CRO 20 1 County borough of Crondom. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH AND SCHOOL MEDICAL OFFICER For the Year 1918. R. VEITCH CLARK, M.A., M.B., Ch.B., B.Sc., D.P.H. CROYDON : PRINTED AT THE " CROYDON TIMES " OFFICE, 108, HIGH STREET. 2 TABLE OF CONTENTS. Page. Vital Statistics— Population 6 Birth Rate 6 Death Rate 6 Infantile Mortality 6 Maternity and Infant Work — Infant Mortality in various Wards 7 Infant Centres 8 Maternity Hostel 9 Sick Nursing 10 Methods of Feeding and Mortality 10 Notifications of Births 12 Midwives 12 General Matters— Influenza 12 The work of the Health Yisitors 18 Tuberculosis and Milk 20 Disinfection 20 Cleansing of Persons at Disinfecting Station 20 Mental Deficiency 20 Venereal Diseases 22 Local Government Board Returns— Table I. Vital Statistics of whole district during 1918 and previous years 27 Table II. Cases of Infectious Disease notified during 1918 28 Table III. Causes of, and Ages at, Death during 1918 30 Table IV. Infantile Mortality during 1918, Death from stated causes in weeks and months under one year of age 43 Table V. Cases notified and deaths from the principal zymotic diseases for the year 1918 and preceding years 52 Table VI. Vital Statistics of separate Wards in 1918 and previous years 53 Work of Sanitary Inspecting Staff— Inspections 54 Notices and Council Orders 54 Municipal and other Common Lodging Houses 54 Factory and Workshop Act 57 Meat Inspections 61 Slaughterhouses 62 Dairies and Cowsheds 63 Food and Drugs Acts 64 Milk and Cream Regulations 65 Meteorological Records 69 Tuberculosis— General Survey of cases dealt with through the Tuber culosis Dispensary and work done in connection with them 71 Sanatorium and Hospital Treatment 73 Work of the Borough Hospital 75 Report on School Medical Work 84 3 Public Health Department, Town Hall, Croydon, December, 1919. To the Mayor, Aldermen and Councillors of the County Borough of Crovdon. Mr. Mayor, Ladies and Gentlemen, I beg to submit the Annual Report of the work carried out by the Public Health Department during the year 1918. In the vital statistics there are one or two notable features. The birth rate is exceedingly low and is less by nearly 1.2 per thousand than the death rate. This comparison, however, is not really a reliable one as the population as estimated by the Registrar General for the calculation of the birth rate is much higher than that used for the calculation of the death rate, a circumstance arising out of the abnormal conditions of the War, a large proportion of the men of the population being overseas. The diminution of the birth rate also is to some extent due to this fact. The infant mortality of 76 per thousand births is the lowest on record. In the years 1912. and 1916 the rate zvas 77. During 1918 the country was visited by two epidemics of influenza, the second of which was by far the most severe which the country has experienced since the outbreak of 1890. An account of these outbreaks in Croydon is given in the report. The most outstanding event of the year in the Maternity and Child Welfare work was the opening of St. Mary's Hostel, presented by the Mayor and Mayoress (Mr. Alderman and Mrs. Howard Houlder). The Hostel has received very high encomiums from the medical inspectors of the Local Government Board. It has been visited by many representatives of other authorities when similar institutions were projected by them. With the Medical Officer of Health’s Compliments. Town Hall Croydon. 4 One of the most urgent needs is the provision of an adequate mothers’ and sick children's nursery or convalescent home in place of the existing small Sick Nursery now at 228, London Road, Croydon. Owing to the fact that (as throughout the War) the whole of the assistant medical staff, all the clerical staff, and a very large proportion of the members of all other sections of the department were on active service, the Public Health activities of the town have, to a certain extent, been limited. I have to acknowledge the unfailing courtesy and assistance winch /, and the whole of the Public Health Department have experienced from the Members of the Council, I am, Your obedient servant, R. VEITCH CLARK, Medical Officer of Health and School Medical Officer. 5 County Borough of Croydon REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1918. 6 VITAL STATISTICS. Population—Census of 1911 —169,551. Estimated Population, June 1918—188,755 (Registrar General's Estimate of Civilian Population). Birth Rate, per 1,000, 13.9. Death Rate, per 1,000 living, 15.1. (See note ‡ at foot of Table I., page 27. Infantile Mortality, per 1,000 births, 76. 7 INFANT WORK. INFANTILE MORTALITY is measured by the proportion of deaths under one year to 1,000 births, and amounted to 76, as compared with 87 in 1917, 77 in 1916, 83 in 1915, 79 in 1914, 94 in 1913, 77 in 1912, 105 in 1911, 87 in 1910, 79 in 1909, and 99 in 1908, During the year 1918, the rate for England and Wales was 97, while in the 96 large towns it was 106, and in the 148 smaller towns 94, and in London 107. The figures for the various Wards were :— Births. Deaths under 1 year Death-rate Per 1000 Births (all causes) Death-rate per 1000 births from "diarrhœal" diseases. Upper Norwood Sub division 84 3 36 0 North Ward . 516 42 81 8 Thornton Heath Subdivision 239 21 87 8 East Ward 303 30 99 13 BOROUGH 2632 202 76 2 Central Ward 205 13 63 5 South Ward 232 17 73 4 West Ward 704 57 80 10 South Norwood Ward 349 19 54 0 The following table shows the fluctuations since 1892 in the infantilc mortality from "all causes," from "diarrhœal diseases," and from "causes other than diarrhœal." Years. Total Infantile Mortality from all causes. Infantile Mortality from "diarrhœal" diseases. Infantile Mortality from other than "diarrhœal" disease 1893—1897 142 25 117 1898—1902 143 38 105 1903 104 9 95 1904 128 29 99 1905 96 14 82 1906 125 42 83 1907 94 10 84 1908 99 12 87 1909 79 7 72 1910 87 10 77 1911 105 33 72 1912 77 11 66 1913 94 16 78 1914 79 12 67 1915 83 8 75 1916 77 7 70 1917 87 12 75 1918 76 7 69 8 DIARRHŒA AND EPIDEMIC ENTERITIS. Deaths classified in the tables supplied by the RegistrarGeneral as diarrhœa, epidemic enteritis, enteritis and gastro-enteritis, have been included as "diarrhœal" deaths: as this classification corresponds with that adopted in former years, comparisons made on the resultant figures are valid. During 1918 diarrhœa and epidemic enteritis accounted for 9 deaths of infants under one year of age, 10 others being due to enteritis or gastroenteritis, making a total of 19 deaths from "diarrhœal" diseases A further 21 deaths at ages from one year or upwards were due to these diseases. INFANT CENTRES. The Borough Centre is held in the same place—228, London Road—as the School Treatment Centre and the Spinal Remedial Class and Sick Nursery. The Infant Centre work consists of two medical consultations weekly on Tuesday and Friday afternoons. At the medical consuliations there have been during the year 1918 approximately thirty-five children attending each afternoon The progress made by the children is extremely gratifying in practically all instances. Acute illnesses are not dealt with, being referred to hospital or private medical men. Expectant mothers are also seen and addressed as to their welfare. Infant foods and, to a small extent, special foods for mothers are obtainable at the Centre. These are supplied free of cost only to the very poorest people. A charge is made to others, not exceeding the cost price of the article. Simple medicines are also prescribed and dispensed. The total number of infants seen at this Centre in the year 1918 has been:— New Cases 382 Total Attendances 3.54 The Centre was opened in the latter part of 1914. One of the Lady Health Visitors acts as the Nurse to the Centre. The Croydon Mothers and Infants Welfare Association provides nine other centres in the town. The own provides the nursing and medical staff for these centres. The work done by the association has grown greatly and has maintained a high level of efficiency. The co-operation between the Association and the Public Health Department is of the closest and Pleasantest nature, 9 For the nine months, April to December, 1918, the number of infants seen at the ten Centres in the town was:— Centre. Under 12 months. Over 12 months. Seen by Doctor New Cases Old Cases Attendances. New Cases Old Cases Attendances. Municipal, 228 London Road 178 458 1556 93 343 1115 1264 Central 53 184 703 19 187 556 533 South Croydon 60 189 703 35 192 639 365 East Croydon 66 186 736 30 102 668 339 Woodside 39 240 770 26 235 693 415 South Norwood 58 274 826 36 501 1441 632 Upper Norwood 60 118 449 49 251 876 490 Grange Hall, Thornton Heath 33 157 465 '9 179 490 535 St. Alban's ,, ,, 54 149 510 31 249 806 502 West Croydon 50 146 526 21 153 482 455 651 2101 7244 359 2482 7766 5530 At all the Centres in the town the children are regularly seen by a doctor. At least once a week all those that really require medical advice are seen, and all the infants under twelve months are seen not less often than once a month. It has at times been difficult to maintain this full service owing to the restrictions of the staff, but on the whole the results of the work are as above stated. At a considerable number of the Centres there are conducted auxiliary forms of activity, such as the demonstration of good modern hygienic infant clothing, penny banks, talks to mothers, and the distribution of fresh and dried milk and other foods, etc. At all the Centres records are kept of both infants and toddlers. MATERNITY HOSTEL. In July was opened the new Maternity Hostel, "St. Mary's," St. James' Road, Croydon. This Hostel is the gift of the Mayor and Mayoress of Croydon, Mr Alderman Howard Houlder, D.L., J.P., and 10 Mrs. Houlder. The Hostel provides seventeen lying-in beds with cots. The professional staff consists of the Matron, Sister, two midvvives, and three or four training midwife pupils. The statistical record of the work of the Hostel is not given for this year as it was only working for the second six months, and the numbers were adversely affected by the unfortunate occurrence of an infective purulent nasal discharge in some of the infants, which secondarily caused a skin trouble. On two occasions this gave rise to a great deal of anxiety and trouble, but was eventually suppressed without any evil results to the children affected. A highly-skilled specialist was consulted and his opinion confirmed that already held, viz., that the condition was a post influenzal one. The Hostel is being conducted this year, 1919, with great successSICK NURSERY. At the Borough Centre is maintained a small Infant Sick Nursery. Six cots are provided, and the children admitted are almost entirely cases of ailing infants suffering from dietetic or marasmic conditions The cots have been kept well filled throughout the whole vear, and the results practically regularly show beneficial changes in the welfare of the infants admitted. This Sick Nursery was established some years ago experimentally and many efforts have been made to obtain larger and better premises, but so far without success. The circumstances under which this work is now carried on are now very disadvantageous, in that the room itself is far from being so light and airy as a sick children's ward should be. It is also very noisy and the practical difficulties in getting the children out into the open air in the garden are all but insuperable. It is urgently necessary to provide a well-equipped up-to-date set of premises for this section of the infant work. » METHOD OF FEEDING. The following are the particulars as to feeding of infants during the first six months of life of children who survived, and of children who died between one week and six months old Deaths of infants under one week have been excluded because it is unlikely that methods of feeding can have been responsible for a fatal issue in so short a time. 11 TABLE A. Infants dying from Diarrhœal Diseases. 0-6 months. Infants dying from other than Diarrhœa! Diseases. 0-6 months. Infants surviving 6 months. Total investigated. Breast Fed only 8 69 666 743 Breast and subsequently Cow's milk 2 7 48 57 Ditto Condensed Milk 4 5 22 31 Ditto Other foods 1 4 73 78 Breast & simultaneously Cow's Milk ... 3 31 34 Ditto Condensed Milk ... 4 27 31 Ditto Other foods ... 2 20 22 Entirely Hand Fed — Cows Milk 3 7 29 39 Ditto Condensed Milk 8 10 34 52 Ditto Other foods 5 11 56 72 Number investigated 31 122 1006 1159 TABLE B.—The same information expressed in percentages. Of all infants investigated under 6 months. Of infants dying from Diarrhœa Diseases. 0-6 months. Of infants dying from other than Diarrhœal Diseases. per cent. per cent. per cent. Breast Fed only 64.1 25.8 56.6 Breast ami subsequently Cow's Milk 4.9 6.5 5.7 Ditto Condensed Milk 2.7 12.9 4.1 Ditto Other foods 6.7 3.2 3.3 Breast and simultaneously Cow's Milk 2.9 ... 2.5 Ditto Condensed Milk 2.7 ... 3.3 Ditto Other foods 1.9 ... 1.6 Entirely Hand Fed—Cow's Milk 3.4 9.7 5.7 Ditto Condensed Milk 4.5 25.8 8.2 Ditto Other foods 6.2 16.1 9.0 100 100 100 12 Table B shows that 25 per cent. of infant deaths from diarrhœal diseases occurred amongst breast-fed children, and the remaining 75 per cent. amongst children who were either entirely hand fed or had artificial kinds of food as well as breast fed. NOTIFICATION OF BIRTHS ACT 1907 This Act was adopted by the Council on January 13th, and came into force on February 19th, 1908, after confirmation by the Local Government Board. During the past year 1,894 notifications were received. These births were notified as follows:— Notified by medical men 511 Notified by parents 333 Notified by certified midwives 1001 I,845 Stillborn births notified 49 Total 1,894 MIDWIVES' ACT, 1902. Seventeen midwives attended at the Municipal Infant Centre, 228, London Road, for inspection, etc., during 1918. One hundred and ten visits were paid by the Inspector of Midwives to the houses of 25 midwives. She does not visit the midwives at St. Mary's Hostel nor those resident outside the Borough. During the year 3 registered midwives left the district, I died, and 7 new names were added, leaving 30 on the register on December 31st, r9i8. GENERAL MATTERS. INFLUENZA. General. The Borough was visited by influenza in epidemic form on two occasions during 1918. The first outbreak occurred in June and July and was of a mild character, the total number of deaths from this disease during these two months totalling 28, of which 19 occurred in the first two weeks in July. The second outbreak lasted for nearly the whole of the fourth quarter of the year and was of an exceptionally severe type. Exceedingly grave complications accompanied the illness in a large proportion of cases, the most fatal of these being septic pneumonia. The first of the tables immediately following shews the deaths from influenza, pneumonia and various other diseases during each week of the year, and it will be observed that the greatest mortality for the second outbreak of influenza occurred in the week ended November 2nd, when no deaths from this cause were recorded. The total deaths from influenza during the year was 478 practically all of which occurred during the two epidemic periods. 13 There is little of importance to note in the weekly death returns from the other diseases shewn in the table excepting that the deaths from phthisis were somewhat above the normal in the middle of the fourth quarter of the year. The incidence on the population was general, no special group or class was characteristically affected. During both outbreaks great inconvenience and in many cases serious distress was caused by the complete incapacitation of all members of individual families. Endeavours were made to secure nursing services throughout the town but with very little success as no nurses were available—a condition which has persisted during the whole war period and which greatly hampered us in a previous outbreak of measles. A very large amount of visiting and help was rendered by the staff of health visitors all of whom are trained nurses and all of whom worked with untiring energy to assist those suffering from this scourge. I am glad to have this opportunity of commending the staff for their unselfishness and devotion in this work, more especially as the actual nursing and assistance which they gave are quite outside the scope of their professional public health duties. Incubation period. The general impression held by medical practitioners with whom I discussed the incubation period of the second outbreak was that the incubation lasted only a few days, certainly under a week. I had one case in which there had only been one contact with influenza and the person fell ill exactly 48 hours after the exposure to infection. Mothers ana Infants. The second of the following tables shews the relative immunity of children under 12 months of age to this infection. Kinemas. On the recommendation of the Medical Officer of Health the Council passed the following resolution relating to the conduct of kinematograph theatres during the period of epidemic disease, viz:— That in view of the serious spread of influenza in the Borough a request be forthwith issued to kinematograph theatre proprietors in the town asking them to observe during the continuance of the epidemic the following conditions, vis:— (a) Not to admit any children under 14 years of age. (b) To allow an interval of two and a half hours between the afternoon and evening exhibitions and during such interval to ensure a thorough through ventilation of the whole of the auditorium, entrances passage and corridors. 14 These were identical with the recommendations which the Medical Officer of Health made to the Public Health Committee, not only on this occasion but on a previous occasion when measles were epidemic. Unfortunately the licensing of the kinemas had just taken place before the outbreak so that we were not able to bring special pressure to bear upon the kinemas in this way. The letter, however, was sent to the kinemas in Croydon and also, I understand, to the Central Association representing Kinematograph Theatres throughout the country. The following resolution of the Council was also forwarded to the Local Government Board That the Local Government Board be asked to consider the desirability of providing by regulation under the D.O.R.A. or otherwise for the enforcement of conditions similar to those set out above (a and b). Publicity arrangements Posters and handbills were freely used throughout the Borough, These were posted up and distributed at all the principal factories and workshops, public institutions, libraries, baths, lavatories, principal business premises, etc. A bundle of handbills was also sent to the Ministers of Churches of all denominations in the town with a letter requesting them to place the leaflets in the church porch for the congregation to take. A copy of the leaflet was also inserted with every letter that went from the Public Health Department during the period of the epidemic. Pamphlets were not sent out to the schools as these were closed. Advantage was also taken of the local press. Interviews having been asked for, the Medical Officer of Health took the opportunity of giving general advice to the public in this manner. Disinfection. This was not carried out in any routine way as, in my opinion, it is of no advantage in ordinary influenza. Disinfection, however, was performed in premises where death or serious complications (more particularly of pneumonic type) had occurred. Schools. In both outbreaks practically the whole of the schools of the Borough were closed. As the disease was not notifiable it is not possible to say what was the effect of closure, but at least, the contact of children of different families with each other was lessened by this procedure. 15 CASES OF DEATHS FROM INFLUENZA AND CERTAIN OTHER CONDITIONS, 1918. Week ending * Influenza. Pneumonia. BronchoPneumonia. Phthisis. Other Resp. Diseases. CerebroSp. F. W Measles. looping Cough. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Jan. 5th — — 2 4 — 2 5 1 — 6 — — — — 1 — 12th — — 4 1 3 1 3 5 5 5 — — — — — 1 „ 19th — — 3 — 1 2 2 1 5 4 — — — — — — „ 26th 2 — 3 — 1 2 4 1 — 2 — — — — — 1 Feb. 2nd 1 1 1 — 1 1 2 3 — 2 — — — — — — „ 9th — — 4 1 — — 5 2 — 5 — — — — — — „ 16th — — 1 1 — 1— 5 1 1 1— — — — — 1 — „ 23rd — —. . — 1 4 2 — 5 4 1 — — — — — 1 Mar. 2nd — — . 2 1 1 1 3 2 1 4 — — — — — — „ 9th — — 1 — 2 1 1 — 3 4 — — — — — — „ 16th — — 1 — 1 2 4 2 4 2 — — — — — — „ 23rd — — 2 — 1 3 3 2 1 3 — — — — — — „ 30th — 1 1 3 — 2 1 3 2 4 — — — — 1 — April 6th — — 1 3 1 3 2 3 2 2 — — — — — — „ 13th 1 1 1 — 1 1 2 3 2 1 — — — — — — „ 20th — — 1 1 2 — 2 2 1 — — — — — — 2 „ 27th — — 2 — — 2 1 2 1 6 — — — — — — May 4 th — — 1 1 — — 4 1 2 3 — — — — — — „ 11th — — 1 1 1 1 1 2 1 2 — — — — — — „ 18th — — — — 1 1 — 3 — 2 — — — — — — „ 25th — — 1 — — — 2 1 — 2 — — — — — 1 June 1st — — — — 1 — 3 2 1 1 — — — — — — „ 8th 1 — — 1 — 1 3 4 1 1 — — — — — — „ 15th — — 1 1 — 1 3 2 3 2 — — — — — — „ 22nd — — 1 1— — — — 3 — 1 — — — — — — „ 29th 2 1 1 — — — 1 1 — 1 — — — — — — 16 July 6th 7 2 1 4 3 — 2 1 3 1 — — — 1 1 — „ 13th 6 4 — 1 — — 2 5 1 1 — — — — — — „ 20th 1 1 — 1 1 — — 1 — 2 — — — — — — „ 27th 3 — — — 2 4 — 3 1 — — — — — — — Aug. 3rd 1 1 — 1 — 1 1 1 — — — — — — — — „ 10th — — 1 — 1 — — 1 3 — — — 1 — — — „ 17th — — 1 — — — 4 2 1 1 — — — — — — „ 24th — — 1 — — — — 3 3 2 — — — — — — „ 31st — 1 — — — — 1 — — — — — — — — — Sept. 7th — — 1 1 1 — 2 3 1 2 — — — — — — „ 14th — — 2 — 1 — 1 2 — — — — — — — — „ 21st — — 1 — — — 1 2 1 — — — — — — — „ 28th — — — — — — 1 1 — — — — — — — — Oct. 5th 1 — — 2 — — — 4 — 1 — — — — — — „ 12th 3 2 — 1 — 1 2 3 2 2 — — — — — — „ 19th 11 9 1 2 — — 4 4 1 4 — — — — — — „ 26th 13 33 2 1 2 — 3 5 — 3 — — — — — — Nov. 2nd 42 68 2 5 5 — 5 5 3 7 — — — — — — „ 9th 45 50 2 5 3 4 4 7 2 6 — — — — — — „ 16th 28 27 1 1 2 1 5 1 2 4 — — — — — — „ 23rd 16 22 2 1 3 1 2 6 4 — — — — — — — „ 30th 16 15 1 3 1 — 4 — 2 3 — — — — — — Dec. 7th 11 8 1 — 2 — 6 1 5 2 — — — — — — „ 14th 7 6 1 1 1 — — 1 1 — — — — — — — „ 21st 1 3 1 1 — — 1 1 1 3 — — — — — — „ 28th 1 2 — — — 2 — 3 3 2 — — — — — — 220 258 58 52 50 44 113 123 80 113 — 1 1 1 4 6 17 INCIDENCE OF INFLUENZA ON PARENTS AND CHILDREN. No. of Persons in household. PARENTS. CHILDREN. Remarks F. M. 0—1. 