DEPT 14 ANNUAL REPORT ON THE HEALTH OF THE Metropolitan Borough of Deptford, BY WILLIAM H. WHITEHOUSE, M.D., D.P.H., Of the Inntr Temple, Barrister-at-Law: Fellow of the Royal Society of Medicine, &-c., &-c. Medical Officer of Health AND M. MACDONALD, M.D., D.P.H., Tuberculosis Officer and Acting Medical Officer of Health. 1916 DEPTFORD: Gaylard & Son, 446 New Cross Road, S.E. Public Health and Housing Committee. Major. Councillor WILLIAM A. WAYLAND, J. P. (ex officio). Chairman. Councillor W. FALKNER. Vice=Chairman Councillor W. H. GREEN. Alderman E. J. KNIGHT. Alderman W. A. SCOTT, J. P. Councillor A. E. BRETT. Councillor Dr. W. H. BROOKS. Councillor W. R. CARNELL. Councillor H. CATTELL. Councillor C. H. KIPPS. Councillor J. SHEPHERD. Councillor R. SOPER. Staff of the Public Health Department. Medical Officer of Health. *William H. Whitehouse, M.D., D.P.H., B.S., Barrister-at-Law. Tuberculosis Officer and Acting Medical Officer of Health. Murdoch Macdonald, M.D., D.P.H., B.ch. public Analnst. Henry G. Harrison, M.A. (Cantab), F.I.C. Sanitary Inspectors. Thomas Turner. John v. Snowdon Robert D. J. Simpson. Arthur G. Kemp. Alfred Priest. Philip Shelley, Frederick Hewett Harky Allam. Sanitary Inspectors ant Health Visitors. Miss F. O' Riordan. Miss W. C. Smart. Health Visitors. Mrs. H. Davies. Miss Butcher. Chief Clerk. Charles A. Chapman. Clerks. *Henry J. L. Smith. George Northmore. Municipal Dispensary for the of Consumption, 78 Amersham Vale, New Cross, S.E. Administrative Tuberculosis Officer —W. H. Whitehouse, M.D. Clinical Tuberculosis Officer — Murdoch Macdonald, M.D. Dispenser Clerk Miss G. F. Greig. Nurse —Miss Porteous. *Attendant—G. Abbott. Disinfecting Staff. C. F. Dowsett (Chief Disinfector). *T. Lyons. F. Smith. *R. G. GLADMAN. Councils Mortuary ant Coroner's Court. *Attendant - G. W. J. Wagner. Cleansing Station. Bath Attendant —Mrs. Wagner. School Nurse— Miss Gilby. *On Service with H.M. Forces. TABLE OF CONTENTS. PAGE PAGE Vital Statistics Overcrowding 28 Summary of 6 Smoke Nuisances 28 Population 7 Disinfection 28 Births 7 Coroner's Court & Mortuary 28 Marriages 8 Summary of Male Inspectors' Work 29-36 Deaths 8 Summary of Women Inspectors' Work 9-13 of Infants 9 from Respiratory Diseases 27 Revenue Act Certificates 28 from Influenza 27 Legal Proceedings 38 from Constitutional Diseases 27 Maternity Cancer 27 Child Welfare 10-13 Statistics for 1916 and previous years 14 Local Government Board Tables 14-17 Food Supply Food Premises 32 Infectious Diseases- Bakehouses 32 Deaths from 18 Dairies, Milkshops, etc 32 Cases notified 18 Ice Cream Premises 83 Smallpox 20 Cowsheds 33 Scarlet Fever 20 Slaughterhouses 32 Diphtheria 20 Unsound Food 38 Enteric Fever 20 Sale of Food and Drugs Acts 38 Erysipelas 20 Puerperal Fever 21 Factories and Workshops Ophthalmia Neonatorum 21 Home Office Tables 34-36 Cerebro-spinal Fever 21 Offensive Trades 33 Polio Myelitis 21 Diarrhoea and Enteritis 21 Measles 22 Tuberculosis Dispensary Whooping Cough 22 Report of Tuberculosis Officer 23-26 Tuberculosis 22 School Exclusions 22 Bacteriological Diagnoses 20 Canal Boats Report of Inspector 37 Sanitary Work Housing, Town Planning, Public Health etc Act 83 Drainage Works 27 Legislation 39 Metrapolitan Borough of Deptford. PUBLIC HEALTH DEPARTMENT, TOWN HALL, NEW CROSS, ROAD, S.E. 14. To the Mayor, Aldermen and Councillors. GENTLEMEN, On behalf of Dr. Whitehouse (who joined H.M. Forces in September, 1916), I have the honour of submitting the Annual Report on the health of the Borough during the past year. The instructions of the Local Government Board with regard to Annual Reports of Medical Officers of Health included a suggestion that in view of the paper shortage, Reports for 1916 should be as brief as possible, and in fact should only be regarded as "interim Reports." I have therefore contented myself with submitting nothing more than a summary of the work done in respect of the more important matters. Owing in part to the excellent arrangements made by Dr. Whitehouse but chiefly to the zeal and loyalty of the staff, the work of the Department has been carried out most satisfactorily. To all members of the Staff I tender my sincere thanks. I have at the same time to acknowledge my indebtedness to the Chairman and Members of the Public Health Committee for the courtesy and consideration they have always shown me in the discharge of my duties. I am, Mr. Mayor and Gentlemen, Your obedient Servant, M. MACDONALD. Summary of Vital and Mortal Statistics for 1916. 1916. 1915. 1,563 acres Area 1,563 acres 110,398 Population— Census 1901 110,398 109,496 Census 1911 109,496 Estimated to middle of year 110,299 110,299 Number of inhabited houses 16,658 16,696 Average number of persons per house 6.6 6.6 70 per acre Density 70 per acre 53 miles approx. Length of Public Streets 53 miles approx. Rateable Value £617,060 £636,361 1d. Rate produces (approximately) £2,427 £2,542 Cost of administration of Public Health Department £1,961 £1,718 Marriages 1,021 1,262 9.3 Marriage Rate 11.4 Births 2,918 2,955 Birth Rate 26.5 26.8 Birth Rate, average for the last 10 years 27.2 27.4 Deaths 1,666 1,962 Death Rate 15.1 17.8 Death Rate, average for the last 10 years 14.8 1 4.5 Infantile Mortality 88per 1 ,000 births 132 per 1,000 births Infantile Mortality, average for the last 10 years 118 per 1,000 births 117 per 1,000 births Zymotic Death Rate 1.03 2.07 POPULATION. As explained in last year's Report the war has made it impossible to adhere to the methods of estimation of local and national populations hitherto in use. For 1916 the Registrar General has adopted the following estimates of population for Deptford for the calculation of the Death Rate and Birth Rate :— For the Death Rate - 107,696. For the Birth Rate - 117,175. The former is an estimate of the civilian population ; the latter of the total population based on the assumption that the ratio between the total and the civilian population is the same in the Borough as in England and Wales as a whole. From local knowledge, however, it is apparent that Deptford has a civilian population as large as, if not larger than the population at the time of the National Register, and for the purposes of this report the estimated civil population has been taken as 110,299. Births. The total number of births registered in the Borough in 1916 was 2,918, viz.: 1,462 boys and 1,456 girls. The Birth Hate was 26'5 per 1,000 as compared with 26'8 for the preceding year. The following table shows the number of births, deaths, and deaths of children under one year of age, with the respective rates. population. Births. Deaths. Deaths of Infants under one year. Ward. No. Rate. No. Rate. No. Rate per per 1000 births. 