GRE21 THE ANNUAL REPORT MADE TO THE COUNCIL OF THE Metropolitan. Borough of Greenwich For the Year 1922, BY ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H (Barrister-at-Law), MEDICAL OFFICER OF HEALTH TO THE BOROUGH, ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, AND EXECUTIVE TUBERCULOSIS OFFICER. Woolwich: Printed by the Pioneer Press, Ltd. (T.U. Fed.), 3, New Road. 1923. 1 Public Health Committee during the Year 1921-22. Councillor E. N. Greenwood, J.P. (Mayor), and 13 Members. Aldermen Mrs. S. A. Kelly and H. J. Norris. Councillors— F. W. Clifton, Chairman. J. Hogg. F. W. Mander. M.A., Vice-Chairman. W. J. Jackman. T. F. Battle. C. L. Skinner. Mrs. N. Cunis. Mrs. C. R. Turner. Mrs. A. M. Edwards. F. Whatley, B.A. R. G. Evans. Duties and Powers of the Public Health Committee— 1.—The Committee shall consist of thirteen elected members. 2.—There shall be referred to the Committee the execution of the Food and Drugs Act, 1875-1899; the Margarine Act, 1887; the Sale of Horseflesh, etc., Regulation Act, 1889; such matters arising under the Housing of the Working Classes Act, 1890 and 1894, and the Working Classes Dwellings Act, 1890; Housing and Town Planning Acts; the Public Health (London) Acts; the Metropolis Management Acts relating to defective drainage; the Canal Boat Acts; the Factory and Workshop Acts; Increase of Rent and Mortgage Interest (Restrictions) Act, 1920; 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; and the Milk (Special Designations) Order, 1922; the by-laws and regulations made under the above Acts, or otherwise relating to the public health and sanitary condition of the Borough, as are not within the reference to any other Committee. 2 3.—The Committee may serve and receive notices, take proceedings, and in particular cases empower any Officer of the Council to make complaints and take proceedings on their behalf under, and otherwise execute, the Public Health (London) Act, 1891, and sections 82, 83, 84 and 85 of the Metropolis Management Act, 1855, relating to the inspection of any premises, drains, sinks, traps, syphons, pipes, or other works or apparatus connected therewith, and otherwise in relation to defective drainage, except as to the recovery of expenses, and the same shall not require the approval of the Council. Provided that the Committee shall report their action at the next following meeting of the Council, who may at any time determine or prohibit or otherwise vary any such notices or proceedings. 4.—All plans for drainage and re-drainage of premises shall be laid before this Committee for consideration. 5.—Works of drainage of houses and premises shall be carried out under the direction of this Committee. 6.-—The Committee shall have the control of Mortuaries erected or maintained by the Council, as the Sanitary Authority, and shall have control of the disinfecting staff, apparatus and plant. 7.—The construction, maintenance and control of public sanitary conveniences, and conveniences maintained by the Council, shall be referred to this Committee. 8.—Provision and maintenance of Tuberculosis Dispensary. Additional matters coming within the definition of the sanitary provisions of any other Act of Parliament:— Notification of Births Act, 1907. Housing and Town Planning Act, 1909, 1919. London County Council (General Powers) Act, 1902, 1907, 1908, 1922. 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. Milk and Dairies (Amendment) Act, 1922. 3 Maternity and Welfare Committee during the year 1921-22. Councillor E. M. Greenwood,. J.P. (Mayor), and 14 Members. Alderman Mrs. S. A. Kelly, Vice-Chairman. Councillors— Mrs. N. Cunis. J. Hogg. F. W. Clifton. R. F. A. Purkiss. R. G. Evans. Miss M. Sherman. Mrs. A. M. Edwards. Mrs. C. R. Turner, Chairman. C. S. Willatt. Co-opted Members— Mrs. M. Hamilton. Mrs. K. W. A. Smith. Dr. H. B. Morgan. Mrs. M. Woodnutt. Powers and Duties of the Maternity and Child Welfare Committee. 1.—The Committee shall consist of 14 members, 10 of whom shall be members of the Council, and four selected by the Council from outside that body. 2.—There shall be referred to the Committee all matters arising out of the powers and duties of the Council under the Maternity and Child Welfare Act, 1918, or any Act or Acts amending the same, or of any Orders or Regulations made under such Act or Acts, and the Committee shall make recommendations to the Council in relation to the matters aforesaid. 4 Public Health Offices, Borough Hall, Royal Hill, Greenwich, S.E. 10. May, 1923. 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 1922, and am pleased to be able again to report that the health statistics generally are of a very satisfactory character. The Death Rate is 12.92 per 1,000 of the estimated population, which, although slightly higher than the figure for 1921, which was 12.41, compares favourably with the average for the last five years, and the Death Rates for the County of London and the 105 Large Towns. The Birth Rate is 21.00 per 1,000, which figure is the same as for the County of London. The Infantile Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered, is 56, which is a record for the Borough, being by far the lowest ever recorded. The previous best was last year's figure of 74. The Zymotic Death Rate of .86 per 1,000 is slightly higher than the figure of last year, which was .76. The figures relating to the different constituent parts of the Borough are as follows :— Districts. Birth Rate. Death Rate. Infantile Mortality per 1000 Births. Zymotic Death Rate. Diarrhoea Death Rate. (Under 2 yrs.) Consumption Death Rate. East Greenwich 21.28 12.17 46 .87 1.05 West Greenwich 18.12 12.53 63 1.03 — 1.14 St. Nicholas, Deptford 29.61 17.61 81 1.69 — 2.60 Charlton 17.05 11.68 74 .36 — 1.15 Kidbrooke* 59.45 12.38 10 .30 — — Whole Borough 21.00 12.92 56 .86 — 1.18 * In this District is situated the Council's Maternity Home. 5 Attack Rates of the various notifiable diseases per 1,000 living in the several districts :— Districts. Small-pox. Diphtheria. Scarlet Fever. Erysipelas. Typhoid Fever. Puerperal Fever. East Greenwich 0.00 7.64 6.48 .49 -04 .11 West Greenwich 0.00 7.45 3.85 .40 — — St. Nicholas, Deptford 0.00 5.73 8.74 .13 — .13 Charlton 0.00 3.68 5.26 .35 – — Kidbrooke 0.00 15.48 11.76 .90 .30 — Whole Borough 0.00 6.95 5.89 .42 .02 .05 During the year Mr. C. W. Nettleton, who has been a Sanitary Inspector for this Council and its predecessors for some 29 years, retired on his pension with the very best wishes of every member of the staff. I regret, however, to report that Mr. C. T. Wilson, recently retired Sanitary Inspector, has passed away. 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. 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. 6 SECTION 1. General Statistics. Elevation—Varies from below high-water mark up to 249 feet above sea level. Area of the Borough and Districts— East Greenwich 1,300 acres West Greenwich 453 „ St. Nicholas, Deptford 115 ,, Charlton and Kidbrooke 1,991 „ 3,859 acres Population— At Census, 1921 100,450 Estimated, 1922 101,930 Density of Population— East Greenwich 34.51 persons per acre West Greenwich 59.75 ,, St. Nicholas, Deptford 66.85 ,, Charlton and Kidbrooke 11.20 ,, Average for the Borough 26.41 persons per acre Number of Inhabited Houses— At Census, 1921 16,526 Number of Uninhabited Houses— Estimated, 1922 288 No. of Families or Separate Occupiers— At Census, 1921 22,972 Rateable Value £770,536 Sum represented by a 1d. rate £3,148 7 Buildings, Dwellings, Rooms and Families in the Borough of Greenwich. Buildings. Population, 1921. Dwellings occupied by Non-private Families. Structurally Separate Dwellings Occupied by Private Families or Vacant. Total Rooms. In course of Erection. Completed. Vacant on Census Night. Occupied by Caretaker. 1—3 Rooms. 4—5 Rooms. 6—8 Rooms. 9 or more Rooms. Total Dwellings Not containing Dwellings. Containing Dwellings. 18 13,844 81,570 I. Undivided Private Houses 32 206 13 861 4,812 6,727 1,412 13,812 83,229 — — 128 1,119 II. Structurally divided Private Houses — 11 — 179 70 46 3 298 1,120 — — 275 5,106 III. Blocks of Flats, Tenements, &c. . . — 25 — 837 372 28 4 1,241 4,017 1 150 1,313 6,537 IV. Shops 5 33 — 170 610 451 77 1,308 7,011 6 324 200 6,118 V. Others 45 13 — 50 77 22 6 155 701 25 474 15,760 100,450 Total 82 288 13 2,097 5,941 7,274 1,502 16,814 96,078 1 125 53 241 Principal Buildings in Group V. (Others) above:— Offices, Factories, Warehouses, Workshops, Hotels, Institutions, Places of Worship Places of Amusement Vacant on Census Night 36 76 110 66 288 1,903 Dwellings occupied by 1 private family 2,013 4,745 3,220 958 10,936 57,936 „ ,, „ 2 „ families 48 1,036 3,447 281 4,812 30,249 ,, „ „ 3 or more private families — 84 497 197 778 5,990 Total Dwellings occupied by private 1 32 4,993 families No. 2,061 5,865 7,164 1,436 16,526 94,175 36 2 6 0/ /o 12 35 44 9 100 — — 4 1 3 Total private families therein 2,109 7,070 11,617 2,176 22,972 — 8 Acreage, Population, Private Families and Dwellings. Municipal Wards and Civil Parishes. Area in Statute Acres (Land and Inland Water) Population. Persons per Acre Families or Separate Occupiers. Population in Private Families. Structurally Separate Dwellings occupied. Rooms Occupied. Rooms per Person. 1911. 1921. Persons. Persons. Males. Females. 1911. 1921. Metropolitan Borough of Greenwich 3,859 95,968 100,450 48,850 51,600 26 20,692 22,972 94,249 16,526 93,410 0.99 Wards— Civil Parishes— Charlton & Kidbrooke Charlton & Kidbrooke 1,991 19,785 21,978 10,371 11,607 11 4,146 4,953 20,149 3,582 23,032 1.14 *Marsh Greenwich (part of) 582 16,383 16,740 8,324 8,416 29 3,366 3,685 15,406 2,444 13,038 0.85 *North ,, 170 13,678 13,580 6,791 6,789 80 3,089 3,137 13,429 2,333 11,574 0.86 North-West ,, 114 9,690 9,504 5,380 4,124 83 1,705 1,778 7,788 1,364 5,758 0.74 South ,, 217 7,408 8,084 3,741 4,343 37 1,768 2,061 7,768 1,374 7,903 1.02 South-East ,, 548 13,067 13,893 6,118 7,775 25 2,982 3,419 13,535 2,739 18,585 1.37 West ,, 122 8,667 9,089 4,371 4,718 75 2,131 2,327 8,808 1,562 8,694 0.99 St. Nicholas, Deptford St. Nicholas, Deptford 115 7,290 7,582 3,754 3,828 66 1,505 1,612 7,366 1,128 4,826 0.66 * Area altered during 1911-1921 intercensal period. 9 Private Families Classified by Size of Family. Rooms Occupied and Density of Occupation. Number of Persons in Family. Number of Private Families Occupying the following Number of Rooms. Total Private Families. Population in Private Families. Rooms Occupied. Density of Occupation. Average No. of Rooms per Person. Population at following densities of Occupation (Rooms per person). 1. 2. 3. 4. 5. 6-7. 8-9. 10 and over. No. % under .3. .3 and under .5. .5 and under 7. .7 and under 10. 1 703 450 222 124 41 50 20 10 1,620 7.1 1,620 3,576 2.21 1 2 416 1,217 1,164 713 255 352 117 50 4,284 18.7 8,568 14,254 1.66 — — 832 — 3 284 962 1,188 1,028 452 536 153 84 4,687 20.4 14,061 17,788 1.27 852 2,886 — 4 88 547 973 1,052 544 558 211 115 4,088 17.8 16.352 17,680 1.08 352 4 2,188 3,888 5 40 236 682 819 468 471 141 116 2.973 12.9 14,865 13,746 0.92 200 1,180 3,410 4,095 6 13 112 426 639 364 370 127 92 2,143 9.3 12,858 10 419 0.81 78 672 6,390 2,184 7 2 49 282 391 205 257 68 70 1,324 5.8 9 268 6 548 0.71 357 1,974 2,737 2,695 1 26 183 262 134 159 46 47 858 3.7 0.63 216 1 464 3,168 1,272 9 – 5 108 172 86 84 19 24 498 2.2 4,482 2,429 0.54 45 2,520 1,323 315 10 - 4 40 103 60 60 10 14 291 1.3 2,910 1,508 0.52 40 1,430 1,050 250 11 1 — 17 38 24 23 6 9 118 0.5 1,298 622 0.48 198 682 253 121 – – 5 16 9 13 2 7 52 0.2 0.51 60 300 180 12 13 – – – 13 7 5 2 27 01 351 143 0.41 312 13 13 14 - - 1 1 1 1 2 2 8 00 112 60 0.54 28 28 28 14 15 and over . — — — — — 1 — — 1 00 16 7 0.44 16 — — Total Private Families .. 1,548 3,608 5,291 5,371 2,650 2,490 922 642 22,972 1000 — – – – – – – Population in Private Families 3,050 10,446 21,043 24,975 12,965 14,100 4,257 3,413 – 94,249 1,574 11,434 24,459 14,859 Rooms Occupied 1,548 7,215 15,873 21,484 13,250 18,655 7,712 7,673 – – – 93,410 0.99 – – – – 6.7 15.7 23.0 23.5 11.5 12.8 4.0 2.8 100.0 1921 Percentage of families living in various units of occupation. 6.4 12.1 21.5 21.7 11.6 17.0 5.1 4.6 100.0 1911 ,, 10 SECTION 2. VITAL AND MORTAL STATISTICS, 1922. POPULATION. The population of the Borough estimated to the middle of the year 1922 is 101,930. This figure shows an increase of 530 over the figure 101,400, which was the revised estimate of the RegistrarGeneral for the middle of the year 1921. The preliminary Census figure was 100,493 ; this was subsequently revised to 100,450, but allowing for adjustment on account of holiday movement, the official Census figure was increased to 101,400, as stated. The distribution of the population throughout the Borough is as follows :— Census, 1921. Estimated Population at middle of year 1922. East Greenwich 44,647 44,873 West Greenwich 26,931 27,069 St. Nicholas, Deptford 7,646 7,689 Charlton 18,959 19,059 Kidbrooke 3,217 3,240 Total 101,400 101,930 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total. M. F. Births Legitimate 2,071 1,082 989 Birth Rate 2.'0 Illegitimate 63 30 33 Deaths 1,313 677 636 Death Rate 12.92 Number of women dying in, or in consequence of, childbirth From Sepsis — „ other causes 3 Deaths of Infants under one year of age per 1,000 births :— Legitimate, 106; Illegitimate, 15; Total, 121. Deaths from Measles (all ages) 29 ,, ,, Whooping Cough (all ages) 11 ,, ,, Diarrhœa (under 2 yaers of age) — 11 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. 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 England in Greenwich. In Churches of England in Charlton and Kidbrooke. St. Nicholas Parish Church. Marriages in Superintendent- Registrar's Office of parties resident in Greenwich or outside the Registration District, and in Chapels and Roman Catholic Church in St. Nicholas & 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 419 197 76 326 1018 102591 1920 384 105 64 322 875 104453 1921 344 124 57 249 774 100493 1922 364 112 45 275 796 101930 BIRTHS. The total number of Births registered in the Borough during the year was 2,185. Of this number 145 occurred in the Greenwich and Deptford Hospital and 219 at various Nursing Homes within the Borough. Of this total of 364 Institution births, 186 only belonged to Greenwich, the remainder being transferred to the appropriate localities. One hundred and twenty-seven births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 2,134—Males, 1,112 ; Females, 1,022. This figure gives a Birth Rate of 21.00 per 1,000 of the population, being 1.16 below the average for the last ten years. 12 The Birth Rate for the County of London equals 21.0 per 1,000 of the population. The Birth Rate for all England and Wales was 20.6. Illegitimate births numbered 63, representing 2.9 per cent. of the total births. Eighty-six illegitimate births were registered in the Borough. In 37 cases, however, the mothers were ordinarily resident outside the Borough, and these births were consequently allocated to the correct areas. Fourteen illegitimate births belonging to Greenwich occurred outside the Borough, thus giving the net figure of 63. Thirty illegitimate births occurred in the Greenwich and Deptford Hospital. Under the provisions of the Notifications of Births Act, 1907. intimations have been received from medical men, parents, and others, with respect to 2,257 births. DEATHS. The total number of deaths registered during 1922 was 1,313, of which 677 were males and 636 females. The crude Death Rate for the Borough of 12.92 per 1,000 compares favourably with 13.4, the Death Rate for the County of London, and 13 0, the Death Rate for the 105 Large Towns. The Death Rate in the various Metropolitan Boroughs varied from 11.1 in Hampstead and Lewisham, 11.2 in Wandsworth, 11.6 in Woolwich, 12.0 in Fulham, up to 17.0 in Bermondsey, 16.3 in Finsbury and Shoreditch, 15.5 in Southwark, and 15.3 in Bethnal Green. Locally the Death Rate varied from 17.61 in St. Nicholas, 15.27 in West Greenwich, 12.38 in Kidbrooke, 11.68 in Charlton, to 11.26 in East Greenwich. Of the total number of deaths 20 under five years of age were of illegitimate birth, 15 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 1917 to 1921, compared with the figures for 1922 :— District. 1917. 1918. 1919. 1920. 1921 Average for 5 Years. 1922. East Greenwich 14.05 16.01 10.58 10.39 12.17 12.64 11.26 West Greenwich 19.55 26.03 18.56 14.84 12.53 18.30 15.27 St. Nicholas 26.07 24.45 12.84 15.61 14.28 18.65 17.61 Charlton 15.50 20.42 13.10 9.39 11.80 14.04 11.68 Kidbrooke 6.71 10.50 6.88 8.90 11.62 8.92 12.38 Borough 15.90 19.16 13.15 11.72 12.41 14.48 12.92 13 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. 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 1922 1,313 121 600 Average 1.386 182 551 AGE MORTALITY. The age mortality and the distribution of the deaths between the different quarters of the year is shown by the following table :— Deaths. