GRE 24 T H E ANNUAL REPORT made to THE COUNCIL of the Metropolitan borough of Greenwich For the Year 1921, by ERNEST GEORGE ANNIS M.R.C.S., L.R.C.P., L.S.A., D.P.H. (Barrister-at-l.aw), MEDICAL OFFICER OF HEALTH TO THE BOROUGH ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, and EXECUTIVE TUBERCULOSIS OFFICER. London: E. G. BERRYMAN & SONS., LTD., PRINTERS. Blackheath Road S.E. 1922. INDEX OF CONTENTS. Page Age Mortality 14 Analysis of Death Causes 15 Anthrax 41 Area of Borough 9 Articles and Rooms Disinfected 42 Articles Destroyed 43 Baby Shows 54 Bacteriological Examinations 61 Bakehouses 29 Births 9, 12 Blackheath and Charlton Cottage Hospital 21 Bones and Joints 20 Books Destroyed 44 Cancer 18 Causes of Death 16-20 Cerebro-Spinal Fever 40 Children Act, 1908 59 Circulatory System 19 Cleansing Children 44 Complaints 21, 72 Constitutional Diseases 18 Consumption 10, 45 Contacts 40 Cowhouses 28 Customs and Inland Revenue Acts 24 Dairies, Cowsheds and Milkshops 28 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 13, 14 Density of Population 9 Dental Work 49,58 Developmental Diseases 18 Diarrhoea and Zymotic Enteritis 17,40 Dietetic Diseases 18 Digestive System 19 Diphtheria 16,35 Diphtheria Anti-Toxin 16 Disinfection 41 Duties and Powers of the Public Health Committee 5, 6 Duties and Powers of the Maternity and Child Welfare Committee 7 Elevation of Borough 9 Emulsion 55 Encephalitis Lethargica 41 Enteritis 17,40 Epidemic Cerebro-Spinal Meningitis 40 Epidemic Diseases 16 Erysipelas 17, 36 External Causes 20 Factories and Workshops 21-24 Food and Drugs—Samples of 31-33 Food—Premises for Preparation of, etc. 29 Glanders 41 Gonorrhoea 17 3 INDEX—continued. Page Health Centres 53,56 Health Visitors, Visits, etc. 57 Home of Rest for Advanced Cases 50 Home Work 23 Horse Slaughterer 25 Hospital and other forms of Gratuitous Medical Relief 21 House Drainage 26 Houses Inspected for Infectious Disease 44 Houses Let in Lodgings 25 Housing 61-66 Hydrophobia 41 Ice Cream Premises 31 Ill-defined Causes 20 Increase of Rent and Mortgage Interest (Restriction Act, 1920 25 Infant Consultations 53, 56 Infantile Mortality 14 & Appendix Influenza 17 Inhabited Houses 9 Inland Revenue Acts 74 Insanitary Areas 61 Institution Deaths 14 Integumentary System 20 Interim Tuberculosis Care Committee 50-51 Introductory Review 10, 11 Legal Proceedings 27 Local Diseases 19 Lymphatic System 19 Malarial Diseases 17,41 Marriages 11 Maternity and Child Welfare 53 Maternity Home 57 Measles 16,38,39,68 Meat 29 Membranous Croup 36 Milk and Cream Regulations 29 Milk, Mothers and Children's Orders 29 Milk Supply 28 Milk Supply for Expectant and Nursing Mothers 54 Miller General Hospital 21 Minor Ailment Centre 56 Mortuary 20 Nervous System 19 Notices, etc. 72 Notifications 35 Notification of Births Act 59 Offensive Trades 26 Ophthalmia Neonatorum 40, 58 Organs of Special Sense 19 Outworkers' Register 21 Overcrowding 73 Parasitic Diseases 18 Persons Cleansed 73 Polio-encephalitis 40 Polio-myelitis 40 Poor Law Relief 20 Population 9,11 Public Health Committee 5 4 INDEX—continued. Page Puerperal Fever 17,38,58 Pyaemia and Septicaemia 17 Rats and Mice (Destruction) Act, 1019 25 Refuse Removal 24 Remarks on Death Causes 16 Reproductive System 19 Respiratory System 19 Rheumatic Fever 17 Sale of Food and Drugs Act * 31-33 Sanitary Work—Summaries, etc. 21, 67-74 Scarlet Fever 16,36,37 Scavenging and Refuse Removal 24 School Clinic 56 Seamen's Hospital 21 Septic Diseases 17 Slaughterhouses 29 Small-pox 16, 35 Smoke Nuisances 26 Sporadic Diseases . 17 Staff of Public Health Department 8 Statistical Summary ' 9 Statistical Tables Appendix Suffocation 20 Suicide 20 Syphilis 17 Tenement Houses 18 Tuberculosis 18-41 Tuberculosis Dispensary—Return of Attendances 52 Tuberculosis—Interim Care Committee 50, 51 Tuberculosis Officer's Report 45-52 Typhoid Fever 17, 38 Underground Bakehouses 24 Underground Rooms 73 Unwholesome Food 29,30,71 Uninhabited Houses 9 Urinary System 19 Vaccination Particulars 34 Venereal Diseases 17 Verminous Premises 73 Verminous Children 44 Virol 55 Vital Statistics 11 & Appendix Water Supply 26,27 Whooping Cough 40 Workshops and Factories 21,22 Workshops and Workplaces 21,22,24 Zymotic Enteritis 17, 40 Zymotic Diseases 16 5 Public Health Committee during the Year 1920-21. Aldenman B. J. Lemmon, J.P. (Mayor), and 13 Members. Alderman Mrs. S. A. Kelly. Councillors— T. F. Battle, Chairman. YV. J. Jackman. F. W. Clifton, Vice-Chairman. F. W. Mandf.k. Mrs. N. Cunis. C. L. Skinner. Mrs. A. M. Edwards. A. Smith. R. G. Evans. F. Whatley. B.A. J. Hogg. C. S. Willatt. Duties and Powers of the Public health Committee— 1.—The Committee shall consist of thirteen electcd members. 2.—There shall be referred to the Committee the execution of the Food and Drugs Act, 187.3-1899; 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 Cinal 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. 6 3.—The Committee may serve and receive notices, take proceedings, and in particular cases empower any Officer of the Council to make complaints and take proceedings on their behalf under, and otherwise execute, the Public Health (London) Act, 1891, and sections 82, 83, 84 and 85 of the Metropolis Management Act, 1855, relating to the inspection of any premises, drains, sinks, traps, syphons, pipes, or other works or apparatus connected therewith, and otherwise in relation to defective drainage, except as to the recovery of expenses, and the same shall not require the approval of the Council, provided that the Committee shall report their action at the next following meeting of the Council, who may at anytime 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.—W orks of drainage of houses and premises shall be carried out under the direction of this Committee. G.—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 stall, 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. 7 Maternity and Child Welfare Committee burnig the Year 1920-21. Alderman B. J. Lf.mmon, J.P. (Mayor), and 12 Members. Alderman Mrs. S. A. Kelly, Chairman. Councillors— T. F. Battle. J. Hogg. Mrs. N. Cunis. R. F A. Purkiss. F. W. Clifton Miss M. Sherman, Vice-Chairman. R. G. Evans. Mrs C. R. Turner. Co-opted Members– Mrs. M. Hamilton. Mrs. H. G. Sargent. Mrs. M. Woodnutt. 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. 8 Staff of the public Health Department. 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 and Tuberculosis Officer— M. Macdonald, M.D., Ch.B., D.P.H. Maternity and Child Welfare Medical Officer— F. L. Pickett. B.A., M.B., Ch.B., M.R.C.S., L.R.C.P. Public Analyst—A. E. Brown. B.Sc., F.I.C. Sanitary Inspectors— A. F Bache. S. A. Radford. C. W. Nettleton. E. Martin. A. E. Morgan. W. R. Drake. Miss G. Davis. Health Visitors Miss M. Molloy. Miss B. M. Buckton. Mrs. M. Donald-Morison. Miss E. Bailey. Miss F. Jagot. Miss A. Hadfield. Tuberculosis Nurses Miss L. Heastman. Miss D. M. Wilkins. Miss T. L Husbands. Miss R. Aldis. Dispenser— Matron Municipal Creche— E. E Burrows. Mrs. E. Chalk. Clerical Staff— F. W. Foulger, Principal Clerk. H. Duck. Mrs L. E. Wright. Miss L. Merrjcks. A. G. Thomas. W. H. Collins. E. P. Tidman (Temporary). Mrs. N. Fcrbank. Milk Salesivommi. Disinfecting- Staff— J. Forrest. A. Clay. F. Mears. F. Stevens. Caretaker at Cleansing Station— Dispensary Keeper— Mrs. E. Robinson. Mrs. G. Vickery. Mortuary Keeper—G. W Moss. 9 Statistical Summary. Elevation—Varies from below high-water mark up to 219 feet above sea level. Area of the Borough and Districts— East Greenwich 1451.1 acres West Greenwich 297.8 „ St Nicholas. Deptford 112.1 „ Charlton and Kidbrooke 1990.1 „ 3851.7 acres Density of Population— East Greenwich 30.48 persons per acre West Greenwich 89.60 „ St. Nicholas, Deptford 67.62 Charlton and Kidbrooke 11.04 „ Average for the Borough 26.09 persons per acre Number of Inhabited Houses— At Census, 1901 14.210 At. Census, 1911 14.722 Estimated, 1921 16.292 Number oi Uninhabited Houses— At Census, 1911 803 Estimated, 1921 153 Population— At Census, 1911 95,972 Estimated, 1921 100,493 Birth Rate, 1921 22.70 per 1,000 Death Rate, 1921 12.41 „ „ (Zymotic) 76 „ „ (Infantile Mortality) 74 per 1,000 Births 10 Pubuc Health Offices, Borough Hall, Royal Hill. Greenwich, S.E.10, May, 1922. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greenwich. Ladies and Gentlemen, I have the honour to submit herewith my Annual Report as Medical Officer of Health for the year 1921, and am pleased to be able again to report that the health statistics generally are of a very satisfactory character. The Death Rate is 12 41 per 1,000 of the estimated population, which, although slightly higher than the figure for 1920, which was 11.72, compares favourably with the average for the last five years, and the Death Rates for the County of London and the ninety six large towns. The Birth Rate is 22.70 per 1,000, the figure for the whole of the County of London being 22 8. The Infantile Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered, is 74, which is below what was regarded as the phenomenally low rate of 75 in 1920. It is useful to compare this figure with that of 1919, viz., 89, and the average of 93 for the last, five years. The Zymotic Death Rate of .76 per 1,000 is also below the figure of last year, which was .84. 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. Diarrhæa Death Rate. Consumption Death Rate. East Greenwich 23.99 12.17 61 .95 .17 1.02 West Greenwich 23.67 12.53 87 .77 .36 1.18 St. Nicholas, Deptford 30.28 14.28 91 .26 .13 1.98 Charlton 19.75 11.80 86 .53 .37 1.38 Kidbrooke 21.04 11.62 15 .62 .31 31 Whole Borough 22.70. 12.41 74 .76 .26 118 Attack Rates of the various notifiable diseases, per 1.000 living in the several districts: — Distircts. Small-pox. Diphtheria. Scarlet Fever. Erysipelas. T vphoid Fever. Puerperal Fever East Greenwich 0.00 7.52 9.61 .68 . 04 .08 West Greenwich 0.00 5.67 7.15 .51 .21 .07 St. Nicholas, Deptford 0.00 3.17 5.81 .82. — .'39 Charlton 0.00 2.99 9.60 .31 . 10 .10 Kidbrooke 0.00 9.10 10.30 – – — Whole Borough 0.00 5.94 9.56 56 . . 09 .09 11 It is my privilege again to express my appreciation of the kindness and consideration which has always been shown to me by the members of the Public Health and Maternity and Child Welfare Committees, and the whole of the members of the Council. I also have to acknowledge gratefully the increased assistance which has been given me on the clerical side, which, coupled' with adequate office accommodation, has served to place the administration of the department on a thoroughly well organised basis. I have only to add that the whole of the staff have carried out their duties in a particularly enthusiastic and satisfactory manner. I am, Ladies and Gentlemen, Your obedient Servant, E. G. Annis. VITAL AND MORTAL STATISTICS, 1921. POPULATION. The decennial census was taken in June, 1021, when it was found that the population in the Borough of Greenwich stood at 100,493, and it is at this figure that the various rates, etc., appearing in this report are estimated. It is interesting to note that this figure shows an advance of nearly 5,000 over the 1911 Census figure, w hich in turn was practicallv the same as the Census figure of 1901. The distribution of the population throughout the Borough is as follows:— Census. 1911. Estimated Population at nvddle of Year 1921 East Greenwich 45,963 44,240 West Greenwich 22,936 26,687 St. Nicholas, Deptford 7,291 7,581 Charlton 16,911 18,790 Kidbrooke 2.876 3,195 Total 95,977 100,493 MARRIAGES. The Superintendent.Registrar of the Greenwich Registration District has kindly furnished me with the particulars relating to 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. 12 The following table shows these particulars, giving the number of marriages in Greenwich and St. Nicholas, etc., for each year since 1911: — Year. In Churches of Eng. land 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 Churchin St. Nicholas and Greenwich. Total. Approximate Population of the districts concerned. 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 119 197 76 326 1018 102591 1920 384 105 64 322 875 104453 1921 344 124 57 249 774 100493 BIRTHS. The total number of Births registered in the Borough during the year was 2,356. Of this number 123 occurred in the Greenwich and Deptford Hospital and 110 at various Nursing Homes within the Borough. Of this total of 239 Institution births, 94 only belonged to Greenwich, the remainder being transferred to the appropriate localities. Fifty-three births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 2,274—Males, 1,171; Females, 1,103. This figure gives a Birth Rate of 22.70 per 1,000 of the population, being .06 below the average for the last ten years. The Birth Rate for the County of London equals 22.8 per 1,000 of the population. The Birth Rate for all England and Wales was 22.4. Illegitimate births numbered 45, representing 1.9 per cent. of the total births. These were distributed as follows: — East Greenwich 19 West Greenwich 17 St. Nicholas 3 Charlton 6 45 13 Ninety two illegitimate births were actually registered in the Borough, but 47 of these belonged to other Boroughs. Thirty.six illegitimate births occurred in the Greenwich and Deptford Hospital, of which 17 only belonged to Greenwich. Under the provisions of the Notifications of Births Act, 1907, intimations have been received from medical men, parents, and others, with respect to 2,564 births. DEATHS. The total number of deaths registered during 1921 was 1,243, of which 668 were males and 575 females. The crude Death Rate for the Borough of 12.41 per 1,000 compares with 12.4, the Death Rate for the County of London, and 12.3, the Death Rate for the ninety.six large towns. The Death Rate in the various Metropolitan Boroughs varied from 11.2 in Hampstead, 11.5 in Hackney and Stoke Nwing ton, 11.7 in Woolwich, 11.8 in Fulham, up to 13 74 in Bermondsev. 13.8 in Kensington, 14.3 in Southwark, 14.4 in Shoreditch and 14.8 in Finsbury. Locally the Death Rate varied from 14.28 in St. Nicholas, 12.53 in West Greenwich, 1217 in East Greenwich, 11.80 in Charlton to 11.62 in Kidbrooke. Of the total number of deaths, 24 were of illegitimate birth, 19 of whom were under one year of age. 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 1916 to 1920, compared with the figures for 1921:— District. 1916. 1917. 1918. 1919. 1920. Average for Five Years. 1921. East Greenwich 12.57 14.05 16.01 10.58 10.39 12.72 12.17 West Greenwich 19.93 19.55 26.03 18.56 14.84 19.78 12.53 St. Nicholas 22.44 26.07 24.45 12.84 15.61 20.28 14.28 Charlton 13.66 15.50 20.42 13.10 9.39 14.41 11.80 Kidbrooke 8.57 6.71 10.50 6.88 8.90 8.31 11.62 Borough 15.14 15.96 19.16 13.15 11.72 15.02 12.41 14 DEATHS IN INSTITUTIONS. The following table shows 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. 1916 1,426 197 544 1917 1,439 203 364 1918 1,718 210 651 1919 1,372 187 603 1920 1,231 195 535 1921 1,243 175 553 Average 1,437 198 539 AGE MORTALITY. The age mortality and the distribution of the deaths between the different quarters of the year is shown by the following table:— Deaths. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Under 1 year of age 59 31 42 43 175 Between 1 and 2 years 15 7 11 21 54 Between 2 and 5 years 7 4 3 12 26 Between 5 and 15 years 11 17 13 17 58 .Between 15 and 25 years 23 16 11 17 67 Between 25 and 45 years 43 41 39 42 165 Between 45 and 65 years 83 67 60 91 301 65 years and upwards 111 91 79 116 397 Total 352 274 258 359 1,243 INFANTILE MORTALITY. The Infantile Mortality, measured by the deaths of children under one year of age to the number of births registered, was 74 per 1,000 births, there having been a total of 175 su;ch deaths' during the year, as compared with 210, 187 and 195, the respective figures for the years 1918, 1919 and 1920. The number for the County of London was 79 per 1,000 births, the average for the past five years in Greenwich being 93 per 1,000 births. 15 For the whole of London the rate was 79 in 1921, compared with 75 in 1920, 85 in 1919 and 107 in 1918. For England and Wales the rate was 83, compared with 80 in 1920, 93 in 1919 and 97 in 1918. Locally, the variations were from 15 per 1,000 births in Kidbrooke, 61 in East Greenwich, 86 in Charlton, 87 in West Greenwich, to 91 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. Avenge for five years. 1906-1910. inclusive. Average for five years, 1911-1915, inclusive. Average for five years. 1916.-1920 inclusive. 1921. East Greenwich 129 106 96 81 61 West Greenwich 126 110 112 110 87 St. Nicholas, Deptford 179 143 167 138 91 Charlton 121 109 76 89 86 Kidbrooke 39 79 16 39 15 Borough 131 111 103 95 73 ANALYSIS OF DEATH CAUSES. Adopting the Registrar-General's classification of diseases, the following table shows the Death Rates for all persons belonging to the Borough per 1,000 of the population living in the Borough. 1921. 1921. Infective Diseases — Local Diseases —continued. Epidemic 0.93 Circulatory System 1.46 Sporadic — Respiratory System 2.16 Venereal 0.03 Digestive System 0.68 Septic 0.01 Lymphatic System 0.07 Malarial 0.02 Urinary System 0.50 Tuberculosis 1.37 Reproductive System 0.02 Parasitic Diseases — Parturition 0.05 Constitutional Diseases 1.40 Bones and Joints 0.009 Developmental Diseases 1.75 Integumentary System 0.009 Dietetic Diseases 0.01 External Causes— Local Diseases — Accidents 0.38 Nervous System 1.17 Homicide 0.009 Organs of Special Sense 0.04 Suicide 0.05 16 REMARKS OX V ARIOUS DEATH CAUSES. Infective Diseases. Epidemic.—There were 94 deaths due to this class of disease,, equalling a Death Rate of .93 per 1,000; the rate last year' was 88, and was 154, 4.80 and 153 in 1917, 1918 and 1919 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 77 deaths, equalling a Death Kate of .76 per 1,000. Locally the Zymotic Death Rate varied from .20 in St. Nicholas (1.90 in 1920), .53 in Charlton (.49 in 1920), .62 in Kidbrooke (.32 in 1920), .77 in West Greenwich (104 in 1920), up to .95 in East Greenwich (.73 in 1920). Small-Pox.—There were no deaths from Small-Fox, this being the nineteenth year since a death occurred from this cause in the Borough. Measles.—Five deaths were ascribed as due to this disease. All the patients were under five years of age. This is the lowest figure recorded since the inception of the Council in 1900. The deaths recorded last year were 26, and 45, 45 and 13 in the years 1917, 1918 and 1919 respectively. One death occurred in East Greenwich and 4 in West Greenwich. The quarterly incidence was 2 in the second quarter and 3 in the fourth. Scarlet Fever.—This disease occasioned 6 deaths, 4 of which were under five years. Four deaths occurred in East Greenwich and 2 in West Greenwich. Two such deaths occurred in 1920 and 7 in 1919. Diphtheria.—There were 28 deaths during the year. This gives a Death Rate of .27 comparing with 12 for the previous year. Thirteen deaths occurred in 1920, and 27, 16 and 15 in 1917, 1918 and 1916 respectively. Fourteen of the patients were under five years of age. Thirty.one tubes of Diphtheria Anti.toxin, containing a total of 62,000 units of serum, for the treatment of patients suffering GRE 24 17 from this disease, have been supplied from the Public Health Department during the year. Typhoid Fever.