxia Neon. 2 2 3 ... ... ... ... ... ... ... 5 2 1 ... ... ... ... ... ... ... 6 2 Congenital Malformations ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Premature Birth 5 3 6 6 1 ... ... 3 1 1 13 13 3 1 ... ... ... ... ... ... 16 14 Congenital Debility 1 ... ... ... ... ... ... 1 ... ... 1 1 4 1 ... 3 ... ... ... ... 5 5 Icterus Neonatorum ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Accidental Death ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 2 Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Totals 10 7 11 7 1 2 1 4 4 2 27 22 21 9 15 9 5 7 4 8 72 55 17 18 3 5 6 49 30 24 12 12 127 Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1505 53 1558 117 10 127 94 South-West Battersea. TABLE IV.—(contd.) Infant Mortality, 1920. Nett Deaths from stated causes at various ages under 1 year. causes of death. age periods. Under 24 hrs. 1 day-1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. M . F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... 1 2 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Abdominal culosis ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 1 2 Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tubercutions) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... ... ... ... ... ... ... 3 ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 1 ... ... ... ... 2 3 Pneumonia, all forms ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... ... 1 1 ... 5 1 Congestion of Lungs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Enteritis& Dyspepsia ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... 1 1 ... 1 ... ... 4 2 Gastritis ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 Syphilis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 1 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, over-¬lying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lack of Care ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Atelectasis & Asphyxia Neon ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Congenital Malformations ... ... 1 ... ... ... ... ... ... ... 1 ... 2 1 ... ... ... 1 ... ... 3 2 Premature Birth 1 3 3 4 ... ... ... 1 ... ... 4 8 2 ... ... ... ... ... ... ... 6 8 Congenital Debility ... ... ... 1 ... ... 1 ... ... ... 1 1 ... 2 2 ... ... ... ... ... 3 3 Icterus Neonatorum ... ... 1 ... ... 1 ... ... ... ... 1 1 1 ... ... ... ... ... ... ... 2 1 Other Causes ... ... 1 1 1 ... ... ... ... 1 2 2 ... ... 1 1 3 ... ... ... 6 3 1 4 7 6 1 1 1 1 2 2 12 14 14 8 9 5 3 3 3 1 41 31 Totals 5 13 2 2 4 26 22 14 6 4 72 Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1024 29 1053 63 9 72 95 Borough of Battersea. TABLE IV.—(contd.) Infant Mortality, 1920. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. % of Total. AGE PERIODS. Under 24 hrs. 1 day-1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under 9 months. 9 months & under 12 months. Total Deaths under 1 year. 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 4.40 ... ... ... ... ... ... 1 ... ... ... 1 ... 2 ... ... ... 2 3 6 3 11 6 Scarlet Fever .26 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Whooping-cough 3.89 ... ... ... ... ... ... ... ... ... ... ... ... 4 3 1 2 1 1 1 2 7 8 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza .26 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Miliary Tuberculosis .78 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... 3 Tuberculous Meningitis .78 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 2 Abdominal Tuberculosis 1.04 ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... 1 ... ... ... 2 2 Other Tuberculous Diseases .26 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Meningitis (not Tuberculous) 1.04 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 1 ... 3 1 Convulsions 3.89 ... ... 2 2 1 ... 1 1 1 1 5 4 3 1 1 1 ... ... ... ... 9 6 Laryngitis .26 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Congestion of Lungs .26 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Bronchitis 10.10 ... ... ... 1 ... ... 1 1 ... 1 1 3 2 9 9 6 6 ... 2 1 20 19 Pneumonia (all forms) 14.76 ... 