FUL 17 Courncil of the Borough of Fulham. ANNUAL REPORT of the Medical Officer of Health, J. CHARLES JACKSON. FOR THE YEAR 1914. Town Hall, Fulham, S.W. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Fulham. Sir and Gentlemen, I have the honour to present to you my Twenty-third Annual Report on the vital statistics and the conditions affecting the health of the borough during the year 1914. The statistics of births, deaths and infectious diseases relate to the fifty-two weeks ended January 2nd, 1915. POPULATION. The population of Fulham as enumerated at the Census taken on April 2nd, 1911, was 153,284, and in the middle of 1914 it was, according to the revised estimate of the Registrar General, 157,303. The following table shows the increase of the population of the borough since 1851:— TABLE I. Year. Population. Increase per cent. during previous intercensal period. Persons to the Acre. Rateable Value. £  1851 Census 11,166 — 7.0 47,492 1861 15,539 30.9 9.1 55,916 1871 23,378 50.5 13.7 96,661 1881 42,900 83.5 25.2 149,899 1891 91,640 113.6 53.8 385,407 1896 113,781 24.4 66.8 560,965 1901 137,289 20.6 80.6 677,332 1911 153,284 11.7 90.1 902,640 1914 Estimated 157,303 - 92.5 915,870 MARRIAGES AND MARRIAGE-RATE. 1,450 marriages were registered during the year, compared with 1,353, 1,387 and 1,382, in the preceding three years. The marriage-rate, i.e., the number of persons married per 1,000 inhabitants was 18.4, the average rate of the preceding ten years being 16.7. 6 BIRTHS AND BIRTH-RATE. Excluding 16 births among non-residents,but including 105 children born of Fulham mothers in lying-in institutions situate in other boroughs, 4,154 births were registered, 2,125 of boys and 2,029 of girls, representing a birth-rate of 26.4 per 1,000 inhabitants, which is the lowest recorded in Fulham. The persistent fall of the birth-rate in Fulham during the last 25 years, which is shared by every part of the United Kingdom, can be seen on reference to the chart showing the birth and death rates. Its seriousness, as affecting the welfare of the community at a time like the present, may be appreciated by remembering that if the birth-rate had been the same as it was 20 years ago, upwards of 1,400 more children would have been born in Fulham last year. The birth-rate of the County of London was 24.3 per 1,000, and in the several Metropolitan boroughs the rates ranged from 10.2 in the City of London, 14.0 in Westminster, and 14.8 in Hampstead, to 31.0 in Bermondsev, 31.6 in Poplar, and 32.1 in Shoreditch. The following table gives the number of births and the birth-rates in the various wards, corrected by the distribution of the births in Fulham Infirmary to the wards in which the mothers resided, and by the inclusion of those occurring in outside Maternity Institutions :— TABLE II. Births in 1914. Ward. Males. Females. Total Births. Birth-rate. Barons Court 93 101 194 15.4 Lillie 359 352 711 28.7 Walham 178 168 346 27.5 Margravine 312 250 562 30.0 Munster 530 590 1,120 28.7 Hurlingham 105 102 207 21.3 Sands End 416 345 761 28.6 Town 132 121 253 19.0 The Borough 2,125 2,029 4,154 26.4 7 TABLE III. VITAL STATISTICS OF WHOLE DISTRICT DURING 1914 AND PREVIOUS YEARS. Year. Population Estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths.† Nett Deaths belonging to the District. Uncorrected Number. Nett. Under 1 Year of Age. At all Ages. of NonResidents registered in the District. of Residents not registered in the District. Number. Rate Number. Rate. Number. * Rate per 1,000 Nett Births. N umber. * Rate. 1 2 3 4 6 6 7 8 9 10 11 12 13 1909 152,501 4,199 4,306 28.2 1,940 12.7 154 329 466 108 2,115 13.9 1910 153,166 4,213 4,310 28.1 1,701 11.2 99 306 462 107 1,908 12.5 1911 153,284 4,012 4,122 26.9 2,019 13.2 169 378 517 125 2,228 14.5 1912 155,402 4,079 4,213 27.1 1,830 11.8 173 366 395 94 2,023 13.0 1913 157,117 4,234 4,302 26.9 1,833 11.3 212 407 412 96 2,028 12.7 1914 157,303 4,065 4,154 26.4 1,878 12.3 137 391 469 113 2,132 13.6 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. The rates are calculated per 1000 of the estimated £ross population. *In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly cor rected by subtraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. †Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in Columns 8 or 9, except in certain instances under 3 (b) below. In Column 8 is stated the number of transferable deaths of "non-residents" which are deducted, and in Column 9 the number of deaths of "residents" registered outside the district which are added in calculating the nett death-rate of his district. The following special cases arise as to Transferable Deaths:— (1) Persons dying in Institutions for the sick or nfirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) are regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferred If the patient has been directly transferred from one such institution to another, the death is transferred to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement are referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known ; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. (4) The deaths of 10 Belgian Refugees which occurred in Fulham in 1914 have not been transferred, and are included in Columns 10 and 12. Area of Distric in acres (exclusive of area covered by water), l701. total population at all ages 153,284 Number of inhabited ordinary dwelling houses 17,324 Average number of persons per house 7.2) At Census of 1911. 8 Illegitimacy. The illegitimates numbered 207 or 5 per cent. of the total births. Of these 172 were born within, and 35 outside the borough. Still-born Children. 128 still-born children were buried in Fulham Cemetery, being in the proportion of one still-born child to every 32 living. Excess of Births over Deaths. The natural increase of the population by the excess of births over deaths was 2,022 compared with 1,894, 2,190 and 2,274 in the preceding three years. DEATHS AND DEATH-RATE. During 1914 1,878 deaths were registered in the borough, but of these 137 were of persons not belonging to the borough, while 391 inhabitants of Fulham died outside the borough chiefly in various public institutions. There were therefore, including 10 deaths among Belgian Refugees, 2,132 deaths of persons (1,032 males and 1,100 females), having their usual residence in Fulham, representing a death-rate of 13.6 per 1,000 inhabitants, the rate for males being 13.8 and for females 13.3. The death rate of the County of London was 14.4, and among the Metropolitan boroughs the lowest rates were 10.5 in Hampstead, 11.0 in Wandsworth and in Lewisham, and the highest 17.9 in Southwark, 19.1 in Shoreditch, and 19.7 in Finsbury. In the following table the mortality of Fulham can be compared with that of the adjoining boroughs and of other groups of areas. BIRTHS AND DEATHS 1886 - 1914. Birth Rate per 1,000 of the population Death Rate from all causes per 1,000 of the population Death Rate from Epidemic Diseases per 1,000 of the population 9 TABLE IV. Mortality in 1914. Area. Annual Rate per 1,000 living. Fulham 13.6 Chelsea 13.3 Hammersmith 14.0 Kensington 13.3 County of London 14.4 97 Great Towns (including London) 14.7 145 Smaller Towns 12.9 England and Wales (less the 242 Towns) 13.4 England and Wales 14.0 Seasonal Mortality. The mortality in the four quarters of the year was as under:— Deaths. Death Rate. First quarter 605 15.4 Second quarter 471 12.0 Third quarter 493 12.6 Fourth quarter 563 14.4 Mortality in previous years. In Table III. will be found the number of deaths and the death-rate in each of the preceding five years. The average rate of the five years 1909—1918 was 0.3 per 1,000 below that of 1914. 10 Distribution of Deaths. Table VI. gives the number and causes of deaths in the several wards of the borough, and in the following table will be found the death-rates of each ward in 1914, and the preceding ten years:— TABLE V. Death-rate per 1,000 persons in each Ward. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. 1904 13.9 15.8 19.9 16.4 15.3 15.0 14.6 14.2 1905 13.3 16.1 18.0 16.8 14.1 15.0 15.3 13.9 1906 11.6 14.3 17.7 18.1 13.4 13.3 13.3 11.8 1907 12.9 15.0 16.9 19.5 13.1 11.9 12.4 11.3 1908 11.9 14.3 17.2 14.2 12.9 15.1 14.1 10.4 1909 12.7 14.6 18.2 16.2 12.5 12.1 12.5 12.2 1910 11.8 11.3 16.5 15.8 11.4 10.9 11.6 12.5 1911 11.8 15.1 19.0 18.2 14.1 10.4 14.3 12.2 1912 13.8 13.7 14.1 14.3 11.9 12.1 12.7 12.8 1913 13.3 13.9 17.6 13.6 11.3 12.1 11.8 10.1 Average of 10 years, 1904-13. 12.7 14.4 17.3 16.3 13.0 12.8 13.3 12.2 1914 12.8 13.8 19.3 15.2 12.3 11.8 13.8 13.7 11 TABLE VI. Causes of and Ages at Death during the Year 1914. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District (a). Total Deaths whether of "Residents" or "NonResidents" in Institutions in the District (b) Nett Deaths at all ages of " Residents " in the Wards oj the Borough whether occurring in or beyond the Wards. Causes of Death 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 upwards Barons Court Ward Lillie Ward Walham Ward Margravine Ward Munster Ward Hurlingham Ward Sands End Ward Town Ward 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 All Causes Certified (c) 2132 469 95 79 81 77 277 516 538 677 151 341 244 283 480 113 338 182 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1–Enteric Fever 9 ... ... ... ... 3 4 2 ... 13 1 ... 1 3 ... 1 3 2–Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3–Measles 31 9 11 9 2 ... ... ... ... 9 ... 5 8 10 5 ... 3 ... 4–Scarlet Fever 21 ... 1 7 8 3 1 ... 1 49 ... 3 ... 4 5 ... 7 2 5–Whooping Cough 43 28 7 6 2 ... ... ... ... 13 2 6 4 8 10 5 7 1 6–Diptheria and croup 23 3 4 5 10 1 ... ... ... 65 ... 7 ... 2 9 1 ... 2 7–Influenza 28 6 ... ... 1 1 3 8 9 ... 3 6 4 2 7 ... 4 2 8–Erysipelas 8 1 ... ... ... ... 1 1 5 7 ... ... 1 2 3 ... ... 1 9–Phthisis (Pulmonary Tuberculosis) 207 4 1 2 9 35 87 57 12 68 3 33 27 29 49 14 34 18 10–Tuberculous Meningitis 24 5 1 7 7 1 2 1 ... 9 ... 1 5 3 7 ... 7 1 11–Other Tuberculous Diseases 21 ... 2 2 6 2 3 5 1 7 ... 9 2 2 1 2 5 ... 12–Cancer, malignant disease 167 ... ... 1 1 1 17 85 62 30 17 25 21 14 33 16 23 18 13–Rheumatic Fever 3 ... ... ... 1 ... 1 ... 1 1 ... ... ... ... 1 ... ... 2 14–Meningitis. See note (d) 10 1 1 1 3 2 ... 2 ... 3 ... 1 ... 1 4 ... 3 1 15–Organic Heart Disease 185 ... ... ... 7 4 21 68 85 48 18 22 24 22 39 9 26 25 16–Bronchitis 153 22 9 3 ... ... 9 35 75 36 8 29 17 20 36 8 24 11 17–Pneumonia (all forms) 219 64 34 15 4 3 24 47 28 60 9 32 29 38 46 10 38 17 18–Other diseases of Respiratory organs 17 2 1 4 1 ... 4 3 2 4 1 5 3 ... 5 1 1 1 19–Diarrhœa and Enteritis 136 114 13 ... ... ... 2 2 5 49 4 17 18 25 48 2 19 3 20–Appendicitis and Typhlitis 11 ... 1 ... 1 4 3 2 ... 3 2 ... 1 3 2 ... 1 2 21–Cirrhosis of Liver 24 ... ... ... ... ... 5 14 5 7 3 6 1 2 7 ... 2 3 2lA-Alcoholism 3 ... ... ... ... ... ... 3 ... 3 ... ... ... ... 3 ... ... ... 22–Nephritis and Bright's Disease 82 ... ... ... 2 1 8 38 33 42 8 18 7 9 20 4 10 6 23–Puerperal Fever 8 ... ... ... ... ... 8 ... ... 9 ... 2 ... ... 4 1 ... 1 24–Other accidents and diseases of Pregnancy and Parturition . 12 ... ... ... ... 1 11 ... ... 3 1 3 2 ... 2 2 1 1 25–Congenital Debility and Malformation, including Premature Birth 147 147 ... ... ... ... ... ... ... 11 8 30 15 13 38 5 28 10 26–Violent Deaths, excluding Suicide 62 13 1 5 7 4 9 11 12 13 5 7 5 10 9 4 16 6 27–Suicides 18 ... ... ... ... 