AC 4386 M BAT34 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1935. by G. MACDONALD, M.A., M.B., D.P.H., MEDICAL OFFICER OF HEALTH. Wightman & Co., Ltd., Printers, Regency Street, S.W.i, and Dugdale Street, S.E.5. Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1935. by G. MACDONALD, M.A., M.B., D.P.H., MEDICAL OFFICER OF HEALTH. 1 Health Committee. (Acting also as the Maternity and Child Welfare Committee.) As constituted 9th November, 1934. Chairman: Councillor Mrs. M. J. Robinson. His Worship the Mayor (Councillor A. Bailey, j.p.). Councillor Mrs. K. S. D. Baker. Alderman Mrs. H. Bowler. Councillor Mrs. A. A. Burton. „ E. W. Coles. „ Mrs. E. A. Cooper. „ Dr. H. L. Gulati. „ T. J. Hines. „ F. Humphrey. „ F. J. Lamb. Alderman G. Lauriks. Councillor R. Moore. As constituted 9th November, 1935. Chairman : Councillor Mrs. A. A. Burton. His Worship the Mayor (Councillor N. G. M. Prichard, m.Sc., j.p.). Councillor A. Bailey. „ Mrs. K. S. D. Baker. Alderman Mrs. H. Bowler. Councillor Mrs. E. A. Cooper. Alderman Mrs. J. F. Dye. Councillor Dr. H. L. Gulati. „ T. J. Hines. „ F. J. Lamb. Alderman G. Lauriks. Councillor R. Moore. „ Mrs. M. J. Robinson. Housing Committer. As constituted 9th November, 1934. Chairman : Councillor I. O. Thomas. His Worship the Mayor (Councillor A. Bailey, j.p.). Alderman J. A. Campbell. „ H. Harling. Councillor A. W. Inman. „ J. F. Lane, jun. „ G. F. Meecham. „ D. A. G. Prichard. „ F. S. Steed. E. J. Sullivan. „ H. T. Vincent. „ W. J. Wye. Alderman C. H. Young, j.p. As constituted 9th November, 1935. Chairman : Councillor I. O. Thomas. His Worship the Mayor (Councillor N. G. M. Prichard, m.sc., j.p.). Councillor Mrs. K. S. D. Baker. Alderman Mrs. J. F. Dye. „ H. Harling. Councillor A. W. Inman. „ J. F. Lane, jun. „ G. F. Meecham. „ E. S. Strange, j.p. „ E. J. Sullivan. „ H. T. Vincent. „ W. J. Wye. Alderman C. H. Young, j.p. 2 Tuberculosis Care Committee. As constituted 9th November, 1934. Chairman—Councillor Mrs. M. J. Robinson. Alderman Mrs. H. Bowler. Councillor Mrs. E. A. Cooper. „ Dr. H. L. Gulati. „ F. J. Lamb. Other Member : Mrs. F. Young. Representatives of the Local Public Assistance Committee : Councillor A. Bailey, j.p. (Mayor). Councillor Mrs. F. E. Mullings. Representative of the London Insurance Committee : Mr. C. F. Botten. Member of the late Dispensary Committee : Mrs. A. Dermott. Members of the late Voluntary Care Committee : Miss B. Home. Miss E. Morris. Consultative Members : L.C.C. District Organiser for Children's Care Committee Work(Miss Thomas) L.C.C. Divisional Medical Officer (Dr. E. J. Boome). Secretary, Invalid Children's Aid Association, Southlands (Miss Denham) . Representative of the War Pensions Committee. Lady Almoner, Brompton Hospital (Miss Marx). Lady Almoner, King's College Hospital (Miss Edmonds). Tuberculosis Almoner, St. George's Hospital (Miss Spencer). Lady Almoner, St. Thomas's Hospital (Miss C. Morris). Lady Almoner, Victoria Hospital (Miss E. W. White). Representative of the S.L. District Nursing Association (Miss A. M. Stanford). Representative of the British Red Cross Society (Mrs. C. E. Peach). As constituted 9th November, 1935. Chairman— Councillor Mrs. M. J. Robinson. Alderman Mrs. H. Bowler. Councillor G. Fineran. „ Dr. H. L. Gulati. „ H. T. Vincent. Other Member : Mrs. F. Young. Representatives of the Local Public Assistance Committee: Councillor Mrs.E. A.Cooper. Mrs. F. E. Mullings. Representative of the London Insurance Committee : Mr. C. F. Botten. Member of the late Dispensary Committee : Mrs. A. Dermott. Members of the late Voluntary Care Committee : Miss B. Home. Miss E. Morris. Consultative Members : L.C.C. District Organiser for Children's Care Committee Work (Miss Thomas) L.C.C. Divisional Medical Officer (Dr. E. J. Boome). Representative of the Invalid Children's Aid Association, Southlands (Miss Denham). Representative of the War Pensions Committee. Lady Almoner, Brompton Hospital (Miss Marx). Lady Almoner, King's College Hospital (Miss Edmonds). Tuberculosis Almoner, St. George's Hospital (Miss Spencer). Lady Almoner, St. Thomas's Hospital (Miss C. Morris). Lady Almoner, Victoria Hospital (Miss E. W. White). Representative of the S.L. District Nursing Association (Miss A. M. Stanford). Representative of the British Red Cross Society (Mrs. C. E. Peach). 3 Staff of Public Health Department. (At 31st December, 1935). Assistant M.O.H. and Tuberculosis Officer A ssistant Medical Officer (Maternity and Child Welfare) Assistant Tuberculosis Officer (part time) Resident Medical Officer, Borough Maternity Hospital Consultant Gynecologist, Borough Maternity Hospital Consultant Obstetrician, Borough Maternity Hospital Consultant Medical Officer, Ante-Natal (V.D.) Clinic Medical Officer, Nine Elms Centre Medical Officer, Diphtheria Immunisation Clinic Dental Surgeon (by arrangement with British Dental Hospital) Public Analyst STANLEY KING, m.d., m.r.c.p., D.P.H. (Miss) M. L. HAMILTON, m.b., Ch.B., D.P.H. (Mrs.) M. J. O'FLYNN, b.a., m.b., B.ch., B.A.O. (Miss) M. O'MAHONEY, m.b., b.ch. (Miss) ALICE BLOOMFIELD, M.D., F.R.C.S., F.C.O.G. F. W. ROQUES, m.d., m.ch., F.R.C.S., m.C.O.G. H. CORSI, F.R.C.S., m.a., m.b., b.Ch., L.R.C.P. (Miss) E. M. SAXTON, m.d. F. PORTER SMITH, M.R.C.S., L.R.C.P. J. RHYS HERBERT, L.M.S.S.A. L.D.S., R.C.S. C. HACKMAN, F.I.C. Senior Sanitary Inspector F. H. CHUTER (a c). Sanitary Inspectors : District. 1. W. E. Selway (b c). 2. G. Weeks (b c). 3. A. Webb (b c). 4. P. D. O'Grady (6 c). 5. J. R. Glover (b c). 6. C. Binding (a c). 7. (Senior Inspector). 8. J. R. Holloway (a c). Other. (Miss) B. L. Kaye (adf Also Health J. Round (a d) visitors. (Food) J. A. H. Brownlow (b c). (Workshops) I. R. Lewis (b c). (Housing) R. J. McCarthy (a c). Organising Rat Officer—A. E. Tubby. Health Visitors : (Miss) B. L. Kaye (a df) „ J. Round (a d) „ N. Playne (a f g) „ D. Heap (a e). „ F. B. Goodall (a df g) A. Bannerman (d f). Also Sanitary Inspectors. (Miss) V. Ventris (e f g). „ H. A. Blackburn (b e f g h). „ B. E. Prager (e f g h). „ I. M. J. Sweeney (e f g). „ M. C. H. Wilkie (e f g). „ E. L. Flemons ( e f e). (For notes see next page.) 4 Clerical Staff— Chief Clerk—F. E. Ward. J. W. Brown (Statistical). E. Cole. W. Halstead. H. C. Godfrey (a). R. Graham. F. Pedrick. P. Brocking. H. N. Carter. (Miss) M. A. Weller (M. & C.W. Records). One temporary Clerk. Two Office youths. Maternity Home— Matron—(Miss) M. Fewer (/g). Sister—(Miss) A. Woodrow (/ g)—4 Staff Nurses. Borough Midwife (District Service)—(Miss) M. L. Thompson (/ g). Tuberculosis Dispensary— Tuberculosis Nurses—(Miss) M. Schotborgh (eg h), (Miss) B. O'Connor (g), (Miss) C. Thompson (f g). Secretary and Clerk—(Miss) L. Wadham (a d). Dispenser—(Miss) E. F. Davies. Clerks—(Miss) C. Turner. (Mrs.) M. E. Werrett (nee Brown). Disinfecting Station—Superintendent—T. Farrow. Mortuary—Keeper—W. Newman. Public Vaccinators and Vaccination Officer—See page 49. (a) Sanitary Inspectors' certificate of the Sanitary Inspectors' Examination Board. (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (c) Meat and other Foods certificate. Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitor's certificate, Board of Education. (e) „ „ „ Royal Sanitary Institute. (f) Central Midwives' Board certificate. (g) State registered nurse. (h) Tuberculosis certificate. 5 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Batter sea. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you my Annual Report on the Health and Sanitary condition of the Borough for the year 1935. In presenting this Report I have pleasure in recording my appreciation of the support given me by the Mayor and members of the Council and of the valuable assistance received from the Chief Officers. My best thanks, also, are due to Mr. Ward, Chief Clerk of the Public Health Department, and to the whole of the staff for their loyal support and efficient service. I have the honour to be, Mr. Mayor, ladies and gentlemen, Your obedient servant, (Signed) G. MACDONALD, Medical Officer of Health. Electric House, Lavender Hill, S.W. 11. June, 1936. 6 CONTENTS. page General 1-6 Vital Statistics 7-18 Maternity and Child Welfare 19-45 Infectious and Other Diseases 46-70 General Sanitary Administration 71-87 Food Supply 88-98 Factories and Workshops 99-104 Housing 105-115 Appendices 116-131 (See Index at end.) 7 Summary of Statistics, 1935. 1. General. Area of Borough— (Including land and inland water) acres 2,163 (Excluding water) acres 2,139.9 Population—(Registrar-General's estimate, midyear 1935) 148,200 Structurally separate occupied dwellings, Census 1931 27,219 Ditto—on rate books at end of 1935 27,644 Rateable value (1935) £1,122,401 Sum represented by a penny rate £4,573 2. Extracts from Vital Statistics of the Year. Births— Males. Females. Total. Legitimate 1,012 1,005 2,017 Illegitimate 36 51 87 Live births 1,048 1,056 2,104 Still births 33 36 69 Live birth-rate 14.2 Still-birth-rate (per 1,000 births live and still) 31.8 Deaths—Males, 917 ; females, 867 1,784 Death-rate (per 1,000 population) 12.04 Percentage of total Deaths occurring in Public Institutions (Battersea deaths only) 58.8 Number of women dying in or in consequence of childbirth— From sepsis Nil Other puerperal causes 4 Deaths erf infants under 1 year— Legitimate, 123; illegitimate, 14 137 Infant mortality rate (per 1,000 live births)— Legitimate, 60-98; illegitimate, 160-92. All deaths under 1 year 65.11 Deaths from Measles (all ages) Nil „ Whooping-cough (all ages) 9 „ Diarrhoea (under 2 years of age) 19 3. Census— Population. Private families. Inhabited dwellings. 1911 167,743 39,439 24,321 1921 167,739 42,988 27,191 1931 . 159,552 44,618 27,219 8 . Vital Statistics. The Registrar-General's estimate of the mid-year population of Battersea (1935) was 148,200 as compared with 150,870 in 1934. The population of Battersea at the Census taken in April, 1931, was 159,552, and the Registrar-General's estimate for 1935 therefore indicates a decrease of 11,352 (or 7 percent.) since the Census, and 2,670 during 1934-5. The Registrar-General's estimate of the mid-year population of the Borough (148,200) has been adopted for the purpose of the statistics contained in this report. The estimated mid-year population based upon the RegistrarGeneral's figures, for the registration sub-districts* and for the nine wards into which the Borough is divided, is set out in the following Table:— Area. Acres. Estimated Mid-Year Population, 1935. Males. Females. Total. Density per acre Wards. 1. Nine Elms 407 11,721 11,929 23,650 58.1 2. Park 316 7,399 8,297 15,696 49.7 3. Latchmere 182 8,143 8,941 17,084 93.9 5. Church 171 7,693 7,870 15,563 91.0 North Battersea 1,076 34,956 37,037 71,993 66.9 4. Shaftesbury 140 6,308 6,797 13,105 93.6 6. Winstanlev 126 8,815 9,007 17,822 141.4 7. St. John 117 3,474 4,476 7,950 67.9 8. Bolingbroke 205 7,781 9,385 17,166 83.7 9. Broomwood 499 8,799 11,365 20,164 40.4 South Battersea 1,087 35,177 41,030 76,207 70.1 Borough 2,163 70,133 78,067 148,200 68.5 BIRTHS. The number of live births registered in the Borough during 1935 was 2,876 (1,431 males, 1,445 females), an excess of 14 females. Of this number 1,113 were transferred out, the permanent residence of the parents being outside the Borough, and 341, registered outside the Borough, were transferred in, giving on balance a total of 2,104 births (1,048 male, 1,056 female) relating to Battersea residents, and a corrected (live) birth-rate of 14.2 per 1,000 of the population. This is a decrease of 0.1 on that of 1934, and the birthrate is the lowest so far recorded in Battersea. The tables on the next two pages give the distribution of the births and the birth-rate per 1,000 of the population in the subdistricts and in the wards for the year 1935, and figures relating to the previous decennium 1925-34:— * Births, deaths, etc., occurring in St. James's Hospital Sub-district (situate within Broorawood Ward) are allocated to the District in which the patient ordinarily resides. 9 BIRTHS AND DEATHS, 1935. In Sub-Districts and Wards. Rates for 1935 and previous 10 Years (per 1,000 Population). Area. Estimated Population 1935 Births Deaths No. Rate. No. Rate. Year. North Battersea. South Battersea. The Borough. Birth Rate. Death Rate. Birth Rate. Death Rate. Birth Rate. Death Rate. Sub-Districts. 1925 21.1 10.9 16.0 10.1 18.5 10.5 North Battersea 71,993 1,094 15.2 831 11.5 1926 20.2 11.4 14.4 11.4 17.3 11.4 South Battersea 76,207 1,010 13.3 953 12.5 1927 18.5 12.1 14.6 12.4 16.6 12.2 Wards. 1928 19.0 12.0 14.5 11.9 16.7 11.9 No. 1, Nine Elms 23,650 381 16.1 259 11.0 1929 18.5 14.4 13.9 14.0 16.2 14.2 No. 2, Park 15,696 224 14.3 193 12.3 1930 17.8 11.7 15.2 11.3 16.5 11.5 No. 3, Latchmere 17,084 248 14.5 198 11.6 1931 16.5 12.2 14.5 11.9 15.5 12.1 No. 4, Shaftesbury 13,105 167 12.7 164 12.5 1932 16.0 11.9 13.6 12.2 14.8 12.1 No. 5, Church 15,563 241 15.5 181 11.6 1933 15.1 12.3 14.3 12.7 14.7 12.5 No. 6, Winstanley 17,822 267 15.0 202 11.3 1934 15.8 12.0 12.9 13.0 14.3 12.5 No. 7, St. John 7,950 115 14.5 101 12.7 Mean 19251934 17.8 12.1 14.4 12.1 16 .1 12.1 No. 8, Bolingbroke 17,166 230 13.4 203 11.8 No. 9, Broomwood 20,164 231 11.5 283 14.0 Borough 148,200 2,104 14.2 1,784 12.0 1935 15.2 11.5 13.3 12.5 14 .2 12.0 10 Vital Statistics of Whole District during 1935 and Ten Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths registered in the district. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Number. Hate. * of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate.* Number Rate per 1,000 Nett Births. Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1925 172,100 3,264 3,184 18.5 2,397 13.9 920 328 186 58 1,805 10.5 1926 171,900 3,198 2,969 17.3 2,547 14.8 948 361 183 62 1,960 11.4 1927 169,000 3,099 2,801 16.6 2,773 16.4 1,102 394 150 53 2,065 12.2 1928 164,100 3,054 2,743 16.7 2,674 16.3 1,091 371 176 64 1,954 11.9 1929 161,800 2,877 2,619 16.2 3,314 20.5 1,400 380 164 63 2,294 14.2 1930 160,700 2,880 2,652 16.5 2,716 16.9 1.227 357 145 55 1,846 11.5 1931 159,800 2,788 2,477 15.5 2,745 17.2 1,301 487 142 57 1,931 12.1 1932 157,000 2,649 2,319 14.8 2,642 16.8 1,306 559 134 58 1,895 12.1 1933 154,000 2,682 2,263 14.7 2,839 18.4 1,485 570 112 49 1,924 12.5 1934 150,870 2,765 2,154 14.3 2,789 18.5 1,414 507 132 61 1,882 12.5 1935 148,200 2,876 2,104 14.2 2,860 19.3 1,456 380 137 65 1,784 12.0 Area of District in acres (land and inland water), 2,163 acres. Total population at all ages 159,552 (Census, 1931) ; number of occupied separate dwellings, 27,219 ; average number of persons in private families per occupied separate dwelling, 5.69 (Census Report 1931). * Rates calculated per 1,000 of estimated population. 11 The birth-rate shows a decline in three Wards of the Borough and an increase in the six remaining Wards. The birth-rate in Battersea is 1.9 per 1,000 lower than the average for the previous decennium 1925-1934. The birth-rate for the County of London was 13.3 per 1,000 of the population, and for England and Wales the rate was 14.7. Illegitimate births numbered 87 or 4.13 per cent. of the live births. The number of births occurring in each quarter of the year is shown in the table on page 12. Under the Births and Deaths Registration Act, 1926, the registration of still-births was made compulsory. During 1935, 69 stillbirths were registered as belonging to Battersea. MARRIAGES. The marriages registered in Battersea during 1935 numbered 1,446. The marriage-rate (i.e., the number of persons married per 1,000 of the population) was 19-5. Year. Marriages. Marriage-Rate. 1930 1,444 18.0 1931 1,421 17.8 1932 1,300 16.6 1933 1,376 17.9 1934 1,432 19.0 Mean, 1930-34 1,395 17.9 1935 1,446 19.5 DEATHS. The number of deaths registered in the Borough during 1935 was 2,860. Of these, 1,456 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were on the other hand, 380 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,784 (males 917, females 867). This gives a recorded death-rate of 12.04 compared with 11.4 for London, and 11.7 for England and Wales. The Registrar-General has supplied a factor for the purpose of rendering the death-rate of the Borough comparable with that of a district the population of which is of standard age and sex distribution. For the year 1935 this factor is 0.99, and the adjusted death-rate for the purpose of such comparison is therefore 11.9. The distribution of the deaths and the death-rate per 1,000 inhabitants for each of the sub-districts and the nine wards is shown in the table on page 9. 12 The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1935:— Under 1 year. 1- 5 - 10 - 15 - 25 - 45 - 65 + Total. M 76 28 8 9 28 82 267 419 917 F 61 11 4 3 29 68 204 487 867 Ttls. 137 39 12 12 57 150 471 906 1,784 %of Total 7.7 2.1 0.7 0.7 3.2 8.4 26.4 50.8 100.0 The number of deaths and infant deaths registered in each quarter of the year is set out in the following table, in which, for convenience, the corresponding figures for births have also been inserted:— Quarter. Births (Live). Infant Deaths (Under 1 year). All Deaths. No. Per cent. of total. No. Per cent. of total. No. Per cent. of total 1 489 23.2 33 24.1 498 27.9 2 555 26.4 36 26.3 432 24.2 3 538 25.6 24 17.5 358 20.1 4 522 24.8 44 32.1 496 27.8 Total 2,104 100.0 137 100.0 1,784 100.0 The death-rate during 1935 was lowest in the Nine Elms Ward (11.0), and highest in Broomwood Ward (14.0). The deaths of persons over 65 years numbered 906 or 50.8 per cent. of the total deaths. The average age at death was 57.5 years, as compared with 55.7 in 1934, 56.8 in 1933, 55.7 in 1932 and 55.3 in 1931. Decreased death-rates were recorded in four wards of the Borough. The natural increase of population (that is the excess of births over deaths) was 320 in 1935 as compared with 272 in 1934. The causes of the 1784 deaths occurring in 1935, classified in various age groups, are shewn in the Appendix, pages 116-7. Deaths in Public Institutions. During 1935 the deaths of Battersea residents occurring in public institutions numbered 1,046. Of this number 708 occurred within and 338 outside the Borough. Of the total Battersea deaths in institutions 728 occurred in the general hospitals of the London County Council. 13 Senile Mortality. During 1935 the deaths of 906 residents of Battersea aged 65 years and upwards were registered. The distribution of these deaths, which constituted 50.78 per cent. of the deaths at all ages, is set out in the following table:— Sub-District. 65 and under 75. 75 and under 85. 85 and upwards. Total over 65. Total M. F- M. F. M. F. M. F. North Battersea 107 90 72 99 12 26 191 215 406 South Battersea 122 100 88 117 18 55 228 272 500 Borough 229 190 160 216 30 81 419 487 906 If the number of " senile " deaths be compared with the total number of deaths it will be found that the ratio has been increasing for some years past. Expressed as percentages the following are the figures for the past ten years:— No. of Senile Deaths per 100 Deaths. 1926 39.3 1929 43.3 1933 48.2 1927 42.4 1930 44.4 1934 48.3 1928 42.4 1931 45.7 1935 50.8 1932 47.4 Infant Mortality. During 1935 the deaths of 137 infants under 1 year of age were registered as belonging to Battersea. The total number of births registered during the year was 2,104, giving an infant mortality rate of 65.11 per 1,000 live births, as compared with 61.28 in 1934, 49.49 in 1933, 57.8 in 1932, and 57.3 in 1931. The infant mortality rate for the year 1933 was the lowest yet recorded in Battersea. The distribution of the 137 infant deaths and the infant mortality-rates for the registration Sub-Districts and the Wards, are shown in the following table:— Area. Live births. Deaths of infants under 1 year of age. Infant mortality per 1,000 live births. m. f. total. Sub-District. North Battersea 1,094 41 27 68 62.2 South Battersea 1,010 35 34 69 68.3 The Borough 2,104 76 61 137 65.1 Ward. 1. Nine Elms 381 11 9 20 52.5 2. Park 224 9 6 15 67.0 3. Latchmere 248 15 4 19 76.6 4. Shaftesbury 167 8 3 11 65.9 5. Church 241 6 8 14 58.1 6. Winstanley 267 8 9 17 637 7. St. John 115 4 5 9 78.3 8. Bolingbroke 230 5 10 15 65.2 9. Broomwood 231 10 7 17 73.6 14 It will be noted that in the sub-districts the rate was higher in South Battersea (68.3) than in North Battersea (62.2). In the wards, Nine Elms showed the lowest rate (52.5) and St. John Ward the highest (78.3). The infant mortality rates in the County of London and in England and Wales during 1935 were 57.9 and 57.0 respectively. The number of infant deaths in each quarter of the year is shown in the table on page 12. There were 73 deaths of infants during the first four weeks of life (or 53.3 per cent. of the total infant deaths) as compared with 53 deaths (or 40.2 per cent.) in 1934 and a percentage for the quinquennium (1930-1934) of 43.9. The deaths from developmental diseases were 81 as compared with 57 in 1934. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1930 to 1935. Year. Under 24 hrs. 1 to 7 days. 1 to 4 weeks. Total under 4 weeks. Percentage deaths under 4 weeks of total infant deaths 1930 24 35 15 74 51.0 1931 28 18 22 68 47.9 1932 16 20 16 52 38.8 1933 21 11 13 45 40.2 1934 25 15 13 53 40.2 Total 1930-34 114 99 79 292 43.9 Mean do 22.8 19.8 15.8 58.4 — 1935 38 26 9 73 53.3 The causes of the 137 infant deaths are shown in detail in the appendix, pages 119-121. Deaths of Illegitimate Infants. The death-rate amongst illegitimate children during 1935 was 160.9 per 1,000 births, as compared with 134.8 in 1934, 69.3 in 1933, 81.4 in 1932, and 83.3 in 1931. The corresponding death-rate of legitimate children in 1935 was 61.0, the ratio of the mortality rate of illegitimate infants to that of legitimate being 2 .6 to 1. Still-births. The registration of still-births became compulsory under the provisions of the Births and Deaths Registration Act, 1926. 15 During 1935 there were 108 still-births registered in Battersea, of which 57 were of Battersea parents. Twelve still-births occurring outside the Borough were registered as belonging to Battersea, making 69 in all, representing a still-birth rate of 31.75 per 1,000 births (live and still) registered. Of the 69 still-births 3 (4.3 per cent.) were registered as illegitimate. The number of Battersea still-births registered, and the stillbirth rates, from 1928 to 1935, were as under:— No. Rate. No. Rate. 1928 90 31.8 1932 72 30.1 1929 71 26.4 1933 65 27.9 1930 103 37.4 1934 65 29.3 1931 66 26.0 1935 69 31.8 Notification of Births Act. During 1935 the number of notifications of live births received belonging to the Borough was 2,040. The corrected number of Battersea births registered during the year was 2,104. The proportion of notified to registered births was, therefore, 97 per cent. There were 298 live births of Battersea children occurring outside the Borough notified from the districts in which these births occurred, these cases being included in the total of 2,040 above. Fifty-eight still-births were notified under the provisions of the Notification of Births Acts during the year, including 8 cases occurring outside the Borough, the number notified being 84.1 per cent, of the total Battersea still-births registered. The homes from which births are notified are visited and revisited by the Council's official health visitors or the health visitors of the voluntary organisations included in the Council's Maternity and Child Welfare scheme. A weekly return of all births notified is forwarded to the London County Council, in accordance with the requirements of the Notification of Births Act, 1907. 16 COMPARATIVE STATISTICS OF BIRTHS, MORTALITY, &c. Year. Mean population for year. Births. Deaths. Natural Increase. Birth Rate. Death Rate. Infant Mortality Rate. 1861 19,582 750 505 245 38.3 25.7 194.7 1871 54,847 2,220 1,472 748 40.4 26.8 194.1 1881 108,342 4,452 2,033 2,419 41.8 18.7 146.2 1882 112,661 4,504 2,214 2,290 39.9 19.6 154.8 1883 116,980 4,711 2,344 2,367 40.2 20.0 168.5 1884 121,299 5,275 2,569 2,706 43.4 21.1 164.7 1885 125,618 4,654 2,566 2,088 37.0 20.4 179.0 1886 129,937 5,140 2,477 2,663 39.5 19.0 162.1 1887 134,256 5,186 2,451 2,735 38.6 18.2 156.6 1888 138,565 5,061 2,187 2,874 36.5 15.7 146.2 1889 142,884 5,161 2,240 2,921 36.1 15.6 138.2 1890 147,203 5,105 2,854 2,251 34.6 19.3 174.1 1891 150,880 5,237 2,697 2,540 34.7 17.9 146.8 1892 153,778 4,990 2,782 2,208 32.4 18.1 164.3 1893 156,719 5,225 2,974 2,251 33.3 18.9 171.3 1894 159,724 5,024 2,577 2,447 91.4 16.1 147.5 1895 162,787 5,264 2,961 2,303 32.3 18.1 177.1 1896 165,309 5,358 2,994 2,364 32.4 18.1 178.8 1897 166,059 5,266 2,737 2,529 31.7 16.4 162.2 1898 166,814 5,157 2,892 2,265 30.9 17.3 166.0 1899 167,570 5,179 2,905 2,274 30.9 17.3 161.2 1900 168,339 5,161 2,978 2,183 30.6 17.6 160.0 1901 ‡ 169,007 5,025 2,766 2,259 29.7 16.4 163.4 1902 ‡ 169,332 4,844 2,581 2,263 28.6 15.2 135.6 1903 ‡ 169,543 4,973 2,476 2,497 29.3 14.6 134.9 1904 ‡ 169,642 4,849 2,543 2,306 28.6 15.0 147.5 1905 ‡ 169,635 4,843 2,561 2,282 28.6 15.1 131.3 1906 ‡ 169,526 4,654 2,384 2,270 27.5 14.1 126.3 1907 ‡ 169,318 4,574 2,406 2,168 27.0 14.2 114.1 1908 ‡ 169,018 4,629 2,272 2,357 21.4 13.4 106.7 1909 ‡ 168,628 4,450 2,417 2,033 26.4 14.3 107.4 1910 ‡ 168,152 4,489 2,124 2,365 26.7 12.6 96.7 1911 167,765 4,381 2,404 1,977 26.1 14.3 124.6 1912 167,589 4,255 2,052 2,203 25.4 12.2 83.0 1913 167,464 4,240 2,365 1,875 25.3 14.1 111.3 1914 167,338 4,303 2,217 2,086 25.7 13.2 92.3 1915 161,945 3,820 2,653 1,167 23.6 16.4 112.0 1916 B* 173,432 3,774 — — 21.8 — 84.3 D* 159,402 — 2,221 1,553 — 13.9 1917 B* 167,233 2,960 — — 17.7 — 101.0 D* 150,023 — 2,285 675 — 15.2 1918 B* 168,014 2,700 — 16.1 — 98.9 D* 149,951 — 2,809 -109† — 18.7 1919 B* 165,960 3,075 — — 18.5 — 74.1 D* 159,316 — 2,061 1,014 — 12.9 1920 B* 166,093 4,669 — — 28.1 — 82.7 D* 165,664 — 2,079 2,590 — 12.5 1921 169,200 3,742 2,060 1,682 22. 1 12.2 73.8 1922 169,200 3,665 2,227 1,438 21.7 13. 69.3 1923 170,600 3,434 1,839 1,595 20.1 10. 49.5 1924 171,000 3,139 2,018 1,121 18.4 11. 62.4 1925 172,100 8,184 1,805 1,379 18.5 10. 58.4 1926 171,900 2,969 1,960 1,009 17.3 11. 61.6 1927 169,000 2,801 2,065 736 16.6 12. 53.5 1928 164,100 2,743 1,954 789 16.7 11. 64.2 1929 161,800 2,619 2,294 325 16.2 14. 62.6 1930 160,700 2,652 1,846 806 16.5 11. 54.7 1931 159,800 2,477 1,931 546 15.5 12.1 57.3 1932 157,000 2,319 1,895 424 14.8 12.1 57.8 1933 154,000 2,263 1,924 339 14.7 12.5 49.5 1934 150,870 2,154 1,882 272 14.3 12.5 61 .3 1935 148,200 2,104 1,784 320 14.2 12.0 65.1 * Population as estimated for purpose of (B) Birth-rate, (D) Death-rate, † Decrease. Census years in heavy type ‡ These are revised figures (approved by the Registrar General) abstracted from London Statistics, Vol. 22., p.49. The birth- and death-rates have been modified accordingly. 17 Births, Deaths And Infant Mortality Rates In Battersea From 1901. 18 Comparative Statistics, Metropolitan Boroughs. Table showing the birth-rates, death-rates and infant mortalityrates in the 29 Metropolitan Cities and Boroughs for the year 1935:— Live Births per 1,000 Population. *Deaths per 1,000 Population. Infant Deaths per 1,000 live births. 1. Poplar 15.41 Lewisham 10.03 Lewisham 42.6 2. Islington 15.05 Wandsworth 10.23 Woolwich 44.3 3. Southwark 1483 Hampstead 10.56 Poplar 46.5 4. Finsbury 14..75 Stoke Newington 10.65 Hackney 47.7 5. Hammersmith 14.65 Chelsea 10.71 Hampstead 49.0 6. Deptford 14.60 Woolwich 10.86 Fulham 50.8 7. Shoreditch 14.59 Greenwich 11.01 Deptford 50.9 8. Bermondsey 14.48 Hackney 11.14 Stoke Newington 51.4 9. Bethnal Green 14.39 Islington 11.25 Bethnal Green 51.5 10. Stepney 14.31 Kensington 11.36 Shoreditch 51.9 11. Battersea 14.20 Deptford 11.56 Islington 52.4 12. Paddington 14.17 Fulham 11.71 Wandsworth 55.2 13. Hackney 14.05 Bethnal Green 11.73 St. Marylebone 55.8 14. Woolwich 14.02 St. Marylebone 11.75 Lambeth 58.9 15. Stoke Newington 13.94 Camberwell 11.82 Finsbury 59.1 16. Fulham 13.85 Westminster 11.86 Chelsea 59.6 17. Greenwich 13.84 Battersea 11.92 Greenwich 59.8 18. Lambeth 13.66 Paddington 11.96 Camberwell 60.5 19. Camberwell 13.47 Lambeth 12.03 St. Pancras 62.9 20. St. Pancras 13.31 St. Pancras 12.21 Stepney 63.1 21. Lewisham 12.52 City of London 12.21 Battersea 65.1 22. Kensington 12.48 Hammersmith 12.26 Southwark 65.7 23. Wandsworth 11.04 Poplar 12.27 Bermondsey 69.3 24. Hampstead 11.03 Holborn 12.69 Hammersmith 69.8 25. Chelsea 10.24 Stepney 13.23 Paddington 71.3 26. St. Marylebone 9.72 Shoreditch 12.45 Westminster 72.0 27. Westminster 8.38 Southwark 13.28 Kensington 78.6 28. Holborn 7.65 Bermondsey 13.33 Holborn 88.6 29. City of London 7.58 Finsbury 13.71 City of London 12.7 County of London 13.34 County of London 11.41 County of London 57.9 * The rates in this column have been adjusted by the " comparability factor" referred to on page 11. 19 Maternity and Child Welfare Scheme. The Maternity and Child Welfare Scheme of the Council includes municipal and voluntary effort and the activities of both are fully co-ordinated. Maternity and Child Welfare Districts. For administrative purposes, the Borough is divided into districts, for each of which a Health Visitor is made responsible. There are nine Maternity and Child Welfare centres (Municipal, 7 ; Voluntary, 2). The situation and times of opening of the centres, municipal and voluntary, and the work carried out thereat, are set out in the tables on the next two pages. Ancillary services included in the scheme are (1) St. Mary's Hostel, Macaulay Road, Clapham Common (vide page 39). (2) St. Margaret's Day Nursery and Resident Hostel, Cambridge Road (vide page 44). The annual contributions which the Council make to the voluntary bodies linked with their Maternity and Child Welfare scheme under the Local Government Act, 1929, as revised by the Ministry of Health in 1933, are as follows:— The Battersea School for Mothers £613 (This payment ceased on the Council taking over the centre on 25th June, 1935—see page 22) The Women's League of Service for Motherhood £546 The Chislehurst Mission £28 The St. Margaret's Day Nursery and Guest House £500 These amounts are approximately equivalent to the grants which, prior to 1930, were paid by the Council, together with those paid by the Ministry direct to the Associations. The Council also made additional contributions in the financial year 1935-36 in connection with their Maternity and Child Welfare scheme as under:— Invalid Children's Aid Association £40 St. Thomas's Babies' Hostel (vide page 41) £150 Victoria Hospital for Children £100 Southwark Diocesan Association for Moral Welfare £150 to o MATERNITY AND CHILD WELFARE CENTRES (at 31st December, 1935.) name and Situation of Centre. Times of Opening. Monday. Tuesday. Wednesday. Thursday. Friday. Municipal- Southlands, High Street (Central Clinic) 9.30 a.m. s.l.