1 1 ... ... ... 2 1 1 ... 4 2 9 5 13 3 6 4 5 6 37 20 Diarrhœa 2.07 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 ... 1 1 2 2 6 Enteritis 10.36 ... ... ... ... 1 2 ... ... 3 ... 4 2 7 5 8 2 2 5 2 3 23 17 Gastritis 1.04 ... ... ... ... ... ... 1 ... ... 1 1 1 1 ... ... ... ... ... 1 ... 3 1 Syphilis 2.59 ... ... ... ... ... ... ... ... ... ... ... ... 4 1 1 1 ... ... 1 2 6 4 Rickets .52 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 2 ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth .78 1 ... ... 2 ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... 1 2 Lack of Care 1.29 1 4 ... ... ... ... ... ... ... ... 1 4 ... ... ... ... ... ... ... ... 1 4 Atelectasis & Asphyxia Neon 4.40 5 5 5 1 ... ... ... ... ... ... 10 6 1 ... ... ... ... ... ... ... 11 6 Congenital Malformations 2.33 1 ... 2 ... ... ... ... ... ... ... 3 ... 2 1 2 ... ... 1 ... ... 7 2 Premature Birth 19.42 14 9 14 17 3 1 1 4 1 1 33 32 6 3 1 ... ... ... ... ... 40 35 Atrophy & Debility 7.77 1 ... ... 2 ... ... 2 1 ... 1 3 4 8 5 3 5 2 ... ... ... 16 14 Icterus Neonatorum 1.04 ... ... 1 ... ... 1 ... ... 1 ... 2 1 1 ... ... ... ... ... ... ... 3 1 Nephritis .26 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Accidental Death .52 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 2 Other Causes 3.63 ... ... 2 1 1 1 ... ... ... 1 3 3 1 ... 1 1 3 2 ... ... 8 6 Totals 23 19 27 26 6 5 9 8 8 7 73 65 53 35 43 28 26 21 23 19 218 168 42 53 11 17 15 138 88 71 47 42 386 Percentage of Total ... 10.88 13.73 2.85 4.40 3.89 35.75 22.80 18.39 12.18 10.88 100.00 Males 56.48 % Females 43.52 % Nett Births in the year. Nett Deaths in the year (Infants under 1 year.) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. M. 2263 77 2340 202 16 218 F. 2246 83 2329 156 12 168 Totals 4509 160 4669 358 28 386 96 97 TABLE V. Deaths Registered from all Causes for the Year 1920. Cause of Death. AGES. Registration District. Sex. 0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. E. N.W. S.W. M. F. M. F. M. F. M. F. 1.—General Diseases. 1. Enteric Fever ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 ... 1 ... ... 1 ... 1 1 2. Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3. Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5. Small Pox— (a) Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Not Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Doubtful ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Measles 17 10 15 3 ... ... ... ... ... ... ... ... ... 45 14 11 7 6 3 4 24 21 7. Scarlet Fever 1 ... 2 4 ... ... ... ... ... ... ... ... ... 7 2 3 1 1 ... ... 3 4 8. Whooping Cough 15 7 9 2 ... ... ... ... ... ... ... ... ... 33 10 6 7 7 1 2 18 15 9. (a) Diphtheria ... 4 13 11 5 3 ... 1 ... ... ... ... ... 37 4 13 3 7 5 6 12 25 (b) Membranous Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10. Influenza 1 1 ... ... 2 10 9 8 9 10 5 2 ... 57 20 7 5 8 11 6 36 21 11. Miliary Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12. Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13. Cholera Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14. Dysentery ... ... ... ... ... ... ... ... ... l ... ... ... 1 ... ... 1 ... ... ... 1 ... 15. Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16. Yellow Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17. Leprosy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18. Erysipelas ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... 1 ... 1 ... ... ... 2 19. (a) Mumps ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Varicella ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (d) Other Epidemic Diseases included under 19 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carried forward 34 22 39 20 7 14 9 10 11 11 5 2 ... 184 50 42 24 30 21 17 95 89 20. (a) Pyæmia 1 ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 1 ... ... ... ... 1 1 (b) Septicaemia ... ... 2 ... 1 ... 1 ... 1 ... 1 ... ... 6 1 ... 1 3 ... 1 2 4 (c) Vaccinia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21. Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22. Anthrax (Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 23. Rabies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 24. Tetanus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25. Mycoses ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26. Pellagra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27. Beri-Beri ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28. (a) Pulmonary Tuberculosis ... 1 1 2 1 30 31 34 20 17 3 4 ... 144 30 37 18 21 16 22 64 80 (4) Phthisis (not defined as Tuberculosis) ... ... ... ... ... 4 2 6 2 2 2 1 ... 19 4 ... 2 5 1 7 7 12 29. (a) Acute Phthisis ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 (b) Acute Miliary Tuberculosis 3 ... ... ... ... 1 1 ... ... ... ... ... ... 6 ... 3 ... 2 1 ... 1 5 30. Tuberculous Meningitis 3 2 7 7 ... ... ... ... ... ... ... ... ... 19 5 3 5 4 3 ... ... 6 31. (a) Tabes Mesenterica 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... (b) Other peritoneal and intestinal tubercle 3 3 ... ... 2 ... 2 ... ... 1 ... ... ... 11 4 2 ... 1 1 3 5 6 32. Tuberculosis of Spinal Column ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... 33. Tuberculosis of Joints ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 34. (a) Lupus ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 (b) Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Tuberculosis of other Organs ... ... ... ... ... ... l ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1.. ... 35. Disseminated Tuberculosis 1 ... 1 4 ... ... 1 ... ... ... ... ... ... 7 2 1 2 ... 2 ... 6 1 36. Rickets, Softening of Bones 2 3 ... ... ... ... ... ... ... ... ... ... ... 5 2 1 2 ... ... ... 4 1 37. Syphilis 10 ... ... ... ... ... ... ... 1 1 ... ... ... 12 4 2 3 1 1 1 8 4 38. Other Venereal Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 39. Cancer of the Buccal Cavity ... ... ... ... ... ... ... ... 1 5 4 3 ... 13 7 1 5 ... ... ... 12 1 40. „ Stomach, Liver, &c. ... ... ... ... ... ... 1 2 11 23 18 7 1 63 16 8 12 4 15 8 43 20 41. „ Peritoneum, Intestines, and Rectum ... ... ... ... ... ... ... 2 4 9 16 8 2 41 10 10 3 4 4 10 17 24 42. „ Female Genital Organs ... ... ... ... ... ... ... 1 5 4 3 1 ... 14 ... 6 ... 5 ... 3 ... 14 43. „ Breast ... ... ... ... ... ... ... 3 5 3 5 3 ... 19 ... 7 ... 3 ... 9 ... 19 44. „ Skin ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 2 ... ... ... ... ... 2 ... 45. „ Cancer of other or unspecified Organs ... 1 ... ... ... 3 ... 2 3 14 17 3 1 44 13 3 7 6 14 1 34 10 Carried forward 58 32 51 34 12 54 48 62 64 90 75 33 4 617 151 127 84 91 82 82 317 300 98 99 Deaths Registered from all Causes for the Year 1920—continued. Causes of Death. AGES. Registration Districts. Sex. 0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. E. N.W. S.W. m F. M. F. M. F. M. F. 46. Other Tumours (situation undefined) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 47. Rheumatic Fever ... ... ... 7 1 4 ... ..3 ... ... ... ... ... 15 2 3 2 4 ... 4 4 11 48. (a) Chronic Rheumatism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Osteo-Arthritis ... ... ... ... ... ... ... ... ... ... 5 2 2 9 ... 1 1 3 ... 4 1 8 (e) Gout ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... ... ... ... 2 ... 2 ... 49. Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 50. Diabetes ... ... ... ... 1 2 1 1 3 2 6 ... ... 16 1 2 1 2 6 4 8 8 51. Exophthalmic Goitre ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 52. Addison's Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 53. (a) Leucocythæmia ... ... 1 1 ... ... ... 1 ... ... ... ... ... 3 ... 1 2 ... ... ... 2 1 (b) Lymphadenoma ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 1 ... ... ... 1 ... 2 ... 54. Anaemia, Chlorosis ... ... ... ... ... ... ... 1 2 4 1 ... ... 8 ... 3 ... 1 3 1 3 5 55. (a) Diabetes Insipidus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Purpura ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Haemophilia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (d) Other General Diseases ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... 