1 5 10 2 1 3 3 2 2 2 1 3 2 28–Other Defined Diseases 452 50 8 12 9 10 49 117 197 114 54 70 46 61 80 27 71 43 29–Diseases ill-defined or unknown 8 ... ... ... ... ... ... 5 3 ... 1 1 1 1 2 1 1 ... 2132 469 95 79 81 77 277 516 538 677 151 341 244 283 480 113 338 182 SubEntries included in above figures. 14 (a) Posterior Basic Meningitis 2 1 ... ... ... ... ... 1 ... 2 ... ... ... ... 1 ... 1 ... 28 (a) Pneumonia other than Broncho-pneumonia 119 17 7 6 3 3 22 40 21 36 7 22 13 17 22 7 22 9 (a) All "Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are included with the other deaths in columns 2—10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales who have died in the District, are in like manner excluded from these columns. For the precise meaning of the term "transferable deaths" see footnote to Table III. (b) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are entered in column 11 of Table VI. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as fied all other deaths are to be regarded as "Uncertified." (d) Exclusive of "Tuberculous Meningitis" (10). but inclusive of Cerebro-Spinal Meningitis. 13 Mortality at Different Ages. Infantile Mortality Of the 2,132 deaths, 469 or 22 per cent were of infants under one year of age, and the rate of the infant mortality measured by the proportion of deaths under one year to births registered was 113 per 1,000, being 17 per 1,000 above that of 1913. The corresponding rate of the County of London was 104 per 1,000 and of the 29 metropolitan boroughs only 7 had higher rates than Fulham. 99 infants, or one out of every 42 born in 1914, died in the first week of life. Table VII. gives the infantile death-rates of the several wards of the borough in 1914 and the preceding ten years. TABLE VII. Deaths under one year per 1,000 Births. Ward. 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 Average Ten Years 1904-1913 1914 Barons Court 181 108 88 146 91 75 122 70 148 108 114 108 Lillie 137 147 137 151 106 122 103 128 85 96 121 100 Walham 185 183 166 184 152 140 156 124 91 117 148 168 Margravine 179 153 171 136 129 133 135 154 112 102 141 136 Munster 140 137 142 116 120 102 103 137 91 91 118 106 Hurlingham 159 98 150 99 81 76 43 59 59 82 91 82 Sands End 156 168 127 107 136 94 109 138 97 102 124 114 Town 121 105 72 64 64 98 81 51 76 60 79 79 The Borough 152 144 133 122 115 108 107 128 94 96 120 113 14 It will be seen from the above table that in 1914 the infant mortality in Walham Ward was, as has generally been the case, much above that of the rest of the borough, and was double that of Town Ward, but the enormous loss of infant life in the poorer districts is best illustrated by the rates obtaining in certain selected areas, viz.:— Deaths of Infants under one year per 1,000 births. Heckfield Place 281 Walham, Rock and Lodge Avenues 305 Field Road Area 290 INFANTILE MORTALITY, 1886 - 1914 DEATHS OF INFANTS UNDER ONE YEAR OF AGE, PER 1.000 BIRTHS. 15 TABLE VIII. INFANT MORTALITY DURING THE YEAR 1914. Nett Deaths from stated causes at various Ages under One Year of Age. Nett Deaths under One Year of residents in the Wards of the Borough whether occurring in or beyond the Wards. Mean number of deaths during eight years 1906—1913. CAUSE OF DEATH. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 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 One Year. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. All causes Certified 99 23 15 13 150 97 102 61 59 469 21 71 58 76 119 17 87 20 503 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 4 5 9 ... 1 2 4 ... ... 2 ... 13.0 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 0.25 Whooping Cough ... ... 1 ... 1 3 7 9 8 28 2 4 4 4 7 3 4 ... 20.0 Diphtheria and Croup ... ... ... ... ... ... ... 1 2 3 ... 1 ... 1 ... ... 1 ... 2.5 Erysipelas ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 ... ... ... 0.5 Tuberculous Meningitis ... ... ... ... ... 1 ... 1 3 5 ... ... ... 2 ... ... 3 ... 6.0 Abdominal Tuberculosis (a) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4.0 Other Tuberculous Diseases ... ... ... ... ... ... 3 ... 1 4 ... ... 2 ... ... ... 2 ... 9.0 Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 6.0 Convulsions 1 1 ... 1 3 1 1 ... ... 5 ... ... 1 2 1 ... ... 1 11.0 Laryngitis ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... ... ... ... 0.5 Bronchitis ... 2 2 ... 4 8 6 2 2 22 1 5 2 3 2 1 8 ... 27.0 Pneumonia (all forms) 1 1 1 1 4 13 17 17 13 64 ... 6 12 14 14 2 14 2 58.5 Diarrhœa ... ... ... 1 1 20 20 10 12 63 2 6 7 13 24 ... 9 2 87.0 Enteritis ... ... ... 1 1 10 21 12 7 51 2 10 4 10 16 2 7 ... 26.0 Gastritis ... ... ... ... ... 3 1 1 2 7 ... 1 1 1 2 ... 1 1 3.0 Syphilis ... 1 1 3 5 4 5 ... 1 15 1 1 3 ... 4 2 3 1 13.5 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2.0 Suffocation, overlying 2 ... 2 ... 4 2 1 ... ... 7 2 ... 1 ... 1 ... 3 ... 12.0 Injury at Birth 8 ... ... ... 6 ... ... ... ... 6 ... 1 ... 2 2 1 ... ... 9.0 Atelectasis 2 ... ... ... 2 ... ... ... ... 2 ... 1 ... 1 ... ... ... ... 14.0 Congenital Malformations 2 3 ... ... 5 2 2 ... ... 9 ... 2 ... ... 4 ... 2 1 16.0 Premature Birth 70 13 1 2 86 8 1 ... ... 95 3 12 9 14 25 4 21 7 91.0 Atrophy, Debility and Marasmus 13 2 3 2 20 14 9 ... ... 43 6 14 5 ... 10 1 5 2 48.0 Other causes 2 ... 4 2 8 8 7 2 3 28 2 5 5 5 6 1 1 3 24.0 99 23 15 13 150 97 102 61 59 469 21 71 58 76 119 17 87 20 504. Nett Births in the year—Legitimate, 3,947; Illegitimate, 207. Nett Deaths in the year of—Legitimate infants, 404; Illegitimate infants, 65. (a) Under Abdominal Tuberculosis are included deaths from Tuberculous Peritonitis and Enteritis and from Tabes Mesenterica. Want of Breast Milk is included under Atrophy and Debility. 17 Causes of Infantile Mortality. Table VIII. gives the causes of the deaths at various periods under one year of age, and in the following table the mortality from certain groups of diseases will be found. TABLE IX. Death-rates of Infants under one year of age from certain groups of diseases. Diseases. Deaths per 1,000 births. 1914. Average of 5 years 1909-13. Infectious Diseases 9.7 8.2 Tuberculous Diseases 2.2 8.5 Diarrhœl Diseases 29.1 22.5 Respiratory Diseases 20.9 18.9 Premature Birth, Congenital Defects and Debility 35.4 34.7 Other Causes 15.7 18.2 113. 106. Notification of Births. Prevention of Infant Mortality. 3,401 notifications of living and 104 of stillborn children were received under the Notification of Births Act, 84 per cent. of the births registered in Fulham being notified. Of these 2,469 or 70.5 per cent. were notified by midwives, 859 or 24.5 per cent. by medical practitioners and 177 or 5 per cent. by relatives. Visits were paid to 1,450 of the babies born in the borough, either by your Sanitary Inspector or by the Superintendent or Assistant Superintendent of the Fulham School for Mothers, and about one half of these were visited again on one or more occasions according to their needs, 4,320 visits being made in all. 621 babies were brought to the consultations held by the three medical officers of the Fulham School for Mothers, and their attendances totalled 7,631 or 1,280 above those in 1913. 18 An important feature in connection with the School in 1914 was the recognition and appreciation by the Government of the work of Schools for Mothers, shown by the provision in the Budget of 1914-15 of funds to be expended in grants in aid of infant welfare work; and in accordance with this decision of the Government, the Board of Education issued regulations for Schools for Mothers. Under these, a School for Mothers is defined as an educational institution providing training and instruction to the mother in the care and management of infants and little children. It is provided that the imparting of such instruction may include systematic classes, home visiting and infant consultations. The provision of specific medical and surgical treatment, if any, is to be only incidental. Provided that the provision made by the institution is adequate and its working efficient, grants may be paid at the rate of one half of the approved expenditure, and the first grants under the regulations were based on the expenditure incurred during the twelve months ending 31st March, 1914. As the conditions laid down by the Board of Education have always been complied with by the Committee of Management, application was made to the Board for a grant, and the sum of £194 was paid to the School in respect of work done during the year which ended 31st March, 1914. Deaths of Illegitimate Children. Of the 469 infants who died before attaining the age of one year, 65 or 14 per cent, were illegitimate, the mortality among them being in the proportion of 314 deaths per 1,000 births against 103 per 1,000 among children born in wedlock. Insurance of Infants. Certificates under the Friendly Societies Act were issued in respect of 304 children under the age of five years, 47 per cent. of the children dying at this age period being insured. 19 Deaths at other age periods. Table X. gives the number of deaths and the deathrates at certain other age periods. TABLE X. Deaths at certain age periods. Age Period. Number of Deaths. Percentage Total Deaths. Death-rate per 1000 of population living at age period. 1 and under 2 years 95 4.5 27.2 2 „ 5 79 8.7 7.3 5 „ 15 „ 81 3.8 2.6 15 „ 25 „ 77 3.6 2.9 25 „ 45 „ 277 13.0 5.5 45 „ 65 „ 516 24.2 21.0 Over 65 „ 538 25.3 86.7 Deaths from Epidemic Diseases. To the seven principal epidemic diseases 254 deaths were ascribed, representing a death-rate of 1.62 per 1,000 which is 0.44 per 1,000 below the average rate of the preceding ten years. The following table gives the number of deaths in the borough from the principal epidemic diseases in 1914 and in the preceding ten years, together with the death-rates:— 20 TABLE XI. Deaths from the seven principal Epidemic Diseases. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. M ean number of Deaths 1904—1913. Mean Deathrate 1904—1913. Deaths 1914. Death-rate 1914. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 64 85 53 69 71 74 65 64 65 49 66 0.44 31 0.20 Scarlet Fever 4 23 18 14 17 10 7 6 6 4 11 0.07 21 0.13 Whooping Cough 58 82 31 75 84 48 60 28 45 27 49 0.38 43 0.27 Diphtheria 24 24 83 88 82 89 14 27 15 15 26 0.17 23 0.15 Enteric Fever 6 10 13 8 10 4 2 8 8 8 8 0.05 9 0.06 Diarrhoea and Enteritis under 2 years of age. 235 202 275 115 130 105 74 211 34 100 148 0.99 127 0.81 Total 391 426 423 819 294 280 222 844 173 203 308 2.05 254 1.62 21 TABLE XII. Cases of Infectious Diseases notified to the Medical Officer of Health. