Gre 20 THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borough of Greenwich For the Year 1920, by ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H (Barrister-at- Law), MEDICAL OFFICER OF HEALTH TO THE BOROUGH, ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, AND EXECUTIVE TUBERCULOSIS OFFICER. Woolwich: Printed by the Pioneer Press, Ltd. (T.U. Fed.), 3, New Road. 1921. INDEX OF CONTENTS. Page Age Mortality 12 Analysis of Death Causes 13 Analysis of Si. kness and Mortality Statistics, London 11 Anthrax 33 Area of Borough 5 Articles and Rooms Disinfected 36 Articles Destroyed 35 Baby Shows 48 Bacteriological Examinations 29, 33 Bakehouses 19 Births 5, 8, 9, 49 Blackheath and Charlton Cottage Hospital 19 Bones and Joints 17 Books Destroyed 34 Cancer 16 Causes of Death 14-18 Cerebro-Spinal Fever 32 Circulatory System 17 Cleansing Children 4 Complaints 19,57 Constitutional Diseases 6 Consumption 6, 15, 33 Contacts 32 Cowhouses 23 Customs and Inland Revenue Acts 24, 59 Dairies, Cowsheds and Milkihops 23, 58 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 5, 9, 12 Density of Population 5 Dental Work 40, 49 Developmental Diseases 16 Diarrhoea and Zymotic Enteritis 15, 32 Dietetic Diseases 16 Digestive System 17 Diphtheria 14, 28, 29 Diphtheria Anti-Toxin 14 Disinfection 33, 34 Duties and Powers of the Public Health Committee 1,2 Duties and Powers of the Maternity and Child Welfare Committee 3 Elevation of Borough 5 Enteritis 15, 32 Epidemic Cerebro-Spinal Meningitis 32 Epidemic Diseases 14 Erysipelas 15, 29 External Causes 17 Factories and Workshops 19-22 Food and Drugs—Samples of 25, 26 Food—Premises for Preparation of, etc. 24 Glanders 33 Gonorrhoea 15 Health Centres 47 Health Visitors 4 INDEX—continued. Page Home of Rest for Advanced Cases 44 Home Work 21 Horse Slaughterer 22 Hospital and other forms of Gratuitous Medical Relief 19 House Drainage 23 Houses Inspected for Infectious Disease 34 Houses Let in Lodgings 50, 58 Housing 50-52 Hydrophobia 33 Ice Cream Premises 24, 58 Ill-defined Causes 18 Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 50 Infant Consultations 47 Infantile Mortality 12 and Appendix Influenza 15 Inhabited Houses 5 Inland Revenue Acts 24, 59 Insanitary Houses 58 Institution Deaths 12 Integumentary System 17 Interim Tuberculosis Care Committee 41, 44 Introductory Review 6 Legal Proceedings 26, 59 Local Diseases 16 Lymphatic System 17 Malarial Diseases 15, 33 Marriages 7 Maternity and Child Welfare 44 Measles 14, 31, 32, 49 Membranous Croup 29 Milkand Cream Regulations 24 Milk, Mothers and Children's Orders 25 Milk Supply 48, 49 Miller General Hospital 19 Minor Ailment Centre 47 Mortuary 18,59 Nervous System 18 Notices, etc. 57 Notifications 28 Notification of Births Act 49 Offensive Trades 23, 58 Ophthalmia Neonatorum 32, 49 Organs of Special Sense 17 Outworkers' Register 19 Overcrowding 58 Parasitic Diseases 18 Persons Cleansed 58 Polio-encephalitis 32 Polio-myeliti 32 Poor Law Relief 18 Population 5, 7 Public Health Committee 1 Puerperal Fever 15, 31, 49 Pysemia and Septicemia 15 Rats and Mice (Destruction) Act, 1919 50 Refuse Removal 22 Remarks on Death Causes 14—18 Reproductive System 17 INDEX—continued. Page Respiratory System 17 Rheumatic Fever 15 Sale of Food and Drugs Acta 25, 26, 55 Sanitary Work—Summaries, etc. 19-23, 53-59 Scarlet Fever 14,29,30 Scavenging and Refuse Removal 22 School Clinic 47 Seamen's Hospital 19 Septic Diseases 15 Slaughterhouses 22, 58 Small-pox 14, 28 Smoke Nuisances 23, 55 Sporadic Diseases 15 Staff of Public Health Department 4 Statistical Summary 5 Statistical Tables Appendix Suffocation 17 Suicide 18 Syphilis 15 Tenement Houses 59 Tubercular Diseases 15 Tuberculosis 15, 16, 33,37-42 Tuberculosis Dispensary—Return of Attendences 43 Tuberculosis—Interim Care Comm ittee 41-44 Tuberculosis Officer's Report 37-42 Typhoid Fever 15, 31 Underground Bakehouses 22 Underground Rooms 58 Unwholesome Food 56 Uninhabited Houses 5 Urinary System 17 Vaccination Particulars 27 Venereal Diseases 15 Verminous Premises 57, 58 Verminous Children 34 Vital Statistics 7 and Appendix Water Supply 23 Whooping Cough 14, 32 Working Centre 44 Workshops and Factories 19, 20 Workshops and Workplaces 20—22 Zymotic Enteritis 15, 32 Zymotic Diseases 14 Public Health Committee During the Year 1919-20. Alderman Sir Charles Stone, J.P. (Mayor), and 9 Members. F. Whatley, Esq., B.A., Chairman. T. F. Battle, Esq., Vice-Chairman. Alderman Mrs. S. A. Kelly. Councillors— T. F. Battle. F. W. Mander. F. W. Clifton. A. Smith. Mrs. N. Cunis. C. S. Willatt. W. J. Jackman. F. Whatley, B.A. 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 Horseflesh, etc., 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 Rats and Mice (Destruction) Act, 1919; the powers of the Council under the Orders of the Local Government Board or Ministry of Health dealing with Tuberculosis; 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. 2 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 re-drainage 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, 1919. 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. Rats and Mice (Destruction) Act, 1919. Rent and Mortgage Interest (Restrictions) Act, 1920. 3 Maternity & Child Welfare Committe During the Year 1919-20. Alderman Sir Charles Stone, J.P. (Mayor), and 12 Members. Mrs. S. A. Kelly, Chairman. Mrs. N. Cunis, Vice-Chairman. Alderman Mrs. S. A. Kelly. Councillors— T. F. Battle. W. J. Jackman. Mrs. N. Cunis. Miss M. Sherman. F. W. Clifton. C. S. Willatt. J. Hogg. Co-opted Members— Mrs. F. P. Cooper-Key. Mrs. M. Woodnutt. Mrs. M. Hamilton. Mrs. C. R. Turner. Powers and Duties of the Maternity and Child Welfare Committee. 1.—The Committee shall consist of 12 members, nine of whom shall be members of the Council, and three selected by the Council from outside that body. 2.—There shall be referred to the Committee all matters arising out of the powers and duties of the Council under the Maternity and Child Welfare Act, 1918, or any Act or Acts amending the same, or of any Orders or Regulations made under such Act or Acts, and the Committee shall make recommendations to the Council in relation to the matters aforesaid. 4 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. Albert E. Morgan. William R. Drake. Public Analyst— Disinfector— A. E. Brown, B.Sc., F.I.C. James Forrest. Assistant Disinfectors— Caretaker at Council's Shelter— Frank Mears. A. Clay. Mrs. Robinson. MUNICIPAL DISPENSARY FOR THE PREVENTION OF CONSUMPTION. Administrative Medical Officer— E. G. Annis, M.R.C.S., Etc., D.P.H. Tuberculosis Medical Officer— Dispenser— M. Macdonald, M.D., Etc. E. E. Burrows. Nurses— L. Heastman. T. I. Husbands. D. M. Wilkins. R. Aldis. Caretaker—Mrs. Vickery. MATERNITY AND CHILD WELFARE WORK. Administrative Medical Officer—E. G. Annis, M.R.C.S., Etc. Medical Officer—K. McNeill, M.B., Ch.B., D.P.H. Health Visitors— Miss M. Molloy. Miss E. Bailey. Mrs. M. D. Morison. Miss A. Hadfield. Miss M. Jagot. Miss J. B. N. Paterson. Miss B. M. Buckton. Matron, Municipal Creche—E. Chalk. Clerks— Miss L. Merricks. H. Duck. W. H. Collins. Mrs. L. E. Wright. A. G. Thomas. Medical Officer of Health— Ernest G. Annis, M.R.C.S., L.R.C.P., D.P.H. (Barrister-at-Law). Assistant Medical Officer of Health— M. Macdonald, M.D., Ch.B., D.P.H. 5 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, Deptford 112.1 „ Charlton and Kidbrooke 1990.4 „ 3851.7 acres. Density of Population— East Greenwich 34.64 persons per acre. West Greenwich 83.54 „ St. Nicholas, Deptford 70.50 „ Charlton and Kidbrooke 10.74 „ Average for the Borough 27.12 persons per acre. Number of Inhabited Houses— At Census, 1901 14,240 At Census, 1911 14,722 Estimated, 1920 16,096 Number of Uninhabited Houses— At Census, 1911 803 Estimated, 1920 206 Population— At Census, 1911 95.968 Estimated, 1920 104,453 Birth Rate, 1920 24.67 per 1,000 Death Rate, 1920 11.72 „ „ (Zymotic) .84 „ „ (Infantile Mortality) 75 per 1,000 Births. 6 Public Health and Housing Department Royal Hill, Greenwich. May, 1921. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greenwich. Ladies and Gentlemen, I have the honour to submit herewith the Annual Report of the Medical Officer of Health for the year 1920. The Birth Rate is 24.67 per 1,000 for Greenwich and 26.5 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 11.72 per 1,000 of the estimated population being less than the corresponding figure for last year, i.e., 1315 per 1,000, and just below the figure of 12.4 per 1,000, which is the Death Rate for the County of London, and 12.5 per 1,000, the figure for the ninety-six large towns. The Infantile Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered, is 75, a decrease from 95, the figure for last year; the figure for all London is 75, compared with 89 in 1919, and the Borough average during the last five years, 1915-19 inclusive, is 101. The Zymotic Death Rate of .84 per 1,000 is the same as it was last year. The figures relating to the different constituent parts of the Borough are as follows:— Districts. Birth Rate. Death Rate. Infantile Mortality per 1000 Births. Zymotic Death Rate. Diarrhoea Death Rate. Consumption Death Rate. East Greenwich 23.62 14.97 60 73 .11 77 West Greenwich 29.11 15.76 82 1.04 .12 2.01 St. Nicholae, Deptford 29.57 27.64 147 1.90 .11 1.77 Charlton 20.67 13.02 60 49 .05. .78 Kidbrooke 10.22 - - .32 - .32 Whole Borough 24.67 15.84 75 .84 .20 1.14 7 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 000 2.93 6.90 .53 .13 .01 West Greenwich 004 2.21 . 5. 08 . 40 . 14 .08 St. Nicholas, Deptford 000 1.14 3.30 . 63 .25 .12 Charlton 000 2.50 2.60 . 39 .14 .04 Kidbrooke 0.00 12.86 11.87 1.31 - - Whole Borough 0. 009 2.86 5.59 .51 .14 .04 In conclusion, I have to thank the Maternity and Child Welfare Committee, 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, Ladies and Gentlemen, Yours respectfully, E. G. ANNIS. * VITAL AND MORTAL STATISTICS, 1920. POPULATION. The number of persons estimated to be living at the middle of 1920 was 104,453. The distribution of the population throughout the Borough is as follows:— Census, 1911. Estimated Population at middle of year 1920. East Greenwich 45,963 50,282 West Greenwich 22,936 24,880 St. Nicholas, Deptford 7,291 7,904 Charlton 16,911 18,280 Kidbrooke 2,876 3,107 Total 95,977 104,453 MARRIAGES. The Superintendent-Registrar of the Greenwich Registration District has kindly furnished me with the particulars relating to 8 the number of marriages solemnised 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. 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. St. Nicholas Parish Church. Marriages in Superintendent- Registrar's Office of parties resident in Greenwich or outside the Registration District, and in Chapels and Roman Catholic Church in St. Nicholau Greenwich. Total. Approximate Population of the districts concerned. 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 1920 384 105 64 322 875 104453 BIRTHS. The total number of Births registered in the Borough during the year has been 2,648, but of these 164 occurred in the Greenwich and Deptford Hospital, the address of the mother being in 49 instances in Deptford, 61 in Lewisham, 13 in Woolwich and one in Wimbledon. Deducting these and adding 67 which were transferred from Lambeth, Stepney, St. Pancras, Deptford, Southwark, Poplar, Lewisham, City of London, Kent County Council, Erith, Cornwall County Council and Woolwich, it will be seen that the number of strictly Greenwich births for 1920 is 2,591, of which 1,340 were males and 1,251 females. This corrected figure gives a Birth Rate of 24.67 per 1,000 of the population, being 5.48 below the average for the last nineteen years, 1901 to 1919, the period since the formation of the Metropolitan Borough. 9 Amongst the total number of births registered in the Borough there were 109 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. Eighty-nine of such births were registered in the East Greenwich District, which includes 75 in the Greenwich and Deptford Hospital; of these 75, in 16 cases the mother was ordinarily a resident in the Borough of Deptford, 33 in Lewisham, seven in Woolwich, one in Brighton, one in Bermondsey and one in Wimbledon, and accordingly this number of births have been transferred to those Boroughs. The home address of the other 16 were: 10 in East Greenwich, five in West Greenwich, and one in Charlton. The remaining 34 were allocated to the district in this Borough in which the mother resided, making 14 of such births belonging to East Greenwich, 15 to West Greenwich, none to St. Nicholas, four to Charlton and one to Kidbrooke. The Birth Rate for the County of London equals 26.5 per 1,000 of the population. The Birth Rate for all England and Wales was 25.4. Under the provisions of the Notifications of Births Act, 1907, intimations have been received from medical men, parents, and others, with respect to 2,714 births. DEATHS. The total number of deaths registered during 1920 was 1,231, of which 679 were males and 552 females. The crude Death Rate for the Borough of 11.72 per 1,000 compares with 12.4, the Death Rate for the County of London, and 12.5, the Death Rate for the ninety-six large towns. The Death Rate in the various Metropolitan Boroughs varied from 9.0 in Hampstead, 10.0 in Wandsworth, 10.4 in Woolwich, 10.8 in Lewisham, 11.1 in Paddington, 11.2 in Hammersmith, up to 14.4 in Southwark, 14.5 in Finsbury, 14.6 in Poplar, 14.7 in Bethnal Green, 14.9 in Holborn and 14.9 in Shoreditch. Locally the Death Rate varied from 15.61 in St. Nicholas, 14.84 in West Greenwich, 10.39 in East Greenwich, 9.39 in Charlton to 8.90 in Kidbrooke. 10 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, 1915 to 1919, compared with the figures for 1920:— District. 1915. 1916. 1917. 1918. 1919. Average for 5 Years. East Greenwich 13.57 12.57 14.06 16.01 10.58 13.36 West Greenwich 19.62 19.93 19.55 26.03 18.56 20.74 St. Nicholas 26.52 22.44 26.07 24.45 12.84 22.46 Charlton 17.56 13.66 15.50 20.42 13.10 15.65 Kidbrooke 43.41 8.57 6.71 10.50 6.88 15.21 Borough 17.56 15.14 15.96 19.16 13.15 16.19 11 ANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON DURING THE YEAR 1920. (Specially compiled for The Lancet.) Cities and Boroughs. Estimated Civil Population, 1920. Notified Cases of Infectious Disease. Deaths from Principal Infectious Diseases. Deaths from all causes. Death-rate per 1,000 living. Small-pox. Scarlet fever Diphtheria. Typhus fever. Enteric fever. Other continued fevers. Puerperal fever. Erysipelas. Cerebro-spinal meningitis. Poliomyelitis. Total. Annual rate per 1,000 persons living. Small-pox. Measles. Scarlet fever. Diphtheria. Whoopingcough. Enteric fever. Diarrhoea and enteritis (under 2 years). Total Annual rate per 1,000 persons living LONDON 4,531,971 16 22,713 13,784 — 391 7 452 2590 156 42 40,151 8.9 4 1007 207 1009 759 49 1141 4176 0.9 56,038 12.4 West Districts : Paddington 149,673 — 503 465 — 19 — 16 80 1 2 1086 7.3 — 24 3 25 14 — 42 108 0 .7 1653 11.1 Kensington 164,177 — 642 348 — 26 1 10 71 5 1 1104 6 .7 — 22 5 22 23 1 70 143 0 .9 2135 13.0 Hammersmith 136,200 — 727 384 — 8 — 21 57 5 6 1208 8.7 — 16 6 35 12 1 23 93 0.7 1525 11.2 Fulham 158,621 — 932 626 — 25 — 32 104 5 2 1726 10.9 — 23 9 45 17 4 35 133 0.8 1790 11.3 Chelsea 62,987 — 185 143 — 7 1 8 26 1 — 371 5..9 — 9 2 8 — 1 10 30 0 .5 748 11.9 City of Westminster 132,615 — 391 237 — 16 1 10 68 2 — 725 5 .5 — 12 5 9 4 3 23 56 0. 4 1532 11.6 North Districts : St. Marylebone 101,856 — 435 122 — 31 — 6 67 2 2 665 6.5 — 8 9 7 13 — 23 60 0. 6 1267 12.5 Hampstead 91,519 1 265 164 — 23 — 1 39 2 2 497 5.4 — 8 4 5 6 2 5 30 0.3 822 9.0 St. Pancras 228,178 — 836 739 — 16 1 17 120 6 — 1735 7.6 — 62 11 30 62 1 44 210 0.9 2808 12.3 Islington 335,907 — 1306 1330 — 24 — 29 165 15 7 2876 8.6 — 93 12 134 72 1 73 385 1.1 4447 13.3 Stoke Newington 52,984 — 223 166 — 2 — 2 24 1 1 419 7 .9 — 5 4 20 10 — 13 52 1.0 676 12.8 Hackney 225,372 — 1093 774 — 14 — 23 124 7 — 2035 9.1 — 86 6 69 67 1 63 292 1.3 2827 12 .6 Central Districts : Holborn 39,676 — 122 147 — 6 — 1 22 1 3 302 7. 6 — 6 2 5 2 — 10 25 0. 6 588 14.9 Finsbury 78.291 — 432 226 — 6 — 5 113 4 3 789 10.1 — 11 4 27 12 — 16 70 0.9 1136 14. 5 City of London 14,447 — 37 33 — 1 — — 5 1 — 77 5 3 — 1 — 1 1 1 2 6 0.4 192 13.3 Fast Districts : Shoreditch 102.044 — 521 398 — 11 — 11 61 3 3 1008 9.9 — 48 6 27 12 1 64 158 16 1567 15. 4 Bethnal Green 114,471 — 1054 581 — 5 — 13 133 7 3 1796 15.7 — 62 12 35 56 2 49 216 19 1676 14. 7 Stepney 241,770 2 2455 684 — 14 — 23 155 14 1 3348 13.9 — 19 15 40 73 3 86 266 11 3465 14. 4 Poplar 159,766 11 1402 698 — 17 — 24 84 11 — 2247 14. 1 3 35 14 57 54 4 47 214 13 2319 14.6 South Districts : Southwark 187,142 — 893 457 — 8 — 17 178 8 — 1561 8.4 — 63 5 37 27 5 53 190 10 2685 14. 4 Bermondsey 129,189 — 1001 278 — 6 1 21 54 6 — 1367 10.6 1 56 7 26 37 1 35 163 13 1673 13. 