56. Alcoholism (acute or chronic) ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... 57. (a) Occupational Lead Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Non-occupational Lead Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 58. Other Chronic Occupational Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 59. Other Chronic Poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2.—Diseases of the Nervous System and of the Organs of Special Sense. 60. Encephalitis ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... 1 ... 1 61. (a) Cerebro-Spinal Fever 2 1 ... 1 ... 1 ... 1 ... ... ... ... ... 6 3 2 1 ... ... ... 4 2 (b) Posterior Basal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Meningitis, other forms 2 1 ... ... ... l ... ... ... ... ... ... ... 4 3 ... ... ... ... 1 3 1 62. Locomotor Ataxy ... ... ... ... ... ... ... ... 2 1 ... ... ... 3 1 ... 1 ... 1 ... 3 ... Carried forward 62 34 52 43 14 62 49 74 73 98 87 35 6 689 163 139 92 101 96 98 351 338 63. (a) Other Diseases of the Spinal Cord ... ... ... ... ... ... ... ... ... 2 2 2 ... 6 4 ... 1 ... 1 ... 6 ... (b) „ „ included under 63 ... ... ... ... ... 1 1 1 2 4 1 ... ... 10 3 4 1 ... 1 1 5 5 64. (a) Apoplexy ... ... ... ... ... ... ... ... ... 2 4 5 ... 12 ... 2 1 1 4 4 5 7 (b) Serous Apoplexy& Œdema of Brain ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Cerebral Congestion ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... ... ... 1 (d) Cerebral Atheroma ... ... ... ... ... ... ... ... 1 ... ... 1 1 3 ... ... ... 2 1 ... 1 2 (e) Cerebral Haemorrhage ... ... ... ... ... 1 ... l 11 12 25 10 3 63 10 13 12 6 8 15 30 33 65. Softening of Brain ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 ... 1 ... 66. (a) Hemiplegia ... ... ... ... ... ... ... ... ... ... ... 3 ... 5 2 ... 1 1 ... 1 3 2 (b) Paraplegia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 (c) Other forms of Paralysis ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... 1 ... 67. General Paralysis of the Insane ... ... ... ... ... ... 2 7 2 1 ... ... ... 12 5 1 3 ... 1 2 9 3 68. Other forms of Mental Alienation ... ... ... ... ... ... ... 1 ... ... 2 1 ... 4 ... ... 1 ... l 2 2 2 69. Epilepsy ... ... ... 1 ... ... 1 1 1 ... 1 ... ... 5 ... 1 ... 3 ... 1 ... 5 70. (a) Convulsions (Epileptiform, 5 yrs. and over) ... ... ... ... ... ... ... ... l ... ... ... ... 1 1 ... ... ... ... ... 1 ... (b) ,, (others 5 yrs. and over) ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... 71. (a) InfantileConvulsions(withteething) ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 1 ... ... 1 1 (b) Other Infantile Convulsions 15 ... ... ... ... ... ... ... ... ... ... ... ... 15 4 5 2 1 3 ... 9 6 72. Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 73. (a) Hysteria, Neuralgia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Neuritis ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... ... ... ... ... 1 74. (a) Idiocy; Imbecility ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Cretinism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Cerebral Tumour ... ... 1 ... ... 2 l ... ... 1 1 ... ... 6 3 ... 1 1 1 ... 5 1 (d) Other Diseases of the Nervous System ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... l 75. Diseases of the Eyes and Annexa ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... l 76. (a) Mastoid Disease ... 1 1 1 2 1 2 ... ... ... ... ... ... 8 ... 4 1 2 ... 1 1 7 (b) Other Diseases of the Ears ... ... l l ... ... ... 1 1 ... ... ... ... 4 ... ... 2 1 1 ... 3 1 3.—Diseases of the Circulatory System. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 77. Pericarditis ... ... ... ... 2 ... ... ... ... ... ... ... 1 3 1 ... ... ... 2 ... 3 ... 78. (a) Acute Myocarditis ... ... ... ... ... ... 1 1 1 ... ... ... ... 3 1 1 1 ... ... ... 2 1 (b) Infective Endocarditis ... ... ... ... ... 2 ... 1 ... ... ... ... ... 4 ... 2 ... 2 ... ... ... 4 (c) Other Endocarditis ... ... ... ... ... ... 1 1 1 ... ... ... ... 3 ... 1 2 ... ... ... 2 1 79. (a) Valvular Disease ... ... ... 1 3 7 4 9 17 30 26 15 ... 