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 Smallpox — — 3 32 40 2 2 — — 1 9 16 94 11 — — — — — — — — — — — Scarlet Fever 286 118 517 701 529 339 627 759 811 847 552 600 552 404 294 779 674 668 596 511 354 384 484 766 1042 Diphtheria 70 69 96 230 329 368 341 378 465 514 630 636 417 286 299 285 403 603 400 322 257 311 231 270 272 Membranous Croup 23 13 15 20 13 18 14 10 11 14 11 8 12 7 3 1 — 1 — — — — — — — Enteric Fever 72 51 41 58 37 57 53 53 71 111 92 133 74 80 39 56 45 58 39 41 18 38 26 34 40 Continued Fever — — — 6 2 3 5 5 1 1 2 1 — — — — — 1 — 1 2 3 — — 1 Typhus Fever 2 3 — 1 — — — — — — — — — — — — — — — — — — — — — Cholera — — — 5 — — 2 1 — 4 — 1 — — — — — — — — — — — — — Puerperal Fever 6 6 10 18 10 6 6 14 8 13 9 7 7 19 8 24 17 15 17 34 20 23 30 19 33 Erysipelas 114 67 104 153 113 94 99 134 121 178 154 132 121 115 131 143 141 128 127 115 115 115 115 121 152 Epidemic Cerebrospinal Meningitis — — — — — — — — — — — — — — — — — 3 4 3 7 3 2 5 1 Ophthalmia Neonatorum — — — — — — — — — — — — — — — — — — — — — 15 13 23 55 Poliomyelitis — — — — — — — — — — — — — — — — — — — — — 1 5 2 — Pulmonary Tuberculosis — — — — — — — — — — — — 137 171 165 152 148 151 179 279 326 613 1173 765 551 Other forms of Tuberculosis — — — — — — — — — — — — — — — — — — — — — — — 289 164 Anthrax — — — — — — — — — — — — — — — — — — — — — — — — — Totals 573 327 786 1224 1073 887 1149 1354 1488 1683 1459 1534 1414 1093 939 1440 1428 1628 1362 1306 1099 1506 2080 2294 2311 22 TABLE XIII. Gases of Infectious Diseases notified during the Year 1914. Notifiable Disease. Number of Cases Notified, Total Cases Notified in each Ward of the Borough. Total cases removed to Hospital At all Ages. At Ages—Years. Barons Court Ward. Lillie Ward. Walham Ward. Margravine Ward. Munster Ward. Hurlingham Ward. Sands End Ward. Town Ward. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox — — — — — — — — — — — — — — — — — Cholera (C) Plague (P) — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 272 1 78 140 31 19 3 — 15 57 16 39 82 9 36 18 255 Erysipelas 152 3 4 11 13 36 52 33 8 34 8 25 30 11 31 5 73 Scarlet Fever 1042 — 238 — — — — — 30 — — — — — — — — Typhus Fever — — — — — — — — — — — — — — — — Enteric Fever 40 — 1 2 16 18 3 — 2 6 6 2 9 — 7 8 35 Continued Fever 1 — — — — — — — — — — — — — — — 1 Puerperal Fever 33 — — — 4 29 — — — 9 3 5 6 1 6 3 32 1 1 1 — 1 Poliomyelitis — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 55 55 — — — — — — — 4 6 15 19 1 10 — 17 551 1 23 95 90 227 105 10 27 84 80 83 126 17 99 35 — Other forms of Tuberculosis 164 2 33 86 17 15 8 3 10 21 18 25 36 7 34 13 — Totals 2311 70 377 981 267 398 172 46 92 359 193 376 579 82 494 136 1331 23 SICKNESS FROM NOTIFIABLE INFECTIOUS DISEASES. Table XII. gives the number of cases of infectious diseases notified in Fulham since 1890, when compulsory notification came into force, excluding duplicate notifications, and Table XIII. gives the number of cases notified in each ward in 1914, with the ages of the patients. The chart shows the number of cases of scarlet fever and diphtheria notified in each week of 1914, together with the average number notified in the corresponding weeks of the ten years 1904-1913. Smallpox. No case of smallpox has occurred in Fulham since 1903 and only two cases were reported in London in 1914. Primary Vaccination. The following tables, furnished by Mr. Davies, Vaccination Officer, give the returns for 1913 and the first six months of 1914. TABLE XIV. Supplemental Vaccination Return for 1913 for the Borough of Fulham. No. of Births Registered from Tan. 1st, 1913. to Dec. 31st, 1913. Successfully Vaccinated. Insusceptible of Vaccination. Dead Unvaccinated. Postponed by Medical Certificate. Certificates granted under Clause 2 of Vaccination Act, 1898. Removed to Districts in which Vaccination Officer has been notified. Removed to places unknown. Outstanding. 4165 2439 6 299 69 852 54 401 45 24 TABLE XV. Vaccination Returns for the period from January to June 1914, for the Borough of Fulham. No. of Births Registered from Jan. 1st, 1914, to June 30th, 1914. Successfully Vaccinated. Insusceptible of Vaccination. Dead Unvaccinated. Postponed by Medical Certificate. Certificates granted under Clause 2 of Vaccination Act, 1898. Removed to Districts in which Vaccination Officer has been notified. Removed to places unknown. Outstanding. 2046 1160 l 148 55 448 30 169 85 There was a further increase in the number of children exempted by statutory declarations of conscientious objection, 852 certificates of exemption being granted in 1913 against 654 in 1912, and 34% of those born in 1913 remain unvaccinated. • Scarlet Fever. Scarlet fever, which had shown a marked increase in the last quarter of 1913, continued to be very prevalent throughout the year, and the fall which always occurs in the spring was not so noticeable as usual. The notifications numbered 1,042, being 276 more than in 1913 and 195 above the highest number previously recorded in 1899. The returns for the four quarters were:— Cases. Deaths. First Quarter 272 1 Second „ 185 4 Third „ 242 6 Fourth „ 343 10 1042 21 Chart Shewing Week by Week the Number of Cases of Scarlet Fever and Diphtheria. Notified by Medical Practitioners as having occurred in the Borough of Fulham during the 52 Weeks ended January 2nd, 1915. 25 Excluding those in public institutions the cases occurred in 772 houses as under: Houses with one case 602 „ „ two cases 120 „ „ three „ 32 „ four „ 12 ,, ,, five ,, 3 ,, ,, six ,, 2 ,, ,, seven ,, 1 Isolation.—Of the cases notified, 967 or 93 per cent. were removed to hospital for treatment. In the autumn there was often considerable delay in the removal of cases owing to the lack of accommodation in the hospitals of the Metropolitan Asylums Board, and a communication was addressed by the Council to the Managers, urging them to re-open the Park Hospital for the reception of infectious cases, as this hospital, originally built as an infectious hospital, was being used as a hospital for children in connection with Poor Law Institutions in London. Fatality, — During the first quarter the disease maintained the mild type shown in 1913, and of the 638 cases notified in the last quarter of 1913 and the first quarter of 1914, only one terminated fatally, but during the later months there was a larger proportion of severe toxic cases and 21 deaths were recorded during the year, representing a case mortality of 2 per cent. compared with 1.24 per cent. in 1912 and 0.4 per cent. in 1913. 26 Distribution,—In TableXIII. will be found the number of cases notified in each ward of the borough, and the following table shows the proportional prevalence of scarlet fever in the several wards and in the County of London in 1914, and the preceding ten years. TABLE XVI. Number of cases of Scarlet Fever notified per 10,000 of the population. 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 Mean of 10 years 1904-13 1914 Barons Court Ward 20 52 25 17 23 32 7 6 14 23 22 24 LillieWard 11 54 63 47 36 33 22 21 10 42 34 58 Walham Ward 21 43 47 28 21 16 19 26 25 52 30 44 Margravine Ward 11 34 40 45 28 33 23 25 23 42 31 97 Munster Ward 26 64 41 35 39 40 29 31 41 52 40 70 Hurlingham Ward 12 40 42 44 43 14 10 20 38 36 30 38 Sands End Ward 24 54 41 64 60 42 24 40 44 73 47 102 Town Ward 23 43 29 32 23 19 19 25 29 34 28 41 The Borough 19 50 42 42 37 32 22 25 31 48 35 66 The County of London 29 42 43 52 46 38 23 23 25 39 36 56 Diphtheria. The cases of diphtheria notified in the four quarters of the year were as under:— Cases. Deaths First Quarter 66 2 Second „ 45 8 Third „ 49 3 Fourth ,, 112 14 272 23 27 The attack rate was the same as last year, viz., 17 per 10,000 inhabitants, the average for the preceding 10 years being 21 per 10,000. The cases occurred in 239 houses as under:— Houses with one case 227 „ „ two cases 10 „ „ three cases 2 In addition there were 14 cases among the staff at the Western Hospital, 3 at Fulham Infirmary, and 2 at the Belgian Refugee Camp, Earl's Court. Isolation,—Of the patients notified 255 or 94 per cent, were treated in hospital. Fatality.—The 23 deaths represent a case mortality of 8.5 per cent., against 8.7, 6.5 and 5.6 per cent. in the preceding three years. Diphtheria Antitoxin.—260,000 units of antitoxic serum were supplied to medical practitioners during the year. Distribution.—Table XIII. gives the number of cases notified in the several wards, and the following gives the proportional prevalence:— 28 TABLE XVII. Number of cases of Diphtheria notified per 10,000 of the population 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 Mean of 10 years 1904-13. 1914 Baron's Court Ward 10 20 17 7 13 10 14 14 15 5 13 12 Lillie Ward 13 14 17 38 24 16 10 9 16 17 18 23 Walham Ward 10 17 15 20 22 20 19 17 29 19 19 13 Margravine Ward 21 22 40 37 29 26 23 27 10 17 25 21 Munster Ward .. 24 17 24 38 25 22 14 26 19 16 23 21 Hurlingham Ward 20 22 16 41 27 23 22 19 8 22 22 10 Sands End Ward 34 22 36 68 28 21 20 27 14 26 30 14 Town Ward 13 12 20 21 23 21 10 13 8 6 15 14 The Borough 20 18 23 38 25 20 16 20 15 17 21 17 The County of London 16 14 18 19 17 14 8 8 16 17 15 20 Enteric Fever. 40 persons were notified as suffering from enteric fever and one case of enteric fever was notified as continued fever, representing an attack rate of 2.6 per 10,000 inhabitants, the decennial average being 2.9 per 10,000. There were 9 deaths and deducting 6 cases of which the diagnosis was not confirmed, the case mortality was 26 per cent. One patient had been employed at Eastbourne, as masseur to a gentleman who had suffered from typhoid two years before, and it was stated that the masseur who preceded him had also contracted typhoid. On my communicating with the Medical Officer of Health for Eastbourne, the employer was examined and found to be a "carrier," the bacillus typhosus being isolated from his excreta. 29 Puerperal Fever. Of puerperal septicaemia 33 cases were notified, being more than in any metropolitan borough, except Stepney, which had the same number. Eight cases proved fatal or 0.5 per 1,000 births. 26 cases were removed to Fulham Infirmary and 5 to the Western Fever Hospital. Erysipelas. 152 cases of erysipelas were notified and 8 deaths were attributed to the disease. Ophthalmia Neonatorum. 55 infants were notified as suffering from ophthalmia, and 17 were removed to a hospital or the Infirmary, of whom 2 died. Most of the other cases were of a mild nature and are reported to have recovered with unimpaired sight. Cerebro-Spinal Meningitis. One case was notified from the Infirmary, and the death was ascribed to posterior basic meningitis, which may be regarded as the sporadic form of cerebro-spinal fever. The death of a man aged 45 in Fulham Infirmary was also certified as due to posterior basic meningitis. Tuberculosis. The notifications received during the year numbered 1516. Under Form A.—Cases not previously notified 863 „ „ B.—By School Medical Officers 26 ,, ,, C.—Cases admitted to Poor Law Institutions and Sanatoria 315 „ „ D.—Cases discharged from Poor Law Institutions and Sanatoria 312 Of the above 715 were notifications of new cases, 551 being of pulmonary, and 164 of other forms of tuberculosis. The following table gives the ages and sex of the persons notified. 80 TABLE XVIII. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of notifications during the period from 4th January, 1914, to January 2nd, 1915. Age periods. Number of Notifications on Form A. Number of Notifications on Form B. (by School Medical Officers) Number of Notifications on Form C. of admission to Primary Notifications. Total Notifications on Form A Primary Notifications. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total. Under 5. 5 to 10 10 to 15 Total. Total Notifications on Form B Poor Law Institutions. Sanatoria. Pulmonary. Males — 12 27 13 22 25 49 60 40 28 3 279 860 1 1 — 2 2 110 61 Females 1 10 25 23 21 22 79 39 28 9 7 264 845 — 2 4 6 8 80 34 Non-pulmonary. Males — 17 30 12 4 4 3 1 1 4 1 77 83 — 3 3 6 7 18 — Females 2 16 19 13 5 4 7 4 2 1 2 75 75 — 3 8 6 9 12 — 31 Mortality from Tuberculosis. 