-m. — 9.30 a.m. s.l.-m. *1.30 p.m. *10.0 a.m. a.n. 2.0 p.m. 2.0 p.m. m.c. — §2.30 p.m. 1.30 p.m. s.l. do. (Dental Clinic) — ‡ 10.30 a.m. 10.30 a.m. — 10.30 a.m. 2.0 p.m. 2.0 p.m. — All Saints' Parish Hall, Prince of Wales Road — *10.0 a.m. a.n. — — — — *1.30 p.m. — 1.30 p.m. — Plough Road Institution *1.30 p.m. — — *10.0 a.m. a.n. 1.30 p.m. — — — 1.30 p.m. † 2.0 p.m. m.c. Chatham Hall, Chatham Road — 2.0 p.m. 2.0 p.m. m.c. — *1.30 p.m. Gideon Road, L.C.C. School — — *1.30 p.m. — 2.0 p.m. Maternity Hospital, Bolingbroke Grove (outpatient department) — *10.0 a.m. p.n. *9.30 a.m. a.n. *9.30 a.m. a.n. — — *1.30 p.m. a.n. *2.0 p.m. a.n. (Special Clinic) — — Nine Elms Centre, 55 Mundella Road 2.0 p.m. *2.0 p.m. — † 2.15 p.m. m.c. † 3.30 p.m. h.t. — Voluntary— Women's League oi Service, Southlands, High St. † 2.30 p.m. M.c. *¶ 2.30 p.m. *¶2.30 p.m. a.n. *2.30 p.m. †2.30 p.m. M.c. † 2.30 p.m. m.c. Chislehurst Mission, St. James's Hall, Ponton Rd. — — — — **2.0 p.m. a.n. Ante-natal clinic. p.n. Post-natal clinic. s.l. Artificial sunlight clinic. h.t. Health talk. m. Massage. m.c. Mothercraft class. * A Medical Officer attends. † Mothers only. § Protection against diphtheria (Schick test clinic). ** A Medical Officer attends alternate weeks. ‡ Children only. ¶ Session held fortnightly. Dinners for expectant and nursing mothers are provided daily (Monday to Friday) by the Women's League of Service at their Southlands premises. A Fathers' Council is held monthly at the Nine Elms Centre, 55, Mundella Road, S.W. 8. 21 Summarised Statistics Relating to Infant Welfare Centres, 1935. Municipal. Voluntary. Grand Total. Southlands Plough Road East Battersea Chatham Road Gideon Road * Mundella Road (½ year). Total. * Battersea School for Mothers (½ year). Chislehurst (St James's) Mission. Women's League of Service. Total Municipal and Voluntary. Sessions held 98 101 101 98 100 54 552 45 51 73 169 721 Weights recorded 2,791 4,768 4,759 5,120 3,886 1,845 23,169 1,608 578 1,781 3,967 27,136 Advice only given 379 897 1,116 473 615 181 3,661 15 231 63 309 3,970 Total attendances 3,170 5,665 5,875 5,593 4,501 2,026 26,830 1,623 809 1,844 4,276 31,106 Average per session 32 56 58 57 45 38 49 36 16 25 25 43 „ „ week 61 109 113 108 86 75 552 65 16 35 116 598 First attendances 178 330 306 342 221 121 1,498 115 26 154 295 1,793 Doctor's attendances 51 48 51 49 50 27 276 45 26 73 144 420 „ interviews 983 1,530 1,338 1,441 1,199 634 7,125 1,002 236 1,104 2,342 9,467 „ average per attendance 19 32 26 29 24 23 26 22 9 15 16 23 *Till midsummer a voluntary centre ; afterwards a municipal centre (see page 22). (Summary of the work carried out at other centres will be found as under:— Ante-natal Clinic, page 32; Dental Clinic, pages 27-8, 65; Light Treatment Centre, pages 43, 66; Anti-diphtheria Clinic, page 51; Massage Centre, page 43 ; Mothercraft classes page 22. 22 At each of the centres a clinic is held once or twice weekly with a woman Medical Officer in attendance, as shewn in the tables on the two previous pages. Each centre is under the supervision of a trained Health Visitor and voluntary helpers assist in the work of the centres. The voluntary centres are conducted on similar lines to those of the municipal centres. Mothercraft Classes. Instruction in mothercraft has been given weekly at 5 centres during the year, the average attendance being respectively:— Southlands 8.1 Chatham Road 9.3 Plough Road 17.7 55 Mundella Road 15.6 Women's League of Service(Southlands) 15.5 Exhibitions of the needlework carried out at the Southlands and Chatham Road centres were given in December, 1935, and January, 1936. Voluntary Centres. Battersea School for Mothers.—Since 1918 a portion of the Nine Elms Ward has been served, for the purposes of Maternity and Child Welfare, by the Society of this name from their centre at 55 Mundella Road, and the Council made an annual contribution towards the cost of the work. In April, 1935, a letter was received from the Society asking whether the Council would be prepared to take over the Centre, and being of opinion that it was imperative that the work should be continued, they decided to do so. The centre was therefore transferred to the Council on the 25th June, the part-time appointment of Dr. Saxton, who had previously acted as Medical Officer of the clinic being confirmed by the Council, and the two health visitors already employed (Miss Wilkie and Miss Flemons) being taken into the Council's service. The premises, already the property of the Council, were brought into decorative repair and the appointment of the caretaker continued. It was estimated that the additional annual expenditure devolving on the Council, after allowing for the discontinuance of the grant formerly paid would be £288. The work of the Centre both before and after the transfer is summarised on page 21. The Fathers' Council continued to meet after the transfer. Women's League of Service.—The Battersea centre of this League (formerly situated at 111 Bridge Road West) was established in 1911, and was transferred to Southlands, Castle Street, in 1928. 23 The district served by the League is a populous one adjoining the Thames, and situate between Battersea Bridge Road and High Street, and a qualified Health Visitor (Miss F. Pethybridge) undertakes the usual duties of a health visitor within the district. An important feature of the work of the League is the provision of cheap dinners for nursing and expectant mothers and children. This centre is carried on as an integral part of the Council's Maternity and Child Welfare scheme, and the Council make an annual grant of £546 towards the expenses. Dr. A. Maud Swanson, Medical Officer in charge of the Clinic, reports:— Ante-natal work.—24 sessions were held, with a total attendance of 242. 23 Mothers were confined at Borough Maternity Home. 9 „ ,, ,, by Borough Midwife. 17 „ „ „ at St. James' Hospital. 1 mother was „ at St. George's Hospital. 6 mothers were ,, by private midwives. 2 „ had miscarriages. 3 „ moved away from the district. Infant Welfare Work.—73 sessions were held with a total attendance of 1,844. 5 cases were referred to hospital for treatment (tonsils and adenoids and other minor ailments). The Borough Dental Clinic, Solarium and Massage Departments have been of valuable help to our mothers and children. The district nurses are constantly in demand for treatment of minor ailments in the homes. Several mothers and babies have been sent to convalescent and rest homes. Our dinners to mothers and children keep up a high standard and our numbers are increasing. The health of the mothers and babies has been good on the whole. Chislehurst (St. James's) Mission.—The centre established by this Society has been held for many years at a Church Hall in Ponton Road. The sessions held weekly are in charge of one of the Council's Health Visitors, who also carries out the necessary visiting work in the area served. At the request of the Society the area attached to the centre was extended in September by the inclusion of a few adjoining streets. Details of the work carried out will be found in the table on page 21. The Council make an annual grant of £28 towards the expenses. 24 Health Visitors. The Health Visiting staff consists of 12 full time Health Visitors, two of whom are partly employed as women Sanitary Inspectors. Facilities are granted by the Council to students of recognised training bodies for practical instruction and training as Health Visitors and women Sanitary Inspectors. During the year nine students from the Hygiene Department, Battersea Polytechnic, received a course of training under the Council's Maternity and Child Welfare scheme, and, on completion of their training, certificates as to their work were supplied to the Polytechnic authorities. The home visiting carried out during 1935 by the Council's Health Visitors and those of the voluntary organisations included in the Borough Maternity and Child Welfare scheme is summarised in the following table:— Visits. Council. Vol. Total. Expectant mothers 3,254 373 3,627 Notified births 10,446 1,347 11,793 Still-births 87 13 100 Children aged 1-5 years 6,201 1,849 8,050 Infant deaths 136 25 161 Notifiable infectious disease 1,802 346 2,148 Non-notifiable disease 176 59 235 Prevention of diphtheria 179 70 249 Dental cases 117 7 124 V.D. cases — — — Maternal deaths 1 3 4 Foster mothers and children 1,297 — 1,297 Other 1,466 350 1,816 Totals 25,162 4,442 29,604 Hospital Provision, In addition to the provision of midwifery services, hospital and district, the Council have provided facilities for the needs of children requiring special hospital treatment by arrangement with the Victoria Hospital for Children, Chelsea, and the St. Thomas's Babies' Hostel (vide page 41). The Council contribute an annual sum to these Hospitals in respect of the facilities afforded (vide page 19). Women and children are referred where necessary from the ante-natal and child welfare centres to appropriate institutions, children being usually sent to one of the above named hospitals. The Council also undertake, on behalf of various hospitals, to visit and report on the home conditions of Battersea women and children receiving treatment in the obstetric, gynaecological and other departments of the hospitals. 25 The following table presents a summary of the number of cases referred to hospitals and other institutions from the various clinics, and also the number of visits paid by the Council's Health Visitors on the request of the hospitals:— Hospital or Institution. Cases referred from clinics. Visits paid for Hospital. Ante- and post-natal visits. Other. Total. Battersea General 2 1 1 2 Bolingbroke 9 — — — Charing Cross — 7 — 7 Clapham Maternity — 1 — 1 Elizabeth Garrett Anderson — 1 — 1 General Lying-in — 265 2 267 Gt. Ormond St., children's 1 — — — Kings College — 6 — 6 L.C.C. general hospitals 16 459 3 462 Maudesley 3 — — — Middlesex 39 1 — 1 Queen Charlotte's — 1 — 1 Royal Eye 1 — — — Royal Free 1 2 — 2 St. George's — 58 4 62 St. Thomas's 15 220 120 340 St. Thomas's, Babies 232 — — — South London, for Women 32 2 1 3 Victoria, Chelsea 331 — 130 130 Vincent Square 1 — 1 1 Westminster 2 28 — 28 Battersea Tuberculosis Dispensary 7 — — — Other Societies — —. 7 7 Totals 692 1,052 269 1,321 Milk for Necessitous Persons. Under the provisions of the Maternity and Child Welfare Act, 1918, milk both fresh and dried is provided by the Council for necessitous expectant and nursing mothers and children under 5 years' of age. The following table gives particulars for the past ten years of the number of persons supplied, quantities distributed and cost after deducting payments made by those able in part to contribute:— 26 Year. Dried Milk. Fresh Milk. Cost (after deducting payments made). £ 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 Persons supplied. lbs. supplied. Persons supplied. Pints supplied. 609 (469) 111 (53) 119 (65) 187 (60) 138 (73) 173 (101) 241 (126) 184 (106) 140 (51) 157 (62) 26,924 2,519 3,286 3,127 3,006 4,209 5,184 3,642 2,449 3,330 699 (469) 1,381 (53) 1,216 (65) 1,101 (60) 1,277 (73) 1,706 (101) 1,939 (126) 1,842 (106) 1,361 (51) 1,276 (62) 89,435 206,717 149,307 141,767 171,367 218,310 273,103 237,636 145,298 147,816 3,262 3,438 2,667 2,532 2,956 3,796 4,372 3,280 2,045 2,718 [The figures in brackets indicate the number of persons who received both dried and fresh milk, and are therefore included in the number of persons supplied in both columns.] It will be noted that the supply of dried milk, in comparison with fresh milk, is comparatively small, dried milk being in general supplied only in those cases where, on medical grounds, it is considered preferable. The scale of income used for the assessment of grants of milk had been revised by the Council in April, 1933, but in January the Council decided to revert to the previous scale. Care is taken to see that there is no abuse of the facilities provided, and investigations are made into the financial circumstances of applicants and one person was prosecuted for making a false statement of income (vide p. 74). Grade A (Tuberculin tested) milk is supplied in sealed bottles by licensed purveyors in the Borough, and the recipients are given their choice of dairymen from the list of licensed dealers. The scheme of the London County Council under which milk or special nourishment is provided for expectant or nursing mothers or delicate children where the family is already in receipt of public assistance (in addition to the relief ordinarily given) was in force during 1935. During the year 151 persons in 115 families who came within its terms were supplied with Grade A (Tuberculin tested) milk through the Public Assistance Authority. The quantity of milk supplied to these families was about 15,008 pints, and 116 lbs. of dried milk were also supplied in 13 cases. The cost involved was approximately £279, which was borne by the London County Council. Under a further arrangement with the London County Council the Council undertakes to supply milk to those expectant mothers (not in receipt of Public Assistance grants) who attend the ante-natal clinics attached to the County Council's general hospitals and who are certified by the medical officers of the County Council to be in need 27 of additional nourishment. The grant of milk in these cases however is limited to those mothers whose income comes within the Council's scale. During the year 1,278 pints of Grade A (Tuberculin tested) milk were supplied under this scheme, the number of mothers affected being 26. These figures are included in the foregoing table. In addition to the grant of milk, at reduced rates or free of charge, a small issue of dried milk is made at cost price to those mothers attending the welfare centres whose income though not entitling them, under the Council's scale, to purchase it at reduced prices, are yet unable to afford the full retail prices. The Committee in September and October approved a scheme by which vouchers were issued by two of the manufacturers and distributed at the welfare centres in suitable cases entitling these mothers to purchase dried milk at chemists' shops at specially reduced prices. From October till 31st December, vouchers for 638 lbs. of dried milk were issued. In addition to the provision of milk, dinners to the number of 34 were supplied during 1935 to necessitous expectant and nursing mothers and children at a cost of 14s. 2d., by arrangement with the Women's League of Service. Necessitous mothers were also referred from the Welfare Centres to the kitchen of the Invalid Kitchens of London Association in Henley Street, where they were supplied with 192 dinners during 1935 at a cost to the Council of £3 4s. Od. Dental Clinic. This Clinic was established in 1920 as an integral part of the Council's scheme for Maternity and Child Welfare to provide facilities for the dental treatment of expectant and nursing mothers and children under 5 years of age. Five sessions are held weekly in addition to one for tuberculous patients (vide page 65). This service is provided, under contract, by the British Dental Hospital, who supply the dental surgeon, equipment, and other requisites. Advice, extractions, fillings, &c., are supplied free of cost, but a moderate charge is made for artificial dentures which is borne by the patient, assisted in necessitous cases by contributions obtained from various philanthropic bodies, including the Samaritan Fund of the British Dental Hospital, and also by grants from the Council. The Dental Clinic is also available for patients recommended by the medical officers of the Maternity and Child Welfare clinics of the voluntary associations linked up with the Council's scheme. The work of the Dental Clinic during 1935 is summarised as follows:— Women. Children. Total. Sessions held 201 50 251 No. of patients treated 456 222 678 No. of new patients 231 137 368 Total attendances 2,411 794 3,205 28 Work carried out:— Women. Children. Total Extractions— Ordinary 2 — 2 With local anaesthetic 57 2 59 ,, general anaesthetic 476 189 665 Totals 535 191 726 No. of teeth extracted 1,701 473 2,174 Scaling and polishing 49 3 52 Fillings 68 18 86 Upper dentures 84 — 84 Lower dentures 71 — 71 Denture visits 516 — 516 Dressings and treatment to gums 122 — 122 Repairs to dentures 22 — 22 Advice 986 581 1,567 The Health Committee in May adopted a scale for the uniform assessment of the cost of dentures supplied to patients attending the clinic. The Council have, since 1927, undertaken the dental treatment at scale charges of Chelsea patients referred by the Chelsea Health Society for the purpose. The scale of charges was revised by the Council in May. The cost of dentures supplied during the financial year amounted to £291 15s. 6d. and the sums received from various sources were as under. £ s. d. Contributed by patients 101 3 0 Payments by Chelsea Health Society 88 14 0 Grants from British Dental Hospital 56 16 0 Grants from Saturday and Sunday Hospital Funds 33 0 0 Grants from other philanthropic agencies 3 15 0 Contribution by the Council 8 7 6 £291 15 6 The net cost of this service during 1935-36 was £518 1s. 3d. Ante-Natal Clinics. The ante-natal clinics provided by the Council under their Maternity and Child Welfare scheme are under the direction and supervision of the consultant gynaecologist (Miss Alice Bloomfield, m.d., f.r.c.s., f.c.o.g.). These clinics are held at the out-patient department of the Borough Maternity Hospital on Tuesdays, Wednesdays and Thursdays, and for the convenience of patients living at a distance from the Hospital a session is held at the Southlands centre on Fridays. Clinics are also held at the Plough Road and 29 East Battersea centres, which are attended by the Assistant Medical Officer (Maternity and Child Welfare); and the Women's League of Service, a voluntary organisation, whose Battersea centre for Maternity and Child Welfare is linked up with the Council's scheme, also holds an ante-natal clinic at their Southlands premises. Each mother who books for admission to the Borough Maternity Hospital, or for attendance by the Borough midwife in her own home, is required to attend the ante-natal clinic periodically before her confinement, and is seen at least once by the consultant gynaecologist. Doctors and private midwives practising in Battersea are also encouraged to send their maternity patients to the central ante-natal clinic at the Borough Maternity Hospital for examination and report without charge by the consultant gynaecologist. Miss Bloomfield (Consultant Gynaecologist) reports:— Tuesday Afternoon (Special) Clinic. Fifty-two sessions of this clinic were held with a total attendance of 818 patients (new patients numbered 733) and an average attendance of 16 per clinic. Blood was taken for the Wassermann test in 613 cases, with a positive reaction in 4 cases, and a doubtful reaction in 8 cases. A large number of gynaecological cases—some ante-natal, where the pregnancy was complicated by some gynaecological condition—others post-natal attended this clinic for diagnosis and treatment. Vaginal discharge.—Six cases attended with vaginal discharge, in all of which films were taken from the cervix and treatment instituted, the total attendances for treatment in these cases numbering 18. Many other cases attended complaining of vaginal discharge, in whom, after examination, treatment was not found necessary. Retroversion of the gravid uterus.—Seven of such cases attended, often several times, requiring examination, and sometimes treatment on each occasion. Other cases.—Nineteen other ante-natal cases, with various complaints, e.g., ordinary incontinence, varices of the vulva, backache, attended this clinic. Post-natal cases.—In all, 33 post-natal cases attended, e.g., for prolapse, 9 cases, unhealed perineum, retroversion, &c. Examinations under anæsthesia.—It is after this clinic, i.e., on Tuesday afternoons, that such examinations are done. During 1935, 24 of such examinations were done—16 for external version of a breech presentation, with 13 successes and three failures—8 as an aid to the diagnosis of presentation and position of the foetus. 30 Wednesday and Thursday Morning Ante-Natal Clinics. 1. Number of sessions held 102 2. Total attendances 3,047 3. Average per session 29.9 4. New cases, 459— Primiparæ 252. Multipara 207. (Not pregnant 1). 5. Period of pregnancy when patient first seen— 1—6 months 384; 6—8 months 62 ; over 8 months 12. 6. Return cases 77 (i.e., 32 per cent. approximately of possible cases). 7. Number of cases of abnormality, 133— Small pelvis or apparent disproportion 33 Albuminuria 42 High blood pressure 9 Cardiac disease 3 Pulmonary disease (cases referred to Tuberculosis Officer) 4 Other abnormalities, e.g., varicose veins, pyelitis and cystitis of pregnancy, &c 42 8. Cases recommended— For dental treatment 122 To hospital for treatment 40 ,, for examination 62 — 102 „ own doctor for treatment 2 ,, V.D. clinic (vaginal discharge) 1 „ Tuberculosis dispensary for examination 4 Friday Morning Clinic (Southlands). No. of sessions held 51 Total attendances 789 Average per clinic 15.5 New cases— Primiparæ 90; multiparas 162; not pregnant, nil. Period of pregnancy when patient first seen— 1—6 months 197; 6—8 months 50; over 8 months 5. Return cases 88, i.e., 54 per cent.of possible cases. Number of cases of abnormality, 20— Albuminuria 3 Small pelvis or apparent disproportion 1 Cardiac disease 2 Pulmonary disease (case referred to Tuberculosis Officer) 1 Other cases 13 31 Cases referred For dental freatment 106 To hospital— For treatment 12 For examination 5 — 17 To private doctor for treatment ... 2 To Tuberculosis dispensary for examination ... 1 In connection with the work of the ante-natal department, the following figures, supplied by the Resident Medical Officer, are of interest. In considering them, attention is drawn to the fact that the same case may appear under more than one heading, e.g., a case of albuminuria treated unsuccessfully by "medicinal induction" may appear again under the heading "induction by rupture of membranes," &c. In-patient Department. Abnormality. Total No. of cases. Indications for Treatment. Results. Mothers. Babies. Albuminuria 35 required in-patient treatment 2 Eclampsia 1 died * 1 transferred 1 satisfactory 1 transferred Cardiac disease 3 required in-patient treatment Good Good Ante-partum haemorrhage— Accidental 2 All good All good Placenta praevia 2 Examinations under anaesthesia 24 For diagnosis of' presentation, 8 cases. Breeches for external version 16 cases (of which number 13 version successful, 3 unsuccessful) Cases delivered as breech at term— A. Diagnosed 4 All good 3 good, 1 still born B. Undiagnosed 3 All good All good (These twins, complinancy) included 1 case 1 case fibroids eating preg- * Also included under "forceps deliveries," next page. 32 Abnormality. Total No. of cases. Indications for Treatment. Results. Mothers. Babies. Inductions of labour— Medicinal 42 of which 24 cases only went into labour Usually albuminuria or other evidence of toxsemia; occasionally postmaturity or large size of child All good 15 good, 4 still born, including 1 anencephalic foetus; 5 premature infants died Rupture of membranes 19 All good 16 good 2 still born 1 premature infant died By bougies 0 Trial of labour 32 High head with possible disproportion All good (2 cases required forceps) 31 good 1 still born Forceps deliveries... 17 Uterine inertia 12 Foetal distress, 2 Persistent occipito presentation, 2 Preeclampsia, 1 16 good 1 died * 15 good 2 still born Caesarean section 10 Cardiac disease 1 Disproportion, 5 Obstruction by uterine fibroid 1 Ante-partum haemorrhage, 1 Albuminuria, 2 All good 9 good 1 baby died on 3rd day (Mother albuminuria) The subjoined table shows in summary the number of attendances, &c., at the municipal ante-natal clinics (excluding the special clinic referred to on page 33) during 1935. Clinics held at Maternity Hospital. Southlands. Plough Road. All Saints' Hall. Total. Sessions 102 51 51 50 254 Attendances 3,047 789 642 543 5,021 ,, average 30 15 13 11 20 New cases 459 252 6 6 723 Cases seen by doctor 3,047 763 581 514 4,905 Average per session seen by doctor 30 15 11 10 19 The work of visiting and reporting upon Battersea cases, which is done by the Council's health visiting staff for the obstetric and gynaecological departments of several of the larger hospitals is summarised on page 25. *See footnote previous page. 33 Ante-Natal (V.D.) Clinic. This special treatment clinic was established in connection with the Out-Patient Department at the Borough Maternity Hospital late in 1921. The clinic is fully equipped with the necessary requisites for diagnosis and treatment, and is under the direction and supervision of a specialist consultant (Mr. H. Corsi, f.r.c.s.). The work carried out during 1935 is summarised in the table on page 34. Mr. Corsi reports as follows:— During 1935 the blood of 613 prospective mothers was examined, and of this number a positive or weakly positive Wassermann reaction was found in 12, a percentage incidence of 1.9. Only four of these however, called for thorough treatment, the others being weak positive reactions; a few injections only were given, and only to some of the eight patients. Of the four serious cases one was treated out of the Borough; two were brought to a successful confinement, and have given birth to healthy infants ; the fourth was a bad case in which, in spite of treatment, the foetus soon died. As this mother has already two children who attend a school for the partially blind, this was probably a fortunate issue. The general atmosphere of the clinic continued to be a pleasant one ; occasionally there was a little difficulty in getting patients to attend, but this was always due to the call of their home duties, and not to any disinclination to have the treatment. Ambulance Service. As stated in the Report for 1934 the London County Council had decided to make their ambulance service available at all hours for the conveyance of maternity cases to hospital without charge, and this extension came into operation in April, 1935. Midwives. So far as can be ascertained there are 13 registered private midwives who reside in Battersea or adjoining districts and practise in the Borough, apart from those employed in the Council's maternity services. In addition to these private midwives and the District service provided by the Borough Council (vide page 38) the eastern portion of the Borough is served by the district midwifery services of St. Thomas's Hospital, Clapham Maternity Hospital and the General Lying-in Hospital, York Road. The scheme adopted by the Council (which is set out fully in the last Annual Report) for the compensation of private midwives who suffer financial loss through the removal of their patients to hospital came into force on 3rd January, 1935. No claims were made under that part of the scheme which relates to patients 34 BATTERSEA ANTE-NATAL (V.D.) CLINIC. Results 1922—1935. Year. Number of expectant mothers tested by W.R. Number giving positive W.R. Per cent. Number of expectant mothers with positive W.R. treated during pregnancy. Babies. Healthy Neg. W.R. Healthy looking. Not yet tested. Positive W.R. Still-born. 1922 — — — 1 1 0 0 0 1923 — — — 8 5 2 1 0 1924 517 18 3.5 15 11 3 0 1* 1925 653 14 21 8 7 1 0 0 1926 658 10 1.5 9 7 2 0 0 1927 674 12 1.7 12 6 4 2 0 1928 934 12 1.3 12 5 6 0 0 1929 804 13 1.6 13 10 3 0 0 1930 704 5 0.7 4 3 0 0 1* 1931 810 6 0.7 5 1 4 0 0 1932 832 11 1.3 11 5 6 0 0 1933 763 6 0.8 4 3 1 0 0 1934 727 5 0.7 3 3 0 0 0 1935 613 12 1.9 3 0 2 0 1 (Syphilitic.) [W.R. — Wasserrmann reaction.] * Not syphilitic. 35 brought to the Council's ante-natal clinics, but in the case of patients removed to hospital on the order of a doctor called in by the midwife at the confinement, payments amounting to £9 were made to 3 midwives in respect of 12 patients so removed. BOROUGH MATERNITY HOSPITAL. The Borough Maternity Hospital is situate at 19 and 20 Bolingbroke Grove, overlooking Wandsworth Common. It was established soon after the war, and was opened for the reception of maternity cases in February, 1921. Accommodation is provided for 30 patients at one time. The Hospital is also a recognised training institution for pupil-midwives, and, in addition, a District Midwifery service for the attendance of the District Midwife on patients in their own homes is directed from the Hospital. The fees are fixed according to a scale adopted by the Council in June. A Sub-Committee of the Health Committee meets monthly to consider, amongst other matters, appeals against the assessments made. The central ante-natal clinics and the special treatment clinic are held at the out-patient department of the Hospital. The nursing staff of the Hospital consists of a matron, sister and 4 staff nurses. There is accommodation also in the Hospital for 12 pupil midwives undergoing training. A post-natal clinic has been established at the Hospital where women who have been confined therein may attend for examination six weeks after confinement. During 1935 there were 52 sessions held and 481 attendances were made, 351 being new cases. The average attendance per session was 9.3. Arrangements have been made for Mr. F. W. Roques, m.ch., f.r.c.s., m.c.o.g., of the Middlesex Hospital, to act as consultant obstetrician, and his services are available in cases of grave emergency. It was found necessary to call in the services of the consultant obstetrician on 25 occasions during the year (as compared with 22 in 1934) for the following reasons:— Caesarean section 10 Albuminuria, &c 4 Ante-partum haemorrhage 1 Pyrexia 4 Haematoma 1 Retained membranes 1 Prolonged labour 1 Adherent placenta 1 Other reasons 2 During 1935, 489 cases were admitted to the Hospital as compared with 493 in 1934, 543 in 1933, 552 in 1932 and 555 in 1931. For each of the past 5 years the number of cases admitted has been approximately 22 to 23 per cent.of the number of Battersea births (live and still), and in 1935 it was 224 per cent. Particulars relating to the cases dealt with during 1935 are as follows:— New cages 484 Patients treated ante-natally in 1934 who re-entered during 1935 5 Total persons admitted - 489 36 Number of admissions— For confinement 480 For ante-natal treatment (54* patients) 60 For post natal treatment (after ment elsewhere) 1 Total admissions - 541 Number of confinements (one patient removed before confinement; one not yet confined at end of year) 478 Number of deliveries— By midwives 444 „ doctors 32 - 476 Number born before arrival 2 Total births (including 7 pairs of twins) 485 Number of maternal deaths 1 (Uraemia, obstetric shock) Number of cases notified as Ophthalmia Neonatorum with result of treatment. (Cured) 1 Number of cases with discharge from eyes however slight 10 Number of infants not entirely breast fed 15 Number of cases notified as puerperal sepsis Nil Number of cases notified as puerperal pyrexia 4 Number of infant deaths (12 still-born, 14 within 10 days of birth) and their causes 26 Still Birth— Died within 10 days— Unsuccessful version 1 Prematurity 11 Short cord; albuminuria; drug induction 1 Anencephalic 1 Hydrocephalic 1 Hydramnios; albuminuria 1 Congenital heart 1 Extended breech (version failed): prolapsed cord; uterine inertia 1 Drug induction; albuminuria 1 Drug induction; unhealthy cord; uterine inertia; forceps ... 