1—5. 5-15. 15 upwards Attacked. Date. Not Attacked Attacked. Date. Not Attacked Attacked. Date. Not Attacked Attacked. Date. Not Attacked Attacked. Date. Not Attacked Attacked. Date. Not Attacked 7 ... ... ... 1 Feb. ... ... ... 1 ... ... ... ... ... 3 ... ... 2 10 ... ... 1 1 Oct. ... ... ... 1 ... ... 4 Oct ... ... ... ... 7 ... ... 1 1 Nov. ... ... ... ... 1 Nov. ... 3 Nov. 1 ... ... ... 7 ... ... ... 1 Oct. ... ... ... 1 1 Oct. ... Oct. ... 1 Oct. ... 4 ... ... 1 1 Mar. ... 1 Mar. ... 1 Mar. ... ... ... ... ... ... ... 4 1 Nov. ... 1 Nov. ... ... ... 1 1 Nov. ... ... ... ... ... ... 9 1 Dec. ... 1 Dec. ... ... ... 1 ... ... ... 4 Dec. ... ... ... 2 10 1 July ... 1 July ... ... ... 1 1 July 6 2 July ... ... ... ... Sept. Sept. 6 Sep. 11 ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... 1 Oct. 4 Sick Nursery 5 1 Sept. ... 1 July ... ... ... 1 1 Sept. 1 Sept. ... ... ... ... Sept. 6 1 Oct. ... ... ... 1 ... ... ... ... ... 1 1 Oct. 2 ... ... ... 2 ... ... ... 1 Nov. ... ... ... 1 ... ... ... ... ... ... ... ... ... 5 ... ... ... 1 Oct. ... 1 Oct. ... ... ... 1 2 Oct. ... ... ... ... 8 ... ... ... 1 Oct. ... ... ... 1 1 Oct. ... 5 Oct. ... ... ... ... 5 ... ... ... 1 Nov. ... ... ... 1 ... ... ... ... ... ... 3 Nov. ... 100 5 ... 3 13 ... 1 2 ... 16 7 ... 2 29 ... 6 5 ... 11 Breast Fed Infants attacked 2 Artificially Fed Infants attacked Nil. Breast Fed Infants not attacked 10 Artificially Fed Infants-not attacked 6 18 19 TABLE H. V. HEALTH VISITORS. -The following is a summary of the work done and visits paid by the Health Visitors. Visits to Houses where the following Diseases have been reported. Mrs. Rylance. Mrs. Wilkinson & Miss Byrn. Miss Chalk. (2) Miss C. Gordon and Miss Davis (1) (2). Miss Massie (1) & (3). Miss Huggins. School Cases. Other Cases. School Cases. Other Cases School Cases. Other Cases. School Cases. Other Cases. School Cases. Other Cases. School Cases. Other Cases. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. subsequent Visits 1st Visits Subsequent Vis ts 1st Visit Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits. 1st Visits. Subsequent Visits- Scarlet Fever ... ... ... ... 6 2 ... ... 16 13 ... ... 8 1 ... ... 5 3 ... ... ... ... 6 6 Diphtheria ... ... ... ... 31 30 ... ... 1 4 ... ... 14 3 ... ... 7 7 ... ... 2 2 1 1 Erysipelas ... ... ... ... 14 1 ... ... 6 1 ... ... 3 ... ... ... 1 ... ... ... 1 2 3 ... Measles 1 ... ... ... 302 11 ... ... 76 5 ... ... 110 9 ... ... 93 3 ... ... 86 21 57 10 German Measles 2 ... ... ... 15 1 ... ... 4 ... ... ... 5 ... ... ... 13 1 ... ... 1 ... ... ... Mumps 27 ... ... ... 423 17 ... ... 265 51 ... ... 362 13 ... ... 188 25 ... ... 103 12 4 2 Whooping Cough ... ... ... ... 240 15 ... ... 74 48 ... ... 192 1 ... ... 225 50 ... ... 62 17 47 12 Chicken pox 8 1 ... ... 67 7 ... ... 138 10 ... ... 95 ... ... ... 65 10 ... ... 64 6 10 1 Sore throat 4 ... ... ... 91 31 ... ... 37 6 ... ... 48 2 ... ... 39 29 ... ... 14 10 2 ... Ringworm (scalp) 13 17 ... ... 33 61 ... ... 26 51 ... ... 33 73 ... ... 23 36 ... ... 71 459 2 ... „ (body) 4 ... ... ... 26 36 ... ... 32 32 ... ... 19 8 ... ... 19 13 ... ... 10 14 ... ... Verminous Heads ... ... ... ... 1 ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... 3 3 ... ... Verminous Bodies 1 2 ... ... 3 3 ... ... 3 6 ... ... 2 ... ... ... ... ... ... ... 1 9 ... ... Impetigo Contagiosa 50 22 ... ... 174 148 ... ... 195 137 ... ... 262 183 ... ... 121 209 ... ... 131 300 5 4 Scabies 24 19 ... ... 91 168 ... ... 67 102 ... ... 50 58 ... ... 38 72 ... ... 20 49 1 5 Infectious Eye Disease 8 3 ... ... 30 19 ... ... 46 28 ... ... 21 20 1 ... 14 11 ... ... 8 12 ... 5 Other diseases 68 101 ... ... 278 92 ... ... 293 120 ... ... 162 2 ... ... 217 80 ... ... 191 69 l 1 Totals 210 165 1 .... 1865 762 ... ... 1289 614 ... ... 1389 373 1 ... 1068 549 4 ... 768 985 139 47 1st Visits. Subsequ't Visits. 1st Visits. Subsequ't Visits. 1st Visits. Subsequ't Visits. 1st Visits. Subsequ't Visits. 1st Visits. Subsequ't Visits. 1st Visits. Subsequ't Visits.* Visits to houses where Infants have been born 38 10 374 258 205 236 414 ... 184 133 100 201 Visits to houses where Infants have died under one year of age ... ... 7 2 3 1 14 ... 41 17 2 ... Tuberculosis cases visited 120 41 49 617 ... 409 96 ... 55 281 ... 382 Addresses given re Infant feeding, etc. ... ... ... ... ... ... ... ... 23 ... ... ... Visits paid to Elementary Schools for Medical Inspections 7 ... 47 ... 21 ... 26 ... 27 ... 29 ... Number of Children prepared for Medical Inspection—Newly Inspected 1C1 1096 ... 479 ... 461 ... 423 ... 334 ... Re-inspected 5 ... 159 ... 19 ... 193 ... 119 ... 93 ... Specially Inspected . ... ... 33 ... 44 ... 26 ... 18 ... 39 ... Other Visits to Elementary Schools 2 ... 8 ... 35 ... 23 ... 6 ... 8 2 Home Visits arising out of Medical Inspection ... ... 176 118 83 25 62 88 69 133 108 183 Home Visits for other information 1 ... 17 4 139 3 86 22 14 4 37 18 Cultures taken 1 ... 195 37 37 ... 41 ... 51 ... 65 ... Special Inspections or Attendances at Clinics 3 ... 16 ... 84 ... 82 ... 86 ... 103 ... Influenza ... ... 46 15 20 4 45 ... 91 16 6 6 Notes.—(1) One attendances at Clinic weekly. (2) Two ,, ,, ,, (3)Twenty-three addresses on Infant Feeding at Domestic Centre. 20 TUBERCULOSIS IN MILK. No samples of milk were taken on account of the impossibility of getting examinations made. DISINFECTION. During the year 1,572 rooms, 24 hospital wards and contents thereof, 31 school class rooms, 1 vehicle, 1 hut and 1 chapel, and 16889 articles were disinfected. The articles disinfected were as follows, viz. 512 beds, 2,519 blankets, 33 blouses, 1,234 bolsters, 528 books (including 378 Library books), 8 boots. 10 capes, 219 caps, 15 carpets, 265 coats, 9 corsets, 65 curtains, 353 cushions, 4 cloaks, 9 costumes, 695 counterpanes, 17 dresses, 109 dressing gowns, 203 handkerchiefs, 10 hearth rugs, 777 mattresses, 117 neckerchiefs, 24 palliasses, 62 petticoats, 1,848 pillows, 83 rugs, 111 shawls, 853 sheets, 724 shirts, 24 skirts, 1,495 stockings (socks),'376 towels, 528 trousers, 149 vests, 74 waistcoats, 830 jackets, 11 mats, 191 underclothing, and 1,799 other articles. Total 16,889. Cleansing of Persons at Disinfecting Station during the Year 1918 Adults other than Soldiers. School Children- Children not of School Age but living in same houses as School Children. Soldiers. — 3 — 26 MENTAL DEFICIENCY. CASES DEALT WITH. Date of Order. Defective Sex. Age at time of Order Nature of Order ( whet her for Institutional treatment or for Guardianship ) and remarks. 1st February 1918 T. G. M. 35 Institutional (Royal Earlswood, Institution). 21 st February 1918 E. B. F. 31 Institutional (Croydon Mental Hospital). 21 14th April 1918 R. S. M. 3 Institutional (Fountain Asylum. Tooling). Order made for contribution of 3s. 6d. per week by father towards maintenance. 24th April 1918 G. B. M. 15 Institutional (Darenth Industrial Colony). 24th April 1918 C. S. M. 15 Institutional (Fountain Asylum, Tooting) Order made for contribution of 3s. 6d. per week by father towards maintennance. 10th May 1918 G. H. M 18 Institutional (Leavesden Asylum). Order made for contribution of 4s. 0d. per week by father towards maintenance. 14th October 1918 G J. M 18 Institutional (Queen's Road Croydon). Criminal Case. Orders under 2. (1) (b) (ii) Mental Deficiency Act. NUMBER OF DEFECTIVES IN THE BOROUGH. The following is the number of mental defectives known by medical examination in the Borough 1918. Male. Female. Total. Education Committee cases 65 47 112 Statutory Committee Cases (including 27 non educable cases under the age of 16 years) 59 39 98 1 he 98 Statutory Committee cases are disposed of as follows:— Male. Female In certified Institutions 20 9 29 Under Guardianship 2 3 5 In Croydon Mental Hospital 2 4 6 In Poor Law Institutions 5 4 9 In their own homes 27 22 49 98 These are all cases which have been specially medically examined. There is a considerable list of cases of alleged mental deficiency notified from various sources not yet specifically examined and classified. 22 VENEREAL DISEASE. A joint scheme in which Croydon takes a part, and which consists of maintenance of clinics at practically all the big London Hospitals, has continued to run successfully. The Medical Officers of the joint authorities have met at frequent intervals during the year in London and discussed points which have arisen in connection with this scheme. No special features call for mention. The main Table sub-joined refers to this scheme. The smaller Table gives details of the work carried out at the Croydon General Hospital Venereal Diseases Clinic during 1918. At this centre only women and children have been treated, but it is hoped that before another twelve months have elapsed this Clinic will include in its activity male cases of this disease. During the year a considerable amount of propaganda work has been carried out in Croydon. VENEREAL DISEASES. Annual Summary Year 1918 London. Middlesex Essex. Surrey. Kent. Herts. Bucks. West Ham. Easf Ham. Croydon All Districts. I. No. of persons dealt with at or In connection with the clinic for the first time and found to be suffering from— Syphilis 5,167 516 282 213 248 61 26 140 60 53 6,766 Soft chancre 96 5 6 5 9 1 1 4 1 1 129 Gonorrhoea 5,222 608 234 185 272 32 33 84 83 3 6,784 Not suffering from V.D. 2,053 242 111 77 96 19 13 43 21 18 2,693 Total 12,538 1371 633 480 625 113 73 271 165 103 16,372 2. No, of persons discharged from the clinic after completion of treatment for— Syphilis 426 23 10 13 14 6 1 3 2 1 499 Soft chancre ... 31 ... 1 2 1 ... ... 1 ... ... 36 Gonorrhœa 759 70 24 21 31 6 5 6 5 5 932 Total 1,216 93 35 36 46 12 6 10 7 6 1,467 3. Total attendances of all persons who were suffering from — Syphilis 70,608 7,305 2,953 2,598 2,931 697 443 1,234 748 570 90,087 Soft chancre 533 12 26 60 52 5 17 1 15 721 Gonorrhœa 56,408 6,990 2,451 1,814 2,498 401 300 1,233 704 245 73,044 Not suffering from V.D. 4,320 501 246 I40 179 32 27 121 42 25 5,633 Total 131,869 14,808 5,676 4,612 5,660 1,130 775 2,605 1,495 855 169,485 4. No. of "in-patient'' days of treatment given to persons suffering from— Syphilis 31,129 2,131 1,481 1,639 2,025 1,329 633 467 207 374 4,415 Gonorrhœa 18,461 761 674 1,326 2,715 503 48 137 42 13 24,680 Total 49,590 2,992 2,155 2,965 4,740 1,832 681 604 249 387 66,095 5. No. of persons treated with Salvarsan substitutes 5,042 479 312 163 289 63 31 142 62 56 6,649 6. No. of doses of Salvarsan substitutes given 23,627 2,582 1,168 1,080 1,112 299 152 524 248 262 31,054 24 PATHOLOGICAL EXAMINATIONS. Nature of Test. London. Middlesex. Essex Surrey Kent. Herts. Bucks. West Ham. East Ham. Croydon All Districts. Treatment Centre. For detection of spirochetes 465 53 14 30 31 2 ... 2 1 2 605 For detection of gonococci 7,145 742 444 264 364 117 48 192 143 37 9,406 For Wassermann re-action 12,610 989 557 451 471 124 77 208 III 96 15,694 Other examinations 152 12 5 2 1 1 ... 4 ... 1 178 Total 20,372 1,801 1,020 747 867 244 125 406 255 136 25,973 For Practitioners. For detection of spirochetes 54 14 ... 5 ... ... ... ... ... ... 73 For detection of gonococci 357 93 30 42 1 8 2 14 7 2 556 For Wassermann re-action 4,641 345 248 98 14 37 11 190 39 43 5,666 Other examinations 70 15 ... ... ... ... ... ... ... ... 85 Total 5,122 467 278 145 15 45 13 204 46 45 6,380 25 VENEREAL DISEASES. RETURN relating to persons residing in the County Borough of Croydon who were treated at the Croydon General Hospital—1918. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. M. F. M. F. M. F. M. F. M. F. Number of persons dealt with at or in connection with the out-patient Clinic for the first time and found to be— Suffering from syphilis — 8 — 11 — 9 – 27 – 55 ,, soft chancre — – — – — — – – — — ,, gonorrhœa — 4 — 7 — 1 – 7 — 19 Not suffering from venereal diseases — — — – — 1 – 12 — 13 — 12 — 18 — 11 – 46 — 87 Number of persons discharged from the out-patient Clinic after completion of treatment for— Syphilis — – — — — — – 5 — 5 Soft chancre – – – – – – – – – – Gonorrhœa — — — 1 — — — 1 — 2 — — — 1 — — — 6 — 7 Number of persons who oeased to attend the out-patient Clinic without completing treatment and who were suffering from— Syphilis — 3 — 4 — — — 1 — 8 Soft chancre — — — — — — — — — — Gonorrhœa — 2 — 1 — 1 — 1 — 5 — 5 — 5 — 1 — 2 — 13 26 Total attendances of all persons at the out-patient Clinic wno were— Suffering from syphilis — 18 — 35 — 50 — 196 — 299 „ soft chancre — — — — — — — — — — „ gonorrhœa — 20 — 23 — 9 — 23 — 75 Not found to be suffering from venereal disease — — — — — 1 — 26 — 27 — 38 — 58 — 60 — 245 — 401 Aggregate number of " In-patient days " of treatment given to persons suffering from— Syphilis — 71 — — — 63 — 169 — 303 Gonorrhœa — 58 — 59 — 17 — 143 — 277 — 129 — 59 — 80 — 312 — 580 Number of persons treated with Salvarsan substitutes — — — — — — — 13 — 13 Number of doses of Salvarsan substitutes given — — — — — 13 — 43 — 56 Examinations of Pathological material— (a) Speciments from persons attending at the Treatment Centre which were examined at this Centre— For detection of spirochetes — — — — — — — — — — ,, „ gonococci — — — — — — — — — — „ Wassermann reaction — — — — — — — — — — Others — — — — — — — — — — (b) Specimens from persons attending at the Treatment centre which were sent for examination to an independent laboratory— For detection of spirochetes — — — — — — — — — — „ „ gonococci — — — 2 — 2 — 9 — 13 „ Wassermann reaction — 7 — 4 — 9 — 31 — 51 Others — — — — — — — 7 — 7 — 7 — 6 — 11 — 47 — 71 27 TABLE I. For whole District, for Calendar Year 1918. Year. Population estimated to Middle of each Year. Births. Total Deaths Reg. in the District. Transferable Deaths Nett deaths belonging to the District. of Non-residents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Uncorrected Number. Nett. Number. Rate.* Number. Rate per 1,000 Nett Births. Number. Rate * Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1906. 151,011 3886 25.7 2085 13.8 160 94 485 125 2019 13.4 1907. 154,342 3967 25.7 1953 12.5 149 97 371 94 1901 12.3 1908. 157,698 4017 25.5 2053 13.0 137 105 398 99 2021 12.8 1909. 161,078 3938 24.4 1974 12 3 165 70 313 79 1879 11.7 1910. 166,884 3810 22.8 1817 10.9 145 111 331 87 1783 10.7 1911. 170,451 3760 3748 22.0 2069 12.1 177 130 395 105 2022 11.9 1912. 174,257 3861 3859 22.1 1934 11.1 200 159 297 77 1893 10.8 1913. 178,094 3890 3895 21.8 2110 11.8 204 190 368 94 2096 11.7 1914. 181,956 4027 4007 22.0 2041 11.2 234 177 319 79 1984 10.9 1915. 177,345 3699 3704 20.8 2463 13.8 269 221 307 83 2415 13.6 1916. 175,765 3589 3636 20.6 2207 12.5 253 197 281 77 2151 12.2 1917.† 186,917 2836 2861 15.3 2207 11.8 262 219 249 87 2164 11.09 1918.‡ 188,755 2632 2626 13.9 2687 15.9 388 245 202 76 2544 15.1 * Rates calculated per 1,000 of estimated population. Census, 1911. Total population at all ages, 169,551. Number of inhabited houses, 34,363. Average number of persons per house, 4.9. Area of District in acres (exclusive of area covered by water), 9,012. †Registrar General's estimate of civilian population. ‡Registrar General's estimate of civilian population for death rate, 168462. 28 TABLE II. Cases of Infectious Disease notified during the Year 1918. Notifiable Disease. Cases notified in whole District. Total Cases notified in each Locality. Total Cases Removed to Hospitals or Sanatoria. At all Ages. At Ages—Years. Unrecorded ages. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. Institution cases which could not be distributed. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65 65 & upwd. Small-pox • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Cholera (C) Plague (P) • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Measles 1057 18 427 501 42 15 2 • • 52 161 75 54 211 100 321 74 52 9 17 German Measles 93 1 14 48 17 12 • • • • 1 8 6 4 18 18 22 15 1 1 2 Diphtheria (including Membranous Croup) 179 2 55 97 11 11 • • • • 3 30 14 8 20 30 48 19 5 5 179 Erysipelas 44 • • 1 3 6 13 12 8 1 7 4 3 5 2 10 2 9 2 10 Scarlet Fever 414 1 70 267 52 22 1 • • 1 98 49 89 59 16 83 33 22 5 386 Typhus Fever • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Enteric Fever 17 • • • • 3 4 6 2 2 • • • • • • 8 3 1 3 • • 1 • • 14 Relapsing Fever (R) Continued Fever (C) • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Puerperal Fever 4 • • • • • • 1 2 1 • • 1 • • 1 2 • • • • • • • • • • 1 Cerebro-spinal Meningitis 25 • • • • 3 19 2 • • • • 1 • • • • • • • • • • 6 • • • • 19 23 Poliomyelitis • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Pulmonary Tuberculosis 378 1 5 39 86 182 57 8 • • 83 63 10 32 33 77 16 27 37 37 Ophthalmia Neonatorum 23 22 • • • • • • • • • • • • 1 8 1 • • • • 2 9 • • 3 • • 6 Other forms of Tuberculosis 71 3 13 27 13 14 1 1 16 10 5 1 6 14 6 3 10 29 Totals 2305 48 | 585 988 251 279 76 18 60 412 222 132 351 308 603 166 123 88 704 The Borough (Fever) Isolation Hospital is situated in the West Ward. The Croydon and Districts Smallpox Hospital is at North Cheam. 29 30 TABLE III Causes of, and ages at, Death during Year ending December 31st, 1918, excluding Deaths of Strangers at the Workhouse, Workhouse Infirmary, Borough Hospital, General Hospital, Purley Cottage Hospital, Norwood Cottage Hospital, 99, Central Hill (Servants' Reformatory), and adding Deaths of Croydon Residents known to have occurred outside the District. No. CAUSE LOCALITIES. Institution & Street Deaths which could not be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases. Total all Ages. Males all Ages. Females all Ages. 0-1 1-2. 2-5. 5-15. 15-25. 25 45. 45-65. 65 and upwards. West North. Centra . East. South. South Norwood. Upper Norwood. Thornton Heath. I — General Diseases. 1 Enteric Fever 1 ... ... ... ... ... 1 ... ... ... ... 2 1 1 ... ... ... ... 1 ... 1 ... 2 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 (A.B.) Relapsing Fever (A) Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (15) Mediterranean Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Small-pox (A) Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Not vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Doubtful ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Measles ... 2 ... ... ... ... ... ... ... 2 ... 2 1 1 ... 2 ... ... ... ... ... 7 Scarlet Fever 6 ... ... ... ... ... ... ... ... 6 (2) ... 6 2 4 ... ... 1 4 1 ... ... ... 8 Whooping Cough 3 1 2 ... ... ... ... 2 ... (1) 10 5 5 7 2 1 ... ... ... ... ... 9 (A) Diphtheria 21 ... ... ... 1 ... ... ... ... 22 1 22 12 10 1 3 6 12 ... ... ... ... (B C.) Croup (B) Membranous laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Influenza 102 102 34 72 38 71 20 39 ... 59(83) 4 478 221 257 7 16 35 43 101 182 53 41 11 Miliary Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Cholera Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Dysentery ... ... ... ... ... ... ... ... ... (1) ... ... ... ... ... ... ... ... ... ... ... ... 16 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Yellow Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Leprosy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Erysipelas ... 1 1 ... ... ... ... 1 ... 1 ... 3 ... 3 ... ... ... ... ... 1 1 1 31 19 (A.B.C.D.) other Epidemic Diseases (A) Mumps ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Varicella ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Other Diseases included under 19 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 (A.B.C.) Pyaemia, Septicæmia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (A) Pyæmia 1 ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... ... ... ... ... ... ... (B) Septicæmia 1 ... ... 2 ... 1 ... ... ... 2 ... 4 3 1 ... ... ... ... ... 2 ... 2 (C) Vaccinia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Anthrax (Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 23 Rabies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 24 Tetanus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 (A.B.) Mycoses ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (A) Actinomycosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other Mycoses ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 1 26 Pellagra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 Beri-beri ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28 (A.B. Pulmonary Tuberculosis (not acute) (A) Pulmonary Tuberculosis 46 65 13 27 10 22 10 11 ... 71(19) 5 204 96 108 1 2 5 13 38 86 51 8 (B) Phthisis (not defined as tuberculous) 10 8 2 1 1 2 3 5 ... 8 (2) 1 32 17 15 ... ... ... 2 5 16 6 3 29 (A) Acute Phthisis 1 ... ... 1 1 ... ... ... ... (1) ... 3 1 2 ... ... ... 1 2 ... ... ... (B) Acute Miliary Tuberculosis ... ... ... ... ... ... ... ... (1) ... ... ... ... ... ... ... ... ... ... ... ... 30 Tuberculous Meningitis 8 5 1 1 2 4 1 ... ... 7 1 22 8 14 2 4 7 7 1 ... 1 ... 31 (A.B. (Tuberculosis of Peritoneum and Intestines (A) Tabes Mesenterica 1 ... ... ... ... ... 1 ... ... ... 2 2 ... 1 ... 1 ... ... ... ... ... (B) Other Peritoneal and Intestinal Tubercle 3 1 1 ... 1 ... 2 1 ... 1 ... 9 5 4 1 ... 2 3 2 ... 1 ... 32 Tuberculosis of Spinal Column ... ... 1 ... ... 1 ... 1 ... 1 (1) ... 3 1 2 ... ... ... 1 1 1 1 ... 33 Tuberculosis of Joints ... 2 ... ... ... ... ... ... ... 3 (2) ... 2 2 ... ... ... ... 2 ... ... ... ... 34 (A B.C.) Tuberculosis of other Organs (A) Lupus 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... (B) Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Other Tuberculosis included under 34 .. 1 ... ... ... ... ... ... 1 (1) ... 1 1 ... ... ... ... ... ... ... 1 ... 35 Disseminated Tuberculosis 1 2 1 ... ... ... ... ... ... 3 (4) 1 4 1 3 ... 1 1 1 1 ... ... ... 36 (A.B.) Rickets, Softening of Bones (A) Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... (B) Other forms of Bone Softening ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 32 TABLE 111—continued. No. CAUSE. LOCALITIES. Institution & Street Deaths which could not be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases. Total all Ages. Males all Ages. Females all Ages. 0.1. 