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Under 1 year of age 44 32 21 24 121 Between 1 and 2 years 33 11 4 6 54 Between 2 and 5 years 26 20 13 10 69 Between 5 and 15 years 20 13 17 17 67 Between 15 and 25 years 22 26 13 9 70 Between 25 and 45 years 56 49 22 23 150 Between 45 and 65 years 111 62 67 61 301 65 years and upwards 161 108 87 125 481 Total 473 321 244 275 1,313 INFANTILE MORTALITY. The Infantile Mortality, measured by the deaths of children under one year of age to the number of births registered, was 56 per 1,000 births, there having been a total of 121 such deaths during the year, as compared with 187, 195 and 175, the respective figures for the years 1919, 1920 and 1921. This figure is the lowest ever recorded for the Borough; the chief factor being the total absence of deaths from Diarrhœa. A further reference to the Infantile Mortality Rate will be found in the Section devoted to the Maternity and Child Welfare Scheme. 14 For the whole of London the rate was 74 in 1922, compared with 80 in 1921, 75 in 1920 and 85 in 1919. For England and Wales the rate was 77, compared with 83 in 1921, 80 in 1920 and 93 in 1919. Locally, the variations were from 10 per 1,000 births in Kidbrooke, 46 in East Greenwich, 63 in West Greenwich, 74 in Charlton, to 81 in St. Nicholas. The following table compares at a glance these figures for the vears since the formation of the Borough :— District. Average for five years, 1901-1905. inclusive. Average for five years, 1906-1910, inclusive. Average for five years, 1911-1915. inclusive. Average for five years, 1916-1920. inclusive. 1921. 1922. East Greenwich 129 106 96 81 61 46 West Greenwich 126 110 112 110 87 63 St. Nicholas, Deptford 179 143 167 138 91 81 Charlton 121 109 76 89 86 74 Kidbrooke 39 79 16 39 15 10 Borough 131 111 103 95 73 56 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. 1922. 1922. Infective Diseases— Local Diseases—continued. Epidemic 1.34 Circulatory System 1.36 Sporadic — Respiratory System 2.91 Venereal 0.01 Digestive System 0.45 Septic 0.07 Lymphatic System 0.03 Malarial 0.01 Urinary System 0.32 Tuberculosis 1.38 Reproductive System 0.05 Parasitic Diseases — Parturition 0.02 Constitutional Diseases 1.27 Bones and Joints. 0.08 Developmental Diseases 1.94 Integumentary Syestem — Dietetic Diseases — External Causes— Local Diseases— Accidents 0.47 Nervous System 0.99 Homicide — Organs of Special Sense 0.04 Suicide 0.03 15 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic.—There were 137 deaths due to this class of disease, equalling a Death Rate of 1.34 per 1,000 ; the rate last year was .93, and was 4.86, 1.53 and .88 in 1918, 1919 and 1920 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 88 deaths, equalling a Death Rate of .86 per 1,000. Locally the Zymotic Death Rate varied from .30 in Kidbrooke (.62 in 1921), .36 in Charlton (.53 in 1921), .87 in East Greenwich (.95 in 1921), 1.03 in West Greenwich (.77 in 1921) and 1.69 in St. Nicholas, Deptford (.26 in 1921). Small-Pox.—There were no deaths from Small-Pox, this being the twentieth year since a death occurred from this cause in the Borough. Measles.—Twenty-nine deaths were ascribed as due to this disease. With the exception of one case all the patients were under five years of age. The number of deaths recorded last year was 5, and in the years 1918, 1919 and 1920, 45, 13 and 26 respectively. Eleven deaths occurred in East Greenwich, 8 in West Greenwich, 7 in St. Nicholas and 3 in Charlton. The quarterly incidence was 17 in the first quarter and 12 in the second quarter. Scarlet Fever.—This disease occasioned 6 deaths, 3 of which were under five years. Three deaths occurred in East Greenwich, 1 in West Greenwich, 1 in Charlton and 1 in Kidbrooke. Six such deaths occurred in 1921 and 2 in 1920. Diphtheria.—There were 42 deaths during the year. This gives a Death Rate of .41 comparing with .27 for the previous year. Twenty-eight deaths occurred in 1921, and 16, 15 and 13 in 1918, 1919 and 1920 respectively. 16 Twenty-four of the patients were under five years of age. Towards the end of the year posters were distributed for exhibition calling attention to the efficacy of Antitoxin treatment. The posters were of foolscap size and read as follows :— DIPHTHERIA. The Greenwich Borough Council wish to bring to the notice of all parents and guardians of children, the vital necessity of getting medical advice at once, in all cases of sore throat and discharge from the nose, as such symptoms are often the signs of an attack of Diphtheria. Diphtheria is a deadly disease if allowed to get a firm hold of the sufferer, but medical science has provided an almost certain cure (known as Antitoxin) if this is used in the very early stages of the disease. Any case of sore throat and discharge from the nose should therefore be seen at once by a doctor and Antitoxin administered if necessary. By doing so you may save your child's life. If specimens have been taken for examination do not put off seeing the doctor because the result has not come through. The Borough Council are doing everything possible in the matter by providing Antitoxin for the use of medical men and paying for examination of specimens. Ernest George Annis, Medical Officer of Health. Public Health Department, Borough Hall, Royal Hill, S.E. 10. Typhoid Fever.—There were no deaths ascribed as due to this disease ; there was 1 in 1921, 2 in 1920, 2 in 1919, and 4 in 1918. Diarrhœa, Dysentery, and Zymotic Enteritis.—Two deaths were said to be due to these causes, equalling a rate of 01 per 1,000. Last year there were 27 deaths and 37, 28, and 22 respectively in 1918, 1919 and 1920. One almost feels that this paragraph ought to be printed in large leaded type on account of its unusually gratifying character, because these two deaths were of people of advanced ages and there were no deaths whatever from this most fatal of infantile ailments amongst the infantile population. 17 Influenza.—Influenza is found to have been the responsible cause of 46 deaths in 1922 ; 39 was the average of the previous three years. Of the 46, 15 were over sixty-five years of age. Sporadic Diseases.—There were no deaths from this class of diseases during the year. Venereal. Syphilis.—Two deaths were given as due to Syphilis, as against 4 in 1921 and 4 in 1920. One occurred in East Greenwich and 1 in Charlton. One of the deceased persons was in the Greenwich and Deptford Hospital and 1 in the Miller Hospital. There were no deaths from Gonorrhoea during the year. Septic Diseases. Erysipelas.—One death occurred from this cause in 1922, 2 in 1921 and 6 in 1920. Puerperal Fever.—There were no deaths from this disease during the year. Pyemia and Septicemia, &c.—There were 6 deaths from this disease during the year and 1 death from other allied diseases. Malarial. Rheumatic Fever.—There was 1 death in 1922 as compared with 3 in 1921, 12 in 1920 and 3 in 1919. Rheumatism of the Heart.—There was 1 death attributed to this cause. Tuberculosis. This class includes the causes of 141 deaths during the year under review, with a rate of 1.38; these figures compare with 174, 147 and 138, the totals of the years 1919, 1920 and 1921 respectively, and respective rates of 1.66, 1.40 and 1.37. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 120 attributed to this cause, or a rate of 1.18 per 1,000. Locally, the deaths were 20 in St. Nicholas (giving a Death Rate of 2.6), 22 in Charlton (giving a Death Rate of 1.15), 31 in West Greenwich (giving a Death Rate of 1.14), and 47 in East Greenwich (giving a Death Rate of 1.05). 18 The remaining forms of Tuberculosis were responsible for 21 deaths, being 10 in East Greenwich, 9 in West Greenwich, 1 in St. Nicholas, and 1 in Kidbrooke. Of these other forms of Tuberculosis, Tuberculosis of the Brain and its membranes was credited with 9 (4 being under five years of age), Tubercle affecting the Intestines 5 (2 being under five years of age), General Tuberculosis 4, and other forms of Tuberculosis 3 deaths. Parasitic Diseases.—There were no deaths from this class of disease. Dietetic Diseases.—There were no deaths from this class of disease. Constitutional Diseases.—The deaths from this cause were 129 in number, which gives a rate of 1.26 per 1,000. Of these, 115 were attributed to Cancer, 5 to Diabetes, 7 to Anaemia, 1 to Gout and 1 to Purpura Hœmorrhagica. The deaths from Cancer were distributed as follows —46 occurred in East Greenwich, 42 in West Greenwich, 4 in St. Nicholas, 19 in Charlton and 4 in Kidbrooke. Developmental Diseases.—There were 198 deaths, equal to a rate of 1.94 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz. :—Congenital defects, 6, and those from causes more or less preventable, viz. :—Premature birth, 37; Injury at birth, 2; Debility at birth, 10; Atrophy, Debility and Marasmus, 4; Atelectasis, 1, and Dentition, 1. The remaining and largest portion of these deaths from developmental diseases, 137, in number, were from Old Age: in 1921 there were 94 deaths from this cause, and 113 in the previous year. Local Diseases. Nervous System.—One hundred and one deaths were attributed to the various nervous diseases, which gives a rate of .99 per 1,000; last year the rate was 1.17 per 1,000. Convulsions were responsible for 2, both of whom were under five years of age; 3 were from Meningitis, 57 from Apoplexy, 4 from Hemiplegia or Brain 19 Paralysis, 3 from General Paralysis of the Insane, 7 from Cerebral Tumour, 4 from Epilepsy, 1 from Encephalitis, 7 from Diseases of Spinal Cord, 3 from Softening of Brain, 2 from Locomotor Ataxy, and 8 from other diseases of thi3 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 137 per 1,000, there being a total of 139 such deaths. Valvular diseases of the Heart were responsible for 116, 3 from Aneurism, 6 from Embolism, 4 from Angina Pectoris and from the remaining diseases of this system, 10. Respiratory System.—Two hundred and ninety-six deaths were due to diseases of the respiratory organs, as compared with 217 in the preceding year. The Death Rate under this heading equals 2.91 per 1,000. Twenty were from Acute and 112 from Chronic Bronchitis, 154 from the various forms of Pneumonia, 66 being under five years of age, 3 from Emphysema, 3 from Pleurisy, and 4 from other diseases. Digestive System.—There were 46 deaths from diseases of this system, equal to a rate of .45 per 1,000. Of this number, Enteritis was responsible for 3, all of whom were under five years of age, 9 to Appendicitis, 8 to Obstruction, and 2 to other diseases of the Intestines, 4 to Cirrhosis, and 4 to other diseases of the Liver, 1 to Peritonitis, 9 to Ulcer of Stomach and Duodenum, 4 to other diseases of Stomach, 1 to diseases of the Mouth and Annexa, and 1 to other diseases of the Digestive System. Lymphatic System.—There were 4 deaths from diseases affecting this system during the year. Urinary System.—Thirty-three deaths, equal to a rate of .32 per 1,000, occurred from diseases affecting this system. Twentynine were from Bright's Disease, 2 from diseases of the Bladder and Prostate, and 2 from ill-defined causes of the urinary system. Reproductive System.—There were only 6 deaths due to diseases of the Generative Organs. There were 3 deaths attributed to diseases of Parturition. Bones and Joints.—There were 9 deaths from diseases of bones and joints. 20 Integumentary System.—There were no deaths from diseases of Integumentary System. External Causes.—There were 52 deaths given as due to causes grouped under this heading; 48 were the result of accident or negligence, and the remaining 4 were from Suicide. One child died from Suffocation by being overlaid in bed (compared with 2 from this cause last year); 5 cases were from Drowning, 8 from Burns and Scalds, while accidents on railways, in vehicular traffic and in building operations, falls, etc., were responsible for 34 deaths. The Suicides were 2 from Drowning, 1 by Cut or Stab, and 1 from Poison. Ill-Defined Causes.—There were two deaths in 1922, the cause of which was not ascertained. MORTUARY. The number of bodies dealt with in the Mortuary since 1911 is shown 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 1922 14 166 180 21 SECTION 3. NOTIFIABLE DISEASES DURING THE YEAR 1922. Disease. Total Cases Notified. * Cases admitted to Hospital. Total Deaths.* Diphtheria 707 683 42 Scarlet Fever 599 567 6 Enteric (including paratyphoid) 3 2 — Puerperal Fever 6 3 — Pnuemonia 165 46 154 Erysipelas 43 13 1 Encephalitis Lethargica 1 1 1 Cerebro Spinal Fever 3 3 1 Malaria 10 — — Ophthalmia Neonatorum 18 9 — Notifiable Locally. Measles 1,286 18 29 Whooping Cough 408 9 11 Chicken Pox 169 — — Diarrhœa 29 — (under 5 yrs). Tuberculosis. (a) Pulmonary— Males 112 Females 106 - 218 3 120 (b) Non-Pulmonary— Males 27 Females 28 - 55 1 21 3,720 1,358 386 * For particulars as to Age Groups see Tables at end of Report. See Report of Tuberculosis Officer on page 31. OPHTHALMIA NEONATORUM. Cases. Vision Unimpaired. Vision Impaired. Total Blindness. Deaths. Notified. Treated. At Home. In Hospital. 18 9 9 15 1* — 2 * Still receiving treatment at Hospital. 22 Notifications under the Provisions of the Public Health (London) Act, 1891.—During the year 3,720 cases have been notified under the above Act, as compared with 2,820, 2,116 and 3,227 respectively in the preceding years 1919, 1920 and 1921. Chicken-Pox.—Owing to the number of cases of Small Pox occurring within the County of London towards the latter part of the year and in view of the possibility of cases occurring within the Borough and to the likelihood of early cases being mistaken for Chicken Pox, the Council made an Order for a period of Three Months from the 18th day of November, 1922, applying Sections 55 and 57 of the Public Health (London) Act, 1891, to the infectious disease known and described as Chicken Pox. During the period from 18th November to the end of the year, 169 cases were notified, all of which were investigated. Small-Pox.—No case of this disease occurred in the Borough during the year. The services of your staff were called upon by both private medical practitioners and hospitals in the District to assist in the diagnosis of many suspicious cases. Fortunately, however, no definite case of this disease was found. Contacts.—Fourteen intimations were received from the Medical Officers of Health of the various Port Sanitary Authorities and neighbouring Boroughs respecting persons who had been in contact with Small-Pox. In every instance they were kept under observation. Details respecting vaccination in the Borough are given in the Supplemental Vaccination Reports on page 30. Diphtheria.—Seven hundred and seven cases of Diphtheria were notified during the year, as compared with 240, 275, 391 and 595 respectively in the years 1918, 1919, 1920 and 1921. The distribution of these cases was as follows :—342 in East Greenwich, 201 in West Greenwich, 44 in St. Nicholas, 70 in Charlton and 50 in Kidbrooke. Of this total number, 683 were removed to the Hospital for treatment, amongst which number the Hospital Authorities reported that in 3 cases they considered the diagnosis incorrect. 23 There were 42 fatalities due to this disease, which gives a case mortality of 5.9 per cent. Three thousand two hundred and thirty-two specimens were forwarded by medical practitioners for bacteriological investigation from cases suspected to be Diphtheria. Of this number 2,857 were reported to give negative or doubtful results, and 375 were positive in character, being dealt with accordingly. The quarterly incidence of the disease for 1922 has been as follows :— lst Quarter—East Greenwich, 164 cases ; West Greenwich, 24 ; StNicholas, 14; Charlton, 19; Kidbrooke, 20; a total of 241 cases. 2nd Quarter—East Greenwich, 40 cases ; West Greenwich, 58 ; St. Nicholas, 5 ; Charlton, 6 ; Kidbrooke, 9 ; a total of 118 cases. 3rd Quarter—East Greenwich, 51 cases ; West Greenwich, 54 ; St. Nicholas, 11 ; Charlton, 20 ; Kidbrooke, 12 ; a total of 148 cases. 4th Quarter—East Greenwich, 87 cases ; West Greenwich, 65 ; St. Nicholas, 14 ; Charlton, 25 ; Kidbrooke, 9 ; a total of 200 cases. Membranous Croup.—There were no cases of Membranous Croup notified during the year. Erysipelas.—Forty-three cases were notified during the year, 21 being in East Greenwich, 11 in West Greenwich, 1 in St. Nicholas, 7 in Charlton and 3 in Kidbrooke. Thirteen of these patients were removed to a Public Institution in the district. Scarlet Fever.—Five hundred and ninety-nine cases were notified during the year, as compared with 481, 587 and 958 cases respectively in the years 1919, 1920 and 1921 ; 290 cases were in East Greenwich, 104 in West Greenwich, 67 in St. Nicholas, 100 in Charlton and 38 in Kidbrooke ; 567 of these cases were removed to the Hospital for treatment, 8 of which were returned as not suffering from this disease. There were 6 deaths from this disease during the year as against 7 last year. 24 Eighteen of the cases removed to Hospital were discharged and notified to be still suffering from Chronic Rhinitis, 4; Chronic Rhinorrhcea, 3; Chronic Otorrhœa, 9; Slight Otorrhœa, 2; Intermittent Ottorhœa, 1; Total, 19. A series of 14 cases arose in the Autumn, all in one district, and on enquiry it was found that they were ail supplied from one Dairy. On investigating there it was found that they were chiefly on one milk round. The boy who left the can at the doors was himself found to be suffering from the disease, and after his removal to Hospital no further cases arose. The proprietors of the dairy rendered us every assistance possible in enquiring into this matter, and fortunately the discovery of the boy patient put an end to what might otherwise have been a very serious outbreak. The following table gives particulars of the 10 cases which would seem to be " return cases." There were 7 such cases in 1921, 6 in 1920, 6 in 1919 and 2 in 1918. 