—There was 1 death ascribed as due to this disease; there were 2 in 1920, 2 in 1919, 4 in 1918, 2 in 1917 and 0 in 1910. The death occurred in Kidbrooke. Diarrhcea and Zymotic Enteritis.—Twenty.seven deaths were stated to be due to this cause, equalling a rate of 26 per 1,000. Last year there were 22 deaths, and 38, 37 and 28 respectively in 1917, 1918 and 1919. The deaths were distributed as follows:—Eight in East Greenwich, 10 in West Greenwich, 1 in St. Nicholas, 7 in Charlton and 1 in Kidbrooke. Eighteen patients were under five years of age. The deaths in 1920 were distributed as follows:—Six in East Greenwich, 7 in West Greenwich, 6 in St. Nicholas and 3 in Charlton. Influenza.—Influenza is found to have been the responsible cause of 19 deaths in 1921; 133 was the average of th,e previous three years. Of the 19, 4 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 4 in 1920 and 11 in 1919. Of these 4 deaths, 3 were under five years of age. Two occurred in East Greenwich and 2 in West 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.—Two deaths occurred from this cause in 1921, 6 in 1920 and 2 in 1919. Puerperal Fever.—There was 1 death from this disease during the year. Pyæmia and Septicemia, &c.—There were 5 deaths from this disease during the year, 1 death from other allied diseases and 1 from Infective Endocarditis. Malarial. Rheumatic Fever.—There were 3 deaths in 1921 as compared with 12 in 1920, 3 in 1919 and 1 in 1918. Malarial Fever.—There was 1 death attributed to this cause, the patient being over 65 years of age. 18 Tuberculosis.—This class includes the causes of 138 deaths during the year under review, with a rate of 1.37; these figures compare with 174, 174 and 147, the totals of the years 1918, 1919 and 1920 respectively, and respective rates of 1.90, 1.66 and 140. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 119 attributed to this cause, or a rate of 118 per 1,000. Locally, the deaths were 1 in Kidbrooke (giving a Death Rate of '31), 15 in St. Nicholas (giving a Death Rate of 1.98), 2G in Charlton (giving a Death Rate of 1'38), 32 in West Greenwich (giving a Death Rate of 1T8), and 45 in East Greenwich (giving a Death Rate of 102). The remaining forms of Tuberculosis were responsible for 19 deaths, being 7 in West Greenwich, 6 in East Greenwich, 3 in St. Nicholas, and 3 in Charlton. Of these other forms of Tuberculosis, Tuberculosis of the Brain and its membranes was credited with 8 (3 being under five years of age), Tubercle affecting the Intestines 2 deaths (1 being under five years of age), General Tuberculosis 4 deaths, and other forms of Tuberculosis 5 deaths. Parasitic Diseases.—There were no deaths from this class of disease. Dietetic Diseases.—There were 2 deaths from this class of disease; both occurred in East Greenwich. Constitutional Diseases.—The deaths from this cause were 141 in number, which gives a rate of 140 per 1,000. Of these, 124 were attributed to Cancer, 11 to Diabetes, 3 to Anaemia, 2 to Osteo.Arthritis and 1 to Lymphadenoma. The deaths from Cancer were distributed as follows:—50 occurred in East Greenwich, 34 in West Greenwich, 11 in St. Nicholas, 24 in Charlton and 5 in Kidbrooke. Developmental Diseases.—There were 176 deaths from this class of causes, equal to a rate of L75 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz.:—Congenital defects, 8, and those from causes more or less preventable, viz.:—Premature birth, 33; Injury at birth, 4; Debility at birth, 13; Atrophy, Debility and Marasmus, 17: Atelectasis, 5; Dentition, 1; and Rickets, 1. The remaining and largest portion of these deaths from developmental diseases, 94 in number, were from Old Age; in 1920 there were 113 deaths from this cause, and 125 in the previous year. 19 Local Diseases. Nervous System.—One hundred and eighteen deaths were attributed to the various nervous diseases, which gives a rate of 1.17 per 1,000; last year the rate was 1.02 per 1,000. Convulsions were responsible for 6, all of whom were under five years of age; 5 were from Meningitis, 61 from Apoplexy, 2 from Hemiplegia or Brain Paralysis, 7 from General Paralysis of the Insane, 7 from Cerebral Tumour, 10 from Epilepsy, 1 from Acute Polio Myelitis, 7 from Diseases of Spinal Cord, 5 from Softening of Brain, andj 7 from other diseases of this system. Organs of Special Sense.—There were 5 deaths from this class of causes, equal to a rate of .04 per 1,000. Circulatory System.—The Death Rate from diseases of this system was 1.46 per 1,000, there being a total of 119 such deaths. Valvular diseases of the heart were responsible for 12.5, 7 from Aneurism, 5 from Embolism, 1 from Angina Pectoris and from the remaining diseases of this system, 11. Respiratory System.—Two hundred and seventeen deaths were due to diseases of the respiratory organs, as compared with 122 in the preceding year. The Death Rate under this heading equals 216 per 1,000. Twenty.five were from Acute and 73 frorr, Chronic Bronchitis, 108 from the various forms of Pneumonia, 48 being under five years of age, 2 from Emphysema, 6 from Pleurisy, and 3 from other diseases. Digestive System.—There were 69 deaths from diseases of this system, equal to a rate of 68 per 1,000. Of this number, Enteritis was responsible for 18 (13 being under five years of age), 7 to Appendicitis, 10 to Obstruction, and 3 to other diseases of the Intestines, 5 to Cirrhosis, and 6 to other diseases of the Liver, 5 to Peritonitis, 7 to Ulcer of Stomach and Duodenum, 5 to other disease, of Stomach, and 3 to other diseases of the Digestive System. Lymphatic System.—There were 8 deaths from diseases affecting this system during the year. Urinary System.—Fifty.one deaths, equal to a rate of 50 per 1,000, occurred from diseases affecting this system. Thirty.two were from Bright's Disease, 3 from Acute Nephritis, 11 from disease of the Bladder and Prostate, 1 from Calculus, and 4 from ill.defined causes of the urinary system. Reproductive System.—There were only 3 deaths due to diseases of the Generative Organs. There were 6 deaths attributed to diseases of Parturition. 20 Bones and Joints.—There was 1 death from diseases of bones and joints. Integumentary System.—There was 1 death from diseases of Integumentary System. External Causes.—There were 46 deaths given as due to causes grouped under this heading; 39 were the result of accident or negligence, 1 from Homicidte, and the remaining 6 were from Suicide. Two children died from Suffocation by being overlaid in bed during 1921 (compared with 3 from this cause last year); 10 cases were from Drowning, 3 from Burns and Scalds, while accidents on railways, in vehicular traffic and in building operations, falls etc., were responsible for 24 deaths. The Suicides were 3 (by Hanging and Strangulation), 2 from Drowning, and 1 by Shooting. Ill Defined Causes.—There was no death in 1921 the cause of which was not ascertained. MORTUARY. The number of bodies dealt with in the Mortuary since 1911 is phown below:— Year. Drowned Bodies from River. Other Bodies. Totals. 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 1921 15 152 167 POOR.LAW RELIEF. I am indebted to the Clerks of the Greenwich and Woolwich Boards of Guardians for the following figures:— Greenwich. Charlton & Kidbrooke. Total amount expended in out door relief £25,715 19 3 £5,594 1 0 Total number of persons treated in Hospital 1,094 110 Total number of persons treated medically in their own homes 2,239 420 Total number of persons admitted to the Workhouse 590 38 21 HOSPITAL AND OTHER FORMS OF GRATUITOUS MEDICAL RELIEF. The Seamen's Hospital have admitted, treated and maintained 211 Greenwich persons for an average of twenty days each, in addition to which there have been 1,174 Out-patients, making altogether 5,322 attendances of persons belonging to the Borough of Greenwich. Miller General Hospital admitted, treated and maintained 375 Greenwich persons for an average of twenty-one days. 6,650 Out-patients have also been treated, the total attendances being approximately 30,000. Blackheath and Charlton Cottage Hospital admitted 180 In-patients from Greenwich, and treated about 120 casualties, making about 1,040 attendances for this purpose. SANITARY WORK. The tables on pages 22 to 24 and 67 to 75 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 21,257 houses and premises have been inspected or re-inspected during the year; 2,147 intimation notices and 636 statutory notices have been served. It was found necessary to institute Police Court proceedings in fifteen cases during the year, particulars of which are contained in the table on page 27. There were altogether throughout the year 957 complaints registered. Factories, Workshops and Workplaces.—Two hundred and thirty-three 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, 5 have been taken off, leaving a total now on the Register of 197. This total includes 14 laundries, 26 dressmaking and mantle works, 7 fuel and lire. wood works, 3 cycle works, 8 milliners, and various others, including workplaces, such as 4 blacksmiths, 14 barge builders, 3 builders' yards, etc. Outworkers' Register.—Twelve lists, containing. 79 names, have been received from employers within the district. One hundred and twenty-four visits of inspection have been paid to these premises. 22 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1— INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 28 9 ... Workshops (Including Workshop Laundries) 82 34 ... Workplaces (Other than Outworkers' Premises) 123 27 ... Total 233 70 ... 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:— Want of Cleanliness 50 50 ... ... Want of Ventilation 1 1 ... ... Overcrowding ... ... ... ... Want of Drainage of Floors ... ... ... ... Other Nuisances 26 26 1 ... Sanitary Accommodation— Insufficient 14 14 ... ... Unsuitable or defective 9 9 ... ... Not Separate for Sexes 2 2 ... ... Offences under the Factory and Workshop Act:— Illegal Occupation of Underground Bakehouse (s. 101) ... ... ... ... Breach of Special Sanitary Requirements for Bakehouses (ss.97 to 100) ... ... ... ... Other Offences 12 12 ... ... Total 114 114 1 ... * Including; those specified in Sections 2, 3, 7 and 8 of the Factor}. Act, as remediable under the Public Health Acts. 23 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. Lists. Outworkers. Contractors Workmen. Contractors Workmen. Wearing Apparel— (1) Making, &c. 11 11 26 ... ... ... ... ... ... ... ... ... ... ... ... (2) Cleaning & Washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, Lace Curtains & Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur Pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper Bags and Boxes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cotton and Kit Bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Box Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rackets and Tennis Balls 1 l 53 ... ... ... ... ... ... ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 12 12 79 ... ... ... ... ... ... ... ... ... ... ... ... 24 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1921. No. Bakehouses 38 Factory Bakehouses 5 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 48 197 5.—OTHER MATTERS. Class. No. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5) — Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspectors 1 Other Underground Bakehouses (sec. 101) :— In use at the end of 1921 13 Customs and Inland Revenue Acts.—Applications were received during the year for certificates under these Acts with respect to 20 Tenements. One certificate only was granted with reference to 4 Tenements. Cleansing and Scavenging.—The question of refuse disposal has been engaging the serious attention of the Council for some time past. The refuse continues to be disposed of by barging, and dumping on the low.lying marsh land in the Borough, but these dumps are now practically filled up, and are becoming a serious menace (o health. Complaints have always arisen from the results of this method of refuse disposal, and a scheme has now been submitted and approved by the Council for the erection of an up.to.date refuse destructor at the Council's Wharf, Tunnel Avenue. 25 The collection of house, etc., refuse in the Borough is under the control of the Borough Surveyor, and very few complaints have been received as to non collection. One thousand and twelve new ash receptacles have been provided. Horse Slaughterer.—The one horse.slaughtering premises in ""the Borough has been inspected and the cleansing of the premises duly carried out. Houses Let in Lodgings.—When the new London County Council By.laws become law the thorough supervision of this class of property will be practicable, but, as was the case in 1920, houses let in lodgings were dealt with as far as possible under the powers conferred by the Public Health (London) Act, 1891. Rats and Mice (Destruction) Act, 1919.—At the suggestion of the Ministry of Agriculture, this Council, in common with the majority of Local Authorities throughout the country, participated in the Annual Rat Week which was held the week commencing 31st October. This was conducted on the same lines as last year. Posters were displayed throughout the Borough, and commercial houses and firms were invited to take concerted action for the destruction of rats. From enquiries and investigations made by the Council's Rats Officer (Mr. Morgan), it appears that occupiers generally are fully alive to the seriousness of the results of rat infestation, and there are reasons to believe that the efforts directed against these pests, not only during Rat Week, but during the whole year, have been attended with marked success. In all four hundred and fifty.seven investigations were made by the Rats Officer, and 64 notices were served upon occupiers of premises who had failed to take the necessary steps for the destruction of rats or for the prevention of rat infestation. It was generally found that owners of rat infested property readily adopted all possible means for the extermination of the vermin so soon as the matter was represented to them. Increase oe Rent & Mortgage Interest (Restrictions) Act, 1920.—Under the provisions of this Act landlords are empowered to make certain increases of rent, and tenants whose houses are not in all respects reasonably fit for human habitation may apply to the Sanitary Authority for a certificate to this effect, enabling them to take proceedings to get the increase suspended until such time as the necessary works shall have been completed. Sixty four such applications for certificates were received. Forty six certificates were granted; in the remaining 18 cases the 26 certificate was unnecessary as the required work was satisfactorily executed. 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. Seventeen observations have been made for smoke nuisances during the year, but in no instance was it found necessary to serve a Statutory Notice. House Drainage.—Seventeen drains have been constructed, 233 drainage systems have been reconstructed or repaired; 410 such systems have also been opened, cleansed and amended; 59 surface drains have been constructed; 163 drains and soil pipes have been ventilated, 321 systems have been tested by smoke, 437 by water, of which number 172 were found to be defective; 47 new soil pipes and 395 traps have been fixed, together with 54 intercepting chambers and fresh.air inlets, and 100 other chambers. Seventeen new covers to manholes have been provided. Thirty. two systems have been sealed off or slurried up. Thirty forecourts, 26 areas, 118 yards, 4 mews and stables drained; 4 cesspools abolished; 37 water.closets have been erected: 218 cleansed and repaired; 45 w.c. doors repaired or provided; 4 w.c.s sealed off. A pan, trap and water supply have been furnished throughout in 113 cases; pan and traps only furnished in 264 cases; pans only in 24 cases, and other fittings provided or improved in 232 cases, whilst the water supply has been renewed in 203 instances. The water supply for lavatory purposes has been disconnected from the drinking water system in 11 instances. Public.house urinals have been cleansed and repaired in 9 instances; 4 urinals were altered, 25 repaired or water laid on, and 1 constructed. The vexed question of drain or combined drain or sewer is coming much more prominently to notice in this Borough, and w hereas in the past owners have been more easily persuadfed to reconstruct as combined systems of drainage many systems which had legally on technical grounds become sewers, now we find that they are taking a much more prominent stand, and require this Council to carry out their legal obligations in the mattfer, and in this way much of the drainage reconstruction work is held up, and at times have been temporarily abandoned. Water Supply.—During the year 4 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. Defective water fittings have been remedied in 137 cases; 32 water supplies have been Reinstated where the supply had been cut off; water fittings have been amended in 240 cases; 27 21 water supplies have been altered so as to draw direct from the main; water supply provided in 13 instances, and cleansing, repairing and covering cisterns in 5 cases. Complaints have been received from time to time respecting the water supply in one portion of this Borough, but on the matter being taken up with the Metropolitan Water Board it was found that the altered character of the water was doubtless caused by the temporary chlorination of the same by that Board in the process of its purification, and when this had been explained to the complainants their fear have been allayed. Legal Proceedings under the Public Health (London) Act, 1891, and By laws during the year 1921. Premises. Complaint. Result of Proceeding's. Fine. Costs. 9, Ransom Road Noil . compliance with Statutory Notice Order to abate within 14 days — 15/. 6, Kirkland Place Ditto Order to abate within 6 weeks — 15/- 7, ditto Ditto 8, ditto Ditto 8, ditto Ditto Withdrawn (Work done) — 5/- 2, Lombard Road Ditto Withdrawn (Work done) — 2/- 122 & 124, West Street Non.deposit of Drainage Plans Withdrawn (Plans deposited) — 5/- Vicinitv of Nos. 15 & 17. Sandtoft Road Filth thrown upon part of street Fined 5 10/- 1, Floyd Road Non. compliance with Statutory Notice Order to abate within 14 days — 5/- 13, ditto Ditto Ditto — 5/- 15, ditto Ditto Ditto — 5/- 41, Park Street Ditto Withdrawn (Work done) — 5/- 25, Sigismund Street Ditto Closing Order made — 10/- 27, ditto Ditto Ditto — 10/. 29, ditto Ditto Ditto — 10/- 28 FOOD. Cowhouses.—The four cowhouses in the Borough have been visited on 12 occasions, and the required cleansing has been duly enforced on 8 occasions. Dairies, Cowsheds and Milkshops Order.—At the commencement of the year there were 90 premises on the Register of Dairies and Milkshops; 17 new applications have been received during the year and added to the Register, and 18 names have been taken oft, thus leaving a total of 89 premises now registered. During the year 107 visits of inspection have been paid to these premises; notices were served upon the occupiers in 3 cases where dairies required limewashing. Under the powers conferred by the London County Council (Ceneral Powers) Act, 1908, Section 5, with respect to the registration of premises unsuitable for the sale of Milk, no registration was refused on the ground of unsuitability of the premises. (a) Milk Supply.