0 Lambeth 293,572 — 1240 714 — 16 — 32 140 6 5 2153 7.4 — 79 16 77 35 1 77 280 1.0 3800 13.0 Battersea 165,664 — 694 563 — 13 — 31 90 9 1 1401 8.5 — 45 7 36 33 2 52 175 1.1 2040 12. 3 Wandsworth 346,990 — 1470 1089 — 23 1 35 176 15 — 2809 8.1 — 49 11 66 19 3 48 196 0.6 3455 10.0 Camberwell 284,712 — 1305 912 — 16 1 20 148 5 — 2407 8.5 — 59 15 63 37 5 80 259 0 .9 3275 11.5 Deptford 115,636 — 717 320 — 11 -— 18 83 — — 1149 100 — 20 2 21 15 2 44 104 0 .9 1386 12.0 Greenwich 102,408 1 585 301 — 15 — 5 53 2 — 962 94 — 26 3 13 20 2 15 79 0.8 1231 11.7 Lewisham 174,438 — 716 464 — 7 — 9 71 6 — 1273 73 — 9 8 45 12 1 21 96 0.6 1872 10.8 Woolwich 141,666 1 531 421 — 5 — 12 79 6 — 1055 7 5 — 21 4 24 14 1 18 82 0.6 1463 10.4 * Including Membranous Croup. 12 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. 1915 1,690 238 690 1916 1,426 197 544 1917 1,439 203 364 1918 1,718 210 651 1919 1,372 187 603 Average 1,529 207 570 1920 1,231 195 535 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. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Under 1 year of age 77 52 21 45 195 Between 1 and 2 years 22 10 3 4 39 Between 2 and 5 years 23 16 3 5 47 Between 5 and 15 years 15 18 8 6 47 Between 15 and 25 years 22 23 15 17 77 Between 25 and 45 years 48 46 42 38 174 Between 45 and 65 years 91 69 53 78 291 65 years and upwards 101 87 81 92 361 Total 399 321 226 285 1,231 INFANTILE MORTALITY. The Infantile Mortality, measured by the deaths of children under one year of age to the number of births registered, was 75 per 1,000 births, there having been a total of 195 such deaths during the year, as compared with 203, 210 and 187, the respective figures for the years 1917, 1918 and 1919. The number for the County of London was 75 per 1,000 births, the average for the past five years in Greenwichlias been 101 per 1,000 births. 13 For all London the rate was 75 in 1920, compared with 85 in 1919 and 107 in 1918. For England and Wales the rate was 80, compared with 93 in 1919, 97 in 1918 and 97 in 1917. Locally, the variations were from nil per 1,000 births in Kidbrooke, 60 in East Greenwich, 60 in Charlton, 82 in West Greenwich, to 147 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. Average for five years, 1916-20, inclusive. East Greenwich 129 106 96 81 West Greenwich 126 110 112 110 St Nicholas, Deptford 179 143 167 138 Charlton 121 109 76 89 Kidbrooke 39 79 16 39 Total 131 111 103 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. 1920. 1920. Infective Diseases— Epidemic 0.88 Sporadic — Venereal 0.03 Septic 0.14 Malarial 0.14 Tuberculosis 1.40 Parasitic Diseases 0.009 Constitutional Diseases 1.36 Developmental Diseases 1.82 Local Diseases— Nervous System 1.02 Organs of Special Sense 0. 01 Local Diseases—continued. Circulatory System 1.21 Respiratory System 2.11 Digestive System 0.58 Urinary System 0.37 Reproductive System 0.009 Parturition 0.01 Bones and Joints — Integumentary System 0. 009 External Causes— Accidents 0.44 Suicide 0.05 14 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic. There were 93 deaths due to this class of diseases, equalling a Death Rate of .88 per 1,000; the rate last year was 1.53, and was 1.71,1.54 and 4.86 in 1916, 1917 and 1918 respectively. Zymotic. The purely Zymotic class of epidemic diseases is credited with causing a total of 89 deaths, equalling a Death Rate of .84 per 1,000. Locally, the Zymotic Death Rate varied from .32 in Kidbrooke (.32 in 1919), .49 in Charlton (.65 in 1919), .73 in East Greenwich (.71 in 1919), 104 in West Greenwich (.92 in 1919), up to 1.90 in St. Nicholas (1.72 in 1919). Small-Pox. There were no deaths from this disease in 1920, this being the eighteenth year since a death occurred from this cause in the Borough. Measles. Twenty-six deaths were ascribed as due to this disease. 21 of the patients being under five years of age, 4 between five and fifteen years of age, and 1 between twenty-five and forty-five years of age, compared with 13 which occurred in 1919. 48, 45 and 45 deaths were recorded in the years 1916, 1917 and 1918 respectively. Ten of the deaths occurred in East Greenwich, 6 in West Greenwich, 7 in St. Nicholas, 2 in Charlton and 1 in Kidbrooke. The quarterly incidence was 18 in the first, and 7, 1 and 0 respectively in the succeeding quarters. Scarlet Fever. This disease occasioned 3 deaths, 2 of which were under five years. All the deaths occurred in East Greenwich. Seven such deaths occurred in 1919 and 1 in 1918. Diphtheria. There were 13 deaths from this disease during 1920. This gives a Death Rate for Diphtheria of .12, comparing with .14, the rate for 1919. Fifteen deaths occurred in 1919 which were attributed to this cause, and 22, 27 and 16 in 1916, 1917 and 1918 respectively. Eleven of the patients were under five years of age. Seventy-eight tubes of Diphtheria Anti-toxin, containing a total of 156,000 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 20 deaths, as against 8, 45 and 9 in the years 1917, 1918 and 1919. These deaths equal a rate of .19 per 1,000. Eleven of the deaths occurred in East Greenwich, 6 in West Greenwich, 0 in St. Nicholas, and 3 in Charlton. 15 Typhoid Fever. There were 2 deaths ascribed as due to this disease; there were 2 in 1919, 4 in 1918, 2 in 1917, 6 in 1916, and 7 in 1915. Both deaths occurred in East Greenwich. Diarrhæa and Zymotic Enteritis. Twenty-two deaths were stated to be due to this cause, equalling a rate of .20 per 1,000. Last year there were 28 deaths, and 42, 38 and 37 respectively in 1916, 1917 and 1918. The deaths were distributed as follows:—Six in East Greenwich, 7 in West Greenwich, 6 in St. Nicholas, and 3 in Charlton. Nineteen patients were under five years of age. The deaths in 1919 were distributed as follows:—Thirteen in East Greenwich, 6 in West Greenwich, 6 in St. Nicholas, 2 in Charlton and 1 in Kidbrooke. Influenza. Influenza is found to have been the responsible cause of 15 deaths in 1920; 134 was the average of the previous three years. Of the 15, 6 were over sixty-five years of age. Sporadic Diseases. There were no deaths from this class of diseases during the year. Venereal. Syphilis. Four deaths were given as due to Syphilis, as against 11 in 1919 and 6 in 1918. Of these 4 deaths, 1 was under five years of age, and all occurred in East Greenwich. One of the deceased persons was in the Greenwich Infirmary and 1 in an outside institution. There were no deaths from Gonorrhoea during the year. Septic Diseases. Erysipelas. Six deaths occurred from this cause in 1920, 2 in 1919, and 2 in 1918. Puerperal Fever. There was 1 death from this disease during the year. Pyæmia and Septicæmia. There were 5 deaths from this disease during the year, 2 deaths from other allied diseases, and 1 from Infective Endocarditis. Malarial. Rheumatic Fever. There were 12 deaths in 1920 as compared with 3 in 1919, 1 in 1918, and 3 in 1917. Rheumatism of the Heart. There were 3 deaths ascribed to this cause during 1920. Tuberculosis. This class includes the causes of 147 deaths during the year under review, with a rate of 1.40; these figures compare with 219, 174 and 174, the totals of the years 1917, 1918 and 1919 respectively, and respective rates of 2.42, 1.90 and 1.66. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 120 attributed to this cause, or a rate of 1.14 per 1,000. 16 Locally, the deaths were 1 in Kidbrooke (giving a Death Rate of .32), 14 in St. Nicholas (giving a Death Rate of 1.77), 16 in Charlton (giving a Death Rate of .78), 39 in East Greenwich (giving a Death Rate of .77), and 50 in West Greenwich (giving a Death Rate of 2 01 per 1,000). The remaining forms of Tuberculosis were responsible for 27 deaths, 16 being in East Greenwich, 7 in West Greenwich, 1 in St. Nicholas, 2 in Charlton and 1 in Kidbrooke. Of these other forms of Tuberculosis, Tuberculosis of the Brain or its membranes was credited with 12 (7 being under five years of age); Tubercle affecting the Intestines, 4 deaths (1 being under five years of age); General Tuberculosis, 11 deaths. Parasitic Diseases. There was one death from this class of disease. Dietetic Diseases. There were no deaths from this class of disease. Constitutional Diseases. The deaths from this cause were 143 in number, which gives a rate of 1.36 per 1,000. Of these, 120 were attributed to Cancer, 8 to Diabetes, 9 to Anaemia, 1 to Osteo-Arthritis, 2 to Lymphadenoma, 2 to Gout, and 1 to Hcemophilia. The deaths from Cancer were distributed as follows:— 55 occurred in East Greenwich, 27 in West Greenwich, 11 in St. Nicholas, 26 in Charlton and 1 in Kidbrooke. Developmental Diseases. There were 192 deaths from this class of causes, equal to a rate of 1.82 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz.:—Congenital defects, 11, and those from causes more or less preventable, viz.:—Premature birth 32; Injury at birth, 1; Debility at birth, 17; Atrophy, Debility and Marasmus, 13; Atelectasis, 4, and Dentition, 1. The remaining and largest, portion of these deaths from developmental diseases, 113 in number, were from Old Age; in 1919 there were 125 deaths from this cause, and 113 in the previous year. Local Diseases. Nervous System. One hundred and eight deaths were attributed to the various nervous diseases, which gives a rate of 1.02 per 1,000; last year the rate was 1.09 per 1,000. Convulsions were responsible for 12, 11 being under five years of age; 3 were from Meningitis, 63 from Apoplexy, 2 from Hemiplegia or Brain Paralysis, 9 from General Paralysis of the Insane, 2 from Cerebral Tumour, 5 from Epilepsy, 2 from Encephalitis, 1 from Encephalitis Lethargica, 4 from Paraplegia, and 5 from other diseases of this system. 17 Organs of Special Sense. There were 2 deaths from this class of causes, equal to a rate of .01 per 1,000. Circulatory System. The Death Rate from diseases of this system was 1.21 per 1,000, there being a total of 128 such deaths. Valvular diseases of the heart were responsible for 110, 2 from Aneurism, 2 from Embolism, 1 from Angina Pectoris and from the remaining diseases of this system, 13. Respiratory System. One hundred and twenty-two deaths were due to diseases of the respiratory organs, as compared with 237 in the preceding year. The Death Rate under this heading equals 116 per 1,000. Forty-eight were from Acute and 53 from Chronic Bronchitis, 111 from the various forms of Pneumonia, 46 being under five years of age, 2 from Emphysema, 5 from Pleurisy, and 3 from other diseases. Digestive System. There were 61 deaths from diseases of this system, equal to a rate of .58 per 1,000. Of this number, Enteritis was responsible for 10 (9 being under five years of age), 10 to Appendicitis, 8 to Obstruction, and 4 to other diseases of the Intestines, 4 to Cirrhosis, and 2 to other diseases of the Liver, 4 to Peritonitis, 12 to Ulcer of Stomach and Duodenum, 4 to other diseases of Stomach, and 3 to other diseases of the Digestive System. Lymphatic System. There was 1 death from diseases affecting this system during the year. Urinary System. Thirty-nine deaths, equal to a rate of .37 per 1,000, occurred from diseases affecting this system. Twentysix were from Bright's Disease, 6 from Acute Nephritis, 4 from diseases of the Bladder and Prostate, and 3 from ill-defined causes of the urinary system. Reproductive System. There was only 1 death due to disease of the Generative Organs, this being attributed to Disease of Ovaries. There were 2 deaths attributed to diseases of Parturition. Bones and Joints. There were no deaths from diseases of bones and joints. Integumentary System. There was 1 death from disease of Integumentary System. External Causes. There were 56 deaths given as due to causes grouped under this heading; 47 were the result of accident or negligence, and the remaining 9 were from Suicide. Three children died of Suffocation by being overlaid in bed during 1920 (compared with 4 from this cause last year); 6 cases were from Drowning, 3 from Burns and Scalds, while accidents 18 on railways, in vehicular traffic and in building operations, falls, etc., were responsible for 35 deaths. The Suicides were 3 by cut or stab, 2 from Drowning, 1 by Hanging and Strangulation, 1 from Asphyxia, 1 from Poison, and 1 by Shooting. Ill-Defined Causes. There was no death the cause of which was not ascertained in 1920. 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 1920 14 175 189 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 Clerks to the Greenwich and Woolwich Boards of Guardians on this subject, who have kindly supplied the following figures:— Greenwich. Woolwich. Total amount expended in outdoor relief £6,423 14s. 3d. £1,133 13s. 6d. Total number of persons treated in Infirmary 2.684 66 Total number of persons treated medically in their own homes 1,399 84 Total number of persons admitted to the Workhouse 335 18 19 HOSPITAL AND OTHER FORMS OF GRATUITOUS MEDICAL RELIEF. The Seamen's Hospital have admitted, treated and maintained 270 Greenwich persons for an average of twenty-four days each, in addition to which there have been 2,102 Out-patients, who attended on an average about three times each patient, making altogether 6,306 attendances of persons belonging to the Borough of Greenwich. Miller General Hospital treated 341 Greenwich residents as In-patients, and about 37,200 Out-patient attendances were also made by Greenwich residents. Blackheath and Charlton Cottage Hospital admitted 184 In-patients from Greenwich, and treated about 156 casualties, making about 1,000 attendances for this purpose. SANITARY WORK. The tables on pages 20 to 25 and 53 to 59 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 20,698 houses and premises have been inspected or re-inspected during the year; 1,980 intimation notices have been served and 642 statutory notices. It was found necessary to institute Police Court proceedings in ten cases during the year. There were altogether throughout the year 5,317 complaints entered in the Public Complaints Register of the Department, but this includes 4,228 complaints referred by the Borough Engineer as to the provision of dust-bins. Bakehouses. Ninety-four inspections have been made of the various Bakehouses in the Borough, and 39 nuisances found therein have been abated as the result Factories, Workshops and Workplaces. Two hundred and eighty-two inspections have been paid to these premises within the Borough during the year. There were 202 workshop premises on the Register at the beginning of the year, 8 have been added during the year, and 8 have been taken off, leaving a total now on the Register of 202. This total includes 14 laundries, 26 dressmaking and mantle works, 7 fuel and firewood works, 3 cycle works, 8 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 the insanitary and ill-lighted condition of a workshop. Outworkers' Register.—Fourteen lists, containing 99 names, have been received from employers within the District. Forty-nine visits of inspection have been paid to these premises. 20 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 38 6 .. Workshops (Including Workshop Laundries) 78 3 .. Workplaces (Other than Outworkers' Premises) 166 10 .. Total 282 19 .. 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecut's. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:— Want of Cleanliness 34 34 .. .. Want of Ventilation 3 3 .. .. Overcrowding .. .. .. .. Want of Drainage of Floors 2 2 .. .. Other Nuisances 20 20 .. .. Sanitary Accommodation—- Insufficient 3 3 .. .. Unsuitable or defective 32 32 .. .. Not Senarate for Sexes 6 6 .. .. Offences under the Factory and Workshop Act:— Illegal Occupation of Underground Bakehouse (s. 101) .. .. .. .. Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) .. .. .. Other Offences 1 1 .. .. Total 101 101 1 .. * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 21 3 —HOME WORK. Nature of Work. Outworkers' Lists, Section 107. Outwork in unwholesome premises. Sec. 108. Outwork in infected premises. Sees. 109 & 110. Lists received from Employers. Notices served on occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 10). Prosecutions (Sees. 109 & 110). Twice in the year. Once in the year. Failing to keep or permit inspection of lists Failing to send lists. Lists. Outworkers. Lifts. Outworkers. Contractors. Workmen. Contractors. Workmen. Wearing Apparel (1) Making, &c 12 12 40 1 .. 3 .. .. .. .. .. .. .. .. .. (2) Cleaning & Washing. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, Lace Curtains & Net. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur Pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cotton and Kit Bigs .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brush Making .. .. .. 1 .. 44 .. .. .. .. .. .. .. .. .. Box Making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rackets and Tennis Balls. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 12 12 40 2 .. 47 .. .. .. .. .. .. .. .. .. 