1.2. 2.5. 5.15. 15.25. 25.45. 45.65. 65 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. 37 Syphilis 1 1 1 ... ... ... ... ... ... 3 ... 3 ... 3 3 ... ... ... ... ... ... ... 38 (A.B.C.) Other Venereal Diseases (A) Soft Chancre ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Gonococcus Infection ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Purulent Ophthalmia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 39 Cancer of the Buccal Cavity ... 2 ... 2 ... 2 1 1 ... 5(1) ... 8 5 3 ... ... ... ... ... ... 4 4 40 Cancer of the Stomach, Liver, &c. 12 23 13 13 8 12 2 3 ... 34(5) ... 86 33 53 ... ... ... ... ... 10 27 39 41 Cancer of the Peritoneum, Intestines & Rectum 17 7 4 5 4 7 3 1 ... 12 (3) 48 19 29 ... ... ... ... ... 4 19 24 42 Cancer of the Female Genital Organs 5 8 1 2 2 1 2 ... ... 6 (1) ... 21 ... 21 ... ... ... ... ... 4 13 4 43 Cancer of the Breast 1 8 5 4 2 2 2 2 8 (5) ... 26 ... 26 ... ... ... ... ... 6 9 11 44 Cancer of the Skin ... 1 ... ... ... 1 ... ... ... 1 ... 2 2 ... ... ... ... ... ... ... ... 2 45 Cancer of other or unspecified Organs 9 10 4 4 2 4 1 3 ... 8 (6) 37 23 14 ... ... ... ... ... 6 9 22 46 (A.B.C.) Other Tumours (situation undefined) (A) Angioma ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Adenoma ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Other Tumours included under 46 ... ... ... ... ... 1 ... ... ... l ... 1 1 ... ... ... ... ... ... ... 1 ... 47 Rheumatic Fever 2 ... ... 1 ... ... ... ... ... (1) ... 3 2 1 ... ... ... ... ... 2 1 ... 48 (A.B.) Chronic Rheumatism, Osteo-arthritis (A) Chronic Rheumatism 1 1 ... ... ... ... ... ... ... ... 2 1 1 ... ... ... ... ... ... ... 2 (B) Osteo-arthritis ... 5 ... ... ... 2 1 ... ... 4 (3) ... 8 1 7 ... ... ... ... ... ... 1 7 (C) Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 49 Scurvy 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... 50 Diabetes 4 10 1 2 4 1 1 1 ... 7(8) 1 24 14 10 ... ... ... ... 2 8 7 7 51 Exophthalmic Goitre ... 2 1 ... ... ... ... ... ... ... ... 3 2 1 ... ... ... ... ... 1 1 1 52 Addison's Disease ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 53 (A.B. Leucocythæmia, Lymphadenoma (A) Leucocythæmia (Leucæmia) ... 1 ... 1 ... ... ... ... ... 1 ... 2 1 1 ... ... ... 1 ... ... 1 ... (B) Lymphadenoma ... ... ... ... ... ... ... ... ... (1) ... ... ... ... ... ... ... ... ... ... ... ... 33 54 Anæmia, Chlorosis 1 1 1 ... ... ... ... 2 ... 2 ... 5 1 4 ... ... ... ... ... 1 2 1 55 (A.B.C.D.) Other General Diseases (A) Diabetes Insipidus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Purpura ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... (C) Haemophilia ... ... ... 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... (D) Other Diseases included under 55 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... 56 Alcoholism (acute or chronic) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 57 (A.B.) Chronic lead poisoning (A) Occupational lead poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Non-occupational lead poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 58 Other chronic occupational poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 59 Other chronic poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... II.—Diseases of the Nervous System and of the Organs of Special Sense. 60 Encephalitis ... 1 ... ... ... 1 ... ... ... 1(2) ... 2 ... 2 ... ... ... ... ... 1 ... 1 61 (A) Cerebro spinal fever 1 ... ... ... ... ... ... ... ... (7) ... 1 1 ... ... ... ... ... ... 1 ... ... 61 (B.C.) Meningitis, other forms or undefined (B) Posterior basal meningitis ... ... ... ... ... ... ... ... ... (1) ... ... ... ... ... ... ... ... ... ... ... ... (C) Meningitis, other forms 2 3 ... 2 1 2 ... 1 ... 2 (1) 1 11 4 7 2 3 1 4 ... ... 1 ... 62 Locomotor Ataxy ... 2 ... 1 ... ... ... 2 ... 2 ... 4 4 ... ... ... ... ... ... 2 1 1 63 (A.B.) Other diseases of the spinal cord (A) Diseases formerly classed to " Other nervous affections 4 2 1 1 2 1 2 ... ... 1 ... 13 8 5 ... ... ... ... ... 1 3 9 (B) Other diseases included under 63 1 3 ... 1 ... 1 2 ... ... 3(1) ... 8 4 4 ... ... ... 1 ... 3 2 2 64 (A.B.C.D.E.) Cerebral haemorrhage, Apoplexy (A) Apoplexy 1 5 ... ... 2 1 ... ... 1 4 (1) ... 10 5 5 ... ... ... ... ... 1 4 5 (B) Serous apoplexy and oedema of brain ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Cerebral congestion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Cerebral atheroma ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (E) Cerebral hæmorrhage 22 45 11 6 10 15 3 7 ... 33( ) 16 119 49 70 2 ... ... 1 ... 2 36 78 65 Softening of brain ... 1 ... 1 ... ... 1 1 ... 2 ... 4 1 3 ... ... ... ... ... ... 3 1 66 (A.B.C.) Paralysis without specified cause (A) Hemiplegia 1 1 ... 3 4 1 ... ... ... 1 ... 10 5 5 ... ... ... ... ... ... 2 8 (B) Paraplegia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Other forms of paralysis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 34 TABLE III—continned. No. CAUSE. LOCALITIES. Institution & Street Deaths which could not be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases Total all Ages. Males all Ages. Females all Ages. 0.1. 1.2. 2.5. 5.15. 15.25. 25.45. 45.65. 65 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. 67 General paralysis of the insane 4 5 2 2 2 2 ... 1 ... 15 ... 18 14 4 ... ... ... ... ... 6 9 3 68 Other forms of mental alienation ... 1 ... ... ... ... 1 ... ... 2 ... 2 1 1 ... ... ... ... ... 1 ... 1 69 Epilepsy 2 5 ... ... 2 1 ... ... 1 8 (4) 1 11 5 6 ... 1 ... 2 4 2 2 70 (A.B.)Convulsions (non-puerperal; 5 yrs & over) (A) Epileptiform convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Others included under 70 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 71 (A.B.) Infantile convulsions (under 5 years) (A) Convulsions with teething ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other infantile convulsions 5 5 3 1 1 3 ... 1 ... 2 11 19 8 11 15 ... 3 ... 1 ... ... ... 72 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 73 (A.B.) Hysteria, Neuralgia, Neuritis (A) Hysteria, Neuralgia, Sciatica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Neuritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 74 (A.B.C.D.) Other diseases of the nervous system (A) Idiocy, Imbecility 1 1 ... ... ... ... ... ... ... 2 ... 2 ... 2 ... ... ... ... ... 2 ... ... (B) Cretinism 1 ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... (C) Cerebral tumour ... 3 ... 1 ... 1 1 ... ... 6 ... 6 3 3 ... ... 1 ... ... 3 2 ... (D) Other diseases included under 74 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 75 Diseases of the eyes and annexa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 76 (A) Mastoid disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 76 (B) Other diseases of the ears ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 1 ... ... ... ... III.—Diseases of the Circulatory System. 77 Pericarditis ... ... ... ... ... ... 1 ... ... 1 1 1 1 ... ... ... ... ... 1 ... ... ... 78 (A.B.C.) Acute endocarditis (A) Acute myocarditis ... ... 1 1 ... ... ... ... ... 1 ... 2 1 1 ... ... ... ... ... 1 1 ... (B) Infective endocarditis ... 2 ... ... ... 1 ... ... ... 1 ... 3 3 ... ... ... ... ... ... 2 1 ... (C) Other acute endocarditis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 79 (A) Valvular disease 29 37 9 13 18 24 6 12 1 31( ) 9 149 53 96 ... ... 2 1 5 25 39 77 79 (B) Fatty degeneration of the heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 79 (C) Other organic disease of the heart 12 10 2 7 4 6 2 8 1 6 (2) 13 52 26 26 ... ... ... ... ... 7 10 35 80 Angina pectoris 2 ... 1 ... ... 2 ... ... ... 3 5 5 4 1 ... ... ... ... ... ... 3 2 81 (A) Aneurysm ... 1 ... 2 ... ... ... 1 ... 1 1 4 2 2 ... ... ... ... ... 1 1 2 81 (B) Arterial sclerosis 8 67 8 6 6 7 2 3 ... 79 ( ) 2 107 45 62 ... ... ... ... ... ... 10 97 81 (C) Other diseases of arteries 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... 82 (A) Cerebral embolism and thrombosis ... 2 ... 2 1 2 ... ... ... 3 ... 7 3 4 ... ... ... ... ... ... 2 5 82 (B) Other embolism and thrombosis 1 2 1 ... ... 1 ... ... ... 3 ... 5 1 4 ... ... ... ... ... 2 2 1 83 (A.B.C.D) Diseases of the veins (Varices Hæmorrhoids, Phlebitis, &c.) (A) Phlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B)Varix ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Pylephlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Varicocele ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 84 (A) Status lymphaticus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 84 (B) Other diseases of the lymphatic system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 85 (A.B.C) Hæmorrhage; other diseases of the circulatory system ( A) Functional disease of the heart ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 (B) Epistaxis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Other diseases included under 85 ... ... ... ... ... ... ... ... ... (3) ... ... ... ... ... ... ... ... ... ... ... ... IV.—Diseases of the Respiratorv System. 86 Diseases of the nasal fossæ ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 87 (A.B.C.) Diseases of the larynx (A) Laryngismus stridulus ... ... ... ... ... ... ... ... ... ... ... 4 1 3 1 ... 2 1 ... ... ... ... (B) Laryngitis 2 ... 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... (C) Other diseases of larynx 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 88 Diseases of the thyroid body ... ... 1 ... ... 1 ... ... ... 1 ... 2 ... 2 ... ... ... ... ... ... 1 1 89 (A.B.) Bronchitis & (A) Bronchiectasis, Bronchial Catarrh, &c. 3 1 ... ... ... 1 ... 1 ... ... ... 6 2 4 2 ... ... ... ... ... ... 4 90 (B) Other bronchitis 42 35 5 11 10 13 10 8 ... 27(17 8 134 55 79 11 9 7 1 1 4 24 77 91 Broncho-pneumonia 28 23 6 9 7 9 2 10 ... 12(10) 6 94 50 44 18 27 20 4 2 7 9 7 92 (A.B.) Lobar and undefined. (A) Lobar pneumonia 13 13 3 11 1 7 1 8 1 16(10) 7 58 30 28 1 2 5 5 6 15 13 11 (B) Pneumonia (type not stated) 15 8 3 7 6 6 2 5 14(13) 5 52 27 25 5 4 2 5 4 10 7 15 35 36 TABLE III—continued. No CAUSE. LOCALITIES. Institution & Street Deaths which could not be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases. Total all Ages. Males all Ages. Females all Ages. .1. 1.2. 2.5. 5.15. 15.25. 25.45. 45.65. 65 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. 93 A. B.) Pleurisy (A) Empyema ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other pleurisy ... 4 ... 1 ... 2 ... 1 ... (1) 1 8 2 6 ... ... ... 1 1 1 1 4 94 (A.B.C.D.) Pulmonary congestion, Pulmonary apoplexy (A) Pulmonary apoplexy and infarction ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Pulmonary oedema and congestion 3 ... 2 ... 1 ... ... 1 ... (1) 1 8 6 2 1 ... ... ... ... ... 1 6 (C) Hypostatic pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Collapse of lung (3 months and over) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 95 Gangrene of the lung ... ... ... 1 ... ... ... ... 1 1 1 1 ... ... ... ... ... ... 1 ... ... 96 Asthma 1 2 2 2 ... 1 1 ... ... 1 ... 9 2 7 ... ... ... 1 ... 2 2 4 97 Pulmonary emphysema 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 98 (A) Fibroid disease of lung 1 1 ... ... ... ... ... ... ... 1 ... 2 1 ... ... ... ... ... ... ... ... 2 98 (B) Other diseases of the respiratory system 2 ... ... 1 ... 1 ... ... ... 1 1 4 2 2 ... ... ... ... 1 1 1 1 V.—Diseases of the Digestive System. 99 (A) Diseases of the teeth and gums 1 1 ... ... ... ... ... ... ... 1 ... 2 ... 2 ... 1 1 ... ... ... ... ... 99 (B C D.) Other diseases of the mouth and annexa (b) Thrush, Aphthous Stomatitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) Parotitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (d) Other diseases included under 99 100 (A.B.C.) Diseases of pharynx, Tonsillitis (A) Tonsillitis ... ... 1 ... ... 1 ... 1 ... ... ... 3 2 1 ... ... 1 1 ... ... ... 1 (B) Ludwig's angina ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 (C) Other diseases of the pharvnx 101 Diseases of oesophagus 1 (1) X X 1 102 Perforating ulcer of stomach 4 1 i 1 1 ... X 5(5) X 9 5 "4 X 3 2 3 37 103 (A) Inflammation of stomach ... 3 2 5 2 1 ... 1 ... 5(2) 1 14 7 7 4 1 1 ... ... 1 3 4 103 (B) Other diseases of the stomach 1 ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 1 *104 (A B.C.D.E.F.G.H.) Diarrhœa and enteritis & (A) Infective enteritis 3 1 1 1 ... ... ... ... ... 1 ... 6 3 3 5 1 ... ... ... ... ... ... 105 (B) Diarrhœa—Not returned as infective 2 ... ... 1 1 2 2 1 ... 2 ... 9 7 2 4 1 1 ... ... 1 1 1 (C) Enteritis—Not returned as infective 1 2 2 2 1 6 1 1 1 9 (2) ... 17 10 7 4 ... 1 ... ... 2 6 4 (D) Gastro-enteritis—Not returned as infective 1 2 ... 3 ... ... ... 2 ... 3 ... 8 4 4 6 ... ... ... ... ... ... 2 (E) Dyspepsia, under 2 years ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (F) Colic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (G) Ulceration of instestines 2 ... ... ... ... ... 1 ... ... 2 ... 3 ... 3 ... ... ... ... ... 2 ... 1 (H) Duodenal ulcer 2 1 1 ... 1 ... ... ... ... 2 (1) 1 5 3 2 ... ... ... ... ... 1 1 3 106 Ankylostomiasis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 107 Other intestinal parasites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 108 Appendicitis 3 1 ... ... 1 ... 1 ... ... 6(5) ... 6 3 3 ... ... ... 2 1 1 1 1 109 (A) Hernia 1 3 1 1 1 ... 1 1 ... 2 (3) 3 9 5 4 1 ... ... 1 1 1 3 2 109 (B) Intestinal obstruction 5 ... 5 1 1 2 ... 3 ... 5 (3) 1 17 5 12 1 ... ... ... ... 4 4 8 110 Other diseases of the intestines ... 2 ... ... ... 1 ... ... ... 3 ... 3 3 ... ... ... ... ... ... ... 3 ... 111 Acute yellow atrophy of liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 112 Hydatid of liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 113 (A. B.C.) Cirrhosis of the liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (A) Cirrhosis of the liver (not returned as alcoholic) 1 1 1 3 1 2 ... ... 3 (3) ... 9 7 2 ... ... ... ... ... 1 4 4 (B) Cirrhosis of the liver (returned as alcoholic) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Diseases formerly classed to " Other diseases of liver and gall bladder " ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... 114 Biliary calculi 1 ... ... ... ... ... ... ... ... (1) 1 1 ... ... ... ... ... ... ... 1 115 Other diseases of the liver ... ... ... 1 ... ... ... ... ... 1 (1) ... 1 1 ... ... ... ... ... ... 1 ... 116 (A.B.) Diseases of the spleen (A) Infarction of spleen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other diseases of the spleen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 117 Peritonitis (cause unstated) 1 ... 1 ... ... ... ... ... ... 1(1) ... 2 1 1 ... ... ... ... ... 2 ... ... 118 (A. B.) Other diseases of the digestive system (A) Abdominal abscess, Sub-phrenic abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other diseases included under 118 ... ... ... ... ... ... ... ... ... (1) ... ... ... ... ... ... ... ... ... ... ... ... 38 TABLE III—continued. No. CAUSE. LOCALITIES. Institution & Street Deaths which could not be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases. Total all Ages. Males all Ages. Females all Ages. 0-1. 1-2. 2-5. 5-15. 15-25. 25-45. 45-65. 65 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. VI.—Non- Venereal Diseases of the Genitourinary System and A nnexa. 119 Acute nephritis 3 1 ... 1 ... ... ... ... ... 3(1) ... 5 3 2 ... ... ... 1 ... 1 2 1 120 (A.B.) Bright's disease (A) Bright's disease as in 1901 list 3 7 5 7 6 2 2 2 ... 12 (4) ... 34 15 19 ... ... ... 1 ... 6 11 16 (B) Nephritis (unqualified), 10 years and over and Uræmia 2 1 1 3 1 2 ... ... ... 2(1) 3 10 6 4 ... ... ... ... 1 2 3 4 121 Chyluria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 122 (A.B.C.D.) Other diseases of the kidney and annexa (A) Abscess of kidney ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Cystic disease ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... (C) Suppression of urine 1 ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... (D) Other diseases included under 122 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 123 Calculi of the urinary passages ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 124 Diseases of the bladder 1 4 ... ... ... ... ... ... ... 4 (1) ... 5 4 1 ... ... ... ... ... ... 2 3 126 (A.B.) Diseases of the urethra, Urinary abscess, &c. (A) Perineal abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other diseases of urethra, &c. ... 2 ... ... ... ... ... ... ... 2 ... 2 2 ... ... ... ... ... ... ... 1 1 126 Diseases of the prostate 1 2 2 1 ... 3 2 ... ... 3 ... 11 11 ... ... ... ... ... ... ... 2 9 127 Non-venereal diseases of male genital organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 128 (A.B.) Uterine hemorrhage (non-puerperal) (A) Menorrhagia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other uterine hæmorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 129 Uterine tumour (non-cancerous) ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... 39 130 (A. B.) Other diseases of the uterus (A Disorder of menstruation (except merorrhagia) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other diseases included under 130 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 131 Ovarian cyst, tumour (non-cancerous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 132 (A.B.) Other diseases of the female genital organs (A) Diseases of ovary (excluding ovarian tumour) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Other diseases included under 132 ... ... ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... 133 Non-puerperal diseases of the breast (noncancerous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VII. — The Puerperal State. 134 (A.B.C. D.E.) Accidents of pregnancy (A) Abortion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Hæmorrhage of pregnancy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Uncontrollable vomiting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Ectopic gestation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (E) Other accidents of pregnancy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 135 Puerperal hæmorrhage 1 ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... 2 ... ... 136 Other accidents of childbirth 3 1 ... ... ... ... 1 ... ... (1) ... 5 ... 5 ... ... ... ... ... 5 ... ... 137 Puerperal fever ... ... 1 2 ... ... ... ... ... 1(1) ... 3 ... 3 ... ... ... ... ... 3 ... ... 138 (A.B.C.) Puerperal albuminuria and convulsions (A) Puerperal nephritis and uræmia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Puerperal albuminuria & Bright's disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Puerperal convulsions ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... 139 (A.B.) Puerperal phlegmasia alba dolens, embolism, and sudden death (A) Puerperal phlegmasia alba dolens, phlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Puerperal embolism and sudden death ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 140 Puerperal insanity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 141 Puerperal diseases of the breast ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... TABLE III—continued. No. CAUSE LOCALITIES. Institution & Street Deaths which could Total Institution Deaths distributed Inquest Cases. Total all Ages. Males all Ages. Females all Ages. 0-1. 1-2. 2-5. 5-15. 15-25. 25-45. 45-65. 65 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. VIII.—Diseases or the Skin and of the Cellular Tissue. 142 (A) Senile gangrene ... 2 1 ... ... ... ... ... ... 2(1) ... 3 1 2 ... ... ... ... ... ... ... 3 142 (B.C.D.) Gangrene, other types (B) Noma. Gangrene of mouth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Noma pudendi ... 1 ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... ... (D) Other gangrene ... 1 ... ... ... ... ... ... ... 1 (1) 1 1 ... 1 ... ... ... ... ... ... 1 ... 143 Carbuncle, Boil ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... 144 (A.B.) Phlegmon, acute abscess (A) Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Acute abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 145 (A. B.C. D.) Diseases of the integumentary system (A) Ulcer, Bedsore ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... 1 (B) Eczema ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... ... ... ... ... ... ... (C) Pemphigus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Other disease of integumentary system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... IX. — Diseases of the Bones and of the Organs of Locomotion. 146 Diseases of the bones ... 1 ... ... ... ... 2 ... ... 3 (2) 2 3 2 1 ... ... ... 2 ... 1 ... ... 147 Diseases of the joints ... ... ... ... ... ... 1 ... ... 1 ... 1 1 ... ... ... ... ... ... 1 ... ... 148 Amputations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 149 Other diseases of locomotor system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... X. —Malformations. 150 (A.B.C.D.) Congenital malformations (A) Congenital hydrocephalus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Phimosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (C) Congenital malformation of heart 1 1 ... ... 1 ... 1 1 ... 1 ... 5 4 1 5 ... ... ... ... ... ... ... (D) Other congenital malformations 2 ... ... ... 1 1 ... ... ... ... ... 4 1 3 4 ... ... ... ... ... ... ... 40 XI.—Diseases of Early Infancy. 151 (A) Premature birth 10 9 2 12 2 4 2 5 4(2) 5 46 38 18 46 ... ... ... ... ... ... ... 151 (B.C.D.E.) Infantile debility, Icterus & Sclerema (B) Infantile atrophy, debility and marasmus 6 10 2 2 5 1 2 1 ... 10 (6) 3 29 17 12 29 ... ... ... ... ... ... ... (C) Icterus neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (D) Sclerema and oedema neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (E) Want of breast milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 152 (A.B.C.D. Other diseases peculiar to early infancy (A) Diseases of umbilicus, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (B) Atelectasis ... 1 ... 1 2 1 ... ... ... ... 