GRE 19 THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borough of Greenwich For the Year 1919, by ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H., MEDICAL OFFICER OF HEALTH TO THE BOROUGH, ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, and EXECUTIVE TUBERCULOSIS OFFICER. London: E. G. BERRYMAN & SONS, ltd., PRINTERS, Blackheath Road, S.E. 1920. 2 INDEX OF CONTENTS. Page. Age Mortality 14 Analysis of Death Causes 15 Analysis of Sickness and Mortality Statistics, London 13 Anthrax 37 Area of Borough 8 Articles and Rooms Disinfected 39, 40 Articles Destroyed 40 Bacteriological Examinations 31, 34, 38, 48 Bakehouses 21 Births 8, 11, 12 Blackheath and Charlton Cottage Hospital 21 Bones and Joints 19 Books Destroyed 38 Cancer 18 Causes of Death 16-20 Cerebro-Spinal Fever 36 Chicken Pox 31 Circulatory System 19 Cleansing Children 61 Complaints 21, 60 Constitutional Diseases 18 Consumption 18, 37 Contacts 37 Cowhouses 26 Customs and Inland Revenue Acts 27, 62 Dairies, Cowsheds and Milkshops 26, 61 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 8, 12, 14 Density of Population 8 Dental Work 43, 46 Developmental Diseases 18 Diarrhoea and Zymotic Enteritis 17, 36 Dietic Diseases 18 Digestive System 19 Diphtheria 16, 31 Diphtheria Anti-Toxin 16 Disinfection 38, 39 Duties and Powers of the Public Health Committee 5, 6 Dysentery 37 Elevation of Borough 8 Enteritis 17, 36 Epidemic Cerebro-Spinal Meningitis 36 Epidemic Diseases 16 Erysipelas 17, 32 External Causes 19 Factories and Workshops 21, 22, 24 Food and Drugs—Samples of 27, 28, 29, 58 Food—Premises for Preparation of, &c. 26, 27 Glanders 37 Gonorrhoea 17 Health Centre 45 Health Visitors 7 Home of Rest for Advanced Cases 43 Home Work 23 Horse Slaughterer 25 Hospital and other forms of Gratuitous Medical Relief 20 House Drainage 25 Houses Inspected for Infectious Disease 38 Houses Let in Lodgings 50, 60, 61 Housing 48, 54 Hydrophobia 37, 46 GRE 19 3 INDEX—continued. PAGE. Ice Cream Premises 26, 61 Ill-defined Causes 20 Infant Consultations 45 Infantile Mortality 14 and Appendix Influenza 17, 37 Inhabited Houses 8 Inland Revenue Acts 27, 62 Insanitary Houses 61 Institution Deaths 4 Integumentary System 19 Introductory Review 9 Legal Proceedings 28, 29, 61, 62 Local Diseases 18 Lymphatic System 17, 37 Malarial Diseases 17, 37 Marriages 10 Maternity and Child Welfare 45 Measles 16, 34, 35, 47 Membranous Croup 32 Milk 46 Milk and Cream Regulations 27 Milk Supply 46 Miller General Hospital 21 Mortuary 20, 62 Nervous System 18 Notices, &c. 60 Notifications 31 Notification of Births Act 47, 48 Offensive Trades 25,61 Ophthalmia Neonatorum 36, 46 Organs of Special Sense 19 Outworkers' Register 21 Overcrowding 58, 61 Parasitic Diseases 18 Persons Cleansed 61 Pneumonia 37 Polio-encephalitis 36 Polio-myelitis 36 Poor Law Relief 20 Population 8, 10 Post-Basal Meningitis 37 Premises Cleansed 57 Public Health Committee 5 Puerperal Fever 17, 34, 46 Pyaemia and Septicæmia 17 Refuse Removal 25 Remarks on Death Causes 16-20 Reproductive System 19 Respiratory System 19 Rheumatic Fever 17 Sale of Food and Drugs Acts 28, 29 Sanitary Work—Summaries, &c. 21-27, 55-62 Sanatoria for Children 44 Scarlet Fever 16, 32, 33 Scavenging and Refuse Removal 25 School Clinic 45 Seamen's Hospital 20 Septic Diseases 17 Slaughterhouses 24, 61 Small-pox 16, 31 Smoke Nuisances 25,58 Sporadic Diseases 17 . Staff of Public Health Department 7 Statistical Summary 8 Statistical Tables Appendix Suffocation 20 4 page. Suicide 20 Syphilis 17 Tenement Houses 62 Trench Fever 37 Tubercular Diseases 18 Tuberculosis 17, 18, 37, 43-45 Tuberculosis Dispensary 41 Tuberculosis Officer's Report 41,42 Typhoid Fever 17, 34 Underground Bakehouses 24 Underground Rooms 58, 61 Unwholesome Food 59 Uninhabited Houses 8 Urinary System 19 Vaccination Particulars 30 Venereal Diseases 17 Verminous Premises 57, 61 Verminous Children 61 Vital Statistics 10 and Appendix Water Supply 26 Whooping Cough 16, 36 Working Centre 43 Workshops and Factories 21, 22 Workshops and Workplaces 22, 24 Zymotic Enteritis 17, 36 Zymotic Diseases 16 5 Public health Committee during the year 1918-19. Charles Stone, Esq., J.P. (Mayor), and 9 Members. A. J. Hunt, Esq., Chairman. H. Baron, Esq., Vice-Chairman. Councillors— H. Baron. A. J. Hunt. H. F. Defrates. E. A. Lovibond. C. Nixon. D. W. Noakes. Dr. J. Gordon Parker, D.Sc. F. Whatley, B.A. E. R. Woodward. Duties and Powers of the Public Health Committee. 1.—The Committee shall consist of nine elected members. 2.—There shall be referred to the Committee the execution of the Food and Drugs Act, 1875-1899; the Margarine Act, 1887; the Sale of Horse-flesh, &c., Regulation Act, 1889; such matters arising under the Housing of the Working Classes Act, 1890 and 1894, and the Working Classes Dwellings Act, 1890 ; the Public Health (London) Acts; the Metropolis Management Acts relating to defective drainage; the Canal Boat Acts; the Factory and Workshop Acts; the sanitary provisions of any other Act of Parliament; the Dairies, Cowsheds, and Milkshops Order of 1885; the by-laws and regulations made under the above Acts, or otherwise relating to the public health and sanitary condition of the Borough, which are not within the reference to any other Committee, shall stand referred to the Committee. 6 3.—The Committee may serve and receive notices, take proceedings, and in particular cases empower any Officer of the Council to make complaints and take proceedings on their behalf under and otherwise execute, the Public Health (London) Act, 1891, and sections 82, 83, 84 and 85 of the Metropolis Management Act, 1855, relating to the inspection of any premises, drains, sinks, traps, syphons, pipes, or other works or apparatus connected therewith, and otherwise in relation to defective drainage, except as to the recovery of expenses, and the same shall not require the approval of the Council, provided that the Committee shall report their action at the next following meeting of the Council, who may at any time determine or prohibit or otherwise vary any such notices or proceedings. 4.—All plans for drainage and redrainage of premises shall be laid before this Committee for consideration. 5.—Works of drainage of houses and premises shall be carried out under the direction of this Committee. 6.—The Committee shall have the control of Mortuaries erected or maintained by the Council, as the Sanitary Authority, and shall have control of the disinfecting staff, apparatus, and plant. 7.—The construction, maintenance, and control of public sanitary conveniences, and conveniences maintained by the Council, shall be referred to this Committee. 8.—Provision and maintenance of Tuberculosis Dispensary. Additional matters coming within the definition of the sanitary provisions of any other Act of Parliament:— Notification of Births Act, 1907. Housing and Town Planning Act, 1909. London County Council (General Powers) Act, 1902, 1907, 1908 Rag Flock Act, 1911. Public Health (Tuberculosis Regulations), 1912. Public Health (Milk and Cream) Regulations, 1912. 7 Staff of the public health Department. Sanitary Inspectors— Charles Turle Wilson. Sydney A. Radford. Arthur E. Bache. Ebenezer Martin. Charles W. Nettleton. Miss G. Davis. Public Analyst— A. E. Brown, B.Sc., F.I.C. Disinfector—James Forrest. Assistant Disinfectors— Frank Mears. A. Clay. Caretakers at Council's Shelter— Edward Jackson. Maria Jackson. MUNICIPAL DISPENSARY FOR THE PREVENTION OF CONSUMPTION. Administrative Medical Officer— E. G. Annis, M.R.C.S., etc., D.P.H. Tuberculosis Medical Officer— † G. H. Dart, M.D. Dispenser—G. W. Vickery. Nurses— L. Heastman. T. I. Husbands. MATERNITY AND CHILD WELFARE WORK. Administrative Medical Officer—E. G. Annis, M.R.C.S., &c. Medical Officer— K. McNeill, M.B., Ch.B., D.P.H. Health Visitors- Miss E. M. Millington. Miss A. B. Reid. Miss M. Molloy. Matron, Municipal Creche—E Chalk. Clerks— *W. H. Peters. *A. H. Sapsed. *T. D. P. Mobsby. Medical Officer of Health— † Ernest G. Annis, M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health— G. H. Dart, M.D., M.R.C.P., D.P.H. *On Military Service. † On Military Service part of the year. 8 Statistical Summary. Elevation.—Varies from below high-water mark up to 249 feet above sea level. Area of the Borough and Districts— East Greenwich 1451•4 acres. West Greenwich 297•8 „ St. Nicholas 112•1 „ Charlton and Kidbrooke 1990•4 „ 3851•7 „ Density of Population— East Greenwich 34•03 persons per acre. West Greenwich 82•06 „ St. Nicholas 69•29 „ Charlton and Kidbrooke 10•55 „ Average for the Borough 26•64 „ Number of Inhabited Houses— At Census, 1901 14,240 At Census, 1911 14,722 Estimated, 1919 16,121 Number of Uninhabited Houses— At Census, 1911 803 Estimated, 1919 179 Population— At Census, 1911 95,968 Estimated, 1919 102,591 Birth Rate, 1919 18.30 per 1,000 Death Rate, 1919 1315 „ ,, (Zymotic) .84 „ „ (Infantile Mortality) 95 per 1,000 Births. 9 Public Health and Housing Department, Royal Hill, Greenwich. June, 1920. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greenwich. Gentlemen, I have the honour to submit herewith the Annual Report of the Medical Officer of Health for the year 1919. The Birth Kate is 18.87 per 1,000 for Greenwich and 18.30 for the whole of the County of London. The Mortality Statistics for the year are, I am pleased to say, of a satisfactory character, the recorded Death Rate of 13.15 per 1,000 of the estimated population being considerably less than the corresponding figure for last year, i.e., 19.16 per 1,000, and just below the figure of 13.4 per 1,000, which is the Death Rate for the County of London, and 13.8 per 1,000, the figure for the ninety-six large towns, although once again I must state that, in my opinion, these Death Rates are quite fallacious, being based on estimates of population which are, in my opinion, considerably too low. The Infantile Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered, is 95, a decrease from 119, the figure for last year; the figure for all London is 89, compared with 107 in 1918, and the Borough average during the last five years, 1914-18 inclusive, is 101. The Zymotic Death Rate of .84 is .86 per 1,000 below the corresponding figure for last year. The figures relating to the different constituent parts of the Borough are as follows:— Districts. Birth Rate. Death Rate. Percentage of deaths under one year of age. Infantile Mortality per 1000 Births. Zymotic Death Rate. Diarrhoea Death Rate. Consumption Death Rate. sumption Death Rate. East Greenwich 18•35 10•58 12•03 71 •71 •25 1•01 West Greenwich 19•97 18•56 13•23 123 •92 •24 2•25 St. Nicholas 22•01 12•84 26•05 152 1•72 •64 1•29 Charlton 18•15 13•10 11•71 84 •65 •10 1•15 Kidbrooke 6•22 6•88 9•52 105 •32 •32 •32 Whole Borough 18•87 13•15 13•63 95 •84 •26 1•35 Attack Rates of the various notifiable diseases per 1,000 living in the several districts:— Districts. Small-pox. Diphtheria. Scarlet Fever. Erysipelas. Typhoid Fever. Puerperal Fever. East Greenwich •00 1•77 5•42 .27 .13 •01 West Greenwich •00 5•03 3•46 .52 •32 •08 St. Nicholas •00 •97 8•41 1.07 — — Charlton •00 2•68 2•19 .49 •27 •10 Kidbrooke •00 •98 1•31 .32 — — Whole Borough •00 2•63 4•61 .45 •19 •04 10 In conclusion, I have to thank the Public Health Committee and Council for the kindness and consideration with which they have regarded my endeavours to carry out my duties, and I desire also to express my appreciation of the manner in which the members of the staff have performed their duties throughout the past year. I am, Gentlemen, Yours respectfully, E. G. ANNIS. VITAL AND MORTAL STATISTICS, 1919. POPULATION. The number of persons estimated to be living at the middle of 1919 was 102,591. The distribution of the population throughout the Borough is as follows:— Census, 1911. Estimated Population at middle of year 1919. Calculated on Birth Rate. East Greenwich 45,963 49,387 West Greenwich 22,936 24,438 St. Nicholas 7,291 7,767 Charlton 16,911 17,948 Kidbrooke 2,876 3,051 Total 95,977 102,591 MARRIAGES. The Superintendent-Registrar of the Greenwich Registration District has kindly furnished me with the particulars relating to the number of marriages solemnized in the Parishes of Greenwich and St. Nicholas. The Superintendent-Registrar for the Woolwich Registration District has also kindly supplied the particulars for the Parishes of Charlton and Kidbrooke, with the exception, in these latter particulars, that the marriages performed in the Woolwich Superintendent-Registrar's Office and in Chapels in Charlton and Kidbrooke, of residents in those Parishes, are not included. 11 The following table shows these particulars, giving the number of marriages in Greenwich and St. Nicholas, etc., for each year since 1910. Year. In Churches of England in Greenwich. In Churches of England in Charlton and Kidbrooke. Marriages in Superintendent-Registrar's Office of parties resident in Greenwich, or outside the Registration District, and in Chapels and Roman Catholic Approximate Population of the districts concerned. St. Nicholas Parish Church. Church in St. Nicholas and Greenwich. Total. 1910 304 110 53 243 710 112935 1911 309 123 34 230 696 95982 1912 266 102 59 228 655 95992 1913 295 120 51 259 725 96015 1914 279 135 72 243 729 96037 1915 472 188 95 406 1161 96385 1916 381 145 74 324 924 94452 1917 343 128 67 653 1191 90440 1918 353 165 55 244 817 89939 1919 419 197 76 326 1018 102591 births. The total number of Births registered in the Borough during the year has been 1,968, but of these, 98 occurred in the Greenwich Union Infirmary, the address of the mother being in 20 instances in Deptford, 35 in Lewisham, 8 in Woolwich and one in Camberwell. Deducting these and adding 38 which were transferred from Lambeth, Stepney, St. Pancras, Deptford, Southwark, Newport, Westminster, Woolwich, Holborn and West Ham, it will be seen that the number of strictly Greenwich births for 1919 is 1,942, of which 992 were males and 950 females. This corrected figure gives a Birth Rate of 18.62 per 1,000 of the population, being 5.48 below the average for the last eighteen years, 1901 to 1918, the period since the formation of the Metropolitan Borough. Amongst the total number of births registered in the Borough there were 111 in which the name of the father was not registered and therefore not given in the return; accordingly, these births may be presumed to be of an illegitimate character. Sixty-nine of such births were registered in the East Greenwich District, which includes the Infirmary of the Greenwich Union. In 16 cases the mother was ordinarily, a resident in the Borough of Deptford, 35 in Lewisham and two in Woolwich, and accordingly this number of births have been transferred to those Boroughs. The home address of the other 16 were 4 in East Greenwich and 12 in West Greenwich. The remaining 42 were allocated to the district in this Borough in which the mother resided, making 17 of such births belonging 12 to East Greenwich, 14 to West Greenwich, 3 to St. Nicholas and 8 to Charlton. The Birth Rate for the County of London equals 18.3 per 1,000 of the population. The Birth Rate for all England and Wales was 18.5. Under the provisions of the Notifications of Births Act, 1907, intimations have been received from medical men, parents, and others, with respect to 2,085 births. deaths. The total number of deaths registered during 1919 was 1,372, of which 776 were males and 596 females. The crude Death Rate for the Borough of 13.15 per 1,000 compares with 13.4, the Death Rate for the County of London, and 13.8 the Death Rate for the ninety-six large towns. The Death Rate in the various Metropolitan Boroughs varied from 11.2 in Hampstead and Wandsworth, 11.4 in Lewisham, 12.1 in Fulham, 12.2 in Woolwich, 12.4 in Camberwell up to 14.9 in Kensington and Southwark, 15.2 in St. Marylebone and Finsbury, 15.7 in Shoreditch and 16.2 in Holborn. Locally the Death Rate varied from 18.56 in West Greenwich, 13.10 in Charlton, 12.84.in St. Nicholas, 10.58 in East Greenwich to 6.88 in Kidbrooke. The following table shows the variation in, and average of, the Death Rates in each of the five Districts of the Borough in the five years, 1914 to 1918, compared with the figures for 1919:— District. 1914. 1915. 1916. 1917. 1918. Average for Five Years. Fast Greenwich 12•87 13•57 12•57 14•05 10•58 12•73 West „ 18•61 19•62 19•93 19•55 18•56 19•25 St. Nicholas 18•73 26•52 22•44 26•07 12•84 21•32 Charlton 11•83 17•56 13•66 13•50 13•10 13•93 Kidbrooke 27•42 43•41 8•57 6•71 6•88 18•60 Borough 14•95 17•56 15•14 15•96 13•15 15•35 13 Analysis of Sickness and Mortality Statistics in London during the Year 1919. (Specially compiled for The Lancet.) Cities and Boroughs. Estimated civil population, 1919. Notified cases of Infectious Disease. Deaths from Principal Infectious Diseases. Deaths from all causes. Death rate per 1000 living. Small-pox. Scarlet Fever. Diphtheria.* Typhus Fever. Enteric Fever. Other continued Fevers. Puerperal Fever. Erysipelas. Cerebro-spinal Meningitis. Poliomyelitis. Total. Annual rate per 1000 persons living. Small-pox. Measles. Scarlet Fever. Diphtheria.