22 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1920. No. Bakehouses 45 Factory Bakehouses 3 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 26 Fuel Works 7 Laundries 14 Milliners 8 Photographers 3 Picture Frame Makers 1 Printers 1 Tailors 6 Underclothing Makers 1 Others 48 — 202 5.—OTHER MATTERS. Class. Number Matters notified to H.M. Inspectors of Faotories :— 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 3 Reports (of action taken) sent to H.M. Inspectors 3 Other — Underground Bakehouses (s. 101) :— In use at the end of 1920 13 Slaughter-Houses. The slaughter-houses in the Borough have been inspected on 32 occasions by the Inspectors. Scavenging and Refuse Removal.—Serious complaints continue to be received respecting the tipping of house refuse on the low-lying marshes and waste land in the Borough. Steps have been taken to obviate, as far as possible, the deposit of offensive material, but even so the nuisance occasioned from flies breeding in this refuse and migrating to surrounding properties is very great. Eight hundred and six new ash receptacles have been provided, and 17 complaints with reference to removal have been forwarded to the Borough Engineer for his attention. Horse Slaughterer. The one horse-slaughtering premises in this Borough has been visited on nine occasions, and cleansing of the premises required on four of the visits. 23 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 recommenced. Smoke Nuisances. Twenty-five observations have been made for smoke nuisances during the year, it being necessary to serve Statutory Notices on three occasions, resulting in Police Court proceedings being instituted in two instances. House Drainage. Twenty-two drains have been constructed, 178 drainage systems have been reconstructed or repaired; 335 such systems have also been opened, cleansed and amended; 62 surface drains have been constructed; 105 drains and soil pipes have been ventilated, 205 systems have been tested by smoke, 394 by water, of which number 220 were found to be defective; 50 new soil pipes and 276 traps have been fixed, together with 49 intercepting chambers and fresh-air inlets, and 46 other chambers; 25 forecourts, 27 areas, 78 yards, 3 mews and stables, 8 washhouses drained; 5 cesspools abolished; 60 water-closets have been erected; a pan, trap and water supply have been furnished throughout in 84 cases; pan and traps only furnished in 174 cases; pans only in 28 cases, and other fittings provided or improved in 457 cases, whilst the water supply has been renewed in 190 instances. The water supply for lavatory purposes has been disconnected from the drinking-water system in 3 instances. Public-house urinals have been cleansed and repaired in 22 instances; 24 urinals were altered, 45 repaired or water laid on, and 1 constructed. Water Supply. During the year 2 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. Defective water fittings have been remedied in 130 cases; 27 water supplies have been reinstated where the supply had been cut off; water fittings have been amended in 200 cases; 29 water supplies have been altered so as to draw direct from the main; water supply provided in 8 instances, and cleansing, repairing and covering cisterns in 9 cases. FOOD. Cowhouses. The four cowhouses in the Borough have been visited on 6 occasions, and the required cleansing has been duly enforced on 5 occasions. Dairies, Cowsheds and Milkshops Order. At the commencement of the year there were 120 premises on the Register of Dairies and Milkshops; 8 new applications have been received during the year and added to the Register, and 38 names have been taken off, thus leaving a total of 90 premises now registered. During the year 112 visits of inspection have been paid to these premises; notices were served upon the occupiers in 7 cases, 6 of which were for dairies requiring limewashing and 2 for sanitary defect. 24 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, one registration was refused on the ground of unsuitability of the premises, which, however, were subsequently rendered suitable and the registration effected. 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 63 taken off, leaving a total of 54 premises. These premises were inspected on 62 occasions, and improvement required by way of cleansing of the premises in 11 cases. Food Preparation. Places where food is prepared have been visited on 162 occasions, improvements being required in 35 instances as detailed below :— Class of Premises. Number of Lists. Number of Inspections Number of instances where matters needed attention. At end of 1919. Added 1920. R moved 1920. At end of 1920. Hotel Kitchens 4 1 .. 5 5 .. Eating Houses 48 15 11 52 55 13 Fried-Fish Shops 22 9 5 26 46 11 Pork Butchers 13 1 .. 14 21 2 Mineral Water Manufacturers 1 .. .. 1 2 .. Ice do. 2 .. .. 2 3 .. Sausage do. 12 7 2 17 21 5 Others 8 .. .. 8 9 — Totals 110 33 18 125 162 35 The 35 instances where matters needed attention included cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 3 where the sanitary arrangements were defective, 1 which required reconstruction, 7 for want of ashpit, and 1 where the premises were not constructed in accordance with the L.C.C. By-Laws. Customs and Inland Revenue Acts.—No applications were received during the year for certificates under these Acts. Milk and Cream Regulations.—During the year no special samples were taken under these Regulations, but by arrangement 25 with the Public Analyst, all samples of milk analysed by him were reported upon as to the presence or absence of preservatives, which are in every sample taken. No samples of Cream were taken, either preservative or otherwise, for this article is not used very largely within the Borough. Milk, Mothers and Children Orders.—During the year 55,384 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-four 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 411 were certified to be genuine and 13 adulterated, the adulterations thus being equivalent to 3.06 per cent. of the samples taken. Of the total number of samples purchased, 91 were milk, of which 5 were certified to be adulterated; the remaining adulterated samples were 7 of vinegar, and 1 of dripping. Proceedings were taken in 6 cases, resulting in fines and costs being imposed in 5 instances. A warning letter was sent in 7 cases. Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1920. Description of Samples. Number of Samples Purchased. Number Genuine. Number Adulterated Remarks as to Action taken. Baking Powder 29 29 .. — Butter 7 7 .. — Cocoa 2 2 .. — Coffee 2 2 .. — Dripping 80 79 1 Police Court proceedings. Milk 91 86 5 Five warning letters sent. Self-Raising Flour 21 21 .. — Vinegar 119 112 7 Police Court proceedings in 5 cases; 2 warning letters sent. Total 424 411 13 26 Sale of Food and Drugs Acts, 1920.—Legal Proceedings, Particulars of Samples adulterated and result of action taken. Description of Sample Nature of Adulteration. Result of Proceedings. Dripping Admixed with 30 per cent. of cotton seed oil Dismissed; costs granted (30s.). Milk Admixed with 4 per cent. of water Warning letter. ,, Admixed with 2.5 per cent. of water Warning letter. „ Slightly deficient in solids not fat Warning letter. „ Admixed with 1.5 per cent. of water Warning letter. „ Deficient in fat to extent of 4 per cent. Warning letter. Vinegar Deficient in acetic acid to the extent of 5 per cent. Warning letter. „ Deficient in acetic acid to the extent of 10 per cent. Fine 10s., Costs 27s. 6d. „ Deficient in acetic acid to the extent of 36 per cent. Fine 10s., Costs 33s. 6d. „ Deficient in acetic acid to the extent of 18 per cent. Fine 10s., Costs 30s. „ Deficient in acetic acid to the extent of 9 per cent. Fine 10s., Costs 30s. „ Deficient in acetic acid to the extent of 4 per cent. Warning letter. „ Deficient in acetic acid to the extent of 61 per cent. Summons withdrawn owing to technical informality. Supplemental Vaccination Return for 1919. Return made on or before the 9th of February, 1921, 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, 1919, inclusive:— Registration Sub-Districts comprised in the Vaccination Officer's District. No. of Birthsfron. 1st Jan. to 31st Dec., 1919. Number of these Births duly entered by 31st Jan., 1920. No. of Birtns winch on 31st Jan., 1920, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31st Jan., 1921, 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 549 279 — — 177 30 — 6 12 45 North Deptford 1069 551 6 — 275 53 — 11 26 147 East Deptford 927 442 5 — 151 79 1 6 76 167 East Greenwich 898 455 1 — 260 62 — 35 34 51 West Greenwich 481 252 2 — 141 39 — — 14 33 Total 3924 1979 14 - 1004 263 1 58 162 443 27 Dated February 4th, 1921. No. of Births entered in "Birth List Sheets" as registered from 1st January to 31st December, 1919 344 Successfully Vaccinated 228 Insusceptible of Vaccination 1 Had Small-Pox — CHARLTON AND KIDBROOKE. Statutory Declarations of Conscientious Objection 84 Dead Unvaccinated 22 Postponed by Medical Certificate 1 Removed to Districts the Vaccination Officer of which has been duly apprised 4 A. E. Rossiter, Vaccination Officer. Removed to places unknown, or which cannot be found; and cases not traced 3 Not accounted for 1 G. E. Oughton. 28 Notifications under the Provisions of the Public Health (London) Act, 1891. During the year 2,116 cases have been notified under the above Act, as compared with 1,400, 2,613 and 2,820 respectively in the preceding years 1917, 1918 and 1919. Small-Pox. Four cases of this disease occurred in the Borough during the year. In one case, the patient, a seaman, seeking admission to the Seamen's Hospital, was diagnosed to be suffering from Small-Pox and immediately dealt with, the Authorities of the district whence he came being informed. One other case occurred in an in-patient in this Hospital, the source of infection being untraced. His complaint was not diagnosed until a patient in an adjoining bed was found to be suffering from some obscure condition, which necessitated for its elucidation his being examined by the various specialists of the Hospital, i.e., blood, ophthalmic and skin, etc., it being decided that he was suffering from some unknown specific poison. The Officers of this Council, as also of the London County Council, were called in and it was immediately recognised that the patient was suffering from Haemorrhagic SmallPox, from which he succumbed shortly after. As he had been an in-patient for some time, it became evident that his infection had been contracted in the Hospital, and on inquiry and examination the patient in the next bed was found to be an unrecognised case of the miliary type. All necessary measures by means of disinfection, isolation of the wards, vaccination of the whole staff and other known contacts were immediately carried out, and it speaks well for the efficiency of such measures when it is realised that only one further case developed from this virulent centre of infection, such case being in the person of the Ward Attendant, whose duty it had been to evacuate and cleanse what were thought to be Acne pustules on the original and infected patient. The effect of the vaccination on this Ward Attendant was so satisfactory, however, that he only suffered a very modified attack of the disease. Details respecting vaccination in the Borough are given in the Supplemental Vaccination Reports on page 27. Diphtheria. Three hundred and one cases of Diphtheria were notified during the year, as compared with 364, 322, 240 and 275, respectively, in the years 1916, 1917, 1918 and 1919. This distribution of these cases was as follows :—147 in East Greenwich, 55 in West Greenwich, 9 in St. Nicholas, 51 in Charlton and 39 in Kidbrooke. Of this total number 275, were removed to the Hospital for treatment, amongst which number the Hospital Authorities reported that in 2 cases they considered the diagnosis incorrect. 29 There were 13 fatalities due to this disease, which gives a case mortality of 4.3 per cent. One thousand seven hundred and eleven specimens were forwarded by medical practitioners for bacteriological investigation from cases suspected to be Diphtheria. Of this number 1,603 were reported to give negative or doubtful results, and 108 were positive in character, being dealt with accordingly. The quarterly incidence of the disease for 1919 has been as follows :— Ist Quarter—East Greenwich, 45 cases; West Greenwich, 17; St. Nicholas, 1; Charlton, 15; Kidbrooke, 10; a total of 88 cases. 2nd Quarter—East Greenwich, 21 cases; West Greenwich, 14; St. Nicholas, 3; Charlton, 8; Kidbrooke, 8; a total of 54 cases. 3rd Quarter—East Greenwich, 17 cases; West Greenwich, 12; St. Nicholas, 2; Charlton, 10; Kidbrooke, 5; a total of 46 cases. 4th Quarter—East Greenwich, 64 cases; West Greenwich, 12; St. Nicholas, 3; Charlton, 18; Kidbrooke, 16; a total of 113 cases. Membranous Croup. No cases of Membranous Croup were notified during the year. Erysipelas. Fifty-four cases were notified during the year, 27 being in East Greenwich, 10 in West Greenwich, 5 in St. Nicholas, 8 in Charlton and 4 in Kidbrooke. Sixteen of these patients were removed to a Public Institution in the district. • Scarlet Fever. Five hundred and eighty-seven cases were notified during the year, as compared with 155, 167 and 481 cases respectively in the years 1917, 1918 and 1919; 346 cases were in East Greenwich, 126 in West Greenwich, 26 in St. Nicholas, 53 in Charlton and 36 in Kidbrooke ; 538 of these cases were removed to the Hospital for treatment. There were three deaths from this disease during the year as against 7 last year. Eleven 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 6 such cases in 1919, 2 in 1918, 0 in 1917 and 6 in 1916. 30 Table showing Return Cases of Scarlet Fever during Year 1920. 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 27th Oct., 1919 29th Oct., 1919 8th Dec., 1919 6th Jan., 1920 28 days Apparently well. 2 20t.h Mar., 1920 • 21st Mar., 1920 7th May, 1920 14th May, 1920 4 „ Very unwell on discharge. 3 5th July, 1920 5th July, 1920 1st Sept., 1920 7th Sept., 1920 4 „ Abscess on neck. 4 26th June, 1920 26 th June, 1920 1st Sept., 1920 14th Sept., 1920 12 „ Slight vaginal discharge, otherwise well 5 16th Sept., 1920 17th Sept., 1920 3rd Dec., 1920 10th Dec., 1920 7 ,, Feet desquamating. 6 27th Oct., 1920 28th Oct., 1920 8th Dec., 1920 13th Dec., 1920 4 „ Apparently well. 31 Typhoid Fever. There were 15 cases of Typhoid Fever notified during the year, 7 being in East Greenwich, 3 in West Greenwich, 2 in St. Nicholas and 3 in Charlton. The ages of the patients were: 4 between five and fifteen years, 3 between fifteen and twenty-five years, 5 between twenty-five and forty-five years, 1 between forty-five and sixty-five years and 2, 65 years and over. Of the total number of cases 11 were removed to the Hospital for treatment. Twenty such cases occurred in 1919, 12 in 1918, 13 in 1917 and 14 in 1916, the average number for the previous 10 years being 14. There were two fatalities from this disease during the year, both being in West Greenwich. No cases of Enteric Fever were traceable to shell-fish. Seven specimens were forwarded for bacteriological examination from cases suspected to be Typhoid Fever in character, 1 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, 1 in St. Nicholas and 1 in Charlton. There were 5 cases in 1919, 1 in 1918, 3 in 1917 and 14 in 1916. There were 5 deaths from this disease during the year. Measles. The Order for the treatment and notification of Measles and German Measles made by the Local Government Board in 1915 having lapsed at the end of the year 1919, no cases of Measles were notified during the first 6 months of the year. During this period large numbers of cases of Measles occurred resulting in 25 deaths, and from a consideration of this fact this Council decided to reintroduce notification, with its attendant means of education of the public to the seriousness of the condition, and accordingly on the 1st July the notification of Measles and German Measles in this Borough was revived and made permanently compulsorily notifiable by Order of this Council under the following conditions :— Metropolitan Borough of Greenwich (Measles and German Measles) Regulations, 1920. Article 5. Subject to the provisions of these Regulations, every Medical Practitioner, as soon as he becomes aware that a person who is resident within the Borough and upon whom he is in professional attendance is suffering from Measles or German Measles, shall forthwith make and sign a notification of the case in the Form set forth in Schedule A to the Public Health (Notification of Infectious Diseases) Regulations, 1918, and shall transmit the notifications to the Medical Officer of Health : 32 Provided that a Medical Practitioner shall not be required to notify a case of Measles or German Measles under this Article, and shall not be paid a fee for so doing— (a) if he has reasonable grounds for supposing that the case has already been notified under these Regulations ; (b) if a case of the disease which he is attending, whether Measles or German Measles, has to his knowledge occurred in the same household or institution, and been notified within the period of two months immediately preceding the date on which he first becomes aware of the disease in the case he is attending; or (c) if the case is being treated in a hospital for infectious dis- eases. From 1st July to the end of the year, only 36 cases of the Disease were notified, giving rise to one death only. Zymotic Enteritis or Summer Diarrhcea. One hundred and forty-one cases of Diarrhcea were notified throughout the whole of the Borough, 77 being under one year of age; 64 between one and five. Fifty of such notifications related to patients in East Greenwich, 55 in West Greenwich, 17 in St. Nicholas and 19 in Charlton. There were 22 deaths ascribed to this disease, comparing with 28 in the previous year. Whooping Cough. Three hundred and sixty-five cases were notified (compared with 141 in 1919), 73 being under one year of age, 170 from one to five, 118 from five to fifteen and 4 from 25 to 45, the districts concerned being East Greenwich, 237; West Greenwich, 91; St. Nicholas, 3, and Charlton, 34. 