25 Table showing Return Cases of Scarlet Fever during Year 1922. No of Case. Date of Removal of Primary Case. Date of Disinfection. Date of Discharge from Hospital. Date of Removal of Second Case. Time between Cases. Remarks, &c. Appearance on discharge from Hospital. 1 19th Nov., 1921 21st Nov., 1921 30th Deo., 1921 10th Jan., 1922 9 days Primary case nasal and aural discharge. 2 1st Nov., 1921 3rd Nov., 1921 6th Jan., 1922 13th Jan., 1922 6 „ Feet desquamating. 3 20th Nov., 1921 21st Nov., 1921 9th Jan., 1922 16th Jan., 1922 7 „ Glands enlarged. 4 30th Dec., 1921 1st Jan., 1922 20th Jan., 1922 3rd Feb., 1922 11 ,, Feet desquamating. 5 31st Dec., 1921 2nd Jan., 1922 6th Feb., 1922 12th Feb., 1922 5 „ Profuse nasal discharge, feet desquama- [ ting- 6 13th Mar., 1922 15th Mar., 1922 22nd April, 1922 26th April, 1922 3 „ Apparently well. 7 31st Mar., 1922 1st April, 1922 11th May, 1922 15th May, 1922 1 „ Feet desquamating. 8 11th May, 1922 12th May, 1922 23rd June, 1922 5th July, 1922 11 „ Apparently well. 9 20th May, 1922 22nd May, 1922 14th July, 1922 19th Julv, 1922 4 „ ,, ,, 10 2nd Oct., 1922 3rd Oct., 1922 11th Nov., 1922 18th Nov.. 1922 7 „ Arms and feet desquamating. 26 Typhoid Fever.—There were 3 cases of Typhoid or Enteric Fever notified during the year, 2 being in East Greenwich, and 1 in Kidbrooke. The ages of the patients were : 1 between five and fifteen years, 1 between fifteen and twenty-five years, and 1 between twenty-five and forty-five years. Two cases were removed to Hospital for treatment. Eleven such cases occurred in 1921, 15 in 1920, 20 in 1919 and 12 in 1918, the average number for the previous 10 years being 16. None of the cases were traceable to the consumption of shellfish, and there were no fatalities from this disease. Four specimens were forwarded for bacteriological examination from cases suspected to be Typhoid Fever in character, 1 giving a positive result. Puerperal Fever.—Six cases of this disease were notified during the year, 5 being in East Greenwich and 1 in St. Nicholas, Deptford. There were 11 cases in 1921, 5 cases in 1920, 5 in 1919 and 1 in 1918. There were no 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. Twelve hundred and eighty-six cases were notified during the year, as compared with 572 during the previous year, and 925 and 794 in the years 1919 and 1918 respectively. The ages and incidence of fatality of the disease were as follows : There were 51 cases under 1 year of age, amongst whom there were 5 deaths giving a case mortality of 10 per cent. Between the ages of one to five years there were 522 cases with 23 deaths at this age period giving a case mortality of 4 per cent., and 710 cases between five years and forty-five with 1 death. The case mortality for the whole district works out at 2.25 per cent. 27 Table showing number of Measles Cases reported during the year 1922. 1st QUARTER. Under 1. 1 to 5. 5 to 15. 25 to 65. East Greenwich 9 88 123 5 1 West Greenwich 4 42 27 - — St. Nicholas, Deptford 3 47 44 1 — Charlton 5 46 83 — — Kidbrooke — — — — — Total 21 223 277 6 1 Total 528. 2nd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 13 114 152 3 1 West Greenwich 7 62 103 3 1 St. Nicholas, Deptford 3 4 4 — — Charlton 2 34 43 3 — Kidbrooke — 3 5 — — Total 25 217 307 9 2 Total 560. 3rd QUARTER. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. East Greenwich 2 16 15 1 — West Greenwich 2 19 26 — — St. Nicholas, Deptford — — — — — Charlton — — 2 — — Kidbrooke — 1 4 — — Total 4 36 47 1 — Total 88. 4th QUARTER. Under 1. 1 to 5: 5 to 15. 15 to 25. 25 to 65. East Greenwich - 20 46 1 - West Greenwich 1 24 13 1 - St. Nicholas, Deptford — — — — — Charlton — 2 1 — — Kidbrooke — — — 1 — Total 1 46 60 3 — Total 110. Total cases in year = 1,286. 28 In view of the epidemic of Measles during the first six months of the year and the difficulty experienced in obtaining hospital accommodation for the treatment of serious cases, a Conference was held at the Metropolitan Asylums Board's offices on the 9th June, 1923, consisting of members of the M.A.B., Ministry of Health, and the Metropolitan Branch of the Society of Medical Officers of Health, to consider as to the desirability of the M.A.B. making better provision than has hitherto been the custom. Statistics showed that in London during the quarter ended 1st April, 1922, there were 642 deaths from Measles as against 387 for Diphtheria and 131 for Scarlet Fever, thus unquestionably showing the need for more adequate Hospital provision for those cases of Measles occurring in the thickly populated areas. It was pointed out, however, that the greater proportion of Infectious Diseases were treated in the Board's Outlying Hospitals, which Institutions were unsuitable for cases of Measles. After full consideration of all the circumstances an understanding was arrived at that the accommodation would be extended and that such cases forwarded by Medical Officers of Health would be specially considered. Zymotic Enteritis or Summer Diarrhoea.—Twenty-nine cases of Diarrhoea were notified throughout the whole of the Borough, 12 being under one year of age and 17 between one and five. Eight of such notifications related to patients in East Greenwich, 18 in West Greenwich, 2 in St. Nicholas and 1 in Charlton. There were no deaths ascribed to this disease, compared with 27 in the previous year. Whooping Cough.—This disease was made permanently notifiable as from the 1st November, 1921. Four hundred and eight cases were notified (compared with 321 in 1920), 40 being under one year of age, 153 from one to five, 209 from five to fifteen, 2 from fifteen to twenty-five, 3 from 25 to 45, and one from 45 to 65 years, the districts concerned being East Greenwich, 179; West Greenwich, 134; St. Nicholas, 20; Charlton, 69; and 6 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 were 3 cases of this disease notified during the year, all of which occurred in East Greenwich. 29 Acute Polio-Myelitis or Acute Polio-Encephalitis.— There were no cases notified during the year, as compared with 3 cases in 1921, 0 in 1920 and 1 in 1919. Ophthalmia Neonatorum.—During the year 18 cases of this disease have been notified, 6 being in East Greenwich, 7 in West Greenwich, 1 in St. Nicholas, Deptford, and 4 in Charlton. Further particulars of this disease will be found on page 83. Malaria.—There were 10 cases of Malaria notified during the year, 3 in East Greenwich, 4 in West Greenwich, 2 in St. Nicholas and 1 in Kidbrooke, as compared with 8 last year. Encephalitis Lethargica.—There was one case of this disease notified during the year. This was a case brought to the Miller Hospital from outside the Borough. 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 273 cases of Tuberculosis notified in the Borough, 218 being pulmonary cases, ordinarily known as Consumption, and 55 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 108 pulmonary and 21 non-pulmonary, occurred in East Greenwich, 50 pulmonary and 21 non-pulmonary in West Greenwich, 24 pulmonary and 7 non-pulmonary in St. Nicholas, 33 pulmonary and 3 non-pulmonary in Charlton, and 3 pulmonary and 3 non-pulmonary in Kidbrooke. The various ages of the patients were as follow :—Pulmonary cases under one, 0; from one to five, 3 cases; five to fifteen, 39 cases; fifteen to twenty-five, 57 cases; twenty-five to forty-five, 78 cases; forty-five to sixty-five, 37 cases; and 4 cases over sixty-five; whilst the Non-Pulmonary were: Under one year of age, 1 case; one to five, 11 cases; five to fifteen, 24 cases; fifteen to twenty-five, 10 cases; twenty-five to forty-five, 7 cases; and forty-five to sixty-five, 2 cases. Four hundred and thirty-nine specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive ; 353 were reported to be negative and 86 positive. Disinfection has been offered and carried out in 96 cases, including 134 rooms and 322 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. 30 Supplemental Vaccination Return tor 1921. Return made on or before the 9th of February, 1923, 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, 1921, inclusive:— Registration SubDistricts comprised in the Vaccination Officer's District. No. of Birthsfrom 1st Jan. to 31st Dec., 1921. Number of these Births duly entered by 31st Jan., 1923. No. of Births which on 31st Jan., 1923, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31st Jan., 1923, not accounted for. Total No. of Certificates of successful Primary Vaccination at all ages received during Calendar Year 1922. No. of Declarations of Conscientious Objection actually received by Vaccination Officer during the Calendar Year 1922. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Certificates of con scientious objection received. Bead, Unvaccinated. Postponement by Medical Certificate. Removalto 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 12 13 South Deptford. 603 253 2 — 244 17 — 14 14 59 .. .. North Deptford. 1094 486 2 — 403 60 1 2 29 111 .. .. East Deptford . 1073 428 2 — 285 75 7 3 75 198 .. .. East Greenwich. 1062 516 2 — 357 62 — 21 43 61 .. .. West Greenwich 644 304 2 — 223 29 1 5 23 57 .. .. Total 4476 1987 10 — 1512 243 9 45 184 486 2796 1357 Dated February 3rd, 1923. A. E. Rossiter, Vaccination Officer. CHARLTON AND KTDBROOKE No. of Births entered in " Birth List Sheets " as registered from 1st January to 31st December, 1921 433 Successfully Vaccinated 264 Insusceptible of Vaccination 3 Had Small-Pox — Statutory .Declarations of Conscientious Objection 123 Dead Unvaccinated 17 Postponed by Medical Certificate 2 Removed to Districts the Vaccination Officer of which has been duly apprised 7 Removed to places unknown, or which cannot be found; and cases not traced 17 Not accounted for — G. E. Oughton. 31 To the Medical Officer of Health. Sir, I have the honour to submit the Tenth Annual Report on the work of the Tuberculosis Department. The notifications and deaths from Tuberculosis in 1922 were as under :— Notifications. Deaths. Pulmonary. Non-Pulmonary. Total. Pulmonary. Non-Pulmonary. Total. 218 55 273 120 21 141 and the averages for the ten years, 1912-1921, were : 300 128 — 140 27 — The notified cases of Pulmonary Tuberculosis were less than in any previous year and it is hoped that the existing measures dealing with Tuberculosis will result in a still further reduction despite such unfavourable conditions as unemployment and overcrowding. Non-Pulmonary Tuberculosis.—The 55 Notifications comprised :— 21 cases Tuberculosis of Glands (mainly Cervical). 4 ,, „ Bones. 12 ,, ,, Joints. 3 ,, ,, Spine. 6 ,, ,, Brain (Meningitis). 8 ,, „ Abdomen. 1 ease ,, Skin (Lupus). During the year the Registers were carefully revised, and an endeavour made to visit every case on the books. Many were examined either at their homes or at the Dispensary, and at the close of 1922 it was estimated that the total number of Tuberculous persons residing in the Borough amounted to 832, as follows :— Men. Women. Children. Total. Pulmonary Tuberculosis 216 227 116 559 Non-pulmonary Tuberculosis 18 22 233 273 This is a decrease of 476 from the previous estimate, and apart from the low incidence this year is mainly explained by the fact that in many cases, especially children, notified in the earlier years (19121915) the condition had cleared up and the patients themselves presented no symptoms and had been apparently well during the past four or more years. These cases were accordingly struck off the Register but will be watched as to their future progress. 32 Late Notification and Non-Notification.—Of the total deaths from Pulmonary Tuberculosis in 83 per cent, of the cases notification had been previously made under the Regulations, whilst in the remaining 17 per cent. it had not. This latter figure is a marked improvement on the previous year, when it was 26 per cent. The following Table shows the Death-Notification Interval of 120 patients who died in 1922 and whose deaths were ascribed to Pulmonary Tuberculosis :— Died before notification received 21 Died within one week of notification 9 ,, ,, one week to one month 7 ,, ,, one month to three months 12 ,, ,, three to six months 20 ,, ,, six to twelve months 30 ,, ,, one to two years 16 ,, ,, two to three years 4 ,, ,, three to four years 1 120 There is no doubt but that many cases are not notified because the Medical Attendant is under the impression that this has already been done. Consumptive patients have a great tendency to move about from doctor to doctor. Non-notification from this source might be obviated if medical men were asked to notify every case they were called to attend. In a few instances, especially in " well-to-do " districts, notification is objected to by the relatives, but a " Confidential Notification," with a request that no visit be made by any Public Health Official, would meet the case, the Medical Attendant undertaking to see that due precautions were taken to prevent infection. Again, Hospitals and Institutions frequently fail to notify their cases, the reason apparently being that it is not the special duty of any one of the staff to inform the Public Health Department. During the ensuing year it is proposed to ask medical men to notify every case they attend and, as in past years, reminders will continue to be sent to both medical men and institutions upon failure to notify. During the year 141 persons died from Tuberculosis (all forms), giving a death rate of 1.38 per 1,000 population; 120 deaths were due to the Pulmonary Form, or a rate of 1.18 per 1,000. 33 The Notifications and Deaths from Pulmonary Tuberculosis, with the Incidence and Death Rates for the previous five years, are recorded in the following Table :— Year. Notifications. Incidence per 1000. Deaths. Death Rate per 1,000. 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 Housing Conditions. — Unfortunately, little progress can be reported under this heading. Unemployment and the Housing Shortage still continue with their attendant evils. Several families referred from the Dispensary have been accommodated in the Council's New Housing Estate, but the shortage of houses is still very great. Although it is all-important that more houses should be built, it must not be lost sight of that it is equally if not more important to clear out our slum areas if progress is to be made in preventing and counteracting the spread of infection. Curiously enough the Districts in the Borough in which the greatest overcrowding exists, and where the hygienic conditions are poorest, furnish the fewest notifications of Tuberculosis, a point which has been noted before in connection with other diseases. The sleeping accommodation of 218 patients notified during the year gave the following information :— 125 were sharing a bed. 51 had a separate bed, but not a separate room. 42 had a separate room and a separate bed. The four shelters provided by the Council have been in constant use throughout the year. Dealing with the Dispensary itself, 795 new patients were examined during the year. The sources from which these patients came will be found in the following Table :— Doctors 170 Hospitals 17 School Medical Service 33 Ministry of Pensions 22 Own Application 78 Other Sources 15 Nurses (Contacts) 460 34 A very satisfactory point to note is the increasing number of patients sent by general practitioners, hospitals, etc. Apart from the nurses, the greater number of patients came from these sources. Contacts.—The search for Contacts is still vigorously continued by the Dispensary staff, and again I would draw attention to the excellent work of the nurses in inducing such a large proportion of Contacts to submit to examination—a very difficult matter in many instances. Of Contacts examined 48 were found Tuberculous and placed under treatment. The work of the nurses might be tabulated as follows :— District. Nurses' Visits. Cases Notified. No. of Contacts. Contacts Examined. ReExamined. Proved Tuberculous. No. 1 1480 64 174 82 18 7 No. 2 1172 53 139 95 31 18 No. 3 1612 96 213 167 30 12 No. 4. 1744 60 187 116 39 11 6008 273 713 460 118 48 Out of a total of 713 Contacts, no fewer than 460 were examined or including re-examinations, 578 giving 81 per cent., the highest recorded since the Dispensary was opened, and a high compliment to all the nurses concerned. With this excellent result it is a matter for extreme regret that in view of their 25 per cent. contribution to the cost of the Dispensary scheme, the London County Council is pressing for a reduction of the nursing staff. The high per centage of Contacts examined is entirely due to the constant visiting and supervision of the four nurses appointed by the Borough Council with the full approval of the Ministry of Health. Now that the work of prevention is well in hand it is surely mistaken economy to curtail in any way the only means whereby Contacts can be thoroughly searched out and induced to present themselves for examination. Reckless economy is as much to be condemned as reckless expenditure. The work of the Dispensary is shown in the Statistical Table, and explains itself. From the table it will be observed that 154 patients were diagnosed at the Dispensary as suffering from Pulmonary Tuberculosis and 34 from Non-Pulmonary Tuberculosis. 