1 5 3 2 5 ... ... ... ... ... ... ... (C ) Injuries at birth 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... (D) Cyanosis neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 153 Lack of care ... ... ... ... ... 1 ... ... ... ... 1 1 ... 1 1 ... ... ... ... ... ... ... XII. Old Age. 154 (A.B ) Old-age (A) Senile dementia 1 1 1 ... 1 ... ... ... ... ... ... 4 2 2 ... ... ... ... ... ... ... 4 (B) Senile decay 23 20 11 10 19 5 7 4 ... 12(6) 2 99 33 66 ... ... ... ... ... ... 1 98 XIII.—Affections produced by External Causes. 155 Suicide by poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 156 Suicide by asphyxia 1 ... 1 ... 1 ... ... ... ... ... 3 3 3 ... ... ... ... ... ... 2 1 ... 157 Suicide by hanging or strangulation ... ... ... ... 1 ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 1 ... ... 158 Suicide by drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 159 Suicide by firearms ... ... 1 ... ... ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... 1 ... 160 Suicide by cutting and piercing instruments 1 5 1 ... ... ... ... ... ... 7(1) 9 8 6 2 ... ... ... ... ... 3 4 1 161 Suicide by jumping from high place ... 1 ... ... ... ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 1 ... ... 162 Suicide by crushing ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... 1 ... ... 163 Other suicides ... ... ... ... 1 ... ... ... ... ... 1 1 1 ... ... ... ... ... ... ... 1 ... 164 Poisoning by food ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 165 Other acute poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 166 Conflagration ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 167 Burns (conflagration excepted) 3 2 1 ... ... 1 ... ... ... 7(2) 9 7 3 4 ... 1 1 1 ... ... 3 1 168 Absorption of deleterious gases (conflagration excepted) 2 ... ... ... ... 1 ... ... ... 2(1) 4 3 2 1 2 ... ... ... ... 1 ... ... 169 Accidental drowning ... ... ... ... 1 ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... 1 170 Injury by firearms ... ... ... ... 1 ... ... ... ... (3) 4 1 1 ... ... ... ... ... ... ... ... ... 171 Injury by cutting or piercing instruments ... 1 ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... 1 41 42 The total Institution Deaths include those of strangers occurring within the Borough. Deaths of such strangers occurring at the Workhouse, Workhouse Infirmary, Borough Hospital, General Hospital, Purley Cottage Hospital, Norwood Cottage Hospital, and 99, Central Hill (Servants' Reformatory), are excluded from all other columns of the Table. The numbers so excluded are in brackets. TABLE III—continued No. CAUSE. LOCALITIES. Institution & Street Deaths which could not, be distributed. Total Institution Deaths distributed and not distributed. Inquest Cases. Total all Ages. Males all Ages. Females all Ages. 0-1. 1-2. 2-5. 5-15. 15-25. 25-45. 45-65. 55 and upwards. West. North. Central. East. South. South Norwood. Upper Norwood. Thornton Heath. 172 Injury by fall 3 2 ... 2 1 ... ... ... ... 7 8 8 6 2 ... ... ... ... 1 1 2 4 173 Injury in mines and quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 174 Injury by machines ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 175 Injury by other crushing (vehicles, railways, landslides, &c.) 8 ... ... 2 2 1 1 ... ... 12(6) 20 14 11 3 ... ... 2 1 ... ... 6 3 176 Injury by animals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 177 Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 178 Excessive cold ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 179 Effects of heat ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 180 Lightning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 181 Electricity (lightning excepted) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 182 Homicide by firearms ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 183 Homicide by cutting or piercing instruments ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 184 Homicide by other means ... ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... ... ... ... ... 1 ... ... 185 Fractures (cause not specified) 1 2 ... 1 ... ... ... ... ... 4 5 5 3 2 ... ... ... 1 ... 1 ... 3 186 Other violence 1 ... ... ... 1 ... ... ... ... 1 2 2 2 ... ... ... ... ... ... 1 ... 1 XIV.—Ill-Defined Causes. 187 Dropsy ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 ... ... ... 188 (A) Syncope (aged 1 year and under 70) ... 1 ... ... 1 ... ... 1 ... ... 3 3 ... 3 ... ... ... ... ... 3 ... ... 188 (B) Sudden death (not otherwise defined) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 189 (A) Heart failure (aged 1 year and under 70) 1 ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 1 ... ... 189 (B.C.D.E.) Other ill-defined causes (B) Atrophy, debility, marasmus (aged 1 year and under 70) ... 1 ... ... ... 1 ... ... ... 1 ... 2 ... 2 ... 2 ... ... ... ... ... ... (C) Teething ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... ... (D) Pyrexia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (E) Other ill defined deaths 1 ... ... ... ... ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... 1 ... 189 (F) Cause not specified 1 ... ... ... ... ... ... ... ... 1(2) 3 1 1 ... ... ... 1 ... ... ... ... ... Totals 582 665 200 298 211 292 118 172 6 736 (388) 208 2544 1165 1379 202 82 115 130 185 503 491 836 43 TABLE IV. —Continued County Borough of Croydon— Whole Borough. INFANT MORTALITY. 1918. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months Total Deaths under 1 Year. All Causes. 43 12 14 1 70 39 38 32 23 202 Certified Uncertified Small-pox Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 2 3 1 1 7 Diphtheria and Croup ... ... ... ... ... ... 1 ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... 1 1 ... ... 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 ... ... ... 3 Meningitis (not Tuberculous) ... ... ... ... ... ... ... 2 ... 2 Convulsions 1 2 1 ... 4 3 5 ... 3 15 Laryngitis ... ... ... ... ... ... ... ... 1 1 Bronchitis ... ... ... ... ... 2 5 5 1 13 Pneumonia (all forms) ... ... 1 ... 1 6 3 8 6 24 Diarrhœa ... ... ... ... ... ... 2 1 1 4 Enteritis ... ... ... ... ... 2 2 3 2 9 Gastritis ... ... 1 ... 1 ... 2 3 ... 6 Syphilis ... ... ... ... ... 3 ... ... ... 3 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 1 ... ... ... 1 ... 1 ... ... 2 Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 1 2 ... ... 3 ... 1 ... ... 4 Congenital Malformations 3 1 2 ... 6 2 ... 1 ... 9 Premature Birth 24 4 8 1 37 6 2 1 ... 46 Atrophy, Debility and Marasmus 7 3 1 ... 11 9 8 1 ... 29 Other causes 5 ... ... ... 5 2 2 5 6 20 43 12 14 1 70 39 38 32 23 202 Nett Births in the year legitimate 2427. illegitimate 205. Nett Deaths in the year of legitimate infants, 177. illegitimate infants 25. 44 TABLE IV. County Borough of Croydon— West Ward. INFANT MORTALITY. 1918. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths Under One Year. All Causes. Certified 10 4 3 ... 17 10 14 4 12 57 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 2 2 ... 1 5 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... 1 ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... 1 ... ... 1 1 1 ... 2 5 Laryngitis ... ... ... ... ... ... ... ... 1 1 Bronchitis ... ... ... ... ... ... 2 ... 1 3 Pneumonia (all forms) ... ... 1 ... 1 1 2 ... 3 7 Diarrhœa ... ... ... ... ... ... 1 1 ... 2 Enteritis ... ... ... ... ... 1 1 1 1 4 Gastritis ... ... ... ... ... ... 1 ... ... 1 Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 1 ... ... ... 1 ... ... ... ... 2 Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations 2 1 l ... 4 ... ... ... ... 4 Premature Birth 5 2 l ... 8 4 ... ... ... 12 Atrophy, Debility and Marasmus 2 ... ... ... 2 ... ... ... ... 4 Other causes ... ... ... ... ... 1 ... 1 2 4 10 4 3 ... 17 10 14 4 12 57 Nett Births in the year legitimate, 659. illegitimate, 45. Nett Deaths in the year legitimate infants, 53. illegitimate infants, 4. TABLE IV. — Continued County Borough of Croydon—North Ward. INFANT MORTALITY. 1918. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 3 Months. 3-6 Months. 6-9 Months. 9-12 Months Total Deaths under 1 Year. All Causes. Certified 8 2 2 ... 12 8 9 11 2 42 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... 1 ... ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... 1 ... 1 Convulsions ... ... ... ... ... 1 2 ... 1 4 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... 1 3 ... 4 Pneumonia (all forms) ... ... ... ... ... ... ... 4 l 5 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... 1 ... ... 1 Gastritis ... ... ... ... ... ... ... 3 ... 3 Syphilis ... ... ... ... ... 2 ... ... ... 2 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis ... 1 ... ... 1 ... ... ... ... 1 Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth 4 1 ... ... 7 2 ... ... ... 9 Atrophy, Debility and Marasmus 2 ... ... ... 2 2 5 ... ... 9 Other causes 1 ... ... ... 1 ... ... ... ... 1 8 2 2 ... 12 8 9 11 2 42 45 Nett Births in the year legitimate 440. illegitimate 76. Nett Deaths in the year legitimate infants 34. illegitimate infants 8. TABLE IV.—Continued County Borough of Croydon—Central Ward. INFANT MORTALITY 1918. Nett Deaths from stated causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1 -2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths Under One Year. All Causes. Certified 3 1 ... ... 4 4 2 3 ... 13 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... 1 ... ... 1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 ... ... ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... 1 ... ... 1 ... l ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... 1 ... 1 ... 2 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... 1 ... 1 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, everlaying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth 2 ... ... ... 2 ... ... ... ... 2 Atrophy, Debility and Marasmus 1 ... ... ... 1 2 ... ... ... 3 Other causes ... ... ... ... ... ... ... 1 ... 1 3 1 ... ... 4 4 2 3 13 46 Nett Births in the year legitimate, 192. illegitimate, 13. Nett Deaths in the year legitimate infants, 13. illegitimate infants, —, TABLE IV.— Continued. County Borough of Croydon—East Ward. INFANT MORTALITY. 1918. Nett Deaths from stated Causes at various ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. All Causes. Certified 10 1 5 ... 16 5 3 3 3 30 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... .... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... 1 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions 1 ... ... ... 1 ... ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 1 1 2 ... 4 Pneumonia (all forms) ... ... ... ... ... 1 1 ... ... 2 Diarrhœa ... ... ... ... ... ... 1 ... ... 1 Enteritis ... ... ... ... ... ... ... 1 1 2 Gastritis ... ... 1 ... 1 ... ... ... ... 1 Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth 8 1 3 ... 12 ... ... ... ... 12 Atrophy, Debility and Marasmus ... ... 1 ... 1 1 ... ... ... 2 Other causes 1 ... ... ... 1 l ... ... 1 3 10 1 5 ... 16 5 3 3 3 3O 47 Nett Births in the year legitimate, 286. illegitimate, 17. Nett Deaths in the year legitimate infants, 26. illegitimate infants, 4. TABLE IV.—Continued. County Borough of Croydon—South Ward. INFANT MORTALITY. 1919. Nett Deaths from stated Causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths Under 1 Year. All Causes. Certified 6 ... ... ... 6 4 4 3 ... 17 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... 1 ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... 1 ... ... ... 1 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... 1 ... ... 1 Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis 1 ... ... ... 1 ... 1 ... ... 2 Congenital Malformations 1 ... ... ... 1 ... ... 1 ... 2 Premature Birth 2 ... ... ... 2 ... ... ... ... 2 Atrophy, Debility, and Marasmus 1 ... ... ... 1 3 1 1 6 Other causes 1 ... ... ... 1 ... ... 1 ... 2 0 ... ... ... 6 4 4 3 ... 17 48 Nett Births in the year legitimate, 221. [illegitimate, 11. Nett Deaths in he year legitimate infants, 12. Illegitimate infants, 5. TABLE IV.—Continued. County Borough of Croydon—South Norwood. INFANT MORTALITY. 1918. Nett Deaths from stated Causes at various ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3 6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. All Causes. Certified 2 3 2 ... 7 3 3 4 2 19 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... 1 ... 1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... 1 ... 1 Convulsions ... ... 1 ... ... ... ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... 1 ... 1 1 3 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... 1 ... ... 1 ... ... ... ... 1 Congenital Malformations ... ... ... ... ... 1 ... ... ... 1 Premature Birth 1 1 2 ... ... ... ... 4 Atrophy, Debility and Marasmus ... 2 ... ... 2 1 ... ... ... 3 Other causes 1 ... ... ... 1 ... 1 1 1 4 2 3 2 ... 7 3 3 4 2 19 49 Nett Births in the year legitimate, 323. illegitimate, 26. Nett Deaths in the year legitimate infants, 17 illegitimate infants, 2. 50 TABLE IV.—Continued. County Borough of Croydon—Upper Norwood. INFANT MORTALITY. 1918. Nett Deaths from stated Causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Montls. Total Deaths Under 1 Year. All Causes. Certifed 1 ... 1 ... 2 ... ... ... 1 3 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... 1 ... 1 ... ... ... ... 1 Premature Birth ... ... ... ... ... ... ... ... ... ... Atrophy, Debilit v . and Marasmus 1 ... ... ... 1 ... ... ... ... 1 Other causes ... ... ... ... ... ... ... ... 1 1 l ... 1 ... 2 ... ... ... 1 3 Nett Births in the year legitimate, 83. illegitimate, 1. Nett Deaths in the year legitimate infants, 3. illegitimate infants, 0. 51 TAB LE IV. -Continued. County Borough of Croydon—Thornton Heath. INFANT MORTALITY. 1918. Nett Deaths from stated Causes at various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Week6. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Monthe. 6-9 Months. 9-12 Months. Total Deaths Under 1 Year. All Causes. Certified 3 1 1 1 6 5 3 4 3 21 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningit s (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... 1 1 ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 1 1 ... ... 2 Pneumonia (all forms) ... ... ... ... ... 1 ... 2 1 4 Diarrhœa ... ... ... ... ... ... ... ... 1 1 Enteritis ... ... ... ... ... 1 ... ... ... 1 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... ... ... 1 ... ... ... 1 Premature Birth ... ... 1 1 4 ... ... 1 ... 5 Atrophy, Debility and Marasmus ... 1 ... ... 1 ... ... ... ... 1 Other causes 1 ... ... ... 1 ... 1 1 1 4 3 l 1 1 6 5 3 4 3 21 Nett Births in the year legitimate, 223. illegitimate, 16. Nett Deaths in the year legitimate infants 19. illegitimate infants, 2. 52 TABLE V. Table showing the number of cases notified and deaths from the principal zymotic diseases for the Year 1918 and ten preceding Years. Disease. 1918. 1917. 1916. 1915. 1914. 1913. 1912. 1911. 1910. 1909. 1908. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. | Cases. Deaths. Cases. Deaths. Notifiable. Cerebro-Spinal Meningitis 25 1 18 .. 29 1 24 9 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Poliomyelitis .. .. 1 .. 2 .. 4 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 414 6 191 2 297 4 414 5 748 5 470 3 476 2 468 7 759 7 727 9 534 5 Diphtheria and (1) Memb.Croup 179 22 191 9 312 4 195 14 226 18 451 16 767 25 514 37 267 21 356 24 405 37 (2) Erysipelas 44 3 56 3 52 1 82 3 96 7 107 6 84 6 79 5 69 1 92 3 60 5 Puerperal Fever 4 3 3 1 7 1 12 5 9 3 6 4 10 3 12 4 8 1 16 5 10 5 Enteric Fever 15 2 6 .. 13 .. 22 3 20 5 32 6 32 7 24 7 26 21 3 52 5 Simple Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tuberculosis (3) 378 204 397 157 326 223 550 238 503 192 519 202 312 140 240 165 130 135 139 152 106 150 Non-notifiable. Measles (4) 1057 2 2944 29 462 .. .. 108 .. 8 .. 58 .. 31 .. 29 .. 31 .. 21 .. 92 Rubella 93 .. 2439 .. 636 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa and Enteritis .. 48 .. 11 .. 50 .. 62 .. 67 .. 85 .. 58 .. 147 .. 51 .. 45 .. 75 Whooping Cough .. 10 .. 9 .. 27 .. 12 .. 24 .. 23 .. 13 .. 38 .. 20 .. 30 .. 29 Influenza .. 478 .. 20 .. 46 .. 45 .. 15 .. 26 .. 18 .. 14 .. 25 .. 59 .. 52 Bronchitis, Pneumonia, and Pleurisy .. 362 .. 302 .. 329 .. 399 .. 313 .. 297 .. 250 .. 280 .. 251 .. 323 .. 282 (1) Notifiable since May, 1897. (2) Notifiable since January, 1900. (3) Voluntary Notification, 1905-09. Poor Law Cases, Compulsorily Notifiable since 1st Jan., 1909- Cases Treated in Hospital, Compulsorily Notifiable since 1st May, 1911. All cases of Pulmonary Tuberculosis notifiable since 1st January, 1912. All forms of Tuberculosis notifiable since 1st February, 1913. (4) Notifiable since January 1st, 1916. In the above Table deaths of Non-residents occurring at the Workhouse, Workhouse Infirmary, Borough Hospital, General Hospital, Norwood Cottage Hospital, Purley Cottage Hospital, and 99, Central Hill (Servants Reformatory), are excluded. Prior to 1903 correction was only made for the first three institutions. 53 TABLE VI.—Vital Statistics of separate Wards in 1918 and previous years. Names or Localities 1. North Ward. 2. West Ward 3. Central Ward. 4. East Ward. 5. South Ward . 6. South Norwood Ward. 7. Upper Norwood Sub-Division. 8. Thorntok Heath Sub-Division. 9. Undistributed Institution Births and Deaths. YEAR Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 Year Population estimate ' to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year, Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 Year. a b c d a b c d a b c d a b c d a b c d a b c d a b c d a b c d b c d 1904 .. .. .. .. *46,741 1319 699 190 17,051 362 229 35 16,346 375 193 47 19,107 399 227 55 21,925 621 322 70 8,327 148 90 20 14,922 463 192 63 82 46 3 1905 .. .. .. .. *47,944 1446 706 162 17,106 344 236 37 16,983 387 161 30 19,404 384 197 34 22,370 648 297 60 8,335 134 105 10 15,562 466 159 39 - 85 21 .. 1906 .. .. .. .. *49,219 1451 744 207 17,171 362 255 51 17,630 393 182 51 19,711 366 232 40 22,825 630 276 61 8,343 148 88 7 16,212 447 227 65 89 15 3 1907 .. .. .. .. *50,500 1515 715 171 17,236 351 207 38 18,083 392 172 25 20,022 363 210 29 23,284 643 285 55 8,351 145 94 9 16,866 456 195 44 102 23 .. 1908 .. .. .. .. *51,801 1550 747 185 17,310 340 209 24 18,634 388 190 30 20,329 361 237 36 23,739 647 267 61 8,364 156 319 6 17,521 492 231 53 83 21 3 1909 .. .. .. .. *5 ,125 1560 721 142 17,394 266 211 24 19,185 396 189 33 20,636 371 198 27 24,195 654 267 39 8,377 151 87 8 18,176 455 184 40 85 23 .. 1910 .. .. .. .. *54, 58 1489 693 149 17,478 298 179 21 19,736 401 195 33 20,943 376 180 30 24,651 548 239 45 8,388 139 102 6 18,831 474 168 47 82 27 .. 1911 29,701 691 275 51 33,592 800 473 107 16,167 295 199 32 20,175 377 217 42 18.998 360 209 42 25,609 572 325 65 8,128 112 105 10 18,081 130 190 43 111 29 2 1913 30,450 683 273 46 34 964 829 436 88 16,119 298 120 25 20,743 417 199 27 19,111 370 203 24 26,228 577 281 39 8,115 131 103 14 18,527 416 174 35 140 34 .. 1913 31,117 781 349 69 36,424 800 451 90 16,070 332 216 36 21,323 402 226 37 19,226 337 234 37 26,850 594 319 54 8,102 112 98 8 18,982 425 182 37 107 21 .. 1914 31,809 729 302 45 37,302 841 490 95 16,021 290 175 27 21,837 468 214 32 19,690 353 218 28 27,498 628 304 42 8,298 109 101 10 19,441 496 159 40 113 21 .. 1915 30,993 669 451 52 36,276 844 553 82 15 ,985 264 236 25 21,236 447 254 31 19,148 308 248 29 26,732 559 848 43 8,069 144 09 7 18,906 385 208 38 79 18 .. 1916 30,659 729 550 44 35,935 769 488 97 15,949 246 182 14 21,041 458 203 20 18,970 309 190 19 26,485 589 245 33 7,995 112 115 9 18,731 377 158 36 61 19 .. 1917 32.810 556 597 56 3 ,406 634 468 65 16,036 197 186 23 22,515 357 212 22 20,276 248 172 23 28,292 451 252 22 8,664 81 94 4 20,019 312 182 34 68 44 .. Averages of Years 1904 to 1917. .. .. .. .. .. .. .. .. 16,649 303 208 29 19,669 404 201 33 19,598 350 211 33 25,049 597 288 49 8,268 130 100 9 17,913 435 186 92 26 0.8 Averages of Years 1911 to 1917 31,085 691 97 52 36,143 788 180 89 Averages of Years 1904 to 1910 .. .. .. .. 50,541 I47fl 718 172 1918 29562, 616 665 42 34,604 704 58 67 14,449 205 200 13 20.340 303 298 30 18,268 232 211 17 25.492 349 292 19 7,717 84 118 3 18,030 239 172 21 66 6 .. NOTES.—Deaths of residente occurring beyond the district are included in sub-columns C of this table, and those of non-residents occurring at the Workhouse, Workhouse Infirmary, Borough Hospital, General Hospital, Norwood Cottage Hospital, Purley Cottage Hospital, and 99, Central Hill (Servants' Reformatory) are excluded. Deaths of residents occurring in Public Institutions are allotted to the respective localities, aocording to the addresses of the deceased, and all deaths of Croydon residents whose exact home could not be ascertained, are included in Block 9. * Including North Ward. 54 WORK OF THE SANITARY INSPECTING STAFF. GENERAL SANITARY WORK. The usual summary is given in Table VII., which gives a fair idea of the various matters engaging the attention of the Sanitary Inspectors. Inspections.—During the year 955 house to house inspections were made. Combined drainage.—The number of systems of combined drainage dealt with as single private drains during the year was 2. This work was carried out under the provisions of the Croydon Corporation Act, 1905. The cost of carrying out the necessary works amounted to £22 10s. od, and was borne by the owners instead of by the inhabitants at large. House drains relaid.—In 16 instances the whole of the house drains were relaid, and 75 house drains were repaired or partially relaid. Examination of drains.—68 written applications were received for the examination of the drains and sanitary condition of houses by occupiers or intending occupiers. In all cases special reports were made by the District Inspectors, copies of which were forwarded to the applicants; where defects were found, and in many cases where improvements were suggested, the work was carried out by the owners without the necessity of serving sanitary notices. Notices and Council Orders.