—The majority of milk supplied to this Borough is obtained from farmers and large firms outside the district. An application was made by the largest cowkeeper in this district tduring the year for permission to again bring into use certain of his premises which had been condemned as a cowshed for many years, so that they might now be utilised for t;he purpose of producing Grade "A" Milk. On going carefully into the matter it was found that the regulations dealing with this Grade "A" Milk practically make it possible for this class of milk to be produced in premises almost in a derelict condition. It was pointed out, however, that, seeing that this Council had required modern premises for the production of ordinary milk, it was more than likely they would require at least modernised premises for the production of this special Grade "A" Milk. It was further pointed out that upon the requirements of the Ministry of Health as to the herd supplying Grade "A" Milk being certified as "Tubercle Free" being complied with, I should require to be informed as to what had happened to the milking cows which had been found on examination to be tuberculous, it being intended by the applicant, until the point was raised, that such cattle as were found on test to be tuberculous should be returned to the ordinary herd for the supply of ordinary quality of milk. Presumably on the applicant's further consideration of these points the application was dropped, as nothing further has been heard on the matter. This application has, however, brought to light the above two points, and particularly the latter one, that animals giving a positive reaction, whilst being excluded from the production of Grade "A" Milk, are still allowed to continue to produce milk of the ordinary quality, and whilst this continues to be permitted I do 29 not see any hope of obtaining "Tubercle Free" milk for the general supply of the population, and, accordingly, cannot see how we can expect any marked reduction in the amount of alimentary tuberculosis amongst the juvenile population. This point has been further prominently brought to my notice during the current year by being called to see the carcases of two beasts at a local butchers, when I found them to be the subject of extensive tuberculosis, necessitating the condemnation of very nearly the whole of the two carcases, and on enquiry into the origin of these two anim'als I found that they had come from this same cowkeeper, and had been supplying milk until within quite a recent period. The moral of this story would appear to be that the general public buying ordinary milk should always shun dairies who also specialise in the supply of Grade "A" Milk, on account of the possibility, in fact almost probability, that the ordinary milk from that dairy will contain a greater proportion of tubercular infection than would the ordinary milk obtained from a firm not also specialising in the production of Grade "A" Milk, which, in my opinion,, is certainly not a condition of things making for the general public good. Milk and Cream Regulations, 1912 and 1917.—During the year no special samples were taken under these regulations, but by arrangement with the Public Analyst all samples of milk analysed by him w ere reported upon as to the presence or absence of preservatives. No samples of Cream were taken, either preserved or fresh, for this article is used to a very limited1 extent. Milk (Mothers and Children) Order, 1919.—During the year 52,693 lbs. (23 tons 10 cwt. 1 qr. 25 lbs.) of dried milk of various kinds have been supplied under these Orders to mothers and children attending our Infant Consultation Centres. (b) Meat.—During the year it was not found necessary to seize any animal or meat (exposed for sale, or deposited in any place for the purpose of sale, or preparation for sale. The following were voluntary surrendered and destroyed:— 5 lbs. of beef, 7 lbs. pigs' liver (2), 60 lbs. rabbits (24). Slaughterhouses.—The number of Slaughterhouses in use in the Borough are as under:— In 1914. In January, 1921. In December, 1921.  Registered - - - Licensed 4 4 4 4 4 4 30 Twenty-one inspections were made by the Inspectors during the year. (c) Other Foods.—Places where food is prepared have been visited on 158 occasions, improvements being required in 28 instances as detailed below:— Class of Premises. Number of Lists. Number of Inspections. Number of instances where matters needed attention.  At end of 1920. Added 1921. Re- moved 1921. At end of 1921. Hotel Kitchens 5 — 1 4 4 1 Eating Houses 52 8 11 49 56 17 Fried-Fish Shops 26 4 4 26 35 10 Pork Butchers 14 9 1 22 23 — Mineral Water Manufacturers 1 — — 1 2 — Ice do. 2 — 1 1 2 — Sausage do. 17 6 1 22 23 — Others 8 6 1 13 13 — Totals 125 33 20 138 158 28 The 28 instances where matters needed attention included cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 6 where the sanitary arrangements were defective, 1 which required reconstruction, 10 for want of ashpit, and 1 where the premises were not constructed' in accordance with the L.C.C. By-laws. Arrangements have been made for an Inspector to be on duty every Saturday evening for the purpose of inspecting shops and other premises where food is prepared, sold or exposed. At the Foreign Animals' Wharf, now being used as a Reserve Supply Depot for Army Stores, there is still a quantity of such stores containing amongst them a large proportion of provisions unfit for the food of man, and from time to time applications are made to allow quantities of such stores to be released for purposes other than for human food. During the year 6,092 cases, each containing 48 lb. tins of preserved meat have been so released, 3,338 lbs. of jam, 2,175 eases 31 of 221b. tins of margarine, and 2 cases pea soup powder. In each case the Medical Officer of Health of the district to which such consignments have been forwarded has been advised of the matter. No seizures, of unsound food were made during the year, but a number of tradesmen voluntarily .surrendered certain articles of food as unwholesome or unfit for the food of man in ad'ditioh to the meat already referred to, particulars of which are set out on page 29. Ice Cream Premises.—There were 54 premises known at the commencement of the year where the manufacture of this commodity was carried on; 39 have been added during the year and 11 taken off, leaving a total of 82 premises. These premises were inspected on 9G occasions, and improvement .required by way of cleansing of the premises in 9 cases. Bakehouses.—Eighty-eight inspections have been made of the various Bakehouses in the Borough, and 45 nuisances found therein have been abated. At the end of the year there were 5 Factory and! 38 other Bakehouses on the Register, 13 of which are underground. Food and Drugs Acts.—Four hundred, and thirty-six samples have been purchased under the provisions of the Sale of Food and Drugs Acts and submitted to the Public Analyst for analysis, of which 422 were certified to be genuine and 14 adulterated, the adulterations thus being equivalent to 3-21 per cent, of the samples taken. Of the total number of samples purchased, 111 were milk, of which 6 were certified to be adulterated; the remaining adulterated samples were 5 of vinegar, and 3 of dripping. Proceedings were taken in 8 cases, resulting in fines and costs being imposed in C instances. The remaining two cases were dismissed. one on account of warranty proved, and the other owing to the defendant's good character, costs being granted. A warning letter was sent in 4 cases. 32 Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1921. Description of Samples. Number of Samples Purchased. Number Genuine. Number Adulterated Remarks as to Action taken.  Baking Powder 14 14 — Butter 70 70 — — Cocoa 1 1 — — Coffee 1 1 — — Cooking Fat 1 1 — — Dripping 68 65 3 Police Court proceedings in one case. One warning letter sent. Milk 111 105 6 Police Court proceedings in three cases, and two warning letters sent. Milk, Separated 1 1 — — Pearl Barley 30 30 — — Rice 40 40 — — Self-Raising Flour 5 5 — — Vinegar 94 89 5 Police Court proceedings in four cases, and one warning letter sent. Total 436 422 14 33 Sale of Food and Drugs Acts. Administrative Action regarding Samples reported to be NOT GENUINE. No. of Sample Description of Sample. Nature of Adulteration. Result of Proceedings.  288 Dripping Admixed with 25 per cent. of butter fat No action taken. 351 „ Admixed with 2 per cent. of water Warning letter. 367 „ Admixed with 7.3 per cent. of water Fine, 8s.; Costs, £1 12s. 72 Milk Admixed with 7 per cent. of water Fine, £8 18s. 6d.; Costs, £1 ls. 6d. (Defendant previously convicted). 101 „ Slightly deficient in solids not fat No action taken. 118 „ After allowing for excess fat, slightly deficient in solids not fat Warning letter. 187 „ Admixed with 2 per cent. of water Warning letter. 206 „ Deficient in fat to the extent of 19 per cent. Fine, 10s.; Costs, £112s. 306 „ Admixed with 8 per cent. of water Case dismissed on account of defendant's good character. Costs, £1 12s. 320 Vinegar Deficient in acetic acid to the extent of 26 per cent. Fine, 8s.; Costs, £112s. 360 „ Deficient in acetic acid to the extent of 12 per cent. Fine, 8s.; Costs, £1 12s. 327 „ Deficient in acetic acid to the extent of 1.5 per cent. Warning letter. 36 „ Deficient in acetic acid to the extent of 7 per cent. Case dismissed. Warranty proved. 395 „ Deficient in acetic acid to the extent of 9 per cent. Fine, 8s.; Costs, £1 12s. In connection with the legal proceedings taken under the Sale of Food and Drugs Acts, it is interesting to note that in the case of Sample No. 367 the conviction was based on the standard of purity laid down under the Sale of Food Order, 1921. 34 Supplemental Vaccination Return for 1920. Return made on or before the gth of February, 1922, 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, 1920, inclusive:— Registration Sub-Districts comprised in the Vaccination Officer's District. No. of Births from 1st Jan. to 31st Dec., 1920. Number of these Births duly entered by 31st Jan., 1921. No. of Births which on 31st Jan.. 1921, remain 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 objections 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 East Greenwich 1,289 691 3 ... 362 71 1 45 29 87 West Greenwich 714 378 1 ... 215 37 ... 3 22 58 South Deptford 688 319 ... ... 262 32 ... 11 11 53 North Deptford 1,467 717 9 ... 472 74 ... 21 22 152 East Deptford 1,288 574 2 ... 304 85 ... 5 64 254 T otal 5,446 2,679 15 ... 1,615 299 1 85 148 604 Dated February 2nd, 1922. A. E. Rossiter, Vaccination Officer. No. of Births entered in "Birth List Sheets" as registered from 1st January to 31st December, 1920 447 Successfully Vaccinated 310 1 nsusceptible of Vaccination 1 Had Small-Pox — Charlton and Kidbrooke. Statutory Declarations of Conscientious Objection 105 Dead Unvaccinated 18 Postponed by Medical Certificate 2 Removed to Districts the Vaccination Officer of which has been duly apprised 4 Removed to places unknown, or which cannot be found; and cases not traced 6 Not accounted for 1 G. E. Oughton. 35 Notifications under the Provisions of the Public Health (London) Act, 1891.—During the year 3,227 cases have been notified under the above Act, as compared with 2,613, 2,820 and 2,116 respectively in the preceding years 1918, 1919 and 1920. Small-Pox.—No case of this disease occurred in the Borough during the year. Details respecting vaccination in the Borough are given in the Supplemental Vaccination Reports on page 34. Diphtheria.—Five hundred #nd ninety-five cases of Diphtheria were notified during the year, as compared with 322, 240, 275 and 391 respectively in the years 1917, 1918, 1919 and 1920. The distribution of these cases was as follows:—332 in East Greenwich, 154 in West Greenwich, 24 in St. Nicholas, 56 in Charlton and' 29 in Kidbrooke. Of this total number, 572 were removed to the Hospital , for treatment, amongst which number the Hospital Authorities reported that in 7 cases they considered the diagnosis incorrect. The exceptional number of Diphtheria cases are accounted for in part by a considerable epidemic of this disease at the Royal Hospital Schools. In all, 109 cases occurred between 10th September and 10th December, and these cases are, of course, all included in the figure of 154 for West Greenwich. The School Authorities, in conjunction with the officers of the Public Health Department, used eVery endeavour to deal adequately with the outbreak. The epidemic, which was of a mild character, died down shortly before the Christmas recess, but, in order that every precaution might be taken, the Medical Officers of Health of the various districts to which the boys journeyed were notified so that they could be kept under observation. The premises meanwhile were thoroughly disinfected throughout by an augmented staff under the direction of the Council's Disinfectors. There were 13 fatalities due to this disease, which gives a case mortality of 4.3 per cent. Two thousand five hundred and forty-two specimens were forwarded by medical practitioners for bacteriological investigation from cases suspected to be Diphtheria. Of this number 2,276 were reported to give negative or doubtful results, and 266 were positive in character, being dealt with accordingly. The quarterly incidence of the disease for 1921 has been as follows:— 36 1 st Quarter—East Greenwich, 96 cases; West Greenwich, 16; St. Nicholas, 10; Charlton, 16; Kidbrooke, 10; a total of 148 cases. 2nd Quarter—East Greenwich, 35 cases; West Greenwich, 8; St. Nicholas, 5; Charlton, 12; Kidbrooke, 7; a total of 67 cases. 3rd Quarter—East Greenwich, 64 cases; West Greenwich, 20; St. Nicholas, 6; Charlton, 3; Kidbrooke, 3; a total of 96 cases. 4th Quarter—East Greenwich, 137 cases; West Greenwich, 110; St. Nicholas, 3; Charlton, 25; Kidbrooke, 9; a total of 284 cases. Membranous Croup.—There was one case of Membranous Croup notified during the year, such case occurring in St. Nicholas. Erysipelas.—Fifty-seven cases were notified during the year, 30 being in East Greenwich, 14 in West Greenwich, 7 in St. Nicholas, 6 in Charlton. Fourteen of these patients were removed to a Public Institution in the district. Scarlet Fever.—Nine hundred and fifty-eight cases were notified during the year, as compared with 167, 481 and 587 cases respectively in the years 1918, 1919 and 1920; 424 cases were in East Greenwich, 194 in West Greenwich, 44 in St. Nicholas, 163 in Charlton and 33 in Kidbrooke; 888 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 Hospital were discharged and notified to be still suffering from Chronic Rhinitis, 4; Chronic Ottorhoea, 7; Total, 11. Mention has already been made of the epidemic of Diphtheria at the Royal Hospital iSchools. Contemporaneous with this outbreak was also an epidemic of Scarlet Fever, a total of 122 cases being notified. The same remarks with regard to the supervision, disinfection, etc., apply as are mentioned in connection with the Diphtheria outbreak. The following table gives particulars of the seven cases which would seem to be "return cases." There were 6 such cases in 1920, 6 in 1919, 2 in 1918 and 0 in 1917. 37 Table showing Return Cases of Scarlet Fever during Year 1921. 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, See. Appearance on discharge from Hospital.  1 22nd Oct., 1920 23rd Oct., 1920 13th Jan., 1921 19th Jan., 1921 5 days Apparently well. 2 16th Nov., 1920 17th Nov., 1920 23rd Feb., 1921 4th Mar., 1921 9 „ Discharge from nose and ears. 3 25th Feb., 1921 26th Feb., 1921 18th April, 1921 27th April, 1921 7 „ „ „ „ 4 22nd June, 1921 23rd June, 1921 6th Aug., 1921 10th Aug., 1921 4 „ Apparently well. 5 23rd Aug., 1921 24th Aug., 1921 3rd Oct., 1921 11th Oct., 1921 7 „ „ „ „ 6 2nd Oct., 1921 3rd Oct., 1921 7th Nov., 1921 16th Nov., 1921 4 „ „ „ „ 7 26th Sept., 1921 26th Sept., 1921 9th Nov., 1921 21st Nov., 1921 8 „ Hands peeling. 38 Typhoid Fever.— There were 11 cases of Typhoid Fever notified during the year, 2 being in East Greenwich, 6 in West Greenwich, 2 in Charlton and 1 in Kidbrooke. The ages of the patients were: 0 between five and fifteen years, 3 between fifteen and twenty-five years, 1 between twenty-five and forty-five years, and 1 between forty-five and sixty-five years. Of the total number of cases, 10 were removed to the Hospital for treatment. Fifteen such cases occurred in 1920, 20 in 1919, 12 in 1918 and' 3 in 1917, 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 traceablc to shell-fish. Thirteen specimens were forwarded for bacteriological examination from cases suspected to be Typhoid Fever in character, 1 giving 3 positive result. Puerperal Fever.—Eleven cases of this disease were notified during the year, 4 being in East Greenwich, 2 in West Greenwich, 3 in St. Nicholas and 2 in Charlton. There were 5 cases in 1920, 5 in 1919, 1 in 1918 and 3 in 1917. There were 5 deaths from this disease during the year. Measles.—This disease was made permanently notifiable by an Order of this Council, approved by the Ministry on the 1st July, 1920. Five hundred and seventy-two cases were notified during the year, as compared with 36 during the previous six months, and. 925, 794 and 1,469 in the years 1919, 1918 and 1917 respectively. The ages and incidence of fatality of the disease were as follows:—There were 249 cases under five years of age, amongst whom there were 5 deaths, giving a case mortality of 2 per cent. Between the ages of five to fifteen years there were 318, with 0 deaths at this age period. Between fifteen and twenty-five there were 4 cases, and 1 case between twenty-five and sixty-five. The case mortality for the whole district works out at .87 per cent. 39 Table showing number of Measles Cases reported during the year 1921. 1st QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65.  East Greenwich 1 8 6 — 1 West Greenwich 3 2 3 1 — St. Nicholas, Deptford 1 — — — — Charlton — — 3 — — Kidbrooke — — — — — Total 5 10 12 1 1 Total 29. 2ND QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65.  East Greenwich 2 76 127 — — West Greenwich 2 18 17 — — St. Nicholas, Deptford 1 — 1 — — Charlton 2 14 54 — — Kidbrooke ... — 1 5 — — Total... 7 109 204 — — Total 320. 3RD QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65.  East Greenwich — 5 4 — — West Greenwich — 1 — — — St. Nicholas, Deptford — 1 1 — — Charlton — 1 3 — — Kidbrooke — — — — — Tota 8 8 — — Total 16. 4th QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65.  East Greenwich 1 11 9 1 — West Greenwich 5 84 54 1 — St. Nicholas, Deptford — — — — — Charlton 2 7 31 1 — Kidbrooke — — — — — Total 8 102 94 3 — Total 207. Total cases in year = 572. 40 Zymotic Enteritis or Summer Diarrhcea.—Two hundred and eleven cases of Diarrhœa were notified throughout the whole of the Borough, 105 being under one year of age; 106 between one and five. Sixty of such notifications related to patients in East Greenwich, 88 in West Greenwich, 10 in St. Nicholas and 53 in Charlton. There were 27 deaths ascribed to this disease, compared with 22 in the previous year. Whooping Cough.