207 deaths (116 of males and 91 of females) were registered from pulmonary tuberculosis, representing a death-rate of 1.32 per 1,000, the average of the preceding ten years being 1.33. The distribution of the deaths was as under:— Males. Females. Deaths in Poor Law Institutions 43 26 Deaths in Hospitals and Sanatoria 14 9 Deaths in Asylums 3 3 Deaths at Home 56 53 To other tuberculous diseases 45 deaths were ascribed, the death-rate being 0.29 per 1,000 against a decennial average of 0.42. In the several wards of the borough the death-rates from phthisis and other tuberculous diseases were as under:— TABLE XIX. Deaths per 1,000 of the population of each Ward from Phthisis and other Tuberculous Diseases. Death-rate from Phthisis. Death-rate from other Tuberculous Diseases. Death-rate from all Tuberculous Diseases. Baron's Court Ward 0.24 0.00 0.24 Lillie Ward 1.33 0.40 1.73 Walham Ward 2.14 0.56 2.70 Margravine Ward 1.55 0.32 1.87 Munster Ward 1.26 0.18 1.44 Hurlingham Ward 1.46 0.21 1.67 Sands End Ward 1.28 0.45 1.73 Town Ward 1.35 0.08 1.43 The Borough 1.32 0.29 1.61 32 Treatment and Prevention of Tuberculosis.—Fulham Tuberculosis Dispensary. In May, 1913, the Borough Council entered into an agreement with the Committee of Management of the Fulham Tuberculosis Dispensary, under which they agreed to contribute for the financial year ending March 31st, 1914, the sum of £300 towards the maintenance of the Dispensary and on the termination of this period they decided to renew the agreement and to increase their contribution for the financial year ending March 31st, 1915, to £750. Of this sum one-half is repaid to the Council by the Local Government Board and one quarter by the London County Council, the net contribution of the Borough Council being £187 10s. The most important feature in the history of the Dispensary during the year has been its removal from 632, Fulham Road, where the accommodation was very inadequate, to 114, New King's Road, which has been leased to the Committee by the Borough Council. The Medical Officer, Dr. Sullivan, in his report states that by the removal to New King's Road, the expansion of various departments previously hampered by want of space has been made possible; the Institution now possesses an excellent laboratory, and the X ray examination of patients at the School Clinic has been largely taken advantage of and has proved of great value, and arrangements are being made to have a larger proportion of the cases examined in this manner. 33 The Medical Officer has also furnished the following tables and other information relating to the the work of the Dispensary:— THE WORK OF THE DISPENSARY DURING 1914. SUMMARY OF STATISTICS. New Patients. 1. Suffering from pulmonary tuberculosis 203 2. ,, ,, other forms of ,, 45 3. Suspected cases 261 4. Non-tuberculous cases 361 Total 870 Number of Patients actually attending (old and new). 1. Insured 286 2. Uninsured 1,268 Total 1,554 Number of Attendances at Dispenary. 1. Insured 2,276 2. Uninsured 8,084 Total 10,360 Doctor's home visits 2,385 Nurses' „ 2,747 Contacts examined at home 311 Contacts who have become patients 212 Patients who had tuberculin treatment 109 „ „ cutaneous tuberculin tests 837 „ ,, subcutaneous „ „ 72 Cases sent to Sanatoria 32 „ Hospitals 6 „ Convalescent Homes 63 „ Infirmary 43 „ Homes for the Dying 5 Cases boarded out 22 34 THE DISPENSARY AS A RECEIVING HOUSE FOR PATIENTS. The various agencies and individuals who have recommended patients may be seen from Table I. which gives an indication of the co-operation between the Dispensary and other Bodies. It is interesting to note the large number of patients sent by medical men. TABLE I. Shewing who recommended the Patients. 165 were recommended by Private Doctors 254 30 ,, Medical Officer of Health sent by 59 „ School Medical Officer Doctors 42 „ School Authorities 11 „ Hospitals 21 ,, London Insurance Committee 3 ,, Infirmary 1 ,, Other Dispensaries 14 ,, Dispensary Staff 2 „ Parish Nurse 1 ,. Matron of Day Nursery 7 ,, Fulham School for Mothers 13 ,, Church Visitors 12 „ Charity Organisation Society 2 ,, Invalid Children's Aid Association 4 „ Children's Country Holiday Fund 5 „ Soldiers' and Sailors' Families Association 13 „ Friends 2 „ Labour Exchange 1 „ Local Paper 3 „ Employers 19 „ Door Plate 228 „ Other Patients 212 were Contacts 870 35 TABLE II. Sex and Age of New Patients for 1914. under 5 5-10 10-15 15-25 25-35 35-45 45 and Over All ages. Males 53 125 65 42 26 34 31 376 Females 67 105 68 57 89 58 50 494 Both Sexes 120 230 133 99 115 92 81 870 55.5 per cent, of the patients were under 15 years of age. THE DISPENSARY AS A CENTRE OF DIAGNOSIS. Differential diagnosis has been greatly assisted by the increased facilities for X-ray, laryngoscopic and laboratory work, especially the bacteriological and cytological examination of sputum, exudates, and discharges, and the more frequent examination of the blood. Patients suffering from aneurism, malignant tumour of the mediastinum, sarcoma of the lung, cancer of the stomach, diabetes and bacillus coli infection of the bladder have presented themselves for examination as possible consumptives. The use of the tuberculin test has been of some assistance, especially in potential cases of tuberculosis, but its findings cannot be relied on for differentiating between an active and a passive lesion. The subcutaneous test which was employed in 174 cases in 1913 and 72 cases in 1914 is far too sensitive for the latter purpose, but a negative result is of some significance. The cutaneous test which was used in 468 cases in 1913 and 387 in 1914 is not so sensitive and a positive result is of some value, especially in children suffering from gland and bone 36 disease, but a negative result after one application of dilute or pure tuberculin (human or bovine) does not exclude active pulmonary tuberculosis, either early or late. TABLE III. Results of Cutaneous Tests, 1914. Age Periods. Total Tests. Positive. Negative. Percentage Positive. Under 5 53 10 43 18.8 „ 10 171 64 107 37.4 „ 15 81 34 47 41.9 „ 25 13 10 3 76.9 „ 35 10 6 4 60.0 „ 45 6 5 1 83.3 45 and over 3 2 1 66.6 All ages 337 131 206 38.8 TABLE IV. Diagnosis of Males and Females. Total Cases. Pulmonary Tuberculosis Other Forms- Suspects Non- Tuber culous. Percentage Tuberculous. 398 Males 91 21 141 145 29.7 472 Females 112 24 120 216 27.5 870 Both Sexes 203 45 261 361 28.5 37 TABLE V. Diagnosis at Various Age Periods. Pul monary Tuberculosis Other Forms. S uspecis NonTuberculosis Percentage Tuberculosis Under 5 6 8 34 74 11.4 „ 10 18 21 74 113 17.2 15 27 13 48 44 30.3 „ 25 45 1 25 30 45.5 35 48 1 35 32 42.2 „ 45 30 1 23 32 36.04 45 and over 29 0 22 36 33.3 All ages 203 45 261 361 28.5 The diagnostic tables shew that 248 out of a total of 870 new patients (or 28.5 per cent.) were suffering from tuberculosis. Out of the total number of children of school age, viz., 480, 93 were tuberculous. The Dispensary as a Clearing House and Centre for Observation TABLE VI. Shewing the number of patients sent to Tuberculosis Institutions and Convalescent Homes. Brompton Sanotoria. Convalescent Homes. Infirmary Tub. Ward. Boarded out. Insured Men 1 16 0 5 0 Uninsured Men 1 1 1 6 0 Insured Women ... 8 4 2 2 Uninsured Women 4 4 10 11 2 Children ... 3 48 19 18 6 32 63 43 22 38 This table shews that 144 patients were sent to residential institutions and 22 were boarded out in the country. The agencies who undertook the responsibility for this treatment were the London Insurance Committee, London County Council in a few cases, Guardians, the Charity Organisation Society and the Invalid Children's Aid Association. It is now an easier matter to obtain Sanatorium treatment for early cases either through the London Insurance Committee or the London County Council. The Insurance Committee also sends a considerable number of more advanced cases to hospitals but cannot retain them indefinitely in these Institutions. Hospital accommodation is urgently needed for advanced cases. This should be made attractive so as to induce patients to remain for long periods, and be placed locally in or near each Borough in order to allow of frequent visitation by friends. London possesses neither Hospitals for advanced cases nor Farm Colonies; the result is that advanced cases are mostly treated at home, or fluctuate between the Infirmaries and their own homes, and that certain cases discharged from Sanatoria are liable to drift into the advanced stage of the disease. Home Visiting. During the year 2,385 visits were made by the Doctors and 2,747 by the Nurses, It is the rule for all new tuberculous cases to be visited by a Doctor and a Nurse, and for the other persons living in the home to be examined as contacts. The home visiting is the most important and the most pleasant part of the Dispensary duties. The Nurses visit the various streets in rotation, and the visits are recorded in a register in which the streets are arranged alphabetically; this has greatly facilitated the work. All notified cases are visited regularly by the nurses and infectious cases are 39 marked for special observation and more frequent visiting, with the object of seeing that disinfection of sputum, dishes, etc., and other preventive measures are carried out, keeping an eye on the other members of the family, as well as ensuring that the treatment is properly carried out. The effect of the home visits is apparent in the more enlightened attitude of the poorer inhabitants and in the improved hygienic conditions of the homes. As time goes on, it become easier to get families to attend to instructions, and it is often a pleasure to see how some poor people faithfully adopt sanatorium methods in their own homes. The home visiting enables us to discover cases in which treatment is prejudiced by insanitary housing, overcrowding, dirt, and destitution. Such cases are referred to other agencies through the Case Committee, or, if need is urgent, directly. Housing Conditions. TABLE VII. Of the 248 tuberculous patients found in 1914:— 5 lived in the Basement 51 ,, on Ground floor 47 „ „ First floor 9 ,, ,, Second floor 2 ,, ,, Third floor 25 „ „ Top floor 20 „ more than on e ,, 56 „ in the whole house Total 215 40 TABLE VIII. Housing Accommodation. The following table gives the number of rooms occupied by tuberculous patients, together with the number of persons living with them:— No. of patients occupying. 1 room 2 rooms 3 rooms 4 rooms 5 rooms 6 rms or more Living alone 5 1 — — „ with one other person 1 2 — — — — „ „ 2 other persons 6 2 4 2 1 — ,, ,, 3 ,, ,, 3 6 10 8 4 1 ,, ,, 4 ,, ,, — 8 11 10 6 3 ,, ,, 5 ,, ,, — 8 11 11 6 2 ,, ,, 6 ,, ,, — 2 5 16 4 4 ,, ,, 7 ,, ,, — 3 4 12 1 1 ,, ,, 8 ,, ,, — — — 6 6 2 ,, ,, 9 ,, ,, — — 5 5 2 1 ,, ,, 10 ,, ,, — — 2 1 — ,, ,, 11 ,, ,, - - - - - 1 Total 15 32 50 72 31 15 Sleeping Accommodation of 215 tuberculous patients when first visited. TABLE IX. The Patient slept— In a separate room in 58 cases Alone in bed with one other in room ,, 16 „ ,, ,, ,, two others ,, ,, 11 „ ,, ,, three ,, ,, ,, 6 „ 41 Alone in bed with four others in room in 3 cases In bed with one person and no others in room ,, 49 „ ,, ,, ,, ,, one other „ ,, 24 „ ,, ,, ,, ,, two others „ „ 16 „ ,, ,, ,, ,, three ,, ,, 5 ,, ,, ,, ,, ,, four ,, ,, ,, 2 „ In bed with two persons and no others „ ,, 14 „ ,, ,, ,, ,, one other ,, ,, 3 ,, ,, ,, ,, ,, two others „ ,, 3 „ ,, ,, ,, ,, four ,, ,, ,, 1 ,, In bed with three persons and no others „ „ 4 „ 215 Examination of Contacts- The Contacts of all tuberculous patients under treatment are examined as a routine measure, and 311 such examina. tions were made; the great majority being examined in their own homes. Table I. shows that 212 of the new patients were contacts; many of these were, however, not contacts of definite cases. The routine examination of contacts during the year has been the means of bringing under treatment 41 new tuberculous cases, most of which in all probability would have been left untouched until a much later stage of the disease. Treatment of Individual Cases- This is on Sanatorium lines, with the addition of special measures such as tuberculin, which was used in 109 cases. The results of the tuberculin treatment of lung cases are not as good in Dispensary as in Sanatorium work, but many patients benefit greatly from its use. The results are specially good in gland cases in which the glands have broken down and ruptured on the surface. 