* Whooping cough. Enteric Fever. Diarrhæa and Enteritis (under 2 years). Total. Annual rate per 1000 persons living. LONDON 4,358,309 26 12,931 9479 1 344 6 313 2829 197 93 26,219 5•9 5 359 145 777 220 59 1372 2937 0•7 59,255 13•4 West Districts: Paddington 143,938 — 261 259 — 10 — 15 77 7 5 634 4•3 — 11 4 17 3 — 52 87 0•6 1896 13•0 Kensington 157,886 — 261 274 — 19 — 12 75 7 2 650 4•1 — 14 2 17 4 — 82 119 0•7 2389 14•9 Hammersmith 130,981 1 186 237 — 9 — 6 78 6 6 529 4•0 — 9 2 21 9 1 65 107 0•8 1674 12•6 Fulham 152,543 — 369 335 — 6 1 35 74 9 2 831 5•4 — 13 5 31 4 2 42 97 0•6 1871 12•1 Chelsea 60,573 — 156 76 — 8 — 3 19 3 3 268 4•4 — 8 4 8 4 — 13 37 0•6 897 14•6 City of Westminster 127,533 — 248 136 — 12 — 4 76 4 1 481 3•7 — 6 3 15 2 2 23 51 0•4 1808 13•9 North Districts: St. Marylebone 97,953 — 198 156 — 4 — 6 57 3 5 429 4•3 — 18 3 10 2 2 30 65 0•7 1517 15•2 Hampstead 88,012 — 126 87 — 8 — 2 36 1 3 263 2•9 — 5 2 7 — — 17 31 0•.3 1004 11•2 St. Pancras 219,434 10 587 354 — 9 — 12 145 10 5 1132 5•1 1 15 5 23 7 2 53 106 0•5 2944 13•2 Islington 323,034 2 1084 654 — 16 1 29 212 16 3 2017 6•1 1 13 12 50 18 3 86 183 0•6 4619 14•1 Stoke Newington 50,954 — 130 118 — 2 — 3 41 2 — 296 5•7 — 2 2 14 4 — 9 31 0•6 657 12•7 Hackney 216,736 — 653 700 — 23 2 17 111 6 6 1518 6•9 — 6 8 91 19 3 66 193 0•9 2860 13•0 Central Districts: Holborn 38,156 — 56 88 — 2 1 — 25 2 — 174 4•5 — 2 — 6 — 1 5 14 0•4 630 16•2 Finsburv 75,291 — 264 143 — 6 — 6 50 5 1 475 6•2 — 9 — 9 1 — 30 49 0•6 1165 15•2 City of London 13,893 — 15 23 - 1 — — 2 — 1 42 3•0 — — — 2 1 — 1 4 0•3 198 14•0 East Districts: Shoreditch 98,134 — 296 260 — 8 — 3 82 4 — 653 6•5 — 14 2 21 2 3 56 98 1•0 1562 15•7 Bethnal Green 110,085 1 390 552 1 4 — 9 163 3 2 1125 10•1 — 12 3 56 8 1 69 149 1•3 1550 13•9 Stepney 232,506 1 1023 795 — 33 1 13 219 12 1 2098 8•9 1 15 9 45 17 6 112 205 0•9 3403 14•4 Poplar 153,644 1 369 323 — 24 — 17 130 16 6 886 5•7 — 9 4 34 26 6 65 144 0•9 2246 14•4 South Districts: Southwark 179,971 — 799 504 — 12 — 19 208 6 2 1550 8•5 — 19 4 42 10 3 92 170 0•9 2728 14•9 Bermondsey 124,239 — 399 283 — 8 — 3 84 4 — 781 6•2 — 23 5 21 5 3 52 109 0•9 1729 13•7 Lambeth 282,322 1 1033 544 — 16 — 17 190 10 7 1818 6•3 — 26 16 62 12 4 89 209 0•7 4194 14•6 Battersea 159,316 3 495 244 — 11 — 11 95 13 6 878 5•4 — 18 3 20 6 3 31 81 0•5 2063 12•7 Wandsworth 333,693 — 906 535 — 18 — 31 147 13 9 1659 4•9 — 18 7 41 14 2 45 127 0•4 3783 11•2 Camberwell 273,802 — 725 511 — 10 — 14 151 6 8 1425 5•1 — 31 12 35 15 3 94 190 0•7 3441 12•4 Deptford 111,205 — 521 263 — 8 — 8 72 2 4 878 7•8 — 21 9 16 1 2 32 81 0•7 1447 12•8 Greenwich 98,484 — 483 276 — 20 — 5 51 9 1 845 8•4 — 12 7 16 10 2 26 73 0•7 1372 13•15 Lewisham 167,754 — 657 374 — 4 — 6 91 12 3 1147 6•7 — 3 9 20 5 — 16 53 0•3 1943 11•4 Woolwich 136,237 4 239 374 — 27 — 7 68 6 1 726 5•2 2 7 3 27 11 5 19 74 0•5 1683 12•2 Port of London — 2 2 1 — 6 — — — — — 11 — — — — — — — — — — — — * Including Membranous Croup. 14 DEATHS IN INSTITUTIONS. The following table gives the particulars showing the number of deaths of Greenwich residents in Public Institutions during the last six years:— Year. Total Deaths of Greenwich Residents. Total Deaths of Greenwich Residents under 1 year of age. Total Deaths of Greenwich Residents in Public Institutions. 1914 1,431 235 414 1915 1,690 238 690 1916 1,426 197 544 1917 1,439 203 364 1918 1,718 210 651 Average 1,541 217 533 1919 1,372 187 603 Age Mortality. The age mortality and the distribution of the deaths between the different quarters of the year is shown by the following table:— Deaths. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Under 1 year of age 46 40 33 68 187 Between 1 and 2 years 12 6 8 11 37 Between 2 and 5 years 13 8 4 13 38 Between 5 and 15 years 20 20 13 15 68 Between 15 and 25 years 30 27 18 15 90 Between 25 and 45 years 83 45 38 59 225 Between 45 and 65 years 82 56 58 103 299 65 years and upwards 162 85 70 111 428 Total 448 287 242 395 1,372 INFANTILE MORTALITY. The Infantile Mortality, measured by the deaths of children under one year of age to the number of births registered, was 95 per 1,000 births, there having been a total of 187 such deaths during the year, as compared with 197, 203 and 210, the respective figures for the years 1916, 1917 and 1918. The number for the County of London was 85 per 1,000 births, the average for the past five years in Greenwich has been 101 per 1,000 births. 15 For all London the rate was 85 in 1919, compared with 107 in 1918 and 103 in 1917. For England and Wales the rate was 93, compared with 97 in 1918, 97 in 1917 and 99 in 1916. Locally, the variations were from 71 per 1,000 births in East Greenwich, 84 in Charlton, 105 in Kidbrooke, 123 in West Greenwich, to 152 in St. Nicholas. The following table compares at a glance these figures for the years since the formation of the Borough:— District. Average for five Years, 1901-1905 inclusive. Average for five Years, 1906-1910 inclusive. Average for five Years, 1911-1915 inclusive. 1916. 1917. 1918. 1919. East Greenwich 129 106 96 68 109 99 71 West 126 110 112 92 106 146 123 St. Nicholas 179 143 167 156 114 123 152 Charlton 121 109 76 75 97 131 84 Kidbrooke 39 79 16 51 — 40 105 Total 131 111 103 83 105 119 95 AN ANALYSIS OF DEATH CAUSES. All death causes are conveniently arranged under various headings, according to the Registrar-General's classification of diseases, and the following table shows the Death Rates for all persons belonging to the Borough (although some of them may have died in Institutions in other Boroughs, or even outside the County of London altogether), per 1,000 of the population living in the Borough. 1919. 1919. Infective Diseases— Local Diseases—continued. Epidemic 1•53 Circulatory System 1•23 Sporadic 0•009 Respiratory System 2•27 Venereal 0•10 Digestive System 0•44 Septic 0•01 Urinary System 0•43 Malarial 0•02 Reproductive System 0•08 Tuberculosis 1•66 Parturition 0•04 Dietetic Diseases 0•01 Bones and Joints 0•01 Constitutional Diseases 1•49 Integumentary System 0•009 Developmental Diseases 2•01 Local Diseases— External Causes— Nervous System 1•09 Accidents 0•38 Organs of Special Sense 0•07 Suicide 0•01 16 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic. There were 160 deaths due to this class of diseases, equalling a Death Rate of 1.53 per 1,000; the rate last year was 4.86, and was 1.71, 1.71 and 1.54 in 1915, 1916 and 1917 respectively. Zymotic. The purely, Zymotic class of epidemic diseases is credited with causing a total of 88 deaths, equalling a Death Rate of 84 per 1,000. Locally, the Zymotic Death Rate varied from .32 in Kidbrooke (.37 in 1918), .65 in Charlton (1.1 in 1918), .71 in East Greenwich (1.78 in 1918), .92 in West Greenwich (2.01 in 1918), up to 1.72 in St. Nicholas (2.06 in 1918). Small-Fox. There were no deaths from this disease in 1919, this being the seventeenth year since a death occurred from this cause in the Borough. Measles. Thirteen deaths were ascribed as due to this disease, 11 of the patients being under live years of age, and 2 between five and fifteen years of age, compared with 45 which occurred in 1918; 46, 48 and 45 deaths were recorded in the years 1915, 1916 and 1917 respectively. One of the deaths occurred in East Greenwich, 5 in West Greenwich, 5 in St. Nicholas, 2 in Charlton and 0 in Kidbrooke. The quarterly incidence was 1 in the first, and 1, 4 and 7 respectively in the succeeding quarters. Scarlet-Fever. This disease occasioned 7 deaths, 2 of which were under two years. Two deaths occurred in East Greenwich, 1 in West Greenwich, 3 in St. Nicholas and 1 in Charlton. One such death occurred in 1918 and 1 in 1917. Diphtheria. There were 15 deaths from this disease during 1919. This gives a Death Rate for Diphtheria of .14 comparing with .07 the rate for 1918. Sixteen deaths occurred in 1918 which were attributed to this cause, and 14, 22 and 27 in 1915, 1916 and 1917 respectively. Ten of the patients were under five years of age. Forty-two tubes of Diphtheria Anti-toxin, containing a total of 84,000 units of serum, for the treatment of patients suffering from this disease, have been supplied by this Council during the year. Whooping Cough. This disease was given as the cause of 9 deaths in 1918, as against 23, 8 and 45 in the years 1916, 1917 and 1918. These deaths equal a rate of .08 per 1,000. Five of the 17 deaths occurred in East Greenwich, 2 in West Greenwich, 0 in St. Nicholas and 2 in Charlton. Typhoid Fever. There were 2 deaths ascribed as due to this disease; there were 4 in 1918, 2 in 1917, 6 in 1916, 7 inl915, 5 in 1914, 3 in 1913, 2 in 1912, 4 in 1911 and 3 in 1910. One death occurred in East Greenwich and 1 in West Greenwich. Diarrhœa and Zymotic Enteritis. Twenty-eight deaths were stated to be due to this cause, equalling a rate of .26 per 1,000. Last year there were 37 deaths, and 37, 42 and 38 respectively in 1915, 1916 and 1917. The deaths were distributed as follows:—Thirteen in East Greenwich, 6 in West Greenwich, 6 in St. Nicholas, 2 in Charlton and 1 in Kidbrooke. Twenty-five patients were under five years of age. The deaths in 1918 were distributed as follows:—21 in East Greenwich, 7 in West Greenwich, 6 in St. Nicholas and 5 in Charlton. Influenza. Influenza is found to have been the responsible cause of 84 deaths in 1919, 114 was the average of the previous three years. Of the 84, 11 were over sixty-five years of age. Sporadic Diseases. There was one death from this class of diseases during the year. Venereal. Syphilis. Eleven deaths were given as due to Syphilis, as against 6 in 1918 and 5 in 1917. Of these 11 deaths, 7 were under five years of age. Three occurred in East Greenwich, 6 in West Greenwich and 2 in St. Nicholas. Four of the deceased persons were in the Greenwich Infirmary, 1 in the Seamen's Hospital and 3 in the Miller Hospital. There were no deaths from Gonorrhoea during the year. Septic. Erysipelas. Two deaths occurred from this cause in 1919, 2 in 1918, 1 in 1917, 3 in 1916 and 4 in 1915. Puerperal Fever. There were 4 deaths from this disease during the year. Pymæia and Septicæmia. There were 3 deaths from this disease during the year, and 2 deaths from other allied diseases. Malarial. Eheumatic Fever. There were 3 deaths in 1919, as compared with 1 in 1918, 3 in 1917 and 1 in 1916. Rheumatism of the Heart. There was one death ascribed to this cause during 1919. Tuberculosis. This class includes the causes of 174 deaths during the year under review, with a rate of 1.66; these figures compare with 170, 219 and 174, the totals of the years 1916, 1917 and 1918 respectively, and respective rates of 1.80, 2.42 and 1.90. 18 Tuberculosis of the lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 141 attributed to this cause, or a rate of 1.35 per 1,000. Locally, the deaths were 1 in Kidbrooke (giving a Death Rate of .32), 12 in St. Nicholas (giving a Death Rate of 1.29), 21 in Charlton (giving a Death Rate of 1.15), 51 in East Greenwich giving a Death Rate of 1.01), and 56 in West Greenwich (giving a Death Rate of 2.25 per 1,000). The remaining forms of Tuberculosis were responsible for 33 deaths, 10 being in East Greenwich, 12 in West Greenwich, 3 in St. Nicholas, 7 in Charlton and 1 in Kidbrooke. Of these other forms of Tuberculosis, Tuberculosis of the Brain or its membranes was credited with 17, 10 being under five years of age; Tubercle affecting the Intestines, 8 deaths (3 being under five years of age); General Tuberculosis, 7 deaths (3 under five); Tubercle of Larynx, 1 over five years of age. Parasitic Diseases. There was one death from this class of disease. Dietetic Diseases. There were 2 deaths from this class of disease in West Greenwich. Constitutional Diseases. The deaths from this cause were 156 in number, which gives a rate of 1.49 per 1,000. Of these, 140 were attributed to Cancer, 6 to Diabetes, 5 to Anaemia, 2 to Osteo-Arthritis, 1 to Lymphia^denoma and 2 to Gout. The deaths from Cancer were distributed as follows:—67 occurred in East Greenwich, 41 in West Greenwich, 9 in St. Nicholas, 21 in Charlton and 2 in Kidbrooke. Developmental Diseases. There were 210 deaths from this class of causes, equal to a rate of 2.01 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz.:—-Congenital defects, 5, and those from causes more or less preventable, viz.:—Premature birth 41; Injury at birth, 7; Debility at birth, 9; Atrophy, Debility and Marasmus, 17, and Atelectasis, 6. The remaining and largest portion of these deaths from developmental diseases, 125 in number, were from Old Age; in 1918 there were 113 deaths from this cause, and 137 in the previous year. Local Diseases. Nervous System. One hundred and fourteen deaths were attributed to the various nervous diseases, which gives a rate of 1.09 per 1,000; last year the rate was .32 per 1,000. Convulsions were responsible for 5, all being under five years of age; 5 were from Meningitis, 70 from Apoplexy, 2 from Softening of the Brain, 2 from Hemiplegia or Brain Paralysis, 19 4 from General Paralysis of the Insane, 3 from Cerebral Tumour, 8 from Epilepsy, 1 from Encephalitis, 2 from Locomotor Ataxy, 1 from Paraplegia, and 11 from other diseases of this system. Organs of Special Sense. There were 8 deaths from this class of causes, equal to a rate of .07 per 1,000. Circulatory System. The Death Rate from diseases of this system was 1.23 per 1,000, there being a total of 129 such deaths. Valvular diseases of the heart were responsible for 119, 1 from Hypertrophy of the Heart, 3 from Aneurism, 3 from Embolism, 2 from Angina Pectoris, and from the remaining diseases of this system, 1. Respiratory System. Two hundred and thirty-seven deaths were due to diseases of the respiratory organs, as compared with 327 in the preceding year. The Death Rate under this heading equals 2.27 per 1,000. Thirty were from Acute, and 84 from Chronic Bronchitis; 113 from the various forms of Pneumonia, 28 being under five years of age, 4 to Emphysema, 1 to Pleurisy, and 5 to other diseases. Digestive System. There were 46 deaths from diseases of this system, equal to a rate of .44 per 1,000. Of this number, Enteritis was responsible for 6 (5 being under five years of age), 1 was due to disease of Pharynx, 1 to disease of (Esophagus, 6 to Appendicitis, 11 to obstruction, and 5 to other diseases of the Intestines, 3 to Cirrhosis, and 2 to other diseases of the Liver, 2 to Peritonitis, 7 to other diseases of Stomach, and 2 to other disease of the Digestive System. Lymphatic System. There were 2 deaths from diseases affecting this system during the year. Urinary System. Forty-five deaths, equal to a rate of .43 per 1,000. occurred from diseases affecting this system. Twentysix were from Bright's Disease, 9 from Acute Nephritis, 8 from diseases of the Bladder and Prostate, and 2 from ill-defined causes of the urinary system. Reproductive System. Disease of the generative organs was the cause of 9 deaths, 2 deaths were attributed to diseases of Uterus and appendages, and 1 to Disease of Ovaries. There were 6 deaths attributed to diseases of Parturition. Bones and Joints. There were 2 deaths from diseases of bones and joints. Integumentary System. There was 1 death from disease of Integumentary System. External Causes. There were 50 deaths given as due to causes grouped under this heading; 40 were the result of accident or negligence, and the remaining 10 were from Suicide. 20 Four children died of Suffocation by being overlaid in bed during 1919 (compared with 0 from this cause last year); 5 cases were from drowning, 3 from Burns and Scalds, while accidents on railways, in vehicular traffic and in building operations, falls, etc., were responsible for 28 deaths. The Suicides were 2 by cut or stab, 1 from Drowning, 3 by Hanging and Strangulation, 1 from Asphyxia, 1 from Poison, 1 by Shooting, and 1 by other cause. Ill-Defined Causes. There was no death the cause of which was not ascertained in 1919. MORTUARY. The number of bodies dealt with in the Mortuary since 1910 is shown below:— Year. Drowned Bodies from River. Other Bodies. Totals. 