35 In connection with the 55 cases of Non-Pulmonary Tuberculosis notified to the Public Health Department during the year it is interesting to learn in view of the recent discussions on the Milk Supply that in only 19 instances was cow's milk used, the remaining 36 using condensed or other milk. Diagnosis.—The same methods outlined last year were continued in 1922 and found increasingly useful. Duration or Illness.—Taking 99 deaths in 1922 from Pulmonary Tuberculosis (52 men, 36 women, 11 children), whose histories were recorded at the Dispensary, the average duration of illness for both sexes worked out at 31.6 months as against 35.5 in 1921, the difference between the males and females being 1.8 months as against 5.6 in the previous year. In the children the average duration was also shorter, being 7.2 months compared with 15.3 in 1921. Family History.—In connection with 99 deaths alluded to in the previous paragraph, there was a history of the Tuberculosis amongst the near relatives (father, mother, brothers, sisters) in 39 instances, and amongst remote relatives (uncles, aunts, etc.) in 11 cases. Amongst the non-tuberculous the proportions were not greatly different. Treatment.—Specific treatment at the Dispensary is now mainly confined to Tuberculin, although other vaccine's are not neglected. In view of the public interest evinced in " Sphalinger's Serum," it might be stated that application was made early last year for a supply of this remedy as soon as it became available. Sanatorium Treatment.—During the year 177 patients were sent to Sanatoria, 108 under the County Scheme, 31 through the Guardians and 38 through other sources. In addition, 36 children are attending the open-air school at Shooters Hill. Warm acknowledgement must be made of the great assistance rendered by the Guardians not only in the prompt admission of cases recommended to them for sanatorium and hospital treatment but also for their ever ready help in affording extra nourishment to patients referred to them from the Dispensary. Admission to Sanatorium under the County Scheme generally involves a delay of several weeks ; under the Guardians removal is effected within a week. Of patients admitted under the County Scheme, 16 were admitted for the second time and one for the third time. The average duration of residence remains much the same, but 15 cases (chiefly " observation cases ") were discharged under one month. 36 Only 4 cases returned fit for ordinary work, the remainder " much improved " or fit for light work, but in this connection one must bear in mind that the majority of these patients were in the second stage of the disease on admission. Two ex-Service men returned after 18 months' training—one in poultry farming and the other in pig-keeping. Both brought excellent testimonials as to their knowledge in the above, but unfortunately, in spite of every effort on the part of the Care Committee, neither has been able to secure suitable employment, and now one is working as builder's labourer and the other is unemployed. Six other ex-Service men were recommended for training under the Ministry's scheme, 5 were rejected as unsuitable for various reasons, the remaining is at present undergoing training in clock and watch repairing. Dental Treatment.—The dentist reports as follows :— Number of Patients 89 Number of Attendances 138 Number of Extractions (Gas) 66 Number of Extractions (Local Anaesthesia) 62 Number of Extractions (Ordinary) 39 Fillings and Scaling 24 Referred to Own Dentist 19 Refused Treatment 4 General Advice 29 Gas was administered on 13 occasions by the Tuberculosis Officer. X-Rays Examinations.—These examinations give valuable aid, especially in children and doubtful cases amongst adults. Taken alone the examination is not conclusive, but in conjunction with the other tests previously mentioned, may prove the deciding factor in the diagnosis. During the year 91 patients were examined, of whom 56 were children. Of the examinations 83 were examinations of the chest and 8 of other parts. Sputum Examinations.—During the year, of 299 sputum specimens bacteriologically examined at the Seamen's Hospital, 58 were positive and 241 negative. At the same time 324 specimens were chemically examined at the Dispensary for Albumin. Like X-Ray tests, the presence of 37 albumin in the sputum is not of itself a proof of Pulmonary Tuberculosis, but its absence after repeated examinations practically excludes Tuberculosis. The results were as under :— Group I. : Tubercle Bacilli present and Albumin present, 51. Group II. : Tubercle Bacilli present and Albumin absent, 3. Group III. : Tubercle Bacilli absent and Albumin present, 18. Group IV. : Tubercle Bacilli absent and Albumin absent, 201. In Group II. subsequent examinations gave positive reaction in 2 cases. In Group III. 11 out of the 18 patients were found by other methods to be Tuberculosis. In Group IV. no case of Tuberculosis has so far developed. During the year 1922 the Interim Tuberculosis Care Committee met 11 times, and it is with pleasure that I am able again to refer to the very material assistance which this Committee has willingly rendered in many cases. The Committee were also instrumental in collecting the sum of £137 19s. Od. towards the cost of Sanatorium treatment provided by the London County Council. This amount is slightly less than that collected in 1921. Circular No. 308 from the Ministry of Health, circulated in June, 1922, suggested that consideration should now be given to the question of establishing permanent Tuberculosis Care Committees, and the matter was still before the Council at the end of the year. Miss M. N. Johnston, the Secretary of the Local Branch of the Charity Organisation Society, has very efficiently discharged the onerous duties of Hon. Secretary, a position she has kindly filled since the inception of the Committee. Apart from the help described above the Borough Council have provided 4 shelters which are constantly in use, and lent bed and bedding to several necessitous patients. Extra nourishment in the form of milk was granted in 30 instances, and in addition 23 others were referred to the Guardians for similar help. The lack of accommodation for advanced cases has been referred to in previous Reports, and still continues. Acknowledgement must be made of the services of the District Nurses in attending and nursing those advanced cases who were referred to them from the Dispensary. Their help was gratefully appreciated by both patients and relatives. 38 The same close co-operation exists between the School Medical Service, the Maternity and Child Welfare Clinics and the Dispensary, whilst the relationship between the General Practitioners and the Dispensary is increasingly cordial. In concluding the Year's Report I would again thank every member of the Staff for their assistance in carrying out the work entrusted to us. I am, Sir, Your obedient Servant, M. MACDONALD, M.D. 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December 361 2. Total number of attendances of patients at the Dispensary during the year—Insured 3,478 Uninsured 4,749 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis . . 283 Return of work carried out in connection with the Maze Hill Tuberculosis Dispensary for the Year 1922. Number of Under Observat'n at the Dispensary on Jan. 1st pending diagnosis. Examined for tiie first time during the year. Total. Found to be Under Observat'n at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary NonPulmonary (a) All persons (including " Contacts.") (b) "Contacts" (included in (a) ). Adults. M. 2 166 168 65 4 95 4 — F. 7 200 207 63 9 128 7 — Children under 15. M. 5 222 227 15 12 195 5 F. 6 207 213 11 10 188 4 — Total M. 20 795 815 154 35 606 20 — Adults — 53 53 14 — 38 1 — F. 2 111 113 20 3 87 3 — Children under 15. M. 2 151 153 2 4 146 1 — F. 5 150 155 3 2 150 — — (c) Insured persons M. 2 150 152 54 4 92 2 — (included in (a)). F. 2 68 70 29 5 34 2 — 39 40 4. Number of cases in which the period of observation at the Dis- pensary exceeded two months 23 5. Number of insured patients under domiciliary treatment on December 31st 167 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 21 7. Number of persons referred to affiliated hospital for consultation 8. Number of consultations with medical practitioners at the homes of patients—Insured 18 Uninsured 5 9. Number of other visits paid by Tuberculosis Officers to the homes of patients 287 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 6,008 11. Number of specimens of sputum examined in connection with the work of the Dispensary 299 SECTION 4. CAUSES OF SICKNESS. There was no special cause of sickness during the year other than Measles, Diphtheria and Scarlet Fever, particulars of which are contained in Section 3 ; in fact, the year has been remarkable as regards Diarrhoea, there having been only 29 cases notified with no resultant deaths. SECTION 5. SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. Professional Nursing in the Home. (a) General. No provision is made by the Council. (b) For Infectious Diseases. Arrangements are made with the Ranyard Nurses for nursing selected cases of Measles, Ophthalmia Neonatorum, Influenza, Dysentery, Epidemic Diarrhoea, Malaria and Pneumonia. The Council contributes annually towards the funds of the Society, and Health Visitors also give advice and assist as far as possible. Midwives.—No midwives are employed or subsidised by the Council. There are 14 practising in the district. 41 Clinics and Treatment Centres. Name. Situation. Nature of Accommodation. By whom provided. Period when held. Maternity and Child Welfare Centres. Borough Hall, Royal Hill, Greenwich. 1 large waiting room. 1 large weighing room. 1 Consulting room. Local Authority. Twice weekly. (a) Infant Consultations Conduit House. Trafalgar Rd., Greenwich. Ditto. (Portion used for Day Nursery Purposes) Ditto. Twice weekly. 105, Shooter's Hill Road. Blackheath. Ground floor consisting of large waiting room, large weighing room and consulting room. Ditto. Once weekly. Albany Institute, Creek Road. Deptford. Large hall and consulting room. Ditto. Ditto. (b) Pre- Maternity. Borough Hall. (See above). Ditto. Twice weekly. (c) Minor Ailments. Borough Hall. 1 large room. Ditto. Daily. Day Nurseries Conduit House 1 large Ward, Playroom, Bathroom, Matron's Offices and Residential Accommodation. Ditto Daily. Nursery School. Rachel McMillan Memorial School, 233, Church Street Deptford, S.E. Extensive. Miss Margaret McMillan. Daily. School Clinics. Park Row, Greenwich. Whole House. Local Medical Practitioners. Daily. Ditto. Health Clinic, Deptford Green, S.E. Several rooms. Miss Margaret McMillan. Daily. Tuberculosis. Dispensary, 7a, Maze Hill, Greenwich. Consulting Room and Dentist's Surgery. Separate Waiting and Cloak Rooms for Men and Women Patients, Nurses' Room and Dispenser's Room. Local Authority. Daily Venereal Diseases. Miller General Hospital, Greenwich Rd. — — Daily. Seamen's Hospital, Greenwich. — — Thrice weekly. 42 Hospitals Provided or Subsidised by Local Authority. (1) Tuberculosis.—Sanatoria provided by London County Council. (2) Maternity.—Maternity Home, 78, Shooters Hill Road, Blackheath, S.E.3, provided by the Council. Accommodation comprises :— (1) Receiving Ward. (2) General Ward with 10 beds. (3) Small Ward with 2 beds. (4) Single Ward with 1 bed. (5) Isolation Ward. (6) Labour Ward. (7) Medical Officer's Room, Laundry, etc., together with residential accommodation for Matron, Nurses, Probationers and Domestic Staff. (3) Children.—None provided by Council but arrangements made with Deptford Fund for Greenwich Children and Grant made by the Council for this purpose. (4) Fever and (5) Small Pox.—Cases of Infectious Disease are treated at the Hospitals of the Metropolitan Asylums Board whose Brook Hospital is situate at Shooters Hill Road, Blackheath. Institutional Provision for Unmarried Mothers, Illegitimate Infants, and Homeless Children. No provision is made by the Council, but assistance is given to the Deptford Fund towards the upkeep of their Shaftesbury House refuge. Ambulance Facilities. (а) Patients suffering from Infectious Diseases are con- veyed to Hospital by the ambulances of the Metropolitan Asylums Board. (b) For Non-Infectious and Accident cases. No provision by the Council. Facilities afforded by the ambulances of the London County Couucil and certain local Hospitals. 43 HOSPITAL AND OTHER FORMS OF GRATUITOUS MEDICAL RELIEF. The Seamen's Hospital have admitted, treated and maintained 270 Greenwich persons for an average of thirty days each, in addition to which there have been 1,920 Out-patients, making altogether 5,760 attendances of persons belonging to the Borough of Greenwich. Miller General Hospital admitted, treated and maintained 382 Greenwich persons for an average of twenty-two days. 6,620 Out-patients have also been treated, the total attendances being approximately 30,000. Blackheath and Charlton Cottage Hospital admitted 140 In-patients from Greenwich, and treated about 120 casualties, making about 1,080 attendances for this purpose. POOR-LAW RELIEF. I am indebted to the Clerks of the Greenwich and Woolwich Boards of Guardians for the following figures for the year ended 31st December, 1922 :— Greenwich Charlton and Parish. Kidbrooke Parish. Total amount expended in out-door relief £76,969 £18,400 Total number of persons treated in Hospital 879 125 Total number of persons treated medically in their own homes 658 393 Total number of persons admitted to the Workhouse 544 27 Note.—Figures are unobtainable as regards St. Nicholas, Deptford Parish 44 SECTION 6. LABORATORY 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 pathological and bacteriological work for this Department, other than under the Sale of Food and Drugs Act, and in this connection 3,232 specimens have been examined for Diphtheria, 4 for Typhoid Fever, 439 for Tuberculosis, and 21 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. Ninety tubes of Diphtheria Antitoxin, containing a total of 180,000 units of serum, have been supplied during the year to Medical Practitioners for the treatment of patients suffering from this disease. List of Adoptive Acts, By-Laws and Local Regulations Relating to the Public Health, in Foece in the District, with Date of Adoption. By-Laws made under Public Health (London) Act, 1891, Sec. 16 (1). By-Laws made under Public Health (London) Act, 1891, Sec. 16 (2). By-Laws made under Public Health (London) Act, 1891, Sec. 39 (1). By-Laws made under Public Health (London) Act, 1891, Sec. 39 (2). By-Laws made under Public Health (London) Act, 1891, Sec. 50. By-Laws made under Public Health (London) Act, 1891, Sec. 94. By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Plans). By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Drainage). By-Laws made under London County Council (General Powers) Act, 1903, Sec. 54. Provisions of L.C.C. (General Powers) Act, 1902, as to Ice Creams. Regulations under Dairies, Cowsheds and Milkshops Orders, 1885 and 1886. Further particulars are given under Powers and Duties of the Public Health Committee on page 1. 45 SECTION 7. SANITARY ADMINISTRATION. The tables on pages 46 to 48 and 53 to 60 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 16,711 houses and premises have been inspected or re-inspected during the year ; 1,521 intimation notices and 222 statutory notices have been served. It was found necessary to institute Police Court proceedings in twelve cases during the year, particulars of which are contained in the table on page 58. There were altogether throughout the year 658 complaints registered. Factories, Workshops and Workplaces.—Two hundred and twelve inspections have been paid to these premises within the Borough during the year. There were 197 workshop promises on the Register at the beginning of the year, 9 have been added and 31 taken off, leaving a total now on the Register of 175. This total includes 8 laundries, 14 dressmaking and mantle works, 7 fuel and firewood works, 3 cycle works, 2 milliners, and various others, including workplaces, such as 4 blacksmiths, 14 barge builders 4 builders' yards, etc. Included in the Returns relating to Inspections, Defects found, etc., on page 46, was an instance of a Firm having premises on the River Bank, such premises being a Workplace without proper sanitary accommodation. The matter was reported to the Public Health Committee and instructions were given for proceedings to be taken out against the occupiers. In the meantime the Firm withdrew their work from the wharf and carried it on a barge on the River Thames. The matter was accordingly reported to the Medical Officer of Health of the Port of London Sanitary Authority for necessary action. Outworkers' Register.—Fourteen lists, containing 73 names have been received from employers within the district. One hundred and fifty-eight visits of inspection have been paid to these premises. 46 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 51 17 .. Workshops (Including Workshop Laundries) 49 11 .. Workplaces (Other than Outworkers' Premises) 112 12 .. Total 212 40 2.—DEFECTS FOUND. Particulars. Number of Detects. Number of Prosecut's. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:- Want of Cleanliness 40 40 .. .. Want of Ven-tilation .. .. .. .. Overcrowding .. .. .. .. Want of Drainage of Floors 3 3 .. .. Other Nuisances 12 12 .. .. Sanitary Accommodation— Insufficient 6 5 .. .. Unsuitable or Defective 15 15 .. .. Not Separate for Sexes .. .. .. .. Offences under the Factory and Workshops Act: — Illegal Occupation of Underground Bakehouse (s. 101) .. .. .. .. Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) 19 19 .. .. Other Offences .. .. .. .. Total 95 94 .. .. * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 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 occupiersasto keeping or sending lists. Prosecutions. Instances. i 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. 14 20 25 .. .. .. .. .. .. .. .. .. .. .. .. (2) Cleaning & Washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, Lace Curtains & Nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. Fur Pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas .. .. .. 1 .. • •.. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cotton and Kit Bags .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. Brush Making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Box Making •• .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rackets and Tennis Balls .. .. .. 1 .. 26 .. .. .. .. .. .. .. .. .. Stuffed Toys Totals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14 20 25 2 — 26 — — — — — — — — — 47 48 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1922. No Bakehouses 37 Factory Bakehouses 5 Barge Builders 14 Blacksmiths 4 Boot and Shoe Makers 7 Builders' Yards 4 Carpenters and Joiners 2 Carriage Builders 2 Coopers 4 Cycle Works 3 Dress and Mantle Makers 14 Fuel Works 7 Laundries 8 Milliners 2 Photographers 3 Picture Frame Makers 1 Printers 1 Tailors 5 Underclothing Makers 1 Others 51 175 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 2 Reports (of action taken) sent to H.M. Inspectors 2 Other — Underground Bakehouses (sec. 101) :— In use at the end of 1922 13 Customs and Inland Revenue Acts.—No applications were received during the year for certificates under these Acts. Scavenging.—The up-to-date refuse destructor on the selective principle, which was foreshadowed in last year's Report, and which has been under consideration throughout the whole of the year, has, however, not yet materialised, and the objectionable practice of dumping refuse on low-lying marsh land in the Borough has continued. This practice on the part of the Council has materially tied our hands in dealing with similar objectionable practices carried out by private individuals, and towards the end of the year the state of popular feeling on this matter in the affected neighbourhood became so great that a private individual 49 took proceedings against the person responsible for one of these dumps and obtained an abatement order. Your officers were subpœnead to give evidence in this case, and as was only to be expected, uncomplimentary remarks were made respecting the continuance of this practice by the Greenwich Borough Council on adjoining land. On this matter being again reported to the appropriate Committee, steps were at once taken by that Committee to discontinue tipping objectionable material. In this way one of the chief causes of complaint has been abated. Unfortunately, private owners in some cases have not been so careful, and it became necessary in the early part of this current year to take further Police Court proceedings against some of these private owners for their default in this respect. The Ministry of Health have issued suggestive precautions for use in connection with these tips, but when these suggestions were brought to the notice of this Council, it was realised that to carry them out would practically entail as much expense as would be occasioned by giving up the tip altogether and otherwise dealing with the refuse. 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. Three hundred and thirty-seven 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.—As mentioned in my Report last year, the thorough supervision of this class of property will not be possible until the new London County Council By-Laws come into force. Rats and Mice (Destruction) Act, 1919. 291 investigations were made by the Council's Rats Officer, but only in one case was it found necessary to serve a notice. In my opinion this indicates that occupiers generally are more sympathetically disposed towards the Act and conduct the destruction of these pests in a systematic and prompt manner. 50 This fact was confirmed during the enquiries carried out in connection with the Annual Rat Week, which was held the week commencing 6th November, and in many instances Firms wrote asking for further advice. Another noticeable feature was the marked diminution of complaints received during the year. Increase of Rent and 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. Twenty-seven such applications for certificates were received. Twenty-two certificates were granted ; in the remaining 5 cases the 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.—Sixteen observations have been made for smoke nuisances during the year, but in no instance was it found necessary to serve a Statutory Notice. The final Report of the Committee on Smoke and Noxious Vapours Abatement, has been considered by the Public Health Committee, and it was felt that as much was being done under the present enactments as it was possible to accomplish, for by far the greater amount of nuisance at present existing of this character was due to smoke not entirely black, and until the law is altered to include smoke of other than this character, nothing can be done to deal with the matter. This defect has been brought to the notice of the London County Council and the Ministry of Health from time to time, but up to the present nothing has been done to assist Local Authorities in this respect. We continue to receive from time to time complaints of alleged nuisances of this character forwarded to us by the London County Council, but I regret to have to state that in my opinion there must be some different form of colour vision in use to substantiate some of these complaints, for in one case at least, I am positively assured that it is a physical impossibility to obtain black smoke, yet from time to time we continue to receive complaints respecting alleged 51 nuisance from black smoke from this factory chimney. Also the chimneys belonging to the London County Council's Electricity Generating Station need our continual care and supervision in this district as from time to time they emit quantities of smoke which is on the border line of being black in character, and also we have numerous complaints about the emission of smuts and grit from these chimney shafts. I may say that our communications to the Engineer in charge of this matter are always received with due respect, and I believe that steps are taken on receipt of such communications to deal with the matter at the moment. House Drainage.—Five drains have been constructed, 173 drainage systems have been reconstructed or repaired ; 290 such systems have also been opened, cleansed and amended ; 77 surface drains have been constructed ; 92 drains and soil pipes have been ventilated; 360 systems have been tested by smoke, 326 by water, of which number 123 were found to be defective ; 35 new soil pipes and 253 traps have been fixed, together with 56 intercepting chambers and fresh-air inlets, and 76 other chambers. Ventilation has been improved in 260 cases. Forty-one new covers to manholes have been provided. Twentythree systems have been sealed off or slurried up. Twenty-six forecourts, 13 areas, 67 yards, 8 mews and stables drained ; 4 cesspools abolished ; 20 water-closets have been erected ; 162 cleansed and repaired ; 67 w.c. doors and seats repaired or provided. A pan, trap and water supply have been furnished throughout in 46 cases ; pan and traps only furnished in 216 cases ; pans only in 17 cases, and other fittings provided or improved in 437 cases, whilst the water supply has been renewed in 71 instances. Public-house urinals have been cleansed and repaired in 10 instances ; 11 urinals were altered, 20 repaired or water laid on, and 6 constructed. The Council has again seriously considered the state of the law in regard to liability for the repair or reconstruction of drains. Recommendations were forwarded to the London County Council asking them to insert a clause in their next General Powers Bill placing the liability upon owners of property for the cost of repairing or renewing drainage systems up to the point of connection with the public sewer. The London County Council in their reply pointed out that they had endeavoured on many occasions to promote legislation on this subject, but without success, and suggested the Metropolitan Borough Couucils should approach the Ministry of Health with a view to the promotion of legislation by public Bill. A communication was accordingly forwarded to the Ministry of Health on these lines, but no further action has resulted. 52 In this connection attention has been drawn to the fact that in the adjoining Borough of Woolwich the difficulty is alleged to have been met by the following Section contained in the Woolwich Borough Council Act of 1905, viz. :— In the application to the Parish of Woolwich of the provisions of the Metropolis Management Acts 1855 to 1893 and other enactments applying to London and notwithstanding anything contained therein or in any Act of Parliament in force within any part of the said Parish prior to the first day of November, One Thousand nine hundred, the word ' drain ' shall include any drain constructed before the said first day of November, One thousand nine hundred, and draining any group or block of houses by a combined operation, and the word ' sewer ' as defined by Section 250 of the Metropolis Management Act, 1855, shall not mean or include any such drain." This Council thereupon decided again to approach the London County Council with a view to their including in their next General Powers Bill, a clause similar in effect to that quoted above. Water Supply.—During the year 237 water supply certificates have been granted under Section 48 of the Public Health (London) Act 1891, This number includes 232 houses comprising the Council's Housing Estate at Charlton. Defective water fittings have been remedied in 41 cases ; 41 water supplies have been reinstated where the supply had been cut off; water fittings have been amended in 136 cases ; 4 water supplies have been altered so as to draw direct from the main ; water supply provided in 2 instances, and cleansing, repairing and covering cisterns in 12 cases. 53 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1922. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Inspections. Houses Inspected 699 547 645 559 2450 Other Premises Inspected 75 38 77 73 263 Re-inspections Calls Made, etc. 3627 2646 2643 2722 11,638 Inspections of Houses Let in Lodgings 35 38 20 22 115 „ Bakehouses 10 42 3 34 89 „ Factories and Workshops 9 15 39 102 165 „ Outworkers' Premises 44 34 32 48 158 „ Slaughterhouses 10 7 7 13 37 „ Cowhouses 3 1 I 4 9 „ Stables and Yards 18 13 14 21 66 „ Piggeries 1 2 1 1 5 „ Courts and Alleys 23 5 4 — 32 ,, Fields, Lanes, etc. 17 49 9 6 81 Investigations (Rats and Mice) 86 55 83 67 291 Inspections of Urinals 23 6 2 9 40 „ Gipsy Vans .. .. .. .. .. ,, Horse Slaughterhouses 2 1 3 „ Dairies, Cowsheds and Milkshops 5 64 17 42 128 „ Soapboilers .. .. .. 1 1 „ Other Offensive Trades .. .. .. .. .. Ice Cream places 1 165 17 1 184 „ Other places where food is prepared 127 253 264 288 932 „ Premises (Children Act, 1908) 3 12 3 6 24 Total 4816 3992 3883 4020 16,711 Drains. Constructed .. 3 1 1 5 Intercepting Chamber, and Fresh Air Inlet 23 15 9 9 56 Other Chambers Constructed 29 13 20 14 76 Reconstructed or Repaired 68 36 35 34 173 Opened, Cleansed, and Amended 97 53 69 71 290 Surface Drains Constructed 13 17 11 36 77 Traps Fixed 79 41 58 75 253 New Soil Pipes 10 6 10 9 35 Soil and Vent Shafts Repaired 11 4 8 9 32 Drains and Soil Pipes Ventilated 37 17 11 27 92 Drains Sealed off, etc. 8 4 4 7 23 Anti-Siphonage Provided 3 .. .. .. 3 Clearing Eye provided .. .. .. 4 4 Drains tested—by Smoke 148 57 81 74 360 „ by Water 123 43 75 85 326 Found Defective 45 32 21 25 123 New Covers to Manholes 15 4 12 10 41 Yards Drained 36 11 3 17 67 54 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Mews and Stables Drained 3 .. 4 1 8 Washhouses Drained 1 1 .. .. 2 Forecourts Drained 10 7 .. 9 26 Areas Drained 5 .. 4 4 13 Cesspools abolished 4 .. .. .. 4 Privies and Earth Closets abolished .. .. •• .. .. Water Closets and Urinals. Closets erected 6 6 4 4 20 W.C. doors and seats repaired or provided 12 14 20 21 67 Sanitary Conveniences or Improvement effected to Factories and Workshops .. 3 7 14 24 Pan, Traps and Water Supply furnished 7 11 15 13 46 Pans and Traps only furnished 83 34 44 55 216 Pans only furnished 7 1 6 3 17 Water Supply Apparatus repaired or provided 49 199 104 85 437 Water Supply renewed 36 13 8 14 71 Water Supply disconnected from Drinking Water Cistern .. .. .. .. .. Soil Pans properly trapped 2 1 .. .. 3 Cleansed and Repaired 25 41 46 51 163 Newly constructed or bettor situated 19 10 54 6 89 Ventilation improved 6 146 60 48 260 Public-house Urinals cleansed or repaired 1 5 1 3 10 Other Urinals altered or cleansed 1 2 1 7 11 Other Urinals constructed 1 .. 2 3 6 Repaired or water laid on 1 10 9 .. 20 Ashpits. Provided 106 73 73 85 337 Covers to receptacles 1 .. 1 2 4 Dust complaints forwarded to the Surveyor .. .. .. .. .. Pavings. Yards 101 79 77 81 338 Forecourts 7 7 4 20 38 Areas 4 1 .. 5 10 Washhouses 8 12 7 13 40 Mews and Stables 1 .. 6 2 9 General Water Supply. Covers to Cisterns adapted 141 52 42 235 Water Supply provided 2 .. .. .. 2 Water Fittings amended 44 19 30 43 136 Cisterns cleansed and repaired 10 2 12 Water Services altered so as to draw direct from main 3 1 .. .. 4 55 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Water Supplies reinstated where cut off through defective fittings 8 5 15 13 41 Defective Water Fittings (causing nuisance from dampness) repaired 12 13 6 10 41 Water Supply Certificates granted (Section 48) 3 141 52 41 237 Other Improvements. Houses generally repaired 118 190 134 133 575 Premises cleansed, lime-washed and repaired 73 77 37 46 233 Verminous Rooms cleansed 33 110 101 42 286 Ventilation improved 52 55 48 40 195 Staircases amended, lighted and ventilated 1 20 23 19 63 Leaky House Roofs and Gutters repaired 155 159 160 137 611 Walls and Ceilings of Premises cleansed throughout 24 36 45 39 144 Ditto ditto partially 144 198 164 164 670 Stoves and Fireplaces repaired 35 38 34 45 152 Washing Coppers repaired 23 32 39 25 119 Sinks provided 5 9 8 16 38 Floors and doors repaired 49 75 90 66 280 Cowhouses cleansed .. 1 1 3 5 Horse Slaughterhouses cleansed .. .. .. .. .. Ice Cream places cleansed or improved .. 12 .. .. 12 Other places where food is stored or prepared .. 26 21 29 76 Provision for Storage of Food 6 9 7 3 25 Other Nuisances Abated. Illegal use of Underground Room discontinued .. 2 .. .. 2 Overcrowdings abated 1 1 3 3 8 Sink, Lavatory and Bath Waste Pipes disconnected, trapped and amended 42 52 40 44 178 Stack Pipes disconnected and amended 36 108 47 29 220 Nuisances from dampness abated 54 52 41 45 192 Animals Kept in Unfit Places discontinued or removed 3 6 6 7 22 Dung Receptacles provided .. .. 3 .. 3 Bakehouse Nuisances abated 7 27 .. 1 35 Houses abolished, unfit for habitation .. .. .. .. .. Accumulations of Manure and other obnoxious matter removed 19 17 7 14 57 Dampness of Walls remedied 35 34 45 44 158 Inundations abated .. .. 1 1 1 Other Nuisances, principally of dilapidations and want of underfloor ventilation 57 72 52 41 222 56 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Contents of Rooms cleansed (i 8 6 2 22 Breaches of By-Laws abated. . 2 2 Bat Infestation abated 13 11 17 11 52 Smoke Nuisances. Observations 3 6 7 16 Statutory Notices served (Sections 23 and 24) Food and Dunns. Samples taken 127 86 128 83 424 Found Adulterated 6 3 1 3 13 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Unwholesome Food. Seizures made — — — — 5 tons, 2 cwts., 100 lbs. of beef. 10 cwt. of Potatoes. ½ cwt. of skate. 2 qrs. of currants. 11 lbs. of dripping. 1 cwt., 2 qrs. of winkles. 166 lbs. of rice. Voluntarily surrendered 435 lbs. of wheat. 4 cwt. of currants. 32 tons, 3 cwts. of dates. 14 cwt. of tomatoes. 2 bushels of apples. 4 forequarters of beef. 10 tons, 18 cwts., 2 qr., 24 lbs. of dates. 57 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Notices, Etc. Intimations served under Public Health (London) Act, 1891 (Section 3) 420 316 318 306 1360 Notices served— Under Housing, Town Planning, etc., Act, 1919 16 44 58 42 160 Rats and Mice (Destruction) Act, 1919 .. 1 .. .. 1 re Verminous Rooms 1 3 1 2 7 Under P.H. (L.) Act and Metropolis Management Act (re combined drainage) 9 18 16 3 46 W.C.'s (Factories, Workshops and Workplaces) .. .. .. .. .. Yards 2 1 .. 