1 Cord prolapse; early rupture of membranes; long 2nd stage 1 Drug induction; membranes ruptured 1 Macerated foetus 4 12 14 In the fourteen years from February, 1921, to the end of 1935 (since the opening of the Borough Maternity Hospital) 10 maternal deaths have occurred in the Hospital in 7,587 births * 5 of these to re-enter during 1936 for confinement. 37 (live and still). The maternal mortality rate for deaths occurring in the Hospital, i.e. the rate per 1,000 births (live and still) is therefore 1.32 compared with 2.79 for the whole Borough during the same period. In the District Midwifery Service, also inaugurated in 1921, only 2 maternal deaths had been recorded in 2,156 births to the end of 1935, the rate per 1,000 births (live and still) being 0.93. Cost of Maternity Hospital. I am indebted to the courtesy of the Borough Treasurer for the following statement of the cost of the Hospital during the financial year ended 31st March, 1936:— Maternity Hospital, 1935—6. Total beds (excluding cots, labour and isolation beds), 30; total cases admitted and discharged during year, 459; average number of beds occupied during the year, excluding cots, labour and isolation beds, 16.9; number of weeks spent in Institution bv such patients. 923. A statement* showing expenditure for the year ended 31st March, 1936, in respect of the Maternity Hospital is given below. Item. Total. Per PatientWeek. Salaries £ £ s. d. Medical 371 0 7 9 Nursing 718 0 15 1 Domestic and other 696 0 14 7 Superannuation (Council's contribution) 78 0 1 8 Provisions 668 0 14 0 Drugs and other medical requisites 124 0 2 7 Fuel, lighting and water 357 0 7 6 Laundry 267 0 5 7 Repairs and renewals Domestic 263 0 5 6 Structural 678 0 14 3 Miscellaneous items— Telephones, stationery, etc., and sundries 117 0 2 6 Totals, excluding rates, insurance and loan charges 4,337 4 11 0 Rates and insurance 76 0 1 7 Loan charges 1,047 1 2 0 Gross cost 5,460 5 14 7 Income Pupil Midwives (including training grant) 340 0 7 2 Patients' payments 2,040 2 2 10 Other 36 0 0 9 Net cost 3 044 3 3 10 * This statement does not take into account the Government Grant. 38 District Midwifery Service. During 1935 there were 189 cases attended in their own homes by the District Midwife as compared with 190 in the previous vear. Particulars relating to this service during the year are set out below:— Total number of cases attended in the district ... 189 Average number of visits to each case ... 14 Number of cases:— (a) Delivered by midwife (171 infants) 169 (b) „ doctors ... — (c) Born before arrival • • • 16 (d) Referred to hospital ... 4 Total number of bookings in 1935 ... 210 Number thereof cancelled or transferred 31 confined during 1935 128 to be confined in 1936 51 210 Number of cases where medical assistance was summoned, with reasons for requiring assistance:— (a) Ante-Natal—3. Placenta praevia 3 3 (6) During Labour—26. Prolonged labour 14 (?) Presentation (triplets) 1 Prematurity and (?) presentation 1 Abnormal breech presentation 4 Adherent placenta 2 Retained placenta, &c. 3 General condition 1 26 (c) After Labour—12. Macerated foetus 2 Post-partum haemorrhage 3 Shock and ruptured perineum 1 Ruptured perineum 3 Other reasons 3 12 (d) For Infant—16. Watery or sticky eyes 6 Prematurity and discharging eye 1 Blue asphyxia and septic spots 1 Septic spots 1 Watery blisters 3 Rash 1 Hare-lip and cleft palate 1 Abrasion 1 Convulsions 1 16 Number of cases of— Puerperal sepsis Nil Puerperal pyrexia 1 Maternal deaths Nil Still births 5 Deaths of infants within 10 days 3 39 During the year, from the end of January until the middle of February, an outbreak of Pemphigus Neonatorum occurred in the practice of the District Midwife. During this period 9 infants were attacked. Fortunately the disease was mild in type and complete recovery took place in each case. Pemphigus Neonatorum may be a very fatal disease, and, moreover, is highly contagious. All the necessary precautions were taken to limit the spread of infection, and the Midwife was sent away for two weeks' holiday prior to resuming her practice on the district. Following her resumption of duty, no further cases of this disease occurred. The number of cases attended by the District Midwife during the four years 1931-4 was on average 187 per annum, as compared with an average of 132 in the four years immediately preceding. The Health Committee, feeling that the midwife could not be reasonably expected to deal with so many cases, made arrangements with a trained midwife already in practice in the Borough, that her services could be called on in emergency and when the District Midwife was not on duty. This arrangement came into force in June, and 18 of the confinements between 29th June and 31st December were conducted by the relief midwife. These figures are included in the summary above. In June the Council adopted a scale upon which to assess the fees payable by applicants for the services of the District Midwife. Southwark Diocesan Homes. For some years past the Council has contributed towards the cost of the maintenance during the period before and after confinement of unmarried mothers and their children resident in the district, by the Southwark Diocesan Association for Moral Welfare, in St. Mary's House, Macaulay Road, Wandsworth, which is an institution affiliated to the Council's Maternity and Child Welfare scheme. They also contributed to the cost of Battersea unmarried mothers who are sent into other approved homes by the Association. The Council have since April, 1933, made a contribution of £150 per annum, in lieu of per capita payments formerly made. The number of Battersea mothers received in the Association's homes with their babies during 1935 was 6, and their average stay about 110 days. Home Helps. Facilities are provided by the Council in suitable cases for assistance in the home during the mother's lying-in period, and a list of women recognised for the service is kept by the Health Visiting staff, from which applicants are permitted to choose a suitable woman, who is paid by the Council. This service has not been used to the extent anticipated, and during the past three years no application for the services of a home help has been received. Having obtained the views of the Ministry of Health upon the subject the Committee in November authorised the extension of this service to any case of temporary illness of an expectant or nursing mother. 40 Maternal Mortality. During 1935, there were 4 deaths of women from diseases or accidents of child-birth which is equivalent to a fatality rate of 1.84 per 1,000 births (live and still), as compared with 7 deaths and a fatality rate of 3.15 in 1934. The certified causes of death were:— Puerperal sepsis Nil Prolonged labour 1 Ruptured ectopic gestation 1 Uræmia, obstetric shock 1 Cæsarean section 1 All these deaths occurred in hospital. In addition there was one maternal death not ascribed to causes directly associated with the puerperium. The rates for London and England and Wales in 1935 were 2.50 and 3.93 respectively. Maternal Deaths in Child-birth, and Maternal Mortality Rate per 1,000 Births (Live and Still). Year. Puerperal sepsis. Other puerperal causes. Total. No. Rate. No. Rate. No. Rate. 1930 4 1.45 6 2.18 10 3.63 1931 5 1.97 10 3.93 15 5.90 1932 2 0.83 2 0.84 4 1.67 1933 4 1.72 1 0.43 5 2.15 1934 3 1.35 4 1.80 7 3.15 Mean, 1930-34 3.6 1.46 4.6 1.84 8.2 3.30 1935 — — 4 1.84 4 1.84 From the above table it will be noted that there was a decrease in maternal mortality in the borough as compared with the previous year. Following the usual procedure, and in accordance with the instructions of the Ministry of Health, each of the 4 deaths of Battersea mothers was fully investigated, and reports submitted to the Ministry. The Council has made free provision under its Maternity and Child Welfare scheme for the ante-natal examination of expectant mothers. Doctors and practising midwives are invited to refer expectant mothers for examination and report by the consultant specialist who attends the ante-natal clinics on three days weekly, but up to the present they have failed to avail themselves of the facilities provided by the Council for this purpose to any extent. 41 The Council have also agreed to compensate any practising midwife who suffers loss of fees owing to her patient (having been referred by her to the Council's ante-natal clinic) entering hospital for her confinement on the advice of the medical officer of the clinic, vide page 33. Arrangements have also been made on the lines suggested by the Ministry to place at the disposal of medical practitioners practising in Battersea, specialist advice in difficult maternity cases. Convalescent Homes. During 1935, accommodation was provided for 12 mothers and 11 children attending the Maternity and Child Welfare clinics at four approved convalescent homes. The cost incurred by the Council amounted to £28 5s. 3d., and five of the families concerned contributed the balance of £3 0s. 0d. Eight other children attending the Council's Welfare Centres were sent away for a period of convalescence through the agency of the Invalid Children's Aid Association. In addition to the above a number of mothers and children attending the voluntary centres linked up with the Council's scheme were sent away for the period of convalescence, the cost of which was not borne by the Council. St. Thomas's Babies' Hostel. Since 1926 cases have been sent from the Borough Maternity and Child Welfare clinics to this Hostel for test feeding and the encouragement of breast feeding. The result of this work during 1935 is as follows:— A. Test Feeds. Number of cases, 145, comprising: Mothers, 145; babies, 146. Number of attendances, 510. 10 of these cases received in-patient treatment. B. In-Patient Treatment. Battersea cases received— 9 mothers and 18 babies sent by Council. 2 mothers and 7 babies sent from other sources. Period of stay. Cases sent by Council—9 mothers and 18 babies, 1,208 days; average, mothers 31.2 days, babies 51.5 days. Other cases—2 mothers and 7 babies, 530 days; average, mothers 42.5 days, babies 63.6 days. A contribution of £150 is made by the Council annually in respect of the work carried out by the Hostel for Battersea mothers. 42 Nursing Facilities. The Council have made arrangements with the South London District Nursing Association, of 109 Clapham Common North Side, for the nursing of mothers and children under the powers contained in the Maternity and Child Welfare Act of 1918, and also of patients suffering from certain infectious illnesses. A payment of 8d. per visit is made in respect of attendances on cases of infectious disease as set out in the table which follows. No charge is made by the Association for the attendance of their nurses upon mothers and children referred to them under the Council's Maternity and Child Welfare scheme. During 1935 the total number of attendances made by the nurses of the District Nursing Association in connection with cases of infectious disease was:— Nursing Service, 1935. Name of Disease. Age. Total. Under 5 years. Over 5 years. Cases. Visits. Cases. Visits. Cases. Visits. Ophthalmia neonatorum, &c. . 106 2,342 — — 106 2,342 Measles — — — — — — Whooping cough 2 27 1 12 3 39 Diarrhoea & vomiting 1 3 — — 1 3 Chicken pox — — — — — — Mumps — — — — — — Pemphigus — — — — — 85 neonatorum 5 85 — — 5 Puerperal pyrexia — — — — — — Pneumonia 14 274 36 572 50 846 Influenza 1 6 13 162 14 168 Erysipelas — — 2 16 2 16 Totals 129 2,737 52 762 181 3,499 Many of these cases were referred to the Association by medical practitioners. In addition to the cases mentioned above 1,091 visits were made by the district nurses to cases sent by the Council, for which no charge was made. The cost of the nursing service in 1935 was £116 12s. 8d. as compared with £153 19s. 4d. in the previous year. 43 Solarium. The Light Treatment centre was established at Southlands in 1929. The Centre is housed in a portion of the Southlands building which has been specially adapted and equipped for the purpose. The equipment consists of:— 2 carbon arc lamps. 4 general radiation lamps. 2 mercury vapour lamps. 4 couches. During the year 120 sessions were held for patients from the maternity and child welfare clinics, the number of patients on the roll at the end of the year being 8. The total attendances numbered 1,426, the average number per session being 11.9. A medical officer attended 17 of the sessions, at which she conducted 195 examinations. The number of persons who received treatment during the year (excluding tuberculous children) was 52, including 10 who commenced treatment in 1934. The ages of the 42 new cases who attended first in 1935 were as follows:— Under 1 year 8 1 to 2 years 26 2 to 3 „ 8 The reasons for their treatment were:— Prevention of Rickets 34 Debility 8 Treatment in these cases was by the mercury vapour lamps. Arrangements are made for massage treatment of children attending the light treatment centre immediately after their treatment by light. Particulars relating to tuberculous patients treated at the Clinic during the year will be found on page 66. Massage Treatment. For many years the Council have provided facilities in suitable cases for massage treatment for children attending their various centres. A competent masseuse gives treatment four times weekly either at the Southlands centre or at her home. A charge of one shilling per treatment is made, but this is borne in whole or in part by the Council in necessitous cases. The charge to be made in individual cases is assessed in accordance with the scale used for the grant of milk to necessitous mothers and children. A masseuse is specially engaged for the children attending the Mundella Road centre. 44 During 1935, 194 massage sessions were held (excluding the weekly sessions held at the Mundella Road centre), at which the attendances numbered 1,884, an average per session of 9.7. The cost to the Council in 1935 was £50 9s. 6d. This service includes the provision of massage treatment where necessary for those patients who attend the Council's artificial light treatment centre (vide page 43). Day Nursery. The only Day Nursery in the Borough is the St. Margaret's Day Nursery at 8 and 10 Cambridge Road, which since 1927 has been incorporated with the National Society of Day Nurseries. It continues, however, to be administered by a local committee upon which the Borough Council is represented. There is accommodation for 27 children, and for 24 in a guest house which is attached for the reception of residents. During 1935 the attendances at the Nursery totalled 5,608, the number of children admitted being 60. Sixty-five children were admitted to the Guest House. An annual grant of £500 is made by the Council in accordance with the requirements of the Scheme made by the Ministry of Health (vide page 19). No serious outbreak of infectious disease occurred during the year among the children attending the Nursery or Guest house. The Council in March, on an enquiry by the London County Council through the Metropolitan Boroughs Standing Joint Committee, expressed themselves in favour of co-operation between the County Council and Metropolitan Borough Councils for the provision of day nurseries (in districts where such provision was necessary), in connection with large County Council Housing estates. Infant Life Protection. The provisions of the Children and Young Persons Acts, 1908 and 1932, relating to infant life protection have since April, 1933, been administered in London by the Metropolitan Borough Councils. Foster mothers and the children in their care were visited throughout the year by the Health Visiting staff, who have been appointed by the Council as Infant Life Protection visitors. The number of visits paid by them in 1935 to foster mothers and children was 1,297. At the end of 1934 there were 70 Battersea foster mothers on the register, having in their care 102 nurse children. At the end of 1935 there were 58 foster mothers with 100 nurse children, a decrease of 12 foster mothers during the year. In addition there were on the register 67 foster mothers who had no children in their charge. 45 Twenty-eight notices of intention to receive nurse children were received during the year from foster mothers not previously registered, and 16 names were removed from the register. There was thus an increase of 12 mothers on the register, but of these a number had no children in their care at 31st December. The ages of the 100 children were as under:— Under 1 year 12 1 to 5 years 57 Over 5 and under 9 years 31 The whole number of nurse children who were under observation during 1935 was 202. Of the children under 5 years of age 21 were attending the infant welfare centres at the end of the year. In one case the Committee exercised their power of fixing the maximum number of nurse children permitted to be kept by a registered foster mother, in 2 cases a maximum previously fixed was increased, and in one case removed. Five cases of infectious disease occurred among nurse children during 1935. It was found necessary in one case to take legal proceedings during the period under report in respect of an offence, viz., failure to give the notice prescribed by the Children Acts of the reception of a nurse child. The defendant was fined £1, vide page 74. In 16 cases foster mothers were cautioned for the undermentioned offences:— Failure to give prescribed notice of— Reception of nurse child 11 Removal of nurse child 3 Reception and removal of nurse child 1 Removal of foster mother and child 1 46 Notifiable Infectious Diseases. During 1935 under the notification clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, 1,982 cases of infectious diseases (excluding tuberculosis) were notified, including cerebro-spinal fever 3, enteric fever 15. In 1934 the total was 5,146. The decrease in the number of cases notified during 1935 was chiefly due to the quiescence of measles. The following is a list of the diseases compulsorily notifiable in Battersea:— Anthrax. Ophthalmia neonatorum. Cerebro-spinal fever. Plague. Cholera. Pneumonia, acute influenzal. Continued fever. „ acute primary. Diphtheria. Polio-myelitis, acute. Dysentery. Polio-encephalitis, acute. Encephalitis lethargica, acute. Puerperal fever. Enteric (typhoid) fever. „ pyrexia. Erysipelas. Relapsing fever. Glanders. Scarlet fever. Hydrophobia. Small pox. Malaria. Tuberculosis. Measles. Typhus fever. Membranous croup. Whooping cough. Excluding tuberculosis, measles and whooping cough, there were 1,204 infectious cases notified, which occurred in 1,000 houses. Of these cases 1,007, or 83.6 per cent., were removed to the isolation hospitals of the London County Council or to other institutions and 197, or 16.4 per cent., remained under treatment at home. Full particulars of all notifiable infectious diseases will be found in the form required by the Ministry of Health on the next page, and the distribution of the cases notified in the registration sub-districts and the wards is shown in the table on page 48. Cases of "Contacts" which were reported to the Medical Officer of Health were kept under observation in connection with various diseases. 47 (Required by the Ministry of Health to be used in the Annual Report of the Medical Officer of Health.) Cases of Infectious Disease (excluding Tuberculosis) notified during the Year 1935, and Deaths from such Diseases. Notifiable Disease. Cases Notified in Battersea. at Ages (Years). Admitted to Hospital from each Sub-District. Deaths. 0- 1- 2- 3- 4- 5- 10- 15- 20- 35- 45- 65 & over Total N. S. Small-pox Diphtheria 2 9 22 26 36 165 51 27 34 7 4 — 383 205 177 9 Erysipelas 1 — — — — 1 1 5 3 12 26 11 62 13 17 1 Scarlet fever 2 15 32 33 54 172 62 13 24 9 1 — 417 237 172 — Enteric fever — — 1 — — 2 2 4 4 — 2 — 15 7 8 — Continued fever — — — — — — — — — — — — — Puerperal fever — — — — — — — 1 2 1 — — 4 — 4 — Puerperal pyrexia — — — — — — — — 2 9 — — 11 3 5 — Meningococcal meningitis — 1 1 — — — — 1 — — — 3 3 — 1 Ophthalmia neonatorum 21 — — — — — — — — — — 21 — 3 — Polio-myelitis, &c. 1 — — — — — 1 1 — — — — 3 — 3 — Polio-encephalitis — — — — — — — — — — — — — — Encephalitis lethargica — — — — — — — — — — 1 — — — — Malaria — — — — — — — — — — 1 1 — — Dysentry — 1 — — — — — — 1 — 2 — 4 4 — 3 Acute primary pneumonia 22 16 20 11 10 28 5 9 33 17 37 25 233 72 53 85 Acute influenzal pneumonia 1 — 1 1 2 4 2 3 8 8 10 7 47 13 5 10 Whooping-cough 81 83 85 106 103 232 5 1 3 — — — 699 36 26 9 Measles 20 15 9 7 11 6 5 4 2 — — — 79 13 6 — Totals 151 140 171 184 216 610 134 69 118 63 83 43 1982 609 479 118 48 Notifications of Infectious Diseases, 1935, in Wards and Sub-Districts. Notifiable Disease. Wards. Districts.† Totals. 1 2 3 4 5 6 7 8 9 N S Small-pox — — — — — — — — — — — — Diphtheria 48 53 55 38 50 78 21 17 23 206 177 383 Erysipelas 12 6 9 4 5 9 6 4 7 32 30 62 Scarlet fever 68 36 54 36 84 66 18 23 32 242 175 417 Enteric (Typhoid) fever — 3 2 — 2 1 1 1 5 7 8 15 Continued fever — — — — — — — — — Puerperal fever — — — — — 2 — 1 1 — — 4 Puerperal pyrexia 1 1 3 1 — 2 — 1 2 5 6 11 Ophthalmia neonatorum 4 2 1 1 — 3 4 3 3 7 14 21 Meningococcal meningitis 3 — — — — — — — — 3 — 3 Polio-myelitis, &c. — — — 1 — — — 1 1 — 3 3 Polio-encephalitis — — — — — — — — — — — — Encephalitis lethargica — — — — — — — — — — — Malaria — — — — 1 — — — — 1 1 Dysentery 2 1 1 — — — — — — 4 — 4 Acute primary pneumonia 37 26 38 17 33 32 13 23 14 134 99 233 Acute influenzal pneumonia 5 4 13 3 11 3 3 2 3 33 14 47 *Whooping cough 155 100 78 43 96 98 20 49 60 429 270 699 * Measles 9 13 21 3 12 7 5 4 5 55 24 79 Tuberculosis (all forms) 39 24 25 19 28 35 7 39 21 116 121 237 Totals 383 269 300 166 322 336 98 168 177 1,274 945 2,219 * Notifiable in Battersea since 1922. †See footnote, page 8. 49 Small-Pox. No case of small-pox was notified in Battersea during 1935. During the year one case was notified in England and Wales, but none in London. Three contacts with a case of small-pox which had occurred on a ship arriving in port were reported to the Medical Officer of Health and were kept under observation for the requisite period. No vaccinations were performed by the Medical Officer of Health during the year under report. Vaccination. The Public Vaccinators and the areas for which they act are shown in the following statement:— District No. 1 (Nine Elms Ward). Dr. M. Sayers, 273 Lavender Hill, S.W. 11 ; 65 Battersea Park Road, S.W. 8. (Deputy—Dr. A. B. Hewlett, 65 Battersea Park Road, S.W. 8.) District No. 2 (Park Ward). Dr. E. W. G. Young, 331 Queens Road, S.W. 8. (Deputy—Dr. M. Sayers, 273 Lavender Hill, S.W. 11 and 65 Battersea Park Road, S.W. 8.) District No. 3 (Latchmere and Church Wards). Dr. P. Purcell, 154 High Street, S.W. 11. (Deputy—Dr. M. Sayers, 273 Lavender Hill, S.W.I 1, and 65 Battersea Park Road, S.W. 8.) District No. 4 (Shaftesbury, Winstanley and St. John Wards). Dr. L. Golomb, 347 Queens Road, S.W. 8. (Deputy—Dr. H. Shaw, 112 Queens Road, S.W. 8.) District No. 5 (Bolingbroke and Brootnwood Wards). Dr. W. Walsham, 61 Clapham Common West Side, S.W. 4. (Deputy—Dr. G. R. Laing, 38 Bolingbroke Grove, S.W. 11.) District No. 6 (St. James's Hospital). Dr. W. L. Maccormac, St. James's Hospital, Ouseley Road, S.W. 12. (Deputy—Dr. A. P. Piggot, St. James's Hospital, Ouseley Road, S.W. 12.) District No. 7 (St. John's Hospital). Dr. E. F. W. Nixey, St. John's Hospital, St. John's Hill, S.W. 11. (Deputy—Dr. F. W. Brunker, St. John's Hospital, St. John's Hill, S.W. 11.) Vaccination Officer—T. C. P. Asbey, Town Hall, Battersea, S.W. 11. 50 The number of successful vaccinations by the Public Vaccinators during 1935 was as under:— Primary vaccinations— Under 1 year 1,080 1 year and upwards 53 Re-vaccinations 1,133 28 1,151 Certificates issued, children under 14 (including children born in other districts) 1,816 Statutory declarations of conscientious objection received during the year 689 Full statistics for the year 1935 had not been prepared at the time this report went to print, the last figures available being for the year 1934, as under:— Children whose births were registered during the year ended 31st December, 1934— Number of births registered 2,765 Successfully vaccinated 1,594 Insusceptible of vaccination 3 Had small-pox — Statutory declarations of conscientious objection 666 Died unvaccinated 135 Postponement by medical certificate 46 Removed to other districts 235 Removals untraced, &c 68 Not yet accounted for 18 2,765 Scarlet Fever. The incidence of scarlet fever was again lower in 1935, 417 cases being notified as compared with 616 in the previous year. No death was registered from the disease. In 54 other notified cases (not included in the above total) the diagnosis of scarlet fever was not confirmed at hospital. Of the cases notified 409 or 98.1 percent, were removed to hospital. The infected houses numbered 361. Diphtheria and Scarlet Fever in Battersea from 1916. (a) No. of cases per 1,000 population. (b) No. of deaths per 100 cases 51 Year. Cases. Houses Invaded. Registered Deaths. Per 1,000 Population Per 100 Cases. Notified. Per 1,000 Population 1931 448 2.80 391 6 0.04 1 .4 1932 545 3.47 450 4 0.03 0-73 1933 826 5.36 726 6 0.04 0-73 1934 616 4.08 540 — — — 1935 417 2.81 361 — — — Average 570 3.70 494 3 0.02 0-56 Diphtheria. In 1935 there were 383 cases of diphtheria notified (excluding 67 other cases in which the diagnosis was not confirmed after removal of the patient to hospital). There were 9 deaths registered as due to the disease. Of the 383 cases, 382 were removed to hospital. Particulars of the incidence of this disease during 1935 and the four preceding years are shown in the following table:— Year. Cases. Houses Invaded. Deaths. Notified. Per 1,000 Population Registered Per 1,000 Population Per 100 Cases. 1931... 298 1 -86 267 5 0-03 1.68 1932... 312 1-99 273 9 0 06 2.88 1933... 396 2-57 344 12 0 08 3.03 1934... 557 3-69 487 20 0-13 3.59 1935... 383 2-58 330 9 0 06 2.35 Average 389 2-54 340 11 0.07 2.71 The incidence of the disease was highest in the Winstanley, Park, and Latchmere wards. Diphtheria anti-toxin, in accordance with the recommendation of the Ministry of Health, is supplied free of charge on the request of any registered medical practitioner, at any hour of the day or night. During the year 20 phials (approximately 136,000 units) of anti-toxin were supplied, on request, to medical practitioners practising in the Borough. Schick Clinic. The Diphtheria Immunisation (Schick) Clinic, established at the close of 1927, is held weekly at the Southlands Maternity and Child Welfare centre. The work is carried on under the supervision of Dr. F. Porter Smith, m.r.c.s., l.r.c.p. 52 The result of the year's work is summarised as follows:— Sessions held 51 Patients attending in 1935 (new 495) 618 Attendances 2,294 „ (average per session) 45.0 Number of tests for susceptibility— New (including 5 second tests) 333 Old (second tests) 8 341 (Positive 257, negative on 1st test 64, on second 11, no reading 9) Patients inoculated— Without test 167 After positive test (old patients) 5 „ (new „ ) 257 429 Inoculations— Old patients 51 New „ 1,237 1,288 Tests after inoculation— Old patients 95 New „ 194 289 (Readings—Negative, 276; positive, 5; no reading, 8) Patients immune or immunised— On primary test 64 After inoculation 276 340 Patients on register at end of year 320* Discontinued treatment 50 The total number of patients immunised or found by test to be immune was 340, out of a total of 618 patients who have attended during the year (55 per cent.). Since the opening of the clinic 1,746 patients have attended, and of these 1,203 have been immunised or found immune by test (68.9 per cent.). Acute Polio-myelitis and Polio-encephalitis. Three cases of acute Polio-myelitis were notified in Battersea during 1935. No death was recorded. Cases of Polio-myelitis are also kept under observation after they have passed the acute stage, and during 1935 37 cases were visited by the Council's woman sanitary inspector, who paid 95 visits during the year. At the end of the year there remained 34 cases on the register. No case of acute Polio-encephalitis was notified during 1935 * Includes 3 negative cases who are to attend again for re-test. 53 Puerperal Fever and Puerperal Pyrexia. Four cases of Puerperal Fever were notified in Battersea in 1935, as compared with 10 in 1934, 3 in 1933, 4 in 1932, and 6 in 1931. No death was registered as due to this disease. One death from septicaemia following unlawful abortion was registered as due to violence. The number of notified cases per 1,000 births (live and still) was 1.84, as compared with 4.5 in 1934, 1.29 in 1933, 1.67 in 1932, and 2 .36 in 1931. There were 2,324 cases of Puerperal Fever notified in England and Wales during 1935, including 249 in London. A comparison of the incidence of Puerperal Fever in London and Battersea will be found on page 118. The number of cases of Puerperal Pyrexia notified in Battersea during 1935 was 11, and the incidence per 1,000 births (live and still) was 5.06. There were 5,888 cases of Puerperal Pyrexia notified in England and Wales during the year, including 686 notified in London. Under the provisions of the Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926, the Council have appointed a consultant to assist medical practitioners in the diagnosis of these diseases, and have provided facilities for the bacteriological examination of discharges, &c., from patients, and for the nursing of cases where required. Hospital accommodation for the treatment of Puerperal Fever is provided by the London County Council in their North Western Hospital. Enteric Fever. During the year 15 cases of Typhoid Fever (including 10 of Paratyphoid B) were notified, excluding 5 other cases in which the original diagnosis was not confirmed. Seven of these cases were notified in September. This is the highest number notified in Battersea since 1916. Careful investigation was made of the causation in every case. In one, the patient gave a history of having, while camping, obtained drinking water direct from a neighbouring river. Fairly conclusive evidence of direct infection from another patient was discovered in a second case. In several instances information was obtained that the patient had eaten ice cream purchased from the same firm of vendors, but bacteriological examination of samples of the ice cream, and investigation of the factory where it was made disclosed no evidence of infection. The possibility of the water supply being the source of infection was also investigated, but no reason to suspect the purity of the supply was found. Fortunately the majority of these cases proved to be mild, and there were no deaths. 