112 24 23 19 12 18 16 61 51 (b) Fatty Degeneration of the Heart.. ... ... ... ... ... ... ... 1 ... 2 3 2 ... 8 2 3 1 ... ... 2 3 5 (c) Other Organic Disease of the Heart ... ... ... ... 2 1 3 4 9 22 67 62 18 188 32 44 25 28 28 31 85 103 80. Angina Pectoris ... ... ... ... ... ... ... ... 1 1 2 ... ... 4 1 1 ... ... 2 ... 3 1 Carried forward 77 36 56 47 25 77 65 104 123 175 223 139 30 1177 257 246 168 62 169 175 594 583 100 101 Deaths Registered from all Causes for the Year 1920—continued. Causes of Death. AGES. Registration Districts. Sex. 0 to 1 1 t0 2 2 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. E. n.w. s.w. M. F. M. F. M. F. M. F. 81. (a) Aneurysm ... ... ... ... ... ... ... ... 1 1 ... 1 ... 3 1 ... ... ... 2 ... 3 ... (b) Arterial Sclerosis ... ... ... ... ... ... ... 1 2 3 15 9 1 31 8 5 2 2 8 6 18 13 (c) Other Diseases of the Arteries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 82. (a) Cerebral Embolism and Thrombosis 1 ... ... ... ... ... ... 1 ... 1 1 1 1 6 2 1 ... 1 ... 2 2 4 (b) Other Embolism and Thrombosis ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 83. (a) Phlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Varices, Hæmorrhoids, &c. ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... 1 ... 84. (a) Status Lymphaticus 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... (b) Other Diseases of the Lymphatic System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 85. (a) Functional Disease of the Heart ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... 1 ... (b) Epistaxis ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... ... ... 1 4 —Diseases of the Respiratory System. 86. Diseases of the Nasal Fossæ ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 87. Diseases of the Larynx— (a) Laryngismus Stridulus ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... l ... (b Laryngitis 1 ... ... ... ... ... 1 ... ... ... ... ... ... 2 1 ... ... ... 1 ... 2 ... 88. Diseases of the Thyroid Body ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 89. (a) Bronchial Catarrh, &c. (under 5yrs.) 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... 2 (b) Bronchitis (under 5 years) 37 2 1 ... ... ... ... ... ... ... ... ... ... 40 14 11 6 3 3 3 23 17 90. (b) Bronchial Catarrh (over 5 yrs.) ... ... ... ... ... 1 ... ... ... 1 ... ... 1 3 ... ... ... 2 ... 1 ... 3 (a) Bronchitis (over 5 yrs.) ... ... ... ... ... 1 1 6 4 17 32 37 9 107 16 15 17 18 21 20 54 53 91. Broncho-Pneumonia 43 8 6 ... ... 3 ... ... 5 10 8 3 ... 86 21 18 24 13 6 4 51 35 92. (a) Lobar Pneumonia 4 ... 2 2 ... ... 3 3 5 3 ... 2 ... 24 9 3 3 3 3 3 15 9 (b) Pneumonia (type not stated) 10 1 ... ... ... 1 2 7 5 2 6 3 ... 37 14 5 3 5 6 4 23 14 93. (a) Empyema ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... ... ... 1 ... (b) Other Pleurisy ... 1 ... 1 ... ... 1 ... 1 ... 1 1 ... 6 1 1 1 1 ... 2 2 4 94. (a) Pulmonary Apoplexy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Pulmonary Congestion 1 ... ... ... ... ... ... ... ... ... 1 ... ... 2 1 .. 1 ... ... ... 2 ... (c) Hypostatic Pneumonia. ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 1 ... 1 ... ... ... 2 ... Carried forward 177 48 66 50 25 84 73 122 148 214 289 198 42 1536 348 407 228 213 220 220 796 740 95. Gangrene of the Lung ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 96. Asthma ... ... ... ... ... ... ... 2 ... 1 ... 1 ... 7 ... ... ... ... 3 2 3 4 97. Pulmonary Emphysema ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... 1 ... 98. (a) Fibroid Disease of the Lung ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... (b) Other Diseases of the Respiratory System ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... 5.—Diseases of the Digestive System. 99. (a) Diseases of the Teeth and Gums 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 (b) Other Diseases of the Mouth and Annexa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 100. (a) Tonsillitis ... ... ... 1 1 ... ... ... 1 ... ... ... ... 3 2 ... ... 1 ... ... 