1910 12 109 121 1911 8 112 120 1912 15 126 141 1913 17 114 131 1914 15 134 149 1915 15 194 209 1916 11 182 193 1917 15 209 224 1918 24 138 162 1919 12 120 132 POOR LAW RELIEF. According to the circular of the Ministry of Health, respecting the Annual Reports of the Medical Officers of Health, it is now necessary that they include some reference to the amount of medical and other forms of Poor Law Relief in the district. I have accordingly been in communication with the Clerk to the Greenwich Board of Guardians on this subject, but have only been favoured with the information contained in the quarterly statement of persons in receipt of Poor Law ,Relief in England and Wales, showing the number of persons in receipt of such relief on the last Saturdays in October, November and December, 1919, for the whole of the South-Eastern District of London, which information for the purpose of this report is, of course, quite useless. HOSPITAL AND OTHER FORMS OF GRATUITOUS MEDICAL RELIEF. The Seamen's Hospital have admitted, treated and maintained 200 Greenwich persons for an average of twenty-four days each, in addition to which there have been 2,268 Out-patients who 21 attended on an average about three times each patient, making altogether 6,804 attendances of persons belonging to the Borough of Greenwich. Miller General Hospital treated about 400 Greenwich residents as In-patients, and about 48,000 Out-patient attendances were also made by Greenwich residents. Blackheath and Charlton Cottage Hospital admitted 145 In-patients from Greenwich, and treated about 150 casualties, making about 100 attendances for this purpose. SANITARY WORK. The tables on pages 22 to 27 and 55 to 62 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 10,642 houses and premises have been inspected or re-inspected during the year; 1,158 intimation notices have been served and 230 statutory notices. With the exception of prosecutions in connection with the Sale of Food and Drugs Act, it was not found necessary to institute Police Court proceedings in any case during the year. There were altogether throughout the year 616 complaints entered in the Public Complaints Register of the Department. Bakehouses. One hundred inspections have been made of the various Bakehouses in the Borough, and 39 nuisances found therein have been abated as the result. Factories and Workshops. One hundred and twenty-three inspections have been paid to these premises within the Borough during the year. There were 200 workshop premises on the Register at the beginning of the year, 8 have been added during the year, and 6 have been taken off, leaving a total now on the Register of 202. This total includes 16 laundries, 29 dressmaking and mantle works, 7 fuel and firewood works, 3 cycle works, 9 milliners, and various others, including workplaces, such as 4 blacksmiths, 14 barge builders, 3 builders' yards, etc. Information has been sent to H.M. Inspector of Factories with respect to a workshop being converted into a factory. Outworkers' Register. Sixty-three Lists of Outworkers containing 221 names and addresses, have been received during the year from the Medical Officers of Health for other Districts; 11 lists, containing 78 names, have been received from employers within the District; 22 names have been forwarded to other Districts, thus giving a total of 277 names and addresses of outworkers within the Borough. One hundred and twelve visits of inspection have been paid to these premises. 22 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 62 3 ... Workshops (Including Workshop Laundries) 108 11 ... Workplaces (Other than Outworkers' Premises) 144 7 ... Total 314 21 ... 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:— Want of Cleanliness 98 98 ... ... Want of Ventilation 9 9 ... ... Overcrowding 8 8 ... ... Want of Drainage of Floors ... ... ... ... Other Nuisances 37 37 ... ... Sanitary Accommodation— ... ... ... ... Insufficient 11 11 ... ... Unsuitable or defective 17 17 ... ... Not Separate for Sexes 2 2 ... ... Offences under the Factory and Workshop Act :— Illegal Occupation of Underground Bakehouse (s. 101) ... ... ... ... Breach of Special Sanitary Requirements for Bakehoases (ss. 97 to 100) 9 9 ... ... Other Offences 4 4 ... ... Total 195 195 ... ... *Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 23 3.—HOME WORK. Nature of Work. Outworkers' Lists, Section 107. Number of nspections of outworkers' premises. Outwork in unwholesome premises. Sec. 108. Outwork in infected premises. Secs. 109 & 110. Lists received from Employers. Numbers of addresses of outworkers received from other Councils. Numbers of addresses of outworkers forwarded to other Councils. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 110). Prosecutions (Secs. 109 & 110). Failing to keep or permit inspection of lists. Failing to send lists. Twice in the year. Once in the year. Lists. Outworkers Lists. Outworkers Wearing Apparel— (1) Making, &c. 9 76 1 1 115 21 ... ... 66 ... ... ... ... ... ... (2) Cleaning & Washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, Lace Curtains & Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur Pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas ... ... 1 1 ... 1 ... ... ... ... ... ... ... ... ... Paper Bags and Boxes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cotton and Kit Bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush Making ... ... ... ... 2 ... ... ... 2 ... ... ... ... ... ... Box Making ... ... ... ... 4 ... ... ... 4 ... ... ... ... ... ... Rackets & Tennis Balls ... ... ... ... 100 ... ... ... 40 ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 9 76 2 2 221 22 ... ... 112 ... ... ... ... ... ... 24 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1919. No. Bakehouses 41 Factory Bakehouses 2 Barge Builders 14 Blacksmiths 4 Boot and Shoe Makers 7 Builders' Yards 3 Carpenters and Joiners 2 Carriage Builders 2 Coopers 4 Cycle Works 3 Dress and Mantle Makers 29 Fuel Works 7 Laundries 16 Milliners 9 Photographers 3 Picture Frame Makers 1 Printers 1 Tailors 5 Underclothing Makers 1 Others 48 202 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5):— Notified by H.M. Inspector Reports (of action taken) sent to H.M. Inspectors Other Underground Bakehouses (s. 101):— In use during 1918 12 Certificates granted in 1918 In use at the end of 1919 12 Slaughter Houses. The slaughter houses in the Borough have been inspected on 45 occasions by the Inspectors. 25 Scavenging and Refuse Removal. The scavenging of the Borough is theoretically carried out on a weekly system of collection. Unfortunately complaints are received from time to time by this Department that the weekly system has become extended into a two or three weekly period. These matters are always brought to the attention of the Borough Engineer and Surveyor so that, he can deal with them. The method of the disposal of the refuse after it has been collected leaves much to be desired, the present method being by means of tipping on the low-lying marshes and waste land in the Borough, but, as these places are gradually becoming tilled up, the sites available are now within too close proximity to occupied houses and other public places to be conducive to healthy conditions, and undoubtedly these refuse dumps are at the present time a breeding ground for large numbers of both rats, mice and flies. Some portion of the refuse is tipped into barges at this Council's Depots on the River Side and barged away for disposal down the river. Two hundred and sixty-three new ash receptacles have been provided, and 26 complaints on this subject have been forwarded to the Borough Engineer for his attention. Horse Slaughterer. The one horse slaughtering premises in this Borough has been visited on eight occasions, and cleansing of the premises required on four of the visits. Other Scheduled Offensive Trades. The Foreign Animals Wharf being still in the occupation of the Military, the Offensive Trades generally carried on therein have not yet been recommended. Smoke Nuisances. Eighteen observations have been made for smoke nuisances during the year, and on no occasion was it found necessary to issue a statutory notice. House Drainage. Twelve drains have been constructed, 89 drainage systems have been reconstructed or repaired; 276 such systems have also been opened, cleansed and amended; 40 surface drains have been constructed; 44 drains and soil pipes have been ventilated, 181 systems have been tested by smoke, 129 by water and 60 by chemicals, of which number 119 were found to be defective; 25 new soil pipes and 129 traps have been fixed, together with 61 intercepting chambers and fresh-air inlets and 17 other chambers; 21 areas, 36 yards, 6 mews and stables, 2 washhouses drained; 1 cesspool abolished, 2 emptied, 2 air-tight covers amended and 1 ventilated; 26 water-closets have been erected; a pan, trap and water supply have been furnished throughout in 83 cases; pan and traps only furnished in 60 cases; pans only in 18 Cases, and other fittings provided or improved in 184 cases, whilst the water supply has 2 6 been renewed in 136 instances. The water supply for lavatory purposes has been disconnected from the drinking water system in 3 instances. Fublic-house urinals have been cleansed and repaired in 27 instances, 5 urinals were altered and 28 repaired or water laid on. Water Supply. During the year 1 water supply certificate has been granted under Section 48 of the Public Health (London) Act, 1891. Defective water fittings have been remedied in 75 cases; 31 water supplies have been reinstated where the supply had been cut off; water fittings have been amended in 109 cases; 3 water supplies have been altered so as to draw direct from the main; water supply provided in 7 instances, and cleansing, repairing and covering cisterns in 3 cases. FOOD. Cowhouses. The four cowhouses in the Borough have been visited on 10 occasions, and the required cleansing has been duly enforced on 7 occasions. Dairies, Cowsheds and Milkshops Order. At the commencement of the year there were 129 premises on the Register of Dairies and Milkshops; 10 new applications have been received during the year and added to the Register, and 19 names have been taken off, thus leaving a total of 120 premises now registered. During the year 101 visits of inspection have been paid to these premises; notices were served upon the occupiers in 8 cases, 7 of which were for dairies requiring limewashing and 1 for sanitary defect. Under the powers conferred by the London County Council (General) Powers Act, 1908, Section 5, with respect to the registration of premises unsuitable for the sale of milk, no registration has been refused on the grounds of the unsuitability of the premises. Ice Cream Premises. There were 103 premises known at the commencement of the year where the manufacture of this commodity was carried on; 14 have been added during the year and 14 taken off, leaving a total of 103 premises. These premises were inspected on 72 occasions, and improvement required by way of cleansing of the premises in 13 cases. Food Preparation. Places where food is prepared have been visited on 177 occasions, improvements being required in 43 instances, as detailed below:— 27 Class of Premises. Number on Lists. Number of Inspections Number of instances where matters needed attention. At end of 1918. Added 1919. Re- moved 1919. At end of 1919. Hotel Kitchens 4 ... ... 4 5 ... Eating Houses 43 12 7 48 63 21 Fried-Fish Shops 22 3 2 22 34 15 Pork Butchers 13 ... ... 13 21 3 Mineral Water Manufacturers 1 ... ... 1 2 ... Ice do. 2 ... ... 2 3 1 Sausage do. 12 ... ... 12 37 ... Others 5 4 1 8 12 3 Totals 102 19 10 110 177 43 The 43 instances where matters needed attention included 35 cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 2 where the sanitary arrangements were defective, 1 which required reconstruction, and 5 for want of ashpit. Customs and Inland Revenue Acts.—No application was received during the year for certificates under these Acts. Public Health, Milk and Cream Regulations, 1912—1917. No special samples have been taken during the year under these regulations, but the Public Analyst reports respecting every sample of milk taken as to the presence or otherwise of preservatives and the actual amount of fat present. Milk, Mothers' and Children's Orders, 1918. During the year 17,038 lbs. of dried milk of various kinds have been supplied under these orders to mothers and children attending our Infant Consultation Centres. Food and Drugs Acts. Four hundred and twenty-six samples have been purchased under the provisions of the Sale of Food and Drugs Acts and submitted to the Public Analyst for analysis, of which 404 were certified to be genuine and 22 adulterated, the adulterations thus being equivalent to 5.1 per cent. of the samples taken. Of the total number of samples purchased, 158 were milk of which 18 were certified to be adulterated; the remaining adulterated samples were 2 of mustard mixture and 2 of vinegar. 28 In addition, 2 samples were taken on behalf of the Food Control Committee. Proceedings were taken in 4 cases, resulting in fines and costs being imposed in all instances. A warning letter was sent in 6 cases. Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1919. Description of Samples. Number of Samples Purchased. Number Genuine. Number Adulterated. Remarks as to Action taken. Baking Powder 23 23 ... — Batter 32 32 ... — Cocoa 8 8 ... — Coffee 26 26 ... — Cooking Fat 1 1 ... — Dripping 62 62 ... — Egg Powder 2 2 ... — Egg Substitute 1 1 ... — Frying Fat 1 1 ... — Milk 158 140 18 6 warning letters sent, Police Court proceedings in 2 cases. Action taken by employer in 1 case. No action in 9 cases. Mustard 3 3 ... — Mustard Mixture 2 ... 2 No action in both cases. Pepper 6 6 ... — Self-Raising Flour 26 26 ... — Spongine 1 1 ... — Vinegar 74 72 2 Police Court proceedings in both cases. Total 426 404 22 29 Sale of Food and Drugs Acts, 1919.—Legal Proceedings, Particulars of Samples adulterated and result of action taken. Description of Sample Nature of Adulteration. Result of Proceedings. Milk Admixed with 17 per cent. of water Fine £5, Costs, £1 1s. ,, ,, 3 ,, ,, Warning letter. ,, Slightly deficient in solids, not fat No action taken ,, ,, ,, ,, ,, ,, ,, ,, Admixed with 4 per cent. of water Warning letter. ,, ,, 4 ,, ,, ,, ,, ,, ,, 10 „ „ Proper formalities not complied with by Military Authorities ,, Deficient in fat to the extent of 14 per cent. Fine 10s., Costs 20s. ,, Deficient in fat to the extent of 4 per cent. Warning letter. ,, Slightly deficient in solids, not fat No action taken. ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, ,, Mustard Mixture Containing 7 percent. flour coloured with turmeric ,, ,, Vinegar Admixed with 10 per cent. of water Fine 9s., Costs 21s. Milk Slightly deficient in solids, not fat No action taken. ,, Admixed with 7 per cent. of water Action taken by employer (employee one month's imprisonment). Mustard Mixture Containing 15 per cent. flour coloured with turmeric No action taken. Milk Admixed with 2 per cent. of water Warning letter. ,, Slightly deficient in solids. not fat No action taken. ,, ,, ,, ,, ,, ,, ,, ,, Admixed with 1.5 per cent of water Warning letter. Vinegar ,, 40 „ „ Fine 40s., Costs 21s. 30 Supplemental Vaccination Return for 1918. Return made on or before the 8th of February, 1920, by Mr. A. E. Rossiter, Vaccination Officer of the several Districts of the Greenwich Union, respecting the vaccination of children whose births were registered in his District from 1st January to 31st December, 1918, inclusive:— Registration Sub-Districts comprised in the Vaccination Officer's District. No. of Births from 1st Jan. to 31st Dec., 1918. No. of these Births duly entered by 31st Jan., 1919. No. of Births which on 31st Jan., 1919, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31s Jan., 1920. not accounted for. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Certificates of conscientious objection received. Dead, Unvaccinated. Postponement by Medical Certificate. Removal to Districts, V.O. of which apprised. Removal to places unknown and cases not found. 1 2 3 4 5 6 7 8 9 10 11 South Deptford 366 188 1 ... 102 21 1 2 14 37 North Deptford 1023 494 9 ... 242 72 11 18 47 130 East Deptford 875 410 6 ... 156 61 25 1 36 180 East Greenwich 818 478 2 ... 160 56 6 35 42 39 West Greenwich 446 245 2 ... 113 33 4 2 25 22 Total 3528 1815 20 ... 773 243 47 58 164 408 Dated February 10th, 1920. 31 Notifications under the Provisions of the Public Health (London) Act, 1891. During the year 2,820 cases have been notified under the above Act, as compared with 1,906, 1,400 and 2,613 respectively in the preceding years 1916, 1917 and 1918. Small-Pox. No case of this disease occurred in the Borough during the year. Details respecting vaccination are given in the Supplemental Vaccination Report. Chicken-Fox. Fifty-four cases of this disease were notified during three months of the year in which it was notifiable. Diphtheria. Two hundred and seventy-five cases of Diphtheria were notified during the year, as compared with 169, 364, 322 and 240, respectively, in the years 1915, 1916, 1917 and 1918. This distribution of these cases was as follows:—89 in East Greenwich, 125 in West Greenwich, 9 in St. Nicholas, 49 in Charlton and 3 in Kidbrooke. Of thiis total number, 235 were removed to the Hospital for treatment. Amongst which number, the Hospital Authorities reported that in 5 cases they considered the diagnosis incorrect. There were 15 fatalities due to this disease, which gives a case mortality of 5.5 per cent. One thousand two hundred and twenty-nine specimens;, were forwarded by medical practitioners for bacteriological investigation from cases suspected to be Diphtheria. Of this number 1,127 were reported to give negative or doubtful results, and 102 were positive in character, being dealt with accordingly. The quarterly incidence of the disease for 1919 has been as follows:— 1st Quarter—East Greenwich, 16 cases; West Greenwich, 68; Charlton, 15; a total of 99 cases. 2nd Quarter—East Greenwch, 23 cases; West Greenwich, 37; St. Nicholas, 2; Charlton, 4; a total of 66 cases. 