42 The Dispensary and its Allies- The influence of the Dispensary cannot be measured by the result of its own work alone, nor by the result of treatment in individual cases, but by the effect of the System of which it is the centre. A satisfactory feature of Dispensary work in Fulham is the co-operation between official bodies and voluntary associations dealing with Consumption, all meeting on common ground at the Dispensary. Institutional Treatment. 76 patients—(53 men and 23 women), notified as tuberculous, received treatment in sanatoria as patients of the London Insurance Committee, their average stay being 12 weeks. Residential Accommodation for the Uninsured. The London County Council state that they are arranging for the provision of residential accommodation of the following kinds:—(1) Observation; (2) Hospital; (3) Sanatorium and (4) Chronic or advanced cases. For the present they propose to secure 160 hospital beds, 240 sanatorium beds and 150 children's beds, but they have not as yet taken into consideration provision for advanced and chronic cases. DEATHS FROM NON-NOTIFIABLE INFECTIOUS DISEASES. Measles. During the first half of the year the borough was practically free from measles, there being only two deaths during that period, but towards the end of the year it became more prevalent and caused eight deaths in the 3rd and 21 in the 4th quarter. The death-rate was 0.20 per 1,000 or 0.24 per 1,000 below the average rate of the preceding ten years. 43 Whooping Cough. The deaths from whooping cough in the four quarters of the year, were:— 1st Quarter 10 2nd „ 16 3rd „ 6 4th ,, 11 43 The death-rate from this disease was 0.27 per 1,000, being 0.5 per 1,000 below the average return of the ten years, 1904-13. Diarrhœa. The deaths from diarrhœa and enteritis in the four quarters of the year, were:— 1st Quarter 12 2nd ,, 12 3rd ,, 83 4th ,, 29 136 Of these 114 were of children under 12 months, and 13 of children between one and two years of age, the decennial average of deaths under two years of age from diarrhœa being 148. The diarrhœal death-rate, measured by the proportions of deaths under two years to births registered, was 30.5 per 1,000. The corresponding rate of the County of London was 27.6 per 1,000 and of the Metropolitan boroughs only seven had higher rates than Fulham. Influenza. 25 deaths were certified to be due to influenza, the numbers in the preceding three years being 19, 16 and 27. 44 DEATHS FROM OTHER DISEASES. Cancer. From the various forms of cancer there were 167 deaths, 57 of males and 110 of females, respresenting a death rate of 1.06 per 1,000, against a decennial average of 1.02. The parts primarily affected were:— Males. Females. Cancer of the Buccal Cavity 4 3 Cancer of the Stomach, Liver, &c. 28 23 Cancer of the Peritoneum, Intestines and Rectum 11 25 Cancer of the Female Genital Organs — 28 Cancer of the Breast — 17 Cancer of the Skin — 4 Cancer of other or unspecified organs 14 10 57 110 Diseases of the Respiratory System. From these diseases there were 389 deaths, or 18.2 per cent, of the deaths from all causes. Violence The deaths of Fulham residents from various forms of violence numbered 80, of which 18 were due to suicide. Other diseases caused the following deaths:- Diseases of the Circulatory System 245 Diseases of the Nervous System 139 Diseases of the Digestive System 100 Diseases of the Urinary System 92 Senile Decay 67 45 Certification of the Causes of Death. Of the 2,132 deaths registered, 1,973 or 92.6 per cent, were certified by registered medical practitioners and the remainder by Coroners after inquest, no death being uncertified. Deaths in Public Institutions—Fulham Infirmary and Workhouse. The deaths of 486 persons, 266 males and 222 females, occurred in Fulham Infirmary, and of 45, 28 males, and 17 females, in Fulham Workhouse Of these 515 lived in Fulham and 16 in other districts. Western Fever Hospital. In the Western Fever Hospital there were 41 deaths of residents in Fulham and 105 of residents in other boroughs. Deaths occurring outside the Borough among persons belonging thereto. The deaths of Fulham residents in public institutions and elsewhere outside the borough numbered 391, and occurred in the following institutions:— St. George's Hospital 57 West London „ 44 Other General Hospitals (Metropolitan) 44 Victoria Hospital for Children 26 Other Hospitals for Children 14 Lying-in and other Hospitals for Women 4 Brompton Hospital 5 Cancer Hospital 8 Other Special Hospitals (Metropolitan) 3 Homes for Incurables 7 Fever Hospitals of Metropolitan Asylums Board 10 46 Other Hospitals of Metropolitan Asylums Board 8 Provincial Hospitals and Sanatoria 19 Lunatic Asylums 75 Workhouses and Poor Law Infirmaries 12 In Private Houses, Nursing Homes, etc 55 391 Of the deaths registered, 892 or 41.9 per cent, took place either in Poor Law institutions, in hospitals, or in public lunatic asylums, the percentages in the various classes of institutions being as under:- Deaths in Workhouses or Workhouse Infirmaries 24.7 „ Metropolitan Asylums Board Hospitals 2.8 „ other Hospitals 10.9 ,, Public Lunatic and Imbecile Ayslums 3.5 41.9 In the County of London, 45.7 per cent, of the deaths occurred in public institutions. GENERAL SANITARY ADMINISTRATION. Special Arrangements made in consequence of the War. In August a letter was received from the Deputy Director of Medical Services for London, stating that he had arranged for the special addition to his sanitary staff of the Medical Officers of Health of each of the City and Metropolitan Boroughs in London. The duties assigned were:— To supervise the sanitary condition of the billets and encampments within his area and report all sanitary defects to the Officer Commanding the unit concerned and also to Headquarters London District. 47 To advise the Officer Commanding on sanitary matters if no medical officer of the Royal Army Medical Corps was attached to him. A circular letter was subsequently forwarded by the Local Government Board, pointing out the necessity for the closest co-operation between the Local Authority and the military sanitary services in order to prevent the spread of disease. The headquarters of the 7th London Brigade Royal Field Artillery, T.F , and of the 2.5th County of London Cyclists, T F., which are in High Street, Fulham, were regularly inspected and some nuisances observed were brought under the notice of the military authorities and abated. 199 houses chiefly in Hurlingham and Town Wards, in which according to information forwarded by the Superintendent of Police troops were billeted, were also inspected. Arrangements were made, at the request of the Local Government Board, for the systematic supervision of the premises of contractors engaged in the supply of food for the Army, in order to secure the proper sanitary condition of the premises and the wholesomeness of the materials used. Two firms, a biscuit manufacturer and a maker of tinned soups, etc., were notified as having contracts for the supply of the Army. Members of the Staff of the Public Health Department serving with His Majesty's Forces Early in August two of your Sanitary Inspectors Mr. Frederick Manning and Mr. Mark Canton joined the 2nd London Sanitary Corps and are now in France. Mr. H. Carter was appointed a temporary Sanitary Inspector during their absence. 48 The Junior Clerk, Mr. Thomas Robey, who was a member of the 2nd London Sanitary Corps, T.F., joined his regiment at the beginning of the War. Mr. H. Goulden, Mortuary Keeper, rejoined his old regiment the 16th Lancers. Belgian Refugee Camp. In October, provision was made by the Managers of the Metropolitan Asylums Board for the accommodation of Belgian refugees at Earl's Court Exhibition, which is situated partly in Fulham and partly in Kensington. All the sleeping accommodation was on the Fulham side and the sanitary arrangements were supervised by your Inspector. The number lodged varied from time to time from about 1,200 to 3,000. Having regard to their circumstances the amount of sickness among them and especially of infectious sickness was small, three cases of scarlet fever, two of diphtheria, and a few of measles and whooping cough being reported There were 10 deaths among them, 5 being of infants under one year of age. Disinfection. The following articles were disinfected at the Council's Disinfecting Station, Townmead Road, during the year:— Beds 2136 Mattresses 2222 Pillows 3693 Bolsters 1929 Blankets 3516 Sheets 3556 Covers 3873 Curtains 3933 Carpets and Rugs 2647 Articles of Clothing 13960 49 Sundries 16769 Spring Beds 88 Cushions 2238 Palliasses 1284 Cradle 1 Pram 1 Uniforms 58 61204 Partly owing to the disinfection carried out for Belgian refugees and the troops, there was a large increase in the work at the disinfecting station, 61,204 articles being disinfected compared with 47,605 in 1913. The cost of the station for the year, including £42 for interest on loans for the building and plant and £216 for repayment of principal, was £1,027. The following rooms were disinfected and cleansed:- After Scarlet Fever 918 „ Diphtheria 244 „ Enteric Fever 39 „ Puerperal „ 27 „ Erysipelas 94 ,, Phthisis 329 „ Measles 233 „ Cerebro-Spinal Fever 1 „ Chickenpox 2 „ Other diseases 31 Verminous rooms fumigated and cleansed 234 School Class Rooms sprayed 8 2060 50 Bacteriological Examinations. The following bacteriological examinations were made on behalf of the Council, by Dr. Bernstein, Pathologist to the West London Hospital. Material from cases of suspected Diphtheria:—  Number of Specimens. True Diphtheria bacillus isolated 66 Hoffmann or Pseudo-Diphtheria bacillus isolated 7 Negative result 332 405 Blood from cases of suspected Enteric Fever:— Widal or Typhoid reaction obtained 25 „ „ „ not obtained 30 55 Sputa from cases of suspected Tuberculosis:— Tubercle bacillus found 158 „ „ not found 524 682 Other examinations 12 1154 Public Mortuary. 149 bodies were removed to the mortuary during the year and were admitted as follows:— At Coroner's request 108 Brought by Police 8 At request of Medical Officer of Health 5 For convenience till funeral 28 149 Inquests were held on 112, and post-mortem examinations were made in 72 of the above cases. 