—The temporary Order for the notification of this disease terminated on the 31st October last, and from a consideration of the results derived from such notification this Council decided to make Whooping Cough permanently notifiable, and an Order was granted by the Ministry of Health as from the 1st November, 1921. Three hundred and twenty-one cases were notified (compared with 365 in 1920), 47 being undter one year of age, 165 from one to five, 107 from five to fifteen, 1 from 25 to 45, and one 65 years and upwards, the districts concerned being East Greenwich, 195; West Greenwich, 87; St. Nicholas, 16; Charlton, 20; and 3 in Kidbrooke. Each of these cases was visited and leaflets and instructions left, together with verbal advice respecting the isolation and care of the patient. Epidemic Cerebro-Spinal Meningitis, Cerebro-Spinal Fever, or Post-Basal Meningitis.—There was 1 case of this disease notified during the year, which occurred in East Greenwich. 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. There were 3 cases notified during the year, as compared with 2 cases in 1918, 1 in 1919 and 0 in 1920. Ophthalmia Neonatorum.—During the year 12 cases of this disease have been notified, 4 being in East Greenwich, 7 in West Greenwich and 1 in Charlton. Further particulars of this disease will be found on page 58. Contacts.—Two intimations were received from the Medical Officers of Health of the various Port Sanitary Authorities respecting persons who had been in contact with Small-Pox, and 5 with Plague, which were kept under observation. 41 Malaria.—There were 8 cases of Malaria notified during the year, 1 in East Greenwich, 4 in West Greenwich, 1 in St. Nicholas, 1 in Charlton and 1 in Kidbrooke, as compared with 20 last year. Encephalitis Lethargica.—There were three cases of this disease notified during the year. Glanders.—No case of Glanders has occurred within the Borough. 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 336 cases of Tuberculosis notified in the Borough, 263 being pulmonary cases, ordinarily known as Consumption, and 73 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 116 pulmonary and 24 non-pulmonary, occurred in East Greenwich, 52 pulmonary and 26 non-pulmonary in West Greenwich, 22 pulmonary and 14 non-pulmonarv in St. Nicholas, 68 pulmonary and 8 non-pulmonary in Charlton, and 5 pulmonary and 1 non-pulmonary in Kidbrooke. The various ages of the patients were as follows:—Pulmonary cases under one, 0; from one to five, 5 cases; five to fifteen, 51 cases; fifteen to twentyfive, 62 cases; twenty-five to forty-five, 96 cases; forty-fiv e to sixtyfive, 45 cases; and 4 cases over sixty-five; whilst the Non-Pulmonarv were: under one year of age, 2 cases; one to five, 10 cases; five to fifteen 37 cases; fifteen to twenty-five, 7 cases; twenty-five to forty-five, 12 cases; forty-five to sixty-five, 4 cases, and 1 case over sixty-five. Four hundred and thirty-three specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive; 317 were reported to be negative and 116 positive. Disinfection has been offered and carried out in 100 cases, including 134 rooms and 431 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputuir. pots where such are found necessary. DISINFECTION. In July last the Council purchased for the sum of £535 10s. a one-ton Ford Motor Van with two interchangeable bodies, for use in connection with the collection and return of infected bedding, clothing, etc., thus superseding the old method by horse and cart. The motor van has been in constant use and greatly facilitated the handling of the great amount of work caused through the epidemic of Diphtheria and Scarlet Fever. The total mileage up to 31st December, 1921, was 3,722 miles, giving an average daily mileage of 25?r miles. 1 he following tables show in detail the work carried out by the Disinfecting Staff during the year:— 42 Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 52 weeks ending 31st December, 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.  Polio-Myelitis 3 7 1 — 1 1 1 5 4 — 1 18 32 Small-pox — — — — — — — — — — — — — Scarlet Fever 715 812 495 5 411 415 1154 1132 59 86 341 440 4538 Diphtheria 400 514 112 — 57 73 242 273 21 22 76 153 1029 Enteric Fever 8 10 8 — 3 7 22 15 2 — 8 47 112 Puerperal Fever 6 6 5 1 3 7 16 10 5 — 6 15 68 Tuberculosis 100 134 59 2 34 42 148 53 14 15 21 43 431 Other Diseases 51 83 38 7 24 35 88 54 13 7 15 145 426 Measles 3 3 — — — — — — — — — — — From Verminous Premises 13 18 9 1 4 5 13 124 2 2 12 300 472 Scabies 11 11 9 — 1 2 6 7 7 — 1 2 35 Influenza and Pneumonia — — — — — — — — — — — — — Cerebro-Spinal Meningitis 1 1 — — — — — — — — — — — Total 1311 1629 736 16 538 587 1690 1673 127 132 481 1163 7143 4 3 Number of Articles Destroyed in connection with the Undermentioned Diseases during: the 52 weeks ending 31st December, 1921. Infectious Diseases. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. Quilts. Miscellaneous. Total.  Small-pox ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 4 2 5 ... ... ... ... ... ... ... 11 Diphtheria ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... Tuberculosis 2 2 2 ... l ... ... ... 1 8 16 Other Diseases 7 4 3 2 8 3 8 ... ... 115 150 From Verminous Premises 2 ... ... ... ... ... ... ... ... 300 302 Total 15 8 10 2 9 3 8 ... 1 423 479 44 Reference has already been made in the Report in the section dealing with Infectious Diseases as to the disinfection carried out at the Royal Hospital Schools. Besides the thorough disinfection of the entire premises, over 3,000 blankets were removed and disinfected at the Council's Disinfecting Station. HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made by Infectious Disease Inspector 1,754 Number of Re-visits 4,012 The Health Visitors also visited 1,127 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease:— Central Libraries, 201; School Libraries, 16; Total, 217. CLEANSING STATION, BLACKWALL LANE. In connection with the cleansing of verminous school children, the arrangements made with the London County Council for reserving the use of the Council's Cleansing Station on Mondays, Wednesdays and Thursdays have been in operation up to 14th December, 1921, when, in consequence of the decreased number of children suffering from Scabies, it was deemed necessary to utilise the Cleansing Station only on Mondays and Thursdays. The following table shows the number of children cleansed:— 1st quarter 436 2nd „ 423 3rd „ 223 4th „ 314 Total 1,396 Fifty-one adults suffering from vermin were also given cleansing baths. In every case the infested clothing was disinfected. 45 REPORT OF THE TUBERCULOSIS OFFICER. To the Medical Officer of Health. Sir, In presenting the Ninth Annual Report of the Dispensary, it is necessary to point out that by the passing into law of the National Health Insurance Act of 1920, Sanatorium benefit as provided by the Insurance Act of 1911 ceased as from the 30th April, 1921, and institutional treatment for both insured and uninsured patients suffering from Tuberculosis, together with the supervision of domiciliary cases, now rests with the London County Council. This change does not affect the work of the Dispensary, and the Borough scheme for dealing with Tuberculosis remains as described in the report of last year. At the close of 1921 it was estimated that there were alive and residing in the Borough some 1,308 persons suffering from Tuberculosis, viz.:— Men. Women. Children. Pulmonary Tuberculosis (Consumption) 326 278 111 Other Forms (Glands, Bones, etc.) 47 50 496 These figures include every case notified to the Public Health Department since 1912, and show a slight decrease from the previous year. Of the 496 children noted above, the large majority of them suffer from "enlarged glands." The Primary Notifications for 1921 numbered 336, of which 263 were of Pulmonary Tuberculosis and 73 of other forms. It is to be regretted that the remarks of last year with regard to notification are still applicable. Thus 32 patients died before notification was received. The great majority of these non-notified cases were connected with Hospitals and similar institutions. Efforts are being made to overcome this difficulty. Taking Pulmonary Tuberculosis alone, 119 patients died in 1921, and the Death-Notification interval works out as follows:— Died before notification received 32 Died within one week of notification 8 ,, ,, one week to one month of notification 6 ,, ,, one month to three months of notification 18 ,, ,, three months to six months of notification 13 ,, ,, six months to twelve months of notification 11 ,, ,, one year to two years of notification 18 ,, ,, two years to three years of notification 4 ,, ,, three years to four years of notification 3 ,, ,, four or more years after notification 6 The following table gives the Notifications and Deaths from Pulmonary Tuberculosis, with the Incidence and Death Rates for 46 each year since 1912. The details &s to Ward distribution, age and sex will be found in the report of the M,ed5cal Officer of Health. Year. Notifications. Incidence per 1000. Deaths. Death Rate per 1000. 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 1921 263 2.6 119 1.18 Home Conditions.—Owing to the prevailing distress caused through unemployment and the continued housing shortage, the home conditions of the patients show little improvement. Much overcrowding exists, and is unavoidable. Following up the inquiry of last year, the sleeping accommodation of 300 patients suffering from Pulmonary Tuberculosis was noted as follows:— 143 were sharing a bed. 91 had a separate bed, but not a separate room. 66 had a separate bed and a separate room. The four shelters provided by the Council were in constant use, and more shelters might possibly be provided if more patients could be induced to sleep in them. The shelters are occupied by three males and one female. Every effort is made by the nurses to encourage patients to have their bedroom windows open, and to live the "open-air life" as far as practicable. The need for accommodation for advanced cases is still claimant, but at present it seems impossible to obtain this, and' the only alternative advice that can be offered is to refer such cases to the workhouse. Dealing with the Dispensary itself, 925 new patients were examined during the year. The sources from which these patients came will be found in the following table:— 47 Males. Females. Children. Total. Doctors 73 56 46 175 Hospitals 7 3 11 21 School Medical Service - - 66 66 Insurance Commissioners 6 2 - 1 8 Ministry of Pensions 29 - - 29 Own Application 2 16 46 64 Other Sources 1 6 23 30 Nurses (Contacts) 50 155 327 532 168 238 519 925 Contacts.—The search for contacts is still vigorously pursued by the Dispensary staff, and again I would draw attention to the work of the nurses in inducing such a large hum'ber of contacts to submit to examination—a very difficult matter in many instances. Of the contacts examined 89 were found tuberculous and placed under treatment.. These are cases which otherwise would have been overlooked. The Work of the Nurses might be tabulated as follows:— Visits. Cases Notified. No. of Contacts. Contacts Examined. examined. Proved T uberculous. Nurse Aldis 1,379 71 185 72 19 13 „ Wilkins 1,283 114 289 223 28 36 „ Husbands 1,573 87 229 141 23 27 „ Heastinan 1,573 64 160 96 34 13 6808 336 863 532 104 89 In reading the table it should be remembered that the "character" of the contacts varies in some of the districts, greater pressure being required in some districts, where the importance of examination is not recognised. Out of a total of 863 contacts no fewer than 532 were examined, or, including the re-examinations, 636, giving 74 per cent., an excellent result, and a high tribute to the nurses concerned. The Dispensary has many important functions, but not one more important than this searching out of contacts. If any hope 48 is to be looked for in the way of preventing infection it must come from this direction. The work of the Dispensary is shown in the Statistical Table, and explains itself. From the table it will be noticed that 161 patients were diagnosed at the Dispensary as suffering from Pulmonary Tuberculosis, and 57 from Non-Pulmonary Tuberculosis. Diagnosis.—Before diagnosing Tuberculosis in children and non-bacillary adults, a certain diagnostic standard was this year adopted at the Dispensary. This standard followed closely that used in the famous Framingham Demonstration, and was found exceedingly helpful. In addition, certain confirmatory tests were used, viz.:— 1. The multi-papillary cutaneous tuberculin test (Ellis). 2. X-ray examination. 3. The chemical examination of the sputum for albumin. 4. Blood pressure. By these methods it is hoped that few cases of Tuberculosis were missed, and, further, that no patient was labelled tuberculous who did not give good reason for the same. Duration ok Illness.—In all cases of death from Pulmonary Tuberculosis inquiry is made as to how long the deceased had been ill. Where the patient had attended the Dispensary at any time there was seldom any difficulty in obtaining a fairly correct history, but in other cases the answers on this point were often vague and indefinite. Taking, however, 76 deaths (39 males, 26 females and 11 children) whose histories were recorded at the Dispensary, the average duration of illness for both sexes worked out at 35.5 months, the difference between the males and females being 5.6 months. In the children the average duration was 15.3 months. A larger series of cases will in time give more reliable d!ata. Family History.—In 31 instances among the 76 deaths alluded to above, there was a history that some near relative was suffering from or had died of Tuberculosis—15 males, 9 females, 7 children. Treatment.—Eighty per cent, of the patients in regular attendance at the Dispensary received or are receiving specific treatment—tuberculin, sodium morrhuate, Raw's vaccine, etc., but it is much too early to speak about results. Careful watch, however, is being maintained, and will form the subject of other reports. Sanatorium Treatment.—During the year 118 patients were referred to sanatoria and 18 to the infirmary. Of the sanatorium patients, one was admitted for the second time. The average 49 tion of residence in the sanatorium was eleven weeks, but, again, it is regretted that too many patients discharge themselves against advice. Feeling better, and anxious to get home, they imagine themselves well, and insist on taking their discharge, only later on to regret their haste. Of those sent to sanatoria, only 7 were discharged fit for "ordinary pcoupation," the remainder as unfit or only fit for such light work as is at present unobtainable. Of those referred to the Infirmary, the majority (15) being advanced cases died in the Institution. Dental Treatment.—Increasing attention is being paid to the state of the teeth of tuberculous patients, and during the yeai1 93 patients were referred to the dentist for special treatment. All patients, however, were advised to see to the proper and regular cleaning of the teeth as part of their routine treatment. Impairment of the digestive function js an all-important symptom of tuberculosis, and without good teeth there cannot be good digestion. The dentist reports as follows:— Number of patients 93 ,, attendances 174 „ extractions 84 „ fillings 16 Cases of pyorrhœa alveolaris 7 Refused treatment 3 Gas was administered by the Tuberculosis Officer on twelve occasions, the number of patients being 33. The number of dentures supplied was 4, total cost amounting to £17 10s., of which £5 was subscribed by patients. A number of patients (3) preferred treatment by their own dentist. The same arrangements exist between the Council and the British Dentists' Hospital as mentioned last vear. X-Ray Examination.—Increasing use is being made of this method of examination in assisting the diagnosis of Pulmonary Tuberculosis, especially in children, in whom the ordinary methods of examination not infrequently give no decided results. During the year 139 patients were so examined, 75 of whom were children. Of the 139 examinations, 132 were examinations of the chest and 7 of other parts. The method is somewhat expensive, but more than worth the money spent on it. Sputum Examinations.—During the year' 374 specimens of sputum were sent for examination to the Bacteriological Laboratory of the Seamen's Hospital, with the following results:—Positive, 98; Negative, 276. 50 At the same time 269 specimens were chemically examined at the Dispensary as to the presence of albumin, by way of assisting diagnosis. The following results were obtained:— Group 1. Tubercle Bacilli present and Albumin present 76 „ II. „ „ „ „ absent 16 „ III. „ „ absent „ present 65 „ IV. „ „ „ „ absent 122 In Group II. nine specimens negative on first examination gave a positive result to albumin on re-examination. With reference to Group III., albumin is present in several diseases of the lung besides Tuberculosis, but it is interesting to note that 19 of the 55 cases comprising this group were found by other methods to be tuberculous. In Group IV. none of the cases have so far been found tuberculous. The great value of the test is a negative one. If albumin is absent from the sputum on several examinations the case is almost certainly not tuberculous. The Interim Tuberculosis Care Committee continues its good work under not very encouraging circumstances. Full reference to this was made last year. I am indebted to Miss Johnston, the Hon. Secretary, for the following Report:— "At the first meeting it was suggested that, as there was no prospect of the Borough Council parrying out the scheme for providing accommodation for advanced cases of Tuberculosis, that if a Voluntary Committee could rent the three houses next to the Tuberculosis Dispensary, and raise sufficient money for alterations and furniture, the home could be carried on through payments received for patients from the London County Council. "The Borough Council were approached, and at a special meeting of the Interim Tuberculosis Care Committee a Home of Rest Committee was formed of members of the Interim, Tuberculosis Care Committee. "This Committee met four times, but it was found advisable to drop the scheme for a time, the Borough Council having decided to sell the houses suggested for the Home. "The continued shortage of houses prevents improvement in the condition of the homes, which are overcrowded and often badly in need of repairs. In one case only a couple were, with help from the Soldiers' and Sailors' Help Society, enabled to move from 51 one room to two. It is generally impossible to arrange for a patient to have a bedroom to himself (or herself), and sometimes impossible to squeeze in even a single bed. The Council lent a bed to a patient who was an ex-naval man, and the G.F.F. gave a grant, for blankets, and to another patient a private donor gave a bedstead, and the family saved enough while the patient was at hospital to buy a blanket. Help was obtained for the families of two patients sent to isanatoria from the Soldiers' and Sailors* Help Society, and extra nourishment from Soldiers' and Sailors' Help Society, Soldiers' and Sailors' Families' Association and National Sailors' Fund for three patients. Clothes from British Red Cross Emergency Fund for two patients, and from Northampton's Charity, two convalescent letters for one patient and a grant towards child's clothes from Regimental Fund. Some of the parents are willing, when paying weekly for their children's treatment, to give a little each week to be saved until their return for clothes, bedding, etc. "The total amount collected for the London County Council, and sent to the Comptroller in 1921, was £149 19s. 6d. "During the year Nurse Thackeray resigned, and Miss Carter and Mrs. Purves joined the Committee. Mrs. Bacchus, who attended and did some visiting in connection with Randall Place Care Committee, has left Greenwich. Miss Dalton helped for three months, but left to go abroad for the winter." It will be seen from a consideration of the above Report that much useful work has been accomplished. In conclusion, I desire to acknowledge my indebtedness to the whole staf! 