3rd Quarter—East Greenwich, 23 cases; West Greenwich, 8; St. Nicholas, 3; Charlton, 13; Kidbrooke, 1; a total of 48 cases. 4th Quarter—East Greenwich, 27 cases; West Greenwich, 12; St. Nicholas, 4; Charlton, 17; Kidbrooke, 2; a total of 62 cases. 32 Membranous Croup. No cases of Membranous Croup were notilied during the year. Erysipelas. Forty-seven cases were notified during the year, 14 being in East Greenwich, 13 in West Greenwich, 10 in St. Nicholas, 9 in Charlton and 1 in Kidbrooke. Ten of these patients were removed to a Public Institution in the district. Scarlet Fever. Four hundred and eighty-one cases were notified during the year, as compared with 193, 155 and 167 cases respectively in the years 1916, 1917 and 1918; 273 cases were in East Greenwich, 86 in West Greenwich, 78 in St. Nicholas, 40 in Charlton and 4 in Kidbrooke; 420 of these cases were removed to the Hospital for treatment. There were seven deaths from this disease during the year as against 1 last year. Seven of the cases removed to the Hospital as suffering from Scarlet Fever were returned as wrongly diagnosed. The following Table gives particulars of the six cases which would seem to be "return cases." There were 2 such cases in 1918, 0 in 1917, 6 in 1916 and 17 in 1915. 33 Table showing Return Cases of Scarlet Fever during year 1919. No. of Case. Date of Removal of Primary Case. Date of Disinfection. Date of Discharge from Hospital. Date of Removal of Second Case. Time between Cases. Remarks, &c. Appearance on discharge from Hospital. 1 8th Nov., 1918 9th Nov., 1918 27th Dec., 1918 4th Jan., 1919 6 days Nasal discharge. Feet desquamating. 2 13th Dec., 1918 14th Dec., 1918 3rd Feb., 1919. 11th Feb., 1919 8 „ Throat sore; glands swollen. 3 1st Sept., 1919 1st Sept., 1919 24th Sept., 1919 6th Oct., 1919 10 „ Feet desquamating. Heavy nasal discharge. 4 1st Sept., 1919 1st Sept., 1919 24th Sept., 1919 5 2nd Sept., 1919 2nd Sept., 1919 1st Oct., 1919 13th Oct., 1919 9 „ Hands and feet desquamating. 6 29th Aug., 1919 30th Aug., 1919 10th Oct., 1919 19th Oct., 1919 9 ,, Apparently well. 34 Typhoid Fever. There were 20 cases of Typhoid Fever notified during the year, 7 being in East Greenwich, 8 in West Greenwich and 5 in Charlton. The ages of the patients were: 1 between one and five years, 11 between five and fifteen years, 2 between fifteen and twenty-five years, 5 between twenty-five and forty-five years, and 1 between forty-five and sixty-five years. Of the total number of cases 19 were removed to the Hospital for treatment. Twelve such cases occurred in 1918, 13 in 1917, 14 in 1916 and 25 in 1915; the average number for the years 1902 to 1918, inclusive, being 25. There were two fatalities from this disease during the year, 1 in East Greenwich and 1 in West Greenwich. No cases of Enteric Fever were traceable to shell-fish, but 3 cases were in the habit of bathing in the river. Fourteen specimens were forwarded for bacteriological examination from cases suspected to be Typhoid Fever in character, 7 giving a positive result. Puerperal Fever. Five cases of this disease were notified during the year, 1 being in East Greenwich, 2 in West Greenwich and 2 in Charlton. There was 1 case in 1918, 3 in 1917, 14 in 1916 and 4 in 1915. There were 4 deaths from this disease during the year. Measles. Nine hundred and twenty-five cases of Measles were notified during the year, as compared with 794 during the previous year, 1,469, 1,378 and 971 in the years 1917, 1916 and 1915 respectively. The ages and incidence of fatality of the disease were as folows: There were 402 cases under five years of age, amongst whom there were 11 deaths, giving a case mortality of 2.7 per cent. Between the ages of five to fifteen years there were 499, with 2 deaths at this age period, giving a case mortality of .40 per cent. Between fifteen and twenty-five there were 15 cases and no deaths; between twenty-five and forty-five, 8 cases and no deaths; and one between forty-five and sixty-five, which recovered. The case mortality for the whole district works out at 1.4 per cent. 35 Table showing number of Measles Cases reported during the year 1919. 1st QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 1 15 39 1 1 West Greenwich 1 5 8 1 1 St. Nicholas ... ... 5 ... ... Charlton 2 12 40 ... 1 Kidbrooke ... ... ... 1 ... Total 4 32 92 3 3 Total 134. 2nd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich ... 71 136 6 3 West Greenwich 2 16 10 1 ... St. Nicholas ... 5 9 ... ... Charlton 3 10 8 1 1 Kidbrooke ... ... ... 1 ... Total 5 102 163 9 4 Total 283. 3rd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 3 35 41 ... 1 West Greenwich 3 67 59 1 ... St. Nicholas 1 25 19 ... 1 Charlton ... ... 15 ... ... Kidbrooke ... ... ... ... ... Total 7 134 134 1 2 Total 278. 4th QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 2 7 13 2 ... West Greenwich 4 55 71 ... ... St. Nicholas 3 42 17 ... ... Charlton ... 5 5 ... ... Kidbrooke ... ... 4 ... ... Total 9 109 110 2 ... Total 230. Total cases in year =925. 36 Zymotic Enteritis or Summer Diarrhœa. In July this Council made an emergency order requiring the notification of all cases of Zymotic Enteritis or Epidemic Diarrhœa occurring in persons under the age of five years, and before this emergency order had expired a similar order of a permanent character was made, so that this disease in persons under the age of five years is now permanently notifiable throughout the Borough, and the provisions of Section 57, 59 and 60 of the Public Health (London) Act, 1891 apply accordingly. Under the provisions of these sections 142 cases of Diarrhoea were notified throughout the whole of the Eorough, 63 being under one year of age; 78 between one and five; 1 between five and fifteen. Thirty-four of such notifications related to patients in East Greenwich, 62 in West Greenwich, 26 in St. Nicholas and 20 in Charlton. There were 28 deaths ascribed to this disease, comparing with 37 in the previous year. Whooping Cough. The order made in Nov., 1917, requiring the notification of cases of Whooping Cough, being due to expire on 31st October, 1919, this Council during the year made a further order, continuing the notification of cases of Whooping Cough until October 31st, 1921, and applying the provisions of section 57, 66 and 68 (1) (a) and (b) of the Public Health (London) Act, 1891. and accordingly under these provisions 141 cases were notified (compared with 497 in 1918), 20 being under one year of age, 62 from one to five, and 59 from five to fifteen; the districts concerned being East Greenwich, 55; West Greenwich, 55; St. Nicholas, 2, Charlton, 28, and 1 in Kidbrooke. Each of these cases was visited, and leaflets and instructions left together with verbal advice respecting the isolation and care of the patient. Epidemic Cerebro-Spinal Meningitis or Cerebro-Spinal Fever. There were 6 cases of Cerebro-Spinal Meningitis notified during the year, 5 in East Greenwich and 1 in Charlton. One of the cases removed to Hospital as suffering from Cerebro-Spinal Fever was returned as wrongly diagnosed. Acute Polio-Myelitis or Acute Polio-Encephalitis. This disease was permanently added to the list of notifiable infectious diseases during 1914, on an order of the London County Council, approved by the Local Government Board. One case was notified during 1919. There were 2 cases in 1918, 0 in 1917 and 2 inl916. Ophthalmia Neonatorum. During the year 20 cases of this disease have been notified, 8 being in East Greenwich, 8 in West Greenwich, 2 in St. Nicholas and 2 in Charlton. 37 Contacts. Twelve intimations were received from the Medical Officers of Health of the various Fort Sanitary Authorities respecting persons who had been in contact with Small-Pox, 6 with Plague and 1 with Cholera, which were kept under observation. Post Basal Meningitis. There were 3 cases of this disease notified during the year, 1 in East Greenwich, 1 in St. Nicholas and 1 in Charlton. Malaria, Dysentery, Influenza and Pneumonia. These diseases were made notifiable in January, 1919. There were 73 cases of Malaria notified during the year, 4 cases of Dysentery and 101 cases of Influenza and Pneumonia. Trench Fever. One case occurring in West Greenwich was notified during the year. During the year the undermentioned Military Discharges have been notified and visited:— Malaria 6 Dysentery 5 11 Glanders. Under the Glanders Order no notification has been made to this authority during the year with respect to outbreaks of Glanders. Glanders, Anthrax and Hydrophobia. No notification of any case of these diseases in man has been received during the year. Tuberculosis. During the year there were 521 cases, of Tuberculosis notified in the Borough, 300 being pulmonary cases, ordinarily known as Consumption, and 221 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 139 pulmonary and 99 non-pulmonary occurred in East Greenwich, 76 pulmonary and 65 non-pulmonary in West Greenwich, 30 pulmonary and 18 non-pulmonary in St. Nicholas, 52 pulmonary and 37 non-pulmonary in Charlton, and 3 pulmonary and 2 non-pulmonary in Kidbrooke. The various ages of the patients were as follows:—Pulmonary cases, under one, 0; from one to five, 2 cases; five to fifteen, 35 cases; fifteen to twentyfive, 73 cases; twenty-five to forty-five, 133 cases; forty-five to sixty-five, 52 cases; and 5 cases over sixty-five; whilst the NonFulmonary were: under one year of age, 4 cases; one to five, 31 cases; five to fifteen, 159 cases; fifteen to twenty-five, 17 cases; twenty-five to forty-five, 9 cases; forty-five to sixty-five, 1 case. Two hundred and seventy-one specimens were forwarded by 38 medical practitioners for bacteriological investigation from patients suspected to be consumptive; 191 were reported to be negative and 80 positive. Disinfection has been offered and carried out in 77 cases, including 94 rooms and 506 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. HOUSES INSPECTED AND ENQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Enquiries made 1,016 Number of Re-visits 3,840 One thousand two hundred and thirty-three notifications were received, the Health Visitor visiting each case, and revisiting when required. During the year, when premises have been entered for the purpose of carrying out disinfection after cases of Infectious Disease, the following books belonging to the Libraries, etc., were destroyed:— Central Library, 30; School Libraries, 2; Total, 32. The following special disinfections were carried out during the year:— March—Royal Hospital Schools, Greenwich Infirmary. Trafalgar Quarters. November—Sixteen Class-rooms at Maze Hill Schools. 39 Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 53 weeks ending 3rd January, 1920. Infectious Diseases. Premises Entered. Rooms Disinfected. Beds Disinfected. Palliasses Disinfected. Mattresses Disinfected. Bolsters Disinfected. Pillows Disinfected. Blankets Disinfected. Sheets Disinfected. Cushions Disinfected. Quilts Disinfected. Odd Articles Disinfected. Total No. Articles Disinfected. Cerebro-Spinal Meningitis 6 8 5 3 8 6 14 17 9 ... 5 18 85 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 400 438 303 8 127 215 633 612 68 62 266 397 2691 Diphtheria 191 208 5 ... 4 1 9 22 6 3 6 ... 56 Enteric Fever 11 18 13 ... 5 12 32 34 18 9 12 53 188 Puerperal Fever 5 5 4 ... 3 5 13 9 4 ... 4 36 78 Tuberculosis 77 94 32 1 21 29 72 17 18 1 22 19 232 Other Diseases 58 74 30 10 41 34 82 146 10 10 12 131 506 Scabies 5 5 13 2 6 14 17 22 10 4 12 24 124 From Verminous Premises 1 1 8 5 3 5 11 31 5 ... 6 19 95 Polio Myelitis 2 2 ... ... 2 1 3 1 2 ... ... 1 10 Measles 15 15 ... ... ... ... ... ... ... ... ... ... ... Total 771 868 413 29 220 322 886 913 150 89 345 698 4065 40 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 53 weeks ending 3rd January, 1920. Infectious Diseases. Beds Destroyed. Palliasses Destroyed. Mattresses Destroyed. Bolsters Destroyed. Pillows Destroyed. Blankets Destroyed. Sheets Destroyed. Cushions Destroyed. Quilts Destroyed. Odd Pieces Destroyed. Total No. Articles Destroyed. Small-pox ... ... ... ... ... ... ... ••• ... ... ... Scarlet Fever 2 1 1 ... ... ... ... ... ... 10 14 Diphtheria ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... Tuberculosis 1 1 3 2 3 ... ... ... ... 8 18 Other Diseases 4 2 ... 3 6 ... ... ... ... ... 15 For Verminous Premises 2 2 ... 1 3 ... ... ... ... ... 8 Total 9 6 4 6 12 ... ... ... ... 18 55 41 TUBERCULOSIS DISPENSARY. Report or Tuberculosis Officer on the Working of the Dispensary for the Year 1919. I have the honour to submit the seventh report upon the work carried out at the Tuberculosis Dispensary. New Patients examined during 1919. Recommended by. Males. Females. Children. Total. Private Practitioners 84 39 23 146 London County Council — — 32 32 From Sanatoria 17 16 4 37 Own accord 20 29 112 161 Contacts 19 60 387 466 Other Institutions, Hospitals, Clinics, &c. ) 3 9 17 29 143 153 575 871 Consultative Cases. Males. Females. Children. Total. Insured Persons 160 37 — 197 Uninsured Persons 13 28 28 69 173 65 28 266 Males. Females. Children. Total. Contacts 19 60 387 466 Found Tuberculous 3 13 73 89 Attendances. Patients retained for Treatment, Males. Females. Children. Total. Patients 119 126 271 516 Re-attendances 1259 1649 4756 7664 Patients retained for Observation. Males. Females. Children. Total. Patients 22 46 221 289 Re-attendances 101 352 2015 2468 Nurses Visits. First Visits 426 Re-visits 3051 3477 42 Patients Primarily Notified from Dispensary. Pulmonary 121 Other Forms 123 244 Sputum Examination. Negative Results 92 Positive „ 53 Number of Examinations 145 Dispensary Patients referred elsewhere. Males. Females. Children. Total. Sanatorium 22 13 11 46 Infirmary 3 3 — 6 Hospital 2 1 3 6 Doctors 5 9 — 14 32 26 14 72 Suspected (Observation) Patients Discharged. Much Improved. Improved. Total. Males ... 13 — 13 Females ... 23 — 23 Children ... 127 — 127 163 — 163 Suspected (observation) Patients disposed of otherwise. Males. Females. Children. Total. Taken on as Patients (Tuberculous) — 3 9 12 Sent to Institution (Hospital Convalescent Home) 2 2 — 4 Deaths 1 — — 1 Left District — — 1 1 3 5 10 18 Deaths of Patients during 1919. Males. Females. Children. Total. At Home 5 4 1 10 Infirmary 1 1 — 2 6 5 1 12 G. H. Dart, Tuberculosis Officer 43 The Treatment. of Advanced Cases. The weakest point in the present scheme is still the lack of adequate institutional accommodation for advanced and failing cases. Denial Work. During the year arrangements were made with the British Dentists' Hospital that they should provide a qualified dental surgeon to attend on one half-day per fortnight to give dental attention to any patient certified by the Tuberculosis Officer as requiring such with a view to an improvement in their physical condition. This scheme commenced on the 8th October, since which date 35 patients have been attended by the dental surgeon. Home of Rest for Advanced Cases. The Interim Tuberculosis After-Care Committee for Greenwich, realising the comparative futility of the present system of discharging incurable and chronic cases to their already impoverished families and poor homes, where they act as strong foci of infection, and being of opinion that it would be far preferable to provide some suitable homely Institution in the district where they might be segregated, decided to draw the attention of this Council to this matter, asking them to take into their consideration the question of providing such an Institution. This matter received the sympathetic consideration of the Public Health Committee, and was also very sympathetically considered by the Local Government Board and London County Council, and it was hoped that a workable scheme would have resulted. Unfortunately the Council did not agree to the recommendation of the Public Health Committee, and, accordingly, these cases have still been allowed to continue as infecting foci, particularly in the poorest homes in the Borough. An attempt was made later on to bring about a combination of the four adjoining Boroughs of Lewisham, Deptford, Greenwich and Woolwich for this same purpose. Unfortunately the combination fell through, and it now remains to be seen whether this Council, as at present constituted, will be able to make the necessary provision which is so urgently needed. Working Centre. The Interim Tuberculosis After-Care Committee for Greenwich, realising the difficulty that discharged Tuberculous patients experienced in finding suitable work under suitable conditions, decided to draw the attention of this Council to the matter, and suggest that a working colony might be established in connection with the Tuberculosis Dispensary. I am glad to be able to state 44 that this matter has received much sympathetic consideration, and a scheme is now before the Ministry of Health and the London County Council for making provision something on the following lines— The discharged patient who is certified to be able to work, say, only half-time, will be admitted to this working centre, and there taught a new occupation, which can be carried out under fresh-air conditions. At the expiration of the half-day which he is allowed to