—Most of the nuisances discovered were remedied on receipt of informal notices, but in 93 cases Council Orders had to be applied for. Seventy-one were complied with at the end of the year. MUNICIPAL COMMON LODGING HOUSE. This Lodging House affords accommodation for 17 women and 84 men. The number of nightly occupants during the year amounted to 28,138 men and 1,193 women, making a total of 29,331. The average number of lodgers amounted to 77 men and 3 women per night. Owing to the increased cost of labour and material the charge for beds to men lodgers was increased on October 7th from 6d. to 8d. per night. 55 The receipts and expenditure (exclusive of sinking fund and interest) for the past seven years were:- Receipts. Expenditure. £ s. d. £ s. d. 1912 764 1 7 662 3 9 1913 765 6 7 623 14 4 1914 822 4 9 735 8 9 1915 787 9 1 737 17 10 1916 722 16 1 682 15 10 1917 678 15 4 698 4 1 1918 781 1 7 854 3 0 OTHER COMMON LODGING HOUSES. There are ten other houses on the register. The following Table gives the situation of the ten registered houses and the accommodation provided therein:- Premises. No. of Rooms. Accommodation. 11 & 12, Princess Road 12 54 men and 8 married couples. 9, Piospect Place 7 18 men and 5 married couples. 19, 20, 21, 22, 23 & 24, Lshore Road 30 50 men, 10 women, and 6 married couples. 52, Union Street 13 30 men. Nos. 19 to 24, Lahore Road—These houses are under one management and worked as one establishment, as also are Nos. 11 and 12, Princess Road. Practically, therefore, only four common lodging houses now remain in the Borough, with a total accommodation of 200 adults, or if we add the Municipal Common Lodging House, a total of five houses with 263 single beds and 19 double beds. During the year common lodging houses received 518 visits, while 10 houses received night visits. Minor infringements of bye-laws were detected on 19 occasions, but in no case were they sufficiently serious for legal proceedings to be taken. 56 HOUSES LET IN LODGINGS. There are 49 houses registered under the bye-laws. During the year these houses received 949 visits. On no occasion were offences discovered for which prosecutions were necessary. At the present moment the following houses are registered as houses let in lodgings:- Wilford Road 25 Forster Road 12 Holmesdale Road 4 Ely Road 8 49 HOUSE INSPECTIONS made by the Sanitary Inspectors during the year ended 31st December, 1918. Inspector. House-to-House Inspections. Informal Notices served. Informal Notices complied with. Culver 5 120 75 Peck 153 188 176 Richardson 241 418 385 Vincent 383 312 3°4 Hunt 173 231 204 Bull - 9 9 Totals for the year 955 1 278 1158 The amount of routine house-to-house inspection is much lower than what is desirable, but the reduction in the sanitary inspecting staff arising out of war circumstances makes this unavoidable. The main attention of the inspectorate has been directed towards the detection and abatement of actual existing nuisances, the routine work unavoidably having been left alone to a considerable extent. As a result of these inspections, 1,278 preliminary notices were served during the year. The numbers in this table are in addition to 633 inspections of houses where infectious diseases have been notified, and 68 inspections on request of larger houses where the drains were tested and special reports sent to occupiers, prospective occupiers, or owners. Full details of general sanitary work are given in the Summary in Table VII. 57 FACTORY AND WORKSHOP ACT. FACTORIES. 640 visits were made to Factories. 170 in reference to sanitary accommodation. 37 „ ,, cleanliness of earth closets. 30 „ „ new occupation. 3 „ „ complaint of smoke nuisance. 79 „ ,, new drinking water regulations. 36 „ ,, extra W.C. accommodation at 8 munition factories. 3 „ „ extra W.C. accommodation and screens at flour mills. 3 „ ,, extra W.C. accommodation at a tailoring factory. 3 „ „ Ditto at steam laundry. 15 ,, ,, Ditto at aeroplane factory. 3 ,, „ Ditto at baking powder factory. 21 „ ,, Ditto at printers 12 „ ,, Ditto at carpenters 16 ,, „ Screening W.C.'s at 3 engineering works 12 „ Ditto at toy works. 2 „ „ Ventilated space in aeroplane works. 6 „ „ Ditto at engineering works. 9 „ „ Ditto at rag factory. 6 „ „ Ditto at printers. 12 ,, ,, extra W.C. accommodation at 4 engineering works. 4 „ „ screening W.C.'s at photographic works. 20 „ ,, screening of W.C.'s at 2 steam laundries. 18 ,, ,, ,, ,, 2 munitions factories 120 „ ,, sundry visits. 640 Total. WORKSHOPS. The number of workshops on register is 650. The number of visits paid by the Inspector is 357. 58 The following is a list of the various matters which required attention:- Factories. Workshops Laundries Bakehouses. Workplaces. Outworkers. Total. Screening of C's. 10 4 - - - - 14 Cleansing, etc. - 9 4 28 2 - 43 Insufficient W.C. accommodation 18 3 - - - - 21 Defective ditto - 18 4 - - - 22 Overcrowding - - - - - - - Dustbins - - - - - - - Paring - - - - - - - Want of ventilation of stoves - 22 - - - - 22 Want of intervening ventilated space 2 8 - - - - 10 Drinking water supply 66 2 - - - - 68 Sundry defects 20 11 - 13 4 - 48 116 77 8 41 6 - 248 Preliminary Notices served- Factories 4 Workshops 5 9 These 9 notices were duly complied with; the remainder of the matters requiring attention were satisfactorily dealt with by verbal notice. Thirty communications were sent to H.M. Inspector of Factories in accordance with the various requirements of the Act. 59 HOMEWORK. 112 lists were received from employers, containing the names of 326 outworkers residing in the Borough. 154 further names were received from the Medical Officers of Health of various neighbouring districts, and the names of 50 outworkers residing outside the Borough were similarly despatched to the Medical Officer of Health for the district concerned. 176 visits were paid to outworkers. 50 visits were made to premises of employers of outworkers for the purpose of examining lists and other particulars. BAKEHOUSES. At the end of the year there were 78 Bakehouses in occupation, of which 7 were underground. 530 visits were made by the Inspector during the year, and 41 nuisances discovered and abated. WORKPLACES. At the end of the year there were 76 workplaces on the register. 49 visits to eating-house kitchens have been made, and 6 nuisances discovered and abated. SMOKE NUISANCES. 3 complaints of smoke nuisances were attended to. RAG FLOCK ACT, 1912. Five inspections were made of premises occupied by upholsterers and bedding manufacturers. Very little private work was done in the work-shops in consequence of the war. The materials in use appeared to be clean. No samples were taken for analysis. 60 TABLE VII. Work done by the Sanitary Inspectors during the Year ending 31st December, 1918. NATURE OF CASES DEALT WITH Deputy Chief Insp. Culver. Insp Fulker. Insp. Earwicker Insp. Peck. Insp. Richardson Insp. Bull. Insp. Vincent. Insp. Flint. Insp. Hunt. Total House to House Inspection 5 .. .. 153 241 .. 383 .. 173 955 No. of Houses inspected where zymotic diseases have occurred 50 .. .. 82 244 .. 135 .. 122 633 No. of Visits of enquiry re infectious disease 196 .. .. 121 311 .. 179 .. 168 975 House drains tested with smoke (primary) 49 .. .. 60 170 .. 115 .. 91 485 ,, ,, ,, on application 14 .. .. 11 7 .. 12 .. 24 68 Drains found defective 13 .. .. 16 17 .. 6 .. 7 59 House drains re-laid 3 .. .. 6 1 .. 2 .. 4 16 ,, ,, repaired 1 .. .. 20 30 .. .. .. 22 73 No. of smoke tests during repair 3 .. .. 27 51 .. 4 .. 41 126 ,, water ,, 28 .. .. 24 14 .. 8 .. 29 103 Damp-proof courses inserted .. .. .. .. .. .. .. .. .. .. Yards paved .. .. .. .. 4 .. .. .. .. 4 Inspection of Premises where offensive trades are conducted .. .. .. .. .. .. .. .. .. .. Inspections of Factories and Workshops, etc .. .. .. .. .. 1173 .. .. .. 1173 ,, ,, Greengrocers, Fishmongers & Ice Cream Shops 4 .. .. 138 15 .. 372 .. 174 703 ,, ,, Schools 3 .. .. 67 12 .. 58 .. 54 194 ,, ,, Shops 232 .. .. .. 4 .. 6 .. 1 243 ,, ,, Bakehouses .. .. .. .. .. 530 .. .. .. 530 ,, ,, Yards and Stables 11 .. .. 311 185 .. 303 .. 530 1340 ,, ,, Common Lodging Houses .. .. .. .. .. 518 .. .. .. 518 „ „ night visits .. .. .. .. .. .. .. .. .. .. ,, ,, Houses let in Lodgings .. .. .. .. 468 481 .. .. 949 ,, ,, ,, ,, night visits .. .. .. .. .. .. .. .. .. .. ,, ,, Urinals 41 .. .. 402 247 .. 327 .. 429 1446 Smoke observations .. .. .. .. .. .. .. .. .. .. Re-inspections of work in progress 210 .. .. 887 1145 .. 755 .. 970 3967 Sundry inspections 632 .. .. 612 600 .. 312 .. 307 2493 Complaints from public investigated 248 .. .. 89 264 .. 163 .. 174 938 NUISANCES DISCOVERED. Houses requiring Cleansing & Whitewashing 25 .. .. 30 92 .. 46 .. 75 268 ,, Overcrowded 1 .. .. 1 8 .. .. .. 4 14 Leaky Roofs 24 .. .. 34 87 .. 42 .. 46 233 Dampness in Houses 5 .. .. 67 25 .. 20 .. 20 137 Drains found stopped 48 .. .. 41 135 .. 80 .. 59 363 Drains and Sanitarv Fittings found defective 58 .. .. 114 206 .. 73 .. 89 540 Defective Yard Surfaces .. .. .. 9 11 .. 11 .. 14 38 ,, Eaves and Downspouts 21 .. .. 23 82 .. 27 .. 29 182 ,, Manure Recentacles .. .. .. .. .. .. .. .. .. .. ,, Urinals .. .. .. .. .. .. 1 .. .. 1 ,, Ashbins 15 .. .. 67 67 .. 15 .. 49 213 Smoke Nuisances .. .. .. .. .. .. .. .. .. .. Animals improperly kept 10 .. .. 1 1 .. .. .. .. 12 Infringements of Bye-laws and Regulations 2 .. .. .. .. .. 1 .. .. 3 Offensive Accumulations 8 .. .. .. 1 .. .. .. 2 11 Sundry other Nuisances 1 .. .. 67 127 .. 2 .. 78 275 Total number of Nuisances 218 .. .. 447 842 .. 318 .. 465 2290 Informal Notices served 120 .. .. 188 418 9 312 .. 231 1278 ,, ,, complied with 75 .. .. 176 385 9 304 204 1153 ,, ,, in abeyance 78 .. .. 26 97 .. 43 270 314 Referred to Committee 6 .. .. 22 10 .. 36 .. 19 93 61 MEAT INSPECTIONS. The Inspection of meat has been carried out as in previous years There are 12 registered slaughter houses in the Borough, in addition to the Municipal slaughter houses at Pitlake, which consist of 12 slaughter houses with lairs. In August a portion of the Public slaughter house premises was rented by the Ministry of Food for the slaughter of calves and at the end of the year was still in their occupation. During this period 4,549 calves were slaughtered, their carcases and offals being consigned to Smithfield Market for allocation in the Metropolitan area. The Ministry of Food in addition slaughtered 1,358 bullocks, the carcases and offal being issued to the various Military Depots in the neighbourhood or consigned to Smithfield Market for allocation in the Metropolitan area. The following table gives a summary of the. work done during the year:— Summary of inspections during 1918. I. Date 1918. Slaughterhouses. Butchers. Fishmongers. Markets. Cowkeepers. Dairies. Other Premises. . January 144 66 22 10 7 17 10 276 February 119 80 33 8 8 23 22 293 March 136 126 30 10 9 40 19 370 April 91 79 29 8 7 28 13 255 May 79 61 23 6 8 16 18 211 June 172 124 35 12 28 73 19 463 July 93 103 21 8 6 20 16 267 August 170 202 33 14 3 6 35 463 September 103 104 27 8 8 25 9 284 October 114 63 24 7 9 19 16 252 November 84 70 25 6 10 20 19 234 December 143 96 41 10 6 19 21 336 Totals 1448 1174 343 107 109 306 217 3704 62 The two following tables shew the number of animals slaughtered at the Public Slaughter Houses, Pitlake, during the year 1918, and a summary of the totals for the last ten years 1918 II. Slaughterhouses. Cattle. Sheep. Pigs Calves. Total. Public 1908 1013 205 72 3198 Private 309 1202 1433 7031 9975 Totals 2217 2215 1638 7103 13173* *Included in the above figures 20 beasts slaughtered for Central Live Stock Fund and 1,338 beasts War Department Ministry of Food, Total 1,358. 4,549 Calves slaughtered from August 26th to December 31st, 1918 dispatched to the Wholesale Meat Association, Smithfield, excepting a few disposed of locally. Summary for ten years,1909 to 1918 III. Year. Cattle, Sheep. Pigs. Calves. Total. 1909 379 7256 20106 2480 30421 1910 743 10541 16854 2990 31128 1911 635 9724 19371 3961 33691 1912 727 7874 19765 4017 32383 1913 458 4863 15282 3003 23606 1914 589 4171 13281 2667 20708 1915 1000 5339 22406 2539 31284 1916 1261 8333 26181 2661 38435 1917 2044 9904 18152 4604 34704 1918 2217 2215 1638 7103 13173 Totals 10253 70219 173036 36025 289533 63 Summary of Car casts in which Tuberculosis was found in the course of inspection and how such carcases were disposed of:- 1918. VI. Animals affected. Carcase and all internal organs destroyed. Part of carcase and all organs destroyed. All or part of organs destroyed. Total. Cattle 25 5 33 63 Pigs 4 21 10 35 Total 29 26 43 98 DAIRIES, COWSHEDS & MILK SHOPS ORDER. Cowkeepers on Register (1917) 23 „ added (1918) 4 Cowsheds on Register (1917) 34 ,, added (1918) 4 Number of Cows provided for 520 Approximate number of Cows (1918) 267 Dairymen and Milk Purveyors on Register 261 ,, ,, added (1918) I Number of Premises 312 There were no removals from the Register during the year, as in many cases business has been temporarily suspended in the case of several cowkeepers, and a considerable number of milk purveyors, and may be resumed at any time. 64 FOOD AND DRUGS ACTS. Table VIII. gives the number of samples taken by the Inspector under the Acts during the year, the results of the analyses and the action taken thereon. PROSECUTIONS, 1918. Date of Purchase. Defendant. Charge. Result. Penalty. Costs. 1918 £ s d. £ s. d. Jan. 4 H. E. H. Selling Milk adulterated with 7 per Cent. of added water Convicted 5 0 0 12 6 „ 4 „ Selling Milk adulterated with 8 per Cent. of added water „ 5 0 0 12 6 „ 31 C. B. Selling Milk adulterated with 28 per Cent. of added water and 15 per Cent. deficient of its fat „ 10 0 0 5 15 6 „ 31 T. F. & Co. Selling Milk 15 per Cent. deficient of its fat „ - 3 3 0 ,, 31 W & s. Selling Milk adulterated with 22 per Cent. of added water and 5 per Cent. deficient of its fat „ 10 0 0 2 12 6 Feb. 26 C. B. Selling Milk adulterated with 26 per Cent. of added water „ 40 0 0 10 6 Mar. 22 G. C. C. Selling Milk 31 per Cent. deficient of its fat No Conviction Warranty Proved May 10 A.J. Selling Milk adulterated with 6 per Cent. of added water Convicted 10 0 0 1 1 0 July 21 S. S. & G. D. Co. Selling Milk adulterated with 9 per Cent. of added water „ 10 0 0 2 13 6 Sept. 20 T.J. Selling Milk 26 per Cent. deficient of its fat „ 5 0 0 2 12 6 Nov. 6 E. F. Selling Milk adulterated with 15 per Cent. of added water „ 3 3 0 1 16 6 Nov. 6 A. J. Selling Milk adulterated with 6 per Cent. of added water „ 20 0 0 2 12 6 „ 24 A. G. Selling Milk adulterated with l8 per Cent. of added water „ 10 0 0 1 11 6 „ 24 G. W. B. Selling Milk adulterated with 7 per Cent. of added water „ 5 0 0 1 11 6 Dec. 17 S. . S& G. D. Co. Selling Milk adulterated with 4 per Cent. ot added water No Conviction - - „ 17 „ Selling Milk adulterated with 3 per Cent. of added water „ - - „ 017 „ Selling Milk adulterated with 4 4 per Cent. of added water Convicted *10 0 0 5 0 0 Total 143 3 0 32 10 6 *This penalty was inflicted after taking into consideration the two preceding cases. 65 During the year 403 samples of milk (401 new and 2 skimmed 0f separated) were taken. In 54 cases the samples were below the standard suggested by the Board of Agriculture. Proceedings were instituted in respect of 1 7 of these samples, and fines and costs were imposed on the vendors to the extent of £175 13s. 6d. The other 37 samples were only slightly below the standard suggested by the Board of Agriculture. In 16 cases the vendors were written to asking for an explanation, and in all cases subsequent samples were taken No samples of cream were submitted for analysis during the year. One sample of butter was taken during the year. This proved to be genuine. Ten other samples were taken, and they proved genuine. MILK AND CREAM REGULATIONS, 1912. The following is a copy of the Report sent to the Local Government Board under the above-mentioned Regulations, viz.:- REPORT OF ADMINISTRATION IN CONNECTION WITH THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Report for the Year ended 31ST December, 1918. 1. Milk; and Cream not sold as Preserved Cream. (a) Number of samples examined for the presence of a preservative. (b) Number in which a preservative was reported to be present. MILK 403 Nii. CREAM Nil. No samples taken during the year 1918. 66 2. Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the label as to preservatives were correct. (i) Correct statements made Nil. (ii) Statements incorrect Nil. Total Nil. (b) Determinations made of milk fat in cream sold as preserved cream. (i) Above 35 per cent Nil. (ii) Below 35 per cent Nil. Total Nil. (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Art. v. (1) and the proviso in Art. v. (2) of the Regulations have not been observed. Nil. (d) Particulars of each case in which the Regulations have not been complied with, and action taken. Nil. 3. Thicketiing substances. Any evidence of their addition to cream or to preserved cream. Action taken where found Nil. 4 Other observations, if any. Nil 67 TABLE VIII.-Food and Drugs Acts. Total Number of Samples taken during the year 1918. Sample of Total Samples. Genuine. Not Genuine. Prosecutions. Convictions. Cautions Milk 401 347 54 17 13 16 „ Separated or Skimmed 2 2 - - - - Margarine 1 1 - - - - Butter 1 1 - - - - Drs'' Prescriptions 2 - - - - - Self-raising Flour 1 1 - - - - Dripping 1 1 - - - - Bacon 1 1 - - - - Sausages 1 1 - - - - Sausage Meat 1 1 - - - - Soup Powder 1 1 - - - Condensed Milk 1 1 - - - - Totals 414 360 54 17 13 16 Country Milk in course of delivery at railway station 55 On Milk rounds Sunday mornings 97 ,, ,, Weekdays 251 Total 403 68 TABLE IX.—Food and Drugs Acts. Particulars of Samples taken during the sixteen years 1903 1918 inclusive:- Year. Number of Samples taken. Number Genuine. •Number Adulterated. Percentage of Adulterated. Prosecutions. Total amount of Fines and Costs imposed. £ s. d. 1903 294 268 26 8.8 4 5 16 0 1904 354 317 37 10.5 6 30 15 0 1905 356 320 36 10 .0 8 36 13 6 1906 400 351 49 12.3 6 15 12 0 1907 448 413 35 7.8 13 86 8 0 1908 438 384 54 12.0 19 40 12 6 1909 455 424 31 6.8 7 55 13 0 1910 480 431 49 10.2 13 33 3 0 1911 501 436 65 12.9 6 18 8 6 1912 525 473 52 9.9 13 35 10 0 1913 535 497 38 7.1 4 37 14 4 1914 526 464 62 11 .8 14 42 13 6 1915 504 427 77 15.2 18 105 11 0 1916 388 297 41 12.1 22 85 3 6 1917 356 305 51 14.3 16 227 11 0 1918 414 360 54 13.0 17 175 13 6 * The term adulterated includes samples found to be not up to standard. 69 TABLE X METEOROLOGICAL RECORD-YEAR 1918. Rain Gauge 5-in. in diameter, 1-ft. above ground, 146-ft. above sea level. Temperature taken in the shade ot a Stevenson's Screen, 4-ft. from the ground. The Ground Thermometer is suspended in an iron tube, the bulb being 4-ft. below the level of the ground. Months 1915. Temperature of Air during the Month. Mean Temperature of Air. Difference from average 50 years at Greenwich. Mean Temperature of Ground at 4-ft. Mean Temperature of the Dew Point. Mean Tensional Difference between Ground and Dew Point Rainfall. Highest. Lowest. Mean of No. of Days on which Rain fell. Amount in Inches. Difference from average 90 years at Greenwich All Highest. All Lowest. January 56° 17° 44° 2 33° .5 38°.8 + 0°.3 40°.8 36° .4 in — .040 16 in. 3.18 in. + 1.39 February 68° 22° 49°-6 38°.2 43° .9 + 4°.4 42° .6 40° .8 — .018 13 0 .98 -58 March 70° 26° 53° 5 35° .2 44° .3 + 2° .6 42°.8 39° .9 — .029 9 0 .99 — .52 April 65° 31° 52° 5 38° .4 45° .4 - l°.8 44°.6 40° .7 — .041 21 4 .17 + 2 .57 May 37° 40" 69° 9 47°.7 58°.8 + 5°.7 50°.1 49° .9 — .002 10 2 .00 + .13 June 81° 38° 68° 6 47°.2 57° .9 - l°.5 54°.5 48° .4 — .085 9 0 .83 — 1 .20 July 82° 46° 72° 6 53°.0 62°.8 + 0° .3 56° .9 54° .6 — .037 18 5.87 + 3.46 August 88° 47° 72° 5 53° .9 63° .2 + l°.6 58° .4 55°.8 — .043 12 0.92 1.46 September 73° 38° 65° 0 50° .9 57°.9 † 0°.7 56° .6 51°.7 — .075 22 4 .16 + 1.96 Octobcr 65° 32° 56° 4 43° .6 50° .0 0° .0 52°.2 46° .7 — .072 18 1 .61 -1.12 November 59° 29° 49° 6 36° .4 43° .0 - 0° 2 48.2 39° .9 — .092 19 2 .49 + 2.20 December 60° 28° 49° 7 41° .4 45° .5 + 5°.8 47° .0 43°.0 — 0.46 23 2 .58 + .64 Means and Totals for the Year. 88° Aug. 22 87° May 21 17° on Jan. 9th 58° 7 43° .3 51°.0 + 1° .5 49° .6 45° .6 —0 048 190 29 .78 + 5.50 The Rainfall for the Year was 3.68 inches above the average of 50 years at Croydon, and the number of days on which it rained was 190 or 27 days above the average. GEO. CORDKN, F.R. Met. Soc., Croydon. 70 TABLE XI. Prevailing direction of the Wind at Croydon in1918. Number of Days each Month. 1918. N.E. E. S.E. S S.W. W. N.W. N. January 3 1 0 13 10 0 3 1 February 1 2 4 7 7 6 0 1 March 6 6 0 6 5 3 1 4 April 6 1 2 0 5 2 1 13 May 7 7 2 3 4 3 2 3 June 4 2 1 3 5 8 7 0 July 1 0 2 9 8 5 4 2 August 0 1 6 7 11 1 2 September 0 3 1 3 11 10 2 0 October 1 3 0 7 9 5 2 4 November 4 3 3 5 10 4 1 0 December 0 0 2 10 11 6 1 1 Totals 33 31 18 72 92 63 25 31 64 90 1S5 56 The 10 years average 1867 to 1876, as embodied in Paper on 10 years Meteorology at Croydon, read to the Croydon Microscopical and Natural History Club, was :— N.E. and E. Winds, yearly average 93.7 S.E. and S. „ „ 63.7 S.W. and W. „ ,, 131. 