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, Cerebro-Spinal Fever, or Post-Basal Meningitis. There were 2 cases of these diseases notified during the year, 1 in East Greenwich and 1 in Charlton. 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. No cases were notified during 1920. There was 1 case in 1919, 2 in 1918 and 0 in 1917. Ophthalmia Neonatorum. During the year 28 cases of this disease have been notified, 11 being in East Greenwich, 8 in West Greenwich, 1 in St. Nicholas and 8 in Charlton. Contacts. Twenty-four intimations were received from the Medical Officers of Health of the various Port Sanitary Authorities 33 respecting persons who had been in contact with Small-Pox, 3 with Plague, and 1 with Malaria, which were kept under observation. Malaria. There were 20 cases of Malaria notified during the yean, 7 in East Greenwich, 8 in West Greenwich, 4 in St. Nicholas and 1 in Charlton. 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 1,711 specimens have been examined for Diphtheria, 7 for Typhoid Fever, 364 for Tuberculosis, and 17 for other various. Fuller details respecting results of the examinations of these specimens will be found under the different headings of the individual diseases. Glanders. One case of Glanders occurred in some Stables within the Borough, the premises being visited and workers kept under observation. 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 435 cases of Tuberculosis notified in the Borough, 264 being pulmonary cases, ordinarily known as Consumption, and 171 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 125 pulmonary and 72 non-pulmonary occurred in East Greenwich, 71 pulmonary and 41 non-pulmonary in West Greenwich, 24 pulmonary and 25 non-pulmonary in St. Nicholas, 41 pulmonary and 33 non-pulmonary in Charlton, and 3 pulmonary and 0 non-pulmonary in Kidbrooke. The various ages of the patients were as follows:— Pulmonary cases, under one, 1; from one to five, 3 cases; five to fifteen, 41 cases; fifteen to twentyfive, 64 cases; twenty-five to forty-five, 96 cases; forty-five to sixty-five, 51 cases; and 8 cases over sixty-five; whilst the NonPulmonary were: under one year of age, 4 cases; one to five, 29 cases; five to fifteen, 116 cases; fifteen to twenty-five, 11 cases; twenty-five to forty-five, 7 cases; forty-five to sixty-five, 3 cases, and 1 case over sixty-five. Three hundred and sixty-four specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive; 272 were reported to be negative and 92 positive. Disinfection has been offered and carried out in 95 cases, including 105 rooms and 288 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. 34 HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made (not including Tuberculosis) 1,681 Number of Re-visits 4,022 Of the total number of notifications received during the year, the Health Visitors have visited 602 cases and re-visited 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, 75; School Libraries, 0; Total, 75. CLEANSING STATION, BLACKWALL LANE. In connection with the cleansing of verminous school children arrangements have now been made with the London County Council for reserving the use of the Council's Cleansing Station for an additional session per week, the days now reserved being Mondays, Wednesdays and Thursdays. The number of children cleansed during the year was as under : 1st Quarter 446 2nd „ 396 3rd „ 245 4th ,, 421 1,508 35 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 52 weeks ending 1st January, 1921. 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 .. .. 3 .. 6 13 9 .. .. 9 40 Scarlet Fever 1 .. .. .. .. .. .. .. .. .. 1 Diphtheria .. .. 1 .. 1 .. .. .. .. .. 2 Enteric Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. Tuberculosis .. .. .. .. .. .. .. .. .. .. .. Other Diseases 3 1 1 1 4 .. .. .. .. 14 24 For Verminous Premises .. .. .. .. .. .. .. .. .. .. .. Total 4 1 5 1 11 13 9 .. .. 23 67 36 Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 52 weeks ending 1st January, 1921. 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 Small-pox 1 10 .. .. 14 .. 34 48 150 .. 22 1701 1969 Scarlet Fever 523 580 340 4 166 281 803 760 34 69 279 200 2936 Diphtheria 263 290 45 2 47 44 125 152 23 9 39 51 537 Enteric Fever 12 15 11 .. 7 9 26 26 9 .. 7 13 108 Puerperal Fever 3 3 3 .. 2 2 4 4 .. .. 2 .. 17 Tuberculosis 95 105 47 .. 18 33 97 47 9 11 18 8 288 Other Diseases 33 55 20 2 42 33 83 69 5 11 10 71 366 Measles 14 25 .. .. 21 .. 2 1 .. .. 20 .. 44 From Verminous Premises 5 .. 14 3 10 10 18 10 10 8 10 97 190 Scabies .. .. 5 .. 1 1 8 2 .. .. .. .. 17 Influenza and Pneumonia 14 20 3 .. 6 5 19 14 2 .. 5 5 59 Cerebro-Spinal Meningitis 1 1 .. .. .. .. .. .. .. .. .. .. .. Total 964 1104 488 11 334 418 1219 1133 242 108 412 2146 6531 37 REPORT OF THE TUBERCULOSIS OFFICER. To the Medical Officer of Health. Sir, In presenting the Eight Annual Report of the Dispensary, it is not possible, owing to the several changes in the Medical Staff, to give a satisfactory survey of the work carried out during 1920, especially with regard to treatment. Shortly after taking up duty, I commenced an inquiry as to the condition of the Borough in respect to Tuberculosis, with a view to obtaining information which might be of use in our efforts to combat the disease. This inquiry was not completed at the close of the year, but it was estimated that at that date there were some 1,336 people residing in the Borough who were suffering from Tuberculosis. Of this number 798 were suffering from Pulmonary Tuberculosis, i.e., Consumption of the Lungs, and 538, chiefly children, from other forms of Tuberculosis, such as Tuberculosis of the Glands and Bones. In arriving at this number every case notified on the books of the Public Health Department as suffering from Tuberculosis since 1912 (the date when notification came into force) was visited by the Dispensary Staff. I append a table showing the notifications and deaths from Pulmonary Tuberculosis with the incidence and death rates for each year. PULMONARY TUBERCULOSIS. Year. Notifications. Incidence per 1,000. Deaths. Death Rate per 1,000. 1912 394 4.1 172 1.80 1913 281 2.9 112 1.15 1914 308 3.2 129 1.35 1915 432 4.4 154 1.60 1916 223 2.1 132 1.40 1917 268 2.6 182 2.01 1918 267 2.6 146 1.62 1919 300 2.9 141 1.35 1920 264 2.5 120 1.14 From the table it will be noted that out of 2,737 cases notified in these nine years, 1,288 (or 47 per cent.) had died by the close of 1920. Further, it was ascertained that of 798 cases still living and residing in the Borough only 447 were fit for work varying from heavy to light, the remaining 351 being unfit for work of any kind. The inquiry also dealt with the hygiene and sanitation of the patients' homes, particular regard being directed to the sleeping arrangements of the patients. Thus it was found that in the case of 543 patients— 382 were sharing a bed. 98 had a separate bed, but no separate room. 63 had a separate bed and a separate room. 38 The inquiry not being yet complete, it is not at present intended to make much comment on the information above given, but sufficient data has been collected to show that if any progress is to be made towards stamping out Tuberculosis in the Borough much anxious consideration must be given to several points, of which the chief are— (а) Provision of accommodation for advanced cases. (b) The home condition of the patients, including the tion of contacts. (c) The earlier notification of the disease. (d) The development of After-Care. With regard to the first point, little exists at present, except the workhouse. It is hopeless to look for much improvement when advanced cases are allowed to come into such intimate contact with young children as they do in the average household. Doctors and nurses may be ever so conscientious in their visits to the homes and their directions as to the prevention of infection, but with the habits and conditions prevailing in the ordinary working-class home it is very unlikely that this is ever fully carried out, and even when it is, the advanced consumptive is an ever-present danger. Proof of this will be found below, where 16 per cent, of the contacts examined this year were found to be tuberculous. Even in the earliest times this danger was recognised. For example, Galen wrote, "It is dangerous to live with consumptives, and with those whose foul breath imparts a heavy odour to the room in which they lie." As to the home conditions, little can be said in view of the existing shortage of houses, but it is hoped that the present method of sub-letting will be considerably altered, and that no person will be allowed to sub-let without a licence. Too frequently, subletting leads to gross overcrowding and to the spread of infection. No licence should be granted to any known consumptive household. In connection with the third point, that of earlier notification' it is to be regretted that many notifications are received too late to be of much use. Early notification is essential in the interest of the patient, as it gives him a better chance of recovery by receiving earlier appropriate treatment. It is also essential in the interest of the public, because it must be remembered that notification is the only means whereby the Public Health Department obtains information as to the existence of infection. Early notification means, therefore, early action in preventing the spread of infection by means of the disinfection of the home, the examination of contacts, etc. To illustrate this point I have analysed the death-notification interval of 120 patients who died in the Borough in 1920 from Pulmonary Tuberculosis. The result should give rise to some thought. 39 Died before notification received 33 Died within one week of notification 4 „ ,, one week to one month of notification 7 ,, ,, one month to three months of notification 11 „ ,, three months to six months of notification 9 ,, ,, six months to twelve months of notification 14 ,, ,, one year to two years of notification 21 ,, ,, two years to three years of notification 9 ,, ,, three years to four years of notification 8 ,, ,, four or more years after notification 4 The fourth point for consideration is the development of aftercare and is perhaps the most important point of all. Any scheme for the prevention of consumption which has not an efficient and vigorous after-care policy is fore-doomed to failure. Yet there is no part of the Tuberculosis Campaign which is more neglected by Local Authorities, many of whom are apparently of opinion that having provided dispensary and sanatorium treatment, they have done all that is necessary, when, in point of fact, their true function is only beginning. The patient is deprived of all help just when he is most requiring assistance. A patient on discharge from sanatorium is, as a rule, much improved in health, but he is by no means cured. His earning capacity is much diminished; in other words, he is not fit for a full day's work. He requires assistance financially to subsidise his wage, and socially to provide him with suitable employment and proper housing. With such assistance, in all probability he would be restored to normal working capacity and become again a useful citizen. An efficient and properly-constituted Care Committee, with funds at its disposal, would in many instances be able to produce such results. As it is, little can be done for lack of financial aid; the patient returns too often to unsuitable conditions, breaks down again, and becomes a burden and a danger to himself, his family, and his neighbours. To put it plainly, the money spent on him is to a large extent wasted, and under present arrangements will continue to be wasted. Dealing now with the work of the Dispensary itself, 919 new patients were examined during the year. The sources from which these patients came were as follows :— Male. Female. Children. Total. Private Practitioners 66 57 51 174 School Medical Officers — — 55 55 London Insurance Committee 39 1 — 40 Own Application 9 32 59 100 Nurses 43 112 367 522 Other sources 3 4 21 28 160 206 553 919 40 Attention is directed to the fact that of the total number (919) no fewer than 522 were sent by the Tuberculosis nurses as a result of their visits to the homes of notified cases. These 522 cases were all "contacts," and that such a large number were induced to submit to examination is a high testimony to the patience and tact of the nurses concerned. Of these contacts, 86, or 16 per cent., were found on examination at the Dispensary to be suffering from Tuberculosis. The importance attached to the examination of contacts cannot be over-estimated. It is one of the chief functions of the Dispensary and an important point of attack in the prevention of infection. I append a Statistical Table in the form designed by the Ministry of Health for the Metropolitan Boroughs to show the work carried out in connection with the various Dispensaries. The Table explains itself, but it may be remarked here that of the 94 patients diagnosed as suffering from Pulmonary Tuberculosis, many were already in the second stage of the disease at the time of examination, too late to look for much improvement. During the year, 82 patients were referred to Sanatorium, 9 to Hospital, and 4 to the Infirmary. Of the 82 Sanatorium patients, 9 were admitted for their second time, and 1 for the third time. The average duration of residence was 8 weeks, but it is unfortunate to note that 25 patients discharged themselves, and against medical advice. On the other hand, 5 patients, chiefly ex-Service men, were discharged for disciplinary reasons. As to the results of Sanatorium treatment, nearly all the patients were discharged with general health greatly improved, while as to working capacity, 38 were reported "fit" for work, the remainder unfit. Treatment at the Dispensary, especially during the early part of the year, was mainly symptomatic, no special treatment being possible owing to the changes incident to Dr. Dart's resignation. During the year 208 specimens of sputum sent from the Dispensary were examined at the Bacteriological Laboratory of the Seamen's Hospital, with the following results: Positive 57, negative 151. Dental Treatment. By arrangement between the Borough Council and the British Dentists' Hospital, a dentist attends the Dispensary once a fortnight for examination of such patients as are referred to him by the Tuberculosis Officer. Details of the work carried out in 1920 are as follows :— Number of patients referred to Dentist 62 Number of attendances made by patients 165 Number of Extractions 38 Number of Fillings 11 Number of Dentures supplied 15 41 Gas was administered by the Tuberculosis Officer on 13 occasions, the number of patients being 21. Dentures are supplied free to necessitous patients, whilst others contribute according to their means, the amount of such contributions being determined by the Public Health Committee. Of 15 dentures supplied 7 were provided free by the Council; 1 was provided by the Ministry of Pensions; 1 was provided by the Charity Organisation Society; whilst 6 patients made part payments amounting to £6 15s., the total amount falling on the Council being £52 17s. 6d. Some difficulty is experienced in inducing the younger patients to submit to dental treatment, but as the importance of such treatment is impressed upon each patient, it is hoped that such objections will in time pass away. A number of patients had treatment by their own dentist. The Interim Tuberculosis Care Committee.