54 Two cases of "Continued Fever" were notified during the year, but subsequently cancelled, the diagnosis after admission to hospital not being confirmed. Cerebro-Spinal Fever. During 1935, 3 cases of Cerebro-Spinal Fever were notified in Battersea, and one proved fatal. Encephalitis Lethargica. No notifications of this disease were received during 1935, and no death was ascribed to this cause. In London the number of cases notified during the year was 18, and in England and Wales (including London), 336. Ophthalmia Neonatorum. There were 21 cases of Ophthalmia Neonatorum notified in Battersea during 1935, as compared with 23 in 1934, 16 in 1933, 30 in 1932, and 37 in 1931. The rate per 1,000 live births was 10-0. There were 4 severe cases amongst the 21 notified, 2 of which were removed to St. Margaret's (L.C.C.) Hospital for treatment. All cases notified during the year were reported to be cured without damage to sight. During 1935 the number of visits paid by nurses, under arrangements made by the Council, to cases of Ophthalmia Neonatorum or other inflammatory condition of the eyes of the newly-born was 2,342. All cases were kept under systematic supervision by the Health Visiting staff, and 158 visits were made to the homes of these children. The following table shews the distribution notified:— of the cases Sub-Districts. Ward. Cases. Births, (live) Rate per 1,000 Births. Year. Cases. Births, (live) Rate per 1,000 Births. N. Battersea 7 1,094 6.4 1930 34 2,652 12.8 S. Battersea 14 1,010 13.9 1931 37 2,477 14.9 1. Nine Elms 4 381 10.5 2. Park 2 224 8.9 1932 30 2,319 12.9 3. Latchmere 1 248 4.0 1933 16 2,263 7.1 4. Shaftesbury 1 167 6.0 5. Church 241 1934 23 2,154 10.7 6. Winstanley 3 267 11.2 7. St. John 4 115 34.8 Mean 1930-34 28 2,373 11.7 8. Bolingbroke 3 230 13.0 9. Broom wood 3 231 13.0 Borough 21 2,104 10.0 1935 21 2,104 10.0 55 Erysipelas. There were 62 cases of Erysipelas notified and 1 death was recorded from the disease during 1935 in Battersea. The casemortality was 1.6 per cent, of the total incidence, and the deathrate per 1,000 population was 0.01. Measles. Seventy-nine cases of Measles were notified during 1935 under the Battersea (Measles and Whooping Cough) Regulations, 1922, and 10 additional cases reported from schools and other sources, making a total of 89 cases, being 0.6 per 1,000 of the population. No death from the disease was recorded. The corresponding figures for 1934 were: cases 3,719, incidence per 1,000 population 24.65, deaths 32, death-rate 0.21, case-mortality rate 0.86 per cent. Of the 89 cases, 19 were removed to hospital. The table below gives particulars for 1935, and in two-yearly periods of the biennial epidemics of measles which have occurred since the Regulations requiring the notification of measles in Battersea ramp into fnrrp Incidence and Mortality of Measles in Epidemic Periods, 1921-1934 and in 1935. Period. Cases notified or reported. Deaths Death rate per 1,000 Population Case rate per 100,000 Population Case mortality (per 100 cases). Under 10. All ages. 1921-2 3,209 68 1 .13 .201 948.3 2.12 1923-4 4,111 75 1.28 .220 1203.5 1.82 1925-6 4,997 47 .87 .137 1452.6 0.94 1927-8 4,197 37 .70 .111 1260.0 0.88 1929-30 3,921 43 .83 .133 1215.8 1.10 1931-32 3,002 25 .51 .079 947.6 0.83 1933-34 4,219 33 .72 .108 1383.9 0.78 1935 89 — - — 60.5 — Whooping-Cough. During 1935 there were 699 cases of Whooping-Cough notified under the Battersea (Measles and Whooping-Cough) Regulations, 1922, to the Medical Officer of Health and 366 additional cases were reported from the public elementary schools and other sources. The total number of cases notified or otherwise reported during 1935 was 1,065, as compared with 682 in 1934, 976 in 1933, 1,109 in 1932, and 747 in 1931, the increase in 1935 compared with 1934 being 56 per cent. Of the total cases, notified and reported, 74 were removed to hospital. There were 9 deaths registered from this disease, the deathrate being 0.06. 56 Whooping Cough, 1935, and Ten Previous Years. Cases. Deaths. Year. Notified or reported. Per 1,000 Population. Registered. Per 1,000 Population. Per 100 Cases. 1925 1,320 7.67 20 0.116 1 .52 1926 1,210 7.04 13 0.076 1 .07 1927 749 4.43 15 0.089 2.00 1928 1,228 7.48 14 0.085 1 .14 1929 1,317 8.14 43 0.266 3.26 1930 537 3.34 7 0.044 1 .30 1931 747 4.67 5 0.031 0.67 1932 1,109 7. 06 11 0.070 0.99 1933 976 6.34 12 0.078 1.23 1934 682 4.52 7 0.046 1 .03 Average 988 6.07 15 0 .090 1.42 1935 1,065 7.19 9 0.061 0.85 TUBERCULOSIS. During the year ended 31st December, 1935, there were 237 cases of Tuberculosis (all forms) notified in Battersea as compared with 236 cases in 1934, 238 cases in 1933, 246 in 1932, and 255 in 1931. In addition 34 cases were reported, or otherwise came to the knowledge of the Medical Officer of Health during the year, making a total of 271 cases. The following table (required by the Ministry ol Health; shows the age and sex distribution of the 271 cases of Tuberculosis notified or otherwise reported during the year ended 31st December, 1935, and of the 126 deaths registered as due to the disease. Age Periods. New Cases. Deaths. Respiratory. NonRespiratory. Respiratory. NonRespiratory. M. F. Total M. F. Total M. F. Total M. F. Total 0 — — — — 2 — 2 — — — 1 — 1 1 — 2 1 3 6 3 9 2 — 2 5 — 1 5 — 3 1 4 2 3 5 — — — — 1 1 10 — 3 — 3 5 4 9 — 1 1 2 1 15 — 7 18 25 2 4 6 2 4 6 1 1 20 — 12 23 35 1 7 8 10 11 21 — 1 1 25 — 29 34 63 2 5 7 16 9 25 1 — 1 35 — 15 12 27 4 3 7 3 4 7 — — — 45 — 18 7 25 1 1 2 13 5 18 — — — 55 — 17 3 20 — — — 19 4 23 — — — 65 and upwards 7 2 9 1 1 2 7 2 9 — — — Totals 113 101 214 26 31 57 72 40 112 10 4 14 Deaths from non-respiratory forms of tuberculosis formed 11.1 per cent, of the total deaths from the disease. 57 PERIOD 1ST JANUARY TO 31ST DECEMBER, 1935. The following table shows the distribution in sub-districts and wards, and the rates per 100,000 of the population, of the 271 cases of tuberculosis notified or otherwise reported, and of the 126 deaths. SubDistrict. New Cases. Deaths. Respiratory Non-Respiratory Total Rate per 100,000 populn. Respiratory Non-Respiratory Total Rate per 100,000 populn. M. F. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. North 59 46 105 13 13 26 72 59 131 182 36 19 55 4 ? 6 40 ?1 61 85 South 55 54 109 13 18 31 68 72 140 184 36 21 57 6 2 8 42 23 65 85 Ward 1 17 17 34 4 6 10 21 23 44 186 11 7 18 3 — 3 14 7 21 89 2 9 14 23 2 1 3 11 15 26 166 6 4 10 1 — 1 7 4 11 71 3 14 9 23 3 5 8 17 14 31 181 8 5 13 — 2 2 8 7 15 88 4 9 7 16 2 6 8 11 13 24 183 4 3 7 1 1 5 3 8 61 5 19 6 25 4 1 5 23 7 30 193 11 3 14 — — 11 3 14 90 6 13 18 31 3 3 6 16 21 37 208 11 0 16 1 1 2 12 6 18 101 7 4 2 6 3 2 5 7 4 11 138 5 1 6 1 1 6 1 7 88 8 17 14 31 4 7 11 21 21 42 245 4 7 11 3 1 4 7 8 15 87 9 12 13 25 1 — 1 13 13 26 129 12 5 17 — — — 12 5 17 84 Boro' 114 100 214 26 31 57 140 131 271 — 72 40 112 10 4 14 82 44 126 — Rate per 100,000 populn. 163 128 144 37 40 38 200 168 — 183 103 51 76 14 5 9 117 56 — 85-02 58 In the tables on pages 122 to 124 is shown the information required by the Ministry of Health in regard to notifications. ine localisation ot the disease m the il\ new cases notified or reported in 1935 was as under:— Pulmonary 214 N on-Pulmonary— Bones and joints 17 Abdomen 8 Other organs 19 Peripheral glands 13 — 57 Non-Notification of Tuberculosis. The following table gives particulars in regard to non-notification of Tuberculosis for the 10 years 1926-1935:— Year. Not notified (dead). Notified after Death. Notified on Form i. & ii. (Primary Notification not received). Reported from other source* Total 1926 13 10 4 7 34 1927 12 14 — — 26 1928 8 10 2 3 23 1929 13 13 1 7 34 1930 10 12 1 2 25 1931 17 14 2 7 40 1932 18 21 1 15 55 1933 14 15 2 6 37 1934 7 17 2 7 33 1935 8 19 — 7 34 In accordance with the suggestions contained in the circular letter of the Ministry of Health, dated 22nd December, 1924, with reference to the requirement of notification, in all cases where the obligation of notification is not complied with the attention of the medical practitioner concerned is drawn to the omission, and an explanation requested. It was not found necessary to take any other action during 1935 in this connection. Deaths from Tuberculosis. The death-rate from Tuberculosis was again lower in 1935 than in the previous year, being 85.02 per 100,000 population, as compared with 87.5 in 1934, 94.8 in 1933, 104.5 in 1932, and 108.3 in 1931. This is the lowest rate yet recorded in Battersea. 59 During 1935 deaths from Tuberculosis registered as belonging to the Borough of Battersea numbered 126, 112 (i.e. 88.9 per cent.) being due to pulmonary tuberculosis, 8 (i.e. 6.3 per cent.) to tubercular meningitis and 6 (i.e. 4.8 percent.) to other forms of the disease. The allocation of the deaths in 1935 according to age and sex, and in the Wards and Sub-Districts is shown on pages 56 and 57, while the chart on the following page shows the death-rates from tuberculosis since 1901. Of the fatal cases 13 were notified within one month before death ; in 19 cases the notifications were received after death, and 8 cases were not formally notified. Of the 8 cases in respect of which no primary notification was received 7 were patients who died in hospitals or other institutions. Of the 19 cases notified after death 9 (5 pulmonary, 4 nonpulmonary) were from Public Assistance Institutions ; 7 cases (3 pulmonary, 4 non-pulmonary) died in other hospitals, and the remaining cases (pulmonary) died at home. The death-rates per 100,000 of the population during the 35 years ended 1935 in quinquennial averages and in the individual years 1931 to 1935 are given in the following table:— Years. Pulmonary. NonPulmonary. Total. 1901-1905 138.1 50.9 189.0 1906-1910 126.8 45.9 172.7 1911-1915 124.2 33.8 158.0 1916-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1926-1930 91.1 14.2 105.3 1931-1935 81.8 14.4 96.2 Average (35 years) 112.8 30.3 143.1 1931 89.5 18.8 108.3 1932 89.8 14.7 104.5 1933 81.2 13.6 94.8 1934 72.2 15.2 87.5 1935 75.6 9.4 85.0 It will be seen from the foregoing table that (except during the war years) there has been a steady decline in the mortality rate from Tuberculosis. 60 Deaths from Tuberculosis in Battersea, from 1901 (per 1,000 population). 61 Public Health (Prevention of Tuberculosis) Regulations, 1925. No action was found necessary during 1935 under the provisions of these Regulations, which relate to the occurrence of Tuberculosis among persons engaged in the handling of milk. Revision of Notification Register. In accordance with the suggestion of the Ministry of Health the Tuberculosis Notification register is periodically revised, and during 1935 the names of 75 patients were removed from the register as compared with 97 in 1934. The County of London (Tuberculosis) Regulations, 1930. Ten children were, by arrangement with the Invalid Children's Aid Association, boarded out under the scheme of the London County Council under the above Regulations. The County Council make no charge to parents or guardians for this service. TUBERCULOSIS DISPENSARY. The work of the Tuberculosis Dispensary during 1935 may be summarised as follows:— The fixed annual contribution made by the London County Council towards the cost of the dispensary treatment of Tuberculosis was £1,037. The amount of this contribution is reviewed periodically, and a re-assessment is to be made for the financial years 1936 to 1939. The staff engaged on Tuberculosis work at the Dispensary will be found on pages 3 and 4, and the appointment of a new Tuberculosis medical officer is recorded on page 87. The Dispensary is affiliated to St. Thomas's Hospital, and 204 patients were referred to that institution for X-ray examination during the year. The Tuberculosis Medical Officer and one of the tuberculosis nurses are employed part-time in the medical inspection of children attending Springwell House Open Air School, Clapham Common North Side. Children exposed to infection in their homes are now eligible for admission to the school, in addition to notified cases. The Health Committee in December recommended the Council to co-operate with the Royal College of Physicians in an investigation being conducted by that body into the early stages of Tuberculosis by means of combined clinical, X-ray and tuberculin examination. The scheme provided for a scholar, appointed by the College, to do the tuberculin testing and to collate the results, the cost being borne by the College. The scholar was to work under the general direction of the Tuberculosis Medical Officer, but in no sense to interfere with the ordinary work of that officer. 62 The Council adopted the recommendation on 1st January, 1936. The Tuberculosis Officer continues to act as honorary Tuberculosis Consultant to St. James's Hospital, and visits the hospital every week. Patients are found to be readier to enter hospital when they know this arrangement exists. In addition to the patients in the tuberculosis wards many special cases are seen in other wards at the request of the Medical Superintendent. Patients and Attendances. In 1935 844 patients attended the dispensary for primary examination, 116 more than in 1934. These consisted of 577 persons who were referred by medical practitioners, otherwise presented themselves for examination, or were receiving treatment under the London County Council's tuberculosis scheme; 227 who had been in contact with cases of tuberculosis; and 40 already notified in other districts, who had moved into Battersea. Of these 844 cases 561 were discharged as non-tuberculous (including 218 of the contacts), 205 were found to be suffering from the disease, and 78 (including 7 contacts) were kept under observation for diagnosis. Particulars of the 205 positive cases are given under the next heading, and also in form T.145 on page 125. Old patients to the number of 615 also attended during the year, and the total number of attendances at the Dispensary during the year was 3,863 (of which 3,019 were of old patients), as compared with 3,577 in 1934. Visits to the homes of dispensary patients were made by the Tuberculosis Officers in 340 instances, and 4,418 visits were made by the Dispensary nursing staff, including 383 to patients not on the Dispensary register. The number of deaths of Dispensary patients was 92 as compared with 95 in 1934. Sixty-one of the patients were discharged as "recovered" or"diagnosis not confirmed" during the year, and 20 others ceased to attend, in addition to 76 patients who removed to other districts. New Patients. The five following tables contain particulars of the 205 new cases found to be suffering from tuberculosis. In the first table the Pulmonary cases are grouped under two headings:— (1) Group T.B. minus. In those cases Tubercle bacilli have never been found to be present in the sputum. (2) Group T.B. plus. In those cases Tubercle bacilli have been found in the sputum at some time. 63 Group T.B. plus is sub-divided under three headings:— Group I.—early cases. Group II.—intermediate cases. Group III.—advanced cases. As in previous years, it will be noted that in the Pulmonary *roup the incidence is highest in the age period 16-25, being 35-5 Der cent, of the total cases. A.—Pulmonary Tuberculosis—Age Groups. Years. 0-5 6-10 11-15 16-25 26-35 36-45 46-55 56-65 over 65 Total. Group T.B. minus 1 4 3 23 15 2 5 2 — 55 Group T.B. plus "Group i — — — 8 2 1 1 — — 12 Grou p II — — 3 26 33 9 8 6 1 86 _ Group 111 — — — 4 4 1 6 3 1 19 Total 1 4 6 61 54 13 20 11 2 172 B.—Non-Pulmonary Tuberculosis—Age Groups. Years. 0-5 6-10 11-15 16-25 26-35 36-45 46-55 56-65 over 65 Total Bones and joints 2 2 3 1 — 5 — — — 13 Abdominal 1 1 1 — — — — 3 Peripheral glands 3 1 2 1 1 — — — — 8 Skin and other organs — — 4 2 2 — 1 — — 9 Total 6 4 9 5 3 5 1 — — 33 C.—Mode of Onset in Pulmonary Cases. Mode of Onset. Number of Cases. Percentage. Cough 89 51.74 " Influenza " 4 2.33 Pleurisy 17 9.88 Pleurisv with effusion 6 3.49 Haemoptysis 41 23.84 Other modes 15 8.72 Total 172 100.00 The large proportion of cases in which the first noticed symptom was haemoptysis (blood-spitting) is again to be noted. 64 D.—Occupations in the 172 cases of Pulmonary Tuberculosis. Occupation. No. of Patients. Occupation. No. of Patients. Baker 1 Needleworkers 6 Barman 1 Newsagent 1 Bookmakers 2 No occupation 10 Builders and Decorators. 4 Nurses 2 Clerks, various 14 Packer 1 Domestic Workers 10 Post Office Workers 2 Drivers, Carmen, &c. 5 Printers 5 Engineers, various 8 Railway Workers 7 Factory Workers, various 12 Sailor 1 Furniture Removers 2 School Children 4 General Dealer 1 Shop Assistants 6 Housewives 37 Soldier 1 Infant 1 Stoker 1 Insurance Agent 1 Student 1 Journalist 1 Tailor 1 Labourers, various 13 Teachers 2 Laundry Worker 1 Travellers 3 Messengers 2 Window Dresser 1 Miner 1 E.—Family History of Tuberculosis in Pulmonary and Non-Pulmonary Cases. Near Relative. Remote Relative. No Family History. Pulmonary 50 4 118 Non-Pulmonary 6 5 22 Totals 56 9 140 Of the 205 cases, therefore, a history of Tuberculosis in a near relative was elicited in 27 per cent, and in a remote relative in 4 per cent. In all 32 per cent, gave a family history of Tuberculosis. Contacts. All contacts are asked to attend the Dispensary for examination. Home contacts of infectious cases are encouraged to attend the Dispensary every six months. Institutional Treatment. The London County Council are the authority for the provision of institutional treatment for Tuberculosis in London, and such treatment is supplied free of charge. In March and August the County Council notified the Council that in future the charges made for dentures and spectacles (if any) required by patients in their institutions would be abolished, unless the patient was entitled to benefits in respect thereof from his approved society. The County 65 Council also notified the Council that they would pay the travelling expenses of necessitous patients to and from their hospitals (not being in the patients' own district), and the Care Committee were asked to advance these fares. In August the County Council notified their intention of providing necessitous patients with necessary clothing, including boots and repairs, during their period of residence in institutions, where this provision could not be obtained from friends or through charitable sources. The number of patients who received institutional treatment under the scheme of the London County Council was 139, and the average length of stay was 78 days. The average period of waiting before admission was 9 days. Of these patients, 85 were discharged during the year, leaving 54 under treatment at the end of the year. Definite improvement as a result of institutional treatment was shown in 38 cases. Thirty-nine patients discharged themselves while undergoing institutional treatment. The results of treatment in 81 of the cases discharged from sanatorium during the year are shown in the following table:— Results of Institutional Treatment. Grade. Quiescent. Much Improved. Improved. In statu quo. No material improvement. Worse. Died. t.c. o.R. T.C. o.R. T.C. o.k. t.c. o.r. T.C. o.r. T.C. o.r. A 4 — 4 — 2 2 — - — 1 — - — B. i 1 - 3 1 1 1 — - - 3 1 BD - - 1 B. ii 2 — 5 4 4 10 — 2 1 13 — - 7 B. iii — — 1 — — — — — 1 1 - — 2 Non-Pulmonary 2 1 — — — — — — — — — — — T.C. = treatment completed. O.K. =ow» request. B.D. = breach of discipline. Tuberculosis Dental Clinic. Dental facilities for tuberculous patients were first provided by the Council in 1922. A weekly session is held at the Dental centre, Southlands, and patients requiring treatment or the provision of dentures are referred to the clinic by the Tuberculosis Medical Officers. The number of sessions held during 1935 was 48, and 246 attendances were made, the average attendance per session being 5.1. The work carried out included:—Extractions, 103 ; scalings, 4; fillings, 20; dentures supplied—whole sets 9, partial sets 6, repairs to dentures, 6; dressings, 16; advice, 57 (average per session, 4.6); total, 221. The net cost to the Council during the financial year 1935-36 for this service was £108 7s. 8d. 66 Extra Nourishment. The amount expended by the Council during the financial year ended 31st March, 1936, upon the provision of extra nourishment for 102 necessitous patients upon the Dispensary books was £464 10s. 5d. Artificial Pneumo-thorax Treatment. The number of dispensary patients who received artificial Pneumo-thorax treatment during the year was 42, as compared with 51 in 1934, and the refills given numbered 549, the cost to the Council amounting to £288 4s. 6d. The number of refills given at the five hospitals attended by these patients was as under:— Brompton Hospital 367 I Grove Park Hospital (L.C.C.) 18 St. Thomas's Hospital 142 I St. George's Hospital 3 Colindale Hospital (L.C.C.) 19 | Examinations and Reports. Bacteriological examinations made during the year numbered 890, 279 of the specimens examined coming from medical practitioners. The number of positive results was 203, or 22.8 per cent. Reports to public bodies numbered 1,011. Consultations with medical practitioners at the homes of patients and reports made on patients sent to the Dispensary totalled 605, while reports received in respect of insured persons on form G.P. 36 numbered 71. There were 218 patients referred to hospitals, including 204 sent to St. Thomas's for X-ray examination. Artificial Sunlight Treatment. During the year 14 Dispensary patients received treatment at the Council's artificial sunlight treatment centre at Southlands (vide page 43). In 7 cases treatment was completed, the usual period of treatment being from three to four months, and in 7 cases definite improvement was reported. The work is carried out by one of the Dispensary nurses under the direction of the Tuberculosis Medical Officer. Shelters and Beds. Provision is made by the Council for the loan, in suitable cases, of shelters for the use of patients to enable them to sleep in their gardens. In addition, two shelters are available at Southlands, adjoining the dispensary, for use during the day by patients selected by the Tuberculosis Officer. These patients may obtain dinners at a small cost. Arrangements are also made for the supply by the Council of beds and bedding in necessitous cases. 67 Dispensary Statistics. On pages 125 to 131 will be found Form T. 145, which contains the returns required by the Ministry of Health of the work of the Dispensary during the year 1935, and Form T. 145a, which shows in a summarised form the condition of all patients whose case records were in possession of the Dispensary at the end of 1935, arranged according to the years (from 1921 to 1935) in which the patients first came under public medical treatment for pulmonary and non-pulmonary tuberculosis. The Tuberculosis Care Committee. This Committee, the constitution of which is set out on page 2, met fortnightly throughout the year at the Dispensary. The following is a summary of the work carried out by the Committee during 1935:— Battersea Borough Council—extra nourishment, 193; dentures, 10; Borough charities, 1 204 Public Assistance Committee—financial assistance, 17; clothing, 15; dentures, 2; beds and bedding, 4; other assistance, 2 40 Charity Organisation Society—financial assistance, 1; clothing 5; boarding out of children, 2 ; other assistance, 3 11 United Services Fund and British Legion—financial assistance, 5; clothing, 2 ; bedding, 2 9 Other Agencies—financial assistance, 7; dentures, 3; clothing, 2; other assistance, 4 16 Training and Employment—Suitable agencies, 1; Council, 1 2 The following are some illustrations of the work done by the Care Committee throughout the year:— M.H., aged 27. This patient was sent away for institutional treatment, and her husband was anxious to obtain better accommodation for her when she returned. The family, consisting of husband, wife and a boy aged 14, were living and sleeping in one furnished room. They had no furniture of their own and could not obtain the things they required on hire purchase terms as the man had no security to offer, and his wages were very small. The Committee referred the case to the Charity Organisation Society who assisted the man to obtain the furniture he needed and he was then able to secure suitable accommodation. T.S., aged 25. Sent away for a long period of institutional treatment and mother could not afford to visit him. The Committee paid her fares and expenses on several occasions, and later, when notice was received of the patient's discharge, obtained a separate bed and bedding, &c., and arranged for the loan of a shelter so that patient could sleep alone in the garden. They were also able to obtain a grant for extra nourishment and financial assistance until the patient was fit to return to work. L.G., aged 24. Died of Tuberculosis, and widow was in financial stress as the insurance company had refused to pay the insurance benefit. 68 The Committee took up the matter with the Company concerned, and as a result of their action the claim was paid in full. F.M., aged 23. This patient was undergoing institutional treatment and was rather depressed as he had no pocket money, and his mother, a widow, was unable to make him any allowance. On enquiry it was found that he was not entitled to insurance benefit on account of arrears which he had been unable to pay. The Committee granted the money for the arrears and took up the case with the Approved Society and obtained payment of insurance benefit. The Health Committee discussed at several meetings a suggestion made by the Care Committee that a handicraft class should be established for the benefit of tuberculous patients. The Committee were generally in favour of such a scheme, but on making enquiries as to the effect which employment in such a class would have upon the patients' benefit under the National Health Insurance Acts the position was found to be obscure, and the matter was not pursued. Non-Dispensary Cases. All the Tuberculosis visiting for the Borough is now undertaken by the Dispensary staff, and this has greatly simplified and coordinated the work. There has been a marked decrease in the cases formerly unknown to the Dispensary. In 1934 there were 184 non-dispensary cases, but in 1935 there were only 133 cases not on the Dispensary register, i.e., 14 per cent, of the total notified cases. Three hundred and eighty-three visits have been paid to these patients during 1935 by the Dispensary nurses. DEATHS FROM ZYMOTIC DISEASES. The principal zymotic diseases are small-pox, measles, scarlet fever, diphtheria (including membranous croup), whooping-cough, enteric fever and diarrhoea. The deaths from these causes in 1935 numbered 38, as compared with 91 in 1934, a decrease of 58 per cent. There was a corresponding decrease in the zymotic death-rate from 0.603 in 1934 to 0.257 in 1935. The following table shows the zymotic death-rate (per 1,000 population) in Battersea for each of the last five years :— Battersea London 1931 0.21 0.33 1932 0.48 0.61 1933 0.38 0.32 1934 0.60 0.40 1935 0.26 0.29 Mean 0.39 0.39 69 NON-NOTIFIABLE DISEASES. Information as to the occurrence of non-notifiable forms of infectious disease is obtained chiefly from the returns made by the head teachers of elementary schools which show the absences of scholars which are attributed to illness, and the nature of the disease. All cases of infectious illness shown on such returns are immediately visited by the Sanitary Inspectorial and Health Visiting staff, and such steps as may be desirable or necessary are taken to prevent the spread of infection. Chicken-Pox. During 1935 there were 178 cases of chicken-pox reported, as compared with 457 in 1934, 790 in 1933, 422 in 1932, and 492 in 1931. Diarrhœa. During 1935 the total number of deaths from diarrhoea of children under 2 years of age was 19, equivalent to a fatality-rate of 0.13 per 1,000 of the population. In 1934 there were 27 deaths and a fatality-rate of 0.18. The rate per 1,000 live births in 1935 was 9.0, as compared with 12.5 in 1934, 9.72 in 1933, 9.49 in 1932, and 3.63 in 1931. Influenza. There were 18* deaths registered as being due to Influenza during 1935, as against 15 in 1934, 71 in 1933, 40 in 1932, and 56 in 1931. The mortality-rate per 1,000 population was 0-12, as compared with 0.10 in 1934, 0.46 in 1933, 0.25 in 1932 and 0.35 in 1931. Influenzal Pneumonia was slightly more prevalent in 1935 than in the previous year, 47 cases being notified as against 41 in 1934, 86 in 1933, 60 in 1932, and 67 in 1931. The death-rate was 0.07 per 1,000 of the population, as compared with 0.03 in 1934. Cancer. During 1935 the number of deaths of Battersea residents from Cancer was 265 (males 140, females 125) as compared with 240 in 1934, 289 in 1933, 268 in 1932, and 283 in 1931. The death-rate from the disease per 1,000 of the population was 1.79. The deaths from cancer constitute 14.9 per cent. of the total Battersea deaths during the vear. The following gives the comparative average death-rates from Cancer in Battersea for quinquennial periods since 1896 :— 1896-1900 0.52 1931-5 1.75 1901-5 ... 