1 4 Statutory Notices served under Section 4 50 21 37 30 138 Statutory Notices re Ashpit provision 9 8 3 7 27 Complaints received and attended to 168 162 173 155 658 Letters written relating to abatement of Nuisances 121 141 150 126 538 Summonses applied for and issued 6 2 4 1 13 Magisterial Orders obtained and enforced 4 1 4 1 10 Drainage Plans received and examined 36 23 20 22 101 58 Legal Proceedings under the Public Health (London) Act, 1891, and By-Laws during the year 1922. Premises. Complaint. Result of Proceedings. Fine. Costs. Wilson's Temperance Brewery, Eastney Street. Non-deposit of Drainage Plans. Withdrawn (Plans deposited). — 2/- 19, Swallowfield Road. Non-compliance with Statutory Notice. Withdrawn (Work done). — 5/- 1, Floyd Road Non-compliance with Abatement Order. Order to abate within 14 days. 10/- — 13, Ditto. ditto. ditto. 10/- — 15, Ditto. ditto. ditto. 10/- — 36, Ditto. Illegal Occupatioi of Underground Room. Premises vacated. — 5/- 41, Ruthin Road. Non-compliance with Statutory Notice. Order to abate within 14 days. — 5/- 137, Shooters Hill Road. ditto. ditto 28 days. — 21/- 1, Floyd Road. ditto. ditto 14 days. — 7/6 9, Ditto. ditto. ditto. — 7/6 11, Ditto. ditto. ditto. — 7/6 13, Ditto. ditto. ditto. — 7/6 59 BOROUGH OF GREENWICH. Proceeding during 1922 Premises. Number of Places. Number of Inspections, 1922. Number of Notices, 1922. Number of Prosecutions, 1922. On Register at end of 1921. Added in 1922. Removed in 1922. On Register at end of 1922. Dairies, Cowsheds and Milkshops 89 19 18 90 127 19 — Slaughterhouses 5 — — 5 22 — — Other Offensive Trade Pre mises — — — — — — — Ice Cream Premises 82 62 23 121 137 10 — Registered Houses Let in Lodgings 247 — — 247 115 — — Total number of Intimation Notices served for all purposes 1550 Overcrowding, 1922— Number of Dwelling-rooms overcrowded 8 Number remedied 8 Number of Prosecutions — Underground Rooms— Illegal occupations dealt with during year 2 Number of Rooms Closed 2 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 286 Number of Cleansing Baths given under Cleansing of Persons Act 11 Shelter provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — 60 Number of Tenement Houses provided with Additional Water Supply 2 Number of Prosecutions ditto — Inland Revenue Acts— Number of Houses for which applications were received during the year — Number of Tenements comprised therein. — Number of Tenements for which certificates were granted — Number of Prosecutions under By-Laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive 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. — (f) 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 — (j) 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 179 Total number of infectious bodies removed 1 180 LEGAL PROCEEDINGS, 1922. Apart from the proceedings under the Sale of Food and Drugs Act, it became necessary to take Police Court proceedings in 12 cases. 61 FOOD. Cowhouses.—The four cowhouses in the Borough have been visited on 9 occasions, and the required cleansing has been duly enforced on 5 occasions. Dairies, Cowsheds and Milkshops Order.—At the commencement of the year there were 89 premises on the Register of Dairies and Milkshops ; 19 new applications have been received during the year and added to the Register, and 18 names have been taken off, thus leaving a total of 90 premises now registered. During the year 127 visits of inspection have been paid to these premises ; notices were served upon the occupiers in 19 cases where dairies required limewashing. No registration was refused on the ground of unsuitability of the premises. Milk Supply.—The majority of milk supplied to this Borough is obtained from farmers and large firms outside the district. During the year the following legislation has been passed :— The Milk and Dairies (Amendment) Act, 1922. The Milk (Special Designations) Order, 1922. The Milk (Special Designations) Amendment Order, 1922 The Milk and Dairies (Amendment) Act, 1922, provides for the postponement until 1st September, 1925, the operation of the Milk and Dairies (Consolidation) Act, 1915. The Act also enacts that separate registers shall be kept, one for retail purveyors of milk and the other for other persons who are registered. Power is also given to local authorities to refuse or remove the name of anyone from the register. This Council, in common with other Metropolitan Boroughs, has, however, been enabled to do this for many years under the powers conferred by the London County Council (General Powers) Act, 1908, Section 5. The Milk (Special Designations) Order, 1922, prescribe the conditions under which licenses may be granted for the sale of milk as " Certified," " Grade A (Tuberculin Tested)," " Grade A" or " Pasteurised." The Ministry of Health will for the present issue licenses to producers, whilst Sanitary Authorities will grant licenses to distributors. The Order also specifies the amount of fees payable for such licenses. The Milk (Special Designations) Amendment Order, 1922, relaxes for a period of six months the conditions under which licenses may be granted for the sale of milk as " Pasteurised." 62 In my opinion more serious attempts ought to be made to improve the general milk supply and not merely improve special qualities as the system of improvement above outlined under these recent Milk Orders appears to have as its end result a considerable depreciation of the general supply, for whilst milk containing the germ of tuberculosis and above a certain number of bacilli coli communis is to be excluded from these special sorts of milk yet it is quite allowable for the same to be still in the general supply. It is feared that the general public do not sufficiently realise that the bacillus coli communis is the bacillus found in excrement, manure, etc. Henoe, whenever this term is made use of, to those who know it connotes " excremental contamination," and the sooner, in my opinion, the general public begin to realise this fact, the better it will be. It has been repeatedly pointed out that until the law is altered so as to compel the milk vendor to guarantee tubercle-free milk, so long shall we have the human deaths from bovine tubercle infection. The present position is that milk, which is a food necessary to infants and invalids, may contain living cultures of the most insidious and terrible poison extent. The Medical Officer of Health for the City of London recently found to be tuberculous one in four samples of milk purchased in the City, and it is estimated that over 6 per cent, of all deaths from tuberculosis are due to drinking tuberculous milk, or approximately 3,000 deaths annually in England and Wales. Obviously it should be compulsory to test milking cows and segregate or destroy those found infected. This would greatly reduce the risk of infection and probably abolish, indirectly, many other ailments which gain their foothold when the powers of resistance are depleted. It would almost appear that the compensation which would be necessary under such a Scheme is allowed to stand in the way of human lives and health. Professor Frederick Hobday, C.M.G., F.R.C.V.S., F.R.S.E., formerly Professor to the Royal Veterinary College, London, and Honorary Veterinary Surgeon to H.M. the King, in an address given bv him before the British Medical Association, makes the following statement, on this subject, which I think is well worth the consideration of the general public :— " Given a free hand, we of the veterinary profession could stamp out tuberculosis of cattle in the same way as we have stamped out glanders and rabies. It would take time and would cost money, but the saving of the suffering and misery 63 entailed by the loss of 10,000 human lives annually would more than counterbalance that, and surely should weigh down the right-side scalepan. Money ought not to count where human life is at stake. Having done our part, it would then rest with us to see that this bovine scourge never again got the upper hand and was relegated to the same position which is now held by glanders and rabies. By doing so we should have again proved the value of having worked together, as opposed to the plan of separate and watertight compartments." A much discussed circular of the Ministry of Health (No. 325) has been issued and, in my opinion, this circular is undoubtedly a retrograde step, which fortunately has been cured during this current year by the withdrawal of the circular itself. 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 were 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 limited extent. Milk (Mothers and Children) Order, 1919.—During the year 62,215 lbs. of dried milk of various kinds have been supplied under these Orders to mothers and children attending our Infant Consultation Centres. 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 voluntarily surrendered and destroyed :— 4 forequarters of beef ; 100 lbs. of beef. Slaughterhouses.—The number of Slaughterhouses in use in the Borough are as under:— In 1914. In January, 1922. In December, 1922. Registered — — — Licensed 4 4 4 4 4 4 Thirty-seven inspections were made by the Inspectors during the year. 64 Other Foods.—Places where food is prepared have been visited on 155 occasions, improvements being required in 44 instances as detailed below:— Class of Premises. Number of Lists. Number of Inspections. Number of instances where matters needed attention. At end of 1921. Added 1922. Removed 1922. At end of 1922. Hotel Kitchens 4 1 — 5 5 1 Eating Houses 49 7 6 50 51 24 Fried-Fish Shops 26 6 5 27 34 11 Pork Butchers 22 1 — 23 24 5 Mineral Water Manufacturers 1 — — 1 3 — Ice do. 2 — — 2 2 — Sausage do. 22 — — 22 22 3 Others 13 1 — 14 14 — Totals 139 16 11 144 155 44 The 44 instances where matters needed attention included cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 5 where the sanitary arrangements were defective and 8 for want of ashpit. An Inspector is 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 11 tons, 11 cwt., 2 qrs., 4 lbs. of preserved meat and 11½ tons corned beef in 61b. tins have been so released. In each case the Medical Officer of Health of the district to which such consignments have been forwarded has been advised of the matter. 65 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 addition to the meat already referred to, particulars of which are set out on page 63. Ice Cream Premises.—There were 82 premises known at the commencement of the year where the manufacture of this commodity was carried on ; 62 have been added during the year and 23 taken off, leaving a total of 121 premises. These premises were inspected on 137 occasions, improvement required by way of cleansing of the premises in 7 cases, and insanitary conditions remedied in 3 instances. Bakehouses.—Eighty-nine inspections have been made of the various Bakehouses in the Borough, 41 nuisances found therein have been abated, whilst in 1 instance the premises were closed owing to defective condition. At the end of the year there were 5 Factory and 37 other Bakehouses on the Register, 13 of which are underground. Food and Drugs Acts.—Four hundred and twenty-four samples have been purchased under the provisions of the Sale of Food and Drugs Acts and submitted to the Public Analyst for analysis, of which 411 were certified to be genuine and 13 adulterated, the adulterations thus being equivalent to 3.16 per cent. of the samples taken. Of the total number of samples purchased, 131 were milk, of which 4 were certified to be adulterated ; the remaining adulterated samples were 3 of vinegar, 2 of dripping, 2 of rice, 1 of zinc ointment, and 1 of medicine. Proceedings were taken in 4 cases, resulting in costs being imposed in 1 instance. The remaining three cases were dismissed, one on account of warranty proved, one owing to the withdrawal of Part 5 of the Food Order, 1921, and the other the summons was withdrawn. A warning letter was sent in 9 cases. 66 Sale of Food and Drugs Acts. Administrative Action regarding Sample reported to be NOT GENUINE. No. of Sample. Description of Sample. Nature of Adulterat on. Result of Proceedings. 69 Milk. Deficient in fat to the extent of 10 per cent. Case dismissed. Warranty proved. 81 Do. Admixed with 2 per cent. of water. Warning Letter. 178 Do. do. 2•5 do. do. 375 Do. do. 5 do. do. 21 Vinegar. Deficient in acetic acid to the extent of 1•5 per cent. do. 91 Do. Deficient in acetic acid to the extent of 6•5 per cent. do. 385 Do. do. 1•5 per cent. do. 19 Dripping. Contained 2•5 per cent. of free fatty acids. do. 38 Do. Contained 3•3 per cent. of free fatty acids. Warranty and Withdrawal of Food Order, 1921 (Part 5). 328 Rice. Contained 0•63 per cent. of extraneous mineral matter. Warning Letter. 419 Do. do. do. 174 Medicine. Contained an excess of Potassium Ioxide amounting to •510 per cent. Summons Withdrawn owing to technical irregu larity. 156 Zinc Ointment. Deficient in Zinc Oxide to the extent of 14 per cent. Costs, 27s. 67 Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1922. Description of Samples. Number of Samples Purchased. Number Genuine. Number Not Genuine. Baking Powder 13 13 — Boric Ointment 4 4 — Butter 105 105 — Camphorated Oil 3 3 — Castor Oil 1 1 — Dripping 15 13 2 Glycerine 2 2 — Medicine 9 8 1 Milk 131 127 4 Olive Oil 2 2 — Pearl Barley 26 26 — Rice 36 34 2 Self-Raising Flour 1 1 — Sulphur Ointment 3 3 — White Precipitate Ointment 2 2 — Vinegar 69 66 3 Zinc Ointment 2 1 1 Total 424 411 13 DISINFECTION. During the year under review the Council has given careful consideration to the question of the provision of a new Disinfection Station in lieu of the existing premises, the tenancy for which expires in January, 1923. These premises have now been in use for 30 years and are in a very unsatisfactory condition. The Council finally decided to erect new buildings at the Tunnel Avenue Depot to include also baths and a cleansing station for verminous persons and children. It is hoped to utilise the present disinfecting apparatus. In July, Tenders were invited to carry out the necessary works, and the tender of the National Building Guild, Ltd. (London Regional Council) was accepted for the sum of £2,150. At the end of the year the works were still in course of construction. The following tables summarise the work carried out by the Disinfecting Staff during the year :— 68 Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 52 weeks ended 30th December, 1922. Infectious Diseases. Premises Entered. Rooms. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. Quilts. Odd Articles. Total No. Articles Disinfected. Polio-Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 502 691 336 6 208 284 807 906 82 60 258 615 3562 Diphtheria 503 642 273 .. 111 183 556 499 48 41 140 78 1929 Enteric Fever 4 4 2 .. 3 3 6 7 1 .. 1 .. 23 Puerperal Fever 4 4 2 .. 3 4 10 12 4 .. 6 17 58 Tuberculosis 96 134 44 2 20 28 116 45 6 16 26 19 322 Other Diseases 41 56 26 4 114 36 187 167 24 16 10 156 740 Measles 6 7 .. .. 2 1 1 3 .. .. .. .. 7 From Verminous Premises 6 6 4 1 4 3 2 12 1 .. 3 12 42 Scabies 5 8 2 .. 2 1 6 7 .. .. 2 .. 20 Influenza and Pneumonia 7 12 4 1 5 5 16 6 1 .. 3 .. 41 Cerebro-Spinal Meningitis 2 3 .. .. .. .. .. .. .. .. .. .. .. Total 1176 1567 693 14 472 548 1707 1664 167 133 449 897 6744 69 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 52 weeks ended 30th December, 1922. Infectious Diseases. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. Quilts. Odd Pieces Total No. Articles Destroyed. Small-pox .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 3 1 2 .. 2 .. .. 3 .. 4 15 Diphtheria .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. Tuberculosis 4 .. 1 .. 3 .. .. .. .. .. 8 Other Diseases 3 2 2 1 3 .. 6 .. 1 46 64 For Verminous Premises. .. 1 .. .. .. .. .. .. .. 24 25 Influenza .. .. .. .. .. .. .. .. .. .. .. Total 10 4 5 1 8 .. 6 3 1 74 112 70 HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made by Infectious Disease Inspector 1,674 Number of Re-visits 3,523 The Health Visitors also visited 1,830 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease :— Central Libraries, 189 ; School Libraries, 18 ; Total, 207. CLEANSING STATION, BLACKWALL LANE. The arrangements made with the London County Council for reserving the use of the Council's Cleansing Station on Mondays and Thursdays for the cleansing of verminous school children continue in operation. The following table shows the number of children cleansed during the year :— 1st quarter 290 2nd „ 227 3rd „ 194 4th „ 246 Total 957 Eleven adults suffering from vermin were also given cleansing baths. In every case the infested clothing was disinfected. 