—Reference has already been made to the importance of After-care, and in spite of many difficulties it must be acknowledged that the Interim Tuberculosis Care Committee has rendered most valuable assistance. The work that is done in visiting, encouraging and assisting patients and their relatives cannot be shown on paper, but is nevertheless very real and much appreciated by the patients. I am indebted to the courtesy of the Hon. Secretary (Miss Johnston) for the following information which shows that with funds this Committee could render great practical assistance. At present the Committee have to rely on the voluntary contributions of a few interested people. During the year the Committee— Supplied Milk for 4 patients for 3 months. Provided 5 Bedsteads, with Blankets. Provided Clothing for 2 patients going to Sanatorium. Provided Surgical Boots for 1 patient. Provided allowances for 2 families whilst the parent was in the Sanatorium. Numerous efforts were made to provide employment for patients unfit for their ordinary work, but without much success, due, no doubt, in great measure to the wave of unemployment throughout the district. The four open-air shelters belonging to the Dispensary and provided by the Council were in constant use throughout the year, and a number of air cushions have now been obtained and are in frequent demand by advanced cases. 42 Before closing the Report it may be advisable to give a brief summary of the Council's scheme for the prevention of Tuberculosis. The Borough is divided into four districts, to each of which a Tuberculosis Nurse is allotted. Every case notified is visited unless a request is expressed to the contrary. Inquiry is made with regard to every death registered. Disinfection is carried out in every instance. Every endeavour is made to induce contacts and relatives to attend the Dispensary for examination. The hours of attendance at the Dispensary have been revisedSeveral additional sessions have been arranged and the Dispensary is now open every week-day. There are two evening sessions for the convenience of patients who may be working or who cannot attend at other times. A special session has been arranged on Saturday mornings for school children, thus avoiding loss of attendance at school. The closest co-operation exists between the Maternity and Child Welfare Centres, the School Authorities and the Dispensary. The Dispensary Staff is ready at all times to render all assistance or advice with regard to Tuberculosis. In concluding this Report I desire to acknowledge my indebtedness to the whole staff for their courtesy and co-operation in carrying out the work at the Dispensary. I am, Sir, Your obedient Servant, M. MACDONALD, M.D., D.P.H. 43 Return as to Work carried out in connection with the Greenwich Dispensary for the Year 1920. Insured. Uninsured. Males. Females Children under 16. Adults. Males. females 1.(a) Number of persons examined for the first time during the above period at or in connection with the Dispensary 145 78 553 15 128 (b) Number included under 1(a) who were found to be suffering from pulmonary tuberculosis 31 23 21 - 19 (c) Number included under 1(a) who were found to be suffering from nonpulmonary tuberculosis 3 1 120 1 2 (d) Number included under 1(a) who were found to be non-tuberculous 84 41 311 13 80 (e) Number included under 1(a) in whom the diagnosis was found to be doubtful 27 13 101 1 27 Insured. Uninsured 2.(a) Total attendances at the Dispensary [including attendances at the Dispensary of persons included under 1(a)] 2233 6519 (b) Number of the above attendances at which systematic physical examinations and records were made 526 1336 3. Number of visits to patients at their own homes by the Dispensary medical officers in connection with the supervision of home conditions 19 26 4. Number of visits to patients at their own homes by the Dispensary nurses in connection with the supervision of home conditions and " following up " 1898 3064 5. Number of persons suffering from or suspected to be suffering from tuberculosis referred to the Hospital to which the Dispensary is affiliated - - 6. Number of consultations with the— (a) Medical Adviser of the Insurance Committee - - (b) Consulting Physicians at the Hospital to which the Dispensary is affiliated - - (c) Practitioners at the homes of patients 53 30 7. Number of written reports concerning individual patients made to— (a) Public authorities 343 190 (b) Practitioners 15 15 8. Number of specimens of sputum examined 142 66 44 The Interim Tuberculosis After-Care Committee for Greenwich continue to press upon the notice of the Public Health Committee of this Council:— (1) The need for an Institution or Home in which advanced cases can be properly cared for, thereby removing such active foci of infection from amidst generally impoverished families in which they occur. Up to the present, however, nothing satisfactory has been accomplished. (2) The need for providing a Working Centre in Greenwich for patients discharged from Sanatoria, cured, but partially disabled by the disease. A Scheme has been put forward for consideration both by the London County Council and the Ministry of Health, and the London County Council have decided that the principles which should govern the provision of this character should be examined by a competent body which should include persons with special knowledge of Tuberculosis, Industry, Trade Union conditions, Public Assistance, and of Insurance. These principles would be of national application, and they accordingly suggest that the Ministry of Health be recommended to institute an inquiry as to the steps which should be taken to provide suitable employment for tuberculous members of urban population, and a representation has been made to the Ministry of Health as to the desirability of instituting an inquiry on these lines. MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare Committee at their meeting held in January, 1920, reported to the Council that they had given consideration to a report on the question of the necessity for extending and developing the Maternity and Child Welfare work of the Borough, particularly in connection with the extension of the Infant Consultation Centres and the Health Visiting work. It was pointed out that as many as 80 children attended the Centres quite regularly each session, and that therefore it was not possible for the Medical Officer to give sufficient personal attention to each of these cases in the time allotted, viz., one afternoon per centre. It therefore appeared necessary that the Maternity Medical Officer should devote an additional morning or afternoon to the Consultation work at each of the Centres. The necessity existed for daily attention being given to cases where children were suffering from ear, nose or throat trouble, eczema, 45 or other minor ailments, so that these conditions could be dealt with properly and systematically, in order to prevent such maladies becoming chronic. It was impossible for these matters to be dealt with under the regime then in existence, as it would involve more time being spent than the Medical Officer could give without neglecting other important duties, nor could it be effectually carried out without additional accommodation and the employment of Nurses. In order to carry out the work in a complete form, as suggested by the Ministry of Health, it was desirable also to establish instructional classes for mothers in the making of children's clothing, etc. It would, further, be advisable to form thrift clubs. At that time the Council had only the use of the premises where the Infant Consultations were carried on on one afternoon per week, and consequently it was thought desirable for separate premises to be rented, if possible in each district, so that they could be used every day for Child Welfare purposes. This would permit of the holding of more frequent Infant Consultations, with the daily attendance of a qualified Nurse to give treatment, under the Medical Officer's supervision and direction, to children needing the same. Milk could also be distributed to Mothers, thereby obviating the necessity for them to attend the Borough Hall whenever supplies were needed. The need for a Centre in the neighbourhood of East Street, Charlton, was very apparent, but with the available staff it was not possible to establish one in this district; the Committee, however, thought that steps should be taken to secure suitable premises, and establish a Centre in that neighbourhood as soon as possible. The attention of the Council had been drawn on more than one occasion by the Ministry of Health to the inadequacy of the staff of Health Visitors. In the circular letter of the Ministry of Health on the subject it is laid down that the minimum number of Health Visitors in any district should be one visitor for each 400 annual births, and as the births in the Borough of Greenwich during the last twelve months reached a total of approximately 2,100 it would appear that five Health Visitors are necessary. From a circular letter received from the Ministry of Health respecting the notification of Measles it was observed that the Ministry suggested that where Measles could be satisfactorily visited, its notification might be continued, and the Committee thought that much good might accrue from the continuance of such notification if the Council were able to devote the requisite amount of visiting and care and attention to the cases; it was considered, therefore, that the time had arrived when an increase in the staff of Health Visitors for this purpose was essential. 46 The Health Visitors would thus be responsible for visiting patients notified to be suffering from:— Measles, German Measles, Whooping Cough, Chicken-pox, Diarrhoea, Ophthalmia Neonatorum, Puerperal Fever, Infective Enteritis, which work would necessitate the appointment of at least one or two additional Health Visitors. With these extended operations in view, and as the time of the Medical Officer was already fully occupied, it appeared desirable to consider whether an Assistant Medical Officer should be appointed for this work. Medical attention could then also be given to the Rachael McMillan Day Nursery, the Committee being of opinion that a daily visit by a Medical Officer was essential. The Scheme outlined in the foregoing particulars was generally adopted, and during the month of June four additional Health Visitors were appointed, bringing the number of Health Visitors up to 7, excluding the Health Visitor attached to the Albany Institute. Each Health Visitor was made responsible for a definite district of the Borough, and on page 48 will be found statistics giving an indication of the work carried out during the year in these several districts. With regard to the suggestion of an Assistant Maternity and Child Welfare Medical Officer it was decided not to make this a full-time appointment, but to obtain the services of Medical Practitioners with suitable qualifications, as required. In this connection I have to acknowledge the services of Drs. Halliday, Pickard, Neary, Cohen, Latimer and Kellett, who have taken sessions as required at the different Clinics during the year. Dr. Katherine McNeill continued her duties as the Council's Maternity Medical Officer up to October, when she resigned the position in order to take up an appointment in South Africa. Towards carrying out the above Scheme, the Committee, on 28th April, reported to the Council that they had received the sanction of the Ministry of Health to the purchase of 105, Shooters Hill Road for the sum of £1,275 for the purpose of an Infant Consultation Centre, Minor Ailment Treatment Clinic, Ante-Natal Clinic, etc., which would be used in place of the existing temporary arrangements at Sunfields Memorial Schoolroom. 47 In November, the extended scheme took a more definite shape; the Council entered into negotiations for the lease of Conduit House,No. 236, Trafalgar Road (which was being used as a Day Nursery only), for a term of five years at a rent of £70 per annum, for the purposes of a combined Day Nursery and Infant Consultation Centre, thus enabling us to dispense with the use of Victoria Hall, where Clinics had been held twice weekly. The following School Clinics, Health Centres, and Infant Consultations are also 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. The total attendances of Babies at our Creche during the year were 2,808. The following figures show the work carried out at the various Infant Consultation Centres and Ante-Natal Clinics:— Borough Hall Victoria Hall. Sunflelds Mem. Schoolroom. Albany Institute. Attendances 5,326 6,546 3,905 2,794 New Cases 483 627 301 271 Medical Consultations 2,269 2,715 1,798 1,310 Nursing mothers seen by Doctors 1,130 1,352 758 271 (The children are weighed and advice given to the Mothers at every attendance.) Number of Cases attending Ante-Natal Clinic 238 Number of Attendances 645 Minor Ailment Centre.—This Centre was opened at temporary premises at 13, Maze Hill, from the 24th August to 7th November, when it was transferred to the Borough Hall. Number of Cases treated 59 Number of Attendances 241 48 Visits paid by Health Visitors during the year:— Visits paid in reference to Births 2,940 Re-visits „ „ 3,793 Visits „ L.C.C. Scabies Cases 85 Re-visits „ ,, ,, 63 Visits ,, L.C.C. Verminous Complaints 56 Re-visits ,, ,, ,, 38 Visits „ Ante-Natal Cases 249 Re-visits „ „ „ 98 Visits „ Measles 43 Re-visits „ „ 24 Visits „ Puerperal Fever 5 Re-visits „ „ „ 7 Visits „ Ophthalmia Neonatorum 28 Re-visits „ ,, „ 72 Visits „ Whooping Cough 413 Re-visits „ „ ,, 57 Visits „ Diarrhoea 146 Re-visits „ ,, 101 Visits „ Pneumonia 3 Re-visits „ ,, 1 Visits „ Dental 71 Re-visits „ „ 6 Visits ,, Dried Milk 557 Re-visits „ „ 493 Miscellaneous Inquiries made 321 9,670 Infant Consultations, Ante-Natal Clinics, etc., attended, 891. Baby Shows.—During October, Baby Shows were arranged at each of the Council's Centres, only babies and children who had attended the Consultations for at least three months being eligible. The Competitions were divided into the following groups :— Group 1. Over three months and under nine months. „ 2. Over nine months and under eighteen months. „ 3. Over eighteen months and under five years. Three prizes were awarded to each Group, and special prizes were given to Twins. The Baby Shows received the enthusiastic suppport not only of the Chairman and Members of the Maternity and Child Welfare Committee, but also of local ladies interested in Child Welfare, and whose valuable assistance considerably helped to make the competitions so successful. Milk Supply, Etc.—Fifty-five thousand three hundred and eighty-four lbs. of Dried Milk (Ambrosia, Glaxo, Cow and Gate) 49 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 1,515 lbs. of Virol and 112 lbs. of Emulsion have been similarly distributed. Dental Work. The arrangements made last year with the British Dentists' Hospital that they should provide a qu lified 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, are still in operation. 110 patients have been attended by the dental surgeon and 15 dentures have been provided, the total cost of the dentures being £52 7s. 6d., of which amount the Committee have decided that the patients should pay £20 7s. 6d. Puerperal Fever. Five cases of this disease were notified during the year, four of which unfortunately proved fatal. There did not 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-eight cases of this disease were notified during the year, both eyes being affected in 18 cases, and one eye only in the remaining ten cases. Fortunately in no case did any permanent injury to the eye remain. Of the total number of,cases, 11 occurred in East Greenwich, 8 in West Greenwich, 8 in Charlton and 1 in St. Nicholas. Measles.—See pages 31 and 32. The following table gives the number and character of the intimations respecting births in the Borough:— 1913. 1914. 1915. 1916. 1917. 1918. 1919. 1920. Total Number of Births notified in each year 2,623 2,513 2,280 2,497 1,992 1,735 2,085 2,714 (a) Attended by Midwives 1,340 1,338 1,226 1,314 1,095 990 1,159 1,494 (b) Attended by Doctors 1,283 1,175 1,054 1,183 897 745 926 1,220 Number of Still Births notified in each year 53 36 42 61 47 44 59 78 Number of Births registered in each year 2,545 2,409 2,347 2,354 1,967 1,753 1,968 2,648 50 Houses Let in Lodgings.