0.88 1931 1.77 1906-10 0-95 1932 1.71 1911-15 11.1 1933 1.88 1916-20 1.28 1934 1.59 1921-25 ... 1.33 1935 1.79 1926-30 1.51 * 10 of these deaths were ascribed to Influenzal Pneumonia. 70 The following table shews the localisation of the disease in the case of the 265 deaths recorded in 1935. Localisation. No. of deaths. Total. Percentage of Total.  Male Female Buccal cavity 11 - 11 4.15 Stomach, liver, peritoneum, intestines and rectum 71 54 125 47.17 Respiratory system 34 2 36 13.58 Female genital organs - 30 30 11.32 Breast 1 26 27 10.19 Skin 2 1 3 1.13 Genito-urinary organs (male) 16 — 16 6.04 Other and unspecified organs 5 12 17 6.42 Total 140 125 265 100.00 Diabetes. For some years past, with the sanction of the Ministry of Health, the Council has borne the cost of insulin required by certain necessitous patients who were receiving treatment for diabetes at London hospitals. During 1935 insulin was supplied to one such case. Venereal Disease. The Health Committee in April approved a scheme of the British Social Hygiene Council for holding a series of lectures and film displays in the Borough on the subject of venereal disease, and gave instructions for assistance to be rendered to the Society in making the lectures known. The work of the Council's Special Clinic in connection with the Borough Maternity Hospital is summarised on pages 33 and 34. Bacteriological Examinations. The bacteriological examination of clinical material (with the exception of specimens of sputum, which are dealt with at the Tuberculosis Dispensary, vide page 66) is carried out by the Clinical Research Association, of Watergate House, Strand. During 1935 the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 1,968 (exclusive of the Tuberculosis specimens). The following table gives particulars of the bacteriological examinations carried out during the year:— Suspected disease. Positive Results. Negative Results. Total.  Diphtheria 181 1,769 1,950 Enteric fever 4 14 18 Total 185 1,783 1,968 The cost of these examinations is borne by the Council, and in 1935 amounted to £256 17s. 6d., as compared with £263 6s. 10d. in 1934. 71 Sanitary Circumstances. SANITARY INSPECTION OF THE BOROUGH. Summary of Sanitary Operations for the Year 1935. Complaints received and attended to 4,266 Water closets cleansed and repaired 748 Number of house inspections 35,103 Cesspools abolished — House to house inspections 1,021 Dust receptacles provided 705 Houses let in separate tenements on register 66 Urinals—inspections 168 Do. altered, repaired or water laid on 46 No. of inspections of do. 843 Shops Act inspections 2,043 Accumulations of manure and other obnoxious matter removed or proper receptacles provided 7 Premises improved, cleansed and repaired 2,510 Underground sleeping rooms : Use discontinued 2 Keeping of animals in unfit state discontinued 17 Defects remedied — Overcrowding abated 18 Gipsy van inspections 122 Leaky house-roofs and gutters repaired 848 Factories, Workshops, &c., inspections. 4,644 Yards and forecourts paved and repaired 425 Sanitary conveniences provided or improvements effected in Factories and Workshops (Sec. 38) 123 Drains laid to new houses and tenements 73 Drains tested—Smoke tests 400 Bakehouse inspections 74 Do. Water tests 1,457 Bakehouse nuisances abated 17 Drains relaid 113 Smoke observations 20 Drains cleansed and repaired 398 Premises disinfected 2,062 Frontage drains constructed or re-constructed 45 Houses supplied with disinfectants 269 Mews and stables drained and paved 2 Certificates of disinfection granted 3,525 Soil pipes and drains ventilated 196 Intimation notices (Sec. 3) 3,535 Sink and rain-water pipes disconnected or repaired 437 Notices under Sec. 4, &c. 1,482 Notices under Secs. 62 & 65 1,465 Houses inspected and certificates granted (Sec. 48) 73 Proceedings ordered by Council and Health Committee 3,554 Houses supplied with water and fittings repaired 52 Summonses issued 23 Magisterial Orders obtained and enforced 18 Cisterns covered, cleansed and repaired 134 Samples taken under the Food and Drugs (Adulteration) Act 1,200 Additional water supplies to upper floors 20 Miscellaneous 2,455 Water closets provided, supplied with water or supply disconnected from drinking water cisterns 31 Total sanitary operations 70,314 72 Legal Proceedings. Legal proceedings were taken by the Council during 1935 in respect of 22 offences against the provisions of various Acts, byelaws, &c., administered by the Health Department. Particulars of each case are set out below. Nature of Offence or Claim. Result of Proceedings. Public Health (London) Act, 1891 and Bye-Laws made thereunder. Being the builder executing certain work, namely, the re-construction of a water closet at No. 100 Castle Street, failed to give at least 24 hours' notice thereof to the Council. That the process or manufacture carried on at defendants' works caused effluvia which was a nuisance. Failing to abate a nuisance at No. 12 Louvaine Road after service of a notice under the Act. Being the builder executing certain work, namely, the re-construction of a water closet at No. 57 Parma Crescent, failed to give at least 24 hours' notice thereof to the Council. Fined 10s. and £1 1s. costs awarded to the Council. Determination adjourned pending the construction of a chimney stack, on the defendants' undertaking to adopt in the meanwhile all practicable steps for abating the nuisance. Liberty given to Council and defendants to apply to restore the summons at the expiration of six months. Order to abate the nuisance in 14 days. £1 1s. costs awarded to the Council. Defendant discharged under the Probation of Offenders Act, 1907. £1 1s. costs awarded to the Council. Public Health (London) Act, 1891. London County Council (General Powers) Act, 1922. Application by Sanitary Inspector for a warrant to enter the premises for the purpose of inspection under the above Acts, admission to the premises having been refused. Application granted and warrant issued by the Magistrate. Metropolis Management Acts. L.C.C. Drainage Bye-Laws. Having deposited plans of drainage work at No. 60 Winstanley Road, failed to show so much of the existing work as would enable the Council to see the relative position of the old and new work. Having deposited plans of drainage work at No. 60 Winstanley Road, failed to deposit such detailed description and particulars as were necessary to enable the Council to ascertain if construction would be in accordance with the byelaws. Penalty of 10s. imposed. Penalty of 10s. imposed. 73 Nature of Offence or Claim. Result of Proceedings. London County Council (General Powers) Act, 1908. Bye-Laws made thereunder. While carrying on the business of a rag and bone dealer distributed a toy. Fined 5s. Food and Drugs (Adulteration) Act, 1928. Sale of Milk Regulations, 1901. Selling a cream sandwich not of the nature, substance and quality of the article demanded by the purchaser. The like. Selling milk deficient in fat to the extent of 15 per cent. below the permitted minimum. Selling milk deficient in fat to the extent of 6 per cent. below the permitted minimum. Summons adjourned for judgment to be written. Adjourned hearing, 29th A pril. Summons dismissed. £3 3s. costs to be paid by the Council to the defendant. By consent, summons withdrawn. Summons dismissed on payment by the defendants of £2 2s. costs to the Council. Fined £3. £2 2s. costs awarded to the Council. Merchandise Marks Acts, 1887 to 1926. Merchandise Marks (Imported Goods) No. 4 Order, 1929. i Exposing for sale imported raw tomatoes without any indication of origin. Exposing for sale tomatoes to which a false trade description as to the country in which such goods were produced was applied. Fined 5s. Fined 2s. 6d. London County Council (General Powers) Act, 1928. Application by the Medical Officer of Health for an order for removal of M.P. to an infirmary. The like. (A.M.) Application by Medical Officer of Health for an order for detention in an infirmary for a further period of three months from 3rd July, 1935. (M.P.) The like. (A.M.) Application by Medical Officer of Health for an order for detention in an infirmary for a further period of three months from 2nd October, 1935. (M.P.) The like. (A.M.) Order made for removal to an infirmary and for detention therein for three months. The like. Order made as asked. The like. Order made as asked. The like. 74 Nature of Offence or Claim. Result of Proceedings. Children Acts, 1908 to 1932. Having undertaken for reward between the 8th and 20th December, 1934, the nursing and maintenance of an infant under the age of nine years apart from its parents, failed to give notice thereof within the required period. Fined £1. Miscellaneous. Attempting by a false statement of weekly income, to obtain a supply of milk at a reduced rate under the Council's Maternity and Child Welfare Scheme. Fined £5 to be paid by weekly instalments of 10s.; one month's imprisonment in default of payment of any instalment. Summary of Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department during 1935 in respect of 22 offences against various Acts and bye-laws, &c. Acts and Regulations under which Proceedings taken. Cases. Persons prosecuted including employees. Convictions. Fines. Costs. Public Health (London) Act, 1891, and bye-laws made thereunder 5 5 4 £ s. d. £ s. d. 0 10 0 3 3 0 MetropolisManagement Acts 2 1 2 1 0 0 - Food and Drugs (Adulteration) Act, 1928 4 5 1 3 0 0 4 4 0 London County Council (General Powers) Act, 1908 1 1 1 0 5 0 - Ditto 1928 6 2 6 - - Children and Young Persons Acts 1 1 1 1 0 0 - Merchandise Marks Acts 2 1 2 0 7 6 - Miscellaneous 1 1 1 5 0 0 - Total 22 17 18 11 2 6 7 7 0 75 New Legislation, &c. During 1935, the following new Acts and Orders affecting the work of the Public Health Department came into force:— (a) Acts of Parliament— (1) Housing Act, 1935 (vide page 105). (2) London County Council (General Powers) Act, 1935, Section 65 of which modifies the method of serving notices under the Metropolis Management and other Acts, and Section 67 gives new powers as to the supply of drinking water to houses, &c. (b) Orders and Regulations— (1) Sale of Food (Revocation) Order, 1935. (2) Anthrax Order, 1935, which regulates the importation of goat hair. (3) Public Health (Meat) Amendment Regulations, 1935, which made some verbal amendments in the Order of 1924. (4) Pharmacy and Poisons Act, 1933 (Date of Commencement) Order, 1935. (5) Poisons List (Confirmation) Order, 1935. (6) Poisons Rules, 1935, which will come into operation on 1st May, 1936. (7) Merchandise Marks Act Orders, relating to pre-packed imported salt, and granting certain exemptions from the Order of 1934 relating to imported meat. (8) Sanitary Officers (London) Regulations, 1935, which lays additional duties on the Medical Officer of Health to furnish annually to the Ministry of Health information as to overcrowding. (9) Orders made under the Agricultural Produce (Grading and Marking) Acts relating to various foodstuffs. (10) Housing Acts (Overcrowding and Miscellaneous Forms) Provisional Regulations, 1935. (11) Housing, England, Regulations, 1935. Sanitary Inspection. Following upon the retirement of the Senior Sanitary Inspector and the engagement of an additional inspector (vide page 87) opportunity was taken to revise the boundaries of the sanitary inspectors' districts, which, with minor exceptions, had remained untouched since 1898. The number of districts was left unchanged at eight, but considerable revision of the boundaries was made, and 76 the division of the Borough was made on the guiding principle of providing equal work (as far as practicable) for each inspector irrespective of the size of the district. District No. 7, however, assigned to the Senior Inspector, was of smaller size in view of the other duties attached to his office. Shops Act, 1934. This Act came into force on 1st January, 1935. The functions of Metropolitan Borough Councils thereunder are limited to enforcement of the provisions relating to (1) ventilation, (2) heating, and (3) sanitary accommodation. It is estimated that there are about 2,800 shops in Battersea, and they have been systematically inspected throughout the year by the staff of sanitary inspectors in so far as their normal duties permitted. The number of shops of which inspection was complete at 31st December was 1,580, and the total number of inspections throughout the year was 2,043. Non-compliance with the Act was noted in the undermentioned cases:— Ventilation 48 Heating 23 Sanitary accommodation 178 249 In many cases, however, the question of heating was deferred for review in the cold season of the year. In the course of inspection for the purpose of the Shops Act, many defects were found in premises which were dealt with under the nuisance clauses of the Public Health (London) Act, but these are not included in the above figures. The 249 defects were found in 229 shops, some of which were found to contravene the requirements in more than one respect. Appropriate action was taken in regard to the defects found, and 236 intimation and 27 statutory notices were served, of which 143 (141 shops) had been complied with at the end of the year. The defects remedied comprised the following:— Water closets provided 11 ,, „ improved 90 Heating provided or improved 6 Ventilation ,, „ 39 in addition to general defects referred to above. The inspection is being continued and it is hoped that the whole of the shops in the Borough will have been dealt with before the end of 1936. 77 With regard to sanitary accommodation the Council are empowered to issue certificates of exemption from the requirements of the Act in cases where, by reason of restricted accommodation or other special circumstances, it is reasonable to do so. During 1935 such certificates were granted by the Health Committee on the reports of their Officers in the case of 18 shops. The enforcement of the Act presents problems, particularly in relation to the requirement as to heating and sanitary accommodation. It is obvious that the heating of a shop used for the sale of perishable goods such as meat or fish, and possibly not even provided with a shop-front, is a matter of considerable difficulty, apart from the necessity of avoiding conditions which would tend to cause damage to the goods exposed for sale. Again, the requirement that sanitary conveniences must be provided in the shop is a cause of difficulty in some cases, e.g., where the shop is small and a few assistants of both sexes are employed. The Act does not require separate conveniences to be provided for each sex, and the Committee, having this question before them, adopted a rule that (other circumstances being favourable) they would not require the provision of separate conveniences for the sexes where not more than four persons, male and female, were employed, provided certain conditions were complied with. These and similar difficulties are being met with in every borough, but there is little reason to doubt that with greater knowledge of the conditions obtaining in London, and a pooling of the experience gained, a common agreement will be reached as to the best method of dealing with the problems. Common Lodging Houses. The Transfer of Powers (London) Order, 1933, placed upon the Council, as from the 1st April, 1933, various duties relating to common lodging houses and the enforcement of the bye-laws made by the London County Council relating thereto. The common lodging houses in Battersea are three in number, and details relating thereto are set out in the following table:— Premises Lodgers authorised. Inspections. Notices. Prosecutions. Served. Complied with. Males— 75 Falcon Road ... 67 32 — — — 134 High Street ... 54 32 — — — Females. 67 Winstanley Rd. 66 15 — — — Total 187 79 — — — 78 Systematic inspection of these houses is carried out by the Council's inspectors, and, generally speaking, they are found to be in a sanitary condition, and conducted in accordance with the requirements of the bye-laws. At the request of the London County Council a special inspection was carried out at midnight of the 21st February, when the number of beds occupied was found to be, men 80, women 26. Applications for the renewal for one year of the existing licences were granted by the Committee in June. There are no seamen's lodging houses in the Borough. Drainage Work. The bye-laws made by the London County Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act relating to waterclosets, &c., are enforced by the Council. The former were revised by the London County Council on 14th March, 1934. During the year new drains were constructed to 230 new buildings, or additions to existing buildings, and the drains of 113 old buildings were partially or entirely reconstructed, under the supervision of the Officers of the Department. Daring 1935, 12 claims made by the owners that the Council were liable for the reconstruction of the common portion of the drainage systems of their premises were dealt with. In 5 cases liability, wholly or in part, was admitted by the Council, and the expenditure incurred by them under this head amounted to £135 5s. l1d. In the other 7 cases liability was not admitted. The total number of plans of proposed drainage work deposited during 1935, as compared with 1934, was as under:— 1934 1935  Re-construction or repair of existing drains 68 83 New buildings or additions to existing buildings 104 133 172 216 In 28 cases the Health Committee gave directions for proceedings to be instituted if necessary against builders who had failed to submit plans of drainage works executed by them, but in only one case was it found necessary to take legal action (vide page 72). In 27 cases work to drains and sanitary fittings was found to have been carried out without notice having first been given or plans submitted to the Council in accordance with the requirements of the drainage and other bye-laws. 79 These cases were reported to the Health Committee, who in the circumstances reported to them ordered the offenders to be cautioned except in two cases where legal proceedings (the result of which is shown on page 72) were instituted. During the year 1935, drains were tested by smoke on 400 occasions and in 104 cases the drains were found defective. The water test was applied on 1,457 occasions, this being mainly applied to drains in course of construction or reconstruction. Soil pipes and drains were ventilated in 196 instances. Water closets were provided in 31 cases and existing closets repaired in 748 cases. The total number of drains relaid during the year was 113. Those cleansed and repaired numbered 398. Public Cleansing. The collection of house and trade refuse is carried out weekly, except in the case of blocks of dwellings, hospitals, schools, &c., where the collection is carried out more frequently. The refuse is disposed of partly by burning at the Council's destructor, but by far the larger amount is removed by barge to suitable "tips" outside London. The removal is carried out under contract which imposes stringent conditions for the avoidance of nuisance. The total quantity disposed of during the year ended 31st December, 1935, was as follows:— House refuse. Trade refuse. Tons. Tons.  Burned at destructor 822 965 Removed by barge 28,700 2,108 29,522 3,073 The use of the destructor at Culvert Road (which was nearly 50 years old) was discontinued at the end of 1935. There are no earth-closets, privies or cesspools in the Borough. Houses Let in Separate Tenements. Bye-laws with regard to houses let in separate tenements were made by the London County Council in 1925 and in 1931 under the provisions of the Housing Act, 1925. These bye-laws, so far as they are applicable, are being enforced by the Council. There are 66 premises in Battersea registered as houses let in separate tenements and 843 inspections of these premises were made in 1935. 80 Sanitary Conveniences attached to Licensed Premises. During 1935 the number of public-house urinals under inspection was 119. In 70 instances the accommodation is accessible to the general public as well as the users of the houses, and in 49 cases the accommodation is accessible to the customers only. As a result of the annual inspection of these conveniences, 14 notices were served to remedy defects discovered, and were duly complied with. Smoke Nuisances. During the year 20 observations were made and 5 complaints received. Five preliminary and 1 statutory notices were served by the Council under the provisions of the Public Health (Smoke Abatement) Act, 1926, to abate smoke nuisances. Effluvium, &c., Nuisances. Reference was made in the last annual Report to complaints received as to nuisance caused by noxious effluvia from a large works situated near the river Thames. For a period of many months the Council had been in communication with the firm owning the works, by whom special apparatus was installed at considerable expense to prevent the nuisance. During the early months of 1935, however, it continued, although the apparatus in question was in full use, and it became necessary for the Medical Officer of Health to "represent" the nuisance formally under Section 21 of the Public Health (London) Act. The Health Committee thereupon issued a summons against the firm, and this was heard at the South Western Police Court on 25th July, when, on a statement by the defendants that a new chimney stack, which was expected to mitigate the nuisance, was already under construction, but would not be completed for some months, the magistrate suspended his final determination pending the construction of this stack on the company undertaking to adopt in the meanwhile all practicable means for abating the nuisance. From this time complaints practically ceased, and the erection of the chimney stack was by the end of the year nearly completed. A few complaints have also been received during the year of offensive smells from the Battersea Power Station of the Central Electricity Board, but no evidence of the existence of a nuisance was obtained. Constant observation is kept on this station by the Council's inspectors. Offensive Trades. There are three premises in Battersea at which scheduled offensive trades are carried on, viz.: fat melters 2, soap boilers 1, all of which have been established for many years and are generally well-conducted. During the year 7 inspections were made of the registered premises in the Borough. 81 Removal of Offensive Matter. The bye-laws of the London County Council with regard to the removal of offensive matter are enforced by the Borough Council. No contraventions of the bye-laws were reported during the year. Water Supply. During 1935 certificates of water supply in respect of 73 houses or tenements were issued in accordance with Section 48 of the Public Health (London) Act, 1891. In 20 cases additional water supply was provided to the upper floors of tenement houses, where required by the Borough Council under the provisions of Section 78 of the London County Council (General Powers) Act, 1907, and Section 48 of the Public Health (London) Act, 1891. During 1935, 41 notices were sent to the Metropolitan Water Board of waste of water observed at various premises during the course of inspection. The water supply for the dwelling-houses on the Council's Latchmere estate is derived from four deep artesian wells situate on the baths premises adjoining. Two of these wells were provided in 1903, and two were then already in existence. The Public Analyst was instructed to examine the water supplied from the wells, and his report, submitted to the Baths Committee in December, showed that all four boreholes yielded water of high organic purity, entirely free from any suspicion of pollution, that there were slight differences in the four samples in regard to their mineral constituents, but all alike were remarkable for their high organic and bacteriological purity. Public Baths. The swimming baths provided by the Council are situated at the Latchmere Road and Battersea Park Road (Nine Elms) establishments. During 1934 modern filtration plant was installed at the Latchmere Road premises for the four swimming pools there, and after a year's working samples of the water were, by instruction of the Baths Committee, taken by the Public Analyst for examination. The following is an abstract from his report thereon:— Latchmere Road Baths. I have to report that, at your request, I visited the above Baths on Wednesday, October 9th, and collected samples from the First Class and Ladies Swimming Baths, with a view to ascertaining the condition of the water, which has been in continuous use since April 1st. I was informed that the number of bathers using the Baths since this date totalled 168,235, and that the make-up water amounted to some 10,000 gallons per week during this period. 82 I now enclose, in tabulated form, the result of my chemical and bacteriological examination of these samples, from which it will be seen that the plant, under the skilful handling of the Baths Superintendent, has proved its efficiency in no uncertain fashion. The purity of the water is remarkable; in fact, in respect of organic and bacterial content, it attains a higher standard than many drinking water supplies. In my opinion it is a matter for congratulation that the inhabitants of the Borough have, at this Institution. Swimming Baths available where they can enjoy this healthy form of exercise under such ideal conditions. The cost of the plant amounted to approximately £7,900, and the Council have in contemplation the provision of similar plant for the Nine Elms establishment. London County Council (General Powers) Act, 1928. Section 28 of this Act contains powers to secure, on Order of the Court, the removal to hospital or suitable institution of persons who are aged, infirm or physically incapacitated or suffering from grave chronic disease, and who are unable to receive proper attention, and are living in insanitary conditions. The procedure prescribed by the Act is cumbrous, and hitherto the few cases arising have been successfully dealt with by persuasive methods. It became necessary during 1935, however, to exercise the powers of the Act in regard to two old women who, chiefly owing to their advanced age and physical infirmities, were living under insanitary conditions. An Order of the Court was obtained in each case and was subsequently renewed, and the two women were removed to suitable institutions provided by the London County Council, where at the end of the year they still remained. Van Dwellings. The number of van dwellings in the Borough in 1935 was 61. In the following table are set out the situations of the dwellings and number of occupants:— Situation of Vans. No. of Vans. Occupants M. F.  Mills' Yard, adjoining 88 Sheepcote Lane 4 3 3 Mills' Yard, adjoining 80 Sheepcote Lane 4* 7 5 Mills' Yard, Culvert Road 17* 14 22 164 Falcon Road (rear of) 6 9 4 Manley's Yard, 45a Cabul Road 30 26 21 Van dwellings are frequently inspected. Six vans were unoccupied at the date of the last inspection. * Including Sheds. 