work, he will be kept under further medical supervision for the remainder of the day in the recreation or similar room, and at the end of the week the amount that he may have earned at the new occupation will be subsidised to bring up his earnings to a standard rate of wages commensurate with the needs of his family, and as his earning power increases so the amount of the subsidy would be decreased. In this way his period of sanatorium treatment will be extended in this working centre, during which time he will have been taught a new occupation, and it is hoped that his physical condition will so much improve that he will eventually be able to work full time at this, or possibly even his old trade, providing, of course, that the physical conditions under which such work will be carried out will be satisfactory. It is proposed that the money to make up a patient's earnings to the living wage agreed upon shall be provided by the Poor Law Authority, who are very sympathetic towards the scheme, and have asked for the consent of the Ministry of Health to join in with the Borough Council in this way. It is hoped that during the current year some definite steps will have been adopted on these lines. Day Sanatoria for Children. The attention of the London County Council has been drawn to the necessity of making some provision of this character in this immediate neighbourhood, and it was suggested that arrangements be made for holding classes in the Greenwich Park or in other premises which had been suggested to the London County Council from time to time. Unfortunately up to the present nothing of this sort has been provided in this district. During the year whilst I was acting as Tuberculosis Officer during the absence of the Tuberculosis Officer on military service, I was struck by the large number of cases of patients who were sent to the Dispensary, or came to the notice of the Department in other ways, in such a comparatively late stage of their illness, and on making enquiries I found that they had been under treatment, frequently for long periods of time, for vague diseases, i.e., debility, anæmia, indigestion and the like, and it was only when the case became very advanced that a notification of Tuberculosis was sent in, being then very frequently accompanied by a request that immediate steps should be taken to obtain the patient's removal 45 to a Sanatorium. Unfortunately, in many instances, the case was too far advanced for anything of this sort to be done. It seems to me that some machinery should be provided whereby patients who are certified to be suffering from some of these vague conditions for long periods might be enabled to have a second opinion upon their case, and it is hoped that far greater use will be made in the future by medical practitioners of the services of the local Tuberculosis Officer in this respect. MATERNITY AND CHILD WELFARE. The following School Clinics, Health Centres, and Infant Consultations are still doing very good work in the Borough: — L.C.C. Clinic. Health Centre, Deptford Green. Miss McMillan's Infant Creche and Cleansing Station, Wellington Street. Albany Institute Infant Consultation, Creche and Babies Home. Greenwich Borough Council's Creche at Conduit House, 236, Trafalgar Road. Greenwich Borough Council's Infant Consultations and AnteNatal Centre. The total attendances of Babies at our Creche has been 2,981 whilst the figures for our Infant Consultation Centres are as follows:- New Cases 930 Attendances 8,717 Medical Consultations 4,613 The Children are weighed at every attendance. The number of cases attending the Ante-Natal Clinic was 94, and the number of attendances 196. The work carried out by the Officers of this Authority at the Albany Institute, and not included in the above figures, is as follows: — Individual babies attended Infant Consultation 134 Seen by Doctor 581 times Weighed 1158 ,, Mothers seen by Doctor 34 ,, 46 Ante-Natal Class— 39 expectant mothers made 253 attendances Births—First visits 343 Revisits 905 Total visits 1248 Milk. Eighty expectant mothers, nursing mothers and bottlefed babies have had one pint of milk daily, for which (excepting special cases) they paid 1s. weekly, necessitating the distribution of 985 gallons of Milk. The mothers paid towards this £39 9s. Milk Supply. Seventeen thousand and thirty-eight lbs. of Dried Milk (Ambrosia, Glaxo, Cow and Gate) were purchased by the Council and disposed of to the mothers attending the Consultations, either at full or reduced rates. During the year also about 8 cwt. Virol has been similarly distributed. Dental Work. During the year arrangements were made with the British Dentists' (Hospital that they should provide a qualified dental surgeon to attend on one half-day per fortnight to give dental attention to any patient certified by the Maternity and Child Welfare Medical Officer as requiring such with a view to an improvement in their physical condition. This scheme commenced on the 8th October, since which date 40 patients have been attended by the dental surgeon and 4 dentures have been provided, the total cost of the dentures being £8 5s., of which amount the Committee have decided that the patients should pay £7. Puerperal Fever. Five cases of this disease were notified during the year, four of which unfortunately proved fatal. There did no; appear to be any common source of infection amongst these cases, as they occurred in different districts and at different times all over the Borough. Ophthalmia Neonatorum. Twenty cases of this disease were notified during the year, both eyes being affected in 18 cases, and one eye only in the remaining two cases. Fortunately in no case did any permanent injury to the eye remain. Two of the children, however, died, one at four months from convulsions, and one at nine days being a prematurely born child. Of the total number of cases, 8 occurred in East Greenwich, 8 in West Greenwich, 2 in Charlton and 2 in St. Nicholas. 47 Measles. Nine hundred and twenty-five cases of Measles were notified during the year, and 1,000 visits were paid to these cases by the different Health Visitors. Fuller details respecting the incidence of the cases will be found in the portion of this report Healing with infectious diseases generally. NOTIFICATION OF BIRTHS ACT, 1907. Date of adoption—17th March, 1909. Misses Millington, Reid and Molloy have carried out the duties of Health Visitors, making' the necessary visitations under the above Act, and also have dealt with the cases of Diarrhoea occurring in their districts. There has been a rise in the Infantile Mortality in St. Nicholas and Kidbrooke, whilst East Greenwich, West Greenwich and Charlton have improved in that respect. Visits paid in reference to Births 1,690 Re-visits „ „ 1,189 Visits „ L.C.C. Scabies Cases 100 Re-visits „ „ „ 91 Visits „ L.C.C. Verminous Complaints 32 Revisits „ „ „ 25 Visits „ Ante-Natal Cases 108 Re-visits „ „ 2 Visits „ Measles 979 Re-visits „ „ 21 Visits „ Puerperal Fever 4 Re-visits „ „ 2 Visits „ Ophthalmia Neonatorum 23 Re-visits ,, „ 65 Visits „ Whooping Cough 105 „ „ Influenza 41 „ „ Diarrhœa 149 Re-visits „ „ 6 Miscellaneous Enquiries made 240 4,872 Infant Consultations, Ante-Natal Clinics, etc., attended, 439 48 The following table gives the number and character of the intimations respecting births in the Borough: — 1912. 1913. 1914. 1915. 1916. 1917. 1918. 1919. Total Number of Births notified in each year since adoption 2,450 2,623 2,513 2,280 2,497 1,992 1,735 2,085 (a) Attended by Midwives 1,412 1,340 1,338 1,226 1,314 1,095 990 1,159 (b) Attended by Doctors 1,038 1,283 1,175 1,054 1,183 897 745 926 Number of Still Births notified in each year 71 53 36 42 61 47 44 59 Number of Births registered in each year 2,393 2,545 2,409 2,347 2,354 1,967 1,753 1,968 Chemical and Bacteriological Work. The long-standing arrangement with the Bacteriological Department of the Seamen's Hospital has been in force throughout the year, whereby that Institution carried out all necessary chemical and bacteriological work for this Department, other than under the Sale of Food and Drugs Act, and in this connection 1,229 specimens have been examined for Diphtheria, 14 for Typhoid Fever, 271 for Tuberculosis, and 22 for other various. Fuller details respecting results of the examinations of these specimens will be found under the different headings of the individual diseases. HOUSING. Generally speaking, the housing conditions in this Borough are very poor, there being a large number of very old properties, and a still larger number of houses of more recent erection, which, owing to the labour and material difficulties of the last few years, have been allowed to deteriorate very considerably, so much so, that a good number of them are now almost beyond repair, at any rate within any reasonable figure of cost. Along with all other districts not only in London, but also throughout the kingdom, as there have been no new houses erected during the last few years the condition of overcrowding is now considerable. In fact, in my opinion, the overcrowding in the Borough was never greater that it has been 49 daring the past year, many cases having been brought to the notice of myself and the Public Health Committee, but definite action to abate the overcrowding was impossible on account of the lack of other vacant premises to which the overcrowded families could remove. On the coming into operation of the Housing and Town Planning Act, 1919, when a sanitary survey of the district was made, I formed the opinion that it was quite time that an official representation under the Housing of the Working Classes Act, 1890, should be made respecting several areas of the Borough, with a view to their being dealt with as unhealthy areas, and the following areas were so dealt with: — 1. Watergate Street area, including 220 premises occupied by approximately 1,200 persons. 2. Roan Street area, including 500 houses, with an approximate population of 3,000 persons, excluding in this area all properties recently thoroughly reconstructed by the Roan School Governors. 3. Thames Street area, including 325 houses, with approximately a population of 2,000 persons. 4. East Street, Charlton, area, comprising 205 houses, with an approximate population of 1,000 persons. In this area it is suggested that on the greater portions, when cleared, no further houses should be erected until the land has been considerably raised above its present level. 5. Eastney Street area, comprising 100 premises occupied by approximately 600 people. In dealing with all these areas it is suggested that the type of buildings to be erected should be of the cottage variety, fitted up for not more than two families in each, and with due provision for a suitable garden in connection therewith, as hitherto gardening has proved very attractive and successful as fostered by the Roan School Governors' scheme. I also estimate that there are approximately 750 new houses required to be built in order to replace old, worn-out and back-toback houses, which should be pulled down and not rebuilt, in different parts of the Borough, viz., 200 in St. Nicholas and NorthWest Wards, 75 in the North and Marsh Wards, 50 in the West and South-West Wards, and 220 in Charlton, including the area No. 4 above mentioned. These figures do not take into account any of the 200 houses required to replace the existing temporary wooden erections in various parts of the Borough. 50 Some portion of the overcrowding in the Borough, and particularly in the St. Nicholas district, is due to the demolition of properties by the London County Council in order to build schools, without that body having provided any rehousing accommodation for the people displaced. This privilege was accorded to the London County Council in spite of the opposition raised by this Council on the point. Houses Let in Lodgings. There was no change in the register of these houses during 1919, for under the existing conditions of occupation it practically occurred that almost every house in the Eorough was a house let in lodgings, and therefore the 247 houses already on the register were left and no additions made thereto. With the coming into force of the Housing and Town Planning Act, 1919, the existing By-laws made by this Council became out of date, and we are waiting the coming into force of the new Bylaws under that Act before this work is again vigorously undertaken. Housing Schemes. The Council throughout a considerable portion of the year had under consideration the question of a Housing Scheme for the Borough, and, after various sites had been considered and reported upon, the Hanging Wood Lane site, Charl,ton, was finally decided upon. Plans and proposals are being put forward as rapidly as possible for the erection of 456 houses, five per cent. of which are to be of a type having one living room and two bedrooms, thirty per cent. to have one living room and three bedrooms, sixty per cent. one living room, parlour and three bedrooms, and five per cent. living room, parlour and four bedrooms. Other sites have been inspected and reported upon, and steps are being taken during the current year for the acquisition of certain of these sites for housing purposes. Conversion of Premises. Under the Housing and Town Planning Act, provision is made whereby local authorities may acquire certain of the large and derelict houses in their district, making the necessary alterations in order to convert them to more modern tenement buildings. In this connection pressure was brought to bear upon this Council by the London Housing Board, so that this Council might hand over its powers in this respect to that Board for them to carry out the work. Giving way to this pressure in August, the necessary resolutions were passed authorising the Housing Board to act on behalf of this Council in purchasing the premises and making the necessary alterations. An official of that Board thereupon went round the district with our Borough Engineer, selecting houses which were thought to be suitable for this purpose, and deciding as to how many flats they should be 51 converted into. Apparently the Ministry of Health, acting through the London Housing Board in this matter, handed over the actual work to H.M. Office of Works, who in turn appear to have let the work to a contractor. No communication was made by the contractor or the Office of Works or the Housing Board to this Department that any works were in contemplation or in progress, and it was only on our being informed by the general public that certain works were being carried out that we found that certain premises were being converted. Although the By-laws relating to such matters specifically state that notices shall be given, as a matter of fact no notices were given, nor were any satisfactory plans deposited showing the alterations to the drainage works proposed or carried out until some nine months from this date, and only then after repeated requests. Adverse reports respecting the character of the work being carried out in connection with these conversions having reached' the Council, I was directed to make an inspection of the premises in question. Thereupon I presented to the Housing Committee of this Council a report setting out the defects and illegalities which I found in connection with the work which was being carried out. This report was forwarded to the Ministry of Health for their information and observations, whereupon this Council was asked to send a deputation to discuss the subject with the Housing Board. I had the honour of being asked to attend along with the deputation, and, after having stated our objections, we were informed by the officials of the Housing Board that we were entirely in the wrong, that that Board had authority to override the Public Health (London) Act, 1891, in respect to its requirements in section 96 relating to underground rooms, and that accordingly probably I might desire to withdraw my report on the sub ject. This I declined to do, and asked that the matter should be referred to the Medical Department of the Ministry of Health, and that the premises should be inspected by one of their Medical Inspectors. This was done and the Medical Inspector concurred with my condemnatory report not only with regard to the technical illegalities, but also as to the unhealthiness and unwholesomeness of the rooms and premises concerned. Since that date numerous conferences have been held between the Housing Authorities and this Council concerning these illegalities and insanitary conditions, and now the whole of the premises in question have been completed on the basis of this Council waiving certain of the requirements under the Public Health (London) Act, 1891, section 96, on condition that the Ministry of Health gives this authority a letter absolving them from all liability concerning the illegalities. Accordingly the following letter has been received from the Ministry of Health upon the subject:— 52 Ministry of Health, Whitehall, S.W.i, 13th May, 1920. Conversion of Houses. Sir, I am directed by the Minister of Health to enclose a statement which sets out the agreement reached at the conference held at this office on the 11th inst. The Ministry are of opinion that the arrangements now made are warranted in the special circumstances of the cases in question, particularly in view of the extreme urgency of providing additional accommodation, and they accept the responsibility for their adoption. It is understood, of course, that the, special measures now adopted will not justify the Council in permitting departures from any statutory requirements in other cases. The Minister trusts that the conference will have cleared away any misunderstandings. He is anxious, as he is sure the Council also are, that additional housing accommodation shall be completed as speedily as possible. I am, Sir, Your obedient Servant, Assistant Secretary. The Town Clerk, Metropolitan Borough of Greenwich. from which it will be seen that the Ministry of Health purports to accept responsibility for the illegal conditions now existing in tenement dwellings owned and let by this Council, the Sanitary Authority for the district, but at the same time this Council are not to permit departures from any statutory requirements in the case of other individuals desiring to make similar alterations to their premises. The material parts of the Public Health (London) Act, section 96, in question are:— . 