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. 52 Return as to Work carried out in connection with the Greenwich Dispensary for the Year 1921. 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 156 82 519 12 156 (b) Number included under 1 (a) who were found to be suffering from pulmonary tuberculosis 67 23 40 6 25 (c) Number included under 1 (a) who were found to be suffering from non-pulmonary tuberculosis 4 3 43 2 5 (d) Number included under 1 (a) who were found to be nontuberculous 72 44 376 3 110 (e) Number included under 1 (a) in whom the diagnosis was found to be doubtful 13 12 60 1 16 Insured. Uninsured. 2. (a) Total attendances at the Dispensary [including attendances at the Dispensary of persons included under 1 («)] 3,059 4,295 (b) Number of the above attendances at which systematic physical examinations and records were made 561 1,357 3. Number of visits to patients at their own homes by the Dispensary Medical Officers in connection with the supervision of home conditions 87 60 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" 2,135 3,673 5. Number of persons snfferingfrom 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 concerning patients 147 91 7. Number of written Reports concerning individual patients made to— (a) Public Authorities 515 287 (b) Practitioners 44 40 8. Number of specimens of sputum examined 265 109 M. MACDONALD, M.D., D.P.H., Medical Officer of the Dispensary. 53 MATERNITY AND CHILD WELFARE. In my Report for the year 1920 I referred to the projected! use of Conduit House, 236, Trafalgar Road, not only for the purposes of a Municipal Creche, but also for the holding of Infant) Consultations, w hich would permit of our giving up Victoria Hall. The necessary alterations, etc., were carried out early in the year by the Council's Works Department at a cost of £607, and Conduit House was first used for Infant Consultation purposes in August. The Council have also acquired the commodious premises, No. 105, Shooters Hill Road, the ground floor of which comprises, very suitable accommodation for our Infant Consultation work in the Charlton and Kidbrooke area. This house was purchased for £1,275, and the necessary alterations were carried out by public contract at a cost of £693 10s. It may be added that the alterations carried out included the cutting off of the two upper floors, which were not required for Infant Consultation purposes, and this portion of the premises ;is let separately as a maisonette. The premises first came into use as a Centre'for Infant Consultations in August, which enabled us to give up the use of the premises which had been previously rented for this purpose at Sunfields Memorial Churchroom. Throughout the year seven Infant Consultations have been held weekly as follows:— Borough Hall—Mondays, Tuesdays and Thursdays. Conduit House—Mondays and Wednesdays. Albany Institute—Thursdays. Shooters Hill Road—Fridays. In addition to these Consultations Ante-Natal Clinics were held Tuesday and Thursday mornings at the Borough Hall. It will be noticed that the Infant Consultations represent one more than were held during 1920, three taking place at the Borough Hall instead of two. A glance at the table on page 57 will serve to convey an adequate appreciation of the really enormous number of attendances at these Clinics. The attendances at the Borough Hall were approximately twice those of the preceding year, owing to an extra Consultation being held, whilst the attendances at the other three centres show generally an appreciable adVance. At the end of 1920 Dr. F. L. Pickett was appointed as Maternity and Child Welfare Medical Officer in succession to Dr. Katherine McNeill, and commenced his duties officially on 24th January, 1921. I also have to acknowledge the services of Doctors Neary and Kellett, who regularly throughout the year conducted the 54 Consultations on Mondays and Thursdays respectively, when Dr. Pickett was engaged at the second Consultation. Baby Shows were held early in October under the direction of a Special Committee consisting of the members of the Maternity and Child Welfare Committee of the Council, together with the Mayor and Mayoress and a number of prominent local ladies. The shows attracted record interest, the total number of entries being 432, which figure included 17 pairs of twins. The ready assistance rendered gratuitously as judges by several local medical practitioners as well as Maternity and Child Welfare Medical Officers in other Boroughs is gratefully acknowledged. The Committee were also indebted to local chemists and the firms from which the Council obtains its dried milk, drugs, etc., for substantial assistance towards the provision of prizes. The entrants from each Centre were divided into three classcs: Class 1.—Three to nine rrionths. Class 2.—Nine to eighteen months. Class 3.-—Eighteen months to five years. Prizes were awarded at each Centre in the general competitions, and also for twins, and a special prize was granted to two babies who were triplets. (One of the triplets had died shortly before the Shows took place.) Supply of Milk, etc., for Expectant and Nursing Mothers and Infant Children.—On the 31st March, 1921, the Ministry of Health issued their circular No. 185, which permitted nursing and expectant mothers and children up to three years of age to receive one pint of milk per day, with one and a half pints to infants between the ages of three months and eighteen months in exceptional cases, and also extended the pint of milk to children between the ages of three years and five years, where such supplies were essential on the grounds of health, a medical certificate being required in these latter circumstances. Hitherto milk had been permitted without reservation for children up to the age of five years. Towards the end of the year the Ministry of Health suggested a drastic cutting down of the supplies, but, owing to strong Representations from Local Authorities as to the ill effects which would be certain to follow such a procedure, the Ministry decided to continue in force the provisions outlined in the ci'rcular above referred to. The suggestion in the Ministry's circular No. 185, that each application for assisted milk supply should be considered by at least one member of the Committee, preferably the Chairman, the Medical Officer of Health and a responsible financial officer, before a supply is authorised, and also that the Committee should meet 55 at frequent intervals to review cases authorised, has been literally followed, and all possible precautions have been taken to prevent any abuse of these facilities. Early in the year the Maternity and Child Welfare Committee considered that three cases in which the wages were misstated were 'deliberate attempts to obtain goods under false circumstances, and were regretfully compelled to institute Police Court proceedings, with the result that one applicant was filled 40s. or twenty-eight days, and the other two 20s. and 20s. costs and 21s. and 21s. costs respectively. It may be added that every care is taken to obviate overlapping on the part of the Guardians and ourselves, and for this reason immediately the week's applications are authorised information is sent to (he Clerks of the Greenwich and Woolwich Guardians as to the families grantjed milk and the quantities allowed. It may be explained here that milk is given free only in necessitous circumstances, a family being judged necessitous when the income per head per week, after deducting rent is not more than 8s. Those above this scale are able to purchase these commodities at practically cost price. The following table shows the amount of dried milk, virol and emulsion purchased and distributed to the mothers attending the Consultations during the year. Free. Sales. Total amount distributed. Milk 24,047 lbs. 28,646 lbs. 52,693 lbs. Virol 596½ 475 „ 1,071½ „ Emulsion 302½ „ 257½ „ 560 „ With regard to the milk question I have always found that the use of a guaranteed full cream dried milk gives satisfactory results, and whilst representing a little more trouble to prepare for the use of infants than ordinary fresh milk, is, in my opinion, preferable to the latter on account of the dried milk being uniformly clean and containing a minimum of harmful bacteria. One pound of dried milk is approximately the equivalent of one gallon of fresh tnilk. The number of dinners supplied to nursing and expectant mothers was 2,629. All these mothers were in necessitous circumstances, and the extra food was specially ordered by the Medical Officer in attendance at the Clinic as necessary to improve the health of the recipient. The dinners were provided at local dining 56 rooms under conditions of privacy at an average cost of Is. per tneal. The following figures show the work carried out at the various Infant Consultation Centres and Ante-Natal Clinics : — Borough Hall. Victoria Hall and Conduit House. Sunfields Mem. Schoolroom and Shooters Hill Road. Albany Institute. Attendances 9,774 6,802 4,381 2,834 New Cases 776 570 259 218 Medical Consultations 4,687 3,498 2,211 1,490 Nursing mothers seen by Doctors 1,885 1,552 890 316 ( The children are weighed and advice given to the Mothers at every attendance.) Number of cases attending Ante-Natal Clinic 285 Number of Attendances 592 The total attendances of babies at our Creche during the year were 2,896. Minor Ailment Centre, Borough Hall.—This Centre provides for the treatment of children from such minor ailments arising from ear, nose or throat trouble, eczema, etc. During the year 45 cases attended, the number of attendances being 145. The following continue their good work in the Borough : — London County Council School Clinic. Health Centre, Deptford Green. Miss McMillan's Infant Creche and Cleansing Station, Well ington Street. Albany Institute Infant Consultation Creche and Babies' Home. 57 Statement showing number of Visits, &c., made by Health Visitors. Visits. Re-visits. Total. Births under 1 year 2,194 2,962 5,156 „ over 1 year 369 2,713 3,082 Measles 632 213 845 Whooping Cough 333 137 470 Diarrhoea 194 144 338 Puerperal Fever 19 18 37 Ophthalmia Neonatorum 24 61 85' Pneumonia 28 24 52 Scabies 52 34 86 Verminous (L.C.C. Report) 37 34 71 Ante-Natal 354 118 472 Milk Scheme 668 369 1,037 Dental Treatment 47 19 66 Dinners 62 8 70 Seen in Office 1,108 — 1,108 Children Act 119 36 155 Lying-in Homes 2 — 2 Infant Consultation attended 749 — 749 Ante-Natal Clinics attended 98 — 98 C.O.S. Meeting attended 31 — 31 Inquest attended 1 — 1 Miscellaneous 111 6 116 Total 7,232 6,895 14,127 Maternity Home.—Now that the Maternity Home is an established Institution, it is interesting to recall the fact that the suggestion of a Maternity Home first received the approval of the Council in June, 1919, and premises in Maze Hill were acquired, which it was thought at that time would be suitable for the purpose. Subsequently, however, these houses were found to require an amount of alteration and adaptation which from the financial aspect rendered the proposition impracticable. It was on the 25th May, 1921, that the Council recommended the making of a definite offer for Kidbrooke House, No. 78, Shooters Hill Road, which had previously been used as a Nursing Institution, was in a fair state of repair, and which from other points of view appeared to be in every way suitable for the purpose required. The approval of the Ministry of Health was obtained to the purchase of the premises for a sum not exceeding £1,800, and subsequently the Ministry of Health approved the amount of £2,115 for the adaptation of the premises, and a sum of £1,372 for furnishing, making a total cost of slightly over £5,000. Having regard to the fact that practically one half of this cost was borne by the Ministry of Health, it will be seen that the initial cos,t of the Maternity Home, so far as the Greenwich Borough Council was 58 concerned, .represents slightly less than a 1d. rate, and that the estimated annual figure for maintenance suggests that the annual cost to the rates will subsequently not exceed the equivalent of a ¼d. rate. There is no question whatever that the Maternity Home is very greatly needed in Greenwich, on account of the fact that a large proportion of the residents, owing to their overcrowded condition, have no satisfactory accommodation of this nature. It will be possible to give special attention to cases of an unusual character, and it is confidently hoped that the Maternity Home will be the means of preventing many of the lifelong miseries which follow what should be a natural physiological function, but which, owing to lack of proper facilities and environment has become in too mamcases an event fraught with grave danger both to mother and child. The purchase of the premises was completed by the end of September, and the necessary redecoration, etc., was at once proceeded with by the Council's Works Department under the direction of the Borough Engineer. Dental Work.—The arrangements made with the British Dentists' Hospital that they should provide a qualified dental surgeon to attend on one half-day per fortnight to give dental attention to any patient certified by the Maternity and Child Welfare Medical Officer as requiring such, with a view to an improvement in their physical condition, are .still in operation. Eighty-seven patients have been attended by the dental surgeon and 18 dentures have been provided, the total cost of the dentures being £70 15s., of which amount the Committee have decided that the patients should pay £55 10s. Puerperal Fever.—Eleven cases of this disease were notified during the year, one 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.—Twelve cases of this disease were notified during the year, both eyes being affected in 8 cases, and one eye only in the remaining 4 cases. With the exception of one case, in which the patient is still attending Hospital for treatment, all the cases recovered. Of the total number of cases, 7 occurred in West Greenwich, 4 in Easi: Greenwich and 1 in Charlton. Measles.—See pages 16, 38 and 39. The following table gives the number and character of the intimations respecting births in the Borough : — 59 1914. 1915. 1916. 1917. 1918. 1919. 1920. 1921. Total Number of Births notified in each year . 2,513 2,280 2,497 1,992 1,735 2,085 2,714 2,564 (a) Attended by Midwives 1,338 1,226 1,314 1,095 990 1,159 1,494 1,452 (A) Attended by Doctors 1,175 1,054 1,183 897 745 926 1,220 1,112 Number of Still Births notified in each year 36 42 61 47 44 59 78 52 Number of Births registered in eagh year 2,409 2,347 2,354 1,967 1,753 1,968 2,648 2,366 Children Act, 1908.—Section 2 (2) of the Children Act, 1908, provides for the Local Authority appointing one or more persons to be Infant Protection Officers, whose duty it shall be from lime to time to visit any infants referred to in any notice given under Part I. of the Act, and the premises in which they are kept, in order to satisfy themselves as to the proper nursing and maintenance of the infants, or to give any necessary advice or directions as to their nursing and maintenance. The Act further provides for the registration as a foster-mother of any person who undertakes for reward the nursing and maintenance of one or more infants under the age of seven years apart from their parents for a longer period than forty-eight hours. In June, 1920, the Greenwich Borough Council made formal application to the London County Council in regard to the appropriate officers of the Greenwich,Borough Council being authorised, to exercise the powers of Infant Welfare Protection Visitors under Section 2 (2) of the Children Act, 1908, and at the meeting of the Greenwich Borough Council on 6th April, 1921, it was reported that the London County Council were prepared to authorise the officers of the Greenwich Borough Council to exercise the powers in question for a period of one year in the place of t)he visitors who had formerly been working under the direct supervision of the London County Council. For a considerable period it had been only too evident that there was a good deal of duplication of work in connection with the supervision of nurse children. Many of the foster-mothers were in the habit of bringing their nurse children to the Infant Consultations, where they were, of 60 course, under the supervision of the Health Visitor in charge, who might, and often did, have occasion to visit the homes of the, children in the course of their district visiting. Dr. Hamer, Medical Officer of Health of the London County Council willingly rendered me every assistance in connection with the transference of the duties, and the benefit of his experience has always been at my disposal. The work was taken over on 25th July, 1921, at which period there were on the register 31 foster-mothers and 50 nurse children. At 31st December, 1921, these figures had increased to 36 fostermothers and 57 nurse children. In several cases the Health Visitors themselves discovered unregistered foster-mothers, who, speaking generally, were unaware of the necessity to register. In all such cases registration was promptly effected, and the foster-mother warned as to the necessity for the strict compliance with the provisions. of the Act. Figures in detail covering the period between the date of taking over on 25th July, 1921, to 31st December, 1921, arc as follow :— Foster-mothers. New Foster-mothers registered 7 Foster-mothers giving up voluntarily or removing 2 Increase .5 Infants. Infants notified (under one year) 17 ,, „ (over one year) 7 — 24 Infants died (all under one year) 4 Infants removed 11 Infants removed owing to foster-mother being deemed unsuitable 1 Infants reached seven years of age 1 — 17 Increase 7 The Council's Health Visitors visit the homes of all nurse children regularly at intervals of about four weeks, and there appears to me to be no question whatever that this very thorough supervision, coupled with advice where 'necessary, has resulted in the maintaining of the health and general condition of the nurse children at as high a level as possible. 61 In November this Council, at the request of the London County Council, consented to allow the Health Visitors to carry out home visiting; with regard to blind children in the Borough up to the age of five years. During the short time available no case came within the notice of the Health Visitors. 