2 1 (b) Other Diseases of Pharynx ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 101. Diseases of Œsophagus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 102. Perforating Ulcer of Stomach ... ... ... ... ... ... 1 3 1 ... 2 ... ... 7 3 1 1 ... 2 ... 6 1 103. (a) Inflammation of Stomach 4 ... ... ... ... ... ... ... 1 2 i 8 2 ... 2 ... 2 2 6 2 (b) Other Diseases of Stomach 1 ... ... ... ... ... ... ... 2 1 ... ... ... 4 1 ... 1 ... 2 ... 4 ... 104. Diarrhoea and Enteritis (under two years of age) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (a) Infective Enteritis 9 1 ... ... ... ... ... ... ... ... ... ... ... 10 6 3 1 ... ... ... 7 3 (b) Diarrhoea (not returned as infective) 8 1 ... ... ... ... ... ... ... ... ... ... ... 9 ... 4 2 l 1 1 3 6 (c) Enteritis (not returned as infective) 13 2 ... ... ... ... ... ... ... ... ... ... ... 15 3 3 2 4 2 1 7 8 (d) Gastro-Enteritis (not returned as infective) 17 1 ... ... ... ... ... ... ... ... ... ... ... 18 3 4 5 3 2 1 10 8 (e) Dyspepsia 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 1 1 1 (f) Colic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (g) Ulceration of Intestines ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (h) Duodenal Ulcer ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 105. Diarrhoea and Enteritis (over two years of age) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (a) Infective Enteritis ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 (b) Diarrhoea (not returned as infective) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Enteritis (not returned as infective) ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 (d) Gastro-Enteritis (not returned as infective) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (e) Dyspepsia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (f) Colic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (g) Ulceration of Intestines ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 ... ... ... 1 ... 1 ... 2 (h) Duodenal Ulcer ... ... ... ... ... ... ... 1 1 3 ... l ... 6 1 2 ... ... 3 ... 4 2 106. Ankylostomiasis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carried forward 231 55 67 51 27 84 75 129 155 221 296 201 42 1634 370 328 244 223 239 230 853 781 102 103 Deaths Registered from all Causes for the Year 1920—continued. Causes of Death. AGES. Registration Districts. Sex. 0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 7 to 85 85 and upwards Totals. E. N.W. s.w. M. f. m. f. m. F. M. f. 107. Other Intestinal Parasites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 108. Appendicitis ... ... 1 1 2 2 1 ... ... 1 ... ... ... 8 1 2 ... 1 3 1 4 4 109. (a) Hernia ... ... ... ... ... ... ... ... 1 1 1 1 ... 4 ... 2 ... ... 1 1 1 3 (b) Intestinal Obstruction 5 ... ... ... ... ... ... ... 1 3 3 ... ... 12 ... 3 ... 1 5 3 5 7 110. Other Diseases of the Intestines ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... ... ... 1 ... 111. Acute Yellow Atrophy of Liver ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... 1 112. Hydatid of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 113. (a) Cirrhosis of the Liver (not returned as alcoholic) ... ... ... ... 1 ... ... ... 1 4 ... 2 ... 8 3 ... 1 3 ... 1 4 4 (b) Cirrhosis of the Liver (returned as alcoholic) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Diseases formerly classed to "Other Diseases of the Liver and Gall Bladder" ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 114. Biliary Calculi ... ... ... ... ... ... ... ... 1 ... 1 1 ... 3 1 1 ... ... ... 1 1 2 115. Other Diseases of the Liver ... ... ... ... ... ... ... ... ... 2 ... 1 1 4 1 1 ... 2 ... ... 1 3 116. Diseases of the Spleen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 117. Peritonitis (cause unstated) ... ... ... 2 1 ... ... ... ... ... ... ... ... 3 ... 1 ... 1 ... 1 ... 3 118. Other Diseases of the Digestive System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 .—Non-Venereal Diseases of the Genito-Urinary System and Annexa. 119. Acute Nephritis 1 ... ... 2 ... ... ... 1 ... ... ... ... ... 4 1 1 ... 1 ... 1 1 3 (a) Bright's Disease ... ... ... ... ... 1 1 3 4 9 9 2 ... 