51 FOOD SUPPLY. The dairies and milkshops, the ice cream shops and kitchens of restaurants, etc., were kept under systematic observation by your Inspectors. Unsound Food. 15 boxes of Fish and 2 bags of Shellfish examined at the request of the owners were condemned and destroyed. Slaughterhouses. The licenses of the undermentioned slaughter houses were renewed by the London County Council in October, no objection to their renewal being offered by the Borough Council. Premises. Licensee. 611, Fulham Road T. S. Payne 640, King's Road E. Vaughan Notice of objection to the renewal of the license of the slaughterhouse at 603, King's Road, was given and the application for renewal was withdrawn. 52 Proceedings under the Sale of Food and Drugs Acts. The undermentioned samples were purchased for analysis in 1914:— Article. Number of Samples taken , Officially. Namber Adulterated. Number of Samples taken Unofficially. Number Adulterated. Total Samples. Total Adulterated. Percentage of Adulteration. Milk 444 26 ... ... 444 26 1 ... Separated Milk 13 ... ... ... 13 ... 5.7 Cream 3 2 ... ... 3 2 66.6 Milk Foods ... ... 2 ... 2 ... ... Preserved Cream 3 3 ... ... 3 3 100 Cheese ... ... 7 ... 7 ... ... Cocoa ... ... 45 ... 45 ... ... Butter 20 4 302 ... 322 23 7.12 Coffee 2 ... 29 ... 31 ... ... Coffee and Chicory ... ... 2 ... 2 ... ... White Pepper 4 ... ... ... 4 ... ... Lemon Squash 3 2 ... ... 3 2 66 6 Lime Juice Cordial 4 3 ... ... 4 3 75.0 Beef Sausage 1 ... ... ... 1 ... ... Pork Sausage 1 ... ... ... 1 ... ... Veal and Ham Patty 1 ... ... ... 1 ... ... Plum Jam ... ... 7 ... 7 ... ... Raspberry Jam ... ... 5 3 5 3 60.0 Salmon and Shrimp Paste ... ... 6 2 6 2 33.3 Camphorated Oil ... ... 33 7 33 7 21.2 Beef Dripping ... ... 10 ... 10 ... ... Lard ... ... 7 ... 7 ... ... Olive Oil ... ... 6 ... 6 ... ... Bread ... ... 6 ... 6 ... ... Flour ... ... 10 ... 10 ... ... Pepper ... ... 5 ... 5 ... ... Brandy ... ... 5 ... 5 ... ... Gin ... ... 5 ... 5 ... ... Rum ... ... 4 ... 4 ... ... Whiskey ... ... 5 ... 5 ... ... 500 40 500 31 1000 71 7.1 53 Samples Purchased for Analysis. In the preceding ten years the samples purchased for analysis were as under:— Number of Samples. Samples Adulterated. Percentage of Adulteration. 1904 673 115 17.1 1905 613 141 22.4 1906 559 163 28.1 1907 659 85 12.9 1908 997 162 16.3 1909 1,000 81 8.1 1910 999 127 12.7 1911 1,035 90 8.7 1912 999 86 8.6 1913 1,004 93 9.2 Of the milk samples 5.7 per cent, were adulterated, compared with 5.7, 7.0 and 4.9 percent, in the preceding three years. The average composition of the samples purchased as new milk in each of the four quarters was as under:- Period. Number of Samples. Solids other than Fat. Fat. Water. First Quarter 121 8.88 3.45 87. 67 Second „ 112 8.76 3.41 87.83 Third „ 77 8.91 3.38 87.71 Fourth „ 134 8.89 3.71 87.40 Public Health (Milk and Cream) Regulations, 1912. The following particulars of proceedings taken in 1914, under the above regulations made in pursuance of the Public Health (Regulation of Food) Act, 1907, are given in the form suggested by the Local Government Board in their circular letter of October 27th, 1913:— 54 1. Milk and Cream not sold as Preserved Cream. Articles. (a) Number of samples examined for the presence of a preservative. (b) Number in which a preservative was found to be present Milk | None Cream 3 2 Nature of preservative in each case in column (b) and action taken under the Regulations in regard to it. Preservative. Amount present. Action taken. 1. Boric Acid 0.05% Vendor cautioned 2. Ditto 0.31% Vendor prosecuted under Sale of Food and Drugs Act, Sec. 6, Summons dismissed on warranty 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. (1) Correct statements made 3 (2) Statements incorrect — (b) Total 3 The examination made of milk fat in preserved cream. cream sold as (1) Above 35 per cent. 3 (2) Below 35 per cent. — 3 (c) Instances where (apart from analysis) the requirements as to labelling of preserved cream in Article 5 (1) and the proviso in Article 5 (2) of the Regulations have not been observed. None (d) Particulars of each case in which the Regulations have not been complied with and action taken. None. 3. Thickening substances. No evidence of their addition to cream or preserved cream. 4. Other observations. None. 55 Prosecutions under the Sale of Food and Drugs Acts, were instituted in the following cases:— Defendant. Offence. Result. Penalty. Costs. William Hart, 226, York Road, Wandsworth. Selling milk 8 per cent, deficient in fat. Convicted. £ s. d. 1 0 0 £ s. d. 12 6 Albert Day, 48, Dawes Road, Fulham. Selling milk adulterated with 4 per cent, added water and 4 per cent, deficient in fat. Ordered to pay costs. — 12 6 Retail Dairy Co., Ltd., 28, Baldrom Street, Bristol. Selling milk adulterated with 10 per cent, added water. Convicted. 50 0 0 2 2 0 Richard Rowlands, 227, Lillie Road, Fulham. Selling milk 7 per cent, deficient in fat. Dismissed. (Warranty proved) — - Frank Bradbury, 62, New King's Road, Fulham. Selling margarine as butter Convicted 2 0 0 14 6 Charles Wheeler, 56, Boscombe Road, Hammersmith. Selling milk adulterated with 5 per cent added water. Dismissed (Warranty proved) — - Ditto Selling milk 8 per cent deficient in fat. Ditto — William Pettitt, 2, Haldane Road, Fulham. Selling milk 8 per cent, deficient in fat. Ditto — - Mary Davies, 219, Dawes Road, Fulham. Selling milk 17 per cent, deficient in fat Convicted. 10 0 12 6 *Arthur Marriott-Mathews, 797, Fulham Road, S.W. Selling milk 13* per cent, deficient in fat Dismissed. - — * Arthur Lurway, 113, Dawes Road, Fulham. Selling milk 13* per cent. deficient in fat Convicted. 5 0 0 12 6 John Chinnock, 81, Estcourt Road, Fulham. Selling milk 11 per cent, deficient in fat Dismissed. - — Express Dairy Co.. Ltd.. Tavistock Place, W.C. Selling cream containing 21.7 grains of boric acid per pound. Dismissed (Warranty proved) — — Lavinia Hall, 11, Margravine Road, Hammersmith. Selling milk from which 9 per cent, of original fat has been abstracted. Ordered to pay costs. - 12 6 C arried forward 58 10 0 5 19 0 * Same Sample. 56 Defendant. Offence. Result. Penalty. Costs. Brought forward £ s. d. 58 10 0 £ s. d. 5 19 0 Beasant & Fry I.td., 770, FulhamRoad, S.W. Selling lime juice cordial containing 6.6 grains salicylic acid per pint. Costs paid withdrawn. - — Star Tea Co., Ltd., 290-314, Old Street, E.C. Selling lemon squash, containing 5.2 grains salicylic acid per pint. Costs paid withdrawn — - Titus Ward & Co., Ltd., 206, Tower Bridge Road, S.E. Selling lime juice cordial containing 4.3 grains salicylic acid per pint. Ditto — — Rees Price & Co., 275, Wandsworth Bridge Road, S.W. Selling milk 7 per cent, deficient in fat Dismissed (Warranty proved) — - Leonard George Death, 156, Wandsworth Bridge Road, S.W. Selling butter containing 32 per cent, of foreign fat Convicted. 2 0 0 14 6 Robt. Swales Watson, 88, Cassidy Road, Fulham. Selling butter containing 36 per cent, of foreign fat Convicted. 2 0 0 14 6 Walter Lawrence, 319, Lillie Road, Fulham. Selling butter containing 71 per cent, of foreign fat Convicted. 10 0 16 6 David Davies, 84, Wandsworth Bridge Road, S.W. Selling milk adulterated with 8 per cent, added water Ordered to pay costs. — 12 6 £63 10 0 £8 17 0 57 Factory and Workshop Acts. The following tables, prepared at the request of the Secretary of State of the Home Department, give a summary of the work done in connection with the Factory and Workshop Act:— I.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors, or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 144 6 — Workshops (Including Workshop Laundries) 362 24 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 185 12 - Total 691 42 — 58 2.—Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. Nuisances under the Public Health Acts:-* Want of cleanliness 36 36 ... ... Want of ventilation 1 1 ... ... Overcrowding 2 2 ... ... Want of drainage of floors ... ... ... ... Other nuisances 4 4 ... ... Sanitary accommodation— Insufficient 3 3 ... ... Unsuitable or defective 9 9 ... ... Not separate for sexes 2 2 ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 5 5 ... ... Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) ... ... ... ... Total 62 62 ... ... * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 59 3.— Home Work. NATURE of WORK. OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES. SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109. 110. Lists received from Employers. Notices served on Occupiers as to keeping ! or sending lists. Prosecutions. Sending twice in the year. Sending once in the year Failing to keep or permit inspection of lists. Failing to send lists. Instances. Notices served. Prosecutions Instances. Orders made (Sec. 110). Prosecutions (Sees. 109. 110). Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel— (1) making, etc. 18 14 48 4 4 14 ... ... ... 26 26 ... ... ... ... (2) cleaning and washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Household linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains and furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and brass articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, latches and keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sacks ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper, etc., boxes, paper bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, etc., of buttons, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chocolates and sweetmeats ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 18 14 48 4 4 14 ... ... ... 26 26 ... ... ... ... 60 4.— Registered Workshops. Class. Number. Workshops on the Register (s. 131) at the end of the year:— Bakehouses 73 Laundries 41 Dressmakers, Milliners, Blousemakers 71 Tailors, Outfitters, etc. 22 Bootmakers 38 Motor and Cycle Makers 28 Cabinet Makers, etc. 21 Other Trades 120 Total number of workshops on Register 414 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) Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5):— Notified by H.M. Inspector 5 Reports (of action taken) sent to H.M. Inspector — Other — Underground Bakehouses (s. 101):— - Certificates granted during the year — In use at the end of the year 48 Housing, Town Planning, etc., Act, 1909. The number of dwelling-houses inspected under and for the purposes of Section 17 of the above Act was as under: Number of houses inspected. Number of houses unfit for habitation. Number of representations. Number of Closing Orders. Number of houses in which defects were remedied without Closing Orders. Number of houses in which defects were remedied after Closing Orders. Number of houses demolished. Number of houses in which repairs were not completed on Dec. 31st, 1914. 140 — — — 115 — — 25 Demolition Orders were made by the Council in respect of 8, 9, 10, 11, 12 and 13, Hatfield Street, which had been closed under Section 17 of the Housing, Town Planning Act, 1909, and had not been rendered fit for human habitation. 