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 2,542 specimens have been examined for Diphtheria, 13 for Typhoid Fever, 433 for Tuberculosis, and 11 for other various conditions. Fuller details respecting results of the examinations of these specimens will be found under the different headings of the individual diseases. HOUSING. Following on the particulars given in my last Report, the Ministry of Health, after considerable negotiation, agreed to the acceptance of the tender of the Guild of Builders (London), Ltd.,for the erection of 164 houses on section 2 of the Council's site, and 26 houses or. the East Mascall's site, Charlton Road. The contract was duly entered into, and the works proceeded to the extent that 55 houses were completed and occupied during the period covered by this Report, which, with 18 houses under the first building contract, and 50 tenements provided by the conversion of houses, made provision for 123 families. Insanitary Areas.—As, after consultation and correspondence with the Housing Department of the London County Council, there did not appear to be any likelihood of these areas (see Appendices) being dealt with by the London County Council in the near future, I reported towards the end of the year further on the subject, suggesting that possibly an arrangement might be made between the London County Council and this Council, whereby the London County Council should authorise this Council to carry out reconstruction schemes in reference to certain of these areas, particularly the worst district in the Borough, viz., East and West Street and Hardens Manorway, Charlton, an area comprising some 205 houses with an approximate population of 1,000 persons. 62 The inhabitants in this area live under grossly insanitary conditions, the chief being the fact that the houses are built on lowlying land, with the result that their drainage systems are not only liable to, but are continually surcharged with sewage from the London County Council's main sewer. It frequently occurs that the soil immediately under the floor boards is in a semi-liquid condition through the admixture of liquid sewage. These houses are undoubtedly unfit for human habitation, but under the present housing conditions generally closing orders cannot be obtained, and the occupation of the houses is therefore allowed to continue. I understand from the District Surveyor that he proposes at an early date to go through this property and serve notices on the various owners requiring them to effect certain substantial structural alterations under the Dangerous Structures clauses of the Building Act. This suggests that at 'he present time the property should be purchasable for very little more than its site value, whereas if these extensive structural alterations were carried out it would be necessary to pay a much greater amount for the houses by reason of the expense known to be incurred. I accordingly suggested to the Committee that it would be desirable for the Council to give serious consideration to the question of purchasing, by arrangement With the London County Council and the Ministry of Health, the whole of this block, and then to deal with the properties by six or eight houses at a time, all new properties erected being placed upon pillars at a considerable level above the present ground surface, and the whole of the site covered with concrete. I think in this way very satisfactory dwellings could be provided for the persons who desire to live in this neighbourhood by reason of its close proximity to their work, etc. Upon a full consideration of this Report the Public Health Committee decided to take no action. Closing Orders.-—A point has arisen in connection with the housing problem which is materially tying our hands at the present time. .Notices to abate pressing nuisances were served on the owners of certain properties which are admittedly in an insanitary condition, and need closing and demolition, and this, under pre-war 63 conditions, would certainly have been their fate; but, on account of the great scarcity of accommodation for this class of persons, we are not able to enforce closing orders. The properties above referred to are in fact no worse, but much better than many of the other 1,300 houses in this Borough requiring demolition. The owners were taken to the Police Court for not having carried out the necessary trifling works required to keep these houses in at least a cleanly condition so long as they were in occupation, but the magistrate, on the application of the owners, made a closing order, which order has not been complied with up to the present, simply because the tenants cannot find alternative accommodation. Whenever we now serve notices upon owners of this class of property, they accordingly immediately threaten to apply to the Court for a closing order, which they know under the existing shortage of housing accommodation cannot be enforced. It therefore follows that tenants of this class of house are compelled to occupy such property without the Council being able to ensure that the owners shall ke,ep them in any way in a reasonable condition of cleanliness and repair during the period of such occupation. 64 APPENDICES. HOUSING CONDITIONS. Si a! is tics for year ended 31 st December, 1921.) 1.—General. (1) Estimated population 100,493 (2) General death rate 12.41 per 1,000 (3) Death rate from Tuberculosis 1.37 per 1,000 (4) Infantile mortality 74 per 1,000 births (5) Number of dwelling-houses of all classes 16,385 (6) Number of working-class dwelling-houses mately) 15,073 (7) Number of new working-class houses erected 73 2.—Unfit Dwelling-houses. 1.—Inspection. (1) Total number of dwelling-houses inspected for ing defects (under Public Health or Housing Acts) 3,580 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 No figures available (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those ferred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 2,231 2.—Remedy of defects without service of formal notices. Number of'defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,772 3.—Action under Statutory powers. (a) Proceedings under section 28 of the Housing, Town Planning, etc., Act, 1919— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 84 65 (2) Number of dwelling-houses which were dered fit— (a) By owners 84 (b) By Local Authority in default of owners Nil (3) Number of dwelling-houses in respect of which closing orders became operative in pursuance of declarations by owners of intention to close Nil (b) Proceedings under Fublic Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,147 (2) Number of dwelling-houses in which defects were remedied— (a) By owners 2,147 (b) By Local Authority in default of owners Nil (c) Proceedings under sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909— (1) Number of representations made with a view to the making of closing orders Nil (2) Number of dwelling-houses in respect of which closing orders were made Nil (3) Number of dwelling-houses in respect of which closing orders were determined, the dwelling-houses having been rendered fit Nil (4) Number of dwelling-houses in respect of which demolition orders were made Nil (5) Number of dwelling-houses demolished in suance of demolition orders Nil 3.—Unhealthy Areas. Areas represented by the Local Authority with a view to Improvement Schemes under (a) Part I. or (b) Part II. of the Act of 1890— (1) Name ol area (1) Watergate Street (2) Roan Street (3) Thames Street (4) East Street, etc., Charlton (5) Eastney Street 66 (2) Acreage (1) 15 acres 3375 sq. yds. (2) 13 „ 3740 „ (3) 8 „ (4) 5 ,, 2436 „ (5) 2 „ 1600 „ (3) Number of working-class houses in area (1) 220 (2) 500 (3) 325 (4) 205 (5) 100 (4) Nurnber of working-class persons to be dis- placed (1) 1220 (2) 3000 (3) 2000 (4) 1000 (5) 600 4.—Number of houses not complying with the Building Bylaws erected with consent of Local Authority under section 25 of the Housing, Town Planning, etc., Act, 1919 Nil 5.—Staff engaged on Housing work with, briefly, the duties of each officer.—No special staff employed. Duties carried out by Medical Officer of Health and five District Sanitary Inspectors and one lady Sanitary Inspector. 67 Summary of Sanitary Work performed during the Year 1921. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Inspections. Houses Inspected 1165 854 728 833 3580 Other Premises Inspected 51 51 74 100 276 Re-inspections, Calls made, etc 4329 4169 3076 4148 15722 Inspections of— Houses Let in Lodgings ... ... ... ... ... Bakehouses 3 43 ... 42 88 Factories and Workshops 41 21 43 40 145 Outworkers' Premises ... ... 85 39 124 Slaughterhouses 4 7 5 5 21 Cowhouses ... 4 3 5 12 Stables and Yards 12 19 10 11 52 Piggeries ... 2 2 1 5 Courts and Alleys 15 15 13 9 52 Fields, Lanes, etc 8 26 13 41 88 Investigations (Rats and Mice) 112 106 122 117 457 Inspection of— Urinals 6 6 7 14 33 Horse Slaughterhouses ... ... 1 ... 1 Dairies, Cowsheds and Milkshops ... 56 6 45 107 Soapboilers ... ... ... ... ... Other Offensive Trades ... ... ... ... ... Ice Cream Places ... 91 5 ... 96 Other Places where Food is Prepared 5 43 80 261 389 Premises (Children Act, 1908) ... ... 5 4 9 5751 5513 4278 5715 21257 68 SUMMARY OF SANITARY WORK—continued. First Quarter Second Quarter. Third Quarter. Fourth Quarter. Total. Drains. Constructed Intercepting Chamber and Fresh Air 5 3 8 l 17 Inlet 17 11 10 16 54 Other Chambers Constructed 13 46 12 29 100 Reconstructed or Repaired 50 74 32 77 233 Opened, Cleansed and Amended 117 125 66 102 410 Surfacc Drains Constructed 8 36 8 7 59 Traps Fixed 88 126 51 130 395 New Soil Pipes 17 10 10 10 47 Soil and Vent Shafts Repaired ... 1 12 5 18 Drains and Soil Pipes Ventilated 40 67 20 36 163 Drains Sealed Off, etc. 11 1 ... 20 32 Anti-Syphon Pipes ... ... ... 6 6 Drains Tested—by Smoke 79 66 48 128 321 „ ,, by Water 195 76 60 106 437 Found Defective 51 50 36 35 172 New Covers to Manholes ... ... 12 5 17 Yards Drained 16 62 10 30 118 Mews and Stables Drained ... ... 3 1 4 Washhouses Drained ... ... ... ... ... Forecourts Drained 4 25 ... 1 30 Areas Drained 7 13 4 26 Cesspools Abolished ... ... ... 4 4 Privies and Earth Closets Abolished 2 ... ... ... 2 Water Closets and Urinals. Closets Erected 11 12 10 4 37 VV.C. Doors Repaired or Provided 12 10 17 6 45 W.C.'s Sealed Off ... ... 3 1 4 Sanitary Conveniences or Improvements effected to Factories and Workshops 7 20 6 2 35 Pan, Traps and Water Supply furnished 19 18 34 42 113 Pans and Traps only furnished 67 78 34 85 264 Pans only furnished 6 4 9 5 24 Water Supply Apparatus Repaired or Provided 10 23 37 65 135 Water Supply Renewed 60 83 22 38 203 Water Supply Disconnected from Drinking Water Cistern 4 7 ... ... 11 Soil Pans properly Trapped 6 1 ... ... 7 Cleansed and Repaired 53 39 62 64 218 Newly constructed or better situated 6 6 5 6 23 Ventilation Improved 14 11 13 29 67 Public House Urinals Cleansed or Repaired 2 3 1 3 9 Other Urinals Altered or Cleansed 1 2 1 ... 4 Other Urinals Constructed ... 1 ... ... 1 Repaired or Water laid on 7 17 ... 1 25 69 SUMMARY OF SANITARY WORK-continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. T otal. Ashpits. Provided 526 209 166 111 1012 Covers to Receptacles 2 ... ... ... 2 Dust Complaints forwarded to the Surveyor 8 ... ... 3 11 Pavings. Yards 86 161 83 122 .452 Forecourts 10 23 3 9 45 Areas 7 13 2 4 26 Washhouses 7 17 4 13 41 Mews and Stables ... 1 3 ... 4 General Water Supply. Covers to Cisterns Adapted ... 1 1 2 Water Supply Provided 6 6 ... 1 13 Water Fittings Amended 78 65 38 59 240 Cisterns Cleansed and Repaired ... ... ... 5 5 Water Services Altered so as to draw direct from main 4 8 5 4 21 Water Supplies Reinstated where cut off through defective fittings 15 4 13 32 Defective Water Fittings (causing nuisance from dampness) Repaired 46 35 30 26 137 Water Supply Certificates granted (Section 48) ... 1 3 ... 4 Other Improvements. Houses Generally Repaired 131 130 140 204 605 Premises Cleansed, Lime-washed and Repaired 128 119 89 100 436 Verminous Rooms Cleansed 33 51 75 73 232 Ventilation Improved 81 75 58 104 318 Leaky House Roofs and Gutters Repaired 207 177 124 169 677 Walls and Ceilings of Premises Cleansed throughout 46 53 51 47 197 Ditto, ditto, partially 199 119 141 219 678 Stoves and Fireplaces Repaired 11 10 8 31 60 Washing Coppers Repaired 17 11 17 13 58 Sinks Provided 7 5 6 3 21 Floors Repaired ... 22 4 ... 26 Cowhouses Cleansed ... 5 3 ... 8 Horse Slaughterhouses Cleansed ... ... ... ... ... Ice Cream Places Cleansed or Improved ... 16 1 1 18 Other Places where Food is prepared 4 16 5 11 36 70 SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Other Nuisances Abated Illegal Use of Underground Room Discontinued 2 l ... ... 3 Overcrowdings Abated Sink, Lavatory and Bath W aste Pipes Disconnected, Trapped and 1 ... 1 2 4 Amended 42 87 67 68 264 Stack Pipes Disconnected and Amended 29 69 32 42 172 Nuisances from Dampness Abated 99 73 62 57 291 Animals Kept in Unfit Places Discontinued or Removed 5 14 5 21 45 Dung Receptacles Provided ... 1 ... ... 1 Bakehouse Nuisances Abated ... 24 ... 21 45 Other Defects Remedied 28 64 50 51 193 Rat Infestation ... ... 22 24 46 Houses Abolished, Unfit for Habitation ... ... ... ... ... Accumulations of Manure and other Obnoxious Matter Removed 21 22 15 7 65 Dampness of Walls Remedied 29 41 43 37 150 Inundations Abated 2 ... ... ... 2 Other Nuisances, principally of Dilapidations and want of Underfloor Ventilation 54 67 31 42 194 Contents of Rooms Cleansed ... ... 2 ... 2 Breaches of By-Laws Abated ... 2 2 1 5 Smoke Nuisances. Observations 1 2 13 1 17 Statutory Notices Served (Sections 23 and 24) ... ... ... ... ... Food and Drugs. Samples Taken 103 95 72 166 436 Found Adulterated 3 2 1 8 14 71 SUMMARY OF SANITARY WORK -continued. Unwholesome Food. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Voluntarily surrendered \ 33 tins of tomatoes. "20 tins of milk. 59 lbs. of salted herrings. 5 lbs. of beef. 17 tins of milk. 9 tins of milk. 238 boxes of raisins. 28¼ lbs. of wheat. 1 tin of salmon. 1 tin of salmon. 1 bushel of winkles. 6¾ cwts. of chestnuts. 1 jar of fishpaste 2363 tins of pears. 6 stone of cod. 3 bags of winkles. 2051 tins of fruit. 7 stone of fresh pears. 13½ stone of skate. 3½ lbs. pigs liver. 7 stone of fresh haddocks. 1 tin of pineapple. 12 stone of haddocks. 3½ lbs. pigs liver. 14 ½-boxes of sultanas. 3 stone of herrings. 14 stone of haddocks. 45 boxes of seedless 256 lbs. of wheat. raisins. 6 stone of turbot. 60 lbs. of rabbit. SUMMARY OF SANITARY WORK—continued. First Quarter. Second Quarter. 1 Third Quarter. Fourth Quarter. Total. Notices, &c. Intimations served under Public Health (London) Act, 1891 (Section 3) 744 592 374 437 2147 Notices served— Under Housing, Town Planning, etc., Act, 1919 18 27 19 20 84 Rats and Mice (Destruction) Act, 1919 6 26 18 14 64 Re Verminous Rooms 4 16 1 ... 21 Under P H. (L.) Act and Metropolis Management Act {re combined drainage) 29 ... 12 7 48 Yards ... ... ... 8 8 Statutory Notices served under Section 4 90 89 46 65 290 Statutory Notices re Ashpit Provision 62 37 11 11 121 Complaints Received and Attended to 228 222 276 231 957 Letters Written relating to Abatement ot Nuisances 599 511 363 431 1904 Summonses Applied for and Issued 9 4 ... 3 16 Magisterial Orders Obtained and Enforced 2 1 ... 3 6 Drainage Plans Received and Examined 32 23 13 30 98 Reports to District Surveyor 6 ... ... 9 15 73 BOROUGH OF GREENWICH. Proceeding's during 1921. Premises. Number of Places. Number of Inspections, 1921. Number of Notices, 1921. Number of Prosecutions, 1921. On Register at end of 1920. Added in 1921. Removed in 1921. On Register at end of 1921. Dairies, Cowsheds & Milkshops 90 17 18 89 107 — — Slaughterhouses 5 — — 5 22 — — Other Offensive Trade Premises — — — — — — — Ice Cream Premises 54 39 11 82 96 — — Registered Houses Let in Lodgings 247 — — 247 — — — Total number of Intimation Notices served for all purposes 2231 Overcrowding, 1921— Number of Dwelling-rooms overcrowded 4 Number remedied 4 Number of Prosecutions — Underground Rooms— Illegal occupations dealt with during year . 3 Number of Rooms Closed 3 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 Premises cleansed under Sec. 20 of the London County Council (General Powers) Act, 1904 182 Number of Cleansing Baths given under Cleansing of Persons Act 51 Shelter provided under Sec. GO (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 74 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 10 Number of Tenements comprised therein 120 Number of Tenements for which certificates were granted 4 Number of Prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. 1 (b) For prevention of nuisance arising from sive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. (/) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. — (i) With respect to sufficiency of water supply to water closets (/') With respect to drainage, etc. (Metropolis Management Act, Sec. 202) — (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 1 Mortuaries— Total number of bodies removed 165 167 Total number of infectious bodies removed 2 LEGAL PROCEEDINGS, 1921. Apart from the proceedings under the Sale of Food and Drugs Act, it became necessary to take Police Court proceedings in 15 cases. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 2nd April, 1921. DISTRICTS. Census Population, 1911. EstImated Population at the middle of the year 1921. Births registered during the 13 weeks ended 2nd April. 1921. Deaths registered during 1 the 13 weeks ended 2nd April, 1921. AGE MORTAL1TY. SEVEN ZYMOTIC DISEASES. . Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumon1a. Heart Disease. Cancer All other Diseases. Rate of Mortal1ty per 1,000. All Causes. Seven Zymot1cs. Under 1 year.` Over 1 and under 5 years. Persons aged 65 years and upwards. Small.Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Typho1d. Other. D1arrhœa. During the corres ponding period year previous. During the 13 weeks ended 2nd April, 1921. During the corres¬. ponding period year previous. During the 13 weeks ended 2nd April. 1921. M. F. M. F. Greenwich East 46960 44240 124 137 83 67 15 12 44 ... ... 2 4 3 ... ... l 16 2 27 18 11 66 12.60 14.60 1.43 .90 Do. West 22933 26687 95 81 58 41 22 3 34 ... ... 1 1 ... ... ... 2 15 2 20 9 11 38 21.93 14.0 1.77 .59 St. Nicholas, Deptford 7290 7581 23 33 18 21 9 4 12 ... ... ... ... ... ... ... ... 2 ... 10 2 l .24 19.29 20.3 3.55 ... Charlton 16910 18790 52 57 30 24 13 3 16 ... ... ... ... ... ... ... ... 7 ... 14 4 5 24 12.73 11.3 .65 ... Kidbrooke 2875 3195 1 2 4 6 ... ... 5 ... ... ... ... ... ... ... ... 1 ... 3 ... 3 3 11.69 12.6 1.9 ... Miller Hospital ... ... ... 7 4 ... 3 2 ... ... ... ... ... ... ... ... ... 2 1 ... 1 7 ... ... ... ... Non-Resident ... ... ... 8 10 4 3 3 ... ... ... ... ... ... ... ... ... 1 2 ... 4 11 ... ... ... ... Seamen's Hospital— Resident ... ... ... 12 0 ... 1 2 ... ... ... ... ... ... ... ... 6 ... 2 1 1 2 ... ... ... ... Non-Resident ... ... ... 15 0 ... ... 1 ... ... ... ... ... ... ... ... 4 ... 2 2 5 ... ... ... ... Greenwich and Deptford Hospital— Resident ... ... ... 36 25 4 1 27 ... ... ... ... ... ... ... ... 3 1 10 3 7 37 ... ... ... ... Non-Resident ... ... ... 45 48 5 1 41 ... ... ... ... ... ... 4 ... 8 3 17 6 4 51 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B.Brook Hospital— Resident ... ... ... 4 3 ... 5 1 . ... 2 3 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... Non-Resident ... ... ... 9 7 ... 6 ... ... 1 5 6 ... ... 1 ... ... ... 1 ... ... 2 ... ... ... ... Cottage Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... 1 1 ... 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Outside Institutions— Resident ... ... ... 