21,340 686 138 East 32.1 461 21.6 95 North 24,043 702 81 29.2 340 14.1 57 54 North-West 23,652 662 28.0 282 11.9 82 17.3 South 12,232 212 184 15.O 52 11 South-East 12,411 291 23.4 212 17.1 27 93 365 22.0 South-West 16,621 187 11.3 14 38 Whole Borough 110,299 2,918 26.5 1,666 15.1 258 88 Illegitimate Births. The illegitimate births, which number 87, occurred in the several Wards, as follows: — East Ward 21 South Ward 8 North Ward 13 South-East Ward 10 North-West Ward 20 South-West Ward 15 Marriages. There were 1021 marriages in the Borough during the year, as compared with 1262 in the previous year and the marriage rate 9.3 per 1000 of the population as compared with 11.4 in 1915. Deaths. 1916 Average for past 10 years. 1,688 Number of deaths 1,666 Average death-rate for previous 5 years 15.4 14.8 Rate per 1,000 Deptford 15.1 „ „ England and Wales 14.0 „ „ 96 Large Towns 14.4 „ „ 148 Smaller Towns 13.0 „ „ County of London 14.3 The number of deaths registered within the Metropolitan Borough of Deptford from all causes during 1916 was 1,126, equal to a deathrate of 10˙2 as compared with 1,406 deaths, and a death-rate of 12˙7 during the previous year. Of this number 535 were males and 591 females. The total number of deaths belonging to Deptford is obtained by deducting the number of deaths of non-parishioners registered in the Borough, viz.: 135, of which number 120 occurred in the Metropolitan Asylums Board's South Eastern Hospital, making 991 deaths actually belonging to Deptford. To this number we must add 675 deaths of parishioners which occurred in public institutions outside the Borough, making a total of 1,666, of which 875 were males and 791 females, and upon these figures the statistics are based. The death-rate for the Borough was equal to an annual rate of 15˙1 per 1,000 of the population, as compared with 17.8 for 1915, and 15˙5 for 1913, the average for the past five years being 15.4. The following table gives the number of deaths belonging to each Ward, and the death rates for each Ward. Ward. Deaths. Death Rate per 1,000. Total. Males. Females. East Ward 249 212 461 21.6 North Ward 180 160 340 14.1 North-West Ward 140 142 282 184 11.9 South Ward 15.0 86 98 South-East Ward 127 85 212 187 17.1 South-West Ward 93 94 11.3 Deaths of residents occurring in outlying public institutions are allocated to their respective Wards according to the addresses of the deceased as received from the Registrar-General's Department. The proportion which the mortality at various ages bears to the total number of deaths during 1915 and 1916 is as follows: — 1916. 1915. Under 1 year 15.5 per cent. 19.9 per cent, deaths. 1 to 2 years 4.3 „ 7.0 „ „ 2 to 5 „ 3.9 „ 6.0 5 to 15 „ 4.5 „ 4.2 „ „ 15 to 25 „ 3.7 „ 4.7 „ „ 25 to 45 „ 12.9 „ 10.9 „ „ 45 to 65 „ 22.2 „ 22.4 „ „ 65 years and upwards 33.0 „ 25.4 „ „ Infantile Mortality. Total deaths of Infants under one year, 258. Average for previous 10 years 1916. Deptford Infantile death rate per 1000 births 88 118 England and Wales 91 96 Large Towns 99 148 Smaller Towns 90 County of London 89 Of the 1,666 deaths recorded during the year 258 were of infants under one year of age. The following table shows the infantile mortality in the various wards: — DEPTFORD. Infantile Mortality per 1000 Births. Births Registered. Deaths under .1 year of age. Ward. East ward 686 95 138 North Ward 702 81 57 North-West Ward 662 54 82 South Ward 11 52 212 South-East Ward 291 27 93 South-West Ward 365 14 38 10 TABLE SHOWING THE NUMBER OF BIRTHS AND DEATHS IN THE BOROUGH DURING THE YEAR 1916. BIRTHS 2918 DEATHS—including 675 in Outlying Public Institutions 1666 Excess of Births over Deaths 1252 I submit a list of the principal causes of the 258 infantile deaths in the Borough during 1916, viz.: — Whooping Cough 6 Measles 4 Tuberculosis 6 Meningitis 5 Convulsions 10 Bronchitis and Pneumonia 55 Diarrhœal Diseases 13 Enteritis and Diseases of Digestive System 33 Syphilis 2 Congenital Malformation, Atelectasis, and Injury at Birth 20 Debility and Marasmus 41 Premature Birth 49 Other causes 14 258 Maternity and Child Welfare. During the year an additional (temporary) Health Visitor was appointed and among them the 4 Health Visitors paid 11,170 visits, as follows: — 1st visits 2nd visits Total Births 2559 4629 1383 7188 Tuberculosis 445 1828 Verminous Children 247 986 1183 31 56 87 Ophthalmia Neonatorum Infant Deaths 192 192 - 328 Miscellaneous 364 692 3838 7332 11,170 The number of births notified under the Notification of Births Act during this period was 2964. 11 In the following table information will be found with regard to the births notified in the different wards,together with the sex, whether born alive or dead, and by whom the birth was notified: — Births Notified. Alive. Dead By whom Notified. Ward. Parent. Other Person. Total. Females. Doctor. Midwife. Males. East 684 351 662 22 95 496 20 333 73 North 692 345 347 683 9 167 242 257 26 344 285 Nth-west 738 210 894 722 16 219 194 40 101 South 102 108 206 4 63 26 20 284 356 144 277 7 97 64 106 17 Sth-East 140 80 Sth-West 178 178 347 9 187 65 24 Totals 2964 1492 1472 2897 67 910 763 1144 147 Details as to the feeding of the babies visited is given below. “Mixed feeding" means both breast and hand-fed. Breast Feeding. Mixed Feeding. Hand Feeding. Wards. Totals. East 481 30 33 544 North 608 18 27 653 North-West 559 31 51 641 South 20 21 186 145 South-East 223 22 26 271 223 19 22 264 South-West 2239 140 180 2559 The duties of the Health Visitors were fully explained in the Report of 1915, and it is perhaps sufficient to add that this work is being energetically continued. A new Municipal Centre for Infant Consultations was opened in the North-West Ward towards the close of the year and already there is evidence that larger accommodation will be required. At present negotiations have been opened with the Albany Institute for the provision of hospital beds in the Babies' Home of that institution. Much remains to be done in the direction of ante-natal work, and as there is an increasing number of expectant mothers coming forward each year, there is ample scope for the employment of additional Health Visitors for this part of the work alone. As regards medical attendance the Medical Officer of Health and the Tuberculosis Officer attend the Town Hall Centres each week, but it has not been found posssible to give