29 8 5 5 1 A 6 17 12 (b) Nephritis and Uæmia ... ... ... ... ... ... 2 ... 1 1 1 ... ... 5 ... 3 ...1 1 1 ... 1 4 121. Chyluria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carried forward 237 55 68 56 31 87 79 133 165 243 311 208 43 1716 386 347 250 235 253 245 389 827 122. (a) Abscess of Kidney ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Cystic Disease ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... ... ... 1 ... (d) Other Diseases of the Kidney and Annexa 1 ... ... ... ... ... 2 1 ... ... 1 2 ... 7 1 2 2 ... 1 1 4 3 123. Calculi of the Urinary Passages ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 1 ... 1 ... ... ... 2 ... 124. Diseases of the Bladder ... ... ... ... ... ... ... ... ... 1 3 1 I ••• 5 1 1 1 ... 2 ... 4 1 125. (a) Perineal Abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Other Diseases of the Urethra ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 1 ... ... ... 1 ... 2 ... 126. Diseases of the Prostate ... ... ... ... ... ... ... ... ... ... 5 ... ... 5 ... ... 1 ... 4 ... 5 ... 127. Non-Venereal Diseases of Male Genital Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 128. (a) Menorrhagia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) Uterine Hæmorrhage(Non-puerperal) ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 129. Uterine Tumour (Non cancerous) ... ... ... ... ... ... ... ... 3 ... 1 ... ... 4 ... 1 ... ... ... 3 ... 4 130. Other Diseases of the Uterus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 131. Ovarian Cyst. Tumour (Non-cancerous) ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 132. Other Diseases of the Female Genital Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 133. Non-Puerperal Diseases of the Breast (Non-cancerous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7.—The Puerperal State. 134. (a) Abortion ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 (d) Accidents of Pregnancy ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 135. Puerperal Hæmorrhage ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 136. Other Accidents of Childbirth ... ... ... ... ... ... 1 1 ... ... ... ... ... 2 ... ... ... ... ... 2 ... 2 137. Puerperal Fever ... ... ... ... ... ... 7 ... ... ... ... ... ... 7 ... 1 ... 3 ... 3 ... 7 138. (a)(b)(c) ,, Albuminuria and Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 139. (a) „ Phlegmasia Alba Dolens ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (b) „ Embolism and Sudden Death ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 140. „ Insanity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 141. „ Diseases of the Breast ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carried forward 238 55 68 56 31 88 92 138 168 247 321 212 43 1757 390 355 256 239 261 256 907 850 104 105 Deaths Registered from all Causes for the Year 1920—continued. Causes of Death. AGES. Registration Districts. Sex. 0 to 1 1 to 2 2 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. E. N.W. S.W. M. F. m. f m. f. m. f 8.— Diseases of the Skin and of the Cellular Tissue. 142. (a) Senile Gangrene ... ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... ... 1 ... ... 1 1 1 (b) Gangrene (other types) ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... ... 1 143. Carbuncle, Boil ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 144. (b) Acute Abscess... 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... ... ... 2 145. Diseases of the Integumentary System (c) Pemphigus 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 (d) Other Skin Disease ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 ... 1 ... 9.—Diseases of the Bones and of the Organs of Locomotion. 146. Diseases of the Bones ... ... ... 1 1 ... ... ... 1 ... ... ... ... 3 2 ... ... 1 ... ... 2 1 147. Diseases of the Joints ... . .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 148. Amputations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 149 Other Diseases of Locomotor System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10.—Malformations. 