30 28 6 3 10 ... ... 1 2 1 ... ... 1 10 2 6 7 4 .24 ... ... ... ... Borough 95968 100493 295 310 193 159 59 22 111 ... ... 3 5 3 ... ... 3 41 4 74 33 31 155 ... ... ... ... 60.5 352 Rate per 1,000 of Estimated Population ... ... 24.16 14.05 ... ... ... ... ... .11 .19 .11 ...... ... .11 1.63 .15 2.95 1.31 ,1.23 6.18 15.20 1405 1.56 .55 Deaths of Ch1ldren under one year per 1,000 b1rths ,, ,, ,, ,, ,, ,, prev1ous correspond1ng per1od County of London 97 102 86 Death Rate of 96 large Engl1sh Towns 13.9; of the County of London 13.4 B1rth Rate „ ,, 23.5; „ „ 23.1 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 2nd July, 1921. Districts. Census Populaton, 1921. Preliminary Figures. Estimated Population at the middle of the year 1921. Births registered during the 13 weeks ended 2nd July, 1921 Deaths registered during the 13 weeks ended 2nd July, 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. All Causes. Seven Zymotics. Under 1 year. Over 1 and under 5 years. Persons aged 65 years; and upwards. Small.Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Typhoid. Other. Diarrhœa. During the corresponding period year previous. During the 13 weeks ended 2nd July. 1921. During the corresponding period year previous. During the 13 weeks ended 2nd July, 1921. M. F. M. F. Greenwich East 44240 44240 140 134 63 57 18 2 44 ... l l ... l ... ... ... 6 2 16 15 12 66 11.33 1088 .79 .27 Do. West 26687 26687 91 84 43 36 6 4 23 ... l ... ... ... ... ... l 7 3 11 5 8 43 14.03 11.65 .96 .28 St. Nicholas, Deptford 7581 7581 30 40 14 9 4 1 3 ... ... ... ... ... ... ... ... 5 2 4 ... 2 10 18.78 1216 1.52 ... Chareton 18790 18790 46 46 27 17 3 3 16 ... ... ... 2 ... ... ... ... 1 ... 6 6 4 25 1032 939 .87 .42 Kidbrooke 3195 3195 7 12 5 3 ... 1 5 ... ... ... ... ... ... ... ... ... ... ... 2 ... 6 10.33 10.00 ... ... Miller Hospital— Resident ... ... ... 7 3 3 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 8 ... ... ... ... Non-Resident ... ... ... 7 7 2 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 2 10 ... ... ... ... Seamens Hospital— Resident ... ... ... 10 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... 8 ... ... ... ... Non-Resident Greenwich and ... ... ... 14 0 ... ... ... ... ... ... ... ... ... ... ... 4 1 ... ... 1 8 ... ... ... ... ford Hospital— Resident ... ... ... 23 32 6 21 ... ... ... ... ... ... l ... 3 l 3 8 7 32 ... ... ... ... Non-Resident ... ... ... 43 45 5 4 16 ... ... ... ... 2 ... ... ... 10 2 14 7 8 45 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... . ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 2 3 ... 2 ... ... l l 2 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Non-Resident ... ... ... 14 16 3 14 ... ... ... 10 15 ... ... ... ... ... ... 2 ... ... 3 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... Non-Resident ... ... ... 1 6 2 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 6 ... ... ... ... Outside Institutions— Resident ... ... ... 31 20 2 2 5 ... ... ... ... ... ... .. ... 4 4 3 3 3 34 ... ... ... ... Borough 100493 100493 314 316 152 122 31 11 91 ... 2 l 2 1 ... ... l 19 7 37 28 26 150 ... ... ... ... 630 274 Rate per 1,000 of Estimated Population ... ... 25.16 10.94 ... ... ... ... .07 .03 .07 .03 ... ... .03 .75 .27 1.47 1.11 1.03 5.99 12.23 10.94 .87 .27 Deaths of Children under one year per 1,000 births ,, ,, ,, ,, ,, ,, previous corresponding period County of London 49 70 59 Death Rate of 96 large English Towns 11.3; of the County of London 10.9 Birth Rate „ „ ... 24.4; „ „ 23.3 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st October, 1921. DISTRICTS. Census Population, 1921. Preliminary Figures. Estimated Population at the middle of the year 1921. Births registered during the 13 weeks ended 1st October. 1921. Deaths registered during the 13 weeks ended 1st October, 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. All Causes. Seven Zvniotics. Under 1 year. Over 1 and under 5 years. Persons aged 65 year and upwards. Small.Pox. . Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhoea. During the corresponding period year previous. During the 13 weeks ended 1st October, 1921. During the corre. 1 sponding period year previous. During the 13 weeks ended 1st October, 1921. Typhoid. Other. M. F. M. F. Greenwich East 44240 44240 157 125 62 51 14 7 28 ... ... ... 4 l ... ... 6 13 1 10 13 15 50 7.98 10.25 .07 .99 Do. West 26687 26687 84 66 28 40 17 4 20 ... ... 1 1 l ... ... 7 2 1 6 6 6 3.70 10.80 10.03 1.12 1.47 St. Nicholas, Deptford 7581 7581 29 26 12 5 3 1 3 ... ... ... ... ... ... ... 1 3 1 1 1 5 5 10.66 3.70 1.01 .52 Charlton 18790 18790 51 43 35 18 7 2 22 ... ... ... 1 ... ... ... 5 9 3 ... 0 6 23 6.80 11.32 .43 1.26 Kidbrooke 3195 3195 16 12 4 3 1 ... 6 ... ... ... ... ... 1 ... 1 ... ... 1 ... 2 2 9.03 8.79 ... 2.50 Miller Hospital Resident ... ... ... 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... Non.Resident ... ... ... 20 8 2 4 3 ... ... ... ... ... ... ... 3 1 ... ... 1 6 15 ... ... ... ... Seamen.s Hospital— Resident ... ... ... 7 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 3 4 ... ... ... ... Non.Resident ... ... ... 11 ... ... ... 3 ... ... ... ... ... ... ... ... 4 ... 1 3 ... 3 ... ... ... ... Greenwich and Deptford Hospital— Resident ... ... ... 20 15 8 ... 13 ... ... ... ... l ... ... 1 1 ... 4 1 7 20 ... ... ... ... Non.Resident ... ... ... 49 49 ... 3 38 ... ... ... ... 4 ... ... 6 4 .. 6 4 10 64 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non.Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B.Brook Hospital— Resident ... ... ... 3 1 ... 1 ... ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non.Resident ... ... ... 8 12 1 7 ... ... 1 2 14 ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... Cottage Hospital— Resident ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... Non.Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 3 ... ... 2 ... ... .. ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... Non.Resident ... ... ... ... 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Outside Institutions— Resident ... ... ... 32 21 8 5 14 ... ... l 2 ... 1 ... 6 6 2 4 3 3 25 ... ... ... ... Borough 10049 100493 337 272 141 117 42 14 79 ... ... l 6 2 1 ... 20 27 6 18 26 34 117 ... ... ... ... 609 258 Rate per 1,000 of Estimated Population ... ... 24.32 10.30 ... ... ... ... ... .03 .23 .07 .03 ... .79 1.07 .23 .71 1.03 1.34 4.67 8.61 10.30 .45 .19 Deaths of Children under one year per 1,000 births ,, ,, ,, ,, ,, ,, previous corresponding period County of London 68 37 93 Death Rate of 96 large English Towns 10.4; of the County of London ... 10.5 Birth Rate „ „ 23.4; „ ,, 225 BOROUGH OF GREENWICH. Return of Birt hs an Ld Deaths registered during the 13 weeks ended 31st December, 1921, DISTRICTS. Census Population, 1921. Preliminary Figures. j Estimated Population at the middle of tnr year 1921. Births registered during the 13 weeks ended 31st December, 1921. Deaths registered during the 13 weeks ended 31st December, 1921. AGE MORTALITY Small.Pox. Measles. Seven zymotic diseases. Diarrhoea. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 years. Persons aged 65 years and upwards. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. During the corresponding period year previous. During the 13 weeks ended 31sc December, 1921. During the corresponding period year previous. During the 13 weeks ended 31st December, 1921. Typhoid. Other. M. F. M. F. Greenwich East 44240 44240 129 112 78 76 18 15 52 ... ... l 13 3 ... ... 1 10 l 29 12 12 72 965 13.97 .63 1.63 Do. West 26687 26687 67 74 40 54 11 10 29 ... 3 1 l ... ... ... 8 l 29 10 9 oo 12.58 13.86 .08 .73 St. Nicholas, Deptford 7581 7581 24 24 16 13 5 7 5 ... ... ... 1 ... ... ... ... 5 ... 5 4 3 11 13.71 15.34 .37 .52 Charlton 18790 18790 40 35 42 28 9 1 20 ... ... ... ... ... ... ... 2 9 ... 13 9 9 28 12.29 14.95 .04 .42 Kidbrooke 3195 3195 11 6 6 6 ... ... 10 ... ... ... ... ... ... ... ... ... ... 1 3 ... 8 3.87 15.17 ... ... Miller Hospital— Resident ... ... ... 5 3 1 2 1 ... ... ... ... ... ... ... ... ... ... 2 ... 1 5 ... ... ... ... Non.Resident 10 10 2 3 3 ... ... ... ... ... ... ... ... ... 1 4 ... 5 10 ... ... ... ... Seamen s Hospital— Resident ... ... ... 6 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... 5 ... ... ... ... Non.Resident ... ... ... 22 2 ... ... 2 ... ... ... ... ... ... ... ... 5 1 2 3 5 8 ... ... ... ... Greenwich and Deptford Hospital— Resident ... ... ... 33 36 3 9 21 ... 1 ... ... 3 ... ... ... 9 1 14 ... 4 32 ... ... ... ... Non.Resident ... ... ... 63 62 4 5 39 ... ... ... ... 1 1 ... 1 14 5 22 6 11 64 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 5 2 ... ... ... ... ... ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 20 14 ... 14 4 ... ... 5 25 ... 1 ... ... 1 ... ... ... ... 2 ... ... ... ... Cottage Hospital— Resident ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... 1 3 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... Other Institutions— Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Non-Resident ... ... ... 1 3 ... ... 3 ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 ... ... ... ... Outside Institutions— Resident ... ... ... 39 25 8 5 11 ... ... l 6 ... ... ... 1 5 ... 9 7 7 28 ... ... ... ... Borough 100493 100493 271 251 182 177 43 33 116 ... 3 l 15 4 ... ... 3 32 2 77 38 33 151 ... ... ... ... 522 359 Rate pur 1,000 of Estimated Population ... ... 20.84 14.33 ... ... ... ... .11 .03 .59 .15 ... ... .11 1.26 .07 3.07 1.51 1.31 6.03 15.45 14.33 .53 1.03 Deaths of Children under one year per 1,000 births ,, ,, ,, ,, ,, ,, previous corresponding period County of London 82 80 Death Rate of 96 large English Towns; of the County of London ... Birth Rate ,, ,,; ,, ,, BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 52 weeks ended 31st December, 1921. DISTRICTS. Census Population, 1921. Preliminary Figures. Estimated Population at the middle of tne year 1921. Births registered during the 52 weeks ended 31st December, 1921. Deaths registered during the 52 weeks ended 31st December, 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. All Causes. Seven Zymotics Typhoid. Other. Diarrhoea. During the corresponding period year previous. During the 52 weeks ended 31sc December, 1921. During the corresponding period year previous. During the 52 weeks ended 31st December, 1921. M F M F Greenwich East 44240 44240 550 508 286 251 65 36 168 ... 1 4 21 8 ... ... 8 45 6 82 58 50 254 1039 1217 .73 .95 Do. West 26687 26687 337 305 169 171 56 21 106 ... 4 2 3 2 ... ... 10 32 7 66 30 34 150 1484 1253 1.04 .77 St. Nicholas, Deptford 7581 7581 106 123 60 48 21 13 23 ... ... ... 1 ... ... ... 1 15 3 20 7 11 50 15.61 1428 1.90 .26 Charlton 18790 18790 189 181 134 87 32 9 74 ... ... ... 3 ... ... ... 7 26 3 33 25 24 100 9.39 11.80 .49 .53 Kidbrooke 3195 3195 35 32 19 18 1 1 26 ... ... ... ... ... 1 ... 1 1 ... 5 5 5 21 8.90 11.62 .32 .62 Miller Hospital ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 23 10 4 6 4 ... ... ... ... ... ... ... ... ... ... 4 ... 2 24 ... ... ... ... Non-Resident ... ... ... ... 45 35 10 11 10 ... ... ... ... ... ... ... ... 1 4 ... ... 17 ... ... ... ... ... Seamen's Hospital— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 35 3 ... 1 4 ... ... ... ... ... ... ... ... 9 ... ... 1 4 19 ... ... ... ... Non-Resident ... ... ... ... 62 2 6 ... ... ... ... ... ... ... ... 17 2 ... 8 3 24 ... ... ... ... Greenwich and Deptford Hospital ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 112 108 21 10 82 ... 1 ... ... 4 ... 1 1 16 3 31 16 25 122 ... ... ... Non-Resident ... ... ... ... 200 204 14 13 134 ... ... ... ... 7 1 4 ... 36 10 59 23 ... 224 ... ... ... ... Herbert Hospital— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B.Brook Hospital— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Kesident ... ... ... ... 14 9 ... 8 1 ... 1 3 16 ... ... ... ... ... ... 0 ... ... 1 ... ... ... ... Non-Resident ... ... ... ... 51 49 4 41 4 ... 2 22 60 ... 2 1 ... 1 ... ... ... ... 9 ... ... Cottage Hospital— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 ... ... ... ... Non-Resident ... ... ... ... 2 3 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 4 ... ... ... ... Other Institutions— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 2 7 2 2 ... ... ... ... 2 ... ... ... ... ... 1 1 ... 4 ... ... ... ... Non-Resident ... ... ... ... 2 12 2 6 ... ... ... ... ... ... ... ... ... ... 2 1 ... 10 ... ... ... Outside Institutions— ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Resident ... ... ... ... 132 94 24 15 40 ... ... 3 10 1 1 ... 8 23 10 22 20 17 111 ... ... ... ... Borough 100493 100493 1217 1149 668 575 175 80 397 ... 5 6 28 10 1 ... 27 119 19 206 125 124 573 ... ... ... ... Rate per 1,000 of Estimated Population 2366 1243 ... ... 2270 12.41 ... ... ... ... 04 .05 .27 .09 .009 ... .26 1.18 .18 2.05 1.24 1.23 5.72 11.72 12.41 .84 ...76 Deaths of Children under one year per 1,000 births 74 Death Rate of 96 large English Towns ... 12.3; of the County of London ... 12 4 „ „ previous corresponding ) 75 Birth Rate „ „ 23.5; ,, ... 22.8 period „ „ County of London ... 79 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 2nd April, 1921. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 66. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich and Deptfrd.Hosptl. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital. M.A.B. Cottage Hospital. Other Institutions. Outside Institutions. All causes Certified 352 59 15 7 11 23 43 83 111 150 99 39 54 10 61 12 11 7 2 58 240 Uncertified. ... ... ... ... ... ...... ... ... ...... ...... ... ... ... ... ... ... ... ... ...... ... Enteric Fever ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... 2 Small-Pox ... ... ... ...... ... ... ... ... ...... ... ... ...... ...... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 3 ... 1 1 1 ... ... ... ... 2 1 ... ... ... ... ... ... ... 2 ... ... 1 7 Whooping Cough 3 1 2 ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... 2 1 2 Diphtheria and Croup 5 2 2 l ... ... ... ... 4 1 ... ... ... ... ... ... ... 3 ... ... 2 4 Influenza 5 ... ... ... l ... ... 3 l 3 1 1 ... ... ... ... ... ... ...... ... ... ... 6 Erysipelas 1 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... 1 Dysentery ... ... ...... ... ... ... ... ... ... ...... ... ... ... ... ... ...... ... ...... ... ... ... ...... ... Phthisis (Pul. Tuberculosis) 41 1 9 22 9 15 2 7 1 3 6 l 10 23 Tuberculous Meningitis ) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... 1 Other Tuberculous ) D iseases ) 4 ... ... ... l 2 ... 1 ... 2 2 ... ... ... 1 ... l ... ... ... ... 2 4 Rheumatic Fever 3 ... ... ... 1 ... ... 1 l 2 ... 1 ... ... 1 ... ... ... ... ... ... ... 1 Cancer, malignant ) disease ) 31 ... ... ... ... ... 1 15 15 11 11 1 5 3 7 1 1 ... ... ... ... 4 20 Bronchitis 38 5 ... ... ... ... 3 8 22 15 12 3 7 1 8 1 ... ... ... ... ... 3 23 Broncho-Pneumonia 23 10 5 ... 1 ... ... 3 4 8 5 6 2 2 2 1 5 Pneumonia (all other ) forms) ) 13 4 1 2 ... 1 1 2 2 4 3 1 5 1 l ... ... ... ... 3 9 Other Diseases of Respiratory Organs ) 6 1 1 ... ... 1 ... 1 2 3 2 1 2 l ... ... ... ... ... 7 Diarrhoea & Enteritis 4 3 ... ... ... ... ... ... 1 2 2 ... ... ... ... ... ...... ... ... ... ... 1 Appendicitis and ) Typhlitis 2 ... ... ... l 1 ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... 1 2 Alcoholism 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ...... ...... ... ... 1 Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... 1 Nephritis & Bright's ) Disease 8 1 ... ... l 2 1 2 1 4 1 3 ... ... 5 ... ... ... ...... ... ... 2 7 Puerperal Fever 2 ... ... ... ... 1 1 ... ... 2 ... ... ... ...... ... ... ... ... ... ...... ... 1 2 Other Accidents and Diseases of Preg- nancy and Partu- rition ) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Debility and Malformation, including Prema- ture Birth 24 24 ... ... ... ... ... ... ... 6 7 4 7 ... 1 ... ... ... ... ... ... 1 7 Violent Deaths, excluding Suicide 11 2 1 ... ... 1 3 3 1 5 3 2 1 ... 1 1 ... ... ... ... ...... 4 7 Suicides 1 ... ... ... ... ... 1 ... ... ...... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Heart Disease 33 ... ... ... ... 2 1 9 21 18 9 2 4 ... 3 1 ... ... ... ... ... 7 12 Other Defined Diseases 90 7 2 2 2 3 8 26 40 37 24 12 14 3 24 1 6 ... 1 ... ... 14 83 Diseases ill-defined or unknown ... ... ... ...... ... ... ... ... ...... ...... ... ... ...... ... ... ... ... ... ... ...... 352 59 15 7 11 23 43 83 111 150 99 39 54 10 61 12 11 ... 7 ... 2 58 240 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 2nd July, 1921. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 15 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Peptford. Charlton. Kidbrooke. Greenwich and Deptfrd.Hosptl. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital, M.A.B. Cottage Hospital. Other Institutions. Outside Institutions. All causes Certified •274 31 7 4 17 16 41 67 91 120 79 23 44 8 55 11 10 5 1 3 51 239 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... Measles 2 1 ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... ... ... 0 Scarlet Fever 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 10 Whooping Cough 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 Diphtheria and Croup ... ... ...... ... 2 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 17 Influenza ... ... 1 ... ... 1 2 3 2 4 2 ... 3 ... ... 1 ... ... ... ... ... ... 2 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Dysentery 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ...... ... ... 1 Malaria 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... Acute Polio Myelitis ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... Phthisis (Pul. Tuberculosis) 19 ... ... ... ... 7 10 2 ... 6 7 5 1 ... 3 1 ... ... ... ... 1 4 18 Tuberculous Meningitis 4 ... ... 1 2 ... ... ... ... ... 2 2 ... ... 1 ... l ... ... ... ... 2 4 Other Tuberculous Diseases 3 1 1 1 2 1 ... ... ... ... ... ... ... ... ... ... 2 1 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... Cancer, malignant disease 26 4 12 10 12 8 2 4 ... 7 ... ... ... ... ... 1 3 18 Bronchitis 21 2 ... 1 6 12 11 3 2 5 ... 3 ... 1 ... ... ... ... ... 10 Broncho-Pneumonia 7 2 1 i 1 2 4 2 1 ... ... 2 ... ... ... ... ... 2 8 Pneumonia (all other ) forms) ) Other Diseases of ) Respiratory Organs 9 1 1 3 1 2 1 5 4 ... ... ... ... ...... ... ... 1 ... ... 1 6 1 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 2 Diarrhoea & Enteritis ... ... ... ... ...... ... ... ... ... ... ... ... ... ...... ... ... ... ...... ... ... ... ... ... Appendicitis and ) Typhlitis ) 2 ... ... ... ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... 1 ... 2 Alcoholism ... ... ...... ... ... ... ... ...... ... ... ... ... ... ... ... ...... ... ... ... ... ... Cirrhosis of Liver 2 ... ... ... ... ... 2 ... ... 1 ... 1 ... ... 1 ... ... ... ... ...... ... 1 Nephritis & Blight's Disease 7 ... ... ... ... 1 1 2 3 4 1 1 1 1 1 ... ... ... ... ... 2 8 Puerperal Fever 1 ... ... ... ... 1 ... ... ... 1 ... ... ...... ... 1 ... ... ... ... ... ... ... 1 Other Accidents and Diseases of Preg- nancy and Partu- rition 3 ... ... ... ...... ... 3 ... ... 1 2 ... ... ... ...... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 18 17 1 ... ... ...... ... ... ... 13 3 1 ... 1 3 2 ... ... ... ... 1 13 Violent Deaths, excluding Suicide 13 1 1 2 2 ... 0 3 0 0 5 ... 3 ... 5 2 2 ... ... ... ... 