71 SECTION 8. Medical Officer of Health and Administrative Medical Officer,. Tuberculosis, and Maternity and Child Welfare— *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— *V. J. F. Lack, F.R.C.S., B.S. (Lond.), M.R.C.S., L.R.C.P. Public Analyst—†A E. Brown, B.Sc., F.I.C. Bacteriologist—†Arthur Davies, M.D., M.R.C.P. Dentist—†*D. Gilbert, L.D.S., R.C.S. (Eng.). Sanitary Inspectors— *A. E. Bache. Professional Associateship of the Surveyors' Institution. Cert, in Sanitary Knowledge including Meat and Other Foods, Royal Sanitary Institute. First Class Full Technological Honours Cert, and Medallist in Principles of Plumbing, City and Guilds of London Institute. Honours Diploma in the Art of Plumbing, The Worshipful Company of Plumbers. Scholarship Award in Sanitary Science, King's College, London. First Class Advanced Certs. Hygiene and Physiology, Theoretical and Practical Chemistry and Geometry, Science and Art Department. *S. A. Radford. Cert. Royal San. Institute. Cert. Sanitary Inspectors Examination Board. Cert. Royal San. Institute, Meat and Other Foods. *A. E. Morgan. Cert. Sanitary Inspectors Examination Board. Cert. Royal San. Institute, Meat and Other Foods. *W. R. Drake. Cert. Royal Sanitary Institute. Cert. Sanitary Inspectors Association Examination Board. Cert. Sanitary Inspectors Examination Board. *Miss G. Davis. Cert. Royal Sanitary Institute. Cert. Sanitary Inspectors Examination Board. Cert. Hygiene and Physiology (Advanced Stage), Board of Education. L.C.C. Cert, in Hygiene. L.C.C. Teacher's Cert, in First Aid. L.C.C. Teacher's Cert, in Home Nursing. L.C.C. Teacher's Cert, in Infant Care. 72 Infectious Diseases Inspector— *E. Martin. Cert, in Sanitary Knowledge including Meat and Other Foods, Royal Sanitary Institute (London and Provinces). Health Visitors— *Miss M. Molloy. Cert. Royal Sanitary Institute. Cert. R.S.I., Health Visitors and School Nurses. Cert. R.S.I., M. and C.W. Workers. Cert. Central Midwives Board. *Mrs. M. Donald-Morison. Cert. Scotch Intermediate Science Examination, University of Edinburgh. Cert. Royal San. Institute, Health Visitors and School Nurses. Cert. Central Midwives Board. Cert. Hygiene, Battersea Polytechnic. *miss f. c. jagot. Cert. R.S.I., Health Visitors and School Nurses. Cert. Central Midwives Board. Cert. General Nursing Training (3 years). *Miss E. Bailey. Cert. R.S.I., Health Visitors and Tuberculosis Nurses. Cert. Central Midwives Board. Cert. General Nursing Training (3 years). *Miss A. M. M. Hadfield. Cert. R.S.I., Health Visitors and School Nurses. Cert. Central Midwives Board. Cert. General Nursing Training (4 years). *†Miss H. Foley. Cert. R.S.I. Health Visitors and School Nurses. Cert. R.S.I. Maternity and Child Welfare. Cert. Central Midwives Board. Cert. Clapham Maternity Hospital. TUBERCULOSIS DISPENSARY. Nurses— *Miss L Heastman. Hospital Certs, for General Training, Tuberculosis and Maternity. Cert. London District Nurses' Association. Teacher's Cert, for First Aid and Home Nursing. *Mtss T. I. Husbands. Cert. R.S.I., Health Visitors and School Nurses. Cert. Hospital and District Nursing Training (3 years.) Cert. London Chest Hospital Tuberculosis Training. *Miss D. M. Wilkins. Cert. Royal Sanitary Institute. Cert. R.S.I., Health Visitors and School Nurses. Cert. Central Midwives Board. Cert. General Nursing Training (3 years). 73 *§Miss R. Aldis. Cert. Royal Sanitary Institute. Cert. General Nursing Training (3 years). Dispenser— Caretaker— *E. E. Burrows. *Mrs. Vickery. MATERNITY HOME. Matron— *Miss N. G. Beeham. Cert. General Hospital Training (3 years). Cert. Queen Charlotte's Hospital. Cert. Central Midwives Board. CRECHE. Sister-in-Charge— *Miss L. Wright. Hospital Certs, of Full General, Fever and Children's Training. Clerical Staff— *F. W. Foulger (Principal Clerk). H. W. Duck. A. G. Thomas. W. H. Collins. E. P. Tidman (Temporary). Miss L. Merricks. F. Jennings do. *Mrs. L. E. Wright. *Mrs. N. Furbank (Milk Saleswoman) Disinfecting Staff. J. Forrest. A. Clay. F. Mears. T. Packham. F. Stevens (Motor Driver). Caretaker at Cleansing Station— Mrs. E. Robinson. Mortuary Keeper— G. W. Moss. The whole of the Staff of the Department are whole time Officers, with the exception of those marked †. * Contributions made in respect of salaries of above Officers, under Public Health Acts or by Exchequer Grants. § Resigned 31st January, 1923. 74 SECTION 9. HOUSING. As mentioned in the previous Report, a Contract was entered into with the Guild of Builders (London), Ltd., for the erection of 164 houses on the No. 2 Section of the Council's Housing Site at Charlton, and 26 on the East Mascalls Site at Charlton Road. At the commencement of the period covered by this Report, 55 houses had been completed under the Contract, and subsequently and before the 31st December, 1922, the whole of the houses were completed and occupied. Twenty-four further houses were erected in Pound Park Road which, with 18 houses erected in Kinveachy Gardens under the first building Contract and the houses converted into tenements last year, makes a total accommodation up to 31st December, 1922, for 282 families. A further Contract has been entered into with Messrs. Roberts (Birmingham), Ltd., to erect 80 houses on the No. 4 Section of the Council's Housing Site. HOUSING RETURN, 1922. Number of new houses erected during the year :— (a) Total 164 (b) As part of a Municipal Housing Scheme 159 1.—Unfit Dwelling-houses. Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,450 (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 re- ferred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1,739 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 429 75 3.—Action under Statutory Powers. (а) 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 *160 (2) Number of dwelling-houses which were dered fit— (a) By owners 160 (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 * Provisional Notices. (б) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,360 (2) Number of dwelling-houses in which defects were remedied— (a) By owners 1,608 (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 4.—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 of area (2) Acreage Particulars given (3) Number of working-class houses in area in 1921 (4) Number of working-class persons to be Annual Report. displaced 76 5.—Number of houses not complying with the Building By-Laws erected with consent of Local Authority under section 25 of the Housing, Town Planning, etc., Act, 1919 Nil 6.—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 four District Sanitary Inspectors and one lady Sanitary Tnspector SECTION 10. MATERNITY AND CHILD WELFARE. The Council's Maternity and Child Welfare Scheme, as outlined in my Report for the year 1921, has, generally speaking, continued on similar lines during the year under review. In May, however, Miss Buckton, one of the Health Visitors, resigned and, as the Council decided not to fill her place, it was necessary to alter slightly the Health Visitors' Districts. Up to May, 1922, seven Infant Consultations were held weekly, three of which, on Mondays, Tuesdays and Thursdays, took place at the Borough Hall. The vacancy caused by Miss Buckton's resignation necessitated the withdrawal of one of these Consultations, which have since been held as follows:— Health Visitor in Charge. Centre. Day. Remarks. Miss Hadfield. Conduit House Monday Attended also by mothers living in Woolwich Rd. and Northwards. (Miss Bailey's District.) Miss Jagot Borough Hall Tuesday — Mrs. Morison Conduit House Wednesday — Miss Molloy Borough Hall Thursday — Miss Foley Albany Institute Thursday — Miss Bailey Shooters Hill Road Friday — In addition to the above, Ante-Natal Clinics have been held at the Borough Hall on Tuesday and Thursday mornings throughout the year, the attendances showing a slight increase over those for the 77 preceding year. The Pre-Maternity Clinics have already proved a very valuable aid to our work at the Maternity Home, the Medical Officer being in a position to give assurance to the normal case and to take adequate measures to correct any untoward conditions which may be presented in cases not following a normal course. The following figures serve to indicate the continued popularity of our Consultations:— Borough Hall. Conduit House. 105, Shooters Hill Rd. Albany Institute. Total. Attendances 7,899 7,481 4,008 2,830 22,218 New Cases 451 452 263 177 1,343 Medical Consultations 4,212 3,418 1,744 1,418 10,792 Nursing Mothers seen by Doctors 1,590 1,364 664 422 4,040 (The children are weighed and advice given to the Mothers at every attendance.) The Borough Hall figures are somewhat below the 1921 standard but compare favourably when the reduced number of Consultations held is borne in mind. The Ante-Natal Clinic attendances numbered 609. compared with 592 during 1921, cases totalling 271. Creche.—The Municipal Creche at Conduit House continues to be much appreciated by those mothers who, having to go out to work, find it necessary for their young children to be looked after during the day. Babies and young children up to five years of age are cared for from 7 a.m. until 5 p.m. at a charge of 8d. per day, the attendances during the year totalling 2,570. Whilst the number on the books liable to attend from time to time is about the same as last year, yet the number of actual attendances is below last year's figure. This is undoubtedly due to the facts that mothers are unable to spare the charge for the care of the children in the Creche, and also that when they do go out to work and the services of the creche would otherwise be requisitioned, now owing to the unemployment of the father or older children, the young child has to be left at home in their care. It will be a question for the early consideration of the Committee as to whether the continuance of the Creche on its present lines during this period of 78 unemployment is advisable or not. There is no doubt that the children in attendance greatly benefit and the mothers who are able to take advantage of its services much appreciate this help, but the number so attending is admittedly small. 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 122 cases were dealt with, the number of attendances being 339. The following continue their good work in the Borough :— Local Medical Practitioners' School Clinic. Health Centre, Deptford Green. Rachel McMillan Memorial Nursery School. Albany Institute Infant Consultation and Babies' Home. Deptford Fund Babies' Home.—During the year 31 children were admitted for treatment in this Home, for varying periods of time. Two of the children unfortunately died and the other 29 were discharged much improved by their stay in the Home. The Day Nursery in connection with the Deptford Fund was closed in September and has not yet been re-opened, it being realised that during this time of exceptional unemployment in the District, when the mothers themselves went out to work, they had not the means to pay for the care of the children in the Day Nursery, and further than that it generally occurred that the father or grown-up sons were out of work, and they had to undertake the duties of looking after the children in their own home. Baby Shows were held in September 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 well-known local ladies. Competitions took place at each of the four Centres, the total entries numbering about 350. As in previous years the entrants at each Centre were divided into three age groups, as follows :— Three to nine months. Nine to eighteen months. Eighteen months to five years. Prizes were awarded for the best babies in each group and special prizes were also given for the best pairs of twins. We were again indebted to several local medical men and women and to the Maternity and Child Welfare Medical Officers of neighbouring 79 Boroughs for very kindly giving their services as judges, and to members of the Committee and their friends for assistance in providing the necessary prizes. Maternity Home.—Kidbrooke House, 78, Shooters Hill Road, was formally opened as the Council's Maternity Home on 25th February, 1922, the first patient being admitted on 2nd March. Between that date and the end of the year 121 cases were accommodated, the average duration of stay in the Home being 15•3 days. The following brief details of these admissions are submitted:— Number of Cases delivered by Midwives 102 ,, ,, ,, Doctors 19 121 Number of Cases in which medical assistance was sought by midwife : (a) Pre-maternity 2 (b) During labour 4 (c) After labour 1 (d) For infant 1 8 It is gratifying to be able to report that there were no maternal deaths, no cases of Puerperal Sepsis, and no incidence of Ophthalmia Neonatorum. Of the 115 living infants, 61 were boys and 54 girls, the average weights at birth being respectively 71bs. 13ozs. and 71bs. 3ozs. With the exception that 5 had supplementary feeds, all were wholly breast fed. At the end of the year all these infants were doing well, incontrovertible evidence surely of the care and attention received by both mother and babe whilst accommodated in the Home. In almost every case the applicant's housing accommodation was either inadequate or unsuitable for the confinement to take place at home, and the many expressions of gratitude to the Council for providing suitable accommodation coupled with expert services have but served to confirm the opinion expressed in last year's Report as to the great need in Greenwich for a Maternity Home. 80 The Home has 12 beds and from the fact that, during the first ten months of opening, 121 cases were accommodated, I am confident that, as the Home becomes better known, we shall experience no difficulty in keeping all the beds constantly occupied. In considering this Report it should be borne in mind that, unlike some other Municipal Maternity Homes, any case that books before labour is accepted, whether likely to be a normal case or otherwise, the Home being fully equipped for any operative procedure that may prove necessary. Cases sent by Local Practitioners are accepted provided there is accommodation, and in the opinion of the Medical Officer of Health such cases are not likely to prove a source of infection—that is, speaking generally, if they are either not in labour or only just at the onset of labour. Three such cases are included in this Report—1 case of Placenta Prævia and 2 cases of severe Albuminuria. One hundred and one of the patients entering the Maternity Home were seen ante-natally by the Medical Officer, a large proportion being seen more than once. The following conditions called for special observation or treatment:— Contracted Pelvis8 Albuminuria 7 Heart Disease 2 Threatened Miscarriage 3 Pyelitis 6 Hydramnios 1 Ventrofixation 1 Others 5 Twenty-one patients, or 17 per cent., were not seen at all by the Medical Officer prior to their labour, which must be considered very unsatisfactory. It cannot be too strongly emphasised that these patients, although chiefly a danger to themselves, are also a definite menace to the other mothers in the Home. Still Births.—Four babies were stillborn :— (1) Died during forceps delivery, in the case of contracted pelvis from Meningeal Haemorrhage. (2) Anencephalic monster. (3) Foetus dead on admission, before onset of labour. (4) Macerated foetus, cause not discovered. 81 Ante-Partum Hemorrhage.—There were 4 cases of this character ; 2, however, were brought off satisfactorily. Placenta Prævia.—Three cases ; in each case a living child was born. Induction of Labour.—Five of the 8 cases of contracted pelvis had labour induced at various stages and in each case a living child resulted, and all of them doing well. The enumeration of this list of unusual cases may appear a large proportion to the number of mothers entering the Home, but it must be realised that when any Expectant Mother attending the Infant Consultation is suspected in any way to have any abnormalities she is invited and persuaded to attend the Pre-maternity Clinic, when, should such abnormality be definitely found, she is strongly urged to enter the Home in order that she may derive the fullest possible benefit from the services provided. Prom this it will be seen that we definitely set ourselves out to attract to the Home cases of abnormal character so that they may be appropriately dealt with at a suitable time, and the results obtained from such course of action have, in my opinion, substantially justified its adoption, for it must be realised that one of the chief advantages of the Home is that the prospective mothers presenting unusual difficulties can be more easily dealt with there than in their own homes. During the year we have had no Puerperal Sepsis, nor have we had any case of unusual rise in temperature at all. A rota of local medical men has been formed who have expressed their willingness to render any help which may be needed by the Medical Officer at the Home. During this period, however, it has only been necessary to ask their assistance in connection with the giving of anæsthetics from time to time. CHILDREN ACT, 1908. Since July, 1921, the duties of Infant Welfare Protection Visitors under the Children Act, 1908, have been delegated to the Greenwich Borough Council by the London County Council. At the end of the year 1921, there were on the register 36 Foster Mothers and 57 Nurse Children. These figures advanced during the year to 43 Foster Mothers and 61 Nurse Children, the increases being accounted for as follows •— 82 Foster Mothers. New Foster Mothers registered 17 Foster Mothers removing, or giving up 10 Increase 7 Nurse Children. New Cases notified—Under 1 year of age 17 Over „ „ „ 13 30 Deaths (all under 1 year of age) 3 Removals 16 Reached 7 years of age (and thus ceased to come within provisions of Act) 7 — 20 Increase 4 In last year's Report I referred to the useful work which had been accomplished by the Council's Health Visitors by means of their regular visitation of the Foster Mothers and Nurse Children in the Borough. Now that the arrangement has had a more extended trial I am all the more convinced that these duties rightly devolve upon the Borough Council. The Health Visitors are able to make regular calls upon the Foster Mothers in the course of their routine work and, apart from the home supervision, many of the Foster Mothers bring their charges regularly to the Infant Consultations to be weighed, and to receive advice, etc., where necessary. The small number of deaths (3) out of a total of 63 Nurse Children must be regarded as satisfactory. 