9 N.W. and W. ,, ,, „ 73.8 GEO. CORDEN, F.R. Met, Soc., Croydon. TABLE XII. CROYDON BOROUGH HOSPITAL. Detailed Analysis of Expenditure under all Heads for the Year ending March 31st, 1919, and ten preceding Years. Year ending March. Average No. of Patients. Provisions. Alcohol. Surgery and Dispensary. Domestic, including Coal and Gas. Establishment and Miscellaneous Charges. Salaries and Wages. Total. Average Cost per Bed occupied. Total. Average Cost per Bed occupied. Tout. Average Cost per Bed occupied. Total. _ Average Cost per Bed occupied. Establishment Charges and Repa rs. Miscellaneous Charges. Total. Average Cost per Bed occupied. Medical Dispensing, Nursing & other. Average Cost per Bed occupied. Total Ordinary Expenditure. Total Average j Cost per Bed occupied. Sinking Fund and Interest. Total Average Cost per Bed occupied including Sinking Fund & Interest. £ s. d. £ s. d. £ s. d. s. d. £ s. d. £ s. d £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d £ s. d £ s. d. £ s. d. 1909 133 2586 11 8 19 9 0 13 5 10 2 0 501 10 8 3 15 4 1697 9 12 15 3 1260 10 11 128 18 10 1389 9 9 10 9 0 2361 9 5 17 15 1 8549 16 8 64 8 5 2101 10 9 80 1 8 1910 127 2523 3 7 19 17 6 6 7 4 1 0 430 13 11 3 7 9 1764 9 10 13 17 10 1363 17 10 460 9 4 1824 7 2 14 7 3 2220 4 17 9 7 8769 6 1 69 0 11 2101 10 9 85 11 11 1911 134 2696 1 8 20 2 5 3 8 9 0 6 487 19 3 3 12 10 1703 9 12 14 3 1179 17 10 387 16 5 1567 14 3 11 14 0 2364 7 10 17 12 11 8823 1 5 65 16 11 2206 10 9 82 6 3 1912 134 2886 19 10 21 10 11 10 17 0 1 7 618 10 10 4 12 4 2062 18 15 7 10 2250 5 2 385 9 1 2635 14 3 19 13 4 2527 15 4 18 17 4 10742 15 6 80 3 4 2721 17 3 100 9 7 1913 134 3047 0 5 22 14 10 10 19 10 1 7 729 8 10 5 8 10 2215 6 11 16 10 8 1959 0 10 467 17 1 2426 17 11 18 2 3 2726 0 4 20 6 10 11155 14 3 83 5 0 2774 12 0 103 19 1 1914 143 3279 12 2 22 18 8 14 12 0 2 1 574 19 8 4 0 4 2467 3 4 17 5 1 2406 1 5 306 4 5 2712 5 10 18 19 4 2970 8 9 20 15 5 12019 1 9 84 11 C 3058 16 9 105 8 9 1915 131 3455 18 1 26 7 7 17 15 9 2 8 410 5 3 2 8 2530 5 8 19 6 4 2433 0 9 558 9 2 2991 9 11 22 16 8 2984 17 9 22 15 9 12390 12 94 11 £ 3095 5 0 118 4 3 1916 96 3628 19 3 37 16 1 23 7 4 4 10 439 4 4 11 6 2566 10 8 126 14 8 1709 12 8 498 11 5 2208 4 1 23 0 1 2937 19 30 12 I 11804 5 122 19 3 3150 3 8 155 16 9 1917 93 3393 18 2 36 9 10 12 11 6 2 8 451 11 11 4 17 2 2713 3 4 29 3 6 1368 1 2 742 7 11 2110 9 1 22 13 10 2751 17 11 29 11 10 11433 11 11 122 18 10 3184 16 3 157 3 9 1918 84 3735 0 1 44 9 3 26 4 8 6 3 556 1 4 6 12 5 3303 3 8 39 6 6 1477 15 9 701 3 8 2238 19 £ 26 13 1 2759 0 32 16 11 12618 9 6 150 4 5 3177 7 5 188 0 11 1919 92 4261 15 6 46 6 6 33 10 0 6 7 745 19 0 8 2 2 3977 4 7 43 4 7 1489 6 1 723 13 0 2212 19 1 24 1 1 3080 6 11 33 9 8 14308 15 1 155 10 3167 12 6 189 19 2 £ s. d. Receipts, 1918-19, from various sources 3488 1 8 71 TUBERCULOSIS WORK. General Survey of Cases dealt with through the Dispensary and work done in connection with them. TABLE T. Table showing origin of Cases seen at the Dispensary for the first time in 1918. Cause of person attending Dispensary. Insured. Uninsured* Grand Total. Men. Women Child'n Total. MeD. Women Child'n Total. (1) Referred, by local doctoy s or hospital for diagnosis, treatment or advice† 155 76 ... 231 27 72 91 190 421 (2) Ditto ditto by School Medical Officers & from Infant Clinics. ... ... ... ... ... 4 58 62 62 (3) Ditto ditto from other, chiefly charitable, sources‡ 13 2 ... 15 8 33 51 92 107 (4) Seen as " Contacts" 9 9 ... 18 1 21 94 116 131 (5) Army Medical Boards 64 ... ... 64 24 ... ... 24 88 241 87 ... 241 60 130 294 484 812 * This includes dependents of insured persons TABLE T. 2. Table showing the way in which new cases were dealt with in 1918. Insured. Uninsured. Grand Total Men. Women Child'n Total. Men. Women Child'n Total. (1) Diagnosed as tuberculous: (a) Treated through the Dispensary 143 50 ... 193 24 49 27 100 293 (b) Treated elsewhere 36 10 ... 46 21 18 28 67 113 (2) Diag?tcsis not settledKept under observation 30 1 ... 31 6 12 149 167 198 (3) Diagnosed not tuberculous 32 26 ... 58 9 51 90 150 208 241 87 ... 328 60 130 294 484 812 72 TABLE T. 3. Table showing details of Medical Examinations made by the Medical Officer to the Tuberculosis Dispensary, 1918. Period. 1918. Total Medical Examinations made. At the Dispensary. Patients Houses. Grand Total. New Cases Examined. Insured. NonInsured. Total. Insured. NonInsured. Total. Insured. NonInsured. Total. Jan. 1st to March 31st 466 1675 2141 21 32 53 2194 62 117 179 April 1st to June 30th 590 1751 2341 22 32 54 2395 96 137 233 July 1st to Sept. 30th 628 1219 1847 18 27 45 1892 103 104 207 Oct.1st to Dec. 31st 481 1399 1880 8 25 33 1913 39 92 131 Totals 2165 6044 8209 69 116 185 8394 300 450 750 Note. In addition to the medical examinations shown in this table the Medical Officer also visited and examined the tuberculous patients at the Borough Hospital twice weekly throughout the year. [The average number of examinations made per day (including visits) was 29 3, and the average number of new cases seen per day was 2.6. 73 The proportion of known tuberculosis in the Borough which is dealt with through the Dispensary continues to be satisfactorily high, as is shown by the following estimate :— (1) Total Primary Notification, 1918 457 (2) Total new cases seen at Dispensary and diagnosed as tuberculous, 1918 406 Practically all the cases in (2) may be reckoned as included in (1). Therefore approximately 89 per cent. of the cases notified in the Borough in 1918 were seen by the Medical Officer to the Tuberculosis Dispensary. In 1918 293 new cases were treated through, as well as being seen, at the Dispensary. SANATORIUM AND HOSPITAL TREATMENT: TABLE T. 4. SUMMARY OF CASES TREATED AT SANATORIA, 1918. M. W. C. T 1. (A) Persons in Sanatoria on Jan. 1st, 1918 25 19 9 53 (B) Persons who were admitted to and discharged from Sanatoria during 1918 80 46 6 132 (C) Persons who were admitted to and died at Sanatoria daring 1918 - 1 - 1 (D) Persons in Sanatoria on December 31st, 1918 27 18 9 54 Note.— One woman and two children appear in (A) and (D). (i.) The total individuals receiving treatment in Sanatoria during 1918 is therefore [A + B + C + 1)—3]. Men 132 239 Women 83 Children 24 (ii ) The total individuals sent to Sanatoria in 1918 is [B + C + D—3]. Men 107 Women 64 184 Children13 Remarks. (i.) 114 men and 51 women were "insured persons." Of the insured men 61 were ex-service men. (ii.) 11 of the children were boys and 13 were girls. 74 TABLE T. 5. SUMMARY OF CASES TREATED AT THE BOROUGH HOSPITAL, 1918. M W C. T l. (A) Persons at the Borough Hospital on Jan. 1st, 1918 7 6 - 13 (B) Persons who were admitted to arid discharged from the Borough Hospital during 1918 14 - - 14 (C Persons who were admitted to and died at the Borough Hospital during 1918 6 2 - 8 (D) Persons at the Borough Hospital on Dec. 31st, 1918 Note.— Three women appear in both (A) and (D). 8 5 - 13 Total individuals receiving treatment at the Borough Hospital in 1918 is A+B + C.+ D —3]: 351 Women 13 48 and total individuals admitted to the Borough Hospital in 1918 is B + C + D — 3: Men 28 Women 7 35 Remarks: (i.) 31 men and 8 women were "insured persons." Of the insured men 14 were ex-service men. (ii.) 3 men in Class A died at the Borough Hospital during 1918, and 2 women. 75 WORK OF THE BOROUGH HOSPITAL. The total nominal accommodation at the Borough Hospital is 170 beds. The following table shows the highest and lowest number of beds occupied on any one night during each month of the year 1918. TABLE H. 1. Month. Beds Occupied. Month. Beds Occupied. Highest. Lowest. Highest. Lowest. January 121 101 July 105 72 February 131 103 August 75 44 March 108 88 September 68 41 April 124 109 October 102 62 May 119 94 November 106 94 June 111 97 December 106 85 During 1918 the average daily number 0f cases under treatment amounted to 93.8 as compared with 75.5 of the previous year. The following table gives the total number admitted from the Borough and other Districts during the year 1918. TABLE H. II. Districts. Remaining at end of 1917. Admitted during 1918. Discharged during 1918. Died during 1918. Remaining at end of 1918. Crystal Palace (Royal Naval Division) 6 28 26 6 2 Penge Urban D.C., nonpauper cases 6 20 31 0 1 The Borough of Croydon 95 657 607 53 92 Total 107 711 664 59 95 76 The following table shows the comparative admissions during 1918 and previous years. TABLE H. III. Cases admitted during 1908. Cases admitted during 1909. Cases admitted during 1910. Cages admitted during 1911. Cases admitted during 1912. Cases admitted during 1913. Cases admitted during 1914. Cases admitted | during 1915. Cases admitted during 1916. Case: admitted during 1917. Cases admitted during 1918. Scarlet Fever 497 608 624 381 365 417 653 413 295 201 386 (1) Diphtheria 354 292 222 430 600 402 211 200 313 207 179 (2) Cerebro Sp. Meningitis - - - - - - - 67 24 38 23 (3) Pulmonary Phthis's - - - - - 48 56 61 44 40 37 (4) Enteric Fever 59 11 15 18 16 28 15 13 10 6 13(5) Puerperal Fever - - - - - 1 2 4 2 2 1 (6) Morbilli - - - - - - - 9 17 25 17(7) Rubella - - - - - - - - - 12 2 (8) M umps - - - - - - - - - 20 6 (9) Erysipelas - - - - - - - - - 18 10 (10) Other diseases 31 45 47 29 25 6 10 11 33 10 37(11) Total 941 956 908 858 1006 902 947 778 738 579 711 (1) Includes 1 case of Diphtheria. ,, 1 case of Lues. ,, 1 case of Pleurisy. ,, 1 case of Scabies ,, 1 case of Rubella. „ 2 case of Morbilli. ,, 1 case of Mumps. ,, 1 case of Varicella. ,, 1 case of No disease. (2) ,, 1 case of Varicella. ,, 7 cases of No disease. ,, 3 cases of Sore Throat. ,, 3 cases of Scarlet Fever. ,, 1 case of Ulcerated Throat. ,, 1 case of Quinsy. (3) ,, 1 case of Pneumonia. ,, 1 case of Tubercular Meningitis. ,, 1 case of No disease. (4) ,, 1 case of Tumour of Lungs. ,, 2 cases of Malignant disease of Lungs. (5) ,, 1 case of Gastritis. (7) ,, 1 case of Rubella. ,, 1 case of Tuberculosis. (8) ,, 1 case of Scarlet Fever (9) ,, 1 case of Parotitis, (10) ,, 1 case of Pneumonia, (11) ,, 1 case of Influenza, 77 The following table gives the number of patients admitted for each disease, an analysis of the admissions, and the number discharged or who have died in the year 1918:— TABLE H. iv. Disease. Remaining at end of 1917. Admitted during 1918. Discharged during 1918. Died during 1918. Remaining at end of 1918. Scarlet Fever 42 376 347 8 63 Admitted to Hospital as Scarlet Fever and found to be other disease 2 8 10 ... ... Admitted to Hospital for observation (including contact) 1 2 3 ... ... Diphtheria 38 158 162 21 13 Admitted as Diphtheria and found to be other disease 5 16 21 ... ... Admitted for observation (including contact) 3 5 8 ... ... Cerebro-Spinal Meningitis 1 20 10 8 3 Admitted as Cerebro-Spinal Meningitis and found to be other disease ... 2 ... 2 ... Admitted for observation (including contact) ... 1 1 ... ... Enteric Fever ... 11 10 1 ... Admitted for observation (including contact) ... 1 1 ... ... Admitted as Enteric and found to be other disease ... 1 1 ... ... Pulmonary Tuberculosis 11 34 20 12 13 Admitted for Pulmonary Tuberculosis and found to be other disease ... 3 2 1 ... Admitted for observation (including contact) 2 ... 2 ... ... Puerperal Fever ... 1 1 ... ... Admitted as Puerperal Fever and found to be other disease ... ... ... ... ... Morbilli ... 15 15 ... ... Admitted as Morbilli and found to be other disease ... 2 1 1 ... Rubella 1 1 2 ... ... Admitted as Rubella and found to be other disease ... 1 1 ... ... Erysipelas ... 9 8 ... 1 Admitted as Erysipelas and found to other disease ... 1 ... 1 ... Mumps ... 5 5 ... ... Admitted as mumps and found to be other disease. ... 1 1 ... ... Other Diseases 1 37 33 3 2 Totals 107 711 665 58 95 78 TABLE H v. The following table gives the fatality for each disease :— 1911. 1912. 1913. 1914. 1915. 1916. 1917. 1918. Scarlet Fever 0.7 1.1 .8 .7 .9 1.8 1.0 2. 1 Diphtheria 8.3 3.6 3.2 6.4 4.02 4.65 4.1 13.2 Enteric Fever 11.1 25.0 19.2 20.0 33.3 100.0 0.0 9.0 Cerebro Sp. Fever - - - - 54.0 13.0 37.9 40.0 Pulmonary Tuber — — 12.5 12.6 37.2 40.0 48.6 35.3 Puerperal Fever - - - - 60.0 100.0 0.0 0.0 Morbilli - - - - 11.1 0.0 4.3 0.0 Mumps - - - - - - 0.0 0.0 Erysipelas - - - - - - 6.5 0.0 Other Diseases - - - - - - 11.1 8.0 All Cases 5.0 3.2 2.9 3.1 .89 7.2 7.0 8.1 Under other diseases are included :— Morbus Cordis Organus 1 Result. Discharged. Ophthalmic Neonatoram 6 4 „ (1) died. (1) remains. Tonsillitis 2 2 Discharged. Varicella 5 5 „ Influenza 10 10 „ Oedema and Debility 1 1 „ Burn (foot) 1 1 „ Laryngitis 1 1 „ Typhoid 1 1 died. Bronchitis 1 1 Discharged. Varicose Veins 1 1 „ Nil 4 4 „ Pertussis 1 1 „ Abscess 1 1 „ Suckling 1 1 remains. Notified as Diphtheria or for observation for Diphtheria— Diphtheria 2 ... ... Result. Discharged. Diphtheria & Varicella 2 ... ... „ Sore Throat 3 ... ... „ Ulcerated Throat 1 ... ... „ Quinsy 1 ... ... „ Scarlet Fever 3 ... ... „ No disease observed 9 ... ... „ 79 Notified as Scarlet Fever or for observation for Scarlet Fever— Scarlet Fever 2 ... ... Discharged. Varicella 1 ... ... „ Diphtheria 2 ... ... „ Mumps 1 ... ... „ Morbilli 1 ... ... „ Lues 1 ... ... „ Rubella 1 ... ... „ Rheumatism 1 ... ... „ Notified as Cerebro-Spinal Meningitis or for observation for C.S.M.— Tubercular Meningitis 1 Died. Pneumonia 1 ,, No disease 1 Discharged. Notified as Pulmonary Tuberculosis or for observation for Pulmonary Tuberculosis— Tumour of Lungs 1 Died. Disease „ „ 2 Discharged. Notified as Enteric or for observation for Enteric— Gastritis 2 Discharged. Notified as Morbilli or for observation for Morbilli— Tuberculosis 1 Died. Rubella 1 Discharged. Notified as Rubella or for observation for Rubella— Scarlet Fever 1 Discharged. Notified as Erysipelas or for observation for Erysipelas— Pneumonia 1 Died. Notified as Mumps or for observation for Mumps— Parotitis 1 Discharged. TABLE H vi Illnesses amongst the Staff— Sore Throat 1 ... ... Discharged. Aortic Disease 1 ... ... „ Morbilli 1 ... ... „ Diphtheria 4 ... ... „ Abcess 1 ... ... „ Tonsillitis 2 ... ... „ Burns 1 ... ... „ Varicose Veins 1 ... ... „ Laryngitis 1 ... ... „ Bronchiits 1 ... ... „ Oedema and Debility 1 ... ... „ Influenza 10 ... ... „ Scarlet Fever 1 ... ... „ 80 BOROUGH HOSPITAL LABORATORY REPORT, 1918. Diphtheria. Swabs. + — Total. Doctors. 60 ... 873 ... 933 M.O.H. 8 ... 591 ... 599 68 1.464 1,532 Ward Swabs. 1,046. Miscellaneous Examinations. + - Totals. B. Anthrax 0 ... 1 ... 1 Urine for B. Typhoid 0 ... 15 ... 15 Gonococci 1 ... 2 ... 3 Ringworm 1 ... 3 ... 4 1 Swab for organisms present. 2 Cphthalmic Swabs for organisms present. 1 Pleuretic Fluid „ „ ,, 1 Blood Film. Blood Serum. 326 dozen tubes at 3s. 6d. per doz.=£57 is. The same economy was practised this year as in the previous year, i,e., both nose and throat swabs of Hospital patients were inoculated on the same tube of media. Special Media. 500" McConkeys bile salt Agar. 950" Maltose Litmus Media. 750" Glucose ,, „ 1,000" Agar Agar. 1,000" Peptone Broth. Outfits. Diphtheria. Tubercle. Enteric. C.S.M. Total. 1,807 606 29 22 2,464 81 CEREBRO-SPINAL MENINGITIS. Results of Examinations for Cerebro-Spinal Meningitis. 1918. Examinations for Borough. Examinations for Hospital. Total. All Examinations. All Examinations. All Examinations. + — Total + — Total + — Total January — — — 6 1 7 6 1 7 February — — — 5 — 5 5 — 5 March 1 6 7 2 4 6 3 10 13 April — — — — 1 1 — 1 1 May — — — — 13 13 — 13 13 June — 6 6 — 5 5 — 11 11 July — — — — — — — — — August — — — — — — — — — September — 4 4 — — — — 4 4 October — — — 2 2 4 2 2 4 November — 6 6 3 8 11 3 14 17 December 1 1 2 2 1 3 3 2 5 First Quarter 1 6 7 13 5 18 14 11 25 Second ,, — 6 6 — 19 19 — 25 25 Third ,, — 4 4 — — — — 4 4 Fourth ,, 1 7 8 7 11 18 8 18 26 Total 2 23 25 20 35 55 22 58 80 82 TUBERCULOSIS. Results of Examinations for Tuberculosis. 1918. Examinations for Borough Examinations for Hospital. Total. All Examinations. All Examinations. All Examinations. + — Total + — Total + — Total January 8 42 50 1 3 4 9 45 54 February 7 25 32 1 — 1 8 25 33 March 10 24 34 2 4 6 12 28 40 April 5 32 37 3 3 6 8 35 43 May 12 26 38 2 — 2 14 26 40 June 9 33 42 — 1 1 9 34 43 July 7 59 66 4 2 6 11 61 72 August 6 16 22 — — — 6 16 22 September 4 19 23 1 4 5 5 23 28 October 2 15 17 — 2 2 2 17 19 November 6 10 16 1 2 3 7 12 19 December — 23 13 — 1 1 — 24 24 First Quarter 25 91 116 4 7 11 29 98 127 Second ,, 26 91 117 5 4 9 31 95 126 Third ,, 17 94 111 5 6 11 22 100 122 Fourth ,, 8 48 56 1 5 6 9 53 62 Total 76 324 400 15 22 37 91 346 437 83 ENTERIC (TYPHOID) FEVER. Results of Examinations for Diseases simulating Enteric fever. 1918. Examinations for Borough. Examinations for Hospital. Total. Agglutinative Reactions. Agglutinative Reactions. Agglutinative Reactions for all Purposes. + — Total + — Total + — Total January 1 — 1 — — — 1 — 1 February 1 2 3 — — — 1 2 3 March — 3 3 — — — — 3 3 April — 7 7 — — — — 7 7 May — 2 2 1 — 1 1 2 3 Tune — 8 8 — 1 1 — 9 9 July — 4 4 — 1 I — 5 5 August — 3 3 1 2 3 1 5 6 September 1 3 4 — — — 1 3 4 October — 1 1 — — — — 1 1 November — 3 3 — — — — 3 3 December — 1 1 — — — — 1 1 First Quarter — 5 7 — — — 2 5 7 Second ,, 2 17 17 1 1 2 1 18 19 Third „ 1 10 11 1 3 4 2 13 15 Fourth ,, — 5 5 — — — — 5 5 Total 3 37 40 2 4 6 s 41 46 84 Public Health Department, Town Hall, Croydon. 26th September, 1919. To the Education Committee. Ladies and Gentlemen, I beg to submit the report of the school medical services in Croydon for the year 1918. During the year the greatest endeavour has been made to maintain the school medical work at the highest possible level and although the volume of work done is of necessity somewhat less than would be in peace time the quality of the work has certainly been successfully maintained. I am especially pleased to record the successful working of the new clinic for the treatment of tonsils and adenoids. This clinic has thoroughly justified its establishment and forms a very important and valuable addition to out medical services. A new feature of the report also is the inclusion of the report of the Organiser of Physical Training as advised by the Board's Chief Medical Officer. I would take this opportunity of noting the exceedingly good results which Miss Appleton obtains at the Spinal Remedial Class and feel confident that the importance of the opportunities of physical training in schools cannot be too greatly emphasised as an important contribution to the physical and mental welfare of the children. At the latter end of the year the Education Committee authorised the doubling of the time of our Dental Surgeons : this it was not possible to give effect to during 1918, but their increased work will be recorded in the Annual Report for 1919. The incidence of influenza upon Croydon seriously affected the schools, but this is dealt with in the general report on the public health of the Borough. The report, although mainly tabular, is largely selfexplanatory and the opportunity of proper analysis of the school medical work afforded by the return of staff to the department in 1919 will enable a more adequate survey to be made by me in the report for that year. Yours faithfully, R. VEITCH CLARK, School Medical Officer and Medical Officer of Health for the County Borough of Croydon. 85 REPORT ON SCHOOL MEDICAL WORK. THE STAFF AND GENERAL 0RGANISATION OF THE WORK. The medical inspection staff consists, as in 1917, of two medicals —one lady and one gentleman—both of whom give only part time to the school work. SCHOOLS. No. of Schools and Accommodation. In 1918 there were in Croydon : 24 provided schools, including 57 departments. Five schools have been taken over for Military hospital purposes, and temporary premises have been rented, so that the accommodation is approximately as in 1917. 14 non-provided schools, including 27 departments. There has not been any change in the accommodati6n of non-provided schools. The total provision in 1918 in the borcugh for elementary school children amounted to 38 schools, with 84 departments. The number of children on the register on December 31st, 1918, was 25,200, as coriipared with 25,187 in 1917. School Buildings and Accommodation. War Hospitals. The school children displaced by the Military Authorities have been accommodated either in other schools for half-day work or in the buildings. The medical inspections have been carried out normally in every case, although in some schools the accommodation for the work is poor. Sanitary Work. The sanitary arrangements of all the schools have been regularly inspected during the year. They have been generally well kept. 86 TABLE E. I. TOTAL NUMBER OF CHILDREN EXAMINED (ROUTINE EXAMINATIONS) DURING 1918. Age. Number of Boys. Number of Girls. Total. 3.4 1 — 1 4.5 35 33 68 5.6 492 432 924 6.7 576 264 540 7.8 74 78 152 8.9 132 179 311 9.10 54 36 90 10.11 28 17 45 11.12 39 13 52 12.13 627 687 1314 13.14 198 134 332 14.15 19 7 26 15.16 2 5 7 Total all ages 1977 + 1885 = 3862 87 TABLE E. II. Showing total number of children inspected—routine inspections— during 1918, classified according to the schools attended, also number of parents and guardians attending medical inspections and the number of inspections held in each department throughout the year:— School. No. of Inspections held. No. of Children Inspected No. of Parents or Guardians present. Council Schools :— BOYS. GIRLS. Beulah Road School (All departments) 6 113 — 69 „ „ „ 6 — 75 56 Boston Road „ „ 5 71 — 34 „ „ „ 3 - 60 20 Brighton Road „ ,, 5 73 — 39 „ „ „ 6 — 93 48 Davidson Road „ „ 6 109 — 61 „ „ „ 5 — 73 47 Dering Place ,, „ 4 52 — 29 „ „ „ 4 — 38 28 Ecclesbourned Rd. „ „ 7 102 — 37 „ „ „ 6 — 88 48 Ingram Road „ ,, 6 89 — 45 „ „ „ 5 — 65 47 Mitcham Road „ „ 5 70 - 34 „ „ „ 6 - 98 47 Oval Road , ,, 4 43 — 31 „ „ „ 4 — 56 33 Portland Road „ „ 11 178 — 100 „ „ „ 10 — 148 104 Princess Road ,, „ 4 70 — 25 „ „ „ 5 — 82 28 South Norwood „ „ 10 185 — 103 „ „ „ 11 — 126 77 Stanford Road „ ,, 3 51 — 36 „ „ 4 - 63 46 Sydenham Road ,, ,, 6 82 — 40 „ „ „ 5 — 57 41 Tamworth Road 1 25 — 3 Tavistock Grove ,, ,, 2 34 - 14 „ „ „ 2 — 34 8 Upper Norwood „ „ 4 65 - 37 „ „ „ 3 — 34 23 Whitehorse Rd. ,, 1 16 — 14 „ „ 2 — 36 19 Winterbourne Rd. „ „ 5 75 - 62 „ „ 7 - 81 66 Woodside „ „ 11 166 — 111 „ „ „ 12 — 190 120 Elmwood Hall ,, „ 1 8 — 1 „ „ 1 — 13 7 Totals 214 1677 1510 1842 88 Council (Non-Provided) Schools: — All Saints' School (All Departments) i 8 — 3 „ „ „ i — 21 13 Christ Church , , „ i 27 - 15 „ „ „ 1 — l6 7 Parish Church ,, ,, 3 40 - 29 „ „ „ 6 - 106 68 St. Andrew's „ „ 4 59 — 21 „ „ „ 3 — 54 29 St. Joseph's ,, „ 1 18 — 9 „ „ „ 1 — — — St. Mark's „ „ 1 11 — 8 „ „ „ 3 — 43 25 St. Mary's „ „ 2 38 — 7 „ „ „ 2 — 32 16 St. Michael's „ „ 1 26 — 20 „ „ „ 1 — 26 14 Arch. Tenison's and St. Peter's „ „ 4 61 - 41 „ „ „ 4 — 61 47 Shirley ,, „ 1 12 — 4 „ „ „ 1 — 16 7 Totals (for Non-Provided) 42 300 375 383 Totals (for Provided) 214 1677 1510 1842 Totals (for Provided and NonProvided) 256 1977 885 2225 3862 In addition to these 3,862 children examined as Routine cases, 522 children were re-examined, Total 4511. and 127 children were specially examined. This does not include the special examinations done at the Treatment Centre nor at the Clinics. ATTENDANCE OF PARENTS OR GUARDIANS. The latter were present to the number of 2,225 for 3,862 children examined, i.e., 57 6 per cent., compared with 56 4 per cent, for the year 1917. DIRECTIONS TO PARENTS. In 2,141 instances written and verbal directions, while in 2,762 instances printed directions, were given to parents. 