the same attention to the 12 outlying Centres. The Committee are indebted to Dr. Beatrice Lovibond, who voluntarily attended the Deptford Park Hall Centre for eight months of the year, but was then compelled, through pressure of work, to relinquish the post. The present arrangement is that mothers attending these Centres who wish to see the Doctor are requested to attend at the Town Hall, but this is not a desirable arrangement from any point of view. The notification of Births Act is working efficiently. The figures for 1916 are:- Births registerd 2918 Births notified 2964 INFANT CONSULTANTS. There are now four municipal and two voluntary centres in the district, viz.:— MUNICIPAL CENTRES. Town Hall. —Two centres : open Wednesdays and Thursdays, average weekly attendance, each centre 50 Deptford Park Hall —Open Tuesdays, average attendance 30 North West Centre (Ilderton Road) —Open Mondays, average attendance 15 VOLUNTARY CENTRES. The Albany Institute. The Deptford Health Centre and Evelyn Home. The Municipal Centres have been well attended during the year, and it is gratifying to note the intelligent interest with which the mothers follow the various lectures, etc. delivered at each centre. At the Annual Examination in Infant Care held in December, 40 mothers were successful in obtaining a " Proficiency Certificate." The Committee are again indebted to the Mayoress (Mrs. W. A. Wayland), who kindly presented a prize to each of the successful Candidates, and who afterwards, with the Mayor, entertained all the members of the various classes to tea. MUNICIPAL CENTRES. —ATTENDANCES. Infant consultations 5213 attendances for the year, Infant Weighing Lecture —156 weekly lectures on Infant care (l hour each). Average number of mothers attending each week, 111. 13 ALBANY INSTITUTE, DEPTFORD FUND. Returns of Infant Consultations from January Ist to December 31 st, 1916. No. of individual Babies who have attended Infant Consultations 329 „ times those Babies have been weighed 2127 „ „ „ seen by Doctor 799 Total attendance of Mothers at Lectures 1991 No. of Infant Consultations held 50 Total attendance made by Children at the Day Nursery for the year 7501 No. of Babies admitted to Babies' Home 39 DEPTFORD HEALTH CENTRE. The following is a summary of the work done :— Throat and nose cases 283 Medical cases 1652 Dental cases 3084 Eye cases 737 Baby Camp—Attendances in middle of 1915 65 119,642 2,906 1910 2,959 24.7 1,232 10.1 116 555 366 123 1,671 13.9 109,475 1911 2,921 3,001 27.4 1,304 11.9 161 585 428 143 1,728 15.8 109,377 1912 2,807 2,896 26.5 1,045 9.6 182 579 258 89 1,442 13.2 3,041 1913 109,280 3,106 28.0 1,283 11.6 181 625 350 113 1,727 15.5 3,071 109,182 1914 3,121 28.6 1,145 10.5 163 616 309 99 1,598 14.6 110,299 1915 132 88 1,962 17.8 2,891 2,955 26.8 1,406 12.7 144 700 391 110,299 1916 2,838 2,918 26.5 1,126 10.2 135 675 258 1,666 15.1 Area of District in acres (land and inland water). 1,563. At census 1911. Total population at all ages 109,496. Total families or separate occupiers, 25,040. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 249 254 1 71 134 32 14 2 49 59 80 13 20 33 .. Diphtheria including Membranous croup Erysipelas 104 1 7 9 15 31 32 9 40 14 14 11 7 18 5 89 1 54 62 117 24 11 32 283 Scarlet fever 300 1 171 24 14 .. Typhus fever .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 2 Enteric fever 5 1 1 1 2 3 5 .. .. .. .. .. .. .. 183 Measles 1137 85 539 463 40 10 304 358 74 113 105 21 .. .. 302 12 52 160 47 29 2 35 60 58 32 76 German Measles 41 .. .. Relapsing fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued fever .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal fever 4 4 .. 3 1 2 .. .. .. .. .. .. .. .. .. Cerebro-Spinal Meningitis .. 5 3 1 1 1 1 2 1 5 .. .. .. .. .. 1 Poliomyelitis 1 1 .. .. 1 .. .. .. .. .. .. .. .. .. Pulmonary Tuberculosis 276 3 7 50 45 111 52 8 90 65 43 18 21 39 162 7 Other forms of Tuberculosis 23 8 11 127 7 27 62 11 13 6 1 57 21 16 Ophthalmia Neonatorum 28 28 10 6 6 3 2 1 .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. Totals 2543 141 794 1052 215 228 95 18 640 631 530 209 218 315 749 16 Table No. 3. METROPOLITAN BOROUGH OF DEPTFORD. Causes of, and Ages at Death during the Year 1916. This Table is prepared in accordance with the requisitions of the Local Government Board.) Nett Deaths at the subjoined Ages of “Resident ” whether occurring within or without the District. Total Deaths whether of “Residents” or “Non-Residents” in Institutions in the District. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upward. CAUSES OF DEATH. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified 258 65 215 370 155 1666 71 75 62 550 Uncertified .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 1 .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. Measles 32 4 11 12 5 5 .. .. .. .. Scarlet Fever 5 2 3 30 .. .. .. .. .. .. 1 12 Whooping Cough 14 6 6 1 .. .. .. .. 5 8 66 Diphtheria and Croup 13 .. .. .. .. .. .. 23 1 1 3 8 10 Influenza .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Phthisis (Pulmonary Tuberculosis) 169 79 8 25 46 7 1 2 2 .. 22 3 2 7 9 1 1 Tuberculous Meningitis .. .. .. 1 Other Tuberculous Diseases 16 1 1 2 1 7 1 2 1 9 60 68 Cancer, malignant disease 138 I .. 1 .. .. .. 7 2 2 1 3 .. Rheumatic Fever .. .. .. .. Meningitis 13 5 2 2 2 1 1 2 .. .. 130 19 58 Organic Heart Disease 5 4 44 1 .. .. .. 2 2 39 104 Bronchitis 184 19 7 3 8 .. Pneumonia (all forms) 137 36 22 11 8 3 15 33 9 3 Other diseases of Respiratory Organs 5 5 .. 16 .. 1 .. 1 4 .. 1 4 3 1 1 Diarrhoea and Enteritis 58 40 9 .. .. Appendicitis and Typhlitis 1 2 1 .. 4 .. .. .. .. .. Cirrhosis of Liver 9 1 6 2 .. .. .. .. .. .. 2 2 Alcoholism 4 .. .. .. .. .. .. .. Nephritis & Bright's Disease 55 1 2 9 29 14 .. .. .. .. 3 Puerperal Fever 3 4 .. .. .. .. .. .. .. 4 Other accidents and diseases of Pregnancy and Parturition 2 2 .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 102 1 100 1 .. .. .. .. .. .. Violent Deaths (excluding Suicides) 55 3 4 9 9 3 8 9 10 .. 1 1 Suicides 2 .. .. .. .. 7 8 .. .. .. 9 43 80 259 7 Other defined diseases 443 36 1 Diseases ill-defined or unknown 7 2 3 1 1 .. .. .. .. .. 1666 258 75 62 215 370 550 71 65 135 17 Table No. 4. METROPOLITAN BOROUGH OF DEPTFORD (This Table is prepared in accordance with the requisitions of the Local Government Board.) Infantile Mortality, 1916. Nett Deaths from stated causes at various Ages under 1 year of Age. CAUSE OF DEATH. Under 1 week. 1 to 2 weeks 2 to 3 weeks Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. 