61 Drainage of Buildings. During the year the following drainage plans were submitted to and approved by the Public Health Committee:- Plans of drainage of new houses 61 ,, ,, „ „ workshops, etc 15 ,, ,, „ „ schools 3 ,, ,, „ „ chapels 3 ,, ,, „ „ additions to existing buildings 17 ,, „ „ „ of the re-construction of the drainage of existing buildings 98 197 Combined Drainage. Three systems of combined drainage for the maintenance of which the Council was liable, were re-constructed by the Council's contractor at a cost of ^24. The sum of £6 16s. 6d. was paid to the owner of a house in respect of work carried out by him in compliance with the Council's notice, in connection with the drain which was a " sewer" as defined by the Metropolis Local Management Act, 1855. Water Supply in Tenement Houses. An additional water supply on the upper floors was required and provided in 46 tenement houses under the provisions of Section 78 of the London County Council (General Powers) Act, 1907, by which a sufficient supply of water can be required on each separately occupied floor of a tenement house. Accommodation for Storage of Food. Suitable accommodation for the storage of food was required and provided in 15 tenements under the powers given by Section 16 of the London County Council 62 (General Powers) Act, 1909, but it is unfortunate that this section does not apply to tenements used or occupied as such before the passing of the Act. Certificates under the Revenue Acts. Applications were received for certificates under the Revenue Acts for exemption from or abatement of inhabited house duty, in respect of 397 tenements, and for the renewal of 1,392 certificates which had been previously granted for a limited period. Of these 1564 were granted, 95 were given after the completion of certain specified repairs and 130 were refused. Cleansing of Children. The names and addresses of 910 school children were forwarded to the Public Health Department during the year, whose homes were visted by your Sanitary Inspector, and if found verminous, cleansed under the powers given by the London Council (General Powers) Act, 1904, their bedding, clothing, etc., being dealt with at the Council's disinfecting station. 1952 baths were given to 892 verminous children at the London County Council's cleansing station in Sedlescombe Road, and 301 baths to 39 children suffering from scabies. General Sanitary Work. 1,406 complaints were received and dealt with by your Sanitary Inspectors. 1,840 intimations and 523 statutory notices were served. One summons for failing to comply with the Council's notice to abate a nuisance was issued, and a Closing Order, with £1 5s. 0d. costs, was made. 63 In one case where the owner failed to comply with a cleansing notice served by the Council under the London County Council (General Powers) Act, 1904, the necessary work was carried out by the Council and the cost, amounting to £3 10s. 0d., was recovered from the owner. The following summary has been prepared at the request of the Medical Officer of Health of the London County Council:— PREMISES. NUMBER OF PLACES. Number of Inspections, 1914. Number of Notices. 1914. Number of Prosecutions, 1914. On register at end of 1914. Added in 1914 Removed in 1914. On register at end of 1914. Milk premises 206 6 25 187 540 ... ... Cowsheds ... ... ... ... ... ... ... Slaughter houses 3 ... 1 2 36 ... ... Other offensive trade premises ... ... ... ... ... ... ... Ice cream premises 133 1 16 118 146 3 ... Registered houses let in lodgings ... ... ... ... ... ... ... Total number of intimation notices served for all purposes 1840 Overcrowding, 1914. Number of dwelling rooms overcrowded 45 Number remedied 45 Number of prosecutions - Underground rooms— Illegal occupation dealt with during year 4 Number of rooms closed 4 Insanitary houses— Number closed under the Public Health (London) Act, 1891 1 64 Number closed under the Housing, Town Planning, etc., Act - Number of rooms cleansed under sec. 20 of the London County Council (General Powers) Act, 1904 195 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year - Revenue Acts— Number of tenements for which applications were received during the year 1789 Number of tenements for which certificates were— (a) granted 317 (b) refused 317 (c) deferred — (d) Certificates previously granted for limited period renewed 1342 Sanitary Staff. An additional Sanitary Inspector (Mr. M. Canton) was appointed in May to deal with Heckfield Place and other insanitary areas as recommended in my report to the Council. In August, Inspectors Manning and Canton joined the 2nd London Sanitary Corps and Mr. H. Carter was appointed as temporary Sanitary Inspector during their absence. The need for the appointment of a Health Visitor which I have repeatedly urged upon the Council is much felt. I am, Sir and Gentlemen, Your obedient Servant, J. CHARLES JACKSON. May, 1915. 65 TABLE A. Showing the localities in which the cases of certain Notifiable Infectious Diseases occurred during the year. (The figures in brackets denote the number of houses in which the cases occurred. The asterisks denote the fatal cases of Scarlet Fever, Diphtheria, Enteric Fever and Puerperal fever). Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Acfold Road .. .. .. .. .. .. Ackmar Road .. .. .. .. .. 2 (2) Adeney Road 3 (3) .. 1 .. 1 6 (5) Aintree Street 3 (2) *1 .. .. 1 5 (8) Alderville Road 1 .. .. .. .. .. Allestree Road 4 (4) 2 (2) .. .. .. 2 (2) Althea Street 4 (3) 1 .. .. .. .. Ancill Street 3 (2) 1 1 .. 1 8 (7) Anselm Road 3 (3) .. .. .. .. 2 (2) Archel Road 2 (2) *2(2) .. .. 1 5 (5) Argon Mews .. .. .. .. .. .. Armadale Road 3 (2) .. .. .. .. 1 Ashcombe Street 5 (3) 2 (2) .. 1 .. .. Ashington Road .. .. .. .. .. .. Ashton Terrace .. .. .. .. .. .. Aspenlea Road .. .. .. .. .. 3 (3) Atalanta Street 1 4 (2) .. .. .. 1 Auriol Road .. 1 .. .. .. .. Avalon Road *7 (4) .. .. .. 1 1 Averill Street 3 (3) .. .. .. .. 1 Avon more Gardens .. 1 .. .. .. .. Avonmore Road .. 1 .. .. .. •• Bagley's Lane .. .. .. .. .. 1 Barclay Road 2 (2) 1 1 1 2 (2) Baron's Court Road .. .. .. .. .. 1 Barton Street 1 .. .. .. .. .. Basuto Road .. 1 .. .. 1 .. Bayonne Road 13 (6) 1 .. 1 3 (2) 2 (2) Bearcroft Buildings .. .. .. .. .. .. Beaufort Mews .. .. .. .. .. .. 66  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Beaumont Crescent .. .. .. .. .. .. Beltran Road 9 (5) .. .. .. 2 (2) 1 Beryl Road 3 (3) 2 (1) .. .. .. .. Bettridge Road .. .. .. .. .. 1 Biscay Road 7 (7) .. .. .. .. 2 (2) Bishop King's Road .. .. .. .. .. .. Bishop's Pk. Mans. 1 .. .. .. .. .. Bishop's Road 7 (7) 2 (2) *1 .. 2 (2) 5 (5) Blake Road .. .. .. .. .. .. Bloompark Road .. .. .. .. .. .. Bothwell Road .. .. .. .. .. .. Bovingdon Road .. .. .. .. .. .. Bowerdean Street 1 1 .. .. .. 1 Bradbourne Street 1 .. .. .. .. .. Bramber Road 2 (2) 2 (1) .. .. .. 5 (4) Brandenburgh Road 5 (4) 1 .. .. 1 .. Branksea Street 2 (2) .. .. .. .. 1 Brecon Road .. .. .. .. .. 5 (4) Breer Street 8 (5) .. .. .. .. .. Britannia Road 4 (2) .. .. .. .. 5 (5) Brookville Road 3 (3) .. .. .. .. 1 Broomhouse Road 1 .. .. .. .. .. Bronsart Road 4 (4) .. *1 .. .. 2(1) Broughton Road *9 (5) .. 1 .. 2 (2) 3 (3) Buer Road .. .. .. .. .. .. Bulow Road 3 (3) 1 .. .. 1 8 (7) Burlington Gdns. .. 6 (4) .. .. .. 2 (2) Burlington Road 3 (2) 1 .. .. .. 1 Burnfoot Avenue 2 (2) *2 (2) .. .. .. 1 Burnthwaite Road 4(3) 2(2) .. 2 (2) .. 5 (5) Byam Street 5 (4) 2 (1) .. .. .. 1 Cambria Street .. .. .. .. .. 2 (2) Campbell Street .. .. .. .. .. .. Campana Road 1 .. .. .. .. 1 Carlton Mews .. .. .. .. .. .. Carnwarth Street .. .. .. .. .. 1 Caroline Place 2 (1) 1 .. .. .. 3 (3) Cassidy Road 1 1 *1 .. 2 (2) 5 (5) Castletown Road .. .. .. .. .. 2 (2) Cedar Road 3 (2) .. .. .. .. 2 (2) Chaldon Road 5 (4) 1 .. .. .. 2 (2) Challoner Street .. .. .. .. .. Chancellor's Road 1 .. 1 .. .. 2 (2) 67  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Charleville Road 1 .. .. .. .. .. Chelmsford Street 5 (3) *1 .. 1 2 (2) 2 (2) Chesilton Road 2 (1) .. .. .. 1 1 Chesson Road 4 (3) *2 (2) 1 .. 1 5 (5) Chiddingstone Street 1 .. .. .. .. 1 Chipstead Street 4 (3) .. .. .. .. 1 Church Path .. .. 1 *1 2 (2) 4 (3) Churchfield Mans. 1 .. .. .. .. .. Clancarty Road 1 .. .. .. .. 1 Claxton Grove 7 (6) 2 (2) .. .. .. 3 (3) Claybrook Road 15 (10) 3 (3) .. .. .. 4 (3) Cloncurry Street .. .. .. .. .. .. Clyde Flats .. 1 .. .. .. .. Clonmel Road 2 (1) .. .. .. 1 1 Colehill Lane 4 (4) .. .. .. 1 .. Comeragh Road .. .. .. .. 1 .. Conan Street .. .. .. .. .. .. Coniger Road 2 (2) .. 1 .. .. 2 (2) Coomer Road 5 (4) .. .. 1 .. 6 (5) Cornwall Street 5 (4) .. .. .. .. 2 (2) Cortayne Road 2 (2) .. .. .. .. 1 Crabtree Lane 3 (3) .. .. .. .. 1 Cranbury Road 4 (3) 1 .. .. .. 4 (3) Crefeld Road 6 (3) .. .. .. 1 2 (2) Cresford Road .. .. .. .. .. .. Crookham Road .. .. 1 .. .. 1 Cristowe Road 2 (2) .. .. .. .. .. Crondace Road 1 .. .. .. .. 1 Crown Mews .. .. .. .. .. .. Cumberland Cres. 1 .. .. .. 1 .. Dancer Road 3 (2) .. .. .. .. 1 Danehurst Street 7 (5) *1 .. .. .. 1 Darlan Road 1 .. .. .. .. .. Dawes Road 6 (3) 2 (1) .. .. 1 9 (8) Dawson Street 4 (3) .. .. .. .. 2 (2) Delaford Street 1 .. 1 .. l 1 Delorme Street .. 1 .. .. 1 1 Delvino Road .. 1 .. .. .. .. De Morgan Road 7 (5) 1 .. 1 1 1 Devonshire Street .. .. .. .. .. .. Dieppe Street .. 1 1 .. .. 3 (2) Dimsdale Road 4 (3) 2 (1) .. .. .. 1 Disbrowe Road 2 (2) .. .. .. 1 .. 68  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary T uberculosis. Distillery Lane 4 (2) 2 (2) .. .. .. 1 Dolby Road .. .. .. .. .. .. Doneraile Street 3 (3) .. .. .. .. .. Doria Road 2 (2) .. .. .. .. .. Dorncliffe Road .. .. .. .. .. .. Dowell Mews .. .. .. .. .. .. Durrell Road .. .. .. .. .. .. Drive The .. 1 .. .. .. .. Dymock Street 1 .. .. 1 2 (2) .. Eddiscombe Road .. .. .. .. .. .. Edenhurst Avenue .. .. .. .. .. .. Edenvale Street 2 (2) .. .. .. .. .. Edgarley Terrace 2 (2) *2 (2) .. .. .. 2 (2) Edith Road .. 1 .. .. .. .. Edith Row .. 1 .. .. .. .. Edith Villas .. 1 .. .. .. .. Eelbrook Terrace .. .. .. .. .. .. Effie Road .. .. .. .. .. .. Effie Place .. 1 .. .. .. .. Elbe Street 4 (2) .. .. .. .. 1 Eli Street 1 .. .. .. .. 2 (1) Eli Mews .. .. .. .. .. .. Ellaline Road 1 .. .. .. .. .. Ellerby Street 3 (2) 1 .. .. .. .. Elmdale Street *10 (8) .. .. .. .. 8 (5) Elmstone Road .. .. .. .. .. .. Elthiron Road .. 2 (2) .. .. 1 .. Elswick Street .. .. .. .. .. 1 Elysium Mews .. .. .. .. .. .. Epirus Mews .. .. .. .. .. .. Epirus Road 2 (2) .. .. .. .. 1 Epple Road .. .. 1 .. .. 2 (1) Estcourt Road 6 (4) 2 (1) .. 1 2 (2) 3 (3) Eustace Road 3 (2) .. 1 1 .. .. Everington Street .. .. .. .. 3 (3) 2 (2) Ewald Road 3 (1) .. .. *1 •• 2 (2) Fabian Road .. .. .. .. 2 (2) .. Fairholme Road .. .. .. .. .. .. Fane Street .. .. .. .. 2 (2) 2 (2) Farm Lane 7 (3) 1 1 .. .. 1 Favart Road 1 .. .. .. .. .. Felden Street *2 (2) .. .. .. .. .. 69  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Fernhurst Road .. .. .. .. .. 2 (1) Field Road 4 (3) 1 .. .. 1 3 (2) Filmer Road 5 (4) 2 (2) .. .. .. 2 (2) Finlay Street 4 (3) .. .. .. 1 .. Firth Gardens 1 .. .. .. .. 2 (2) Fitzgeorge Avenue .. .. .. .. .. .. Fitzjames Avenue .. .. .. .. .. .. Foskett Road .. *1 .. .. .. .. Francis Street .. 1 .. 1 .. 1 Friston Street .. .. .. .. 2 (2) .. Fulham Palace Road *6 (6) 2 (2) 1 .. .. 4 (4) Fulham Pk. Gardens .. .. .. .. .. 2 (2) Fulham Road 15 (11) *3 (3) .. .. 1 11 (9) Furness Road 3 (2) .. .. .. 1 .. Garvan Road 4 (4) 2 (1) .. .. .. 2 (2) Gastein Road 4 (4) .. .. .. 2 (1) .. Gilstead Road 2 (2) .. .. .. .. 2 (2) Gironde Road .. .. .. .. .. 1 Glazsbury Road .. .. .. .. .. 1 Gledstanes Road .. .. .. .. .. .. Glenrosa Street **10(8) .. .. .. .. 1 Gliddon Road .. .. .. .. .. .. Goodson Road .. l .. 1 1 2 (2) Gorleston Street 2 (2) 3 (2) .. .. .. .. Gowan Avenue 6 (5) 1 1 .. .. 2 (2) Greswell Street 3 (2) .. .. .. .. 2 (2) Greyhound Road 6 (5) 1 .. .. 1 5 (5) Grimston Road 1 .. .. .. 1 .. Grove Terrace 1 .. .. .. .. .. Guion Road .. 1 .. .. 1 1 Gunterstone Road .. .. .. .. .. .. Gwendyr Road 1 .. .. .. .. .. Haldane Road 2 (1) .. .. .. .. 