—The By-Laws which have been in force since 1911 have become abrogated, new London County Council By-Laws have been prepared and forwarded to the Ministry for their approval. In the meantime this class of property has been dealt with, as far as possible, under the powers conferred by the Public Health (London) Act, 1891. Such legislation does not, however, give the Inspector wide enough scope for the necessities of the case. Rats and Mice (Destruction) Act, 1919. In conformity with a memorandum received from the Ministry of Agriculture and Fisheries which suggested that a National Week should be held in the Autumn in the district of every Local Authority responsible for the enforcement of the Rats and Mice (Destruction) Act, 1919, tliis Council selected the week commencing 1st November. Posters were displayed throughout the Borough and Commercial Houses and Firms having premises abutting on the River Creek and River Thames were circularised with a view to taking joint action for the destruction of rats. It appeared from subsequent inquiries that the attempt at concerted action received considerable support and valuable reports indicative of success were received from various sources. Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. In connection with the provisions of this Act, and in order that the inhabitants of the Borough would be more thoroughly acquainted with the Act, explanatory pamphlets were prepared and circulated throughout the Borough. Under the provisions of the Act, landlords are allowed to make certain increases of rent and occupiers are afforded the opportunity of applying to the Sanitary Authority for a Certificate to the effect that the house is not in all respects reasonably fit for human habitation, or is otherwise not in a reasonable state of repair. From the 14th July to 31st December only 126 such applications were received from occupiers for certificates. Of this number 94 certificates were granted. No certificates were granted in the remaining 32 cases, this being principally due to the fact that the work required to be executed had been satisfactorily carried out. HOUSING SCHEME. The earlier months of the year were fully occupied in discussing with the Ministry of Health both by correspondence and innumerable interviews the question of the provision of houses in the Borough. At one of the earliest interviews the Council was called to account for not having considered the provision of a much larger number of houses than had already been thought necessary, but 51 on it being pointed out that the present Council were considering much more extensive housing operations, the Housing Board of the Ministry of Health expressed their satisfaction, and even went further than that by suggesting that the real number of houses that were required for the needs of the Borough was somewhat in the neighbourhood of 6,000, and that, at any rate, the principle which the Council should aim at was definitely providing during the then current year not less than 1,000. The Council made a compulsory order for the acquisition of about 40 acres of land, known as the " Hanging Wood Lane Site," and in due course entered into possession. It was decided to divide the site into four sections, No. 1 known as the " Kinveachy Gardens Site," to accommodate 18 houses ; No. 2, called the " Fairfield Site," to accommodate 164 houses ; No. 3, the " Allotments Site," to accommodate 76 houses, and No. 4, known as the " Pound Park Site," upon which it was proposed to build 180 houses. A contract was entered into with Mr. W. J. Maddison, 124-127, Minories, E. 1, for the erection of the 18 houses on Site No. 1, and at the end of the period covered by this Report, the Ministry of Health were considering tenders received by the Council for the erection of a further 164 houses on the No. 2 Site, and 26 houses proposed to be erected on the land at the rear of " East Mascalls " (which house had been acquired for the purpose of conversion into tenements), the lay-out of which had been approved by the Ministry. The following is a description of the four different types of houses approved by the London Housing Board to be erected on the Hanging Wood Lane Site :— Type. Accommodation. Proportion of each Type of Houses proposed. A2 1 living room, 2 bedrooms, scullery with copper, bathroom and w.c. upstairs, coal accommodation and larder. 5% of total number. A3 1 living room, 3 bedrooms, scullery with copper adjoining bathroom, w.c. upstairs, coal accommodation and larder. 30% of total number. B3 1 living room, parlour, 3 bedrooms, bathroom, scullery with copper, w.c. upstairs, coal accommodation and larder. 60% of total number. B4 1 living room, parlour, 4 bedrooms, scullery, bathroom downstairs and adjoining scullery with copper, w.c. downstairs, coal accommodation and larder. 5% of total number. The sites of the houses will average 28 feet by 120 feet. 52 The 464 houses to be erected will be distributed as follows:— Site. A2 A3 B3 B4 Totals. No. 1 4 6 6 2 18 No. 2 6 46 102 10 164 No. 3 — 36 36 4 76 No. 4 — 50 122 8 180 East Mascalls — — 26 — 26 10 138 292 24 464 53 SUMMARY OF SANITARY WORK PERFORMED DURING THE YEAR 1920. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Inspections. Houses Inspected 688 880 770 746 3084 Other Premises Inspected .. 115 44 40 199 Investigations .. 175 166 212 553 Re-inspections, Calls made, etc. 2906 3175 3171 4540 13792 Houses Let in Lodgings 6 .. .. 15 21 ,, ,, Re-inspections 3 .. .. 108 111 Inspections of Bakehouses 9 41 19 25 94 „ Factories and Workshops 34 37 27 83 181 ,, Outworkers 12 .. .. 37 49 „ Slaughterhouses 10 7 8 7 32 ,, Cowhouses .. 3 2 1 6 ,, Stables and Yards 27 32 15 13 87 „ Piggeries .. 1 2 .. 3 „ Courts and Alleys 15 15 18 14 62 ,, Fields, Lanes, etc. 9 12 10 13 44 Urinals 14 25 23 11 73 „ Gipsy Vans .. .. .. .. .. ,, Horse Slaughterhouses 4 5 .. .. 9 ,, Dairies Cowsheds and Milkshops 14 24 46 28 112 ,, Soapboilers .. .. .. .. .. ,, Other Offensive Trades .. .. .. .. .. „ Ice Cream places 1 25 36 .. 62 „ Other places where food is prepared 44 43 39 36 162 Total 3796 4615 4396 5929 18736 Drains. Constructed 6 8 5 3 22 Interceptor Chamber and Fresh Air Inlet 8 7 14 20 49 Other Chambers 9 19 4 14 46 Reconstructed or Repaired 28 47 19 84 178 Opened, Cleansed and Amended 64 105 115 51 335 Surface Drains Constructed 29 19 9 5 62 Traps Fixed 63 84 50 79 276 New Soil Pipes 10 19 10 11 50 Drains and Soil Pipes Ventilated 23 25 17 40 105 Drains Sealed off .. .. 1 .. 1 Drains Tested—by Smoke 53 35 54 63 205 ,, by Water 86 89 85 134 394 Found Defective 47 38 59 76 220 Anti-Siphonage .. 12 .. 6 18 Manhole Covers provided .. .. .. 1 1 Yards Drained 17 22 15 24 78 Mews and Stables drained 1 .. 2 .. 3 Washhouses Drained 5 1 1 1 8 Forecourts Drained 5 6 1 13 25 Areas Drained 9 8 6 4 27 Cesspools abolished 3 1 .. 1 5 54 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Water Closets and Urinals. Closets erected 20 19 7 14 60 W.C. Doors repaired or provided .. .. 7 15 22 Sanitary Conveniences or Improvements effected to Factories and Workshops 21 11 4 12 48 Temporary Pail system (Workplaces) .. .. 12 .. 12 Pan, Traps and Water Supply furnished 34 25 9 16 84 Pans and Traps only furnished 33 64 22 55 174 Pans only furnished 2 13 6 7 28 Water Supply apparatus provided 22 36 10 20 88 „ repaired .. .. 14 2 115 Water Supply renewed 30 71 42 47 190 Water Supply disconnected from Drinking Water Cistern 2 .. .. 1 3 Soil Pans properly trapped 1 .. .. .. 1 Cleansed and Repaired 44 61 56 79 240 Newly constructed or better situated 13 18 5 1 37 Ventilation improved 5 16 12 9 42 Urinal constructed 1 .. .. 1 2 Public-house Urinals cleansed or repaired 7 2 9 4 22 Other Urinals altered 5 10 7 2 24 Repaired cr Water laid on 11 12 7 15 45 Ashpits. Number provided 141 298 144 223 806 Covers to Receptacles .. .. .. .. .. Dust Compleints forwarded to the Surveyor 5 5 3 4 17 Pavings. Yards 55 78 52 111 296 Forecourts 5 4 4 11 24 Areas 9 8 5 4 26 Washhouses 17 4 7 10 38 Mews and Stables 1 1 2 .. 4 General Water Supply. Covers to Cisterns adapted .. 1 .. .. 1 Water Supply provided 3 2 1 2 8 Water Fittings amended 32 46 46 76 200 Cisterns Cleansed and Repaired 5 .. 4 .. 9 Water Services Altered so as to draw direct from Main 2 16 .. 11 29 Water Supplies reinstated where cut off through Defective Fittings 4 10 13 .. 27 Defective Water Fittings (causing nuisance from dampness) repaired 30 29 21 50 130 Water Supply Certificates granted (Section 48) •• .. .. 2 2 55 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Other Improvements. Houses generally Repaired 79 127 128 173 507 Premises Cleansed, Lime-washed and Repaired 106 94 96 104 400 Verminous Rooms not L.C.C 9 20 31 52 112 Ventilation improved 27 107 72 154 360 Leaky House Roofs and Gutters repaired 138 193 199 257 787 Walls and Ceilings of Premises Cleansed throughout 48 97 42 87 274 Ditto ditto partially 77 96 136 199 508 Cowhouses cleansed .. 4 1 .. 5 Horse Slaughterhouses Cleansed 1 1 1 .. 3 Ice Cream places Cleansed or Improved .. 1 6 .. 7 Other places where Food is prepared .. 19 11 5 35 Other Nuisances Abated. Illegal use of Underground Room discontinued .. .. 1 .. 1 Overcrowdings abated Sink, Lavatory end Bath Waste Pipes 1 .. 3 2 6 disconnected, trapped and amended 34 86 54 74 248 Stack Pipes disconnected & amended 21 37 2 52 135 Nuisances from Dampness abated 71 120 5 77 332 Animals kept in Unfit Places discontinued or removed 5 5 12 9 31 Dung Receptacles provided .. 1 2 2 5 Bakehouse Nuisances abated 5 11 4 14 34 Houses Abolished (Unfit for Habitation) .. .. .. .. .. Accumulations of Manure and other Obnoxious Matter removed 9 32 9 12 62 Dampness of Walls remedied 21 29 30 26 106 Inundations abated .. .. 5 2 7 Other Nuisances, principally of Dilapidations and want of under-floor Ventilation 48 42 16 57 163 Breaches of By-Laws abated .. .. 3 3 6 Cases of Rat Infestation remedied .. .. 55 31 86 Smoke Nuisances. Observations 3 13 5 4 25 Statutory Notices served (Sections 23 and 24) .. 3 .. .. 3 Food and Drugs. Samples taken 133 113 95 83 424 Found Adulterated 5 3 1 4 13 56  1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Unwholesome Food. Voluntarily surrendered. 2,356 boxes of dates. 70 tins of milk. 2½ stone of mackerel. 38 boxes of prunes. 12 rabbits. 4 bags of whelks. Forequarter of tubercular cow. 14½ boxes of sultanas. 221bs. ditto in parts. 28cwt. of flour. Heart, lungs and tripe of tubercular cow. 31 tins of milk. 5lbs. tripe. 7 stone fresh herrings. 81bs. collar of bacon. 18 tins of tomatoes. 20lbs. bacon. 241bs. corned beef. 1 bag of winkles. 11 tins of fruit. 521bs. foetus of calf. 801bs. haddocks. 18 pineapples. 6 tins of salmon. 116lbs. calf. 67 bags of currants. 561bs. of Government butter. 1 tin of corned beef. 11 bags of raisins. 10lbs. sultanas. 81 tins of milk. 2 tins of beans. 129 boxes of carton raisins 24 tins of salmon. 2 jars of fish-paste. 118 lbs. of beef. 4 tins of corned beef. 9 rabbits. 7 tins of fish-paste. 1 tin rabbit. 27 tins of tomatoes. 11 tins of fruit. 2 tins of beans. 1041bs. of fish. 9 rabbits. 57 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Notices, Etc. Intimations served under Public Health (London) Act, 1891 (Sec. 3) 335 500 489 509 1833 Complaints received and attended to 193 235 315 346 1089 Intimation Notices served under Housing, Town Planning, Etc., Act, 1919 .. 30 39 26 95 Ditto, Rats and Mice (Destruction) Act, 1919 .. 34 12 6 52 Statutory Notices served under Sec. 4, P.H. (L.) A 77 85 63 140 365 Ditto, re Ashpit provision 42 67 35 48 192 Ditto, re Verminous Rooms 3 5 5 7 20 Ditto, served under P.H. (L.) A. and Metropolis Management Act 18 4 .. 36 58 Ditto, re W.C.'s (factory, workshops and workplaces) 1 4 .. .. 5 Ditto, served under H.T.P. Act .. 1 1 .. 2 Letters written relating to Abatement of Nuisances 228 428 419 545 1620 Summonses applied for and issued .. .. 10 .. 10 Magisterial Orders obtained and enforced .. .. 6 .. 6 Drainage Plans received and examined 31 35 17 30 113 58 BOROUGH OF GREENWICH. Proceedings during 1920. Premises. Number of Places— Number of Inspections, 1920. Number of Notices, 1920. N umber of Prosecutions, 1920. On Register at end of 1919. Added in 1920. Removed in 1920. On Register at end of 1920. Dairies : Cowsheds and Milkshops 120 8 38 90 112 7 .. Slaughterhouses 5 .. .. 5 32 .. .. Other Offensive Trade Premises .. .. .. .. .. .. .. Ice Cream Premises 103 14 63 54 62 5 .. Registered Houses Let in Lodgings 247 .. .. 247 132 .. .. Total number of Intimation Notices served for all purposes 1980 Overcrowding, 1920— Number of Dwelling-rooms Overcrowded 6 Number Remedied 6 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 - Number of Verminous Rooms Fumigated 5 Number of Cleansing Baths given under Cleansing of Persons Act 12 Shelter provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year - 59 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 the 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 Management 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 189 189 Total Number of Infectious Bodies Removed 0 LEGAL PROCEEDINGS, 1920. Apart from the proceedings under the Sale of Food and Drugs Act, it became necessary to take Police Court proceedings in 10 cases. BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 1st January, 1921. Causes of Death. Deaths in Whole District at Subjoined ages. Deaths in Localities at all Ages. Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District Al! 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 Gr'n'ch. & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military' Hospital Brook Hospital, M.A.B. Cottage Hospital Other Institutions Outside Tnstitutions All Causes Certified 285 45 4 4 7 17 38 7 92 121 78 27 56 3 42 13 7 .. 2 4 2 47 232 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. 9 Whooping Cough 1 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Croup 3 1 2 .. .. .. .. 1 .. 1 1 .. .. .. .. .. 1 .. .. 1 18 Influenza 1 .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Erysipelas 2 .. .. .. .. 1 .. 1 .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 2 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentry .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 29 .. .. .. 2 6 12 7 2 12 13 .. 3 .. 5 5 .. .. .. .. .. 6 27 Tuberculous Meningitis 3 3 .. .. .. .. .. .. .. 1 2 .. .. .. .. .. .. .. .. .. .. 2 2 Other Tuberculous 4 .. .. .. .. 2 1 1 .. 3 .. .. .. 1 .. .. .. .. .. .. .. .. 2 Rheumatic Fever 2 .. .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. 1 .. .. .. .. .. 1 Cancer, Malignant Disease 35 .. .. .. .. .. 3 18 14 14 9 3 9 .. 8 2 .. .. .. .. .. 10 22 Bronchitis 21 2 .. .. .. .. 1 5 13 6 9 2 3 1 3 1 .. .. .. 1 .. .. 19 Broncho-Pneumonia 14 3 3 .. 1 2 .. 3 2 6 4 2 2 .. 1 .. 2 .. .. .. .. .. 6 Pneumonia (all other forms) 9 .. .. .. .. .. 6 3 .. 5 2 .. 2 .. 1 1 .. .. .. 2 .. .. 5 Other Diseases of Respiratory Organs 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. 2 Diarrhoea and Enteritis 9 8 1 .. .. .. .. .. .. 5 2 2 .. .. 3 .. 1 .. .. .. .. .. 5 Appendicitis and Typhlitis 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. 2 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 3 .. .. .. .. .. .. 2 1 .. 1 .. 2 .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 10 .. .. .. .. 1 2 2 5 6 3 .. 1 .. 1 .. 1 .. .. .. .. .. 2 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Accidents & Diseases of Pregnancy, Parturitior 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Congenital Debility anc Malformation, including Premature Birth 20 19 .. 1 .. .. .. .. .. 13 5 1 1 .. 5 .. .. .. .. .. .. 1 7 Violent Deaths, excluding Suicide ' 7 .. .. .. 1 1 3 1 .. 3 2 2 .. .. .. 2 .. .. .. .. .. 2 8 Suicides 3 .. .. .. .. .. 1 2 .. 1 .. 2 .. .. 1 .. .. .. .. .. .. 1 2 Heart Diseass 38 .. .. .. 1 .. 5 1 30 15 9 2 12 .. 4 .. .. .. .. .. .. 4 14 Other Defined Diseases . 6 7 .. .. 2 2 3 19 34 25 16 6 19 1 9 1 2 .. .. .. 2 16 76 Diseases ill-defined or un known .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 285 43 4 4 7 17 38 78 92 121 78 27 56 3 42 13 7 .. 2 4 2 47 232 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 52 weeks ending 1st January, 1921. Causes of Death. Deaths in Whoi.e District at Subjoined Ages. Deaths in Localities at all Ages. Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District Al! Ages Under 1 ] and under 2 1 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 Gr'n'ch. & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital, M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 1231 195 39 46 48 77 172 282 372 521 368 123 192 27 224 72 27 .. 8 6 8 190 1046 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 2 .. .. .. .. .. 2 .. .. .. 2 .. .. .. .. 1 .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 26 8 5 8 4 .. 1 .. .. 10 6 7 2 1 8 .. .. .. .. .. .. .. 20 Scarlet Fever 3 .. .. 2 .. 1 .. .. .. 3 .. .. .. .. .. .. .. .. 2 .. .. .. 16 Whooping Cough 29 12 2 4 1 1 .. .. .. 11 6 .. 3 .. 4 .. .. .. .. .. .. 1 6 Diphtheria and Croup 13 3 1 7 2 .. .. .. .. 7 3 1 2 .. 1 .. .. .. 5 .. .. 5 66 Influenza .. .. .. .. .. 1 2 6 6 6 5 3 1 .. 1 3 .. .. 1 .. .. .. 7 Erysipelas 5 1 .. .. .. 1 .. 2 1 2 1 2 .. .. 4 1 .. .. .. .. .. 1 7 Posterio Basal Meningitis 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Dysentry 2 .