3 to 4 weeks. All Causes ( Certified) Uncertified 258 60 13 11 7 91 49 54 29 35 .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. Chicken pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 4 Measles .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping cough 1 1 4 6 .. .. .. .. .. .. Diphtheria and croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis 2 1 3 .. .. .. .. .. .. .. Abdomional Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases 1 2 3 .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. 1 3 1 5 .. .. .. .. .. 3 5 2 1 1 10 Convulsions 2 1 .. .. Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis 4 4 5 6 2 2 19 .. .. .. 36 Pneumonia (all forms) 2 2 9 10 4 11 .. .. .. 2 6 2 3 13 Diarrhœa .. .. .. .. .. Enteritis 3 13 7 4 27 .. .. .. .. .. .. Gastritis 1 1 2 3 1 6 .. .. .. 2 2 Syphilis .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying .. .. .. .. .. .. .. .. .. Injury at Birth 1 1 1 .. .. .. .. .. .. .. 9 9 9 Atelectasis .. .. .. .. .. .. .. Congenital Malformations 6 1 .. 7 1 1 1 10 .. .. Premature Birth 49 29 7 4 3 43 6 .. .. .. Atrophy, Debility, and Marasmus 9 4 .. 13 11 10 5 2 41 .. Other Causes 3 .. 2 5 2 2 1 4 14 .. 35 258 60 13 11 7 91 49 54 29 Nett Births—Legitimate, 2831; Illegitimate, 87. Nett Deaths—Legitimate infants,251 Illegitimate infants, 7. B 18 INFECTIOUS AND OTHER DISEASES. Mortality from the Principal Epidemic Diseases. The following diseases are included under this heading : —Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fevers (that is to say, Typhus, Enteric and Continued), Diarrhoeal Diseases, and Plague. DEATHS AND DEATH RATE. Altogether 114 deaths were registered during 1916 and the death rate from all these diseases, calculated on the estimated population, was 103 per 1000 of the population, compared with an average of 1.8 forthe past ten years. In 1915 the death rate was 2.07; in 1914, 1.69; and in 1913, 1.87. In the following table will be seen the number of deaths from these diseases and the epidemic death rate in each Ward:— Epidemic Death-rate. Deaths. East Ward 55 2.58 North Ward 27 1.12 North-West Ward 15 0.63 5 0.41 South ward South-East Ward 7 1.56 South-West Ward 5 0.30 114 1.03 Infectious Diseases, 1916. Total number of notifications received. Relating to patients. Errors of diagnosis. Cases Contracted in hospital. Nett number of cases. Disease. Small Pox - - - - - Cholera - - - - - Diphtheria (including Membranous Croup) 271 268 14 254 24 1 Erysipelas 113 104 104 - Scarlet Fever 314 311 11 300 13 Typhus Fever - - - - - Enteric Fever 6 6 1 5 - Relapsing Fever - - - - - Continued Fever - - - - - Puerperal Fever 5 5 1 4 - Plague - - - - - Cerebro-spinal Fever 7 7 2 5 - Anthrax - - - - - Hydrophobia - - - - - Glanders - - - - - Pulmonary Tuberculosis 661 276 276 - - Other Tubercular Diseases 167 127 127 - - 37 Ophthalmia Neonatorum 28 28 - - - - - Acute Poliomyelitis 1 1 1 - Measles 1137 1137 1137 - German Measles 302 302 302 - Total 2572 29 2543 3021 38 Previous year 1460 50 1410 2000 - 1906 6 0.05 71 0.61 0.13 61 0.52 18 0.15 146 1.26 2.72 - 16 318 - - 1.32 1907 5 0.04 55 0.47 13 0.11 35 0.30 26 0.22 20 0.18 154 - 1908 6 0.05 33 0.28 6 0.05 25 0.21 10 0.08 82 0.70 162 1.37 - - 1909 6 0.05 - 66 0.55 13 O.11 47 0.40 16 0.13 46 0.39 194 1.63 - 1910 4 0.03 60 0.50 3 0.03 44 0.37 12 0.10 82 0.68 205 1.71 - - 35 2 0.02 0.32 0.14 172 1.57 2.72 1911 67 0.61 7 0.06 15 298 - - 24 1912 2 0.02 - 28 0.26 6 0.05 0.22 11 0.10 28 0.26 99 0.91 - 43 1913 2 0.02 50 0.45 3 0.03 0.39 20 0.18 90 0.81 208 1.87 - - 9 1914 3 0.03 - 50 0.46 9 0.08 0.08 25 0.23 88 0.81 184 1.69 - 61 - - 1915 5 0.05 49 0.44 0.55 10 0.09 94 0.85 228 2.07 9 0.08 Avera ge for 10 years. 4 0.04 - - 53 0.46 8 38 0.34 16 0.14 85 0.75 205 1.80 0.07 1916 1 0.01 - - 32 0.29 5 0.05 14 0.13 13 0.12 49 0.44 114 1.03 The deaths under this heading for the years 1906 to 1910 refer only to those certified to be due to epidemic or summer diarrhœa, or epidemic, zymotic or infective enteritis. From 1911 onwards, deaths from Gastroenteritis, Gastro-intestinal Catarrh, Muco-enteritis, Colitis, &c, are also included 20 Notifiable Infectious Diseases. The total number of cases of Infectious Diseases notified during the year under the provision of the Public Health (London) Act, 1891, and the Tuberculosis Regulations was 1104. This shows a decrease of 327 on the preceding year. In addition, 1439 cases of measles and German measles were notified under the Local Government Board Regulations, which came into force at the beginning of the year. In this connection the Council have undertaken to provide Medical and Nursing Assistance in necessitous cases of measles, and have entered into an agreement with the Ranyard Nursing Association whereby the Association undertakes to provide a supply of nurses for such cases at 8d.per visit. The total cost to the Council is not to exceed £40 per annum. During the few months in which the scheme has been in operation some 27 visits have been paid, and in two instances fees have been paid for medical attendance. Bacteriological Diagnosis. The number of specimens of blood, secretions, etc., sent to the Seamen's Hospital from suspected cases of diphtheria, enteric fever, etc., for bacteriological diagnosis was 370, of which 108 gave a positive result. Specimens of sputum from suspected cases of tuberculosis are now examined at the dispensary, and last year amounted to 380, of which 89 were positive. Small Pox. No cases of this disease were notified during the year. Scarlet Fever. The notifications received numbered 314, relating to 311 cases. The disease was of a mild type and there were only 5 deaths. Diphtheria and Membraneous Croup. The number of cases notified was 254, of whom 13 died. The cases were not limited to any particular district and the disease was most prevalent in the last quarter of the year. Bacteriological examinations were made in 170 instances, 48 giving a positive result. Enteric Fever. There were 6 cases notified but 1 proved to be an error in diagnosis ;of the 5 genuine cases 1 died. None of the cases call for special comment. Erysipelas. 104 cases were notified, all of whom recovered. 21 Puerperal Fever. 4 notifications were received; of the patients 3 died. All the circumstances were carefully inquired into and the rules of the Central Midwives Board rigorously enforced. Ophthalmia Neonatorum. This disease occurred in 28 infants, all of whom were visited by the Health Visitors and promptly placed under treatment, with the result that in only 1 case did the disease lead to any impairment of vision. Epidemic Cerebro Spinal Meningitis. 