1. Any underground room which was not let or occupied separately as a dwelling before the passing of this Act shall not be so let or occupied unless it possesses the following requisites:— (a) Unless the room is in every part thereof at least seven feet high, measured from the floor to the ceiling, and has at least three feet of its height above the surface of the street or ground adjoining or nearest to the room; provided that, if the width of the area hereinafter mentioned is not less than the 53 height of the room from the floor to the said surface of the street or ground, the height of the room above such surface may be less than three feet, but it shall not in any case be less than one foot, and the width of the area need not in any case be more than six feet; (b) Unless every wall of the room is constructed with a damp course, and, if in contact with the soil, is effectually secured against dampness from that soil; (c) Unless there is outside of and adjoining the room, and extending along the entire frontage thereof, and upwards from 6in. below the level of the floor thereof, an open area properly paved at least 4ft. wide in every part thereof; Provided that in the area there may be placed steps necessary for access to the room, and over and across such area there may be steps necessary for access to any building above the underground room, if the steps in each case be so placed as not to be over or across any external window; (g) Unless the room is effectually secured against the rising of any effluvia or exhalation; (i) Unless the room has a fireplace with a proper chimney or flue. It accordingly now comes about that this Council, who are the Health Authority for the district, and presumably should set the highest example with respect to their own property, are the owners of basement dwellings and underground rooms which do not comply with some or all of the above-mentioned requirements. I am unable to state definitely, but have strong reasons to suppose that the walls in some of these premises are without proper damp courses, and that the rooms are not effectually secured against the rising of any effluvia or exhalation from the soil. The area in front of a room marked on the plan as a bedroom, instead of having a width of 4ft. is only 2ft. 8in. The width of several other areas is also below the statutory requirements in each case. In some cases instead of the properly paved area at the front of the room being 6in. below the floor level of the adjacent room, the area is level with the floor, but a 9in. half-round channel has been placed along the side wall from some 3in. to 6in. deep. In one case also a room marked as bedroom on the plan has no fireplace with proper chimney or flue. There are also two rooms in an attic which were originally marked on the plan as bedrooms, whose average height is only 54 5ft. 3in. This tenement, however, has been let to tenants on the understanding that these two rooms shall not be used as bedrooms. These various reductions in the standard of sanitary conditions are much to be regretted, as, although we hold the above-mentioned absolution from the Ministry of Health concerning the matter, it will enable builders and others in the neighbourhood, when requested to put their own property into good sanitary condition, to point to our own illegal and insanitary properties. These illegalities and irregularities are all the more remarkable when one realises that the Ministry of Health in their own Manual of Unfit Houses, volume 2, page 52, set out in detail all the conditions with which these properties should comply, and still they themselves fail in compliance therewith. I may say that I have already received complaints in respect of one of these basement tenements as to the damp condition of the walls and rooms. The completion of these works of conversion with the numerous letters, discussions and conferences occasioned by the absolute disregard of all sanitary rules, regulations and by-laws which was originally adopted by the Housing Board, has all occurred during the current year. It was thought better to complete the report upon the subject in this Annual Report rather than produce in this report the wholly condemnatory reports which had originally to be presented on the subject, and leave until next year the explanation as to how these matters were finally dealt with. (55) Summary of Sanitary Work performed during the Year 1919. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Inspections. Houses Inspected under Public Health London) Act, 1891, &c. 323 535 579 732 2169 Re-inspections, Calls made, &c. 1167 1534 2165 2591 7457 Houses let in Lodgings 8 16 ... ... 24 Inspections of Bakehouses 3 45 9 43 100 „ Factories and Workshops 35 32 12 44 123 „ Outworkers' Premises 45 8 45 14 112 „ Slaughterhouses 14 10 5 16 45 „ Cowhouses 2 2 6 10 „ Stables and Yards 12 17 18 16 63 „ Piggeries 4 8 2 14 „ Courts and Alleys 25 14 14 16 69 „ Fields, Lanes, &c. 3 9 7 13 32 „ Urinals 7 18 13 13 51 „ Fish Curer ... ... ... ... ... „ Gipsy Vans ... ... 1 ... 1 „ Horse Slaughterhouses 2 3 - 3 8 „ Dairies, Cowsheds and Milkshops 3 22 27 49 101 „ Soap Boilers ... ... ... 1 1 „ Other Offensive Trades ... ... ... ... ... „ Ice Works 2 1 ... ... 3 „ Ice Cream Places 1 50 21 ... 72 „ Other places where food is prepared 16 75 43 43 177 „ Military Dep6t and Quarters 6 2 1 1 10 Total 1676 2401 2964 3601 10642 56 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Drains. Constructed 2 2 1 7 12 Intercepter Chamber, and Fresh Air Inlet 8 7 35 11 61 Other Chambers 7 2 5 3 17 Reconstructed or Repaired 30 17 35 7 89 Opened, Cleansed and Amended 40 52 86 98 276 Surface Drains Constructed 16 20 ... 4 40 Traps Fixed 29 38 31 31 129 New Soil Pipes 6 7 7 5 25 Anti-Siphonage Pipes ... ... ... 1 1 Drains & Soil Pipes Ventilated 10 14 12 8 44 Drains Tested—by Smoke 8 67 57 49 181 „ ,, by Water 18 24 43 44 129 Found Defective 20 39 35 25 119 Yards Drained 10 6 16 4 36 Mews and Stables Drained 3 ... 2 1 6 Washhouses Drained ... ... ... 2 2 Forecourts Drained ... ... ... ... ... Areas Drained 3 5 8 5 21 Cesspools Abolished ... ... 1 ... 1 ,, Emptied ... 2 ... ... 2 „ Amended and Airtight Covers ... ... ... 2 2 „ Ventilated ... ... ... 1 1 Water Closets and Urinals. Closets Erected ... 14 9 3 26 Sanitary Conveniences or improvements effected to Factories and Workshops ... 9 8 8 25 Pan, Traps and Water Supply furnished 16 22 23 22 83 Pans and Traps only furnished 22 7 13 18 60 Pans only furnished ... 8 7 3 18 Water Supply Apparatus provided 8 2 ... 11 21 Water Supply renewed 36 30 22 48 136 Water Supply disconnected from Drinking Water Cistern 2 ... 1 ... 3 Soil Pans properly Trapped ... 4 ... 4 Cleansed and Repaired 19 19 20 47 105 Newly constructed or better situated ... 3 3 3 9 Ventilation Improved 1 3 4 12 20 Public-house Urinals Cleansed or Repaired 3 ... 15 9 27 Other Urinals Altered 1 1 1 2 5 Repaired or Water laid on 17 8 ... 3 28 57 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Ashpits. Provided 53 37 86 87 263 Covers to Receptacles ... ... ... ... ... Dust Complaints forwarded to the Surveyor 11 9 5 1 26 Pavings. Yards 11 33 49 40 133 Forecourts ... ... ... ... ... Areas ... 5 8 5 18 Washhouses ... ... ... 5 5 Mews and Stables ... ... ... 1 1 General Water Supply. Covers to Cisterns Adapted 1 ... ... 1 2 Water Supply Provided 3 1 2 1 7 Water Fittings Amended 11 21 37 40 109 Cisterns Cleansed and Repaired 1 ... ... 1 2 Water Services Altered so as to draw direct from main ... • • • 1 2 3 Water Supplies Reinstated where cut off through defective fittings 10 5 3 13 31 Water Supplies cut off ... ... ... ... ... Defective Water Fittings (causing nuisance from dampness) repaired 17 20 25 13 75 Water Supply Certificates granted (Section 48) ... ... 1 ... 1 Other Improvements. Houses Generally Repaired 10 18 70 83 181 PremisesCleansed, Limewashed and Repaired 34 54 28 52 168 Ventilation Improved 2 6 9 30 47 Leaky House Roofs and Gutters Repaired 66 63 113 134 376 Walls and Ceilings of Premises Cleansed throughout 28 52 73 106 259 Ditto, ditto, partially 29 49 76 61 215 Cowhouses cleansed ... 2 1 4 7 Horse Slaughterhouses cleansed 1 1 1 1 4 Ice Cream Places cleansed or improved ... 5 8 ... 13 Other Places where Food is prepared ... 26 20 21 67 58 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Other Nuisances Abated. Illegal use of Underground Room Discontinued ... ... ... ... ... Overcrowdings Abated ... 10 11 3 24 Sink, Lavatory and Bath Waste Pipes Disconnected, Trapped and Amended 6 19 42 47 114 Stack Pipes Disconnected and Amended 7 8 28 20 63 Nuisances from Dampness Abated 13 34 27 44 118 Animals kept in Unfit Places Discontinued or Removed ... ... ... 1 1 Dung Receptacles Provided ... ... 1 ... 1 Bakehouse Nuisances Abated l 21 ... 17 39 Accumulations of Manure and other obnoxious matter Removed 9 14 16 8 47 Dampness of Walls Remedied 4 10 27 33 74 Other Nuisances, principally of Dilapidations and want of Under-floor Ventilation 10 21 17 11 59 Breaches of By-laws Abated ... ... ... ... ... Smoke Nuisances. Observations ... 7 6 5 18 Statutory Notices served (Secs. 23 and 24) ... ... ... ... ... Food and Drugs Samples taken 129 130 89 78 426 Found Adulterated 7 7 3 5 22 For Food Control Committee 2 ... ... ... 2 59 SUMMARY OF SANITARY WORK—continued.  First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Unwholsome Food. 2 bushels of winkles. 2 tons of dates. 16 boxes of kippers. 384 lbs. of beef. 65 qrs. of damaged wheat. 39 cases dates. 2 tons 1 qr. 397 cases of dates. 1 box of mackerel. 68 lbs. of skinless rabbits. 21 lbs. of carrots. 15 lbs. of apples. 1 crate of rabbits. 9 cases of raisins. 1 case of frozen rabbits. 4 cases of cod fish. Voluntarily surrendered 2 barrels of unsalted herrings. 35 lbs. of mackerel. 21 lbs. of filleted haddock. 6 lbs. of corned beef. 1 box of dates (64 lbs.). 6 boxes of smoked haddocks. 19 lbs. of rabbit. 5 stone of skate. 20 lbs. of butter. 500 eggs. 24 rabbits. 1 box of dates. 60 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total.  Notices, &c. Intimations served under Public Health (London) Act, 1891 (Section 3) 200 277 399 282 1158 Houses let in lodgings ... ... ... ... ... Complaints Received 131 168 160 157 616 Complaints Attended to 131 168 160 157 616 Statutory Notices Served under Section 4 33 44 38 57 172 Statutory Notices re Ashpit provision 216 11 15 16 58 Statutory Notices re Yard Paving ... ... ... ... ... Letters Written relating to Abatement of Nuisances 116 257 176 200 749 Summonses Applied for and Issued ... ... ... ... ... Magisterial Orders Obtained and Enforced ... ... ... ... ... Drainage Plans received and examined 5 6 16 16 43 61 BOROUGH OF GREENWICH. Proceedings during 1919. Premises. Number of Places— Number of Inspections, 1919. Number of Notices, 1919. Number of Prosecutions, 1919. On Register at end of 1918. Added in 1919. Removed in 1919. On Register at end of 1919. Dairies— Cowsheds & Milkshops 129 10 19 120 101 ... ... Slaughterhouses 5 ... ... 5 45 ... ... Other Offensive Trade Premises ... ... ... ... ... ... ... Ice Cream Premises 103 14 14 103 72 ... ... Registered Houses Let in Lodgings 247 ... ... 247 24 ... ... Total number of Intimation Notices served for all purposes 1158 Overcrowding, 1919— Number of Dwelling-rooms Overcrowded 24 Number Remedied 24 Number of Prosecutions ... Underground Rooms— Illegal Occupation dealt with during year ... Number of Rooms Closed ... Insanitary Houses— Number Closed voluntarily under the Public Health (London) Act, 1891 ... Number Closed voluntarily under the Housing of the Working Classes Acts 1 Number of Verminous Rooms Fumigated 1 Number of Cleansing Baths given under Cleansing of Persons Act 1173 62 Shelter provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — Number of Tenement Houses provided with Additional Water Supply — Number of Prosecutions ditto — Inland Revenue Acts- Number of Houses for which applications were received during year — Number of Tenements comprised therein — Number of Tenements for which Certificates were granted — Number of Prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, &c. — (b)For prevention of nuisance arising from offensive matter running out of any manufactory, &c. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, &c., of dwelling houses — (e) In connection with the removal of offensive matter, &c. — (f) As to cesspools and privies, removal and disposal of refuse, &c. — (g) For securing the cleanliness of tanks, cisterns, &c. - (h) With respect to water closets, earth closets, &c. — (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, &c. (Metropolis Manage ment Act, Sec. 202) — (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (By-laws) Act, 1899) — Mortuaries— Total Number of Bodies Removed 131 Total Number of Infectious Bodies Removed 1 132 LEGAL PROCEEDINGS, 1919. It is a matter for satisfaction that, apart from the proceedings under the Sale of Food and Drugs Act, no other summonses were needed. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 29th March, 1919. districts. Census Population, 1911. Estimated Population at the middle of the year 1919. Births registered during the 13 weeks ended 29tn March, 1919. Deaths registered during the 13 weeks ended 29th March, 1919. age mortality. Small-Pox. Measles. seven zymotic diseases. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Scarlet Fever. Diphtheria. Whooping Cough. Fever Dysentery. Diarrhœa. All Causes. Seven Zymotics During the corresponding period year previous. During the 13 weeks ended 29th March, 1919. During the corresponding period year previous. During the 13 weeks ended 29th March, 1919. Typhoid. Other. M. F. m. F. Greenwich East 45960 49387 85 92 73 85 17 10 66 ... ... ... 2 1 ... ... 2 ... 12 3 39 13 10 76 . . . . Do. West 22933 24438 59 41 99 58 14 9 51 ... ... ... 2 ... ... ... ... 1 9 4 47 7 10 77 . . . . St. Nicholas, Deptford 7290 7767 26 18 12 10 2 2 9 ... ... ... ... ... ... ... ... ... 1 ... 6 1 2 12 . . . . Charlton 16910 17948 35 37 60 45 13 4 33 ... 1 1 ... ... ... 1 ... 1 9 3 17 9 8 55 . . . . Kidbrooke 2875 3051 2 2 4 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 . . . . Miller Hospital— Resident ... ... ... 3 3 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 ... ... ... ... Non-Resident ... ... ... 15 5 3 2 ... ... ... ... 1 ... ... ... ... ... 2 1 1 1 2 12 ... ... ... ... Seamen's Hospital- Resident ... ... ... 43 1 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 14 ... 2 25 ... ... ... ... Non-Resident ... ... ... ?8 3 ... ... ... ... ... ... ... ... ... ... ... ... 5 ... 5 ... 3 18 ... ... ... ... Greenwich Union — Workhouse and Infirmary Resident ... ... ... 42 23 3 5 4 ... ... ... ... ... ... ... ... ... 3 2 20 3 5 32 ... ... ... ... Non-Resident ... ... ... 124 97 11 2 53 ... ... ... ... ... ... 1 ... 2 13 ... 65 5 10 125 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital- Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Manna Mead, The Grove Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Royal Hospital School Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Outside Institutions — Resident ... ... ... 34 24 5 5 7 ... ... ... 4 ... 1 2 1 7 6 5 1 3 28 ... ... ... ... Borough 95968 102591 205 190 246 202 46 25 162 ... 1 1 4 1 ... 1 2 2 31 10 109 30 30 226 ... ... ... ... 395 448 Rate per 1,000 of Estimated Population ... ... ... ... ... ... ... . . . . . . . . . . . . . . . . . . . BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 28th June, 1919. districts. Census Population, 1911. Estimated Population at the middle of the year 1919. Births registered during the 13 weeks ended 28th June, 1919. Deaths registered during the 13 weeks ended 28th June, 1919. age mortality. seven zymotic diseases. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Dysentery. Diarrhoea. Alt Causes. Seven Zymotics During the corresponding period year previous. During the 13 weeks ended 28th June, 1919. During the corresponding period year previous. During the 13 weeks ended 28th June, 1919. Typhoid. Other. M. F. M. F. Greenwich East 45960 49387 97 102 62 54 10 7 36 ... ... l 4 ... 1 ... ... 1 15 3 11 8 20 52 . . . . Do. West 22933 24438 53 51 57 39 18 4 24 ... ... l ... l ... ... ... ... 16 3 21 4 9 41 . . . . St. Nicholas, Deptford 7290 7767 21 18 16 8 7 2 5 ... ... l ... ... ... l ... i 5 1 6 1 2 6 . . . . Charlton 16910 17948 31 30 32 14 4 1 17 ... 1 ... ... ... ... 1 ... ... 3 2 8 7 7 17 . . . . Kidbrooke 2875 3051 1 3 2 3 1 ... 3 ... ... ... ... ... ... ... ... l ... 1 1 ... ... 2 . . . . Miller Hospital— Resident ... ... ... 4 3 ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 4 ... ... ... ... Non-Resident ... ... ... 9 9 1 2 1 ... ... ... ... ... ... ... ... ... ... 1 1 3 1 12 ... ... ... ... Seamen's Hospital— Resident ... ... ... 20 0 ... ... 1 ... ... ... ... ... ... ... ... ... 7 ... 3 1 3 6 ... ... ... ... Non-Resident ... ... ... 23 0 ... ... 1 ... ... ... ... ... ... ... ... ... 6 2 2 4 3 6 ... ... ... ... Greenwich Union— Workhouse and Infirmary Resident ... ... ... 23 21 8 2 9 ... ... ... ... ... ... ... ... ... 8 4 12 2 5 13 ... ... ... ... Non-Resident ... ... ... 65 63 4 3 38 ... ... ... ... ... ... 2 ... ... 14 4 21 4 11 72 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... Manna Mead, The Grove Resident ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Royal Hospital School Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Outside Institutions— Resident ... ... ... 27 22 4 3 6 ... ... 2 4 l l 2 ... ... 4 4 2 2 7 20 ... ... ... Borough 95968 102591 203 904 169 118 40 14 85 ... 1 3 4 1 1 2 ... 3 39 10 47 20 38 118 ... ... ... ... 407 287 Rate per 1,000 of Estimated Ponulation ... ... ... ... ... ... ... . . . . . . . . . . . . . . . . . . . BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 27th September, 1919. districts. Census Population, 1911. Estimated Population at the middle of the year 1919. Births registered during the 13 weeks ended 27th September, 1919. Deaths registered during the 13 weeks ended 27th September, 1919. age mortality. seven zymotic diseases. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 6 years. Persons aged 65 years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. . Whooping Cough. Fevers. Dysentery. Diarrhœa. All Causes. Seven Zymotics During the corresponding period year previous. During the 13 weeks ended 27th September, 1919. During the corresponding period year previous. During the 13 weeks ended 27th September, 1919. Typhoid. Other. m. F. m. F. Greenwich East 45960 49387 121 107 63 55 19 3 34 ... ... ... ... 2 ... 2 ... 6 11 2 7 12 14 62 . . . . Do. West 22933 24438 64 46 45 24 7 3 19 ... 1 ... 1 1 ... 1 ... 1 11 4 7 5 11 26 . . . . St. Nicholas, Deptford 7290 7767 18 21 9 10 3 4 3 ... 3 ... ... ... ... ... ... 3 1 ... 1 1 4 6 . . . . Charlton 16910 17948 39 36 20 13 3 2 13 ... ... ... ... 2 ... ... ... 1 6 1 2 3 3 15 . . . . Kidbrooke 2875 3051 2 4 2 1 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 . . . . Miller Hospital— Resident ... ... ... 1 7 1 ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 2 2 1 ... ... ... ... Non-Resident ... ... ... 12 5 ... ... 1 ... ... ... ... ... ... ... ... 1 3 1 1 ... 2 9 ... ... ... ... Seamen's Hospital— Resident ... ... ... 20 0 ... ... 1 ... ... ... ... ... ... ... ... ... 7 1 1 2 2 7 ... ... ... ... Non-Resident ... ... ... 17 0 ... ... ... ... ... ... ... ... ... ... 1 1 5 1 ... ... ... 9 ... ... ... ... Greenwich Union— Workhouse and Infirmary Resident ... ... ... 34 22 7 1 11 ... ... ... ... ... ... ... ... 3 2 2 5 4 11 29 ... ... ... ... Non-Resident ... ... ... 53 59 8 1 31 ... ... ... ... ... ... ... ... 8 5 1 9 3 16 70 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B.Brook Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... 1 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... Manna Mead, The Grove Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Royal Hospital School Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Outside Institutions— Resident ... ... ... 20 18 3 3 3 ... ... ... 1 ... ... 2 ... 1 7 1 4 1 6 15 ... ... ... ... Borough 95968 102591 244 214 139 103 33 12 70 ... 4 ... 1 5 ... 3 ... 11 30 7 17 22 32 110 ... ... ... ... 458 242 Rate per 1,000 of Estimated Population ... ... ... ... ... ... ... . . . . . • • . . . • . . . . . . . . BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 14 weeks ended 3rd January, 1920. DISTRICTS. Census Population, 1911. Estimated Population at the middle of the year 1919. Births registered during the 14 weeks ended 3rd January, 1920. Deaths registered during the 14 weeks ended 3rd January. 1920. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer All other Diseases. Rate of Mortality per 1,000. All Causes. Seven Zymotics Under 1 year. Over 1 and under 6 years. Persons aged 65 years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Dysentery. Diarrhoea. During the corresponding period year previous. During the 14 weeks ended 3rd January, 1920. During the corresponding period year previous. During the 14 weeks ended 3rd January, 1920. Typhoid. Other. M. F. M. F. Greenwich East 45960 49387 162 152 73 67 19 8 54 ... 1 1 1 2 ... 3 ... 6 13 2 15 18 23 55 . . . . Do. West 22933 24438 89 93 89 50 22 9 29 ... 4 ... 2 ... 1 2 ... 4 20 1 23 15 11 56 . . . . St. Nicholas, Deptford 7290 7767 45 37 28 26 19 5 9 ... 2 2 1 ... ... ... ... 2 5 2 7 5 1 27 . . . . Charlton 16910 17948 62 61 29 26 8 2 17 ... ... ... 2 ... ... 1 ... ... 3 1 9 9 3 27 . . . . Kidbrooke 2875 3051 1 6 3 4 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 5 . . . . Miller Hospital— Resident ... ... ... 8 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 1 5 ... ... ... ... Non-Resident ... ... ... 11 6 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 11 ... ... ... ... Seamen's Hospital— Resident ... ... ... 34 0 ... ... ... ... ... ... ... ... ... ... ... ... 12 1 6 5 1 9 ... ... ... ... Non-Resident ... ... ... 14 0 ... ... 2 ... ... ... ... ... ... 1 ... ... 2 1 1 1 2 6 ... ... ... ... Greenwich Union— Workhouse and Infirmary Resident ... ... ... 41 39 10 7 21 ... ... ... ... ... ... 2 ... 11 7 1 9 7 10 33 ... ... ... ... Non-Resident ... ... ... 82 60 8 1 54 ... 1 ... 1 ... ... 1 ... 3 8 3 31 8 17 69 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B.Brook Hospital— Resident ... ... ... 1 0 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 4 3 1 3 ... ... ... ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Manna Mead, The Grove Resident ... ... ... 0 2 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Non-Resident ... ... ... 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Royal Hospital School Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Outside Institutions— Resident ... ... ... 27 30 9 7 10 ... ... 3 3 ... 1 2 ... 1 ... ... 4 7 7 25 ... ... ... ... Borough 95968 102591 359 349 222 173 68 24 112 ... 7 3 6 2 1 6 ... 12 41 6 54 47 40 170 ... ... ... ... 708 395 Rate per 1,000 of Estimated Populat ion ... ... ... ... ... ... ... . . . . . . . . . . . . . . . . . . . BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 53 weeks ended 3rd January, 1920. districts. Census Population, 19 . Estimated Population at the middle of the year. Births registered during the 53 weeks ended 3rd January, 1920. Deaths registered during the 53 weeks ended 3rd January, 1920. age mortality. seven zymotic diseases. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. cancer. All other Diseases. Rate of Mortality per 1,000. All Causes. Seven Zymotics Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Dysentery. Diarrhœa. During the corresponding period year previous. During the 53 weeks ended 3rd January, 1920. During the corresponding period year previous. During the 53 weeks ended 3rd January, 1920. Typhoid. Other. m. f. m. f. Greenwich East 45960 49387 465 453 271 261 65 28 190 ... 1 2 7 5 1 5 2 13 51 10 72 51 67 245 16·01 10·77 1·78 ·71 Do. West 22933 24438 265 231 290 171 61 25 123 ... 5 1 5 2 1 3 ... 6 56 12 98 31 41 200 26·03 18·86 2·01 ·92 St. Nicholas, Deptford 7290 7767 110 94 65 54 31 13 26 ... 5 3 1 ... ... 1 ... 6 12 3 20 8 9 51 24·45 15·32 2·06 1·72 Charlton 16910 17949 167 164 141 98 28 9 80 ... 2 1 2 2 ... 3 ... 2 21 7 36 28 21 114 20·42 13·36 1·1 ·65 Kidbrooke 2875 3051 4 15 9 12 2 ... 10 ... ... ... ... ... ... ... ... 1 1 1 1 1 2 14 10·50 6·88 ·37 ·32 Miller Hospital— Resident ... ... ... 16 14 2 1 1 ... ... ... ... ... ... ... ... 2 1 ... 5 3 4 15 ... ... ... ... Non-Resident ... ... ... 47 25 ... ... ... ... ... ... 1 ... ... ... ... 1 5 3 6 4 8 44 ... ... ... ... Seamen's Hospital— Resident ... ... ... 117 1 ... ... 2 ... ... ... ... ... ... ... ... ... 29 2 24 8 8 47 ... ... ... ... Non-Resident ... ... ... 82 3 ... ... ... ... ... ... ... ... ... 1 1 1 18 4 8 5 8 39 ... ... ... ... Greenwich Union— Workhouse and Infirmary Resident ... ... ... 140 105 28 15 45 ... ... ... ... ... ... 2 ... 14 20 9 46 16 31 107 ... ... ... ... Non-Resident ... ... ... 324 279 ... ... ... ... 1 ... 1 ... ... 4 ... 13 40 8 126 20 54 336 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 1 ... ... ... ... ... ... l ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 4 3 1 3 ... ... ... ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... 2 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 ... ... ... ... Non-Resident ... ... ... 1 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... ... ... ... Manna Mead, The Grove Resident ... ... ... 3 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... Non-Resident ... ... ... 4 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... Royal Hospital School Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Outside Institutions— Resident ... ... ... 108 94 21 18 26 ... ... 5 12 1 2 7 2 3 20 13 15 11 23 88 ... ... ... ... Borough 95968 102591 1011 957 776 596 187 75 429 ... 13 7 15 9 2 12 2 28 141 33 227 119 140 624 ... ... ... ... 1968 1372 Rate per 1,000 of Estimated Population ... ... ... ... ... ... ... 0·00 ·12 ·06 ·14 ·08 ·01 ·11 ·01 ·26 1·36 ·32 2·20 1·16 1·36 6·08 19·16 13·15 1·70 ·84 Deaths of Children under one year per 1,000 births 95 previous corresponding period 119 „ „ „ County of London 85 Death Rate of 97 large English Towns 13·8; of the County of London 13·4 Birth Rate „ „ 2008 „ „ „ 18·3 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 29th March, 1919. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 15 and under 65. 35 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. G.U.Workhse and Infirmary. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital, M.A.B. Cottage Hospital. "Manna Mead," The Grove. Outside Institutions. All causes Certified 448 46 12 13 20 30 83 82 162 158 157 22 105 6 65 44 6 ... ... 1 ... 58 389 Uncertified. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Scarlet Fever 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Whooping Cough 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Diplitheria and Croup 4 ... ... 3 1 ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... 4 1 Influenza 67 1 2 1 2 11 31 10 9 15 31 1 17 3 2 22 1 ... ... ... ... 5 55 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Dysentery 2 ... ... ... ... ... 1 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... Phthisis (Pul. Tuberculosis) 31 ... ... ... ... 6 14 7 4 12 9 1 9 ... 3 3 ... ... ... ... ... 7 26 Tuberculous Meningitis 5 ... ... 1 2 1 1 ... ... 1 1 ... 3 ... ... ... ... ... ... ... ... 4 1 Other Tuberculous Diseases 5 1 1 1 ... ... 1 ... 1 2 3 ... ... ... 2 ... ... ... ... ... ... 2 2 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cancer, malignant disease 30 ... ... ... ... ... 1 12 17 10 10 2 8 ... 5 2 ... ... ... ... ... 3 22 Bronchitis 49 3 1 2 1 ... 2 12 28 17 19 5 8 ... 12 ... ... ... ... ... ... 3 45 Broncho-Pneumonia 43 7 5 3 2 2 13 8 3 12 24 ... 7 ... 3 14 ... ... ... ... ... ... 30 Pneumonia (all other forms) 17 2 2 1 3 3 2 3 1 10 4 1 2 ... 5 ... 1 ... ... 1 ... 2 32 Other Diseases of Respiratory Organs 4 ... ... 1 1 1 ... ... 1 2 2 ... ... ... 2 ... ... ... ... ... ... 1 3 Diarrhoea & Enteritis 2 2 ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 2 Appendicitis and Typhlitis 2 ... ... ... ... 1 ... ... 1 2 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Nephritis & Bl ight's Disease 8 ... ... ... ... ... 1 3 4 4 3 1 ... ... 1 1 ... ... ... ... ... 1 6 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 3 ... ... ... ... 1 2 ... ... 2 1 ... ... ... ... ... 1 ... ... ... ... 1 2 Congenital Debility and Malformation, including Premature Birth 21 21 ... ... ... ... ... ... ... 8 5 1 7 ... 4 ... ... ... ... ... ... ... 14 Violent Deaths, excluding Suicide 8 2 ... ... ... ... 1 2 3 7 ... ... 1 ... 2 ... ... ... ... ... ... 1 11 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Disease 30 ... ... ... ... 1 3 8 18 13 7 1 9 ... 3 ... ... ... ... ... ... 1 9 Other Defined Diseases 112 6 1 ... 5 3 10 15 72 36 34 9 30 3 20 2 3 ... ... ... ... 19 126 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 448 46 12 13 20 30 83 82 162 158 157 22 105 6 65 44 6 ... ... 1 ... 58 389 BOROUGH OF GREENWICH. Causes of, and Ages at. Death during the 13 weeks ending 28th June. 1919. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. G.U.Workhse and Infirmary. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital, M.A.B. Cottage Hospital. "Manna Mead," The Grove. Outside Institutions. All causes Certified 287 40 6 8 20 27 45 56 85 116 96 24 46 5 44 20 7 ... ... ... 1 49 245 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Scarlet Fever 3 ... ... ... 2 1 ... ... ... 1 1 1 ... ... ... ... ... ... ... ... ... 2 ... Whooping Cough 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... Diphtheria and Croup 4 ... ... 2 2 ... ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... 4 ... Influenza 13 ... ... ... 2 2 3 5 1 6 5 1 1 ... ... 3 ... ... ... ... ... 1 6 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 2 1 ... ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pul. Tuberculosis) 39 ... ... 1 2 13 15 7 1 15 16 5 3 ... 8 7 1 ... ... ... ... 4 36 Tuberculous Meningitis 7 2 1 3 1 ... ... ... ... 3 2 1 1 ... 3 ... ... ... ... ... ... 2 6 Other Tuberculous Diseases 3 2 ... ... 1 ... ... ... ... ... 1 ... 1 1 1 ... ... ... ... ... ... 2 5 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cancer, malignant disease 38 ... ... ... ... ... 6 16 16 20 9 2 7 ... 5 3 1 ... ... ... ... 7 24 Bronchitis 26 3 1 ... ... ... 2 2 18 7 9 5 5 ... 10 ... ... ... ... ... ... 1 28 Broncho-Pneumonia 11 5 ... ... ... ... 4 ... 2 2 7 1 ... 1 1 2 ... ... ... ... ... 1 7 Pneumonia (all other forms) 10 2 ... 1 ... ... 3 3 1 2 5 ... 3 ... 1 1 1 ... ... ... ... ... 5 Other Diseases of Respiratory Organs 2 ... ... ... 1 ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 Diarrhœa & Enteritis 3 2 ... ... ... ... ... 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... Appendicitis and Typhlitis 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... Nephritis & Bright's Disease 8 ... ... ... ... ... 1 4 3 4 3 1 ... ... ... 1 ... ... ... ... ... 4 8 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 1 Congenital Debility and Malformation, including Premature Birth 17 16 1 ... ... ... ... ... ... 6 8 2 1 ... 2 ... ... ... ... ... ... 1 3 Violent Deaths, excluding Suicide 12 2 2 1 1 3 1 2 ... 4 3 1 4 ... ... 1 1 ... ... ... ... 2 12 Suicides 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 2 Heart Disease 20 ... ... ... 3 3 2 4 8 8 4 1 7 ... 2 1 ... ... ... ... ... 2 15 Other Defined Diseases 62 4 ... ... 4 2 7 10 35 28 21 1 10 2 11 1 3 ... ... ... 1 9 82 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 287 40 6 8 20 27 45 56 85 116 96 24 46 5 44 20 7 ... ... ... 1 49 245 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 27th September, 1919. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Peptford. Charlton. Kidbrooke. G.U.Workhse and Infirmary. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital, m.a.b. Cottage Hospital. "Manna Mead," The Grove. Outside Institutions. All causes Certified 242 33 8 4 13 18 38 58 70 118 69 19 33 3 56 20 8 ... ... 1 ... 38 235 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 ... 2 2 ... ... ... ... ... ... 1 3 ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 5 4 ... ... 1 ... ... ... ... 2 1 ... 2 ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... Influenza 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 2 ... 1 ... 1 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Phthisis (Pul. Tuberculosis) 30 ... ... ... ... 9 16 5 ... 11 11 1 6 1 2 7 ... ... ... ... ... 7 22 Tuberculous Meningitis 3 1 ... ... 1 1 ... ... ... 1 1 ... 1 ... ... 1 ... ... ... ... ... 1 1 Other Tuberculous Diseases 4 1 ... ... ... ... 2 1 ... 1 3 ... ... ... 2 ... ... ... ... ... ... ... 5 Rheumatic Fever 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Cancer, malignant disease 32 ... ... ... ... ... 3 19 10 14 11 4 3 ... 11 2 2 ... ... ... ... 