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. 4 Malaria 3 .. .. .. .. .. 3 .. .. .. 2 1 .. .. .. 2 .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 120 1 1 .. 9 30 47 27 5 39 50 4 16 1 15 15 .. .. .. .. .. 25 90 Tuberculous Meningitis 12 4 3 .. 2 .. 3 .. .. 8 4 .. .. .. 2 1 1 .. .. .. .. 5 12 Other Tuberculous Diseases 15 .. 1 .. 3 6 3 2 .. 8 3 1 2 1 2 1 .. .. .. .. .. 5 12 Rheumatic Fever 9 .. .. 1 2 4 1 1 4 2 2 1 .. 1 .. 1 .. .. .. .. .. 4 Cancer, Malignant Disease 120 .. .. 1 .. .. 12 57 50 55 27 11 26 1 30 5 3 .. .. .. .. 22 88 Bronchitis 98 21 3 4 »• 2 3 24 41 34 37 14 11 2 15 3 1 .. .. 1 .. 1 60 Broncho-Pneumonia 58 21 14 2 2 2 4 9 4 22 18 11 7 .. 5 4 4 .. .. .. .. 3 31 Pneumonia (all other forms) 57 4 5 2 .. 3 21 10 12 27 20 3 6 1 3 11 3 .. .. 3 .. 3 42 Other Diseases of Respiratory Organs 10 1 .. 1 .. .. 1 6 1 7 3 .. .. .. 5 1 .. .. .. 1 .. 1 11 Diarrhoea and Enteritis . . 20 16 1 2 .. .. .. .. 1 6 5 6 3 .. 5 .. 2 .. .. .. .. 4 13 Appendicitis and Typhlitis 9 .. .. 2 .. 2 4 .. 1 4 2 1 2 .. 2 .. 2 .. .. .. .. 2 12 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 6 .. .. .. 1 .. 1 2 2 1 2 .. 3 .. .. .. .. .. .. .. .. 1 2 Nephritis and Bright's Dis ease 32 .. .. .. 2 1 6 12 11 16 10 1 4 1 7 .. 2 .. .. .. .. 4 24 Puerperal Fever 5 .. .. .. .. 1 4 .. .. 2 .. 1 2 .. 1 1 .. .. .. .. .. 1 7 Other Accidents & Diseases of Pregnancy, Parturition 2 .. .. .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. 1 1 Congenital Debility and Malformation, including Premature Birth 74 71 .. 2 1 .. .. .. .. 32 25 6 11 .. 15 .. 1 .. .. .. .. 6 41 Violent Deaths, excluding Suicide 47 5 .. 3 9 5 11 8 .. 5 13 4 4 1 11 7 2 .. .. .. .. 10 49 Suicides 9 .. .. .. .. .. 3 6 .. 3 2 3 1 .. 1 .. .. .. .. .. .. 2 5 Heart Disease 109 .. .. 3 3 7 10 34 52 42 33 7 25 2 11 5 .. .. .. .. .. 13 61 Other Defined Diseases . 328 26 2 2 6 7 31 76 178 147 83 24 59 15 75 7 5 .. .. 1 8 74 .. Diseases ill-defined or un known .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1231 195 39 46 48 77 172282 372 521 368 123 192 27 224 72 27 .. 8 6 8 190 1046 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending 3rd April, 1920. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. Number 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 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 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. Diphtheria 88 .. 14 51 13 10 .. .. 45 17 .. 15 10 36 .. .. 15 .. 75 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Erysipelas 11 .. 1 1 2 4 2 1 7 2 .. 2 .. 3 .. .. .. .. 3 Scarlet Fever 133 1 30 74 24 4 .. .. 69 24 8 15 17 58 20 8 15 17 118 Malaria 4 .. .. .. 1 3 .. .. I 3 .. .. .. .. .. .. .. .. .. Enteric Fever 5 .. .. 1 1 3 .. .. 2 1 .. 2 .. 1 .. .. 2 .. 3 Encephalitis Lethargica 2 .. .. 1 .. 1 .. .. .. 1 .. .. 1 .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. 1 1 Cerebro-Spinal Fever, or Post Basal Meningitis 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 121 21 62 37 .. 1 .. .. 59 47 1 14 .. .. .. .. .. .. .. Diarrhœa 2 2 .. .. .. .. .. .. 1 .. 1 .. .. 1 .. .. .. .. 1 Ophthalmia Neonatorum 7 7 .. .. .. .. .. .. 4 2 .. 1 .. .. .. .. .. •• 1 Tuberculosis, Pulmonary 58 .. 2 10 .. 23 13 .. 28 14 8 8 .. .. .. .. .. .. .. ,, Non-Pulmonary 53 1 12 40 .. .. .. .. 21 4 9 9 .. .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 67 7 26 12 .. 7 8 7 44 19 1 3 .. 8 1 .. .. .. 9 Totals 553 40 147 227 51 57 23 8 282 145 29 69 28 108 37 9 32 26 1 212 * 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 3rd July, 1920. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. Number 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 Greenwich West St. Nicholas, Deptford Charlton Kidbrooke* Total Under 1 1 to 5 5 to 15 15 to 25 25 to 45 .5 to 65 65 and upwards Small-Pox 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 54 1 12 28 7 5 1 .. 21 14 3 8 8 19 13 3 7 8 50 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 15 2 .. 1 1 5 3 3 9 2 1 3 .. 2 .. 1 .. .. 3 Scarlet Fever 81 1 13 52 10 5 .. .. 40 24 7 9 1 39 21 6 7 1 74 Malaria 2 .. .. .. .. 2 .. .. 2 .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 Encephalitis Lethargica 1 .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever, or Post Bas il Meningitis 1 .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Measles 4 .. 3 1 .. .. .. .. 1 2 .. 1 .. .. .. .. .. .. .. Whooping Cough 167 31 80 51 .. 2 .. .. 131 30 1 2 .. 1 .. .. .. .. 1 Diarrhœa 6 3 3 .. .. .. .. .. 3 3 .. .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 6 6 .. .. .. .. .. .. 2 2 .. 2 .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 47 .. .. 7 11 19 7 3 24 11 5 7 .. .. .. .. .. .. .. ,, Non-Pulmonary 75 1 11 58 3 2 .. .. 39 3 7 16 .. .. .. .. .. .. .. Pneumonia, Acute Primary or Influenzal 26 .. 4 5 5 8 2 2 16 2 4 3 1 1 .. 1 .. .. 2 Totals 487 45 127 207 38 49 13 8 291 104 29 53 10 63 35 12 14 9 133 * Coses 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 1st January, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality Number 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 Greenwich West St. Nicholas, Deptford Charlton Kidbrooke* Total Under 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 ant upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 46 .. 13 23 4 4 .. .. 17 12 2 10 5 17 11 2 .. 5 45 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 17 .. .. 1 1 5 6 .. 7 5 2 .. 3 3 1 .. .. 3 7 Scarlet Fever 137 .. 19 94 17 6 .. .. 93 29 2 9 4 87 26 1 .. 4 127 Malaria 8 .. .. .. 1 6 1 .. 4 1 2 1 .. .. 1 1 .. .. 2 Enteric Fever 7 .. .. 1 2 1 1 .. 4 2 .. 1 .. 2 2 .. .. .. 5 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 22 3 11 6 1 1 .. .. 8 11 2 1 .. .. .. .. .. .. .. Whooping Cough 39 11 16 12 .. .. .. .. 11 13 1 14 .. .. .. .. .. .. .. Diarrhoea 101 56 45 .. .. .. .. .. 39 34 11 17 .. .. .. .. .. .. .. Ophthalmia Neonatorum 5 5 .. .. .. .. .. .. 2 1 1 1 .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 79 1 .. 15 22 30 9 2 37 22 6 13 .. 3 1 .. .. .. 4 „ Non-Pulmonary 22 1 3 9 6 1 2 .. 6 7 4 5 .. .. .. .. .. .. .. Pneumonia 13 1 1 1 1 4 4 1 7 1 2 3 .. 1 1 1 .. .. 3 Totals 497 81 108 162 55 58 24 9 235 138 36 75 13 114 43 6 20 12 195 •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 1st January, 1921. Notifiable Disease. Cases Notified in Whole District. Total. Cases Notified is each Locality Number 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 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 Small-Pox •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Chicken-Pox •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Cholera •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diphtheria 113 3 23 59 22 6 •• •• 64 12 3 18 16 59 •• 3 16 •• 105 Mem. Croup •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Erysipelas 11 1 •• 1 1 1 5 •• 4 1 2 3 1 •• •• 2 1 •• 3 Scarlet Fever 236 1 44 146 33 12 •• •• 144 49 9 20 14 137 •• 8 18 11 219 Malaria 6 •• •• •• •• 5 1 •• •• 4 2 •• •• •• •• •• •• •• •• Enteric Fever 2 •• •• 1 •• 1 •• •• 1 •• 1 •• •• 1 •• 1 •• •• 2 Relapsing Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Continued Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Puerperal Fever 3 •• •• •• •• 3 •• •• 1 1 •• 1 •• 1 •• •• •• •• 3 Cerebro-Spinal Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Measles 10 5 2 3 •• •• •• •• 2 7 1 •• •• •• •• •• •• •• •• Whooping Cough 38 10 12 15 •• 1 •• •• 33 1 •• 4 •• 1 •• •• •• •• 1 Diarrhoea 32 16 16 •• •• •• •• •• 7 18 5 2 •• •• •• •• •• •• 1 Ophthalmia Neonatorum 10 10 •• •• •• •• •• •• 3 3 4 •• 2 •• •• •• •• 2 Tuberculosis, Pulmonary 80 •• 1 9 21 24 22 3 36 24 5 13 •• 2 •• •• •• •• 3 ,, Non-Pulmonary 21 1 3 9 2 4 1 1 6 7 5 3 •• •• •• •• •• •• Pneumonia 17 •• •• 3 3 6 4 1 2 2 •• 3 •• 2 •• •• 2 •• 4 Totals 579 47 101 246 82 63 33 7 313 129 33 71 33 205 59 15 38 26 343 *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 52 weeks ending 1st January, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality Number 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 Greenwich West St. Nicholas, Deptford Charlton i Kidbrooke* Total Under 1 1 to 5 5 to 15, 15 to 25 25 to 45 5 to 65 65 and upwards Small-Pox 1 •• •• •• •• 1 •• •• •• 1 •• •• •• •• 1 •• •• •• 1 Chicken-Pox •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Cholera •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diphtheria 301 6 62 161 46 25 1 •• 147 55 9 51 39 131 50 9 48 37 275 Mem. Croup •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Erysipelas 54 3 1 4 5 15 16 •• 27 10 5 8 4 8 1 3 1 3 16 Scarlet Fever 587 4 106 366 84 27 •• •• 345 126 26 53 36 321 112 23 49 33 538 Malaria 20 •• •• •• 2 16 2 •• 7 8 4 1 •• •• 1 1 •• •• 2 Encephalitis Lethargica 3 •• •• 1 1 1 •• •• •• 1 •• 1 1 •• •• •• •• •• •• Enteric Fever 15 •• •• 4 3 5 1 •• 7 3 2 3 •• 4 2 2 3 •• 11 Continued Fever •• •• •• •• •• •• •• •• •• .. •• •• •• •• •• •• •• •• •• Puerperal Fever 5 •• •• •• •• 4 1 •• 1 2 1 1 •• 1 2 1 1 •• 5 Cerebro-Spinal Fever, or Post Basal Meningitis 2 1 1 •• •• •• •• •• 1 •• •• 1 •• 1 •• •• •• •• 1 Measles 36 8 16 10 1 1 •• •• 11 20 3 2 •• •• •• •• •• •• •• Whooping Cough 305 73 170 118 •• 4 •• •• 237 91 3 34 •• 2 •• •• •• •• 2 Diarrhoea 141 77 64 •• •• •• •• •• 50 55 17 19 •• 1 •• 1 •• •• 2 Ophthalmia Neonatorum 28 28 •• •• •• •• •• •• 11 8 1 8 •• 4 1 •• •• •• 5 Tuberculosis, Pulmonary 264 1 3 41 61 96 51 8 125 71 24 41 3 5 2 •• •• •• 7 „ Non-Pulmonary 171 4 29 116 11 7 3 1 72 4. 25 33 •• •• •• •• •• •• •• Pneumonia, Acute Primary or Influenzal 123 8 31 21 9 25 18 11 79 24 7 12 1 12 2 2 2 •• 18 Totals 2116 213 483 842 226 227 93 32 1121 516 127 268 84 490 174 42 104 73 883 " 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 1920. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 1 Month 1-3 Months 3-6 Months 6-9 Months 9-12 Months Total Deaths under 1 Year All Causes. Certified 40 12 8 11 71 42 36 30 16 195 Uncertified .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-Pox .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. 5 3 8 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. .. .. 5 1 12 Diphtheria—Croup .. .. .. .. .. .. .. .. 3 3 Erysipelas .. .. .. 1 1 .. .. .. .. 1 Tuberculous Diseases. ' Tuberculous Meningitis .. .. .. .. .. .. 2 2 .. 4 Abdominal Tuberculosis . . .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. 1 .. .. 1 Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. Convulsions 2 1 1 i 5 1 2 .. 2 10 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. .. 2 10 5 4 .. 21 Pneumonia, all forms .. .. .. .. .. 7 9 6 3 25 Diarrhoea Diseases. Diarrhoea, all forms .. .. .. .. .. 1 .. 1 .. 2 Enteritis .. .. .. .. .. 3 3 5 2 13 Gastritis .. .. .. .. .. .. 1 2 .. 3 Syphilis .. .. .. .. 1 .. .. .. .. 1 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying .. .. .. .. .. 2 1 .. .. 3 Injury at Birth 1 .. .. .. 1 .. .. .. .. 1 Actelectasis 2 .. .. 2 4 1 .. .. .. 5 Congenital Malformations 4 .. 1 .. 5 2 1 .. .. 8 Premature Birth 19 5 .. 5 29 4 .. .. .. 33 Atrophy, Debility and Marasmus 9 3 3 .. 15 9 3 .. 2 29 Other Causes 3 2 1 2 8 2 2 .. .. 12 Totals 40 12 8 11 71 42 36 30 16 195 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st January, 1920. DISTRICTS. Census Population, 1911. Estimated Population at the middle of the Year 1920. Births Registered during the 13 weeks ended 3rd April, 1920. Deaths Registered during the 13 weeks ended 3rd April, 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. Under 1 Year. Over 1 and under 5 | Years. Persons aged 65 Year and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping-Cough. Fevers. All Causes. Seven Zymotics. Typhoid. Other. During the corresponding period year previous. During the 13 weeks ended 3rd April, 1920. During the corresponding period year previous. During the 13 weeks ended 3rd April, 1920. M. F. M. F. Greenwich East 45960 50282 168 177 77 81 26 15 61 . . 6 2 4 6 . . . . . . 9 1 41 4 13 72 12.81 12.60 .40 1.43 Do. West 22933 24880 119 105 84 52 29 19 23 . . 5 . . 2 2 1 . . 1 14 3 46 10 4 48 25.72 21.93 .48 1.77 St. Nicholas, Deptford 7290 7904 31 35 19 19 9 7 5 . . 5 . . . . . . . . 1 1 4 1 14 2 2 8 11.33 19.29 . . 3.55 Charlton 16910 18280 70 45 32 26 13 3 16 . . 1 . . . . 2 . . . . . . 4 1 12 2 6 30 23.48 12.73 2.06 .65 Kidbrooke 2875 3107 3 4 2 7 . . 1 6 . . 1 . . . . . . . . . . . . . . . . 1 2 . . 5 7.89 11.69 . . 1.29 Miller Hospital— Resident . . . . . . 6 3 3 1 1 . . . . . . . . . . . . . . . . . . . . 2 . . 1 6 . . . . . . . . Non-Resident . . . . . . 8 3 1 1 . . . . . . . . . . . . . . . . . . . . 2 . . 3 . . 6 . . . . . . . . Seamen's Hospital— Resident . . . . . . 25 2 . . . . . . . . . . . . . . . . . . . . . . 5 1 13 2 1 5 . . . . . . . . Non-Resident . . . . . . 21 . . . . . . . . . . . . . . . . . . . . . . 1 5 . . 7 . . . . 8 . . . . . . . . Greenwich & Deptford Hospital- Resident . . . . . . 30 39 7 6 16 . . 7 . . 1 1 . . . . . . 2 3 8 2 5 40 . . . . . . . . Non-Resident . . . . . . 95 75 14 6 51 . . 9 . . 1 . . . . . . 2 7 1 25 6 17 102 . . . . . . . . Herbert Hospital— Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M.A.B. Brook Hosdpital- Resident . . . . . . 2 1 . . . . . . . . . . 1 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . 13 16 . . 12 . . . . 2 6 18 . . . . . . . . . . 1 1 . . . . 1 . . . . . . . . Cottage Hospital— Resident . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . Non-Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Institutions— Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Outside Institutions— i Resident . . . . . . 35 24 3 4 12 . . . . . . 3 1 1 7 1 6 4 5 31 . . . . . . . . 391 366 214 185 Borough 95968 104453 757 399 77 45 111 . . 18 2 6 10 1 1 2 31 6 114 20 25 163 . . . . . . . . Rate per 1,000 of Estimated Population . . . . . . . . . . . . . . . . .68 .07 .22 .38 .03 .03 .07 1.18 .22 4.34 .76 .95 6.21 17.52 15.20 .46 1.56 Deaths of Children under 1 Year per 1,000 births, 102 ,, ,, previous ,, ,, corresponding period. „ „ County of London, 93 Death Rate of 96 large English Towns, 16.1; of the County of London, 16.4. Birth Rate ,, ,, 30.3; „ 31.4. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st January, 1920. DISTRICTS. Census Population, 1911. Estimated Population at the middle of the Year 1920. Births Registered during the 13 weeks ended 3rd July, 1920. Deaths Registered during the 13 weeks ended 3rd July, 1920. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortalitv 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. Diarrhoea. All Causes. Seven Zymotics. Typhoid. Other. During the corresponding period year previous. During the 13 weeks ended 3rd July, 1920. During the corresponding period year previous. During the 13 weeks ended 3rd July, 1920. M. F. M. F. Greenwich East 45960 50282 183 173 77 65 24 15 32 . . 4 . . . . 4 . . . . . . 10 7 17 13 12 73 9.40 11.33 .56 .79 Do. West 22933 24880 97 106 45 42 11 5 25 . . 1 . . 1 4 . . . . . . 14 1 9 9 7 41 15.72 14.03 .32 .96 St. Nicholas, Deptford 7290 7904 34 27 19 18 13 2 5 . . 1 . . . . . . . . . . 2 4 . . 7 2 3 18 12.36 18.78 1.54 1.52 Charlton 16910 18280 65 63 26 21 4 4 22 . . 1 . . . . 1 . . . . 2 5 1 2 7 5 23 10.28 10.32 .44 .87 Kidbrooke 2875 3107 6 3 2 6 . . . . 3 . . . . . . . . . . . . . . . . . . . . 1 . . . . 7 5.57 10.33 1.31 . . Miller Hospital— Resident . . . . . . 5 2 1 2 . . . . . . . . . . . . . . . . 1 . . . . 2 . . 2 2 . . . . . . . . Non-Resident . . . . . . 7 4 1 . . . . . . . . . . . . . . . . . . . . . . 1 1 1 . . 8 . . . . . . . . Seamen's Hospital— Resident . . . . . . 14 1 . . 1 1 . . . . . . . . . . . . . . . . 3 . . 3 2 . . 7 . . . . . . . . Non-Resident . . . . . . 16 1 . . . . 1 . . . . . . . . . . . . . . . . 4 . . 4 . . 2 7 . . . . . . . . Greenwich & Deptford Hospital— Resident . . .. . . 38 33 12 6 23 . . 1 . . . . 3 . . 1 2 2 3 5 4 8 42 . . . . . . . . Non-Resident . . . . . . 64 56 13 2 39 . . . . . . . . 2 . . 2 1 9 3 17 9 8 69 . . . . . . . . Herbert Hospital— Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . 2 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . 2 . . . . . . . . M.A.B. Brook Hospital— Resident . . . . . . 1 . . . . 1 . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . 7 10 1 4 . . . . . . . . 13 . . . . . . . . . . . . . . . . . . 2 . . . . . . . . Cottage Hospital— Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Non-Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Institutions— Resident . . . . . . 2 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . 1 . . . . . . . . Non-Resident . . . . . . . . 2 . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . Outside Institutions— Resident . . . . . . 24 22 4 1 5 . . . . . . 1 . . . . . . . . 6 4 . . 4 3 28 . . . . . . . . 385 372 169 152 Borough 95968 104453 757 321 52 26 87 . . 7 2 9 . . . . 