5 cases of this complaint were received, of which 2 were fatal. Acute Polio-Myelitis or Polio-Encephalitis. Only 1 case of this disease was notified. The patient made a good recovery. Diarrhœa and Enteritis. Average of previous 10 years. 1916 Number of Deaths 58 49 0.53 0.44 109 85 0.82 0.75 Number of deaths under two years of age Death rate per 1,000 (all ages) Death rate per 1,000 (under two years of age) Under this heading are included deaths registered as due to epidemic diarrhoea, epidemic enteritis, infective enteritis, zymotic enteritis, summer diarrhoea, dysentery and dysenteric diarrhoea, choleraic diarrhoea, cholera (other than Asiatic or epidemic) and cholera nostras. Under the heading of “Enteritis” are included deaths registered as due to enteritis, muco-enteritis, gastro-enteritis, gastric catarrh, and gastro-intestinal catarrh. Gastritis is a separate disease. These diseases were the cause of 58 deaths during 1916 compared with 116 for 1915. Of this number 50 were of children under five years of age, 49 of these being under two years of age. The death rate was 0'53 per 1,000 at all ages, and 0'44 for infants under two years of age. The older statistics do not give an accurate comparison with 1911-1916, because the heading of Diarrhoea did not, before these dates, include the names mentioned above, but simply cases registered as epidemic or summer diarrhoea, or epidemic, zymotic or infective enteritis. It is usual now to consider the infantile mortality in this case as being for all children under two years of age. 22 Measles and German Measles-The Public Health (Measles and German Measles) Regulations, 1915, came into operation on Ist January, 1916, and in all 1439 cases (measles 1137, German measles 302), were notified during the year; of the measles cases, 32 proved fatal. Under the above regulations, measles and German measles are now to be notified by medical practitioners, parents and guardians. Special notices were sent to medical practitioners, and every effort was made to let parents know that these diseases were now notifiable. Very few notifications were received from parents. As already stated, the Council, under an agreement with the Ranyard Nursing Association, now provide the services of a nurse for severe cases in necessitous circumstances. Schools. In 10 schools, one or more departments were closed for a varying period, the children excluded, and the rooms disinfected. Whooping Cough. This being a non-notifiable disease it is impossible to state the number of cases that occurred. The deaths registered as due to it, however, numbered 14, against 61 in 1915. Pulmonary Tuberculosis, including Phthisis. Number of cases notified, 1916 276 Number of deaths 169 Death-rate per 1,000 (Deptford) 1˙53 In the following table will be seen the number of cases notified, the number of deaths and the death-rate in each Ward:— Fresh Patients notified during the Year. Death-rate per 1,000. Estimated Population to middle of year. Deaths Wards. East 90 63 3.0 21,340 65 North 34 1.4 24,043 43 North-west 27 1.1 23,652 18 South 11 0.9 12,232 21 South-east 17 1.4 12,411 South-west 39 17 1.0 16,621 Whole borough 169 1.53 276 110,299 23 AGES OF PATIENTS NOTIFIED. Under 1 1-5 5-15 15-25 65 & upwards. All Ages. 25-45 48-65 7 50 45 111 52 8 276 3 General Tuberculosis. Thirty-eight deaths were recorded as being due to these diseases. Twenty-two deaths were classified as tuberculous meningitis and 16 as other tuberculous diseases. The following gives the ages at which death occurred:- Under 1 2 to 5 5 to 15 15 to 25 45 to 65 65 and upwards. 1 to 2 25 to 45 Cause. 3 7 9 - 1 - - Tubercular Meningitis 2 1 2 1 7 1 2 1 Other Tubercular Diseases 1 Tuberculosis Dispensary. In accordance with recommendation of the Local Government Board only an " outline" report is given of the work of the Dispensary during 1916. A more complete report is unnecessary as the methods of administration and of treatment were fully detailed in the previous report. It is sufficient to state that these methods are still adhered to. The number of new patients examined in 1916 was 871, of whom 137 were insured. The number of attendances recorded by all patients (old and new) was 7035, being an increase of 1119 over the attendance of the previous year. The following tables explain themselves and show, in part, the results of treatment. Otherwise I would only emphasize my remarks of previous years with regard to the crying need for accommodation, apart from Poor Law, for advanced cases of Pulmonary Consumption. 24 Table I. SOURCE OF CASES EXAMINED AT THE DISPENSARY. Applied on own initiative. Sent by Doctor. Sent by Health Visitor. Sent by School or Hospital etc. Totals. Diagnosed as suffering from (a) Pulmonary Tuberculosis 48 79 23 45 195 (b) Non-Pulmonary Tuberculosis 12 21 33 9 75 (c) No Tubercular disease 284 71 220 26 601 Totals 171 276 80 871 344 Table II. DETAILS OF CONTACTS. Discharged Non-tubercular Diagnosed as Tubercular Remaining under observation Examined under 16 years under 16 years Total M. Under 16 years. M. F. Under 16 years Total M. F. Total M. F. F. Total Insured - - 7 18 25 7 11 - 18 1 3 - 4 - - - Non-Insured 244 3 32 279 — 28 230 258 3 7 11 21 - - 3 3 244 10 50 304 7 39 230 273 4 10 11 25 3 - 3 - Table III. DETAILS OF PATIENTS' SUFFERING FROM PULMONARY TUBERCULOSIS. Discharged Died Left District, etc. Total Discharged Remaining under treatment, 31 Dec., 1916. 31 Dec, 1916. Carried forwd, 31 Dec., 1915. Admitted.1916. Total treated, 1916. Improved Ntt Improved Male 61 19 7 115 176 109 8 143 33 88 Female 79 80 159 9 6 3 106 53 140 195 13 11 249 86 335 28 197 25 Table IV. AGE AND SEX DISTRIBUTION OF 195 CASES ADMITTED AS PULMONARY TUBERCULOSIS. Under 5 Between 5-15 Between 15-25 Between 25-35 Between 35-45 Between 45-55 55 and over Totals. Males 2 27 20 27 22 17 - 115 Females 2 25 24 19 7 3 - 80 Totals 4 52 44 46 29 20 - 195 TABLE V. SHOWING STAGE OF DISEASE OF ABOVE PATIENTS. (TURBAN’S CLASSIFICATION.) 