6 33 Bronchitis 7 ... ... ... ... ... 1 3 3 2 4 ... 1 ... 3 1 ... ... ... ... ... 2 13 Broncho-Pneumonia 3 ... 1 2 ... ... ... ... ... ... 1 1 1 ... 1 ... ... ... ... ... ... 1 1 Pneumonia (all other forms) 7 ... ... ... ... ... 1 4 2 5 2 ... ... ... 1 ... 1 ... ... ... ... 1 3 Other Diseases of Respiratory Organs 2 ... ... ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Enteritis 11 8 1 ... 2 ... ... ... ... 6 1 3 1 ... 3 ... 2 ... ... ... ... 1 15 Appendicitis and Typhlitis 2 ... ... ... 1 ... ... 1 ... 2 ... ... ... ... ... 1 ... ... ... ... ... 1 2 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 Nephritis & Bright's Disease 7 ... ... ... ... ... 3 1 3 4 2 ... 1 ... 4 ... ... ... ... ... ... ... 13 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... ... 2 ... ... 1 ... ... 1 ... ... ... 1 ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 11 9 1 ... 1 ... ... ... ... 10 1 ... ... ... 1 ... ... ... ... ... ... 1 3 Violent Deaths, excluding Suicide 9 3 2 ... ... 1 ... 2 1 4 2 ... 2 1 ... 2 ... ... ... ... ... 1 10 Suicides 5 ... ... ... ... 1 1 2 1 4 1 ... ... ... 1 ... ... ... ... ... ... 2 8 Heart Disease 22 ... ... ... 1 2 1 7 11 12 5 1 8 1 4 2 2 ... ... ... ... 1 11 Other Defined Diseases 70 6 ... ... 4 4 8 11 37 33 20 6 11 ... 23 4 ... ... ... 1 ... 9 92 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 242 33 8 4 13 18 38 58 70 118 69 19 33 3 56 20 8 ... ... 1 ... 38 235 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 14 weeks ending 3rd January, 1920. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Instituticns in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. '25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas. Deptford. Charlton. Kidbrooke. G.U.Workhse and Infirmary. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. "Manna Mead," The Grove. Outside Institutions. All causes Certified 395 68 11 13 15 15 59 102 112 140 139 54 55 7 80 34 9 ... 1 2 2 57 309 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 7 1 3 2 1 ... ... ... ... 1 4 2 ... ... ... ... ... ... ... ... ... ... 1 Scarlet Fever 3 ... ... 2 1 ... ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... 3 ... Whooping Cough 2 1 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup 6 ... ... 4 2 ... ... ... ... 1 2 1 2 ... ... ... ... ... 1 ... ... 3 9 Influenza 3 1 ... ... ... ... ... 1 1 3 ... ... ... ... ... ... ... ... ... ... ... ... 1 Erysipelas 2 ... ... ... ... ... 1 ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis ( Pul. Tuberculosis) 41 ... ... 1 1 4 22 13 ... 13 20 5 3 ... 7 12 ... ... ... ... ... 2 29 T uberculous Meningitis 2 1 ... 1 ... ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... 2 Other Tuberculous Diseases 4 ... ... ... ... ... 2 1 1 ... 1 2 1 ... ... 1 ... ... ... ... ... 2 4 Rheumatic Fever 2 ... ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 Cancer, malignant disease 40 ... ... ... ... ... 4 23 13 23 11 1 3 2 10 1 1 ... ... ... 1 7 35 Bronchitis 32 7 1 ... ... ... 1 9 14 11 13 4 4 ... 6 2 1 ... ... ... ... 2 34 Broncho-Pneuinonia 11 4 1 1 ... ... ... 1 4 2 5 1 3 ... 1 1 ... ... ... ... ... 2 6 Pneumonia (all other forms) 11 1 ... ... 3 2 2 3 ... 2 5 2 2 ... 2 3 1 ... ... ... ... ... 12 Other Diseases of Respiratory Organs 2 ... ... ... ... ... 1 ... 1 ... 1 ... ... 1 ... 1 ... ... ... ... ... ... 1 Diarrhœa & Enteritis 12 8 4 ... ... ... ... ... ... ... 4 2 ... ... 11 ... ... ... ... ... ... 1 14 Appendicitis and Typhlitis 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... 3 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 Nephritis & Bright's Disease 12 ... ... ... ... ... 2 7 3 5 2 3 1 1 5 1 ... ... ... ... ... 1 18 Puerperal Fever 4 ... ... ... ... 1 3 ... ... 2 1 ... 1 ... 2 ... ... ... ... ... ... 2 3 Other Accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... ... 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 1 ... Congenital Debility and Malformation, including Premature Birth 30 30 ... ... ... ... ... ... ... 4 12 8 6 ... 2 ... ... ... ... ... ... 4 6 Violent Deaths, excluding Suicide 11 ... ... 1 3 1 3 1 2 2 3 2 3 1 ... 1 ... ... ... 1 ... 4 11 Suicides 4 ... ... ... ... 3 1 ... ... 1 1 ... 1 1 ... ... ... ... ... ... ... ... 2 Heart Disease 47 ... ... ... ... 3 6 23 15 18 15 5 9 ... 7 5 1 ... ... 1 ... 7 23 Other Defined Diseases 102 14 1 1 4 1 8 17 56 38 37 14 12 1 25 6 5 ... ... ... 1 15 92 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 395 68 11 13 15 15 59 102 112 140 139 54 55 7 80 34 9 ... 1 2 2 57 309 BOROUGH OF GREENWICH. Causes of, and Ages at Death during the 53 weeks ending 3rd January, 1920. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 6. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. G.U. Workhse and Infirmary. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital. M.A.B. Cottage Hospital. "Manna Mead," The Grove. Outside Institutions. All causes Certified 1372 187 37 38 68 90 222 298 429 532 161 119 229 21 245 118 30 ... 1 4 3 202 1178 Uncertified. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 2 ... ... ... ... 1 1 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 13 1 6 4 2 ... ... ... ... 1 5 5 2 ... ... ... ... ... ... ... ... ... 1 Scarlet Fever 7 ... ... 2 4 1 ... ... ... 2 1 3 1 ... ... ... ... ... ... ... ... 5 ... Whooping Cough 9 6 1 ... 2 ... ... ... ... 5 2 ... 2 ... ... ... ... ... ... ... ... 1 ... Diphtheria and Croup 15 1 ... 9 5 ... ... ... ... 7 5 1 2 ... ... ... ... ... 1 ... ... 12 10 Influenza 84 2 2 1 4 13 34 17 11 25 36 2 18 3 2 25 1 ... ... ... ... 6 62 Erysipelas 2 ... ... ... ... ... 1 ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 5 2 1 ... 1 1 ... ... ... 2 ... 1 2 ... ... ... ... ... ... ... ... 5 1 Dysentery 2 ... ... ... ... ... 1 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 1 Phthisis (Pul. Tuberculosis) 141 ... ... 2 3 32 67 32 5 51 56 12 21 1 20 29 1 ... ... ... ... 20 113 Tuberculous Meningitis 17 4 1 5 4 2 1 ... ... 7 4 1 5 ... 4 1 ... ... ... ... ... 7 10 Other Tuberculous Diseases 16 4 1 1 1 ... 5 2 2 3 8 2 2 1 5 1 ... ... ... ... ... 6 16 Rheumatic Fever 3 ... ... ... 1 ... ... 2 ... 1 2 ... ... ... ... ... ... ... ... ... ... ... 1 Cancer, malignant disease 140 ... ... ... ... ... 14 70 56 67 41 9 21 2 31 8 4 ... ... ... 1 23 114 Bronchitis 114 13 3 2 1 ... 6 26 63 37 45 14 18 ... 31 3 1 ... ... ... ... 8 120 Broncho-Pneumonia 68 16 7 6 2 2 17 9 9 16 37 3 11 1 6 17 ... ... ... ... ... 4 44 Pneumonia (all other forms) 46 5 2 2 6 5 8 13 4 19 16 3 7 ... 9 4 4 ... ... 1 ... 3 52 Other Diseases of Respiratory Organs 10 ... ... 1 2 1 1 1 4 5 4 ... ... 1 2 1 ... ... ... ... ... 2 5 Diarrhœa & Enteritis 28 20 5 ... 2 ... ... 1 ... 13 6 6 2 1 14 ... 2 ... ... ... ... 3 31 Appendicitis and Typhlitis 6 ... ... ... 2 1 ... 1 2 5 ... ... 1 ... 2 1 ... ... ... ... ... 1 8 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 3 ... ... ... ... ... ... 3 ... 1 1 ... 1 ... ... ... ... ... ... ... ... 1 3 Nephritis & Bright's Disease 35 ... ... ... ... ... 7 15 13 17 10 5 2 1 10 3 ... ... ... ... ... 6 45 Puerperal Fever 4 ... ... ... ... 1 3 ... ... 2 1 ... 1 ... 2 ... ... ... ... ... ... 2 5 Other Accidents and Diseases of Pregnancy and Parturition J 9 ... ... ... ... 2 7 ... ... 5 1 ... 3 ... ... ... 2 ... ... ... ... 3 4 Congenital Debility and Malformation, including Premature Birth 79 76 2 ... 1 ... ... ... ... 28 26 11 14 ... 9 ... ... ... ... ... ... 6 26 Violent Deaths, excluding Suicide 40 7 4 2 4 5 5 7 6 17 8 3 10 2 2 4 1 ... ... 1 ... 8 44 Suicides 10 ... ... ... ... 4 2 3 1 6 2 ... 1 1 1 ... ... ... ... ... ... 3 12 Heart Disease 119 ... ... ... 4 9 12 42 52 51 31 8 28 1 16 8 3 ... ... 1 ... 11 58 Other Defined Diseases 346 30 2 1 17 10 33 53 200 135 112 30 63 6 79 13 11 ... ... 1 2 52 392 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1372 187 37 38 68 90 225 298 429 532 461 119 239 21 245 118 30 ... 1 4 3 202 1178 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending March 29th, 1919. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Loc ality No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton Kidbrooke.* Greenwich East. Greknwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Chicken-pox 33 5 13 15 ... ... ... ... 6 10 5 11 1 ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 99 ... 12 77 ... l ... ... 16 68 ... 15 ... 12 52 ... 13 ... 77 Mem. Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 8 ... ... ... 1 4 l l 2 3 2 1 ... ... 1 1 ... ... 2 Scarlet Fever 54 ... 11 36 7 ... ... ... 25 13 6 9 l 19 14 4 9 1 47 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... ... l ... ... ... ... 1 ... ... ... ... ... ... ... Malaria Fever 6 ... ... ... 1 5 ... ... 1 3 2 ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 134 4 32 92 3 3 ... ... 57 16 5 55 l ... ... ... ... ... ... Whooping Cough 16 2 7 7 ... ... ... ... 13 ... ... 3 ... 5 ... ... ... ... 5 Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 3 3 ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... Tuberculosis, Pulmonary 78 ... 1 14 15 30 17 l 36 17 8 17 ... 4 ... ... 1 ... 6 „ Non-Pulmonary 87 ... 14 67 5 1 ... ... 39 28 6 14 ... ... ... ... ... ... ... Pneumonia 31 2 3 5 6 9 3 3 8 14 2 5 2 ... ... ... ... l 1 Totals 551 17 93 313 47 54 22 5 206 172 36 132 5 40 68 5 24 2 139 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending June 28th, 1919. Notifiable Disease. Cases Notified in Whole District. Total Casus Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich west. St. Nicholas, Deptford. Charlton. Kidbkooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Post Basal Meningitis 2 2 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... Chicken-pox 21 ... 9 12 ... ... ... ... 6 12 1 2 ... ... ... ... ... ... ... Malaria 17 ... ... ... 4 13 ... ... 9 6 2 ... ... ... ... 1 ... ... 1 Diphtheria 66 ... 16 42 7 1 ... ... 23 37 2 4 ... 21 36 2 4 ... 63 Influenzal Pneumonia 34 2 1 3 12 8 7 1 14 13 3 4 ... 1 2 1 ... ... 4 Erysipelas 6 ... ... ... ... 1 4 1 2 3 ... 1 ... ... ... ... ... ... ... Scarlet Fever 60 1 20 35 2 2 ... ... 22 19 17 ... ... 19 16 17 ... 1 53 Trench Fever 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Enteric Fever 2 ... ... 2 ... ... ... ... 2 ... ... ... ... 2 ... ... ... ... 2 Dysentery 2 ... ... ... 1 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 4 ... 1 ... 2 1 ... ... 3 ... ... 1 ... 3 ... ... 1 ... 4 Measles 283 5 102 163 9 3 1 ... 216 29 14 23 ... ... ... ... ... ... ... Whooping Cough 28 2 10 16 ... ... ... ... 8 19 ... 1 ... 1 ... ... ... ... 1 Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 6 6 ... ... ... ... ... ... ... 5 1 ... ... ... ... ... ... ... ... Tuberculosis, Pulmonary 76 ... ... 7 16 40 10 ... 39 21 9 7 ... 6 1 1 ... ... 8 „ Non-Pulmonary 01 3 5 36 4 3 ... ... 18 13 9 10 1 2 1 ... 2 ... 5 Totals 659 21 164 316 58 73 22 5 362 180 59 54 4 55 56 22 7 1 141 * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Ividbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending September 27th, 1919. Notifiable Disease. At all Ages. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Grernwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Poliomyelitis 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Dysentery 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... Malaria 29 ... ... ... 5 24 ... ... 21 4 2 2 ... ... ... ... ... ... ... Diphtheria 48 1 7 32 6 2 ... ... 23 8 3 13 1 22 7 3 12 1 45 Influenzal Pneumonia 11 1 ... 3 2 4 l ... 7 4 ... ... ... 2 1 ... ... ... 3 Erysipelas 11 ... ... 1 ... 8 2 ... 3 3 2 2 1 ... 1 1 ... ... 2 Scarlet Fever 114 1 20 75 14 4 ... ... 51 15 42 5 l 50 14 40 4 1 109 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 14 ... 1 8 2 3 ... ... 4 8 ... 2 ... 4 8 ... 2 ... 14 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 2 ... ... 2 ... ... ... ... 2 ... ... ... ... 2 ... ... ... ... 2 Measles 278 7 134 134 1 2 ... ... 80 130 46 22 ... ... ... ... ... ... ... Whooping Cough 39 8 18 13 ... ... ... ... 21 3 ... 15 ... ... ... ... ... ... ... Diarrhœa 119 50 68 1 ... ... ... ... 26 55 20 18 ... ... ... ... ... ... ... Ophthalmia Neonatorum 5 5 ... ... ... ... ... ... 2 2 ... 1 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 67 ... 1 4 23 28 10 l 30 17 4 13 3 3 3 ... ... ... 6 „ Non-Pulmonary 43 1 5 31 2 3 1 ... 23 13 2 5 ... ... 2 ... 3 ... 5 Totals 782 74 255 304 56 78 14 l 293 263 121 99 6 83 36 44 22 2 187 *Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 14 weeks ending January 3rd, 1920. Notifiable Disease. At all Ages. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton Kidbrooke* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Influenza & Pneumonia 25 1 4 9 2 6 2 1 14 7 2 2 ... 2 2 ... ... ... ... Malaria 21 ... ... ... 6 11 4 ... 9 8 4 ... ... ... ... ... ... ... ... Dysentery 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Diphtheria 62 ... 9 43 8 2 ... ... 27 12 4 17 2 23 7 3 16 1 ... Post. Basal Meningitis 1 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... Erysipelas 22 ... ... 1 3 7 7 4 7 4 6 5 ... 1 2 3 ... ... ... Scarlet Fever 253 1 62 162 17 11 ... ... 175 39 13 26 ... 144 35 11 21 ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... 1 ... 2 ... ... 1 ... ... 2 ... 1 ... ... 2 ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 4 ... ... ... 1 3 ... ... 1 2 ... 1 ... 1 ... ... 1 ... ... Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 230 9 109 110 2 ... ... ... 24 130 62 10 4 ... ... ... ... ... ... Whooping Cough 58 8 27 23 ... ... ... ... 13 33 2 9 1 ... ... ... ... ... ... Diarrhœa 23 13 10 ... ... ... ... ... 8 7 6 2 ... 2 ... ... ... ... ... Ophthalmia Neonatorum 6 6 ... ... ... ... ... ... 3 1 1 1 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 79 ... ... 10 19 35 15 ... 34 21 9 15 ... 7 5 4 3 ... ... „ Non-Pulmonary 40 ... 7 25 6 2 ... ... 19 11 1 8 1 3 1 ... ... ... ... Totals 828 39 228 384 64 80 28 5 337 275 110 98 8 185 52 21 43 1 ... * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 53 weeks ending January 3rd, 1920. Notifiable Disease. At all Ages. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 6. 5 to 15. 15 to 26. 26 to 46. 46 to 65. 65 and upwards. Post Basal Meningitis 3 3 ... ... ... ... ... ... 1 ... 1 1 ... 1 ... ... ... ... ... Chicken-pox 54 5 22 27 ... ... ... ... 12 22 6 13 1 ... ... ... ... ... ... Malaria 73 ... ... ... 16 53 4 ... 40 21 10 2 ... ... ... 1 ... ... ... Diphtheria 275 1 44 194 30 6 ... ... 89 125 9 49 3 78 102 8 45 2 ... Poliomyelitis 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... Erysipelas 47 1 ... 2 4 20 14 6 14 13 10 9 1 1 4 5 ... ... ... Scarlet Fever 481 3 113 308 40 17 ... ... 273 86 78 40 4 232 79 72 34 3 ... Trench Fever 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Enteric Fever 20 ... 1 11 2 5 1 ... 7 8 ... 5 ... 7 8 ... 4 ... ... Dysentery 4 ... ... ... 2 2 ... ... 1 3 ... ... ... ... ... ... ... ... ... Influenza & Pneumonia 101 6 8 20 22 27 13 5 43 38 7 11 2 5 5 1 ... 1 ... Puerperal Fever 5 ... ... ... 1 4 ... ... 1 2 ... 2 ... 1 ... ... 2 ... ... Cerebro-Spinal Fever 6 ... 1 2 2 1 ...... ... 5 ... ... 1 ... 5 ... ... 1 ... ... Measles 925 25 377 499 15 8 1 ... 377 305 127 110 6 ... ... ... ... ... ... Whooping Cough 141 20 62 59 ... ... ... ... 55 55 2 28 1 6 ... ... ... ... ... Diarrhoea 142 63 78 1 ... ... ... ... 34 62 26 20 ... 2 ... ... ... ... ... Ophthalmia Neonatorum 20 20 ... ... ... ... ... ... 8 8 2 2 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 300 ... 2 35 73 133 52 5 139 76 30 52 3 20 10 5 4 ... ... „ Non-Pulmonary 221 4 31 159 17 9 1 ... 99 65 18 37 2 5 4 ... 5 ... ... Totals 2820 151 740 1317 225 285 86 16 1198 890 326 383 23 363 212 92 96 6 ... * Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. INFANTILE MORTALITY DURING THE YEAR 1919. Deaths from stated Causes in Weeks and Months under One Year of Age Cause or Death. Under 1 Week. 1—2 Week.. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—3 Months. 3—6 Months. 6—9 Months. 9—12 Months. Total Deaths under One Year. All Causes. Certified 63 10 8 3 84 30 33 21 19 187 Uncertified ... ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases. Measles ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 3 1 ... 2 6 Diphtheria—Croup ... ... ... ... ... 1 ... ... ... 1 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 2 2 ... 4 Tuberculous Diseases. Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 ... 1 2 4 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... 1 1 Convulsions 1 1 ... 1 3 ... 1 ... ... 4 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 ... 3 1 5 4 1 ... 3 13 Pneumonia, all forms ... ... ... ... ... 4 7 4 6 21 Diarrhoea Diseases. Diarrhoea, all forms ... ... ... ... ... 2 1 2 ... 5 Enteritis ... ... ... ... ... 4 7 2 2 15 Gastritis ... ... ... ... ... ... 1 2 1 4 Syphilis 1 ... ... ... 1 2 3 1 ... 7 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlaying 3 ... ... ... 3 ... 1 ... ... 4 Injury at Birth 6 1 ... ... 7 ... ... ... ... 7 Actelectasis 6 ... ... ... 6 ... ... ... ... 6 Congenital Malformations 4 1 1 1 7 3 1 ... ... 11 Premature Birth 31 4 2 ... 37 2 2 ... ... 41 Atrophy, Debility, and Marasmus 5 2 1 ... 8 4 2 3 ... 17 Other Causes 5 1 1 ... 7 ... 3 4 1 15 Totals 63 10 8 3 84 30 33 21 19 187