5 33 9 36 31 27 162 . . . . . . . . Rate per 1,000 of Estimated Population . . . . . . . . . . . . . . • • .26 . . .06 .34 . . . . .19 1.25 .34 1.36 1.18 1.02 6.17 11.22 12.23 .58 .87 Deaths of Children under 1 Year per 1,000 births, 70 „ „ „ previous corresponding 98 period. „ ,, „ County of London, 62 Death Rate of 96 large English Towns, 12.9; of the County of London, 12.5. Birth Rate „ „ 27.6; „ 28.3. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st January, 1920. DISTRICTS. Census Population, 1911. Estimated Population at the middle of the Year 1920. Births Registered during the 13 weeks ended 2nd October, 1920. Deaths Registered during the 13 weeks ended 2nd October, 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. Under 1 Year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping-Cough. Fevers. Diarrhœa. All Cause Seven Zymotics. Typhoid. Other. During the corresponding period year previous. During the 13 weeks ended 2nd October, 1920. During the corresponding period year previous. During the 13 weeks ended 2nd October, 1920. M. F. M. F. Greenwich East .. .. 151 140 54 46 3 4 42 .. .. .. 1 .. .. .. .. 8 4 8 10 16 53 9.57 7.98 .80 .07 Do. West .. .. 70 66 49 18 8 1 23 .. .. .. .. .. 1 2 4 9 1 5 5 7 33 11.30 10.80 .81 1.12 St. Nicholas, Deptford .. .. 31 23 14 7 5 .. 3 .. 1 .. .. .. .. .. 1 5 .. 3 1 3 7 9.79 10.66 3.09 1.01 Charlton .. .. 40 38 13 18 5 1 11 .. •• .. 1 .. .. .. 1 4 .. 3 4 6 12 7.37 6.80 .66 .43 Kidbrooke .. .. 4 1 3 4 .. .. 3 .. .. •• •• •• •• •• •• 1 •• •• •• 1 5 9.10 9.03 •• •• Miller Hospital— Resident •• •• •• 4 •• •• •• 1 •• •• •• •• •• •• •• •• •• 1 2 •• •• 1 •• •• •• •• Non-Resident •• •• •• 7 8 3 1 1 •• •• •• •• •• .. •• •• •• •• •• 2 •• 13 •• •• •• •• Seamen's Hospital—- Resident •• •• •• 17 •• •• •• •• .. •• •• •• •• •• •• 2 2 1 2 1 2 5 •• •• •• •• Non-Resident .. •• •• 16 •• •• •• 1 •• •• .. •• •• •• •• •• 5 •• 1 2 3 5 •• •• •• •• Greenwich & Deptford Hospital— Resident •• •• •• 25 17 1 1 13 •• •• •• •• •• •• •• •• 6 •• 3 1 7 24 •• •• •• •• Non-Resident •• •• •• 47 42 7 •• 29 •• •• •• •• •• •• 1 12 5 4 8 9 49 •• •• •• •• Herbert Hospital — Resident •• •• •• •• 1 •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• •• Non-Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• M.A.B. Brook Hospital— Resident •• •• •• 1 1 1 1 •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Non-Resident •• •• •• 9 7 3 •• •• •• •• 1 13 •• •• •• •• •• •• 1 •• •• 1 •• •• •• •• Cottage Hospital— Resident •• •• •• 1 1 •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• 1 •• •• •• •• Non-Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Other Institutions— Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Non-Resident •• •• •• •• 3 •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• 2 •• •• •• •• Outside Institutions— Resident •• •• •• 26 12 3 •• 6 •• •• •• •• •• •• •• 1 6 3 •• 1 4 23 •• •• •• •• 306 268 133 93 Borough •• •• 573 226 21 6 82 •• 1 •• 2 •• 1 2 6 27 5 19 20 33 110 •• •• •• •• Rate per 1,000 of Estimated Population •• •• •• •• •• •• •• •• .03 •• .07 •• .03 .07 .22 1.02 .19 .72 .75 1.25 4.19 9.46 8.61 .93 .45 Deaths of Children under 1 Year per 1,000 births, 37 „ „ „ previous corresponding72 period ,, ,, „ County of London, 59 Death Rate of 9G large English Towns, 10.0; of the County of London, 9.6. Birth Rate „ „ 24. 8; » 25.1. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st January, 1921. DISTRICTS. Census Population, 1911. Estimated Population at the middle of the Year 1920. Births Registered during the 13 weeks ended 1st January, 1921. Deaths Registered during the 13 weeks ended 1st January, 1921. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Diarrhœa. 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. All Causes. Seven Zymotics During the corresponding period year previous. During the 13 weeks ended 1st January, 1921. During the corresponding period year previous. During the 13 weeks ended 1st January, 1921. Typhoid. Other. M. F. M. F. Greenwich East .. .. 140 141 68 53 25 5 36 .. .. 1 1 1 .. .. 5 12 4 17 15 14 51 11.35 9.65 1.13 .63 Do. West .. .. 07 72 44 34 10 1 23 .. .. .. .. .. .. .. 2 13 2 15 9 9 28 12.77 12.58 2.05 .08 St. Nicholas, Deptford .. .. 27 23 16 11 7 1 6 .. .. .. 1 .. .. .. 2 1 .. 5 2 3 13 27.83 13.71 3.60 .37 Charlton .. .. 44 37 33 23 3 1 26 .. .. .. 1 .. .. .. .. 3 .. 7 12 9 24 12.29 12.29 .66 .04 Kidbrooke .. .. 6 4 2 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 9.20 3.87 .. .. Miller Hospital— Resident .. .. .. 4 3 2 .. .. .. .. .. .. .. .. 1 .. .. .. 2 .. .. 4 .. .. .. Non-Resident .. .. .. 9 8 3 1 3 .. .. .. .. .. .. 1 .. .. 2 1 .. 3 10 .. .. .. .. Seamen's Hospital— Resident .. .. .. 13 .. .. .. 3 .. .. .. .. .. .. .. .. 5 .. 2 .. 2 4 .. .. .. .. Non-Resident .. .. .. 18 1 1 .. .. .. .. .. .. .. .. .. .. 7 .. 3 3 3 3 .. .. .. .. Greenwich & Deptford Hospital- Resident .. .. .. 23 19 5 .. 13 .. .. .. .. .. .. .. 3 5 .. 5 5 8 16 .. .. .. .. Non-Resident .. .. .. 60 36 7 .. 43 .. .. .. .. .. .. .. .. 10 2 16 6 5 57 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. 1 1 .. 2 .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. 14 14 4 13 .. .. .. 8 17 .. .. .. .. .. .. .. .. .. 3 .. .. .. .. Cottage Hospital— Resident .. .. .. 3 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. 3 .. .. 1 .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. Non-Resident .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Outside Institutions— Resident .. .. .. 29 18 6 .. 10 .. .. .. 1 .. .. .. 2 6 2 1 4 10 21 .. .. .. .. 284 277 163 122 Borough .. .. 561 2 2 45 8 92 .. .. 1 3 1 .. .. 9 29 7 45 38 35 117 .. .. .. .. Rate per 1,000 of Estimated Population .. .. .. .. .. .. .. .. .. .03 .11 .03 .. .. .34 1.10 .26 1.71 1.44 1.33 4.45 15.45 10.85 1.45 .53 Deaths of Children under 1 Year per 1,000 births, 80 ,, „ previous corresponding 96 period „ ,, County of London, 79 Death Rate of 90 large English Towns, 13 0; of the County of London, 131. Birth Rate 22.7; 22.9. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 52 weeks ended 1st January, 1921. DISTRICTS. Census Population, 1911. Estimated Population at the middle ot' the Year 1920. Births Registered during the 52 weeks ended 1st January, 1921. Deaths Registered during the 52 weeks ended 1st January, 1921. 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. Diarrhoea and Dysentry. All Causes. Seven Zymotics During the corresponding period year previous. During the 52 weeks ended 1st January, 1921. During the corresponding period year previous. During the 52 weeks ended 1st January, 1921. Typhoid. Other. m. F. m. F. Greenwich East .. .. 642 631 276 245 78 39 171 .. 10 3 7 11 .. .. 6 39 16 83 42 55 249 10.77 10.39 .71 .73 Do. West .. .. 353 349 222 146 58 26 94 .. 6 .. 3 6 2 2 7 50 7 75 33 27 150 18.86 14.84 .92 1.04 St. Nicholas, Deptford .. .. 123 108 68 55 34 10 19 .. 7 .. 1 .. .. 1 6 14 1 29 7 11 46 15.32 15.61 1.72 1.90 Charlton .. .. 228 183 104 88 25 9 75 .. 2 .. 2 3 .. .. 3 16 2 24 25 26 89 13.36 9.39 .65 .49 Kidbrooke .. .. 19 12 9 18 .. 1 13 .. 1 .. .. .. .. .. .. 1 1 3 2 1 18 6.88 8.90 .32 .32 Miller Hospital— Resident .. .. .. .. 19 8 6 3 2 .. .. .. .. .. .. 1 1 1 8 .. 3 13 .. .. .. .. Non-Resident .. .. .. .. 31 23 8 3 4 .. .. .. .. .. .. 1 .. .. 5 2 6 3 37 .. .. .. .. Seamen's Hospital— Resident .. .. .. .. 69 3 .. 1 4 .. .. .. .. .. .. 2 2 15 2 20 5 5 21 .. .. .. .. Non-Resident .. .. .. .. 71 2 1 .. 2 .. .. .. .. .. .. .. 1 21 .. 15 5 8 23 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. .. 116 108 25 13 49 .. 8 .. 1 4 .. 2 5 15 6 21 12 28 122 .. .. .. .. Non-Resident .. .. .. .. 266 209 41 8 65 .. 9 .. 1 2 .. 3 4 38 11 62 29 39 277 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Non-Resident .. .. .. .. 3 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. .. 5 3 1 4 .. .. .. 2 6 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. 43 47 8 29 .. .. 2 17 61 .. .. .. .. .. 1 2 .. .. 7 .. .. .. .. Cottage Hospital— Resident .. .. .. .. 5 2 .. .. 1 .. .. .. .. .. .. .. .. .. .. 5 .. .. 2 .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. .. 4 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 4 .. 1 .. .. .. .. Non-Resident .. .. .. .. .. 6 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 .. 5 .. .. .. .. Outside Institutions— Resident .. .. .. .. 114 79 22 5 33 .. .. .. 5 1 .. 1 4 26 10 9 13 22 102 .. .. .. .. 1 305 1283 6.9 552 Borough 2648 1231 195 85 372 .. 26 3 13 20 2 3 22 120 27 214 09 120 552 .. .. .. .. Rate per 1,000 of Estimated Population .. .. .. .. .. .. .. .. .26 .02 .13 .18 .01 .02 .20 1.14 .27 2.03 1.03 1.14 5.25 13.15 11.72 .84 .84 Deaths of Children under 1 Year per 1,000 births, 75 „ „ ,, previous corresponding} 95 period „ „ „ County of London, 75 Death Rate of 96 large English Towns, 125; of the County of London, 12.4. Birth Rate „ „ 26 2; „ 26.5 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 3rd April, 1920. Causes of death. Deaths in Whole District at Subjoined Ages. Deaths in Localities at all Ages. Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District Al! 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 Gr'n'ch. & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital, M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 399 77 22 23 15 22 48 81 in 158 136 38 58 9 69 27 9 3 i 59 340 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 18 5 3 5 4 .. 1 .. .. 6 5 5 1 1 7 .. .. .. .. .. .. .. 19 Scarlet Fever 2 .. .. 1 .. 1 .. .. .. 2 .. .. .. .. .. .. .. .. 1 .. .. .. 4 Whooping Cough 10 7 1 1 .. 1 .. .. .. 6 2 .. 2 .. 1 .. .. .. .. .. .. 1 1 Diphtheria and Croup 6 .. .. 4 2 .. .. .. .. 4 2 .. .. .. 1 .. .. .. 2 .. .. 3 19 Influenza 6 .. .. .. .. .. .. 3 3 4 2 .. .. .. .. 1 .. .. .. .. .. .. 2 Erysipelas 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 3 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Encephalitis 1 .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 31 .. 1 .. 2 11 14 3 .. 9 14 4 4 .. 2 5 .. .. .. .. .. 7 20 Tuberculous Meningitis 2 .. 1 .. .. .. 1 .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. .. 4 Other Tuberculous 4 . . 1 .. 1 2 .. .. .. .. 2 1 1 .. .. 1 .. .. .. .. .. 1 2 Diseases Rheumatic Fever 2 .. .. 1 .. .. .. .. 1 1 1 .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 25 .. .. .. .. .. 3 12 10 13 4 2 6 .. 7 1 1 .. .. .. .. 5 25 Bronchitis 57 15 2 4 .. 2 1 16 17 20 24 5 7 1 7 2 1 .. .. .. .. 1 21 Broncho-Pneumonia 32 12 8 1 1 .. 4 4 2 10 11 7 4 .. 1 3 1 .. .. 1 .. 3 13 Pneumonia (all other forms) 25 4 4 1 .. 1 7 3 5 11 11 2 1 .. 2 6 .. .. .. .. .. 2 23 Other Diseases of Respiratory Organs 4 .. .. 1 .. .. .. 2 1 2 2 .. .. .. 2 1 .. .. .. .. .. .. 4 Diarrhoea and Enteritis 2 2 .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 3 Appendicitis & Typhlitis. 2 .. .. 1 .. .. 1 .. .. .. 1 .. 1 .. .. 1 1 .. .. .. .. .. 4 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 2 .. .. .. 1 .. .. .. 1 1 1 .. .. .. .. .. .. .. .. .. .. 1 2 Nephritis and Bright's Disease 8 .. .. .. .. .. 1 6 1 2 4 1 1 .. 2 1 .. .. .. .. .. 9 Puerperal Fever 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 2 Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 26 24 .. 1 1 .. .. .. .. 7 12 .. 7 .. 4 .. 1 .. .. .. .. 3 15 Violent Deaths, excluding Suicide 10 2 .. .. 2 1 1 2 2 4 4 .. 2 .. 2 .. 1 .. .. .. .. 2 11 Suicides 2 .. .. .. .. .. 1 1 .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. 2 Heart 20 .. .. 1 .. 1 2 8 8 4 10 2 2 2 2 2 .. .. .. .. .. 4 13 Other Defined Diseases 98 6 1 1 .. 1 9 20 60 49 19 7 18 5 27 4 2 .. .. .. .. 24 119 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 399 77 22 23 15 22 48 81 111 158 136 38 58 9 69 27 9 .. 3 1 .. 59 340 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 3rd July, 1920. Causes of Death. Deaths in Whole District at Subjoined Ages. Deaths in Localities at all Ares. Deaths in Public Institutions (Residents). Total Deaths in Public Institutions in the District Al! 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 Or'n'ch. & Deptford Hospital Seamen's Hospital Miller Hospital lieiocic xviilitary Hospital Brook Hospital, M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 321 52 10 16 18 23 46 69 87 142 87 37 47 8 71 15 7 .. 1 .. 3 46 267 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 7 2 2 3 .. .. .. .. .. 4 1 1 1 .. 1 .. .. .. .. .. .. .. 1 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Whooping Cough 9 4 1 3 1 .. .. .. .. 4 4 .. 1 .. 3 .. .. .. .. .. .. .. 5 Diphtheria and Croup 2 1 .. 1 .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. 14 Influenza 6 .. .. .. .. 1 2 1 2 1 3 1 1 .. 1 2 .. .. 1 .. .. .. 5 Erysipelas 1 1 .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Posterior Basal Meningitis 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 3 .. .. .. 4 5 11 11 2 10 14 4 5 .. 2 3 .. .. .. .. .. .. 18 Tuberculous Meningitis 4 1 1 .. 1 .. 1 .. .. 4 .. .. .. .. 1 .. .. .. .. .. .. 2 2 Other Tuberculous 5 .. .. .. 2 2 1 .. .. 3 1 .. 1 .. 2 .. .. .. .. .. .. 2 5 Diseases Rheumatic Fever 5 .. .. .. 2 2 .. 1 .. 2 1 1 1 .. 1 .. .. .. .. .. .. .. 3 Cancer, Malignant Disease 27 .. .. .. .. .. 4 14 9 12 7 3 5 .. 8 .. 2 .. .. .. .. 3 20 Bronchitis 13 3 1 .. .. .. .. 3 6 5 1 6 1 .. 3 .. .. .. .. .. .. .. 16 Broncho-Pneumonia 9 5 2 1 .. .. .. 1 .. 5 2 1 1 .. 2 .. 1 .. .. .. .. .. 8 Pneumonia (all other forms) 14 .. 1 1 .. 2 5 .. 5 7 6 .. .. .. .. 3 1 .. .. .. .. .. 8 Other Diseases of Respiratory Organs 3 1 .. .. .. .. .. .. .. 2 1 .. .. .. 2 .. .. .. .. .. .. .. 3 Diarrhoea and Enteritis 5 2 .. 2 .. .. .. .. 1 1 .. 2 2 .. 2 .. 1 .. .. .. .. .. 4 Appendicitis and Typhlitis 4 .. .. 1 1 2 .. .. .. 3 .. .. 1 .. 2 .. 1 .. .. .. .. 1 4 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 9 .. .. 1 .. .. 2 3 3 5 2 .. 2 .. 2 .. .. .. .. .. .. 2 6 Puerperal Fever 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 Other Accidents and Diseases of Pregnancy and Parturition 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 Congenital Debility and Malformation, including Premature Birth 24 24 .. .. .. .. .. .. .. 12 6 4 2 .. 6 .. .. .. .. .. .. 1 16 Violent Deaths, excluding Suicide 19 .. .. 2 3 1 7 4 2 10 5 2 1 1 5 3 1 .. .. .. .. 5 17 Suicides 4 .. .. .. .. .. 1 3 2 1 1 .. .. .. .. .. .. .. .. .. 1 .. Heart Disease 31 .. .. 1 1 4 3 9 13 13 9 2 7 .. 4 2 .. .. .. .. .. 4 19 Other Defined Diseases . 83 8 1 .. 3 4 6 17 44 36 21 8 13 5 23 2 .. .. .. .. 3 17 88 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 321 52 10 16 18 23 46 69 87 142 87 37 47 8 71 15 7 .. 1 .. 3 46 267 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ending 2nd October, 1920. Causes of Death. Deaths in Whole District at Subjoined Ages. Deaths in Localities at all Ages. Deaths in Public Institutions (Residents). Total Deaths ir, Public Institutions in the District Al! 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 tf5 and upwards Greenwich East Greenwich West St. Nicholas, Deptford Charlton Kidbrooke Gr'n'ch. & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital, M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 226 21 3 3 8 15 40 54 82 100 67 21 31 7 42 17 4 1 2 1 3 38 207 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Croup 2 1 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. 15 Influenza 2 .. .. .. .. .. .. 1 1 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentry 2 .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. 4 Malaria 2 .. .. .. .. .. 2 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 27 1 .. .. 1 8 10 6 1 8 9 5 4 1 6 2 .. .. .. .. .. 6 25 Tuberculous Meningitis 3 .. 1 .. 1 .. 1 .. .. 2 1 .. .. .. .. 1 1 .. .. .. .. 1 4 Other Tuberculous 2 .. .. .. .. .. 1 1 .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 3 Diseases Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 33 .. .. 1 .. .. 2 13 17 16 7 3 6 1 7 2 .. .. .. .. .. 4 21 Bronchitis 7 1 .. .. .. .. 1 .. 5 3 3 1 .. .. 2 .. .. .. .. .. .. .. 4 Broncho-Pneumonia 3 1 1 .. .. .. .. 1 .. 1 1 1 .. .. 1 1 .. .. .. .. .. .. 4 Pneumonia (all other forms) 9 .. .. .. .. .. 3 4 2 4 1 1 3 .. .. 1 2 .. .. 1 .. .. 6 Other Diseases of Respiratory Organs 2 .. .. .. .. .. 1 1 .. 2 .. .. .. .. 1 .. .. .. .. .. .. 1 2 Diarrhoea and Enteritis 4 4 .. .. .. .. .. .. .. .. 2 1 1 .. .. .. .. .. .. .. .. 1 1 Appendicitis and Typhlitis 2 .. .. .. .. 2 .. .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. 1 2 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 5 .. .. .. 1 .. 1 1 2 3 1 .. .. 1 2 .. .. .. .. .. .. 2 7 Puerperal Fever .. .. .. .. .. .. 3 .. .. 1 .. 1 1 .. 1 1 .. .. .. .. .. .. 3 Other Accidents & Diseases of Pregnancy Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 4 4 .. .. .. .. .. .. .. .. 2 1 1 .. .. .. .. .. .. .. .. 1 3 Violent Deaths, excluding Suicide 11 3 .. .. 3 2 .. 1 2 8 2 .. 1 .. 4 2 .. .. .. .. .. 1 13 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Heart Disease 20 .. .. 1 1 2 .. 5 11 10 5 1 4 .. 1 1 .. .. .. .. .. 1 15 Other Defined Diseases 80 5 .. 1 1 .. 13 20 40 37 27 3 9 4 16 .. 1 1 .. 1 3 17 72 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 226 21 3 3 8 15 40 54 82 100 67 21 31 7 42 17 4 1 2 1 3 38 207