1st stage 2nd stage 3rd stage Totals Male 38 48 29 115 37 Female 30 13 80 75 78 42 195 NON-PULMONARY TUBERCULOSIS. The particulars of patients admitted with other forms of Tuberculosis than that of the lungs will be found below. The nature of the cases admitted was as follows :— Glands —Cervical 40 ; Abdominal 8 ; Bones and Joints 21 ; Skin 3 ; other 3. Table VI. DETAILS OF PAITENTS SUFFERING FROM NON-PULMONARY TUBERCULOSIS. Carried forward 31.12.15 Admitted 1916 Total treated 1916 Discharged. Left District etc. Total Discharged Remaining under treatment 31.12.16 Died Improved Not improved Male 13 35 47 36 8 - - 44 3 Female 22 40 63 40 7 2 2 51 12 35 75 110 76 15 2 2 95 15 26 Table VII. AGE AND SEX OF 75 CASES ADMITTED AS NON-PULMONARY TUBERCULOSIS. Under 5 Between 5-15 Between 15-25 Between 25-35 Between 35-45 55 and over Totals. Between 45-55 Males 7 24 1 1 1 - 1 35 Females 5 29 3 - 1 2 - 40 12 53 4 1 2 1 75 Totals 2 NON-TUBERCULAR AND DOUBTFUL CASES. As before remarked, fewer people attended the Dispensary this year with the idea that it was open for treatment of all kinds of diseases. The great majority of the cases referred to in the following table suffering from chest complaints sir h as bronchitis, " colds," asthma, etc., and were directed to their family medical attendant or to Hospital as seemed advisable. Table VIII. DETAILS OF PATIENTS DIAGNOSED AS NON-TUBERCULAR. Carried forward 31st Dec, 1915. Admitted 1916. Total examined. Discharged non-tubercular. Remaining Under observation, 31st Dec., 1916. 252 274 268 6 Male 22 349 379 375 4 Female 30 52 601 10 653 643 TABLE IX. Homes visited by Tuberculosis Officer and Medical Officer of Health. 204 Visits by staff on first notification 492 Revisits 1387 Special cases referred to staff by Tuberculosis Officer 81 During the year 81 patients from Deptford were admitted to Sanatoria under the National Insurance scheme and 152 to Poor Law Institutions. 27 Respiratory Diseases. Under this heading are included bronchitis, pneumonia, pleurisy, and other diseases of the respiratory organs. The number of deaths registered was 337. Of these deaths 55 were of children under one year of age, 44 over one and under five years, and 118 were persons over 65 years of age. Influenza. This disease, which is an infectious one, accounted for 23 deaths during the year compared with 21 for the year 1915. 11 of the deaths occurred between the ages of 25 and 65, and 10 were of persons over 65. Constitutional Diseases These diseases which form a group which are only second in importance to those known as the epidemic diseases accounted for 175 less deaths in 1916 than in 1915. They include rheumatic fever, rheumatism, rickets, diabetes, gout, anaemia, heart, arterial and other defined diseases. During the year they caused 669 deaths against 944 for the previous year. Cancer and Malignant Diseases. One hundred and thirty-eight deaths from cancer and malignant diseases were recorded during the year. They were equal to a death rate of 12˙5 per 10,000 of the population, which is 1˙7 above the rate recorded in the preceding year. General Sanitary Administration. During the year 5013 premises were inspected and 16,518 reinspections, calls, etc., were made by the District Inspectors. Building operations were considerably restricted as no new buildings could be erected without permission under an order made under the Defence of the Realm Act. Plans received numbered 34 and were chiefly for new drainage. 28 Inland Revenue Act, 1903. No certificates under this Act were issued during the year. Overcrowding was abated in 16 cases without having to take legal proceedings. Smoke Nuisances. During the year 5 observations of chimneys were made. Cleansing and Disinfection Station. Number of premises disinfected 1599 Number of rooms disinfected 1827 School children.—Baths given 1604 Mortuary and Coroner's Court. Number of bodies received 100 Number of inquests held 91 29 METROPOLITAN BOROUGH OF DEPTFORD. Table. REPORT OF SANITARY INSPECTORS FOR THE 52 WEEKS ENDED DECEMBER 30th, 1916. Number of District. 1 3 5 6 Totals. 2 4 7 Complaints Received 37 9 41 29 35 15 22 188 Total Premises Inspected 282 642 974 897 862 427 929 5013 Re-Inspections, Calls, Service of Notices, &c. &c. 3247 700 2513 2888 3158 1387 2625 16518 28 Inspections under notice from Con- tractors,per Bye-Laws 12 5 8 4 48 7 112 Number of Cases in which Pro- ceedings have been taken 2 1 3 ... ... ... ... ... “Intimations” Served 154 152 346 439 536 179 278 2084 “Statutory Notices” Served 2 8 25 3 4 59 2 15 Water Closets— I Old Closets abolished ... ... 1 1 ... ... ... ... New Closets provided 1 1 ... ... ... ... ... ... „ „ „ in Workshops ... ... ... ... ... ... ... 2 ... Basin and Trap provided 3 36 11 14 37 14 117 Water Supply provided 10 4 15 11 40 ... ... ... Water Supply Apparatus provided 2 10 3 22 51 10 2 90 ... Limewashed 8 2 1 ... 25 64 ... 7 ... Walls Repaired 9 19 3 39 1 ... ... Floors Repaired 5 6 ... 4 15 ... ... ... Doors provided 3 15 1 2 21 ... ... ... 5 5 Ventilated ... ... ... ... ... ... Seats provided 3 4 3 4 14 ... .. ... 4 Basins Cleansed 11 7 2 7 29 ... ... Sealed off from Scullery 2 ... ... ... 2 ... ... ... Drains— I Drains Re-constructed 7 13 5 6 4 4 39 ... Surface Drains provided ... ... ... ... ... ... ... ... Cleansed and Amended 3 76 37 22 65 23 47 273 Gully Traps fixed 2 32 30 7 23 2 7 103 New Soil Pipes and Vent Pipes fixed 7 4 1 3 ... 14 29 ... Chambers built and Interceptors provided 5 5 2 12 ... ... Interceptors only fixed ... ... ... ... ... ... ... ... ... Ventilated 9 15 1 28 3 ... ... ... Provided to Stables ... ... ... ... ... ... ... ... ... Clearing Eyes 3 1 10 1 15 ... ... Sinks, Bath & Lavatory Wastes, and Rain Water Pipes— Disconnected from drains, trapped and ventilated ... 28 8 34 28 10 108 ... 30 REPORT OF SANITARY INSPECTORS FOR THE 52 WEEKS ENDED DECEMBER 30th, 1916- continued. Table — continued. Number of District. 1 2 3 4 5 6 7 Totals Cesspools— I I I I I I I I Abolished ... ... ... ... ... ... ... ... Dustbins— IJ I J I J ... LJ I J I J ... Provided Repaired 20 72 63 166 132 61 71 585 1 1 ... ... ... ... ... ... Yards— I Paved 12 7 1 19 39 ... ... .. Surface Repaired 15 11 40 17 83 ... ... ... Urinals— Provided ... ... .. ... ... ... ... ... Repaired ... ... 2 2 ... ... ... ... 2 Cleansed ... ... ... 2 ... ... ... Scullery & Wash-house Floors- J I Floors paved or paving repaired Coppers repaired or renewed 1 4 10 32 1 48 ... ... 13 30 ... ... 1 44 ... ... Forecourts — . I Paved 2 1 3 ... ... .. ... ... ... 3 5 8 Surface Repaired ... ... ... ... Gutters and Rain Water Pipes I I Provided and Repaired 15 55 47 58 174 22 52 423 Water Supply— I I Store Cisterns provided ... ... ... ... ... ... ... ... 1 1 „ „ Covers provided ... ... ... ... ... ... „ „ Cleansed ... ... ... ... ... ... ... 5 abolished 2 3 5 ... ... ... ... ... Supply Reinstated 8 6 3 6 39 7 8 1 Fittings Repaired 4 38 8 7 47 5 35 144 New Houses Inspected for Certificates before Occupation ... 3 ... 3 ... ... ... ... Potable Water provided from Service ... ... 