83 Rag and Bone Dealers. Five offences against that part of the bye-laws of the London County Council which prohibits the giving of toys in exchange for rags, &c., were reported during 1935, the offenders in each case being itinerant traders. Three cases were dealt with by cautionary letter, and legal proceedings were ordered in the two remaining cases, but in one of these a false name and address had been given and the trader could not be traced. The result of the proceedings in the other case is shown on page 73. Rag Flock Acts, 1911 and 1928. These Acts were passed to prevent the use of material known as rag flock, unless such material complies with the standard of cleanliness laid down in the Act. No proceedings were taken under these Acts in Battersea during 1935. Rats and Mice (Destruction) Act, 1919. This Act, which became operative on the 1st January, 1920, imposes on local authorities and occupiers of premises additional resDonsibilities in connection with rat repression. The work carried out during 1935 under the Council's Rat Repression Scheme is summarised as follows:— Premises visited 1,978 Contracts made or renewed 8 Poison baits used 14,800 Dead rats found 1,300 Value of contracts £123 0 0 Cash for poison bait, &C. £6 8 0 Total expenditure (financial year 1935-36) £498 13 7 Income (financial year 1935-36) £128 1 6 Drains were tested at 94 premises in connection with this work, and in 79 cases defects of more or less serious character were found. The presence of rats in houses is usually regarded as prima facie evidence of drain defects. The work of the Rat Officer therefore is carried on in close co-operation with that of the district Sanitary Inspectors. As in previous years an intensive effort for the repression of rats was organised during "Rat Week" (3rd to 9th November). Bait was laid in the sewers, and was supplied to all applicants during the week free of charge. The co-operation of the public was invited by posters and advertisements. The results were good, considerable numbers of rats being found dead. Destruction of Pigeons. By Section 52 of the London County Council (General Powers) Act, 1927, the Council have power to destroy doves or pigeons congregating in such numbers as to cause nuisance, annoyance or damage, subject to certain limitations imposed by the Act. 84 During 1935, with the consent of the Church authorities, the Council undertook the destruction of pigeons infesting St. Luke's and St. Peter's Churches, 152 birds being destroyed. Propaganda. The Council during 1935 made a grant of £10 to the Central Council for Health Education in furtherance of their work of education in the principles of health. They also gave support to lectures arranged by the British Social Hygiene Council, which are referred to on page 70. A booklet enumerating the various activities of the Public Health Department was prepared by order of the Health Committee, and distributed in large numbers among the inhabitants of the Borough. A shorter brochure, containing in compact form particulars of the public health services available was also issued to the medical practitioners practising in Battersea. Various leaflets with regard to diphtheria, measles, &c., were issued to families in which these diseases occurred, and posters were exhibited from time to time with regard to infant life protection, rats and mice, &c. Fouling of Footways by Dogs. One offence against the Council's bye-law with regard to the fouling of footways by dogs was reported during the year, and by order of the Committee the offender was cautioned. The application of this bye-law to the Borough appears undoubtedly to have effected a diminution of this objectionable form of nuisance on the public footways. Personal Cleansing Station. During the year 1935, there were 3,791 children and 194 adults cleansed and treated at the station. Of the 3,791 children attending, 1,049 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. Of these children 3,750 attended from the public elementary schools in the Borough by arrangement with the London County Council, who have entered into a contract with the Borough Council for the use of their Personal Cleansing Station. The cleansing and treatment of the school children is carried out under the supervision of officers of the London County Council while the disinfestation of the clothing and of the homes is carried out concurrently by the Borough Council's sanitary staff. The following table shows the numbers of persons cleansed and treated at the Personal Cleansing Station and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun. 85 Number of Baths. &c. Year. Adults. Children. *Expenditure *Amount Contributed. Verminous and Scabies. Verminous and Scabies. £ £ 1906-1915 10,443 6,430 1,037 303 1916-1925 3,269 39,117 5,007 3,155 1926 229 4,371 916 425 1927 256 4,360 960 418 1928 221 3,769 863 400 1929 278 4,335 927 400 1930 263 3,901 856 400 1931 283 3,898 875 400 1932 248 3,703 786 400 1933 223 3,385 821 400 1934 209 3,780 730 401 1935 194 3,791 787 401 16,116 84,840 £14,565 £7,503 * Financial year ending 31st March. Disinfecting Department. Summary of work carried out by the Disinfecting Department during 1935. Total premises disinfected 2,062 Rooms disinfected 2,563 Staircases disinfected 80 Schools disinfected 4 Number of articles laundered 18,431 „ „ destroyed 576 „ verminous, etc., persons (including 3,750 school children) 3,985 „ infectious disease contacts 601 „ library books collected 348 Articles. No. Weight. Tons. cwts qrs. lbs. Bedding, &c., disinfected 34,108 83 3 0 9 Ditto (articles from shelters and Cleansing Station, &c.) 8,138 (not weighed) Bedding, &c., lent 1,641 5 1 2 7 Verminous clothing, &c. 12,440 2 15 2 4 Articles from Welfare Centres 1,710 (not weighed) Total 58,037 91 0 0 20 Coroner's Court and Mortuary. The Council, in September, at the request of the Commissioner of Police, made arrangements with a local undertaker to remove drowned bodies found on the foreshore or in the Thames to the public mortuary. This duty had hitherto been carried out by the Police. Details as to the number of inquests held at the Coroner's Court, and bodies received into the Mortuary during 1935 are set out in the following table:— 86 Details of Bodies Received. Usual Place of Residence. Total  Battersea. Wands -worth Elsewhere Residence unknown Inquest at Coroner's Court— Post-mortem at Mortuary 25 54 35 8 122 Post-mortem elsewhere 16 46 23 — 85 No post-mortem 10 43 14 1 68 Post-mortem at Mortuary— No inquest (Coroner's certificate) 57 108 19 — 184 Second post-mortem 1 1 — — 2 Other bodies received— Sanitary and other reasons 2 2 1 — 5 Total bodies received 110 253 92 9 464 Total inquests held 51 143 72 9 275 Total post-mortems held at Mortuary 83 163 54 8 308 VERDICTS AT INQUESTS HELD— Natural causes 3 10 3 — 16 Accident and Misadventure—- Anæsthesia, operation, &c. 3 2 6 — 11 Asphyxia 1 5 2 — 8 Burns and scalds 4 10 3 — 17 Collapse of masonry, &c. — 1 2 — 3 Drowning — 1 2 — 3 Electric shock — 1 — — 1 Fall 10 31 7 — 48 Injury at birth — 2 — — 2 Injuries (various) — 5 1 — 6 Overlying — 2 — — 2 Poisoning—Gas — 2 1 — 3 Railway and street 6 32 17 — 55 Silicosis (occupational) 1 — — — 1 War wounds — — 2 — 2 Open verdict— Abortion 1 1 — — 2 Congenital defects and prematurity 1 — — 3 4 Drowning 2 1 9 1 13 Motor injuries 2 3 — — 5 Poisoning—Drugs, &c. — 2 — — 2 Railway — 1 1 — 2 Still-born — — 1 5 6 Sepsis of unknown origin — 1 — — 1 Suicide— Cutting 3 4 1 — 8 Drowning — 1 3 — 4 Firearms — 2 1 — 3 Hanging 5 2 — — 7 Jump from high place — 1 — — 1 Poisoning—Coal gas 6 11 1 — 18 „ Drugs, &c. 3 7 5 — 15 Strangulation — 1 — — 1 Homicide— Manslaughter — — 1 — 1 Unlawful abortion — — 1 — 1 Wilful murder — 1 2 — 3 Grand Total 51 143 72 9 275 87 Changes in Staff, 1935. Tuberculosis Medical Officer and Assistant Medical Officer of Health.—Dr. Stanley King, m.d., m.r.c.p., d.p.h., was appointed on 2nd January, 1935. Sanitary Inspectors.—Mr. James Lawrence, appointed senior inspector in 1926, and previously (since 1894) sanitary inspector, retired on superannuation on 30th April. Mr. F. H. Chuter, inspector for No. 4 District, was promoted to succeed Mr. Lawrence as from that date. Messrs. J. R. Glover and P. D. O'Grady were appointed in March to the two vacant positions on the inspectorial staff, one of which had remained unfilled since 1933. These officers took up their duties in May. Health Visitors.—Miss I. M. J. Sweeney, who had previously held a temporary appointment as Health Visitor, was appointed to the permanent staff in January vice Miss M. Carr, who was superannuated in the previous year. Miss M. C. H. Wilkie and Miss E. L. Flemons, health visitors attached to the Battersea School for Mothers, were taken into the service of the Council when that body gave up their work (vide page 22). Clerical Staff.—Mr. H. N. Carter was appointed in January to fill the vacancy caused by the retirement of Mrs. R. O. E. Bower (né e Dove), who left the Council's service in October, 1934. Disinfecting Station Superintendent.—Mr. C. H. Woodhouse, who had held this appointment since the opening of the Station in 1902, retired on superannuation on 1st February, 1935. Mr. T. J. Farrow, formerly charge hand at the Station, was appointed Superintendent in May, after having previously served three months on probation. Maternity Hospital.—Dr. J. M. Oldfield held the appointment of Resident Medical Officer from 1st January to 20th June, 1935, and was succeeded on the latter date by Dr. M. O'Mahoney. Miss D. Anthony, sister at the hospital, resigned her appointment in January, and Miss A. Woodrow was appointed to the vacant post on 19th February. Miss G. Islip, who had been retained since 1926 to give weekly lectures to pupil midwives, resigned the appointment at the end of 1935. 88 Protection of Food Supply. INSPECTION AND SUPERVISION OF FOOD. Unsound Food. The following is a tabulated return of unsound foods which under the provisions of Section 47(8) of the Public Health (London) Act, 1891, were brought to the notice of the Sanitary Inspectors and voluntarily surrendered during 1935:— Food. Quantity. Food. Quantity. Fish. 1 box. Fruit, Vegetables, etc. Cod Steaks Dog Fish 5 stones. Grapes 10 casks. Kippers 15 boxes. Peaches 28 boxes. Mackerel 51 Rock Salmon... 3 stones. Meat & Poultry. Skate Wings ... 1 box. Pigs' Heads and Plucks 3 Food Poisoning. Under the provisions of the London County Council (General Powers) Act, 1932, medical practitioners are required to notify to the Medical Officer of Health of the district cases of persons under their care suffering or suspected to be suffering from food poisoning. Seventeen such cases were notified to the Medical Officer of Health during the year, in 12 of which the patient was the only member of his family who suffered. In only 1 case was a portion of the food suspected available for bacteriological investigation, and the examination in that case gave a negative result. In each case notified the patient recovered. Slaughterhouses and Knackers' Yards. The duty of licensing knackers and slaughterers of cattle and horses, and the premises used by them, was transferred to the Metropolitan Borough Councils in 1933. The licences for the two slaughterhouses remaining in Battersea were renewed by the Council for 1 year from 1st July, 1935, and three slaughtermen's licences were issued during the year under the Slaughter of Animals Act, 1933. 89 These two slaughterhouses have been kept under systematic inspection by the staff, and during the year 1935, 127 inspections were made by the Council's inspector. The carcases of 90 animals (calves 5, sheep 69, and pigs 16) were examined after slaughter. No contravention of the Public Health (Meat) Regulations or the By-laws in regard to slaughterhouses was reported during the year. There are no knackers' yards in the Borough. Butchers' Shops. The number of butchers' shops in the Borough at the beginning of the year 1935 was 103. Deducting 2, which were closed during the year, there remained 101 on the register at 31st December. There are in addition a number of premises where the sale of cooked meats is carried on, as well as grocers' and provision merchants' shops at which cooked meats are among the articles sold. All butchers' shops in the Borough are systematically inspected, and for the most part they are well kept and provided with cold storage facilities. During the year, 1,431 inspections of these premises were carried out by the Council's Food Inspector. Public Health (Meat) Regulations, 1924. It was not found necessary during 1935 to take action for any contravention of the Public Health (Meat) Regulations, 1924. Food and Drugs (Adulteration) Act, 1928. The analysis of samples of food and drugs procured under the provisions of the above-mentioned Act, or informally (i.e., without following in detail the procedure prescribed by the Act) is carried out by the Public Analyst for the Borough, at the laboratory at 325 Kennington Road, S.E. 11. The bacteriological examination of samples (mainly milk) is carried out by the Clinical Research Association, Ltd., at Watergate House, Strand, W.C. The total number of food samples taken under the Act during 1935 was 748, of which 9 or 1.2 per cent. were certified by the Public Analyst to be adulterated. In addition to the foregoing, 452 informal samples were procured, of which 9 or approximately 2 per cent. were reported against. The percentage of samples reported by the Public Analyst to be adulterated during the quinquennia 1921 to 1935 and in each year from 1926 onwards, is given in the following table. 90 Year. Formal Samples. (per cent.) Informal Samples. (per cent.)  Mean 1921—1925 6.4 7.4 1926 4.3 3.7 1927 4.5 0.8 1928 2.6 1.4 1929 2.6 4.1 1930 2.6 2.2 Mean 1926—1930 3.3 2.4 1931 3.5 Nil 1932 2.4 2.9 1933 1.0 0.5 1934 0.7 5.0 1935 1.2 2.1 Mean 1931—1935 1.8 2.1 The Public Analyst points out that the adulteration of formal samples in the year under review has increased slightly, while that for informal samples has fallen, and that the mean results for the quinquennial period, 1931-5, are distinctly lower than those for the quinquennial period 1926-30; further, that the figures considered for the ten-year period, 1926-35, illustrate the marked decline in adulteration which is now more or less the present experience of the London Boroughs and represents a state of affairs long desired by all interested in the public weal. Adulterated Samples. The total number of samples taken in 1935 and certified by the Public Analyst to be adulterated, or not to comply with the requirements of the various Orders or Regulations, was 18, as follows:— Milk.—Six formal samples. (See following pages.) Lemonade Powder.—Two informal samples prepared with tartaric instead of citric acid. Cream Sandwich.—Two formal and four informal samples, the creamy filling of which was found to be practically devoid of cream. (See page 95.) Zinc Ointment.—One formal and one informal sample, containing an excess of zinc oxide of 11.3 and 16.8 per cent. respectively. A cautionary letter was, by direction of the Committee, addressed to the vendor of the formal sample. Epsom Salts.—Two informal samples which failed to comply with the lead limit requirement of the British Pharmacopoeia of 5 parts per million. They contained 9 and 7 parts per million respectively. 91 The following tables give details of the articles of which samples were obtained for the purpose of analysis. Main Statement. TABLE I. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Butter 6 53 59 0 0 0 Cocoa. — 20 20 — 0 0 Coffee — 12 12 — 0 0 Cream — 32 32 — 0 0 Flour — 2 2 — 0 0 Flour, Self-raising — 11 11 — 0 0 Jam — 8 8 — 0 0 Lard — 9 9 — 0 0 Margarine — 10 10 — 0 0 Marmalade — 4 4 — 0 0 Milk 738 — 738 6 — 6 „ Condensed (Full Cream) — 5 5 — 0 0 „ „ (Machine Skimmed) — 9 9 — 0 0 Mustard — 11 11 — 0 0 Sugar — 25 25 — 0 0 Tea — 18 18 — 0 0 Vinegar — 10 10 — 0 0 Drugs 2 35 37 1 3 4 Other Articles 2 178 180 2 6 8 Total. 748 452 1200 9 9 18 TABLE II. Drugs. Examined. Adulterated. Nature of Sample. Formal. Informal. Total. Formal. Informal. Total. Camphorated Oil — 6 6 — 0 0 Cream of Tartar — 4 4 — 0 0 Epsom Salts 1 8 9 0 2 2 Iodine, Tincture — 9 9 — 0 0 Ointment, Zinc 1 4 5 1 1 2 Seidlitz powder — 4 4 — 0 0 Total 2 35 37 1 3 4 92 TABLE III. Other Articles. Nature of Sample. Examined. Adulterated. Formal. Informal. Total. Formal. Informal. Total. Almonds, ground — 4 4 — 0 0 Cakes, sponge — 12 12 — 0 0 Cornflour — 4 4 — 0 0 Cream sandwich 2 8 10 2 4 6 Custard powder — 16 16 — 0 0 Dripping — 11 11 — 0 0 Fish, bottled — 1 1 — 0 0 „ canned — 10 10 — 0 0 ,, paste — 3 3 — 0 0 Fruits, dried — 15 15 — 0 0 Ginger, ground — 4 4 — 0 0 Jelly, table — 6 6 — 0 0 Junket preparations — 4 4 — 0 0 Lard substitute — 3 3 — 0 0 Lemonade powder ... — 4 4 — 2 2 Meat, minced — 3 3 — 0 0 „ paste — 1 1 0 0 Oatmeal — 1 1 — 0 0 Olive Oil — 8 8 — 0 0 Peel, Candied — 8 8 — 0 0 Pepper — 4 4 — 0 0 Rice — 18 18 — 0 0 Sago — 1 1 — 0 0 Sausages — 4 4 — 0 0 ,, breakfast ... — 4 4 — 0 0 Spice, Mixed — 4 4 — 0 0 Sponge mixture — 4 4 — 0 0 Suet, shredded — 4 4 — 0 0 Tapioca — 6 6 — 0 0 Wines, non-alcoholic — 3 3 — 0 0 Total 2 178 180 2 6 8 Milk. Of the 738 samples of milk (all formal) submitted during the year, 6 or 0.8 per cent. were reported as adulterated, 4 of these samples being deficient in milk fat and 2 containing extraneous water. The percentages of extraneous water found in the 2 adulterated samples were 2 and 7 respectively, whilst the deficiency in milk fat in the 4 samples so reported against ranged from 4 to 15 per cent. In the 5 years 1930-34, and in 1935, the percentage of adulterated (formal) samples of milk was as under:— 93 Year. Samples taken. Adulterated. No. Percentage. 1930 707 18 2.5 1931 777 28 3.6 1932 760 13 1.7 1933 768 6 0.8 1934 750 5 0.7 Mean 752 14 1.9 1935 738 6 0.8 A considerable proportion of the milk supply of London is received at Clapham Junction and the South Lambeth Goods Stations and samples are systematically taken on the arrival of the milk at these two stations. Such samples are included in the return on page 91. The average composition of the 732 samples of milk (all formal), reported as genuine, proved to be as under:— Total milk solids 12.47 per cent. Milk fat 3.59 „ „ Non-fatty solids 8.88„ „ The content of milk fat in these 732 samples ranged as follows: 4 per cent. and over 64 samples or 8.7 per cent. Between 3.9 and 4.0 per cent. 45 „ „ 6.2 „ „ 3.8 „ 3.9 „ 67 „ „ 9.2 „ „ 3.7 „ 3.8 „ 83 „ „ 11.3 „ „ 3.6 „ 3.7 „ 77 „ „ 10.5 „ „ 3.5 ,, 3.6 ,, 115 „ „ 15.7 „ „ 3.4 „ 3.5 „ 108 „ „ 14.8 „ „ 3.3 „ 3.4 „ 102 „ „ 13.9 „ „ 3.2 „ 3.3 „ 47 „ „ 6.4 ,, „ 3.1 „ 3.2 „ 17 „ „ 2.3 „ „ 3.0 „ 3.1 „ 7 „ „ 1.0 „ 732 100.0 All samples were systematically tested for the presence of preservatives and colouring matter but with negative results. Milk sampling was carried out on 5 Sundays during the year, and 30 samples were purchased for analysis on these occasions. Samples of milk in course of delivery by wholesale firms to the number of 36 were taken during the year. Many of these samples were taken at Clapham Junction (S.R.) or South Lambeth (G.W.) 94 Railway Stations. Samples of milk to the number of 52 were taken in course of delivery to hospitals and elementary schools in the Borough, all of which were certified to be genuine. The supply of milk to hospitals and institutions is kept under careful supervision and samples are periodically taken for chemical and bacteriological analysis. During the year 30 samples of milk were taken for bacteriological examination. Of these 26 were of pasteurised milk, 1 of Grade A (Tuberculin tested) milk, and 3 of ungraded milk. The results of the bacteriological examination showed that all the samples complied with the requirements. Two samples were taken in course of delivery during the year at the request of the Medical Officers of Health of neighbouring Boroughs under the provisions of Secs. 21 and 29 and the second schedule of the Food and Drugs (Adulteration) Act, 1928, which permits the vendor to require (within 60 hours) the Council to take samples from a corresponding delivery or milking. During the year advantage was also taken of these provisions by 5 Battersea milk purveyors in regard to 11 samples of milk. Proceedings with regard to adulteration were taken in two instances of fat abstraction, particulars relating to which will be found set out in the table on page 73. Milk and Dairies Acts 1915 and 1922. Milk and Dairies Order, 1926. The provisions of the above-named Acts and Order continued to be enforced by the Council during the year under report, but no action was found necessary in respect of any contraventions thereof. Milk (Special Designations) Order, 1923. Under this Order the Council are authorised to issue licences (other than "producers'" licences) under the above-named Order. The licences so granted are available for a period up to the end of the year in which they are issued. There is a scale of fees payable to the Licensing Authority by applicants for licences. The number of licences in force during 1935 was as follows:— Full. Supplemental. Certified milk 9 1 Grade A (Tuberculin tested) milk 50 2 Grade A milk 6 2 Pasteurised milk 51 8 116 13 Two licences to bottle Grade A (T.T.) milk, and four to pasteurise milk, were granted and are included in the above figures. 95 Cautionary letters were, by order of the Committee, addressed to two vendors who were found to be dealing in milk labelled "pasteurised milk" without holding the necessary licence. The bacteriological examination of samples of milk is referred to on page 94. Milk Shops. The number of premises registered in Battersea for the sale of milk is 130 (including 7 wholesalers premises). Two premises were added to the register and 1 removed therefrom on discontinuance of the sale of milk. In 12 cases registration was transferred on account of change of proprietorship. There are also 8 premises registered for the sale of cream only. All milk shops are kept under systematic inspection, and during the year 522 inspections were carried out and 2 intimation and 2 statutory notices were served to remedy defects found on inspection. Forty-seven vendors whose registered premises are without the Borough are registered as purveyors within Battersea. In addition to the above there are 184 persons registered for the sale of milk in sealed receptacles only. The improvement which has been noted in recent years with regard to the results of the analysis of milk is also found in the condition of premises in the Borough in which milk is sold or stored. These have all been brought up to a satisfactory sanitary standard. Condensed Milk. During the year 14 informal samples of Condensed Milk were submitted for examination, of which 5 were described as " fullcream " and 9 as " machine-separated." All were found to be genuine and to comply with the requirements of the Public Health (Condensed Milk) Regulations, 1923. Artificial Cream Act, 1929. Only 2 shops are registered under the provisions of this Act for the sale of artificial cream, one of these being registered during the year. These premises are periodically inspected. Cream Sandwiches. Two samples of " cream sandwich " were certified by the Public Analyst to contain a white filling which was practically devoid of cream and which respectively contained 48.2 per cent. and 51 per cent. of fat, of which not less than 95 per cent. consisted of fat not derived from milk. The two samples had been sold to the Council's inspector as cream sandwich. 96 The matter was reported to the Health Committee, who were informed that in another London borough convictions had been obtained in the case of confectionery described as " real cream " sandwiches, &c., and the Committee ordered proceedings to be taken against the two traders concerned. The case against the first defendant was heard at the South Western Police Court on 17th April, 1935, and the Magistrate subsequently delivered a written judgment as follows :— The question that 1 have to decide is whether when a cream sandwich is asked for and an article supplied in which the so-called cream contains 95 per cent. of fat not derived from milk, this constitutes a breach of S.2 of the Food and Drugs (Adulteration) Act, 1928. It was common ground between the parties that the Artificial Cream Act, 1929, does not affect my decision. Various dictionary definitions of the word cream were submitted to me, but even without them I should hold that cream does not necessarily mean a product of the cow as is shown in the names face cream, cold cream, etc. As applied to confectionery evidence was called by the defence that various substances are used in the trade as fillings that do not emanate from the cow. I accept this evidence as representing the general position. The witness for the prosecution, while urging that dairy cream ought to be used, admitted that it frequently was not. I hold that the article which in this case the purchaser could reasonably expect to receive was the article supplied, and that therefore the purchaser was not prejudiced. Summons dismissed and 3 guineas costs to be paid by prosecutors. Defendants were represented by Counsel and evidence was called on both sides as to the practice in the trade. The case against the second defendant was not proceeded with in view of the judgment. Notice of appeal against the Magistrate's decision was given on behalf of the Council, but, later, in view of Counsel's opinion, the Law Committee decided not to proceed with the appeal, but to refer the question to the Metropolitan Boroughs Standing Joint Committee. That body subsequently informed the Council that they had drawn the attention of the Minister of Health to the case and had urged him to give effect to the recommendations contained in the report of the Departmental Committee on the Composition and Description of Foods, which was issued in 1934, namely that the Minister should be empowered to make regulations as to the composition of foods. The Joint Committee were of opinion that the principle raised by the Council was one which the Departmental Committee had in mind when they framed their recommendation. Ice Cream. There were at the end of the year 229 premises in the borough used for the manufacture, storage, or sale of ice cream. Twenty-three additional premises were registered during the year and six removed from the register, the number of registered premises therefore being 17 more than in 1934. 97 All the premises, stalls, barrows, &c., from which the trade is carried on are kept under inspection during the season. During the year 191 inspections were made, and it was found necessary to serve 3 intimation notices and 1 statutory notice in respect of these premises. The improved conditions under which this commodity is now prepared and sold in Battersea, referred to in previous annual reports, are on the whole being maintained. Preservatives in Food. The provisions of the Public Health (Preservatives, etc., in Food) Regulations are referred to in the Annual Report for the year 1928. All samples submitted to the Public Analyst are examined for the presence of preservatives and during 1935 no contraventions of the Regulations were reported. Preserved Food Premises. The duty of registering premises in which preserved foods are prepared or manufactured was placed upon Metropolitan Borough Councils by the London County Council (General Powers) Act, 1932. There were 179 premises upon the register at the end of 1935, 3 having been added and 3 removed during the year. One intimation notice was served during 1935 for nuisance found. Agricultural Produce (Grading and Marking) Act, 1928. No legal action was found necessary during the year under review in regard to the various Orders made under this Act. Merchandise Marks Act, 1926. The Medical Officer of Health and the staff of sanitary inspectors have been authorised by the Council to enforce the provisions of the various Orders made under the Act. Two offences were reported during 1935, 1 offender being cautioned by order of the Committee and the second being prosecuted (vide page) 73. New Orders were made in 1935 dealing with imported meat. Fish Shops. Fish shops in which fish either cooked or uncooked is sold, or in which the curing of fish intended for sale is carried on, number 77 (one less than at the end of 1934). All these premises are kept under systematic inspection. Inspections made during 1935 numbered 173, and 8 notices (7 intimation and 1 statutory) were served for various defects found on inspection. 98 Restaurant Kitchens. The number of restaurant kitchens and eating houses on the register at the end of 1935 was 125, 2 having been added to the register and 5 removed during the year. The number of inspections carried out in 1935 was 263, and in 17 cases it was found necessary to serve notices to remedy various defects. Street Stalls for Sale of Food. There are 191 street stalls in the borough for the sale of foodstuffs of varied character. These were systematically inspected during the year, but no action was found necessary in regard to the food sold, which is generally sound and wholesome, and no offences against the statutory requirements with regard to the food exposed on these stalls were reported during the year. Inspections numbering 180 were made of the premises used by street vendors for the storage of their stocks, but no defects were discovered calling for action by the Council. 99 Factories, Workshops, Workplaces and Homework. 1.—Inspections of Factories, Workshops and Workplaces (including Inspections made by Sanitary Inspectors or Inspectors of Nuisances), 1935. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 774 23 - Workshops (including Workshop Laundries) 765 42 - Workplaces (other than Outworkers' premises referred to on page 102) 2,529 143 - Total ... 4,068 208 - 2.—Defects found in Factories, Workshops and Workplaces Particulars. Found on Inspection. Remedied. Referred to H.M. Inspector. Number of Prosecutions. 1 2 3 4 5 Nuisances under Public Health Act — Want of Cleanliness 134 131 - - Want of Ventilation 3 3 - - Overcrowding 1 1 - - Want of drainage of floors ... 1 1 — - Other nuisances 60 54 - - Sanitary accommodation (Insufficient 9 9 - - ( Unsuitable or defective ... 116 111 _ _ Not separate for the sexes 3 3 - - Offences under the Factory and Workshop Act— Illegal occupation of underground bakehouse (Sec. 101) - - - - Other Offences (excluding Offences relating to Outworkers which are referred to on page 103) - - _ — Total 327 313 - - 100 3.—Registered Workshops. Workshops on Register (Section 131) at end of 1935 :— Bakehouses 6 Bootmakers 6 Cycle makers 7 Dressmakers 17 Laundries 3 Milliners 5 Motor repairers 20 Rag sorters 15 Tailors 36 Other trades 98 Total number of workshops 213 4.—Other Matters. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Section 133) 9 Notified by H.M. Inspector 7 Underground Bakehouses (Section 101), in use at end of the year 18 Factories and Workshops. Factories. The following is a list of the factories on the register at the end of 1935 :— Trade. Number of Factories on Register. Males. Females. Adults. Young Persons. Adults. Young Persons. Baker 50 254 33 29 36 Barge builder 3 22 Bootmaker 29 75 7 Builder 4 87 9 Butter blender 1 210 18 40 33 Chaff and forage 2 36 — 11 2 Chemical works 1 3 Coachbuilder 2 9 Chocolate, &c., maker 5 34 3 69 20 Cycle maker 1 2 — — — Dyer 3 46 4 48 2 Engineer 23 1,189 143 28 36 Firewood cutter 7 35 4 9 Flour mills 2 135 8 16 2 Foundry 2 29 2 — Lift maker 2 33 3 Mason 7 420 46 Mineral water 2 18 6 30 5 Motor repairer 21 242 9 10 — Printer 17 80 19 21 11 Steam laundry 16 78 12 491 149 Other trades 78 3,878 567 1,483 453 Total 278 6,915 893 2,285 749 101 Although 11 new factories have been opened in 1935, and only 7 removed, the number of factories included in the foregoing table is 278, as compared with 311 in the corresponding table in the last annual report. The reduction is due to the fact that 37 "one-man" factories (i.e., where the occupier is the only worker) have been excluded from the present figures. In spite of this reduction the number of persons employed is shewn to be 64 greater than in 1934. 