4 14 Suicides 5 ... ... ... ... ... 1 3 1 2 2 1 ... ... ... ... ... ... ... ... 1 1 Heart Disease 28 ... ... ... 1 2 2 4 19 15 5 6 2 8 ... ... ... ... ... ... 3 17 Other Defined Diseases 88 6 ... ... 5 2 9 26 40 34 26 8 16 4 22 2 3 ... ... 1 1 25 79 Diseases ill-defined or unknown ... ... ... ... ... ...... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... 274 31 7 4 17 16 41 67 91 120 79 23 44 8 55 11 10 ... 5 1 3 51 239 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 1st October, 1921. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich and Deptfrd.Hospt). Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital. .m.a.B. Cottage Hospital. Other Institutions. Outside Institutions. All causes Certified 258 42 11 3 13 11 39 60 79 113 68 17 53 7 35 7 4 4 2 3 53 213 Uncertified ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 1 Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Scarlet Fever 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 Whooping Cough 2 2 ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... 5 Diphtheria and Croup 6 ... 2 1 2 1 ... ... ... 4 1 ... 1 ... ... ... ... ... 4 ... ... 2 17 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... Dysentery 2 ... ... ... ... ... 1 ... 1 1 1 ... ... ... ... 1 ... ... ... ... ... 1 1 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Polio Myelitis 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pul. Tuberculosis) ) 27 ... ... ... 1 7 12 6 1 13 2 3 9 ... 1 ... ... ... ... 1 ... 6 12 Tuberculous Meningitis 2 ... ... ... 1 ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 Other Tuberculous Diseases 4 ... 1 ... 2 1 ... ... ... ... 1 1 2 ... ... ... ... ... ... ... ... 2 2 Rheumatic Fever ... ... ... ... ...... ... ... ... ... ...... ... ... ... ...... ... ... ...... ... ... ... ... ... ... Cancer, malignant disease. 34 ... ... ... ...... ... 3 18 13 15 6 5 6 2 7 3 ... ... ... ...... ... 3 26 Bronchitis 7 1 ... ... ... ... ... 2 4 4 2 1 ... ... 3 ... ... ... ... ... ... 1 8 Broncho-Pneumonia 7 2 1 1 ... ... 1 1 1 5 1 ... ... 1 1 ... ... ... ... ... ... 2 3 Pneumonia (all other forms) 4 1 ... ... ... ... 1 1 1 1 3 ... ... ... ... ... ... ... ... ... ... 1 ... Other Diseases of Respiratory Organs 3 ... ... ... ... 1 2 ... 1 1 ... 1 ... 1 ... ... ... ... ... ... 1 1 Diarrhoea & Enteritis 23 16 3 ... ... ... ... 1 3 6 9 1 6 1 2 ... ... ... ... ... ... 7 12 Appendicitis and Typhlitis 2 ... ... ... ... 1 ... ... 1 1 1 ... ... ... ... 1 1 ... ... ... ... ... 8 Alcoholism 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Cirrhosis of Liver 2 ... ... ... ... ... ... 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 Nephritis & Bl ight's Disease 8 ... ... ... ... ... ... 4 4 4 1 ... 3 ... 3 ... ... ... ... ... 1 1 5 Puerperal Fever 2 ... ... ... 1 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Preg- nancy and Partu- rition 2 ... ... ... ... ... 2 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Congenital Debility and Malformation, including Premature Birth 14 13 1 ... ... ... ... ... ... 5 5 3 1 ... 3 ... ... ... ... ... ... 2 8 Violent Deaths, excluding Suicide 6 ... ... ... 3 ... 2 1 ... 3 ... 1 2 ... ... ... ... ...... ... ... ... ... 5 Suicides 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ...... ... ... ... ... ... ...... ... ... ... Heart Disease 26 ... ... ... 1 ... 5 6 14 13 6 1 6 ... ... ... ... ... ... ... 1 3 12 Other Defined Diseases 70 7 3 1 1 ... 10 15 33 29 24 1 14 2 12 2 3 ... ... 1 1 19 80 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ...... ... ... ... ... ... ... 258 42 11 3 13 11 39 60 79 113 68 17 53 7 35 7 4 4 2 3 53 213 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 31st December, 1921. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. |65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich and Deptfrd. Hosptl. Seamen's Hospital. Miller Hospital. HerbertMilitary Hospital. Brook Hospital. M.A.B. Cottage Hospital. Other Institutions. Outside Institutions. All Certified 359 43 21 12 17 17 42 91 116 154 94 29 70 12 69 8 8 7 l l 64 305 causes Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... Measles 3 2 ... 1 ...... ... ... ... ... ... 3 ... ... ... 1 ... ... ... ... ...... ... ... 1 Scarlet Fever 1 ... ... 1 ... ... ... ...... ... ... ...... ... ... ... ... ... ... ... ... ... 1 5 Whooping Cough 4 ... 4 ... ... ... ... ... 3 1 ... ... ... 3 ... ... ... ... ... ... ... 4 Diphtheria and Croup 15 ... 5 2 8 ... ... ... ... ... 1 1 ... ... ... ... ... ... 7 ... ... 6 32 Influenza 5 ... ... 1 1 1 1 1 2 1 2 ... ... 1 ... ... ...... ... ... ... ... 3 Erysipelas 1 ... ... ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... Dysentery 1 ... ... ... ...... ...... ... ... ...... 1 ... ... ... ... ... ... ... ... ... 1 ... Malaria ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Polio Myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Put. Tuberculosis 32 ... ... 1 ... 9 9 11 2 10 8 5 9 ... 9 2 ... ... ... ... ... 5 31 T uberculous Meningitis Other Tuberculous 2 1 ... ... ... ... 1 ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 3 Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cancer, malignant disease 33 ... ... ... 1 1 3 16 12 12 9 3 9 ... 4 ... 1 ... ... ... ... 7 26 Bronchitis 3.2 4 1 ... ... ... 2 8 17 13 12 ... 7 ... 6 ... ... ... ... ... ... 1 23 Broncho-Pneumonia 25 3 8 2 ... ... 1 6 5 8 10 5 1 1 7 ... 1 ... ... ... ... 2 14 Pneumonia (all other forms 20 3 1 ... ... 1 8 3 4 8 7 ... 5 ... 1 1 1 ... ... ... l 6 11 Other Diseases of Respiratory Organs 1 ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... ... ... 1 Diarrhoea & Enteritis 11 9 ... 1 ... ... ... 1 3 2 1 4 1 1 1 3 3 Appendicitis and Typhlitis 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 3 Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of l.iver 1 ... ... ... ... ... 1 1 1 ... ... ... ... ... ... ... 1 Nephritis & Bright's Disease 12 ... ... ... ... 1 3 4 4 4 4 1 3 2 ... ... ... ... ... ... 2 3 Puerperal Fever 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 2 Other Accidents and Diseases of Preg- nancy and Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... Congenital Debility and Malformation, including Prema- ture Birth 20 17 1 1 1 ... ... ... ... 10 5 ... 3 ... 3 ... ... ... ... ... ... 5 4 Violent Deaths, excluding Suicide 9 1 2 3 1 i 1 4 1 1 1 2 2 2 1 1 13 Suicides ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Heart Disease 38 ... ... ... 1 1 3 17 16 12 10 4 9 3 5 ... ... ... ... ... ... 7 15 Other Defined Diseases 91 3 1 1 2 1 9 24 50 47 19 2 18 5 19 3 3 ... ... l ... 16 100 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 359 43 21 12 17 17 42 91 116 154 94 29 70 12 69 8 8 ... 7 ... l 64 305 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 52 weeks ended 31st December, 1921. Causes of Death. Deaths in whole District (at Subjoined Ages). Deaths in Localities (at all Ages). Deaths in Public Institutions. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich and Deptfrd. Hosptl. Seamen's Hospital. Miller Hospital. Herbert Military Hospital. Brook Hospital, M.A.B. Cottage Hospital. Other Institutions. Outside Institutions. All causes Certified 1243 175 54 26 58 67 105 301 397 537 340 108 221 37 220 38 33 23 4 9 226 997 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 4 Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 5 3 ... 2 ... ... ... ... ... 1 4 ... ... ... 1 ... ... ... 1 ... ... ... 5 Scarlet Fever 6 ... 2 2 0 ... ... ... ... 4 2 ... ... ... ... ... ... ... 3 ... ... 0 24 Whooping Cough 10 4 6 ... ... ... ... ... ... 8 2 ... ... ... 4 ... ... ... ... ... 2 1 13 Diphtheria and Croup 28 ... 9 5 13 1 ... ... ... 21 a 1 3 ... ... ... ... ... 16 ... ... 10 70 influenza 19 ... 1 1 1 2 ... 7 4 9 4 3 3 ... 1 1 ... ... ... ... ... ... 11 Erysipelas 0 1 ... ... ... ... ... ... 1 ... ... 2 ... ... 2 ... ... ... ... ... ... ... 4 Cerebro-Spinal Hover ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...2 Dysentery 4 ... ... ... ... ... 1 1 2 1 2 1 ... ... ... 1 ... ... ... ... ... 2 2 Malaria 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... Acute Polio Myelitis ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Phthisis(Pul. Tuberculosis) 119 ... ... 1 2 32 53 28 3 45 32 15 26 1 16 9 1 ... ... 1 ... 25 84 Tuberculous Meningitis 8 1 1 1 3 ... 1 ... 1 2 3 2 1 ... 2 ... 1 ... ... ... ... 2 9 Other Tuberculous Diseases 11 ... 1 ... 4 4 1 1 ... 4 4 1 2 ... 1 ... 1 ... ... ... ... 6 12 Rheumatic Fever 3 ... ... ... 1 ... ... 1 1 2 ... 1 ... ... 1 ... ... ... ... ... ... ... 1 Cancer, malignant disease 124 ... ... ... 1 1 11 61 50 50 34 11 24 5 25 4 2 ... ... ... 1 17 90 Bronchitis 98 12 1 ... ... ... 6 24 55 43 29 6 19 1 20 1 1 ... ... ... ... 5 64 Broncho-Pneumonia 62 17 15 3 2 1 4 10 10 21 20 13 4 4 10 2 1 ... 1 ... ... 6 30 Pneumonia (all other forms) 46 9 3 2 3 2 11 8 8 18 17 1 10 ... 1 2 2 ... 1 ... 1 11 26 Other Diseases of Respiratory Organs 11 1 1 ... ... 1 1 4 3 5 4 ... 2 ... 4 2 ... ... ... ... 1 11 Diarrhoea & Enteritis 38 28 3 ... 1 ... ... 1 5 11 13 2 10 2 3 ... 1 ... ... ... ... 11 15 Appendicitis and Typhlitis 7 ... ... ... 1 2 3 ... 1 6 1 ... ... ... 3 1 1 ... ... ... 1 1 15 Alcoholism 2 ... ... ... ... ... 2 ... ... 2 ... ... ... ... 2 ... ... ... ... ... ... 2 Cirrhosis of Liver 5 ... ... ... ... ... ... 4 1 o 1 2 ... 1 1 ... ... ... ... ... 4 Nephritis & Bl ight's Disease 35 1 ... ... 1 4 5 12 12 16 7 5 7 ... 11 1 ... ... ... 1 7 23 Puerperal Fever 6 ... ... ... 1 4 1 ... ... 5 ... ... 1 1 ... ... ... ... 2 5 Other Accidents and Diseases of Preg- nancy and Partu- rition 5 ... ... ... ... ... 5 ... ... 2 3 ... ... ... ... ... ... ... ... ... ... 1 ... Congenital Debility and Malformation, including Prema- ture Birth 76 71 3 1 1 ... ... ... ... 34 20 10 11 1 10 ... 2 ... ... ... ... 9 32 Violent Deaths, excluding Suicide 39 4 2 4 8 2 8 7 4 17 9 4 7 2 8 5 3 ... ... ... ... 9 39 Suicides 7 ... ... ... ... ... 2 4 1 3 2 ... 2 ... ... ... ... ... ... ... ... 2 2 Heart Disease 126 ... ... ... 3 5 11 36 70 58 30 7 25 5 16 1 ... ... ... ... 1 20 56 Other Defined Diseases 339 23 6 4 10 6 36 91 163 147 93 23 62 14 77 8 15 ... 1 3 2 74 342 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1243 175 54 26 58 67 165 301 397 537 310 108 221 37 220 38 33 ... 23 4 9 226 997 BOROUGH OF GREENWICH. Cases of infectious Disease notified during the 13 weeks ended 2nd April, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Loc ality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich East. Greknwich W est. St. Nicholas. Deptford. Charlton. Kidbrooke. Total. Under 1. 1 to 5. 5 to 16. 15 to 26. 26 to 46. 45 to 65. 65 and upwards. Encephalitis Lethargica 3 ... ... 1 ... 1 l ... 1 1 ... ... 1 1 1 ... ... 1 3 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 148 3 40 80 14 10 l ... 96 16 10 16 10 92 16 10 16 ... 143 Mem. Croup 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... l ... ... 1 Erysipelas 13 1 ... 1 ... 3 8 ... 6 4 2 1 ... ... ... 1 ... ... 1 Scarlet Fever 175 ... 36 108 21 10 ... ... 83 48 12 19 13 79 46 10 16 ... 163 Malaria 2 ... ... ... 1 1 ... ... ... 1 1 ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 ... ... ... ... 3 ... ... 2 1 ... ... ... 1 1 ... ... ... 2 Cerebro-Spinal Fever 1 ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Measles 29 5 10 12 1 1 ... ... 16 9 1 ... 3 ... ... 1 ... ... 1 Whooping Cough 61 11 44 5 ... ... ... l 56 1 ... 2 2 1 . ... ... ... ... 1 Diarrhoea 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ...... ... ... Ophthalmia Neonatorum 5 5 ... ... ... ... ... ... 1 3 ... 1 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 91 ... o 2 25 19 29 16 ... 45 19 7 19 1 ... ... ... 1 ... 1 „ Non-Pulmonary 27 ... 3 16 1 6 1 ... 10 11 3 2 1 ... ... ... ... ... ... Pneumonia, Acute Primary or Influenzal 44 6 10 7 6 7 7 2 34 8 ... 2 ... 4 1 ... ... ... 5 Totals 605 30 148 256 63 71 34 3 352 123 37 62 31 179 65 23 33 22 322 * 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 ended 2nd July, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Casus 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. Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox . ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 67 1 5 47 13 1 ... ... 35 8 5 12 7 34 6 5 12 ... 64 Mem. Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ...... Erysipelas 14 ... ... ... 1 3 9 l 5 3 2 4 ... 1 1 1 ... 3 Scarlet Fever 189 ... 39 122 18 9 1 106 39 7 31 6 102 38 7 28 5 180 Malaria 4 ... ... ... ... 4 ... ... ... 2 ... 1 1 ... ... ... ... ... Enteric Fever 2 ... ... 1 1 ... ... ... 1 1 ... ... ... 1 1 ... ... ... 2 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... ... 2 ... ... 1 ... 1 ... ... 1 ... 1 ... ... 2 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 320 7 109 204 ... ... ... ... 205 37 2 70 6 2 ... ... ... 2 Whooping Cough 92 12 35 44 ... 1 ... ... 48 25 7 12 ... ... ... ... ... ... ... Diarrhoea 10 6 4 ... ... ... ... ... 4 6 ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Tuberculosis, Pulmonary 61 ... ... 7 12 33 9 ... 22 12 5 20 2 ... ... ... ... ... ... „ Non-Pulmonary 28 1 4 15 4 2 2 ... 9 7 8 4 ... ... ... ... ... ... ... Pneumonia, Acute Primary or Influenzal 29 1 7 9 1 7 3 l 19 5 1 4 ... ... 1 1 ... ... 2 Totals 819 29 203 449 50 62 24 2 455 146 38 158 22 141 47 15 40 12 255 * 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 ended 1st October, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich West. St. N icholas, Dbptford. Charlton. Kidbrooke.* Greenwich East. Greenwich W est. 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. Kncephalitis I.ethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ...... ... ... ... ... ... ... Diphtheria 96 1 17 64 13 l ... ... 64 - 20 6 3 64 20 6 3 3 96 Mem. Croup ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... Erysipelas 10 l 1 1 2 1 ... 7 2 ... 1 ... 3 ... ... ... ... 3 Scarlet Fever 182 4 38 114 20 6 ... ... 88 31 11 47 5 83 31 11 45 4 174 Malaria 2 ... ... ... ... 1 l ... 1 1 ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... ... 1 1 1 1 ... 1 1 ... 1 1 1 1 ... 1 1 4 Dysentery 1 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... 1 1 ... ... 1 ... ... 1 ... 1 ... ... 1 ... 2 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Polio Myelitis 2 ... 1 ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... Measles 16 ... 8 8 ... ... ... ... 9 1 2 4 ... ... ... ... ... ... ... Whooping Cough 136 21 62 53 ... ... ... ... 67 55 7 6 1 2 4 ... ... ... 6 Diarrhoea 181 91 90 ... ... ... ... ... 54 65 9 53 ... 2 1 1 ... ... 4 Ophthal m ia N eonatoru m 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Tuberculosis, Pulmonary 63 ... ... 10 14 17 10 2 15 12 6 18 2 1 ... ... 1 ... 2 „ Non-Pulrnonary 12 ... 3 .5 ... 2 l 1 3 4 3 ... ... ... ... 1 ... 1 Pneumonia, Acute Primary or Influenza 8 ... ... 2 ... 3 2 i 5 2 ... 1 ... 1 ... ... 1 ... 2 Totals 706 119 219 258 . 50 36 16 8 317 196 44 137 12 158 57 18 53 8 294 * 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 ended 31st December, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Loc ality. No. of Cases Removed to Hospital From Each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich West. Sr. 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. Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 284 I 36 202 36 8 l ... 137 110 3 25 .9 125 109 3 23 9 269 Mem. Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 20 ... i ... 4 10 3 ... 12 5 3 4 2 1 ... ... 7 Scarlet Fever 412 4 52 292 54 9 1 ... 147 176 14 66 9 136 161 13 54 7 371 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... ... 3 1 ... ... ... ... 3 ... 1 ... ... 3 ... 1 ... ... 4 Dysentery 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 4 ... ... ... 1 3 ... ... ... 1 1 ... ... 1 ... 1 ... 4 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Polio Myelitis 1 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Measles 207 8 102 94 3 ... ... ...... 22 144 ... 41 ... 1 1 ... ... ... 2 Whooping Cough 32 3 24 5 ... ... ... ... ... 24 6 2 ... ... 4 2 ... ... ... 6 Diarrhoea 19 8 11 ... ... ... ... 1 17 1 ... ... ... ... ... ... ... ... Ophthalmia N eonatorum 5 5 ... ... ... ... ... ... 2 3 ... ... ... ... ... ... ... ... ... Tuberculosis, Pulmonary 58 3 9 17 17 10 2 34 9 ... 11 ... 1 1 ... 1 ... 3 „ Non-Pulmonary 6 1 ... 1 2 2 ... ... 2 4 ... ... ... ... ... ... ... ... ... ... Pneumonia, Acute Primary or Influenza 44 2 10 5 6 13 5 3 23 12 ... 9 ... 2 2 9 ... 6 Totals 1097 32 239 612 124 62 21 7 406 490 29 154 18 274 282 19 82 16 673 * 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 ended 31st December, 1921. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Total. Under 1. 1 to 5. 5 to 15. 1 5 to 25. 25 to 45. 45 to 65. 65 and upwards. Encephalitis Lethargica 3 ... ... 1 ... 1 1 ... 1 1 1 1 1 1 3 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 595 6 98 393 76 20 2 332 154 24 56 29 315 151 24 54 28 572 Mem. Croup 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... 1 Erysipelas 57 2 1 2 6 18 21 7 30 14 7 6 ... 8 3 3 ... ... 14 Scarlet Fever 958 8 165 636 113 34 2 ... 424 194 44 163 33 400 276 41 143 28 888 Malaria 8 ... ... ... 1 6 1 ... 1 4 1 1 1 ... ... ... ... ... ... Enteric Fever 11 ... ... 6 3 1 1 ... 2 6 ... 2 1 2 5 ... 2 1 10 Dysentery 2 ... ... ... ... 1 1 ... 2 ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 11 ... ... ... 2 9 ... ... 4 2 3 2 ... 3 2 3 ... ... 10 Cerebro-Spinal Fever 1 ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Acute Polio Myelitis 3 ... 1 1 ... 1 ... ... 1 2 ... ... ... 1 ... ... ... ... 1 Measles 572 20 229 318 4 1 ... ... 252 191 5 115 9 3 1 1 ... ... 5 Whooping Cough 321 47 165 107 ... 1 ... 1 195 87 16 20 3 7 6 ... ... ... 13 Diarrhoea 211 105 106 ... ... ... ... ... 60 88 10 53 ... 2 1 1 ... ... 4 Ophthalmia Neonatorum 12 12 ... ... ... ... ... ... 4 7 ... 1 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 263 ... 5 51 62 96 45 4 116 52 22 68 5 2 1 ... 3 ... 6 „ Non-Pulmonary 73 2 10 37 7 12 4 1 24 26 14 8 1 ... ... ... 1 ... 1 Pneumonia, Acute Primary or Influenzal 125 8 27 23 13 30 17 37 81 27 1 16 ... 7 4 1 3 ... 15 Totals 3227 210 809 1575 287 231 95 20 1530 955 148 511 83 752 451 75 208 58 1544 * 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 1921. 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 One Year. All Causes. Certified 48 6 10 6 70 31 35 21 18 175 Uncertified ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases. Small-Pox ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 3 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 1 1 1 4 Diphtheria—Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... ... ... 1 ... 1 Tuberculous Diseases. Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions 1 ... ... 1 2 ... ... 2 2 6 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 ... ... 1 2 2 5 1 2 12 Pneumonia, all forms 1 1 2 ... 4 5 10 3 4 26 Diarrhoeal Diseases. Diarrhoea, all forms ... ... ... ... ... 1 4 1 ... 6 Enteritis ... ... 1 ... 1 3 9 8 1 22 Gastritis ... ... ... ... ... 1 ... ... 2 3 Syphilis ... ... ... 1 1 ... 2 ... ... 3 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlaying ... ... ... 1 1 ... ... ... 1 2 Injury at Birth 2 1 ... ... 3 ... ... ... ... 3 Actelectasis 4 ... 1 ... 5 ... ... ... ... 5 Congenital Malformations 4 ... ... ... 4 1 1 ... ... 6 Premature Birth 21 1 3 1 26 3 1 ... ... 30 Atrophy, Debility, and Marasmus 12 2 1 1 16 11 2 1 ... 30 Other Causes 2 1 2 ... 5 2 ... 3 1 11 T otals 48 6 10 6 70 31 35 21 18 175