2 ... ... 2 ... ... Cleansing and Repairs— L.l LJ ... 11-1 LJ Houses Cleansed and Limewashed 155 38 113 201 162 73 183 925 Houses repaired and Ventilation improved 33 12 130 75 11 28 289 House roofs repaired ... 99 77 18 45 462 34 35 ... 154 Dampness abated 13 32 13 58 ... ... ... Staircases, &c, lighted ... 5 5 ... ... ... ... ... Stoves repaired or new ones provided ... 4 33 37 ... ... ... ... Window frames, sashes, or doors repaired or renewed and fastenings provided 29 3 33 1 ... ... ... ... 47 9 56 Floors repaired ... ... ... ... ... 2 Handrails fixed or repaired 10 4 7 23 ... ... ... Standards fixed or repaired 2 ... 29 ... 31 ... ... ... ... Miscellaneous 93 93 ... ... ... ... ... 31 REPORT OF SANITARY INSPECTORS FOR THE 52 WEEKS ENDED DECEMBER 30th, 1916 -continued. Number of District. Table —continued. 1 2 3 4 5 6 7 Totals. Dung Receptacles— I Abolished ... ... ... ... ... ... ... ... Repaired ... ... ... ... ... ... ... ... ... ... Provided ... ... ... ... ... ... Underground Used as dwellings abolished ... ... ... ... ... ... ... ... Overcrowding— I 1 I .. I Cases Abated ... 4 4 ... 1 3 4 16 Accumulations I Removed 3 1 9 29 ... 12 4 ... Animals— I I Ceased keeping as a Nuisance 5 1 ... ... 2 2 ... ... 1 Smoke Cases Abated .. ... 1 ... ... ... 5 ... Observationas ... ... 5 ... ... ... ... Rooms occupied in such a manner as to be a nuisance ... ... ... ... ... ... ... ... ... ... Inland Revenue Act I Houses inspected for Certificates ... ... ... ... ... ... ... Number of Tenements ... ... ... ... ... ... Number of Certificates granted ... ... ... ... ... ... ... ... Number of Certificates refused ... ... ... ... ... ... ... ... ... District No. 1 —Inspector SIMPSON (on military service). District No.2. —Inspector PRIEST. District No.3.—lnspector SHELLEY. District No.4.—Inspector SNOWDON. District No. 5.—lnspector KEMP. District No.6. —Inspector HEWETT. District No.7. —lnspector ALLAM. 32 The Housing, Town Planning, &c., Act, 1909. The following is a tabular statement of the work carried out during the year:— Number of houses inspected 1784 Number of houses represented as unfit for habitation 2 Number of houses represented as unfit for habitation, and not capable of being made fit - Number of houses closed 2 Number of underground sleeping rooms upon which Closing Orders were made - Number of houses demolished — Number of houses made habitable 4 Number of back-to-back houses converted to through houses — Number of closing orders made 2 Number of demolition orders made - Houses closed voluntarily - Houses dealt with under Section 15 — Dairies, Milkshops and Purveyors of Milk. The following cases of infectious disease occurred in connection with these premises during 1916: —Measles 10, Diphtheria 2, Scarlet Fever 3, Erysipelas 1, Enteric Fever 1 ; total 17. In each instance action was taken in accordance with the Dairies, Cowsheds and Milkshops Orders, the sale of milk being prohibited until after disinfection and certification of the premises by the Medical Officer of Health. Slaughter Houses. The following are the slaughter houses in the borough at present licensed by the London County Council: — (1) 180 Brockley Road. (2) 13a High Street. The premises were cleansed and limewashed every quarter as required by the bylaws. Number of slaughter houses in the borough 2 Number of inspections for the year 55 Offensive Businesses. There are still two premises in the borough of offensive businesses under the offensive trade regulations of the London County Council,viz.: — Messrs. Wheen & Sons, Ltd., Copperas Street. Messrs. Hill & Sons, Ltd., 1 Frankham Street. Number of inspections during the year 20 The premises were periodically cleansed and limewashed in accordance with the regulations. I am pleased to report that very few complaints were received in reference to these premises, and that they were well supervised. 33 Table. METROPOLITAN BOROUGH OF DEPTFORD. PROCEEDINGS DURING 1916. PREMISES. NUMBER OF PLACES— Number of notices Number of proceedings Number of inspections on register at end of 1915 Added 1916 Removed 1916 On register at end of 1916 Milk premises 252 38 37 253 408 16 .. Cowsheds 2 2 .. 2 .. .. .. Slaughter-houses 2 2 55 .. .. .. .. .. Other offensive trade premises Ice cream premises 2 2 20 .. .. .. 143 1 6 138 184 7 .. Registered houses let in lodgings .. .. 289 289 578 (a) 176 .. (a) For overcrowding. Table. METROPOLITAN BOROUGH OF DEPTFORD. PUBLIC HEALTH DEPARTMENT. TABULATION OF REPORT AS REQUIRED BY S. 131 OF THE FACTORY AND WORKSHOP ACT, 1901. INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES, during 1916. CLASS OF WORK. Number of Prose- Number of Places Number of Inspections. Numberof On Register at end of 1915. On Register at end of 1916. Removed 1916. Written Intimations. Under Factory Acts. Under Public Health Acts. Added 1916. Notices, Premises. Rooms Factories Factory Laundries 7 1 6 28 8 2 1 Factory Bakehouses 3 24 19 8 1 10 Other Factories 118 11 2 127 242 91 10 Workshop Laundries 7 1 6 26 22 Workshops- 2 53 Workshop Bakehouses 55 56 162 3 1 Other Workshops 190 7 8 189 249 47 7 1 Places where Food is prepared for Sale 125 2 6 121 235 95 6 Workplaces Work places other than the above 70 2 7 65 68 12 9 1 1 767 Home-workers' Premise 124 57 834 836 242 2 Total 1374 149 1441 1764 39 4 1 85 698 34 Table. METROPOLITAN BOROUGH OF DEPTFORD This Table is by request of the Secretary of State. Annual Report of Medical Officer of Health for the year 1916. On The Administration of The Factory And Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. factories (including Factory Laundries) 118 13 Workshops (including Workshop Laundries) 231 12 Workplace (other than outworkers' premises included in part 3 of this Report) 107 16 1 1 Total 456 41 2—DEFECTS FOUND. PARTICULARS. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts. Want of Cleanliness 213 213 Want of Ventilation 2 2 Overcrowding Want of Drainage of Floors 100 94 Other Nuisances Insufficient 2 2 Sanitary Accommodation Unsuitable or defective 42 42 Not Separate for Sexes Offences under the Factory and Workshop Act. Illegal Occupation of Underground Bakehouse (s. 101) Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) Other Offences (excluding offences relating to outwork which are included in Part 3 of this Report) Total 359 353 NATURE OF WORK. OUTWORKERS' LISTS. SECTION 107 OUTWORK IN UNWHOLESOME PREMISES. SECTION 108 OUTWORK IN INFECTED PREMISES. SECTIONS 109. 110 Notices served on Occupiers as to keeping or sending lists. Lists received from Employers. Prosecutions. Instances. Twice in the year. Once in the year. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110) Lists. outworkers. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Contractors. Workmen. Workmen. Contractors. 1 2 3 5 8 10 11 12 13 14 15 4 6 7 9 16 Wearing Apparel— I I I I. I L.l I . I I I I. I I I I I [ I I I I I I I I I (1) making, &c. (2) cleaning and washing I I I " I I I I ! I I i 62 4 415 2 .. 8 73 .. .. 35 .. .. .. Household linen mm Lace, lace curtains and nets • I I I I I Curtains and furniture hangings Furniture and Upholstery 2 .. 4 .. .. .. .. Electro Plate .1 m I I I I I mj I I I File making I I Brass and brass articles mam Fur pulling I I Cables and Chains Anchors and Grapnels I I Cart Gear Locks, Latches and Keys I I Umbrellas, &c. mm I Artificial flowers ■I t f Nets, other than wire nets I I I Tents •I Sacks Racquet and tennis balls I I Paper, etc., boxes, paper bags Brush making mm Pea picking I Feather sorting •I I I Carding, &c., of buttons, &c. Stuffed Toys I Basket making m Chocolates and Sweetmeats ■I I Cosaques, Christmas Crackers, Christmas Stockings, etc. • I I I Textile Weaving U. _ u J_ I I I I I I II I Total 64 4 419 2 8 75 1 —I I —1 35 1—I 2 36 Table— continued. 4—REGISTERED WORKSHOPS. Workshops on Register (s. 131) at the end of year. Number. Bakehouses 53 Dressmaking 65 Laundries 6 Millinery 14 Shirtraaking 2 Tailoring 17 Wheelwrights (Smiths, &c.) 17 Others 74 Total number of Workshops on Register 248 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 2 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshops Act (s. 5, 1901) Notified by H.M. Inspector 3 Reports (of action taken) sent to H.M Inspector 3 3 Other Underground Bakehouses (s. 101): — Certificates granted during the year - In use at the end of the year 20 37 Canal Boats Acts. The following is the report of Inspector Turner, the Sanitary Inspector to whom is assigned the performance of the duties under the above Acts:— Gentlemen, I have the honour to present my report under the Canal Boats Acts for the year ended 31st December, 1916, as follows : For the purposes of inspection during the year, visits were made on the following dates, viz., February 3rd, March Ist and 17th, April 6th, 12th, 20th and 27th, May 3rd and 17th, June 21st, July 20th and 26th, August 9th, and November Bth. Boats were found and inspected on the following dates: — March 17th (four boats), April 6th (two boats), April 27th (two boats), May 3rd (one boat), June 21st (one boat), and July 26th (three boats). Number of visits 14 Number of boats inspected 13 Infringements. The following matters were found requiring attention: — March 17th —Boat “Hereford” 1271. Registration papers not produced. Notice served and Certificate of Registration received. March 17th —Boat " Mary" 114. Wrong Registration number on boat. Notice served and Certificate of amendment received. Children on Boats. No children of school age were found on the boats inspected. No cases of sickness were found. The boats inspected were found to be in a cleanly and habitable condition. General. The arrangements made for the inspection of boats in this Borough are : —Periodical inspection by a Sanitary Inspector, duly appointed an Inspector under the Canal Boats Acts jointly with other duties as Inspector of Workshops, Dairies, Cowsheds and Milkshops, etc. I am, Gentlemen, Your obedient Serrant, Thos. Turner, Canal Boats Inspector. 38 Under Section 3 of the Canal Boats Acts, this Council as a Sanitary Authority is required each year to make a report to the Local Government Board as to the execution of the Canal Boats Acts, and the steps taken to enforce the provisions of the same. Sale of Food and Drugs Acts. The total number of samples purchased during the year and examined by the Public Analyst was 411. The following is a list of the articles purchased, with the results of the analyses. Article. Number Genuine. Number Adulterated. Total. Percentage of Adulteration. Baking Powder 10 1 11 9.1 Butter 56 1 57 1.8 Custard Powder 3 .. 3 .. Cocoa 7 .. 7 .. .. Coffee 1 1 .. Dripping 4 1 4 .. Ginger, Ground .. 1 1 100 Egg Powder 3 1 4 25.0 Flour, Self-raising 2 .. 2 .. Jelly, table 4 4 .. .. Lard 6 .. 6 .. 292 Milk 267 25 8.6 „ Separated 4 1 5 20.0 Mustard 10 .. 10 .. Pepper 7 .. 7 .. Vinegar 1 .. 1 .. Total 381 30 411 7.3 Proceedings were taken in 30 cases for adulteration or other offences, the fines and costs inflicted amounting to £8 2s. 6d. Unsound Food. The following quantities of food were, upon examination by officers of the Public Health Department, found to be unsound, unwholesome, and unfit for the food of man, and were destroyed:— Inspector. Description of Food. Remarks. Mr.Priest 1 case of Cod Voluntarily surrendeied. 1 barrel of Sprats „ „ „ „ 1 box of Hake „ Shelley „ „ Not exposed for sale. „ „ 2 cwt. of Bacon 39 Public Health Legislation in 1916. Venereal Diseases. A Royal Commission appointed in 1913 reported in 1916, and the Public Health (Venereal Diseases) Regulations were issued during the year. Local Authorities are given power to provide facilities for persons suffering from various forms of Venereal Diseases to obtain advice and treatment free and secretly. For London, the Metropolitan Boroughs, the London County Council is the Authority, and the Borough Council and Medical Officer of Health are merely required to advertise the scheme submitted to them. The Miller General Hospital and the Seamans' Hospital, Greenwich, are the two local centres for treatment. Co-operation of Civil and Military Authorities. The scheme of co-operation between the two Authorities, adopted last year, has been continued and developed during 1916. The chief work has been the supervision of Military Contacts with Infectious Disease, the personal bathing and disinfecting of military clothing. In addition, doubtful or suspected cases of Tuberculosis amongst recruits called up for examination, are now referred to the Tuberculosis Dispensary for detailed examination and report. By Order of the Local Government Board, Medical Officers of Health are now required to furnish to the Army Council particulars of all male persons, who, being on Ist January, 1916, between the ages of 18 and 45, have been notified since Ist February, 1913, as suffering from Tuberculosis. A list is also sent in weekly of notified males. The operation of the Order is limited to the duration of the war, and its object is to assist the Army Council in securing that men suffering from Tuberculosis are not enlisted.