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. During the year 20 preliminary and 3 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, and all were duly complied with. Workshops. The following is a list of the workshops on the register at the end of 1935 :— Trade. No. of Workshops. No. of Workrooms. Persons Employed. Males. Females. Adults. Young Persons. Adults. Young Persons. Baker 6 6 11 - - - Blindmaker 5 6 12 1 1 — Bootmaker 6 6 11 — — — Builder 6 7 10 2 — — Carpenter 4 4 11 1 — — Coach builder 4 5 23 1 — — Cycle maker 7 8 18 5 — 3 Dressmaker 17 20 — — 39 3 Embroiderer 1 2 — — 12 — Farrier & smith 5 5 13 — — — Florist 5 6 1 — 11 4 Laundry 3 10 3 — 8 — Mason 1 1 3 1 — — Milliner 5 5 — — 9 — Motor repairer 20 23 77 12 — — Musical instrument maker 3 4 9 4 Photographer 2 6 2 1 1 — Poster and sign writer 5 7 17 1 Rag sorter 15 31 36 21 11 — Tailor 36 48 65 2 48 15 Upholsterer 8 8 25 — 6 1 Other trades 49 97 180 14 35 2 Totals 213 315 527 62 181 32 102 In certain of these trades in which female labour is mainly used, the inspection of the workshops is carried out by a female sanitary inspector, and during 1935 the number of her inspections amounted to 170. Thirty intimation and 13 statutory notices were served during the year for various defects in workshops found on inspection, all of which were complied with. Of these, 13 intimation and 1 statutory notices were served by the female inspector. Twenty-six new workshops were added to the register, dealing with the following trades :— Cycle maker 2 Motor repairer 1 Dressmaker 5 Rag sorter 1 Embroiderer. 1 Tailor 7 Florist 1 Other trades 7 Millinery 1 Seventeen workshops closed during the year, and after deducting these, and a number in which only one person was employed the total number of workshops was reduced from 300 to 213. The following are particulars relating to workshops in which " protected persons " were employed, notice of which was duly sent to H.M. Inspector during 1935 :— Trade. No. of Workshops Protected Persons Employed. Women. Young Persons. Total. Alterations 2 2 - 2 Dressmaker 3 1 2 3 Florist 1 1 2 3 Knitted garments 1 4 — 4 Ladies' tailor 1 1 — 1 Lingerie 1 1 1 Outworkers. During 1935, 94 lists of outworkers were received, viz., 46 from Battersea employers, containing 180 names, and 48 from the Medical Officers of Health of other districts, containing 250 names. After eliminating outworkers not residing in Battersea (of whom 117 names were forwarded to the Medical Officers of the districts concerned) and duplicated entries there remained the names and addresses of 152 Battersea outworkers. 103 The total number of registered outworkers in the Borough is 174, of whom 18 are " contractors," i.e., employers of labour for the purpose of the home-work received by them, and many of the premises are workshops in the meaning of the term as used in the Factory and Workshop Act. The following table gives details of the outworkers' premises in the Borough, most of which are visited by the female sanitary inspector. The figures in brackets indicate the premises visited by the male inspector, which are included in the totals shown. Trade. Number on Register. Persons Employed. Premises. Workrooms Blousemaker 1 1 3 Bootmaker 19 (19) 24 (24) 30 (30) Dressmaker 29 29 40 Embroiderer 28 28 30 Fancy goods 9 9 9 Fancy boxes 7 7 7 Fine needlework 2 9 2 Glovemaker 1 1 1 Knitting and crochet 1 1 1 Tailor 57 (39) 63 (45) 118 (85) Underclothing 4 4 5 Other trades 16 (2) 29 (2) 19 (5) Female Inspector 114 127 145 Male „ 60 71 120 Total 174 198 265 There were 55 new outworkers' premises added to the register during 1935, and 26 were removed, there being thus an increase of 29 in the number registered. There were 576 inspections of outworkers' premises during the year, of which 478 were by the female inspector. Five intimation and 2 statutory notices were served for sanitary defects found on inspection. No case of infectious disease occurred in these premises during 1935. Bakehouses. There were 60 bakehouses in Battersea at the end of 1935, at four of which no person other than the proprietor was employed. 104 Of this total 52 use power and are therefore technically factories. Eighteen of the 60 are underground bakehouses. Additions to and removals from the list during 1935 were:— New bakehouses Factories—2 (above ground) „ ,, Workshops—Nil. Premises closed Factory—1 (under ground) „ „ Workshops—2 (above ground) Inspections made during the year numbered 74, of which 56 were to factory bakehouses, and 11 intimation and 2 statutory notices were served, mainly for failure to carry out the half-yearly lime-whiting of the bakehouses within the statutory period. Warehouses and Wharves. At the end of 1935, there were 64 premises on the register, including railway yards. These premises are systematically inspected, and during the year 87 inspections were made. Five intimation notices were served to remedy nuisances found on inspection, and were complied with. 105 Housing. The housing activities of the Council have proceeded satisfactorily during the year and the standards of previous years have been well maintained. Housing Act, 1935. The Housing Act, 1935, which received the Royal Assent on the 2nd August, gives additional powers and imposes new duties on local authorities. It is not practicable to deal with the Act in detail in this Report, but the following notes will indicate briefly the main points which affect the Council. Clearance Areas.—The Act amends previous legislation as to the classes of property which may be included in an area ; abolishes the reduction factor which hitherto applied to the price to be paid for land forming an area which is compulsorily acquired for rehousing ; enables the Minister to direct that compensation be paid in respect of a house which, although rightly included in the area, has, nevertheless, been well maintained ; permits compensation to be paid in special cases, and allows land acquired under clearance area procedure to be exchanged. It is necessary prior to the local enquiry to provide an owner who objects to a clearance order with a statement of the principal grounds for the inclusion of his house in the area and, on confirmation of the Order, the Minister must, on request, furnish such objector with a statement showing his reasons for holding that a house is unfit. Improvement Areas.—The provisions of the 1930 Housing Act relating to Improvement Areas are repealed. Their place is taken by provisions for " Redevelopment Areas " which consist partly of houses which are unfit for human habitation, and partly of houses which are overcrowded, or both. Closing Orders.—These can now be made in respect of any part of a building occupied or intended for occupation for habitation, and not, as heretofore, a part let as a separate dwelling, and in respect of an underground room which fails to comply with the regulations, whether used for sleeping purposes or not. Demolition Orders.—An owner must undertake to submit within reasonable time any offer to carry out works he may desire to make. Failure to do so will preclude him from submitting such an offer to the Court in an appeal against a demolition order. Redevelopment and Reconditioning by Owners.—An owner may submit a voluntary offer to redevelop or recondition his property. If his proposals are approved by the local authority such property 106 cannot be included in any clearance order, redevelopment scheme, demolition order or closing order made by the local authority within a specified period. Overcrowding.—A standard is laid down as to the number of people who may occupy a dwelling without causing it to be overcrowded. The Act also requires a survey of the district to be carried out to ascertain what overcrowding exists. (The results of the survey which was carried out during the year will be found set out on pages 108.9.) The powers of the Council for the enforcement of the abatement of overcrowding will not take effect until a day appointed by the Minister of Health, and in the case of overcrowding existing prior to the appointed day an abatement order cannot be enforced unless suitable alternative accommodation has first been offered. A local authority must supply, on request, a landlord or occupier with a statement of the number of persons who may occupy a dwelling. Financial.—The financial provisions of the Act relate to the contributions from the Exchequer and to the consolidation of housing accounts. New Working Class Dwellings. During the year 50 tenements were erected at Stewarts Lane by the Council as part of their housing programme. These flats form two of the four blocks to be erected and were intended to rehouse families displaced through the operation of clearance orders. Inasmuch as the schemes which the Council had under consideration had not progressed sufficiently to require the immediate use of these tenements for this purpose the Council agreed to rehouse the tenants from the Didcot Street and Lithgow Street clearance areas, on the condition that the London County Council would provide an equivalent amount of accommodation for this Council when required. The net rents fixed by the Council were 6s. 4d., 7s. 9d. and 9s. weekly for the 3-roomed, 4-roomed and 5-roomed dwellings respectively. Plans and estimates for the two remaining blocks were passed during the year, and it is anticipated that these flats also will soon be occupied. The Council decided to name the block on the Battersea Park Road frontage " Lennane House," after Dr. G. Quin Lennane, who was Medical Officer of Health from 1906 to 1934. Plans and estimates were also prepared for the erection of a block of tenements on the site of Nos. 231 to 253 York Road, which formed part of the original Plough Road area represented in 1920, and the freehold interest of which had been acquired by the Council for future development after it had been excluded from the area by the Minister of Health. 107 Houses Erected by Private Enterprise. Twenty-two houses and one tenement, all situate in Broomwood Ward, were erected by private enterprise during the year. Overcrowding. Some improvement has taken place in the abatement of overcrowding due, in part, to the activities of the Borough Council and to the assistance provided by the County Council. There is, however, considerable room for improvement in certain areas in the Borough. The subjoined table, extracted from the 1931 Census Report, indicates the position of the metropolitan boroughs in regard to overcrowding on the basis of persons per room. Housing Statistics. Extract from Census Report, 1931. Borough. Population in Private Families. No. of Families. No. of Occupied Dwellings. No. of Occupied Rooms. Average No. of Persons Per Room. Battersea 155,004 44,618 27,219 158,118 .98 Bermondsey 108,488 28,766 18,305 86,654 1.25 Bethnal Green 105,700 27,916 18,156 78,466 1.35 Camberwell 242,604 68,435 42,114 253,360 .96 Chelsea 52,374 16,332 10,966 66,525 .79 Deptford 104,181 29,248 17,750 105,823 .98 Finsbury 67,459 19,059 10,369 47,641 1.42 Fulham 146,071 43,153 26,245 150,313 .97 Greenwich 94,066 25,144 18,114 99,863 .94 Hackney 208,728 59,143 34,155 208,779 1.00 Hammersmith 127,938 37,345 22,307 126,466 1.01 Hampstead 78,763 23,709 14,758 112,014 .70 Holborn 27,524 9,355 6,177 25,622 1.07 Islington 309,216 93,613 43,162 276,592 1.12 Kensington 158,491 47,713 28,999 197,256 .80 Lambeth 280,885 83,777 48,873 290,666 .97 Lewisham 213,950 58,673 46,739 263,155 .81 Paddington 125,430 40,714 19,281 139,600 .90 Poplar 149,800 38,901 23,340 120,000 1.25 St. Marylebone 84,453 27,352 17,575 103,695 .81 St. Pancras 178,341 56,929 24,980 158,489 113 Shoreditch 94,521 25,084 13,678 65,330 1.45 Southwark 164,274 46,372 27,168 128,558 1.28 Stepney 214,061 54,657 35,671 161,570 1.33 Stoke Newington 49,443 14,908 8,196 55,219 .90 Wandsworth 333,863 95,383 71,566 421,286 .79 Westminster 101,442 33,056 22,536 132,882 .76 Woolwich 137,979 38,176 29,870 156,050 .88 City of London 7,590 2,499 2,359 8,300 .91 Total 4,122,639 1,190,030 730,628 4,198,292 — Average . 142,160 41,036 25,194 144,768 0.98 108 The survey which the Council were required to carry out under section 1 of the Housing Act, 1935, to ascertain the extent of overcrowding in the Borough, was commenced on the 1st November, 1935, and completed on the 18th January, 1936. The additional temporary staff engaged for the survey consisted of 1 supervisor, 26 enumerators, 12 survey assistants and 7 clerks, who were employed for varying periods. The results of the survey have been tabulated and are summarised in the following table :— Area. No. of Dwellings surveyed. No. of cases of Overcrowding. Percentage* Nine Elms Ward 6,055 411 6.79 Park Ward 3,843 303 7.88 Latchmere Ward 4,703 285 6.06 Shaftesbury Ward 3,913 111 2.84 Church Ward 4,503 276 6.13 Winstanley Ward 4,531 408 9.00 St. John Ward 1,915 68 3.55 Bolingbroke Ward 5,569 74 1.33 Broom wood Ward 5,831 32 0.55 The whole Borough... 40,863 1,968 4 82 Supplemental figures were also prepared relating to the estates owned by the London County Council and this Council respectively and are summarised in the subjoined table :— Group. No. of Dwellings surveyed. No. of cases of Overcrowding. Percentage* Estates owned by the London County Council 170 33 19.4 Estates owned by the Battersea Borough Council 850 114 13.4 Of the 114 cases of overcrowding on the estates owned by this Council, six were transferred to larger accommodation during 1935, and, judging from the experience gained in the measurement of rooms in doubtful cases there would appear to be only about 24 cases which could be regarded as serious overcrowding, the remainder being probably one unit or less in excess of the permitted number. * i.e. percentage of cases of overcrowding among dwellings surveyed. 109 It might also be pointed out that it has been the practice of the Council to re-house on their own estates families from badly overcrowded or otherwise unsuitable houses, and this, to a certain extent at least, accounts for a larger percentage of overcrowding on the Council's estates as compared with the Borough as a whole. The distribution of overcrowding on the Council's estates is as follows :— Latchmere Estate 34 Town Hall Estate 4 Savona Street 3 Chatham House 4 Latchmere House 5 Plough Road Improvement Scheme and Extension 24 St. John's Estate 34 Stewarts Lane 6 — 114 There are in the Borough 49 occupied caravan dwellings which have been included in the return. Of these 41 are overcrowded. Under section 21 of the Act, it is incumbent upon the London County Council to submit a return to the Minister of Health showing the number of houses required to abate the overcrowding existing in the Metropolitan Boroughs, and in order that the calculation for each borough should be made on a uniform basis the London County Council issued suggestions, which had been agreed to by the Metropolitan Boroughs Standing Joint Committee, for guidance in computing the number of houses required. After the necessary adjustments had been made for vacant dwellings, the dwellings vacated by the abatement of overcrowding, the cases of overcrowding in clearance areas, and the standard to which the Council should conform in rehousing these cases it was estimated that the following number of dwellings were required to abate the overcrowding in the borough :—. 3-roomed dwellings 221 4 „ „ 148 5 „ „ 174 6 „ „ 38 7 „ „ 28 8 „ „ 7 9 „ „ 2 Total 618 It should be borne in mind that this estimate was arrived at in a theoretical manner. In practice it will probably be found that the majority of the cases of overcrowding occur amongst that portion of the population which, for economic reasons, will be unable 110 to meet the rentals charged for accommodation suitable for their needs. The estimate, however, is probably sufficient to form the basis of the first re-housing proposals. During the year 24 families who were living under overcrowded or other insanitary conditions were accommodated on the Council's Housing Estates on the recommendation of the Medical Officer of Health. In addition 26 applications for housing accommodation were referred to the London County Council for special consideration on the grounds of hardship or overcrowding. The following table shows the result of such action :— Referred in previous years but not then dealt with. Referred in 1935. Total. Families accommodated 3 7 10 Offer declined or applicant otherwise suited 3 7 10 Recommendation not accepted by the London County Council - 3 3 Still under consideration — 9 9 Totals 6 26 32 It is the practice of the London County Council to notify the Medical Officer of Health of the families resident in the borough who have been accommodated on their estates. During the year 337 Battersea families were provided with accommodation on London County Council Estates—mainly St. Helier—outside the Borough. In the case of 12 other Battersea families accommodation was provided by them at Battersea Bridge Buildings or Durham Buildings. Clearance Areas. The Sheepcote Lane Area, which was referred to in the report of the Medical Officer of Health for 1934, was during 1935 represented by the London County Council, who have agreed to make the necessary clearance and compulsory purchase orders and to purchase the property on behalf of this Council, leaving it to this Council to clear and redevelop the area and rehouse the families displaced. No date has yet been fixed for the hearing of the Local Inquiry. The Council also agreed to deal with another area in the borough, consisting of 45 houses, in the same manner. This area, however, was not represented during the year. Preliminary steps have also been taken with a view to the representation of three other small areas comprising some 19 houses. 111 During the year the London County Council made clearance orders in respect of 7 houses in Lithgow Street and 13 houses in Thibet Street. After a local inquiry the orders were duly confirmed. It is not intended to redevelop the sites for housing purposes. Repair of Unfit Houses. Since the War, the repair and reconditioning of unfit houses either under the Housing Acts or the Public Health Act, has been systematically proceeded with, and the work carried out during 1935 will be found summarised on pages 113 to 115. In no case was it found necessary for the Council's Works Department to enter and carry out, in default of the owner, the necessary repairs in compliance with notices served under the Housing Acts. Appeals. During 1935 the right of appeal by owners against notices served under section 17, or against Demolition Orders made under section 19 of the Housing Act, 1930, was not exercised. Demolition Orders. During the year an undertaking was accepted in respect of a house in Creek Street which had been represented under section 19 of the Housing Act, 1930, during 1934. The necessary works of repair were subsequently carried out. An undertaking was also accepted in respect of two houses in Verona Street, which had been represented under this section, that they would not be used for human habitation. These houses have since been vacated. Two other houses in Gwynne Road were represented with a view to demolition orders being made in respect thereof, and the matter was under consideration at the end of the year. Closing Orders. A closing order was made by the Council during 1935 in respect of dwelling rooms over a garage at the rear of a house in Lavender Road which had been represented in 1934. The premises were subsequently demolished by the owner. Increase of Rent, Etc., Acts. During 1935, 4 applications were received from tenants for the certificate, and 1 from an owner for the report of the Sanitary Authority under the above mentioned statutes. The application for a certificate and that for a report was granted in each case. Action under Section 5 of the Housing Act, 1925. During 1935, in 12 cases (relating to 29 houses) contraventions of section 5 of the Housing Act, 1925, which requires, under penalty, the rent book to be kept in a prescribed form, were reported to the 112 Housing Committee. Satisfactory explanations having been received and the rent books having been put in order, no legal proceedings were considered necessary, but the Housing Committee directed cautionary letters to be sent to the offenders. Structural Defects. The attention of the District Surveyor of the London County Council was drawn, in 136 instances, to structural defects observed by the Sanitary Inspectors during the course of their duties. Insanitary Houses. The following is a list of streets in the Borough in which houses were found, on inspection, to be insanitary, and were dealt with by the Council under the provisions of the Housing Acts, either informally or by the service of notice under section 17 of the Housing Act, 1930, or under the provisions of section 19 of the Act, during 1935:— Street. Houses dealt with. Street. Houses dealt with. Street. Housel dealt with. Afghan Road 1 Falcon Terrace 4 Musjid Road 3 Aliwal Road 16 Frances Street 2 Almeric Road 1 Nepaul Road 2 Auckland Road 1 Goulden Street 12 Austin Road 2 Granfield Street 1 Orbel Street 1 Grayshott Road 1 Orville Road 9 Basnett Road 2 Green Lane 1 Battersea Bridge Gwynne Road 17 Park Road Road 1 (Bridge Road) 1 Battersea Rise 1 Haines Street 28 Parkham Street 1 Beaufoy Road 1 Hanbury Road 1 Parkside Street 32 Benfield Street 1 Harbut Road 32 Patmore Street 13 Bridge Road West 3 Heaver Road 1 Plough Road 1 Broughton Street 1 Henley Street 1 Power Street 17 Bullen Street 2 Henry Street 23 Poyntz Road 1 High Street 2 Cairns Road 4 Home Road 1 Radstock Street 1 Candahar Road 1 Robertson Street 1 Castle Street 1 Inworth Street 27 Roydon Street 1 Chatham Road 1 Russell Street 2 Chivalry Road ] Kerrison Road 1 Church Road 1 Kilton Street 1 Sewell Road 13 2 Shirley Grove 1 Chrunna Road Latchmere Street 3 Southolm Street 1 Culvert Road 1 Lavender Road 2 Spencer Street 1 Lavender Sweep 2 Stockdale Road 54 Dashwood Road 6 Lavender Terrace 2 Stockwood Street 1 Doddington Grove 6 Lombard Road 2 Dufiield Street 6 Longhedge Street 9 Trott Street 1 Louvaine Road 1 Tweed Street 19 Edna Street 1 Lubeck Street 1 Elcho Street 2 Usk Road 1 Este Road 34 Mendip Road 20 Ethelburga St. 1 Meyrick Road 3 Verona Street 2 Middleton Road 1 Falcon Grove 21 Montefiore Street 1 Wadhurst Road 4 Wayford Street 1 113 Summary. No. 1 District* ... ... ... 142 houses „ 2 „ ... ... ... 59 „ „ 3 „ ... ... ... 94 „ „ 4 „ ... ... ... 106 „ „ 5 „ ... ... ... 10 „ „ 6 „ 70 „ „ 7 „ ... ... ... 2 „ „ 8 „ ... ... ... 26 „ Total 509 „ Statistics for the Year ended 31st December, 1935. Number of New Houses or Tenements erected during the year :— (1) By the Local Authority 50 (2) By other Local Authorities Nil (3) By other bodies and persons 23 Number of Houses Demolished during the year :— (1) In pursuance of demolition orders Nil (2) Voluntarily 60 1. Inspection of Dwelling-houses during the year :— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 6,127 (b) Number of inspections made for the purpose 31,832 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,116 (b) Number of inspections made for the purpose 8,729 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3,271 * During the year the boundaries of each district were revised (vide page 75). 114 2. Remedy of Defects during the Year without Service of formal Notices :— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 302 3. Action under Statutory Powers during the Year :— (a) Proceedings under sections 17, 18 and 23 of the Housing Act, 1930— (1) Number of dwelling houses in respect of which notices were served requiring repairs 43 (2) Number of dwelling houses which were rendered fit after service of formal notices :— (a) By owners 40 (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts :— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 2,764 (3,366 intimation notices) (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (а) By owners 2,620 (3,248 intimation notices complied with) (б) By Local Authority in default of owners Nil (c) Proceedings under sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which Demolition Orders were made Nil (2) Number of dwelling houses in respect of which an undertaking was accepted under subsection 2 of section 19 3 (3) Number of dwelling houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 115 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil (e) Number of representations made to Local Authority with a view to:— (а) Service of notice requiring the execution of works 263 (relating to 505 houses) (б) The making of Demolition Orders 2 (relating to 4 houses) (c) The making of Closing Orders Nil 116 APPENDIX. Table 3.—Causes of Death at different Periods of Life in Battersea, 1935. The following tables are supplied by the Registrar General at the request of the Ministry of Health:— Causes of Death. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— All Causes M. 917 76 15 13 17 28 43 39 93 174 229 190 F. 867 61 8 3 7 29 30 38 68 136 190 297 1. Typhoid and paratyphoid fevers M. - - - - - - - - - - - - F. - - - - - - - - - - - - 2. Measles M. - - - - - - - - - - - F. - - - - - - - - - - - - 3. Scarlet fever M. - - - - - - - - - - - - F. - - - - - - - - - - - - 4. Whooping cough M. 5 4 1 - - - - - - - - - F. 4 2 2 - - - - - - - - - 5. Diphtheria M. 7 1 2 4 - - - - - - - F. 2 - - - 1 - - - - 1 - - 6. Influenza M. 9 1 1 2 - 2 1 1 1 F. 9 — — — — 1 — — — 4 1 3 7. Encephalitis lethargica M. - - - - - - - - - - - - F. - - - - - - - - - - - - 8. Cerebro spinal fever M. 1 - 1 - - - - - - - - - F. - - - - - - - - - - - - 9. Tuberculosis of respiratory system M. 72 1 1 12 16 3 13 19 6 1 F. 40 — — — 1 15 9 4 5 4 2 — 10. Other tuberculous diseases M. 10 1 2 3 2 1 1 - - - - - F. 4 — — — 2 2 — — — — — — 11. Syphilis M. 4 - - - - - - - - 2 2 - F. 3 1 - - - - - - - 1 1 — 12. General paralysis of the insane, tabes dorsalis M. 7 - - - - - - 1 3 1 2 — F. 1 - - - - - - - 1 - - - 13. Cancer, malignant disease M. 140 1 1 6 15 38 53 26 F. 125 - - - - - 4 9 22 32 38 20 14. Diabetes M. 14 - - - - - - - 2 4 5 3 F. 12 - - - - - - - 1 4 5 2 15. Cerebral haemorrhage, etc. M 12 - - - - - - 1 - 3 6 2 F. 24 - - - - - - 1 1 8 5 9 16. Heart disease M. 230 - 2 1 1 7 15 34 68 102 F. 311 — — — — 5 2 5 14 32 73 180 17. Aneurysm M 2 - - - - - - - - 1 1 F. 6 - - - - - - - 1 2 2 1 117 Causes of Death, 1935—(contd.). Causes of Death. Sex. All Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— 18. Other circulatory diseases M. 38 - - - - - - - 4 12 13 9 F. 40 - - - - - - - 2 9 17 12 19. Bronchitis M. 42 1 1 - - 2 6 8 12 12 F. 25 3 1 — — — 1 — 1 3 2 14 20. Pneumonia (all forms) M. 50 9 5 4 2 1 4 3 5 4 9 4 F. 34 6 5 — 1 — — 1 2 4 3 12 21. Other respiratory diseases M. 6 1 1 4 — — F. 6 1 — — — 1 — 2 — 2 — — 22. Peptic ulcer M 20 - - - - - 3 3 3 6 5 F. 8 - - - - - - - 2 2 3 1 23. Diarrhoea, &c. M. 12 9 2 - - - - - 1 - - - F. 8 8 - - - - - - - - - - 24. Appendicitis M. 3 - - 1 - - - - - - 1 1 F. 6 — — — 1 — — 1 — 1 2 1 25. Cirrhosis of liver M. 3 - - - - - - - - 1 1 1 F. 1 - - - - - - - - - - - 26. Other diseases of liver, &c. M. 5 1 1 1 1 1 — F. 4 — — — — — I — 1 — 2 — 27. Other digestive diseases M 22 5 - - - 1 - 2 4 5 2 3 F. 12 — — 1 — 1 2 — 1 3 1 3 28. Acute and chronic nephritis M 33 1 - - - - 2 2 2 8 13 5 F. 36 - - - - - 1 3 6 8 10 8 29. Puerperal sepsis F. - - - - - - - - - - - - 30. Other puerperal causes F. 4 — - — — 1 1 2 — — — — 31. Congenital debility, premature birth, malformation, &c. M. 46 43 - - - 2 - 1 - - - — F. 39 38 - - - - - - - - - - 32. Senility M 6 - - - - - - - - - - 6 F. 17 - - - - - - - - - - 17 33. Suicide M. 15 1 1 2 5 3 2 1 F. 4 - - - - - 1 1 1 1 — — 34. Other violence M 32 - - 1 3 4 6 4 - 8 1 F. 12 — — 1 — — 2 — 2 1 3 3 35. Other defined diseases M 71 2 1 - 3 1 7 3 9 15 18 12 F. 70 2 — 1 1 3 6 8 5 13 20 11 36. Causes ill-defined, or unknown M. - - - - - - - - - - - - F. - - - - - - - - - - - - 118 Maternal Mortality in the County of London and in Battersea, 1921-1935. Year. London. (Rate per 1,000 live births.) Battersea. (Rate per 1,000 live births.) Puerperal Sepsis. Other Causes. Total. Puerperal Sepsis. Other Causes. Total. 1921 1.42 1.56 2.98 1.07 2.67 3.74 1922 1.36 1.48 2.84 0.82 1.64 2.46 1923 1.37 1.52 2.89 — 2.91 2.91 1924 1.24 1.84 3.08 1.27 1.59 2.86 1925 1.42 1.77 3.19 0.94 0.94 1.88 Mean (1921-1925) 1.36 1.63 2.99 0.82 1.95 2.77 1926 1.61 1.74 3.35 1.01 2.36 3.37 1927 1.31 1.60 2.91 0.36 1.78 2.14 1928 1.59 2.00 3.59 1.09 1.46 2.55 1929 1.88 1.73 3.61 0.76 115 1.91 1930 1.93 1.40 3.33 1.51 2.26 3.77 Mean (1926-1930) 1.66 1.69 3.35 0.95 1.80 2.75 1931 2.01 1.80 3.81 2.02 4.04 6.06 1932 1.33 1.66 2.99 0.86 0.86 1.72 1933 1.69 1.97 3.67 1.77 0.44 2.21 1934 1.34 1.46 2.80 1.39 1.86 3.25 1935 115 1.43 2.58 — 1.90 1.90 Mean (1931-1935) 1.50 1.66 3.17 1.21 1.82 3.03 Puerperal Fever Notifications in the County of London and in Battersea, 1921-1935. Year. London. (Rate per 1,000 live births.) Battersea. (Rate per 1,000 live births.) 1921 3.55 4.00 1922 3.28 3.55 1923 3.84 2.04 1924 3.43 4.78 1925 3.83 1.88 Mean (1921-1925) 3.59 3.25 1926 4.24 4.04 1927 3.57 3.21 1928 4.09 2.55 1929 4.46 1.53 1930 4.15 3.39 Mean (1926-1930) 4.10 2.94 1931 4.44 2.42 1932 3.51 1.72 1933 4.51 1.33 1934 4.48 4.64 1935 4.32 1.90 Mean (1931 -1935) 4.25 2.40 119 North Battersea. Infant Mortality, 1935. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... 1 3 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 2 ... ... ... 4 2 Diarrhoea & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 3 2 1 2 1 5 6 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Cancer ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 . . . Premature Birth 9 5 3 4 ... ... ... ... 1 ... 13 9 3 ... 1 ... ... ... ... ... 17 9 Congenital Malformation 1 1 2 2 1 ... ... 1 ... 1 ... 5 1 1 ... ... ... ... ... ... 5 6 Congenital Debility ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis and Asphyxia Neonatorum ... 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbilical Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Asphyxia, accidental ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... Other Causes ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... 1 ... ... ... 2 1 10 7 7 6 1 ... ... 2 1 I 19 16 7 3 7 4 6 1 2 3 41 27 Totals 17 13 1 2 2 35 10 11 7 5 68 Nett Births in the year. •■lett Deaths in the year (Infants under 1 year) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1,053 41 1,094 62 6 68 120 South Batteraea. Infant Mortality, 1935. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. f. M. f. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... PulmonaryTuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Other Tuberculous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 ... 