150. Congenital Malformations : (a) Congenital Hydrocephalus 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 (c) Congenital Malformation of Heart 4 1 ... 1 ... ... ... ... ... ... ... ... ... 6 2 1 2 ... ... ... 5 1 (d) Other Congenital Malformations 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 1 ... ... ... 1 2 2 2 11.—Diseases of Early Infancy. 151. (a) Premature Birth 73 ... ... ... ... ... ... ... ... ... ... ... ... 73 16 13 17 13 6 8 39 34 (b) Infantile Debility 32 ... ... ... ... ... ... ... ... ... ... ... ... 32 9 6 5 6 3 3 17 15 (c) Icterus Neonatoram 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... 1 ... 2 1 3 1 152. (a) Diseases of Umbilicus, &c. 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 (b) Atelectasis 17 ... ... ... ... ... ... ... ... ... ... ... ... 17 4 4 6 2 1 ... 11 6 (c) Other Diseases peculiar to early Infancy 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 1 1 ... ... 1 2 153. Lack of Care 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 ... 1 1 2 ... 1 1 4 Carried forward 384 57 68 58 32 88 92 138 169 248 323 213 43 1913 424 381 290 267 277 274 991 922 12.—Old Age. 154. (a) Senile Dementia ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 ... ... ... 1 ... (b) Senile Decay ... ... •• ... ... ... ... ... ... 1 14 48 21 84 9 27 8 13 7 20 24 60 13.—Affections Produced by External Causes. 155. Suicide by Poison • •• ... ... ... ... 1 ... 1 1 ... ... ... ... 3 ... 1 1 ... ... 1 1 2 156. „ Asphyxia ... ... ... ... ... ... ... 1 1 2 ... ... ... 4 3 ... 1 ... ... ... 4 ... 157. ,, Hanging or Strangulation ... ... ... ... ... ... ... 1 2 2 ... ... ... 5 1 1 2 1 ... ... 3 2 158. „ Drowning ... ... ... ... ... ... 1 ... 1 ... ... 1 ... 3 1 ... 1 ... 1 ... 3 ... 159. „ Firearms ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... 160. ,, Cutting or Piercing Instruments ... ... ... ... ... ... 1 ... 1 1 ... ... 3 1 ... 1 ... 1 ... 3 ... 161. „ Jumping from High Place ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... 162. ,, Crushing ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 1 ... ... ... 1 ... 2 ... 163. ,, Other Means ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 164. Poisoning by Food ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 165. Other Acute Poisonings ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... 1 ... ... 1 ... 166. Conflagration ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 167. Burns (Conflagration excepted) ... 3 3 ... ... 2 ... ... ... ... ... 1 ... 9 1 2 1 3 1 1 3 6 168. Absorption of Deleterious Gases (Conflagration excepted) 1 ... ... ... ... ... ... ... ... ... ::: ... ... 1 ... ... ... 1 ... ... ... 1 169. Accidental Drowning ... ... ... 2 1 ... 1 1 1 ... ... ... ... 6 4 ... ... 1 1 ... 5 1 170. Injuries—Firearms ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 171. „ Cutting or Piercing Instruments ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 172. „ Fall 1 1 ... 1 ... 2 ... 1 2 7 1 1 1 18 9 3 1 2 2 1 12 6 173. „ Mines and Quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 174. „ Machines ... ... ... ... ... 1 1 1 1 175. ,, Vehicles, Railways, &c. ... ... 1 6 1 ... 3 2 1 1 3 ... ... 18 9 1 4 1 3 ... 16 2 176. „ by Animals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 177. Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 178. Excessive Cold ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 179. Effects of Heat ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 180. Lightning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 181. Electricity (Lightning excepted) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 184. Homicide ... ... ... ... ... ... 2 ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... 2 186. Other Violence ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... 1 189. Ill defined causes—(a) Heart Failure ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 (b) Atrophy ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... Total 386 62 72 67 34 93 101 147 181 263 344 264 65 2079 466 417 312 291 295 298 1073 1006