89 TABLE E III. Shewing at each age the number of boys and girls inspected at each school; also the number of boys and girls re-inspected and specially inspected at each school. Council Schools. Ages:— ROUTINE INSPECTIONS. Re| Inspected. Specially Inspected. Total.  3-4 4-5 i-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15-16 Beulah Road Boys ... 9 17 11 5 2 3 2 i 54 9 ... ... 5 4 122 ,, Girls ... 4 24 10 11 5 ... ... ... 17 4 ... ... 5 2 82 Boston Road Boys ... ... 21 ... ... 1 1 ... ... 28 18 2 ... 23 ... 94 ,, Girls ... ... 19 ... ... ... ... ... ... 39 2 ... ... 15 5 80 Brighton Road Boys ... 7 14 6 ... 5 5 ... ... 28 8 ... ... 19 3 95 ,, Girls ... 4 22 6 2 1 ... ... 1 57 ... ... ... 18 3 114 Davidson Road Boys 1 5 17 15 1 3 2 ... ... 61 4 ... ... 11 7 127 ,, Girls ... 2 9 14 ... 6 8 ... 1 30 3 ... ... 12 15 100 Dering Place Boys ... ... 2 6 ... ... ... ... ... 36 7 1 ... 10 6 68 ,, Girls ... ... 8 5 ... 5 3 ... ... 10 4 ... ... 11 7 56 Ecclesbourne Road Boys ... ... 13 14 2 1 ... ... 3 54 15 ... ... 10 4 116 ,, Girls ... ... 25 13 3 1 ... ... 1 32 10 ... ... 8 ... 96 Ingram Road Boys ... ... 31 15 4 1 ... ... 3 32 3 ... ... 10 1 100 ,, Girls ... 3 25 8 2 ... ... ... ... 23 4 ... ... 5 ... 70 Mitcham Road Boys ... 5 35 2 ... ... ... ... 1 19 8 ... ... 34 1 105 ,, Girls ... 6 28 14 ... ... ... ... ... 50 ... ... ... 11 ... 109 Oval Road Boys ... ... 15 20 5 3 ... ... ... ... ... ... ... 9 2 54 ,, Girls ... ... 11 15 6 2 5 ... ... 16 1 ... ... 11 5 72 Portland Road Boys ... ... 39 12 3 25 18 ... ... 67 14 ... ... 20 3 201 ,, Girls ... ... 33 11 5 45 5 1 1 +3 3 1 ... 13 2 163 Princess Road Boys ... ... 30 15 5 5 ... 6 ... 3 6 ... ... 9 2 81 „ Girls ... 2 10 7 3 4 3 2 3 10 38 ... ... 3 ... 85 South Norwood Boys ... 3 62 13 6 15 1 ... 12 70 3 ... ... 19 10 214 ,, Girls ... 3 45 21 3 13 1 ... 1 30 9 ... ... 9 1 136 Stanford Road Boys ... ... 17 9 2 ... ... ... ... 17 4 2 ... ... 3 54 ,, Girls ... ... 18 5 ... ... ... ... ... 30 7 3 8 ... 71 Sydenham Road Boys ... ... 34 22 2 ... ... ... ... 11 13 ... ... 18 ... 100 ,, Girls ... ... 26 29 1 1 ... ... ... ... ... ... ... 13 2 72 Tarn worth Road Boys ... ... ... ... ... ... ... ... ... 3 10 10 2 8 ... 33 Tavistock Grove Boys ... ... 3 7 ... ... ... ... ... 6 18 ... ... 5 ... 39 ,, Girls ... ... 1 6 ... ... ... ... ... 26 1 ... ... 6 ... 40 Upper Norwood Boys ... 6 17 10 5 1 3 2 2 7 12 ... ... 4 ... 69 „ Girls ... 7 11 11 5 ... ... ... ... ... ... ... ... 2 ... 36 Whitehorse Road Boys ... ... 1 12 2 1 ... ... ... ... ... ... ... ... ... 16 „ Girls ... ... 2 5 3 ... 1 ... ... 23 2 ... ... ... ... 36 Winterbourne Road Boys ... ... 29 15 5 ... ... ... ... 24 2 ... ... 8 1 84 ,, Girls ... ... 30 14 6 7 2 ... ... 19 3 ... ... 2 ... 83 Woodside Boys ... ... 38 9 12 30 5 ... ... 59 12 1 ... 28 3 197 ,, Girls ... ... 24 20 10 35 1 4 2 86 18 ... ... 3 14 207 Elmwood Hall Boys ... ... ... ... ... 5 ... 3 ... ... ... ... ... ... ... 8 „ Girls ... ... ... ... ... 5 ... 8 ... ... ... ... ... 4 ... 17 Totals (Council Schools) 1 66 806 430 119 228 67 28 32 1120 265 20 5 409 106 3702 90 TABLE E III. continued. Council (Non-Provided) Schools. Ages:— ROUTINE INSPECTIONS. ReInspected. Specially Inspected Total. 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 1314 14-15 15-16 All Saints' Boys ... ... ... ... ... 8 ... ... ... 1 ... ... ... ... ... 9 ,, Girls ... ... ... ... 2 12 ... 1 ... ... 3 1 1 ... ... 20 Christ Church Boys ... ... ... ... ... ... ... ... ... 19 8 ... ... ... ... 27 „ Girls ... ... ... ... ... ... ... ... ... 16 ... ... ... 12 ... 28 Parish Church Boys ... ... 17 19 4 ... ... ... ... ... ... ... ... ... 6 46 ,, Girls ... ... 14 18 8 7 1 ... 1 45 11 i ... 5 2 113 St. Andrew's Boys ... ... 7 5 2 6 9 3 ... 14 10 3 ... 15 1 75 ,, Girls ... ... 2 6 ... 9 1 1 ... 34 1 ... ... 5 6 65 St. Joseph's Boys ... ... ... ... ... 7 1 ... ... 3 7 ... ... ... ... 18 ,, Girls ... ... ... ... ... ... ... ... ... ... ... ... ... 5 1 6 St. Mark's Boys ... ... 9 2 ... ... ... ... ... ... ... ... ... 1 ... 12 ,, Girls ... 2 19 4 2 1 ... ... 2 3 9 1 ... 22 ... 65 St. Mary's Boys ... ... 7 8 ... 9 1 ... 9 3 1 ... ... 2 3 43 ,, Girls ... ... 5 5 1 10 1 ... ... 4 6 ... ... 11 1 44 St. Michael's Boys ... ... 7 11 5 2 ... ... ... ... ... ... ... ... ... 26 ,, Girls ... ... ... ... ... ... 1 ... ... 25 ... ... ... 8 ... 34 ArchbishopTenison's Boys ... ... 10 18 4 ... 5 12 7 4 1 ... ... 4 ... 65 „ ,, Girls ... ... 21 14 5 4 3 ... ... 13 ... ... ... 16 ... 77 Shirley Boys ... ... ... ... ... 2 ... ... ... 5 5 ... ... 2 ... 14 ,, Girls ... ... ... ... ... 6 ... ... ... 5 5 ... ... 5 1 22 Totals Non Prov. Schools ... 2 118 110 33 83 23 17 20 194 67 6 2 113 21 809 Grand Totals 1 68 924 540 152 311 90 45 52 1314 332 26 7 522 127 4511 TABLE E iv. Age. Number Examined. Parents or Guardians Present. Total Number in whom Defects found. Nature of Defects. Want of Cleanliness. Clothing. Vision. Teeth. Tonsils. Glands. Adenoids present. Ear Trouble- Mentally Defective. Mentally Subnormal. Heart Affections. Lung Trouble. Deformity and Spinal Dis. Communicable Disease. Sundry Defects If employed Written and Verbal directions to Parents. Printed directions Number Re- inspected Number Specially Inspected Heads. Body. Clothing. Defective Footgear. 6/9 6/12 and worse- External Eye Disease. trition. One to Four Decayed. More than Four Decayed Ear Disease. Deafness- Phthisis. Bronchitis Other Lung Disease. Spinal Curvature. Other Deformities. General Hygienic Advice. Medical or Surgical Treatment. Ver. Nits only. Dirty. Ver. Dirty. Defective. Dirty. + + + Palpable + BOYS' SCHOOLS. 3-4 1 1 ... ... ... ... ... ......... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4-5 35 28 21 ... 5 1 ... 1 ... 1 ... ... ... ... 1 11 6 1 ... ... 1 ... ... ... ... ... 3 ... 1 ... ... ... 1 I 16 7 25 ... ... 5-6 492 361 349 3 19 11 6 9 9 2 10 ... ... 5 10 184 125 37 24 1 38 23 2 3 ... 2 29 2 16 21 ... 8 5 42 ... 145 108 369 28 2 6-7 276 192 230 1 6 10 1 2 5 ... 6 ... ... 4 9 124 82 17 21 1 16 15 3 1 3 19 1 1 2 18 2 1 1 17 3 66 64 167 30 12 7-8 74 50 62 1 2 1 ... 2 ... 1 1 ... 1 ... 2 35 20 11 7 ... 5 3 ... ... ... ... 7 ... 1 5 2 1 ... 3 ... 29 21 54 30 10 8-9 132 72 114 ... 5 1 ... ... 1 1 1 26 7 5 4 63 42 8 5 ... 4 6 1 ... 1 ... 7 ... ... 4 ... 6 15 ... 56 48 117 24 8 9-10 54 29 42 ... ... ... ... ... ... ... ... 10 4 ... 7 23 11 5 3 ... 2 2 ... ... 1 ... 6 1 ... ... ... ... ... 8 ... 25 19 39 27 5 10-11 28 11 24 ... ... 2 ... 1 ... ... 1 ... ... ... ... 19 2 4 ... ... ... ... ... ... ... ... 4 ... 1 2 ... ... ... 2 ... 9 5 19 20 5 11-12 39 10 18 ... ... ... ... ... ... ... ... 4 1 ... ... 13 6 1 ... ... 1 1 ... ... ... ... 1 1 ... 3 ... 3 1 1 ... 8 7 34 16 7 12-13 617 256 448 2 12 3 1 6 6 4 9 57 71 5 10 307 53 32 20 3 18 15 2 4 ... 3 53 2 2 18 7 7 2 76 5 202 134 499 46 7 13-14 198 60 139 ... 4 1 2 1 3 ... 5 25 10 1 ... 89 17 7 4 ... 2 5 ... ... ... ... 4 ... ... 3 2 2 1 14 ... 49 33 139 46 4 14-15 19 5 12 ... ... ... ... ... ... ... ... ... 2 2 ... 5 3 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 16 6 ... 15-16 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... Total 1977 1075 1461 7 53 30 10 22 24 9 33 122 90 20 43 874 367 125 87 5 87 70 8 8 5 8 133 7 33 74 13 28 11 180 8 607 448 1480 274 60 Per. cent. 100. 54.3 73.9 0.3 2.6 1.5 0.5 1.1 1.2 0.4 1.6 6.1 4.8 1.0 2.1 44.2 18.5 6.3 4. 4 0.2 4.4 3.5 0.4 0.4 0.2 0.4 6.7 0.3 1.6 3. 7 0.6 1.4 0.5 9.1 0.4 30.7 22.6 74.8 13. 8 5.0 GIRLS' SCHOOLS. 4-5 33 24 20 1 6 ... ... 1 ... ... ... ... ... 1 ... 8 4 2 ... ... 1 1 ... ... ... 1 2 ... 2 2 ... ... 1 1 ... 14 11 23 ... ... 5-6 432 335 333 7 52 8 3 3 5 3 8 ... ... 8 13 171 99 37 24 ... 30 21 4 9 1 1 25 2 6 25 2 7 4 34 ... 123 93 294 11 14 6-7 264 182 215 2 31 ... 1 2 5 3 5 ... ... 4 13 108 84 21 13 ... 19 15 2 3 2 ... 14 1 2 15 1 3 1 26 1 76 63 154 32 6 7-8 78 54 69 1 11 1 1 ... 1 1 ... 2 1 2 6 34 27 2 3 ... 4 3 ... ... ... ... 3 ... 2 12 ... 1 ... 8 ... 22 19 55 40 4 8-9 179 120 144 ... 22 ... 1 ... 1 ... 1 41 27 ... 4 88 46 10 14 ... 9 11 ... 1 1 ... 10 ... 3 1 2 4 ... 23 ... 66 83 126 33 9 9-10 36 24 30 ... 4 1 1 1 ... ... ... 6 ... ... 3 22 8 1 2 ... 1 2 ... ... ... 5 ... 1 4 1 1 ... 4 ... 12 12 14 10 11 10-11 17 11 15 ... 7 ... 1 1 ... ... ... ... 2 ... ... 9 3 ... 2 ... 1 1 ... ... ... ... 2 ... 1 ... 1 ... ... 4 ... 4 1 17 29 5 11-12 13 5 11 ... 5 ... ... ... ... ... ... 4 2 ... ... 4 9 ... 2 ... ... 2 ... ... ... ... 1 1 1 1 1 1 1 2 ... 2 6 6 12 4 12-13 687 343 491 ... 94 3 6 5 10 2 17 25 93 3 27 307 57 46 37 1 19 18 4 4 ... 2 48 2 1 6 8 16 2 71 ... 234 176 491 47 9 13-14 134 47 96 ... 48 1 1 1 2 1 1 113 10 2 5 70 12 2 7 ... 3 1 ... 1 ... 1 9 ... ... 1 4 I ... 18 ... 22 37 95 21 5 14-5 7 3 6 ... 2 ... ... ... ... ... ... 2 2 ... ... 4 ... ... 1 ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... 3 3 6 7 ... 15-16 5 2 5 ... ... ... ... ... ... ... ... ... 1 ... ... 3 2 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 4 1 ... ... Total 1885 1150 1435 11 282 14 15 14 24 10 32 193 138 20 71 828 351 121 106 1 87 75 10 18 4 5 121 6 19 68 20 35 9 193 1 578 508 1282 248 67 Per cent. 100 61.0 76.1 0.5 14.9 0.7 0.79 0.7 1.2 0.5 1.7 10.2 7.3 1.0 3.7 43.9 18.6 6.4 5. 6 .05 4.6 3. 9 0.5 0.9 0.2 0.2 6.4 0.3 1.0 3.6 1. 0 1.8 0.4 10.2 ... 30.1 26.9 68. 0 13.1 3.5 TOTALS FOR BOYS AND GIRLS. 3862 2225 2896 18 335 44 25 36 48 19 65 315 234 40 114 1702 718 246 193 6 174 145 18 26 9 13 254 13 52 142 33 63 20 373 9 1185 956 2762 522 127 Per cent. 100 57. 6 75.0 0.4 8.7 1.1 0.6 0.9 1.2 0.4 1.6 8.1 6.0 1. 0 2.9 44 18.5 6.3 5.0 0. 1 4.5 3.7 0.4 0.6 0.2 0.3 6.5 0.3 1.3 3. 6 0. 8 1. 6 0.5 9.6 0.2 30.4 24.7 71.4 13.5 4. 2 91 GENERAL RESULTS OF ROUTINE MEDICAL INSPECTIONS. HEIGHTS AND WEIGHTS. The following table gives the averages of the children examined at three age periods in ten of the schools in Croydon :— Age. Average Height in Inches. Average Weight in Pounds. Boys. Girls. Boys. Girls. 5 41.7 40.9 39.7 37.4 8 48.4 39 52. 9 39.7 13 56. 3 56.7 72.8 77.2 VANT OF CLEANLINESS. Of 3,862 children examined, 18 had vermin in their heads. „ „ 335 „ nits „ „ „ „ 44 „ dirty heads apart from vermin Proportion of children with head vermin = 0.46 per cent ,, ,, ,, nit = 8 6 ,, Of 3,862 children examined, 25 had vermin of the body,=6.4 er cent., and 36 had dirty bodies. CLEANSING STATION. During the year 3 children have had to be cleansed on account verminous conditions of scalp or body or both. CLOTHING. Children with insufficient clothing = 48 = 1.2 per cent. „ dirty „ „ 19 „ 0.5 „ defective footgear „ 65 „ 1.6 , ALNUTRITION. 114 cases occurred = 2.9 per cent. Percentage for 1917 = 57 „ 92 EYE DISEASES. External eye diseases were present in 42 cases. 549 children had sub-normal vision. Reference to the ophthalmic specialist of eye cases his been systematically made when necessary, as in previous years. TONSILS AND ADENOIDS. Tonsils were markedly enlarged in 193 cases, and slightly in 246. 145 children were found to have adenoids. GLANDS. Glands were markedly enlarged in 174 cases and slightly in 6 All marked tubercular cases have as heretofore been referred to the Tuberculosis Dispensary for supervision and treatment. EAR DISEASE. This was noted in 18 cases, and 26 children suffered from deafness. DEFORMITIES. Curvature of the spine was found in 35 cases. Other deformities amounted to 63. AFFECTIONS OF THE HEART were tound in 254 cases. LUNG DISEASES. Affections of the lung were found in 207 cases. Of these : 52 children had bronchial catarrh, 142 ,, ,, other conditions of the lung, 13 ,, „ pulmonary tuberculosis. MENTAL CONDITIONS. 13 children were classified as mentally sub-normal, and 9 as mentally defective. 93 DENTAL DEFECTS. The prevalence of dental trouble is shown in the following table :— TABLE E. VII. BOYS. Age Group. 1—4 Decayed Teeth. Over 4 Decayed Teeth. Number with sound Teeth. Percent'ge with sound Teeth. 34 ... ... 1 100.0 4-5 11 6 18 51.4 5-6 184 125 183 37.2 6-7 124 82 70 25.3 7-8 35 20 19 25. 6 8-9 63 42 27 20.4 9-10 23 11 20 37.0 10-11 19 2 7 25.0 11-12 13 6 20 57.2 12-13 307 53 267 42.5 13-14 89 17 92 46.4 14-15 5 3 11 57.8 15-16 1 ... 1 50.0 Totals 874 367 736 37.2 GIRLS. 4-5 8 4 21 63. 3 5-6 171 99 162 37.5 6-7 108 84 72 27.2 7-8 34 27 17 21.7 8-9 88 46 45 25.1 9-10 22 8 6 16.6 10-11 9 3 5 29.4 11-12 4 9 ... ... 12-13 307 57 323 47.0 13-14 70 12 52 38.8 11-15 4 ... 3 42.8 15-16 3 1 ... ... Totals 828 351 706 37.4 94 MENTAL DEFICIENCY. SPECIAL EXAMINATION OF CHILDREN FOR MENTAL DEFICIENCY. No. of new cases examined 53 ,, new cases certified 36 „ cases found not to be mentally defective 14 „ cases under observation 3 „ cases returned to ordinary school — ,, cases transferred to Statutory Committee 10 „ cases examined for the second or third time 45 The number of children at the special school for mental defectives during 1918 is given below. GRANGE WOOD SPECIAL SCHOOL. On Register, 31st December, 1917 27 Admitted to class during 1918 27 Discharged and re-admitted to Council Schools, 1918 none Discharged for unsuitability 5 Left the Borough 5 On Register, December 31st, 1918 44 THE WORK OF THE OPHTHALMIC SURGEON. The number of refractions done in 1918 was 494; in 1917 the number was 743. The total number of children examined for eye trouble in 1918 was 531, as contrasted with 761 in 1917. The following is a summary of the cases seen in the eye clinic at the Town Hall:— Total No. of children examined 531 „ ,, „ attendances 1207 TABLE E. viii. Children refracted 479 Glasses were ordered for 303 Glasses not needing changing 58 Glasses needed changing 9 Glasses not advised at present 60 Glasses—normal vision 49 479 Glasses were needed and ordered as follows:— Myopia 77 Myopic Astigmatism 25 Hypermetropia 84 Hypermetropic Astigmatism 52 Mixed Astigmatism 4 Anisometropia 16 Strabismus, internus 38 „ externus 2 „ alternating 4 „ periodic 1 303 95 Of the glasses ordered 87 were urgently needed and were as follows:— Myopia 19 Myopic Astigmatism 4 Hypermetropia 6 Hypermetropic Astigmatism 12 Mixed Astigmatism 1 Strabismus, internus 38 „ externus 2 ,, alternating 4 „ periodic 1 87 Other diseases treated and advised, were:— Conjunctivitis 107 „ contagious 4 „ tubercular 1 Blepharitis 31 Dermoid 1* Phlyctenula 18 Ulcer of cornea 18 Nebula 13 Hordeolum 6 Tubercle 1 Nystagmus 8 Interstitial Keratitis 12 Keratitis 5† Ectropion R.E. 1 Pannus 1 Pseudo diplopia 1 Pigmentary retinitis 2 Kerato-iritis 1 Excision of post-wall of canaliculus 7 Limoma and congenital lens opacities 1‡ Optic neuritis 1 Paresis L. exter-rectus 1 Dacryo cystitis 2 Strabismus internus 2§ Epiphora 3 Coloboma R.E. 1 Cataract, L.E. 2 „ lamellar 1 Lenticular opacities 1 Nebula from ophthalmia neonatorum 1 Dark glasses ordered 1 Aphia 1 Eczema 2 Nictitatio 1 Retino choroiditis 1 Total 259 * Removed at the Croydon General Hospital. Hospital advised in 1 case. ‡ Institution advised § Hospital advised (operation in 1 case). 96 THE WORK OF THE SCHOOL DENTISTS. TABLE E. ix. Dental Inspection of Schools School. Children Examined. Teeth all sound. Teeth Defective. Percentage with Sound Teeth. Boys. Girls Total. Boys. Girls. Boys. Girls. Boys. Girls. St. Andrew's Old Town 11 12 23 3 2 8 10 27.2 16.6 St. Peter's 26 38 64 2 1 24 37 7.7 2.6 Parish Church 48 58 106 10 7 38 51 20.8 12.0 Davidson Road 15 17 32 1 2 14 15 6.6 11.7 Tavistock Grove 38 29 67 9 4 29 25 23.7 13.8 St. Mary's 7 20 27 ... 3 7 17 ... 15.0 Oval Road 8 22 30 2 3 6 19 25.0 13.6 Mitcham Road 49 36 85 5 7 44 29 10.2 19.4 Christ Church, Longley Rd. 17 8 25 2 ... 15 8 11.7 ... Woodside 45 60 105 5 10 40 50 11.1 16.6 South Norwood 58 39 97 7 4 51 35 12.0 10.2 Brighton Road 34 30 64 1 5 33 25 2.9 16.6 Dering Place 20 14 34 9 5 11 9 45.0 35.7 St. Andrew's 28 27 55 6 6 22 21 21.4 22.2 Boston Road 30 28 58 9 4 21 24 30.0 14.2 Christ Church, Boston Rd. 27 27 54 6 4 21 23 22.2 14.8 Whitehorse Road 51 49 100 7 6 44 43 13.7 12.2 St. Michael's 6 8 14 1 1 5 7 16.6 12.5 Stanford Road 20 17 37 4 2 16 15 20.0 11.7 Portland Road 52 55 107 8 9 44 46 15.3 16.3 St. Mark's 14 28 42 ... 6 14 22 ... 31.4 Ingram Road 18 12 30 2 1 16 11 11.1 8.3 Winterbourne Road 28 26 54 4 2 24 24 14.2 7.7 St. Saviour's 15 23 38 2 3 13 20 13.3 13.0 Princess Road 41 34 75 5 3 36 31 12.2 8.8 Beulah Road 35 41 76 4 4 31 37 11.4 9.7 Sydenham Road 25 40 65 ... 4 25 36 ... 10.0 Holy Trinity 7 20 27 2 4 5 16 28.5 20.0 Ecclesbourne Road 32 18 50 1 2 31 16 3.1 11.1 All Saint's 11 28 39 2 5 9 23 18.1 17.8 Upper Norwood 7 7 14 ... 2 7 5 ... 28.5 St. Joseph's 3 1 4 1 ... 2 1 33.3 ... Stanford Road 8 2 10 1 ... 7 2 12.3 ... Whitehorse Road 3 1 4 ... ... 3 1 ... ... Ingram Road 6 2 8 2 1 4 1 33.3 50.0 Wintcrbourne Road 3 2 5 ... ... 3 2 Portland Road 4 5 9 ... ... 4 5 ... ... Sydenham Road ... 5 5 ... ... ... 5 ... ... Princess Road 7 3 10 ... ... 7 3 ... ... Upper Norwood 3 3 ... ... ... 3 ... ... St. Joseph's 3 6 9 i 2 2 4 33.3 33.3 Totals 860 901 1761 124 124 736 777 14.4 13.6 97 TABLE E x.—Dental Re-inspection of Schools. Date. School. Children with teeth all Bound at previous inspection. At re-inspection. Children who were treated for caries discovered at previous inspection. At re-inspection. Children found to have defective teeth at primary inspection, but who have not been treated at the Dental Clinic. At re-inspection. All sound. Requiring treatment. Requiring no further treatment Requiring further treatment Children treated privately. Children treated privately and now requiring further treatment. Children treated privately and not requiring further treatment. Children who have received no dental treatment. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. 1918. Jan. 17 St. Andrew's 2 3 ... ... ... ... ... ... ... ... ... ... ... ... 15 23 „ 17 St. Peter's 2 ... 3 ... ... ... ... ... ... ... ... ... ... ... 13 18* „ 18 Whitehorse Road ... ... ... ... 7 3 1 ... ... 1 ... 1 ... ... 41 39 Oct. 4 St. Michael's ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 6 „ 4 Stanford Road 2 2 ... ... 3 2 ... ... 1 ... ... ... 1 ... 4 7 „ 15 Whitehorse Road 2 2 ... 3 3 1 ... 1 2 ... 1 ... 1 ... 23 23† „ 15 Holy Trinity 1 3 1 ... ... ... ... ... ... 1 ... 1 ... ... 4 7† Nov. 18 St. Andrew's, Old Town ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 7 7 „ 18 St. Andrew's 3 2 ... ... ... ... ... 2 ... ... ... ... ... ... 18 11 „ 19 Ingrain Road 1 ... ... ... ... 2 ... ... ... ... ... ... ... ... 12 6* „ 19 Winter bourne Road 3 2 ... ... 3 3 1 1 1 1 1 ... ... 1 9 10* „ 21 Parish Church 2 4 1 ... 5 3 ... ... ... ... ... ... ... ... 33 22** „ 26 Portland Road 5 5 1 1 6 5 ... 1 3 ... 3 ... ... ... 19 20* „ 26 St Mark's ... 5 ... 1 ... 2 ... ... 1 1 1 1 ... ... 4 9* Dec. 2 Mitcham Road 2 3 ... ... ... ... 1 3 ... ... ... ... ... ... 39 22 „ 2 Boston Road 6 5 3 ... ... ... ... ... ... ... ... ... ... ... 14 15 „ 2 Christ Church, Boston Road 3 2 3 2 ... ... ... ... ... ... ... ... ... ... 18 15 „ 5 St. Peter's ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 20 „ 5 Dering Place 4 3 1 1 ... ... ... ... ... ... ... ... ... ... 2 7 „ 6 Sydenham Road ... ...... ... ... ... ... ... ... 1 ... ... ... ..1 ... 20 22* „ 6 Princess Road 4 3 ... ... ... ... ... ... 1 ... 1 ... ... ... 23 24* „ 10 Beulah Road 3 3 ... ... 5 3 ... ... ... 1 ... 1 ... ... 14 18* „ 10 All Saints 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 5 11* „ 10 Rockmount Road ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 3 4* „ 10 St. Joseph's ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...‡ * Many absent. † Many absent (influenza). ‡ All absent. *** 16 absent, 98 TABLE E. xi. Table of Schools inspected by the School Dental Officers during the year 1918, showing the number of children found with defective teeth Date of Inspection, 1918. Name of School. (Infants' Departments.) Number of children examined. Number found with defective teeth. January 17th St. Andrew's (Old Town) 21 18 18th Whitehorse Road 101 88 February 7th St. Peter's 64 61 7th Parish Church 106 89 „ 15th St. Michael's 14 12 „ 15th Stanford Road 37 31 „ 21st Davidson Road 32 29 „ 21st Tavistock Grove 67 54 „ 26th Portland Road 107 90 „ 26th St. Mark's 42 36 March 7th St. Mary's 27 24 „ 7th Oval Road 30 25 „ 21st Mitcham Road 85 73 „ 21st Christ Church (Longley Road) 25 23 April 12th Ingram Road 30 27 „ 12th Winterbourne Road 54 48 „ 18th Woodside 105 90 „ 18th South Norwood 97 86 „ 23rd St. Saviour's 38 33 „ 23rd Princess Road 75 67 „ 30th Beulah Road 76 68 „ 30th Sydenham Road 65 61 May 2nd Brighton Road 64 58 „ 2nd Dering Place 34 20 „ 2nd St. Andrew's 55 43 „ 7th Holy Trinity 27 21 „ 7th Ecclesbourne Road 50 47 „ 9th Hoston Road 58 45 „ 9th Christ Church (Boston Road) 54 44 „ 14th All Saints' 39 32 „ 14th Rockmount Road 14 12 „ 14th St. Joseph's 4 3 October 4th Stanford Road 10 9 „ 15th Whitehorse Road 4 4 November 19th Ingram Road 8 5 19th Winterbourne Road 5 5 „ 26th Portland Road 9 9 December 6th Sydenham Road 5 5 „ 6th Princess Road 10 10 „ 10th Rockmount Road 3 3 „ 10th St. Joseph's 9 6 99 TABLE E. xii. DENTAL CLINIC Particulars as to Fillings, etc. Date Attendances. Fillings. Extractions. Pressings. Appointments for N2O Gas. Remarks. Ordinary. With "local" or N2O Gas. boys. Girls. Boys. Girls. Roys. Girls. Boys. Girls. Boys. Girls. Boys. Girls. January 71 89 34 34 7 11 67 86 28 31 1 14 76 children did not attend. February 79 92 28 45 22 9 61 51 24 36 9 10 5 children were unwell 46 children did not attend. March 86 97 38 45 15 5 36 134 43 22 5 8 1 unwell, 2 refused 45 children did not attend. April 55 82 24 34 1 5 60 75 6 15 ... 4 3 refused treatment. 37 children did not attend. Ag N.03 May 42 69 18 37 1 2 40 64 10 7 4 2 3children did not attend. 31 children did not attend. June 97 135 30 49 7 3 141 177 11 21 5 5 54 do do. July 67 96 20 26 ... 2 79 127 3 19 2 4 2 refused treatment. 55 children did not attend. August 18 26 9 13 1 2 18 22 ... 3 2 2 3 refused treatment. 27 children did not attend. Sept. 139 89 68 29 10 10 131 107 3 16 15 10 70 do. do. 1 refused treatment, 2 unwell October 85 114 53 58 ... 4 105 124 4 5 5 13 76 children did not attend. Nov. 71 102 26 42 2 ... 99 123 7 20 3 3 4 refused, 1 Bad mouth, 1 sealing 89 children did not attend. Dec. 47 55 16 20 ... 2 74 69 ... 