1 ... ... ... ... 1 3 Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 2 ... ... 1 5 4 Diarrhoea & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 1 1 ... ... 4 2 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 ... Cancer ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 4 7 4 5 1 ... ... 1 ... ... 9 13 2 ... ... ... ... ... ... ... 11 13 Congenital Malformation ... 4 1 ... ... ... 1 ... ... ... 2 4 1 ... ... ... ... ... ... ... 3 4 Congenital Debility ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... 3 Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth 2 ... I ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... 3 ... Atelectasis & Asphyxia Neonatorum 2 2 ... ... ... ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... 2 2 Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbilical Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Asphyxia, accidental ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... 2 1 Totals 8 13 6 7 1 ... 1 1 1 ... 17 21 8 3 5 7 4 1 1 2 35 34 21 13 1 2 1 38 11 12 5 3 69 Nett Births in the year. Nett Deaths in the year(Infants under 1 year) Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 964 46 1,010 61 8 69 121 Borough of Battersea. Infant Mortality, 1935. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. AGE PERIODS. Under 24 hours. 1.7 days. Weeks. Total u:ider 4 weeks. Months. Total deaths under 1 year. Percentage of Total. 1.2 2.3 3.4 1.3 3.6 6.9 9.12 Small.pox M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping.cough ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... 2 4 2 4.38 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethar. gica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... MeningococcalMenin. gitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 0.73 Other Tuberculous disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 ... 1 ... ... ... ... 1 3 2.92 Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ... ... ... 1 2 4 3 4 ... ... 1 9 6 10.95 Diarrhoea & Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 4 3 2 2 i 9 8 12.41 Cancer ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 0.73 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 0.73 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 ... 1.46 Premature Birth 13 12 7 9 1 ... ... 1 1 22 22 5 ... 1 ... ... ... ... ... 28 22 36.49 Congenital Malformation 1 5 3 2 1 ... 1 1 ... 1 6 9 2 1 ... ... ... ... ... ... 8 10 13.14 Congenital Debility ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... 3 2.19 Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 0.73 Injury at Birth 2 ... 1 ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... 3 ... 2.19 Atelectasis & Asphyxia Neonatorum 2 3 1 ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... ... ... 3 3 4.38 Lack of Care ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...Umbilical Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 0.73 Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Asphyxia, accidental ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... 1 .46 Other Causes ... ... ... 1 ... ... ... 1 ... ... ... 2 1 ... 1 ... 2 ... ... ... 4 2 4.38 18 20 13 13 2 ... 1 3 2 1 36 37 15 6 12 11 10 2 3 5 76 61 100.00 Totals 38 26 2 4 3 73 21 23 12 8 137 ... Percentage of Total . 27.7 19.0 1.5 2.9 2.2 53.3 15.3 16.8 8.7 5.9 m.55.5 f.44.5 m. Nett Births in the year. Nett Deaths in the year (Infants under 1 year). Legitimate. Illegitimate. Total. Legitimate. Illegitimate. Total. 1,012 36 1,048 70 6 76 f. 1,005 51 1,056 53 8 61 Totals 2,017 87 2,104 123 14 137 122 Form T137 1935. Public Health (Tuberculosis) Regulations, 1930. Part I.—Summary of Notifications during the period from the 1st January, 1935, to the 31st December, 1935, in the area of the Metropolitan Borough of Battersea (to which this return relates). Age Periods. Formal Notifications. Number of Primary Notifications of new cases of Tuberculosis. Total Notifications 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all ages) Pulmonary Males — 1 3 3 6 12 29 13 18 11 2 98 137 „ Females — 1 1 — 18 23 32 11 7 2 1 96 125 Non-Pulmonary Males 1 2 2 4 1 1 4 1 — 1 17 18 „ Females — 3 3 4 4 4 4 3 1 — — 26 29 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) NOTES—Part I. (а) Formal notifications are notifications which are made in pursuance of Article 5 of the Public Health (Tuberculosis) Regulations, 1930, or by Naval, Military or Air Force Medical Authorities in pursuance of Section 5 (b) of the Local Government (Emergency Provisions) Act, 1916. (б) Primary notifications for the purpose of columns (2)—(13) relate to patients who have never previously been formally notified in the area to which the Return relates. A patient who changes his residence from one Sanitary District to another in the same County may properly be the subject of Primary Notification in each such District. Only the first of such notifications, however, should be recorded in columns (2)-(13) of the Return for the County concerned, the subsequent notification(s) being included in column (14). (c) Column (14). All formal notifications, whether duplicate or not, should be included in this column. General.—Patients notified as suffering from combined pulmonary and non-pulmonary tuberculosis should be included among the " pulmonary " returns only. If a patient already notified as suffering from one form of tuberculosis is subsequently notified to the Medical Officer of Health of the same Sanitary District as suffering from another form of tuberculosis, the fact should be noted in the Notification Register, but such notification should be recorded as a duplicate notification. 123 Supplemental Return. Part II.—New Cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period otherwise than by formal notification. Age Periods. 0- 1- 5- 10- 15- 20 - 25- 35- 45- 55- 65- Total Pulmonary Males — 1 — — 1 — — 2 — 6 5 15 „ Females — — — — — — 2 1 — 1 1 5 Non-Pulmonary Males 1 4 — 1 1 — 2 — — — — 9 „ Females — — — — 3 1 — — — 1 5 The source or sources from which information as to the above-mentioned cases was obtained should be stated below:— Source of Information. No. of Cases. Pulmonary. Non-pulmonary. Death Returns f from local Registrars 2 1 transferable deaths from Registrar-General 3 2 Posthumous notifications 12 7 " Transfers " from other areas (other than transferable deaths) 3 4 Other sources if any (specify) — — NOTES.—Part II. (а) New cases of tuberculosis first coming to knowledge otherwise than by formal notification may, in some instances, afterwards be formally notified under the Regulations. Should such formal notification be received within the same year as that in which the case first came to the knowledge of the Medical Officer of Health, it should be recorded as a " Primary Notification," and excluded from the Supplemental Return. If the formal notification is received in a subsequent year, such notification should be regarded as duplicate, as the case has already been included in the Supplemental Return for a previous year. (б) A formal notification which is not received until after the death of the patient should be included in the Supplemental Return as a " posthumous notification." (c) Particulars of cases coming to knowledge through the Death Returns, as well as of cases notified posthumously, are required by Article 10 (2) of the Regulations to be entered in the Notification Register. It follows that such cases will also be duly included in the number of cases removed from the Register during the year by reason of "death."—(cf. Head 3 of the second section of Part III. of the form overleaf.) (d) No case should be included both in the Summary of Notifications and in the Supplemental Return for the same year. (e) In Counties, the particulars for the purposes of this Return should be obtained by the procedure suggested in paragraph 2 of Part II. of Circular 549. 124 Part III.—Notification Register. Pulmonary. Non-Pulmonary. Total Cases Males Females Total Males Females Total Number of cases of Tuberculosis remaining at the 31st December, 1935, on the Register of Notifications kept by the Medical Officer of Health of the Metropolitan Borough 368 321 689 124 120 244 933 Number of cases removed from the Register during the vear bv reason inter alia of:— 1. Withdrawal of notification — 3 3 5 3 8 11 2. Recovery from the disease 25 18 43 13 19 32 75 3. Death... 85 43 128 7 7 14 142 NOTES.—Part III. In Counties, the information should be compiled from the quarterly statements for the year 1935, which are required to be furnished to the County Medical Officer of Health by the Medical Officer of Health of each District in the County, in pursuance of Article 10 (8) of the Regulations, and should represent the sum of the figures relating to each District in the County. If any of these quarterly statements has not been duly received by the County Medical Officer of Health, the Ministry should be furnished with particulars, including the name of the District concerned. Further, if the County Medical Officer of Health is in any doubt as to the accuracy of the figures included in his Return, he should record the fact, giving reasons. 125 Form T145. TREATMENT OF TUBERCULOSIS. BATTERSEA METROPOLITAN BOROUGH COUNCIL. Return for the Year 1935. (a.) Return showing the work of the Dispensary (or Dispensaries). Diagnosis. Pulmonary. Non- Pulmonary. Total. Grand Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 73 57 3 2 5 9 6 8 78 66 9 10 163 *(6) Diagnosis not completed — — — — — — —- — 21 21 12 17 71 (ic) Non-tuberculous — — — — — — — — 106 130 55 52 343 B.—Contacts examined during the year:— (a) Definitely tuberculous — 2 — — — — — — — 2 2 *(b) Diagnosis not completed — — — — — — — — 2 1 1 3 7 (c) Non-tuberculous — — — — — — — — 30 60 68 60 218 C.—Cases written of! the Dispensary Register as— 17 14 3 2 1 3 8 10 IS 17 11 12 58 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) — — — — — — — — 154 222 134 126 636 D.—Number of cases on Dispensary Register on December 31st :— (a) Definitely tuberculous 315 246 19 28 34 48 69 41 349 294 88 69 800 (b) Diagnosis not completed — — — — — — — — 24 30 19 35 108 1. Number of cases on Dispensary Register on January 1st 933 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 53 3. Number of cases transferred to other areas, cases not desiring further assistance under the Scheme, and cases " lost sight of " 96 4. Cases written off during the year as Dead (all causes) 92 5. Number of attendances at the Dispensary (including Contacts) 3,863 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 186 7. Number of consultations with medical practitioners :— (a) Personal f ... 12 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) f 340 (b) Other 320 9. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 4,035 10. Number of (a) Specimens of sputum, &c., examined (b) X-ray examinations made in connection with Dispensary work 622 ( + 268 non-dis) 204 11. Number of " Recovered " cases restored to Dispensary Register, and included in A (a) and A (6) above 3 12. Number of " T.B. plus " cases on Dispensary Register on December 31st 395 (B.)—Number of Dispensaries for the treatment of Tuberculosis (excluding centres used only for special forms of treatment):— Provided by the Council 1 Provided by Voluntary Bodies — • i.e., remaining undiagnosed on 31st December. [See Memo. 37/T (Revised), p. 10, Sec. II., Note 4.] † All personal consultations, whether held at the homes of patients or elsewhere, should be included in item 7 (a) ; and all visits by Tuberculosis Officers to homes, whether or not accompanied by a personal consultation already included in item 7 (a), should be entered in item 8. 126 TUBERCULOSIS SCHEME OF THE BATTERSEA METROPOLITAN BOROUGH COUNCIL. Form T145a. PULMONARY TUBERCULOSIS. Supplementary Annual Return showing in summary form (a) the condition at the end of 1935 of all Patients remaining on the Dispensary Register; and (b) the reasons for the removal of all cases written off the Register. The Table is arranged according to the years in which the patients were first entered on the Dispensary Register as definite cases of pulmonary tuberculosis, and their classification at that time. Condition at the time of the last record made during the year to which the Return relates Previous to 1921 1921—6 1927 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) 1 (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults—M. 6 2 — — 2 2 — 3 — 3 1 1 1 — 2 F. — 1 1 — 2 — 2 3 5 1 — 1 Children 3 — — — — 2 — — — — — — — — — Disease not arrested. Adults—M. 1 5 6 — 11 — 8 13 1 22 1 1 1 — 2 F. 1 3 2 — 5 1 4 1 1 6 — — 1 — 1 Children — — — — — — 1 — — 1 — — — — — Condition not ascertained during the year 11 4 2 — 6 10 3 6 2 11 1 — 1 1 Total on Dispensary Register at 31st December 22 15 11 — 26 15 18 26 4 48 3 3 4 — 7 (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as recovered. Adults—M. — — All classes 63 10 6 5 — 11 2 2 — 4 F. — — — — 69 17 — 2 — 2 1 — — — — Children — — — — 240 12 3 1 — 4 2 — — — — Lost sight of, or otherwise removed from Dispensary Register — 585 113 54 112 40 206 22 3 29 4 36 DEAD. Adults—M. — — — — 249 27 26 148 155 329 3 3 27 23 53 F. — — — — 185 14 15 74 112 201 6 — 22 19 41 Children ... — — — — 44 8 1 6 6 13 1 — 3 — 3 Total written off Dispensary Register — — — — 1435 201 105 348 313 766 35 8 83 46 137 Grand Totals — — — — 1483 216 123 374 317 814 38 11 87 46 144 127 PULMONARY TUBERCULOSIS—(Contd.). Form T145a—(Contd.). Condition at the time of the last record made during the year to which the Return relates 1928 1929 1930 1931 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group Group 2 Group 3 Total (Class T.B. plus) Group Group 2 Group 3 Total (Class T.B. plus) Group Group 2 Group 3 Total (Class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults—M. — — 2 — 2 3 1 — — 1 3 1 — — 1 1 2 — — 2 F. 4 — 1 — 1 2 2 — — 2 — — — — — 1 1 — — 1 Children — — — — — 1 — — — — 1 — — — — — — — — — Disease not arrested. Adults—M. — 4 8 — 12 2 3 2 1 6 1 6 5 — 11 3 4 6 — 10 F. — 2 1 3 2 1 8 1 10 6 2 5 — 7 7 4 7 1 12 Children — — — — — — — — — — 2 — — — — 3 — — — — Condition not ascertained during the year. 4 — 7 — 7 3 5 1 — 6 6 3 — — 3 3 6 1 — 7 Total on Dispensary Register at 31st December 8 4 20 1 25 13 12 11 2 25 19 12 10 — 22 22 17 14 1 32 (b) Not now on Dispensary Register andj reasons for removal therefrom. Discharged as recovered. Adults—M. 5 1 — — 1 6 — 2 — 2 1 — — — — — — — — — F. — — 1 — 1 3 — 1 — 1 — — — — — — — — — — Children . 1 — — — — — — — — — — — — — — — — — — — Lost sight of, or otherwise removed from Dispensary Register 15 9 18 8 35 12 15 24 4 43 18 8 25 5 38 6 12 16 4 32 DEAD Adults—M. 6 4 24 19 47 4 6 33 28 67 9 4 28 18 50 6 12 20 4 36 F. 6 3 18 28 49 7 3 17 22 42 6 1 14 14 29 6 10 9 6 25 Children . 1 — —— — — 1 — 1 1 2 1 — — 2 2 2 — — — — Total written off Dispensary Register 34 17 61 55 133 33 24 78 55 157 35 13 67 39 119 20 34 45 14 93 Grand Totals 42 21 81 56 158 46 36 89 57 182 54 25 77 39 141 42 51 59 | 15 125 128 PULMONARY TUBERCULOSIS—(Contd.). Form T145a (Conld.). Condition at the time of the last record made during the year to which the Return relates 1932 1933 1934 1935 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group Group 2 Group 3 Total (Class T.B. plus) (a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults—M. 2 — 1 — 1 1 — — — — — — — — — — — — — — F. — — — — — — — — — — — — — — — — — — — — Children — — — — — — — — — — — — — — — — — — — — Disease not arrested. Adults—M. 4 5 5 1 11 8 3 17 20 9 10 32 1 43 16 5 33 1 39 F. 8 3 8 1 12 10 4 14 1 19 14 4 15 19 18 2 24 2 28 Children . — — — — — 1 1 — — 1 — 1 — 1 2 5 — — — — Condition not ascertained during the year 2 1 5 — 6 4 2 3 — 5 8 1 3 — 4 — — — — — Total on Dispensary Register at 31st December 16 9 19 2 30 25 10 34 1 45 31 16 50 2 68 39 7 57 3 67 (6) Not now on Dispensary Register and reasons for removal therefrom. Discharged as recovered. Adults—M. — — — — — — — — — — — — — — — — — — — — F. — — — — — — — — — — — — — — — — — — — — Children — — — — — — — — — — — — — — — — — — — — Lost sight of, or otherwise removed from Dispensary Register 19 7 13 1 21 15 10 16 — 26 6 6 15 — 21 2 2 6 — 8 DEAD. Adults—M. 5 6 22 5 33 2 4 19 9 32 — 2 14 10 26 1 — — 8 8 F. 3 7 9 6 22 3 — 13 5 18 — — 7 8 15 1 — 2 5 7 Children 1 — — — — — — — — — 1 — 1 1 2 — — 1 — 1 Total written off Dispensary Register 28 20 44 12 76 20 14 48 14 76 7 8 37 19 64 4 2 9 13 24 Grand Totals 44 29 63 14 106 45 24 82 15 121 38 24 87 21 132 43 9 66 16 91 to CD NON-PULMONARY TUBERCULOSIS. Form T14S. -iContd.). Supplementary Annual Return showing in summary form (a) the condition at the end of 1935 of all Patients remaining on the Dispensary Register; and (6) the reasons for the removal of all cases written off the Register. Condition at the time of the last record made during the year to which the Return relates Previous to 1921 1921—6 1927 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands. Total Bones and Joints. Abdominal Other Organs Peripheral Glands Total 1(a) Remaining on Dispensary Register on 31st December. Disease arrested. Adults—M. F. — — — — — — 1 — — 1 — — — — — — — — — — — — — — — — — — 1 1 Children 2 — — — 2 5 — — 9 14 1 1 — 2 4 Disease not arrested. Adults—M. — — — — — — — — — — 1 — — 1 2 F. — — — — 1 1 1 2 — 4 — — — — — Children — — — 1 1 1 — 1 1 3 — — — 1 1 Condition not ascertained during the year... — — — 2 2 1 2 4 10 17 1 1 2 Total on Dispensary Register at 31st December 2 1 3 6 8 4 7 20 39 3 1 — 6 10 (b) Not now on Dispensary Registers and reasons for removal therefrom. | Transferred to Pulmonary 2 — — — 2 2 1 1 1 5 — — — — — Discharged as Recovered. Adults—M. 1 — 1 1 3 2 1 2 3 8 2 — — — 2 F. 1 1 4 6 1 1 2 Children 5 3 2 29 39 17 12 2 66 97 1 i 2 1 5 Lost sight of, or otherwise removed from Dispensary Register 21 7 15 49 92 27 7 10 60 104 2 3 4 8 17 DEAD. Adults—M. 1 — — — 1 4 — 2 — 6 3 — — — 3 F. 1 1 — 3 5 1 1 4 2 8 — — — 1 1 Children 1 — — 8 9 4 1 1 3 9 1 — — — 1 Total written off Dispensary Register . 30 11 18 90 149 56 23 21 138 238 9 4 7 11 31 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 32 11 19 93 155 64 27 28 158 277 12 — 7 17 41 130 NON-PULMONARY TUBERCULOSIS—(Contd.). Form T145a— (CotUd.). Condition at the time of the last record made during the year to which the Return relates 1928 1929 1930 1931 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bnnes and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total (a) Remaining on Dispensary Register1 on 31st December. Disease arrested. Adults—M. — — — — — — 1 — — 1 1 — — — 1 2 — — — 2 F. 1 — — — 1 1 — — — 1 — — 1 1 2 1 — — — 1 Children 2 1 — — 4 — — — 5 — 3 1 1 1 6 1 — — 1 2 Disease not arrested. Adults—M. — — — — — 1 — — — 1 — — — — — — — — — — F. — — — — — — — 1 — 1 — — — — — 1 — — — 1 Children 1 — — — 1 — — — 1 1 1 2 — — 3 1 — — 4 5 Condition not ascertained during the year 1 — 2 1 4 1 — — — 1 1 — — 2 3 1 — — — 1 Total on Dispensary Register at 31st December 5 1 2 2 10 3 1 1 6 11 6 3 2 4 15 — — — 5 12 Transferred to Pulmonary — — — — — — — — — — — — — — — — — — — — (b) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered. Adults—M. 2 1 — — 3 — — — 3 3 — 1 — 1 2 — — — — — F. — 1 — — 1 1 — — 3 4 1 — — 2 3 1 — — 1 2 Children 2 1 3 1 1 2 5 1 1 2 4 Lost sight of, or otherwise removed from Dispensary Register 2 1 3 7 13 3 1 5 9 2 2 1 8 13 6 1 3 3 13 DEAD. Adults—M. — — — — — — — — — — 2 — 1 — 3 — — — — — F. — — — — — 1 — — — 1 1 — — 1 2 2 2 — — 4 Children — — 1 — 1 — — — — — 1 — — — 1 1 — — — 1 Total written off Dispensary Register 6 3 4 8 21 6 2 1 13 22 7 4 3 14 28 10 3 3 4 20 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 11 4 6 10 31 9 3 2 19 33 13 7 5 18 43 17 3 3 9 32 131 NON-PULMONARY TUBERCULOSIS.—(Contd.). Form T145a (Contd.). Condition at the time of the last record made during the year to which the Return relates 1932 1933 1934 1935 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints 1 Abdominal i Other Organs Peripheral Gl&nds Total Bones and Joints Abdominal Other Organs Peripheral Glands 1 Total Bones and Joints Abdominal Other Organs Peripheral Glands Total 1 (a) Remaining on Dispensary Register on 31st December! Disease arrested Adults—M. — — — 1 1 — — — — — — — — — — — — — — — F. 1 — — — 1 — — — — — — — — — — — — — — — Children 2 1 — 3 6 — — — — — — — — — — — — — — — Disease not arrested. Adults—M. 4 — 2 — 6 2 — 2 1 5 — — 1 — 1 4 — — — 4 F. — — 2 1 3 2 1 1 3 7 — — 2 2 4 2 1 2 3 8 Children — 1 — 3 4 2 — — 2 4 2 1 — 2 5 4 2 2 4 12 Condition not ascertained during the year 6 — 2 2 10 1 — 1 1 3 3 — — 2 5 — — — — — Total on Dispensary Register at 31st December 13 2 6 10 31 7 1 4 7 19 5 1 3 6 15 10 3 4 7 24 Transferred to Pulmonary — — — — — — — — — — — — — — — — — — — — (6) Not now on Dispensary Register and reasons for removal therefrom. Discharged as Recovered. Adults—M. — — — — — — — — — — — — — — — — — — — — F. — — — — — — — — — — — — — — — — — — — — Children — — — — — — — — — — — — — — — — — — — — Lost sight of, or otherwise removed from Dispensary Register 5 1 3 1 10 3 1 1 2 7 3 3 6 — — — — 1 DEAD. Adults—M. 2 — 2 — 4 1 — 1 — 2 — — — — — — — — — — F. — — — 1 1 — — — — — — — — — — — — — — — Children — 1 — — 1 — — — 1 1 — — — — — — — 1 — 1 Total written off Dispensary Register 7 2 5 2 16 4 1 2 3 10 3 — — 3 6 — — 2 — 2 Grand Totals of (a) and (b) (excluding those transferred to Pulmonary) 20 4 11 12 47 11 2 6 10 29 8 1 3 9 21 10 3 6 7 26 132 INDEX. (Chief references in heavy type.) PAGE Adulteration of food 8996 Aged and infirm persons 73, 82 Agricultural Produce (Grading, &c.) Acts 75, 97 All Saints' Hall centre 2021, 29, 32 Ambulances 33 Analysis of food, &c 8996 Analyst 3, 89 Animals 71, 89 Antenatal clinics 20, 23, 2834, 35 Anthrax 75 Appeals (housing) 111 Area of Borough, Wards, &c. 7, 8 Artificial Cream Act 95,96 Artificial light treatment—see Solarium Assessment of fees—see Fees. Bacteriological examinations 66, 70, 89, 94 Bakehouses 71,99, 100, 101, 103 Baths (swimming) 81 Battersea General Hospital 25 Battersea Polytechnic 24 Battersea Power Station 80 Battersea School for Mothers 1921, 22 Births 7, 811, 12, 13, 1618, 24, 119121 Bolingbroke Hospital 25 Breast feeding 41 British Dental Hospital 3, 27, 28 British Legion 67 British Social Hygiene Council 70, 84 Brompton Hospital 66 Butchers 89 Cancer 69,116, 119, 121 Caravans—see Gipsy vans. Census 7, 8, 107 Central Council for Health Education 84 Centres—see Antenatal, Dental, Maternity, Postnatal. Cerebrospinal fever 46, 47, 48, 54, 116 Charing Cross Hospital 25 Charity Organisation Society 67 Charts 17, 512, 60 Chatham Road centre 20, 21, 22 Chatham Road flats 109 Chelsea Health Society 28 Chicken pox 42,69 Children's Acts—see Infant Life Protection. Chislehurst (St. James's) Mission 1921, 23 Clapham Maternity Hospital 25, 33 Clearance areas 105, 110 Clerical staff 3, 87 Closing orders 105, 111, 115 Colindale Hospital 66 Combined drain claims 78 Common lodging houses 77 Complaints 71 Condensed milk 91. 95 Consultants 3, 29, 33, 35, 53, 62 Convalescence 23, 41 Coroner's Court 856 Cream and artificial cream 73,90,95 Creche—see St. Margaret's Day Nursery. 133 PAGE Dairymen 95 Day Nursery—see St. Margaret's. Deaths7, 9, 10-14, 16, 17, 18, 40. 56-60, 62, 68, 85-6, 116-7 Demolition orders 105, 111, 113, 114, 115 Density of population 8, 107 Dental treatment 20, 23, 24, 27-28, 65 Diabetes 70,116 Diarrhoea 7,42,69,117,119-121 Didcot street site 106 Dinners for mothers and children 20, 23, 27 Diphtheria 24, 47, 48, 51, 70, 84, 116 Disinfection 71, 85 District midwife 4, 23, 29, 37, 38-9 Dogs, nuisances by 84 Drains 71, 72, 78, 83 Drugs, analysis of 90,91 Dust collection, &c. 71, 79 Dysentery 47, 48 Effluvium nuisance 72, 80 Elizabeth Garrett Anderson hospital 25 Encephalitis lethargica 47,48,54 Enteric (typhoid) fever 47,48,53,70 Epsom salts ' 90 Erysipelas 42, 47, 48, 55 Factories 71, 99-101 Families 7, 107 Fat melters 80 Fathers' Council 20, 22 Fees, scales for assessment 26, 28, 35, 39, 43 Fish shops 97 Food— Departmental Committee on 96 Poisoning 88 Preservatives in 93, 97 Protection of supply 71, 89-98 Sale of Food order 75 Street stalls 98 Unsound 88 Foster Mothers and Children.—see Infant Life Protection. General Lying-in hospital 25, 33 Gideon Road centre 20-21 Gipsy vans 71, 82, 109 Grants 19, 61 Great Ormond Street Hospital 25 Grove Park Hospital 66 Health Committee 1 Health Visitors 3, 22, 24, 44, 87 Home helps 39 Hospitals 24-5, 66, 79, 94 Houses erected 106, 107, 113 Houses let in separate tenements 71,79 Houses, number of 7, 107 House to house inspections 71,113 Housing 75, 105-115 Housing Committee 1 134 PAGE Ice Cream 53, 96 Illegitimate births and deaths 7, 11, 14, 119-121 Improvement areas 105 Increase of rent, &c., Acts 111 Infant Life Protection 24, 44-5, 74 Infant mortality 7,10,12,13,16,17,18,24,36,38,116-7,119-121 Infectious disease 24, 46-70, 103 Influenza 42, 69, 116 Inquests 86 Inspections (see also under subject) 71,113 Institutional deaths 7, 12 Insulin 70 Invalid Children's Aid Association 19, 41, 61 Invalid Kitchens Association 27 King's College Hospital 25 Kitchens 98 Knackers' yards 89 Latchmere Estate 81, 109 Laundries 99, 100, 101 Legal proceedings 71-74 Legislation 75 Lemonade powder 90,92 Light treatment—see Solarium. Lithgow Street area 106,111 Lodging Houses 77 Longevity 12, 13 Malaria 47, 48 Marriages 11 Massage 23, 43 Maternal mortality 7, 24, 36, 38, 40, 117, 118 Maternity and Child Welfare 19-45 Maternity Centres 19-21,85 Maternity Hospital 4, 20-21, 23, 29, 31, 32, 35-37, 87 Maternity—Specialist advice 41 Maudsley Hospital 25 Measles 7.42,47,48,55,84,116 Meat 75, 88, 89 Medical Officer of Health 3, 5, 75 Merchandise Marks Acts 73, 75, 97 Metropolitan Boroughs statistics 18, 107 Middlesex Hospital 25 Midwives (see also District Midwife) 33,41 Milk- Condensed 91, 95 Milk and Dairies Acts and Orders 94 Sampling and Analysis 73,90-94 Shops 95 Special designations 26, 94 Supply to schools and hospitals 94 mothers and children 25-27, 74 Tradesmen 95 Mortuary 85-6 Mothercraft classes 20, 22 Mumps 42 Mundella Road centre 20, 21, 22, 43-4 135 PAGE Non-notifiable diseases 69-70 Notices, service of (see also under subject) 71, 75 Notification of Births Acts 15 Nurse children—see Infant Life Protection. Nursing 23, 42, 54 Offensive matter, removal 71, 81 Offensive trades 80 Open Air School 61 Ophthalmia neonatorum 36, 42, 47, 48, 54 Outworkers 99, 102-3 Overcrowding 71, 75, 106, 107-9 Pemphigus neonatorum 39, 42 Personal Cleansing Station 84 Pharmacy and Poisons Act 75 Physicians, Royal College of 61 Pigeons 83 Plans, non-submission of 72, 78 Plough Road Centre 20-21, 22, 28, 32 Plough Road flats 109 Pneumonia 42,47,48,69, 117, 119-121 Poisons 75 Polio-myelitis and-encephalitis 47,48,52 Population 7, 8, 9, 16, 107 Post-natal clinic 20,35 Preservatives in food 93, 97 Propaganda 84 Public Analyst 3, 89 Public Assistance 26, 67 Public cleaasing 79 Public Health Regulations and Orders— Condensed milk 95 Meat 89 Preservatives, &c., in food 97 Public Houses 80 Public Institution deaths 7, 12 Puerperal fever and pyrexia 7, 36, 38, 40, 42, 47, 48, 53, 117, 118 Pupil health visitors 24 Pupil midwives 35 Queen Charlotte's Hospital 25 Rag and bone dealers 73, 83 Rag Flock Acts 83 Rateable value 7 Rats and mice 83 Refuse removal 79 Registration Sub-Districts 8, 9, 13, 14, 47, 54, 57, 119-120 Rent-books 111 Rent and Mortgage Restrictions Acts 111 Restaurant kitchens 98 Royal College of Physicians 61 Royal Eye Hospital 25 Royal Free Hospital 25 St. George's Hospital 23, 25, 66 St. Helier Estate 110 St. James's Hospital 8, 23, 62 St. John's Estate 109 St. Luke's Church 84 136 PAGE St Margaret's Day Nursery, &c 19, 44 St Margaret's (LCC) Hospital 54 St Mary's House 19, 39 St Peter's Church 84 St Thomas's Babies Hostel 19, 24, 25, 41 St Thomas's Hospital 25, 33, 61, 66 Sampling of food 71,89-96 Sanitary Inspectors 3, 24, 75, 87 Savona Street flats 109 Scale of fees—see Fees Scarlet fever 47,48,49 Schick test clinic 20, 51 Schools 79, 84-5, 94 Senile mortality 12, 13, 116-7 Sheepcote Lane site - 110 Shops Act, 1934 71, 76 Slaughter of Animals Act, 1933 88 Slaughter-houses and Slaughtermen 88 Smallpox 46, 47, 49 Smoke nuisance 71, 80 Soap boilers 80 Solarium 20, 43, 66 Southlands centres 20-21, 22, 28, 30, 32 South London District Nursing Association 42 South London Hospital for Women 25 Southwark Diocesan Association 19, 39 Specialists—see Consultants Staff 3, 24, 35, 61, 75, 87, 108 Stewarts Lane site 106, 109 Still-births 7, 11, 14, 15, 24, 36, 38 Street stalls 98 Structural defects 112 Suicide 86 Sunlight treatment—see Solarium Swimming baths 81 Tenement houses 71, 79 Thames, river 85 Thibet Street houses 111 Town Hall Estate 109 Tuberculosis— Artificial light treatment 66 „ pneu mo-thorax 66 Bacteriological examinations 66, 125 Beds 66, 67 Boarding out 61, 67 Care Committee 2, 67 Clothing 65, 67 Contacts 62, 64, 125 Deaths 56-60, 62, 116, 120-1, 123-31 Dental treatment 64,65,67 Dispensary 25, 30, 31, 61-68 Extra nourishment 66, 67 Handicraft class 68 Institutional treatment 64 Investigation by Royal College of Physicians 61 Localisation 58 LCC Tuberculosis scheme 62, 64 New cases 62-64, 125 Non-dispensary patients 68 Notifications 48, 56-59, 122, 123 137 Tuberculosis—(contd.) page Open-air School 61 Recovery from disease 62, 125-131 Register of cases 61, 124 Shelters 66 Statistics 48,56-60.67,122-31 Tuberculosis Officers 3, 62, 87, 125 Tuberculosis Regulations 61 United Services fund 67 Visiting 62, 68, 125 X-ray examinations 61, 66 Typhoid fever—see Enteric Fever. Underground rooms 71, 114-5 Unmarried mothers—see Southwark Diocesan Association. Unsound food 88 Urinals 71, 80 Vaccination 49-50 Vans 71, 82, 109 Venereal disease 24, 30, 33-4, 70 Vermin 84-85 Victoria Hospital for Children 19, 24, 25 Vincent Square Hospital 25 Vital Statistics 7, 16, 18, 116-21 Voluntary Centres (Maternity and Child Welfare) 19-22 Wards 8, 9, 12, 13, 14, 48, 49, 54, 57, 108 Warehouses 104 Water-closets 71, 72, 79 Water supply 53,71,75,81 Westminster Hospital 25 Wharves 104 Whooping-cough 7, 42, 47, 48, 55, 116, 119-121 Women's League of Service 19-21, 22, 27, 29 Workshops and workplaces 71, 99-102 York Road tenements 106 Zinc ointment 90 Zymotic diseases 68 . Battersca Borough Council. With tthe compliments of the Medical officer of Health.