2 (2) Halford Road 9 (6) *4 (3) .. .. 2 (2) 3(3) Hamble Street 5 (4) 1 .. .. .. .. Hammersmith Road 1 .. .. .. .. .. Hannell Road 2 (2) *2(2) .. .. .. 1 Harbledown Road 2 (2) 1 .. .. .. 1 Harbord Street 3 (1) 3 (1) .. .. .. .. Hartismere Road 1 .. .. .. .. 3 (3) Hartopp Avenue **8 (6) 1 .. .. .. 2 (2) Harwood Road 1 1 .. .. .. 6 (5) 70  Scarlet Fever. - Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Harwood Terrace 2 (2) .. .. .. 1 1 Hatfield Street .. .. .. .. .. .. Hawksmoor Street .. .. .. .. .. .. Hawes Buildings 1 .. .. 1 .. .. Hazlebury Road *9 (8) 1 .. 1 .. 3 (3) Heckfield Place 5 (2) 3 (2) 1 .. .. 8 (8) Hestercombe Avenue 3 (1) 1 .. .. .. 1 High Street .. .. .. .. .. .. Hilmer Street 4 (4) 2 (2) .. .. 1 4 (4) Hildyard Road .. .. .. .. .. .. Holyport Road 15 (7) 1 .. .. .. 3 (2) Homestead Road .. .. .. .. .. .. Horder Road *2 (2) 1 .. .. .. 1 Hugon Road 17 (11) 1 .. .. 1 1 Humbolt Road *12 (6) 6 (6) .. 1 .. 2 (2) Humbolt Mansions 5 (2) .. .. .. .. .. Hurlingham Gardens .. .. .. .. .. .. Hurlingham Road 2 (2) .. .. .. .. 1 Imperial Cottages .. .. .. .. .. 2 (1) Inglethorpe Street 3 (3) 1 .. .. .. 1 Irene Road 4 (3) .. .. .. .. 1 Ismalia Road 2 (2) .. .. .. .. .. Jerdan Place .. .. .. .. .. .. Jervis Road 1 .. .. .. .. .. Kelvedon Road 1 .. .. .. .. 1 Kempson Road .. .. .. .. .. .. Kenneth Road .. .. .. .. 2 (2) 1 Kensington Hall Gardens .. .. .. .. .. .. King's Court Mans 3 (1) .. .. .. .. .. Kenyon Street 2 (2) *l .. .. 1 3 (3) Kilkie Street 3 (1) 1 .. .. .. .. Kilmaine Road 1 .. .. .. .. 2 (2) Kimbell Gardens .. .. .. .. .. 1 King's Road 1 1 .. .. 2 (2) 1 Kingwood Road 6 (4) *1 .. .. 1 4 (4) Kinnoul Road 3 (2) 1 .. .. .. 3 (3) Knivet Road 1 .. *l .. .. 1 Lalor Street .. .. .. .. .. 1 Lambrook Terrace 1 .. .. .. •• -• 71  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Landridge Road .. .. .. .. .. .. Lanfrey Place .. .. .. .. .. 2 (2) Langford Road 4 (4) 1 .. .. .. 7 (5) Langthorn Street 4 (3) (22) .. *1 .. .. Larnach Road 2 (2) .. .. .. .. .. Laundry Road 4 (2) .. .. .. .. 5 (5) Lawn Terrace .. .. .. .. .. .. Letterstone Road .. .. .. .. .. .. Lettice Street .. .. .. .. .. .. Lillie Road 4 (4) *7 (7) .. .. 3 (3) 7 (7) Lillie Yard 1 .. .. .. .. .. Lillie Mansions 1 .. .. .. .. 1 Lilyville Road 2 (2) .. .. .. 1 .. Lindrop Street 10 (6) .. 1 .. 1 1 Lintaine Grove 3 (3) 3 (3) .. 1 .. 5 (5) „ ,, Flats .. .. .. .. .. 3 (2) Linver Road 3 (3) 1 .. .. .. .. Lisgar Terrace .. .. .. .. .. .. Lodge Avenue .. .. .. .. .. 1 Lochaline Street 11 (9) 1 .. .. 1 1 Lundy Street .. .. .. .. .. .. Lurgan Avenue 11 (8) 1 .. .. 1 .. Lysia Street 5 (3) 2 (2) .. .. 1 2 (2) Mablethorpe Road 2 (2) 1 .. *1 1 2 (2) Macmurdo Road .. .. .. .. .. .. Margravine Gdns. *2 (1) .. .. .. .. .. Margravine Road 3 (2) .. .. .. .. .. Marinefield Road 5 (4) .. .. .. 1 1 Marville Road 3 (3) 1 .. .. .. 3 (3) Matheson Road .. .. .. .. 1 3 (3) Maxwell Road 2 (1) .. .. .. .. 1 May Street 2 (2) 2 (2) .. .. 1 1 Melmoth Place .. .. .. .. .. .. Melton Street 3 (2) .. .. .. .. 1 Mendora Road 13 (8) 1 .. .. 1 1 Merrington Road .. .. .. .. .. 1 Micklethwaite Road 2 (2) 1 .. .. 2 (2) .. Mimosa Street 1 .. .. .. .. 2 (2) Mirabel Road .. 1 .. .. .. .. Mitford Buildings .. .. .. .. .. .. Molesford Road .. .. .. .. .. .. Mooltan Street .. .. .. .. .. 1 Moore Park Road 2 (2) .. 1 1 1 .. 72  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Mornington Avenue .. .. .. .. .. .. Moylan Road .. .. .. .. .. 1 Mulgrave Road 3 (3) 1 .. .. .. 2 (2) Mund Street .. 1 .. .. .. 2 (2) Munden Street 4 (3) .. .. .. .. .. Munster Road 7 (6) 5 (5) .. .. 2 (2) 3 (3) Musard Road 7 (5) .. .. .. 2 (2) 3 (3) Musgrave Road .. .. .. .. .. .. Musgrave Crescent 1 .. .. .. .. .. Napier Avenue .. .. .. .. .. .. Nella Road 1 .. .. .. .. .. Narborough Street 1 .. .. .. .. 2 (2) New King's Road 1 2 (2) .. 1 3 (3) 5 (5) Niton Street 6 (5) 4 (3) .. .. .. .. Norfolk Terrace .. .. .. .. .. .. Normand Gdns. 1 .. .. .. .. .. Normand Mews .. .. .. .. .. .. Normand Road 1 .. .. .. .. .. Northampton Place .. .. .. .. .. .. North End Road 3 (3) 1 .. .. 2 (2) 6 (6) Novello Street 1 1 .. .. 2 (2) 3 (3) Oakbury Road 5 (5) 2 (2) .. .. .. .. Ongar Road .. .. .. .. 1 4 (3) Orbain Road 3 (2) *3 (2) .. .. 1 2 (2) Orchard Place .. .. .. .. .. .. Orchard Street .. .. .. .. .. .. Oxberry Avenue 2 ( 2) .. .. .. .. 1 Palliser Road *.. .. .. .. .. .. Parfrey Street 13 (11) 1 .. .. .. 2 (2) Parkville Road 3 (1) 1 .. .. 2 (2) 2 (2) Parsons Green 2 (1) 1 .. .. 1 .. Parsons Green Lane 1 .. .. .. .. 1 Parthenia Road 4 (4) .. .. .. .. 2 (2) Peabody Buildings 8 (6) 2 (2) .. 1 .. 3 (3) Pearscroft Road .. 1 .. .. 1 2 (2) Pellant Road 2 (2) .. 1 * .. 2 (2) Perham Crescent 1 .. .. .. .. .. Perham Road .. .. .. .. .. .. Perrymead Street 7 (5) 1 .. .. .. .. Peterborough Road .. .. .. .. 1 .. Peterborough Villas .. .. .. .. .. .. 73  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Petley Road 7 (6) 1 .. .. .. 1 Playfair Street 3 (3) 1 .. .. .. 1 Portland Place .. .. .. .. .. .. Pownall Road 1 .. .. .. 2 (2) .. Prince of W. Mews .. .. .. .. .. .. Protheroe Road 3 (2) 5 (4) .. .. 1 4 (4) Purcell Crescent 8 (6) .. .. .. .. 3 (3) Purser's Cross Road 2 (2) .. .. .. .. 1 Quarrendon Street .. 2 (2) .. .. .. 1 Queen's Club Gdns. *l .. .. .. .. 1 Querrin Street 8 (4) .. .. .. .. 1 Queensmill Road 6 (6) 2 (2) .. .. .. 3 (3) Radipole Road 2 (2) 1 .. .. .. 1 Racton Road 2 (2) 1 .. .. .. .. Rainville Road 7 (3) 4 (3) .. .. .. .. Ranelagh Avenue .. .. .. .. 1 .. Ranelagh Gardens .. .. .. .. .. .. Rannoch Road 2 (2) .. .. .. 1 .. Rectory Road 3 (3) .. .. .. .. .. Reporton Road 7 (5) .. .. .. .. 3 (3) Richmond Place .. .. .. .. 2 (2) Rickett Street 5 (4) 1 .. .. 1 .. Rigault Road 1 .. 1 .. .. 3 (3) Ringmer Avenue 2 (2) .. .. .. .. .. Rock Avenue 1 1 1 .. 1 6 (6) Rosaline Road 6 (3) 1 .. .. .. 4 (4) Rosaville Road 1 .. *1 .. .. 1 Rosebank Terrace .. .. .. .. .. .. Rosebury Road 15 (10) 3 (2) .. .. 1 3 (3) Rostrevor Road 2 (2) .. .. .. .. 1 Rowallan Road 4 (3) 2 (2) .. *1 .. 2 (2) Roxby Place 4 (1) 1 .. .. .. 1 Rycroft Street .. .. .. .. .. 1 Rylston Road 6 (5) 1 .. .. .. 1 St. Alban's Terrace 2 (1) .. .. .. .. 1 St. Clement's Mans. 1 .. .. .. .. .. St. Dunstan's Road 2 (2) . . .. .. .. 2 (2) St. Maur Road 1 1 .. .. .. .. St. Margaret's Mans. 2 (1) .. .. .. .. .. St. Olaf's Road 6 (3) *3 (3) 2 (2) .. 3 (3) 3 (3) St. Peter's Terrace .. .. .. .. .. .. 74  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. St. Thomas Road .. .. .. .. 1 .. Salisbury Mews .. .. .. .. .. .. Salisbury House 1 .. .. .. .. .. Sandilands Road 2 (2) 1 *2 (2) .. .. 1 Sands End Lane 2 (1) .. 1 .. .. 3 (2) Seagrave Mews .. .. .. .. .. .. Seagrave Road 6 (5) 2 (2) .. *1 1 .. Sedlescombe Road 7 (5) 1 .. .. .. 1 Settrington Street 4 (4) .. .. .. .. .. Silverton Road .. .. .. .. .. .. Sherbrooke Road .. 1 *2 (2) .. 1 1 4 (3) Shorrolds Road 5 (4) .. 1 .. 5 (4) 2 (2) Shotley Street .. *1 .. .. .. 1 Shottendane Road .. .. .. .. .. .. Silvio Street .. .. .. .. .. .. Snowbury Road 4 (2) .. .. .. 1 .. Sotheron Road .. .. .. .. .. .. Southcombe Street .. .. .. .. .. 1 Stamford Place .. .. .. .. 1 .. Stamford Road 2 (2) .. 1 .. .. 1 Stamford Street 1 .. .. .. 1 2 (2) Stanley Road 2 (2) .. .. .. .. .. Stanwick Road .. .. .. .. .. .. Star Road 2 (1) 2 (1) *1 .. 2 (2) 2 (2) Stephendale Road 16 (13) *4 (3) .. .. 1 6 (6) Stevenage Road .. .. .. .. .. 1 Stokenchurch Road 4 (3) .. .. .. .. 1 Stonor Road .. .. .. .. .. .. Strode Road 2 (2) 3 (3) .. .. .. 5 (4) Studdridge Street .. 1 .. .. .. .. Swift Street 1 .. .. .. .. .. Talgarth Road 1 .. .. .. .. .. Tamworth Street *5 (4) 2(2) .. .. .. 1 Tasso Road 6 (6) 3 (3) .. .. 2 (2) .. Tilton Street 1 .. .. .. .. 1 Tournay Road 2 (1) .. 1 .. .. .. Townmead Road **12 (6) .. .. .. 2 (2) 6 (5) Trevanion Road .. .. .. .. .. .. Twynholm Mans. 1 .. .. .. .. .. Turneville Road 1 2 (1) .. .. .. 1 Tynemouth Street 9 (6) .. .. 1 1 4 (4) Tyrawley Road .. .. .. .. .. .. 75  Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Puerperal Fever. Erysipelas. Pulmonary Tuberculosis. Vanston Place 1 .. .. .. .. 1 Varna Road .. *1 .. 1 .. .. Vera Road 5 (5) 1 .. .. .. 1 Vereker Road 1 .. .. .. .. .. Vernon Street 2 (2) •• .. .. .. .. Waldemar Avenue .. 1 .. .. .. 4 (3) Walham Avenue 2 (2) 2 (2) .. .. .. 3 (3) Walham Grove 2 (2) 2 (1) .. .. .. 1 Wandon Road .. .. .. .. .. .. Walham Yard .. .. .. .. .. .. Wandsworth Bg. Rd. 17 (10) *2 (2) 1 .. 2 (2) 10 (9) Wardo Avenue *5 (5) 1 .. .. .. 3 (3) Waterford Road 4 (4) 1 .. .. 1 2 (2) Welford Terrace .. .. .. .. .. 1 Welbeck Court .. .. .. .. .. 1 Werley Avenue 1 .. .. .. .. .. Westbury Terrace .. .. .. .. .. .. West Kensington Mansions 1 .. .. .. .. .. Wheatsheaf Terrace 1 .. .. .. .. .. Whittingstall Road 1 .. 1 *1 .. .. Wigan Street .. .. .. .. .. .. Wingrave Road 1 .. .. .. .. .. William Street 1 .. .. .. .. . . Winchendon Road 1 .. **2 (1) .. 1 .. Wyfold Road .. .. .. .. .. .. Woodlawn Road *2 (2) l .. .. .. .. Whiteley's Cottages .. .. .. .. .. .. Woolneigh Street 1 1 .. .. .. 1 Yeldham Road 3 (3) 1 . . .. .. 1 Western Hospital *15a 14a .. .. 1a .. Fulham Workhouse 2a .. .. .. 10 12 Fulham Union Inf. 8a 3a 1a .. .. .. Refugee's Camp Earl's Court 3 **2 .. 1 .. .. (a) Staff. 76 TABLE B. Showing the number of Cases of Infectious Diseases notified to the several Metropolitan Medical Officers of Health during the Year 1914. Cities and Boroughs. Estimated population in the middle of 1914. Notified Cases of Infectious Disease. Small-pox. Scarlet fever. Diphtheria. Typhus fever. Enteric fever. Other continned fevers. Puerperal fever. Erysipelas. Cerebro-spinal meningitis. Poliomyelitis. Total. Annual rate per 1,000 persons living. West Districts. Fulham 157,303 - 1042 272 - 40 1 33 152 1 - 1541 9.8 Paddington 142,055 - 743 295 - 10 2 10 140 1 3 1204 8.5 Kensington 170,817 - 962 200 - 11 2 6 165 2 - 1348 7.9 Hammersmith 124,750 - 977 179 - 14 - 7 102 2 1 1282 10.4 Chelsea 63,791 - 272 74 1 23 1 8 34 1 - 414 6.4 City of Westminster 152,346 1 844 186 - 49 2 10 111 1 1 1204 7.8 North Districts. St. Marylebone 112,892 - 434 235 - 37 - 9 67 1 - 783 6.9 Hampstead 86,731 - 281 231 - 17 - 7 45 - 3 584 6.8 St. Pancras 212,497 - 1207 451 - 44 1 18 224 3 3 1951 9.1 Islington 324,764 - 1851 661 - 75 - 25 335 7 8 2962 9.1 Stoke Newington 50,454 - 264 98 - 4 - 3 49 - - 418 8.3 Hackney 223,724 - 806 495 - 28 3 17 296 3 5 1653 7.4 Central Districts. Holbora 45,861 - 171 64 - 15 - 4 22 - - 276 5.9 Finsbury 83,212 - 449 145 - 19 - 11 157 3 1 785 9.3 City of London 17,129 1 85 31 - 5 - - 10 - - 131 7.4 East Districts. Shoreditch 108,869 - 424 221 - 19 1 13 198 3 1 880 8.1 Bethnal Green 127,662 - 654 376 - 18 - 9 305 2 7 1371 10.8 Stepney 273,265 - 2089 885 - 47 - 33 403 4 27 3488 12.7 Poplar 160,222 - 633 353 - 34 - 23 222 9 8 1312 8.2 South Districts. Southwark 186,941 - 1447 340 - 24 - 29 325 6 4 2175 11.6 Bermondsey 124,213 - 581 216 - 8 - 5 123 5 1 939 7.6 Lambeth 296,724 - 1754 560 - 50 3 23 2? 7 5 10 2642 8.9 Battersea 167,338 - 996 267 - 21 - 13 156 1 1 1455 8.7 Wandsworth 338,998 - 1410 537 - 47 - 31 238 3 2 2268 6.9 Camberwell 262,020 - 1541 458 - 29 1 24 270 4 5 2332 8.9 Deptford 109,182 - 863 252 - 9 - 5 229 - 1 1359 12.5 Greenwich 96,037 - 552 243 - 10 1 3 123 4 - 936 9.8 Lewishim 172,433 - 955 406 - 51 - 7 129 - 1 1549 9.2 Woolwich 122,836 - 693 387 - 15 - 7 101 1 - 1204 9.9 Port of London - - 4 1 - 6 - - 2 1 - 14 - County of London 4,516,612 2 25,014 9119 1 779 18 393 4970 73 93 40.460 9.0