4 2 1 2 refused treatement, 1 sealing 48 children did not attend. Totals in 1918 857 1046 364 432 66 57 961 1159 139 199 53 76 1 refused treatment Totals in 1917 878 922 411 448 244 160 662 762 256 226 53 69 100 THROAT CLINIC. During the year a throat clinic was established for the surgical treatment of enlarged tonsils and adenoids in school children. The clinic is housed by the courtesy of the Croydon General Hospital in one of the wings of the Hospital. The clinic is held weekly on Thursday afternoons. The surgical work is done by a rota of eight medical men, of whom two are on duty at one time. Two of the health visitors attend the clinic acting as nurses. The system of working is that cases with marked tonsils and adenoids found at medical inspections are given the opportunity of being operated upon at the clinic. When this is accepted the cases are forwarded by the school nurse to the nurse in charge of the clinic, who arranges for the attendance of the children for examination by the surgeon, the surgeons operating on the children during the week following the first examination, and the children come up to the clinic on a third occasion (seven days after the operation) for inspection by the surgeon who operated. Instructions are issued to the parents in each case as to the importance of breathing exercises as after treatment. These instructions are also given to the school teacher in charge of the child. The clinic was opened in June, 1918, and from that date to the end of the year 147 cases were operated upon—an average of 7.3 patients per session. SCHOOL TREATMENT CENTRE AND SPINAL REMEDIAL WORK. TREATMENT OF SCHOOL CHILDREN. Total number of new cases 840 Total number of attendances 4104 The Centre is as heretofore open daily for the treatment of minor ailments. One of the medical staff is present on two mornings each week and a nurse every morning to carry out the treatment advised. In the school year the new cases averaged 16.5 per week. RINGWORM. Ringworm in school children has been treated at the School Treatment Centre, and also by Dr. Critchley when X-ray treatment was advised and accepted. TABLE E. xiii. Totals. Total No. of children treated Scalp 131 Body 26 157 No. of attendances Scalp 786 Body 104 890 No. of cases X-rayed 97 Total attendances for X-ray treatment 194 No. of cases treated by Drugs Scalp 34 Body 26 60 101 SPINAL REMEDIAL CLASS. Children treated during year: 40 girls, 1 boy. Discharged, 10 (not requiring further treatment). Discharged, 3 (not advisable to continue). Discharged, 1 (owing to irregular attendance). Left school, 9. Left district, 2. Still attending class, 16. Class closed May 10th till Aug. 26th, owing to illness of Organiser. Class closed Oct. 23rd till Nov. 11th, owing to Influenza epidemic. SPECIAL EXAMINATION OF CHILDREN AT THE SCHOOL TREATMENT CENTRE. Number of Children who have attended for the following diseases at the request of the Education Committee's officers or of teachers or parents:— Diseases of Lungs 49 „ Heart 16 „ Ear, Throat and Nose 112 „ Skin (Scabies 79) 177 Ringworm— Scalp 112 Body 26 138 * Mentally Defective Children 6 Diseases of Nervous System 16 Spinal Affection 3 Eye Diseases or Defects 8 Glands 42 Rheumatism 7 Debility 14 Anaemia 14 Various 163 Infectious Diseases 2 Measles 13 2 Chicken Pox 8 Mumps 1 Diphtheria 778 * This is exclusive of children examined in accordance with the requirements of the Mental Deficiency Act. 102 ACTION TAKEN TO PREVENT SPREAD OF INFECTIOUS DISEASES. TABLE E. xv. 6,863 notices of illness (including duplicate notices) were received from School Teachers or Attendance Officers during 1918. 7,643 notices of illness were despatched to the respective schools by the Public Health Department. These notices dealt with, amongst others, 4,664 school children actually suffering from the infectious diseases mentioned in the Table:— Illness. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Scarlet Fever 49 63 34 90 236 Diphtheria 31 15 15 20 81 Measles 129 205 15 3 352 Mumps 300 734 89 48 1171 Whooping Cough 544 137 10 3 694 Chicken-pox 84 151 35 28 298 Sore Throat 58 33 13 14 118 Ringworm (Scalp) 52 48 9 28 137 „ (body) 31 16 8 11 66 Impetigo 191 173 70 143 577 Scabies 87 75 27 81 270 Infectious Eye Disease 22 32 18 16 88 Other diseases 151 130 49 246 576 Totals 1729 1812 392 731 4664 The table records only the number of actual sufferers from the infectious diseases therein mentioned, as it is thought that this information is of more practical use than a detailed record of the number of notices sent. WORK OF THE HEALTH VISITORS. The duties of the lady health visitors in connection with school medical services have mainly been attendance at the medical inspections, the visitation of children who were absent from school because of suspected infectious disease, and for the following up of cases of defect discovered at inspections. Each district health visitor carries out all the school nurses work in her own area. Certain of the health visitors spend part of their time at the dental, eye, X-rays, and minor ailments clinics. The work of the health visitors is set out in detail in the following table, with the exception of the clinic work. 103 TABLE E. xvi. Visits to Houses where the following Diseases have occurred. School Cases. 1st Visits. Subsequent Visits. Scarlet Fever 22 13 Diphtheria 66 25 Measles 667 53 German Measles 36 1 Mumps 1219 124 Whooping Cough 928 122 Chicken Pox 433 23 Sore Throat 210 68 Ringworm (scalp) 209 707 (body) 112 104 Verminous Heads 9 4 Verminous Bodies 10 22 Impetigo Contagiosa 826 1040 Scabies 270 459 Infectious Eye Disease 108 91 Other Diseases 1428 475 6553 3331 Visits paid to Elementary Schools for Medical Inspection 155 - Number of Children prepared for Medical Inspection:—Newly Inspected 3862 - Re-inspected 522 - Specially Inspected 127 - Other Visits to Elementary Schools 71 2 Home Visits arising out of Medical Inspection 523 512 Home Visits for other information 369 64 Cultures taken 380 32 104 SCHOOL CLOSURE. During the year 1918 the following schools were closed in accordance with Article 45 (b) of the Code TABLE E. xvii. School. Department. Class. Disease. Date of Closure. Length of Closure. St. Saviour's Infants & Girls - Whooping Cough January 24th 1 month. Princess Road Infants - Whooping Cough January 31st 1 month. St. Andrew's Infants — Measles February 6th 1 month. Whitehorse Road Boys 1 Measles February nth 5 days. Dering Place Mixed & Infants — Measles February 27th 3 weeks. Portland Road Infants - Measles February 28th 3 weeks. Portland Road Mixed 2a Measles March 4th 5 days. South Norwood Entire School — Measles March 4th 2 weeks. Woodside Entire School — Measles March 4th 2 weeks. Parish Church Infants 6 Measles March nth 5 days. Shirley Mixed 1 Measles March 13th 1 week. St. Mark's Girls 2 Measles March 18th 5 days. Sydenham Road Boys 7 Measles March 18th 5 days. Portland Road Infants — Measles March 25th 4 days. Christ Church (Boston Road) Infants - Whooping Cough & Mumps March 26th 1 month Mitcham Road Infants — Mumps April 8th 2 weeks. St. Mark's Infants — Measles April 15th 1 month. Sydenham Road Boys — Influenza June 27th 3 weeks. Brighton Road Infants — Mumps July 1st 3 weeks. Tavistock Grove Entire School — Influenza July 3rd 17 days. Upper Norwood Entire School — Influenza July 3rd 17 days. Holy Trinity Mixed & Infants - Influenza July 3rd 17 days, 105 TABLE E xvii. (continued). School. Department, Class. Disease. Date of Closure. Length of Closure. Boston Road Entire School — Influenza July 3rd 17 days. Christ Church Boston Road) Infants - Influenza July 3rd 17 days. South Norwood Entire School - Influenza July 3rd 17 days. Davidson Road Hoys - Influenza July 3rd 17 days. St. Mary's Mixed - Influenza July 3rd 17 days. Oval Road Girls & Infants - Influenza July 3rd 17 days. Sydenham Road Girls & Infants - Influenza July 4th 16 days. Tamworth Road Boys - Influenza July 4th 16 days. St. Mary's Infants — Influenza July 5th 15 days. St. Michael's Entire School - Influenza July 5th 15 days. Woodside Girls - Influenza July 5th 15 days. Brighton Road Boys - Influenza July 5th 15 days. Ecclesbourne Rd. Infants — Influenza July 5th 15 days. Mitcham Road Girls - Influenza July 5th 15 days. Christ Church (Longley Road) Entire School — Influenza July 5th 15 days. St. Andrew's Entire School - Influenza July 5th 15 days. Parish Church Entire School — Influenza July 5th 15 days. Whitehorse Road Boys — Influenza July 5th 15 days. Oval Road Roys — Influenza July 8th 12 days. St. Saviour's Entire School — Influenza July 8th 12 days. Brighton Road.. Girls — Influenza July 8th 12 days. Davidson Road Girls — Influenza July 8th 12 days. Ecclesbourne Rd. Girls - Influenza July 8th 12 days. Arch. Tenison's & St. Peter's Entire School - Influenza July 8th 12 days. Whitehorse Road Girls & Infants — Influenza July 8th 12 days. 106 TABLE E xvii. (continued). School. Department. Class. Disease. Date of Closure. Length of Closure. Portland Road Entire School — Influenza July 8th 12 days St. Mark's Entire School - Influenza July 8th 12 „ Princess Road Entire School — Influenza July 8th 12 „ Mitcham Road Entire School - Influenza July 8th 12 „ Winterbourne Rd. Hoys — Influenza July 8th 12 „ Davidson Road Infants - Influenza July 10th 10 „ All Saints' Entire School — Influenza July 10th 10 „ Woodside Boys — Influenza July 10th 10 „ Woodside Infants — Influenza July nth 9 „ Elmwood Hall Entire School — Influenza July 11 th 9 „ Dering Place Infants - Influenza July 11th 9 „ Ingram Road Boys — Influenza July nth 9 „ Ecclesbourne Rd. Boys - Influenza July nth 9 „ Winterbourne Rd. Infants - Influenza and other infectious diseases July 15th 5 „ Dering Place Mixed — Influenza July 15th 5 „ St. Andrew's Boys — Influenza October 14th 2 weeks. Oval Road Girls & Infants — Influenza October 14th 2 „ Ingram Road Boys — Influenza October 15th 2 „ Oval Road Boys - Influenza October 15th 2 „ St. Andrew's Girls & Infants - Influenza October 15th 2 „ Davidson Road Girls — Influenza October 18th 2 „ Ingram Road Girls — Influenza October 18th 2 .. Dering Place Mixed - Influenza October 18th 2 „ Upper Norwood Entire School - Influenza October 18th 2 „ Ingram Road infants — Influenza October 21st 2 „ Arch. Tenison's & St. Peter's Entire School - Influenza October 21st 2 „ 107 TABLE E xvii (continued). School. Department. Class. Disease. Date of Closure. Length of Closure Whitehorse Road Entire School — Influenza October 21st 2 weeks Portland Road Infants — Influenza October 21st 2 „ Woodside Infants — Influenza October 21st 2 „ Davidson Road Boys & Infants — Influenza October 21st 2 ,, Brighton Road Infants — Influenza October 21st 2 „ Elmwood Hall Junior Mixed — Influenza October 21st 2 „ Tavistock Grove Entire School — Influenza October 21st 2 „ Parish Church Entire School — Influenza October 21st 2 „ South Norwood Entire School — Influenza October 21st 2 „ Boston Road Entire School — Influenza October 22nd 2 „ Christ Church (Boston Road) Infants - Influenza October 22nd 2 „ Beulah Road Entire School - Influenza October 22nd 2 „ Winterbourne Rd. Entire School - Influenza October 22nd 2 „ Ecclesbourne Rd. Girls - Influenza October 22nd 2 „ Brighton Road Girls - Influenza October 22nd 2 „ St. Saviour's Girls & Infants — Influenza October 22nd 2 „ Grange Wood Entire School - Influenza October 22nd 2 „ Brighton Road Boys — Influenza October 22nd 2 „ Ecclesbourne Rd. Boys & Infants — Influenza October 22nd 2 „ Mitcham Road Entire School — Influenza October 22nd 2 „ Portland Road Mixed & Girls — Influenza October 22nd 2 „ Princess Road Entire School — Influenza October 22nd 2 „ Stanford Road Entire School — Influenza October 22nd 2 „ Sydenham Road Entire School — Influenza October 22nd 2 „ Woodside Boys& Girls - Influenza October 22nd 2 „ All Saints' Entire School — Influenza October 22nd 2 „ 108 TABLE E xvii. (continued). School. Department. Class. Disease. Date of Closure Length of Closure. Christ Church Entire School — Influenza October 22nd 2 weeks, Holy Trinity Entire School — Influenza October 22nd 2 „ St. Saviour's Boys — Influenza October 22nd 2 „ St. Andrew's (Old Town) Entire School — Influenza October 22nd 2 „ St. Joseph's Entire School — Influenza October 22nd 2 „ Shirley Entire School — Influenza October 22nd 2 „ St. Mark's Entire School - Influenza October 22nd 2 „ St. Mary's Entire School — Influenza October 22nd 2 „ St. Michael's Entire School — Influenza October 22nd 2 „ Brighton Road Girls — Influenza November 18th 2 „ Portland Road Entire School — Influenza November 8th 2 „ 109 PHYSICALLY AND MENTALLY DEFECTIVE CHILDREN SENT TO INSTITUTIONS. At the end of the year 1918 the following Croydon children were under treatment in residential institutions:— Blind 7 Deaf 8 Mentally defective 8 Epileptic 3 EXAMINATION OF BURSARS, STUDENT AND PUPIL TEACHERS. Twenty-two young persons who desired to become Bursars and Student Teachers were medically examined during the year. TEACHING OF INFANT CARE. The Infant Care Class has been continued at the Tavistock Grove and Beulah Road Schools. It has not been possible to maintain such a regular attendance of one of the medical officers owing to staffing difficulties, but this has been maintained very fully on the whole. One of the health visitors attends regularly. Short talks have been given at each meeting by one or other of these officers on matters relating to infant welfare. 110 REPORT OF THE ORGANISER OF PHYSICAL TRAINING. Ladies and Gentlemen, I beg to submit the Report of my work as Organiser of Physical Training for the year 1918. My time was devoted to:— (1) Visiting all the Departments of the Elementary Schools (with the exception of the Boys' Departments) for the purpose of advising the teachers on the physical training carried on in the Schools. (2) Attending at the School Treatment Centre, 228, London Road, four sessions weeklv, for the purpose of giving Remedial Exercises. (3) Visiting the gymnastic classes held in connection with the Girls' Evening Institutes. (4) Holding Physical Training Classes for the Student Teachers and Teachers in the Elementary Schools. I was absent from duty from May 10th to August 26th, owing to illness. Physical Training in the Elementary Schools was carried on in spite of many difficulties, e.g., the two outbreaks of influenza, bad weather, etc. I would again emphasise the need of suitable covered accommodation for physical exercises. As I pointed out in my Report of March, 1918, the accommodation for the practice of physical exercises in extreme cold and heat, and in wet weather, is inadequate in most of the schools. I would beg to quote from the 1917 Report of the Chief Medical Officer of the Board of Education: "Authorities will understand that physical exercises cannot be taken satisfactorily between desks or on a rough uneven playground surface and though a special hall or room for gymnastics is not available in all cases, it seems not unreasonable to suggest the provision of an adequate covered shed in the playgrounds, suitably lighted, ventilated and floored, in which exercises can be taken in practically all weathers," During the year I found it advisable to draw the attention of the Clerk to the rough state of some of the playgrounds, as I felt there was a certain amount of risk in the playing of running games. It was found impossible, however, for any improvements to be made owing to the Board of Trade regulations as to the use of tar. May I urge, however, that the necessary repairs be made as soon as is possible, as much of the spirit and joy of a physical exercise lesson is lost if free running has to be omitted. I have endeavoured, during my visits to the various classes, to get the work as bright and vigorous as possible and, by the introduction of more free formation work and brightening movements, to make the tables less formal, especially in the Infants and lower standard classes. The Syllabus of Games and Play Movements, introduced into the Infants' Departments in 1917, has proved successful in most cases and I would like to bear tesimony to the loyal support and co-operation of the teachers in the Infants' Schools in the introduction of this scheme. 111 Progress has been made in some schools in the provision of suitable clothing for physical exercises but, owing to war conditions, the difficulties of obtaining suitable material have been very great. Tunics and knickers have been made in many schools, also shoes. The decision of the Education Committee that material for such hand-made shoes can, in future, be requisitioned, will prove a tremendous impetus in this matter. A certain number of the teachers in the Girls' Departments now wear gymnastic costume themselves when giving a physical training lesson, but the number is limited, owing to the total lack of dressing-room accommodation in most of the schools and also to the exposed nature of the playgrounds. The number of schools devoting time to organised playground games increases but slowly. I would suggest that the provision of a certain amount of simple apparatus, such as bean-bags, basket-balls, skipping ropes, etc., would do much to increase interest and enthusiasm. Many of the schools find the provision of the necessary apparatus for basketball, swimming, etc., a verv great difficulty, and I am strongly of the opinion that a "games subscription" from the scholars is undesirable, as it so often excludes those children who need games most. I would again emphasise the fact, mentioned in my last report, that many of the desks still in use in the schools, are harmful to the growing child, and urge that every seat should at least have a suitable back. As mentioned earlier in this report, I attended the Spinal Remedial Class four sessions weekly. Formerly each child attended for treatment twice weekly, but this year an experiment was made of having the more severe cases three or four times weekly, and it was found they responded more quicklv to treatment in this way. Children treated during year Girls, 40; Boys, 1 Discharged (not requiring further treatment) 10 „ (not advisable to continue) 3 „ (owing to irregular attendance) 1 Left School 9 Left District 2 Still Attending Class 16 Total Attendances during Year 995 The Class was closed for three months, owing to my illness, and again for a fortnight in November, owing to the second outbreak of influenza. I was only able to visit the gymnastic classes held in connection with the Evening Institutes once, as they were held on the same evenings as the teachers' classes and therefore I was not free. The following Courses were conducted by me during 1918:— (1) A Course of twenty-five lessons in the Theory and Practice of Physical Exercises, for the Teachers of the Senior Departments. This Course was held at the Girls' High School and was arranged in conformity with the requirements of the Board of Education examination. Several pupils expressed their intention of taking 112 the examination but many diffiulties were encountered—notably air raids—and in the end only two students were presented for examination, although the attendance at the class never fell below eight or ten, except on the nights when air raids actually took place or were expected. (2) A Course of eighteen lessons in Games and Play Movements, for the Teachers of the Infants' Schools. The response of the Infants' Teachers to the invitation to attend this class was remarkable and over seventy obtained the certificate granted for attendance. Every Infants' Department, with the exception of four, was represented—in some cases by practically all the staff. (3) A Course of eight lessons of Country and Folk Dances, for the Teachers of the Senior Departments. This again was well attended. At the request of the Superintendent, a demonstration of Country and Folk Dances was given at the Croydon Recreation Club, at the end of the Course. (4) A Course of twenty-five lessons for the Student Teachers, at the Girls' High School. This, too, was interrupted on several evenings by air raids. In July I attended, at the Committee's desire, the Conference of Women Organisers of Physical Training, arranged by the Board of Education, although I was forbidden by my medical adviser to take an active part in the Conference, as I was then absent from duty on sick leave. I found the Conference most helpful and am looking forward to the opportunity to attend similar ones in the future. May I suggest the lines along which I think progress should come in our Croydon Schools in the near future—progress which to my mind is possible even under existing difficulties:— (1) A daily lesson of Physical Training, in all schools, of not less than twenty minutes. In the case of senior schools, where the children make a rule of changing their shoes for the lesson, thirty minutes would not be too long. (2) Better provision for swimming and organised games. (3) Improved facilities for the provision of suitable clothing, especially shoes. (4) Adequate accommodation for physical training in all weathers. In this connection would "it not be possible to arrange for the utilisation of the huts and wooden buildings recently used by the military authorities, many of which would serve the purpose excellently. In conclusion may I say how I value the resolution of the Education Committee that the report of the Organiser of Physical Training shall be incorporated yearly in that of the School Medical Officer. As the Chief Medical Officer of the Board of Education states in his report for 1917, " the School Medical Service is concerned to watch over the normal as 113 well as the abnormal growth of children the education and building up, the development and strengthening of the natural powers of the body of the normal child that it may be able not only to resist disease but to become its best. Hence the teaching and practice of hygiene, of physical exercises and of games." To attain such results will always be my earnest desire and I am confident that in this I shall always have the enthusiastic co-operation of the teachers in the schools. I am, Your obedient servant, MAY APPLETON. 114 115 116