83 Statement showing number of Visits, &c., made by Health Visitors. Reason for Visit. Visits. Re-visits. Total. Births under 1 year 2,177 2,047 4,224 Births over 1 year 166 3,138 3,304 Measles 1,272 311 1,583 Whooping Cough 468 122 590 Puerperal Fever 6 18 24 Pneumonia 31 32 63 Diarrhœa 33 23 56 Ophthalmia Neonatorum 20 50 70 Verminous (L.C.C. Report) 45 31 76 Scabies 36 24 60 Dental Treatment 17 2 19 Milk Scheme 398 28 426 Ante-Natal 271 47 318 Seen in Office 2,607 — 2,607 Children Act 245 104 349 Infant Consultations 651 — 651 Ante-Natal Clinics 106 — 106 Minor Ailment Clinics 207 — 207 Miscellaneous 14 — 14 Dinners 42 1 43 C.O.S. Meetings attended 15 — 15 Lying-in Homes 1 — 1 Totals 8,828 5,978 14,806 Dental Work.—Arrangements are 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. Fifty-six patients have been attended by the dental surgeon and 5 dentures have been provided, the total cost of the dentures being £15 12s. 6d., of which amount the Committee have decided that the patients should pay £12 2s. 6d. The total number of patients' attendances was 155. Puerperal Fever.—Six 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.—Eighteen cases of this disease were notified during the year, both eyes being affected in 7 cases, and one eye only in the remaining 11 cases. 84 Two babies unfortunately died, and of the remainder 15 have recovered, whilst one is still attending Hospital for treatment. Of the total number of cases, 7 occurred in West Greenwich, 6 in East Greenwich, 1 in St. Nicholas, and 4 in Charlton. Measles.—See pages 26 and 28. Notification of Births Act, 1907. The following table gives the number and character of the intimations received respecting births in the Borough:— 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. Total Number of Births notified in each year 2,280 2,497 1,992 1,735 2,085 2,714 2,564 2,257 (a) Attended by Midwives 1,226 1,314 1,095 990 1,159 1,494 1,452 1,484 (b) Attended by Doctors 1,054 1,183 897 745 926 1,220 1,112 773 Number of Still Births notified in each year 42 61 47 44 59 78 52 53 Number of Births registered in each year 2,347 2,354 1,967 1,753 1,968 2,648 2,366 2,185 Milk, &c., supplied to Nursing and Expectant Mothers and Young Children.—The instructions contained in Circular No. 185 of the Ministry of Health, dated 31st March, 1921, have been rigidly adhered to during the year, the quantities distributed being as follows:— Free. Sales. Total Amount Distributed. Milk 38,361 lbs. 23,854 lbs. 62,215 lbs. Virol 5273/4 „ 8581/2 „ 1,3861/4 „ Emulsion 7471/2 „ 4591/2 „ 1,207 „ Malt and Cod Liver Oil 634 „ 352 „ 986 „ 85 It may be useful to repeat that, ordinarily, milk is supplied free in necessitous cases only to : (a) Nursing mothers ; (b) Expectant mothers in the last three months of pregnancy and (c) Children up to 3 years of age. The quantity allowed is 1 lb. of Dried Milk per week (equivalent to 1 pint of fresh milk per day) with the exception that Infants between 3 months and 18 months are permitted l1/2lbs. per week subject to a special medical certificate being issued by the Medical Officer that such extra quantity is essential on grounds of health. In exceptional cases milk is given at the rate of 1lb. per week to children between the ages of 3 and 5 ; but, again, such cases necessitate the special medical certificate. Before milk is granted all applications are first carefully checked, and then submitted weekly to the Chairman of the Maternity and Child Welfare Committee who, in conjunction with the Principal Clerk and one of the Borough Treasurer's senior assistants, further considers each applicant's statements. The Council's scale as indicating necessitous circumstances is 8s. per head per week after deducting rent and insurances, and milk is granted free for four weeks ; at the expiration of which a fresh application must be made if the supply is to be continued. Mothers receiving milk must bring their infants regularly to the Consultation unless specially excused attendance by the Medical Officer, and those who have a weekly income per head higher than the scale figure are able to purchase dried milk, etc., at slightly above cost price. In my Report last year I referred specially to the hygienic advantages of dried milk over ordinary fresh milk, particularly when kept in the dwellings of the poor, and a further year's experience has served fully to convince me that to this factor is attributable very largely the marked decrease in the infantile mortality rate, which in Greenwich during the year 1922 fell to the lowest level in the history of the Borough. In addition to milk, nursing and expectant mothers in necessitous circumstances are eligible for free dinners, and during the year 4,108 such meals were provided. In every case the Medical Officer certifies that the extra nourishment is necessary to improve the health of the mother. Throughout the year the duties of Maternity and Child Welfare Medical Officer and Medical Officer in Charge of the Maternity Home were in the capable hands of Dr. V. J. F. Lack, who was appointed to succeed Dr. Pickett in January, 1922. 87 INDEX OF CONTENTS. Page Adoptive Acts, By-laws and Local Regulations 44 Age Mortality 13 Ambulance Facilities 42 Analysis of Death Causes 14 Anthrax 29 Area of Borough 6 Articles and Rooms Disinfected 68 Articles Destroyed 69 Baby Shows 78 Bacteriological Examinations 44 Bakehouses 65 Births 11 Blackheath and Chariton Cottage Hospital 43 Bones and Joints 19 Books Destroyed 70 Cancer 18 Causes of Death 15-20 Causes of Sickness 40 Cerebro-Spinal Fever 28 Chicken Pox 22 Children Act, 1908 81, 82 Circulatory System 19 Cleansing Children 70 Complaints 45 Constitutional Diseases 18 Consumption 17 Contacts 22 Cowhouses 61 Creche 77 Customs and Inland Revenue Acts 48 Dairies, Cowsheds and Milkshops 59, 61 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under1 Appendix Deaths, with Age Mortality 12, 13 Deptford Fund Babies' Home 78 Density of Population 6 Dental Work 36, 83 Developmental Diseases 18 Diarrhoea and Zymotic Enteritis 16 Dietetic Diseases 18 Digestive System 19 Diphtheria 15, 22, 23 Diphtheria Anti-Toxin 16 Disinfection 67 Duties and Powers of the Public Health Committee 1,2 Duties and Powers of the Maternity and Child Welfare Committee 3 Elevation of Borough 6 Emulsion 84 Encephalitis Lethargica Enteritis 17,28 Epidemic Cerebro-Spinal Meningitis 28 Epidemic Diseases 16 88 INDEX—continued. Page Erysipelas 17, 23 External Causes 20 Factories and Workshops 45-48 Food and Drugs—Samples of 65-67 Food—Premises for Preparation of, etc. 64 Glanders 29 Gonorrhoea 17 Health Centres 41, 70 Health Visitors, Visits, etc. 70, 76, 83 Home Work 47 Horse Slaughterer 49 Hospital and other forms 6f Gratuitous Medical Relief 43 House Drainage 51 Houses Inspected re Infectious Disease 70 Houses Let in Lodgings 49, 59 Housing 74-76 Hydrophobia 29 Ice Cream Premises 59, 65 Ill-defined Causes 20 Increase of Rent and Mortgage Interest (Restriction) Act, 1920 50 Infant Consultations 41, 77 Infantile Mortality 13 Influenza 17 Inhabited Houses 6 Inland Revenue Acts 48 Insanitary Areas 75 Institution Deaths 13 Integumentary System 20 Interim Tuberculosis Care Committee 37 Introductory Review 4, 5 Legal Proceedings 58 Local Diseases 18 Lymphatic System 19 Malarial Diseases 17, 29 Marriages 11 Maternity and Child Welfare 76-85 Maternity Home 42, 79-81 Measles 15, 26-28 Meat 63 Membranous Croup 23 Milk and Cream Regulations 63 Milk (Mothers and Children) Order 63 Milk Supply 61 Milk Supply for Expectant and Nursing Mothers 84 Miller General Hospital 43 Minor Ailment Centre 78 Mortuary 60 Nervous System 18 Notices, etc. 57 Notifications 22 Notification of Births Act 84 Nursing Arrangements 40 Offensive Trades 50 Ophthalmia Neonatorum 21, 29, 83 Organs of Special Sense 19 Outworkers' Register 45 89 INDEX—continued. Page Overcrowding 59 Parasitic Diseases 18 Persons Cleansed 70 Polio encephalitis 29 Polio-myelitis 29 Poor Law Relief 43 Population 6, 10 Public Health Committee 1 Puerperal Fever 17,26,83 Pyaemia and Septicæmia 17 Rats and Mice (Destruction) Act, 1919 49 Remarks on Death Causes 15 Reproductive System 19 Respiratory System 19 Rheumatic Fever 17 Sale of Food and Drugs Act 65-67 Sanitary Work—Summaries, etc. 45-65 Scarlet Fever 15, 23, 25 Scavenging and Refuse Removal 48, 49 School Clinic 41 Seamen's Hospital. 43 Septic Disease 17 Slaughterhouses 59, 63 Small-pox 15, 22 Smoke Nuisances 50 Sporadic Diseases 17 Staff of Public Health Department 71-73 Statistical Tables Appendix Suffocation 20 Suicide 20 Syphilis 17 Tuberculosis 17, 18, 29 Tuberculosis Dispensary—-Return of Attendances 39, 40 Tuberculosis—Interim Care Committee 37 Tuberculosis Officer's Report 31-40 Typhoid Fever 16,26 Underground Bakehouses 48 Underground Rooms 59 Unwholesome Food 56 Uninhabited Houses 6 Urinary System 19 Vaccination Particulars 30 Venereal Diseases 17 Verminous Premises 59 Verminous Children 70 Virol 84 Vital Statistics 6-10 & Appendix Water Supply 52 Whooping Cough 28 Workshops and Factories 45-48 Zymotic Enteritis 16, 28 Zymotic Diseases 15 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st April, 1922. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1922. Births Registered during the 13 weeks ended 1st April, 1922. Deaths Registered during the 13 weeks ended 1st April, 1922. 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 Zymotica. Over 1 and under 5 years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhœa. Typhoid. Other. During the corresponding period year previous. During the 13 weeks ended 1st April, 1922. During the corresponding period year previous. During the 13 weeks ended 1st April, 1922. M. F. M. F. Greenwich East 44213 44873 156 128 98 84 3 21 72 .. 5 1 10 2 .. .. .. 15 1 49 10 12 77 14•60 16•27 •90 1•60 Do. West 26677 27069 64 59 74 82 3 15 50 .. 5 .. 3 1 .. .. 1 12 3 45 13 17 56 14•60 23•12 •59 1•4 St. Nicholas, Deptford 7582 7689 36 28 28 28 9 18 10 .. 6 .. 2 2 .. .. .. 2 .. 24 4 1 15 20•63 29•23 .. 5•21 Charlton 18785 19059 43 40 42 29 8 5 25 .. 1 1 .. .. .. .. .. 8 1 14 6 4 36 11•53 14•95 .. •42 Kidbrooke 3193 3240 11 3 3 5 1 .. 4 .. .. .. .. .. .. .. .. .. 1 1 1 .. 5 12•56 9•9 .. .. Miller Hospital— Resident .. .. .. 6 9 1 2 1 .. .. .. 1 .. .. .. .. .. 1 4 1 1 7 .. .. .. .. Non-Resident. .. .. .. 8 13 1 3 1 .. .. .. .. .. .. .. .. .. 2 1 1 3 14 .. .. .. .. Seamen's Hospital— Resident .. .. .. 18 1 . .. 4 .. .. .. .. .. .. .. 1 1 1 1 1 4 10 .. .. .. .. Non-Resident .. .. .. 15 1 . .. 1 .. .. .. .. .. .. .. .. 1 .. 3 .. 5 7 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. .. 60 45 9 12 44 .. 5 .. .. 1 .. .. .. 3 .. 35 5 8 48 .. .. .. .. Non-Resident .. .. .. .. 86 98 9 35 74 .. 7 .. 3 6 .. .. .. 11 4 57 10 7 79 .. .. .. .. Herbert Hospital— .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. .. 7 43 .. 4 .. .. 2 1 8 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. .. .. .. .. 17 14 2 15 .. .. 1 8 19 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. Cottage Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. .. 1 3 .. .. 3 .. .. .. .. .. .. .. .. .. .. 2 .. .. 2 .. .. .. .. Non-Resident. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Outside Institutions .. .. .. .. 36 29 2 10 19 .. 1 1 4 1 .. .. .. 4 1 7 1 9 36 .. .. .. .. 310 258 245 228 Borough 100450 101930 568 473 44 59 161 .. 17 2 15 5 .. .. .. 37 6 133 34 34 190 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 22•36 18•62 .. .. .. .. •66 •07 •58 •19 .. .. .. 1•45 •23 5•23 1•33 1•33 7•48 14•05 18•62 •55 1•53 Deaths of Children under 1 Year per 1,000 births, 77 previous ,, ,, ,, corresponding 97 period ,, ,, ,, County of London 100 Death Rate of 105 large English Towns, 18.3; of County of the London, 19.7. Birth Rate „ „ 23.0 „ „ 22.7. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st July, 1922. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1922. Births Registered during the 13 weeks ended 1st July, 1922. Deaths Registered during the 13 weeks ended 1st July, 1922. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhœa. All Causes. Seven Zymotics. During the corresponding period year previous. During the 13 weeks ended 1st July, 1922. During the corresponding period year previous. During the 13 weeks ended 1st July, 1922. Typhoid. Other. M. F. M. F. Greenwich East 44213 44873 113 116 62 57 14 11 40 .. 6 1 1 1 .. .. .. 10 3 24 18 14 41 10•88 10•63 •27 •80 Do. West 26677 27069 67 64 52 44 7 12 30 .. 3 .. 3 4 .. .. .. 7 4 21 5 6 43 11•65 14•23 •28 1•48 St. Nicholas, Deptford 7582 7689 23 26 21 21 5 6 9 .. 1 .. 2 .. .. .. .. 11 .. 10 5 .. 13 12•16 21•92 .. 1•56 Charlton 18785 19059 42 35 27 24 6 2 24 .. 2 .. 1 .. .. .. .. 4 .. 11 6 4 23 9•39 10•73 •42 •63 Kidbrooke 3193 3240 29 20 2 11 .. .. 5 .. .. 1 .. .. .. .. .. .. .. 2 1 1 8 10•00 16•10 .. 10•23 Miller Hospital— Resident .. .. .. .. 4 4 .. 1 .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 5 .. .. .. .. Non-Resident .. .. .. .. 13 5 2 4 2 .. .. .. .. .. .. .. .. 1 1 1 1 3 11 .. .. .. .. Seamen's Hospital— Resident .. .. .. .. 18 1 .. 1 1 .. .. .. .. .. .. .. .. 2 2 5 1 .. 9 .. .. .. .. Non-Resident .. .. .. .. 18 .. .. .. .. .. .. .. .. .. .. .. .. 6 .. 1 1 4 6 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. .. 37 30 4 8 27 .. 1 .. .. 3 .. .. .. 3 2 13 7 7 31 .. .. .. .. Non-Resident .. .. .. .. 66 62 12 21 39 .. 12 .. .. 12 2 .. .. 7 2 24 7 15 47 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. .. 4 3 .. 5 .. .. 1 2 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. 19 27 1 26 .. .. 8 12 22 1 .. 1 .. .. 1 .. .. .. 1 .. .. .. .. Cottage Hospital— Resident .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. .. 2 3 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 3 .. .. .. .. Non-Resident .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. Outside Institutions .. .. .. .. 16 24 2 4 9 .. 1 .. 3 .. .. .. .. .. 1 2 2 2 21 .. .. .. .. 274 261 164 157 Borough 100450 101930 535 321 32 31 108 .. 12 2 7 5 .. .. .. 32 7 68 35 25 128 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 21•06 12•63 .. .. .. .. •47 •07 •27 •19 .. .. .. 1•25 •27 2•67 1•37 •98 5•04 10•94 12•63 •27 1•02 Deaths of Children under 1 Year per 1,000 births, 59 previous „ „ „ corresponding 49 period County of London 76 Death Rate of 105 large English Towns, 12•7; of the County of London, 13•1. Birth Rate 22•2 22•2. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 30th September, 1922. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1922. Births Registered during the 13 weeks ended 30th September, 1922. Deaths Registered during the 13 weeks ended 30th September, 1922. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhœa. All Causes. Seven Zymotics. During the corresponding period year previous. During the 13 weeks ended 30th Sept., 1922. During the corresponding period year previous. During the 13 weeks ended 30th Sept., 1922. Typhoid. Other. M. F. M. F. Greenwich East 44213 44873 120 112 53 46 8 5 35 .. .. 1 5 i .. .. 8 3 5 14 10 52 10•25 8•85 •99 •62 Do. West 26677 27069 63 64 36 38 7 10 28 .. .. 1 5 .. .. .. .. 8 2 10 5 11 32 10•03 10•97 1•47 •88 St. Nicholas, Deptford 7582 7689 31 29 6 13 2 1 2 .. .. .. .. .. .. .. .. 7 .. 3 1 1 7 3•70 9•91 •52 .. Charlton 18785 19059 46 36 31 12 3 1 16 .. .. .. .. .. .. .. .. 6 .. 3 4 8 22 11•32 9•05 1•26 .. Kidbrooke 3193 3240 27 32 3 6 1 .. 6 .. .. .. .. .. .. .. .. .. .. 1 .. 1 7 8•79 11•14 2•50 .. Miller Hospital— Resident .. .. .. .. 3 5 .. 2 1 .. .. .. .. .. .. .. .. .. .. .. .. 2 6 .. .. .. .. Non-Resident. .. .. .. .. 10 9 .. 4 2 .. .. .. .. .. .. .. .. 1 1 1 3 1 12 .. .. .. .. Seamen's Hospital— Resident .. .. .. .. 6 4 .. 4 .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 7 .. .. .. .. Non-Resident .. .. .. .. 18 1 .. .. 5 .. .. .. .. .. .. .. .. .. .. 3 3 1 12 .. .. .. .. Greenwich & Deptford Hospital— Resident 27 21 1 1 18 .. .. .. .. .. .. .. .. 6 2 3 7 4 26 .. .. .. .. Non-Resident .. .. .. .. 42 28 3 4 31 .. .. .. .. 1 .. .. .. 6 1 7 14 9 32 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. .. 5 3 .. 6 .. .. .. 1 7 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. 13 19 1 15 .. .. 1 2 28 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Cottage Hospital— Resident .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Non-Resident .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Other Institutions— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. 2 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 1 1 .. .. .. .. Outside Institutions .. .. .. .. 24 22 2 4 15 .. .. 1 3 .. .. .. .. 8 1 3 3 7 20 .. .. .. .. 287 273 129 115 Borough 100450 101930 560 244 21 17 87 .. .. 2 10 1 .. .. .. 29 5 22 24 31 120 .. .. .. .. Rate per 1,000 of Estimated Population .. .. .. .. .. .. .. .. .. •07 •39 •03 • • .. .. 1•15 •19 •86 •94 1•21 4•72 10•30 9•60 1•19 •41 Deaths of Children under 1 Year per 1,000 births, 37 previous „ „ „ corresponding 68 period „ „ „ County of London 44 Death Kate of 105 large English Towns, 9•3; of the County of London, 8•9. Birth Rate „ „ 21•4 „ „ 21•2. BOROUGH OF GREENWICH, Return of Births and Deaths registered during the 13 weeks ended 30th December, 1922. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1922. Births Registered during the 13 weeks ended 30th December, 1922. Deaths Registered during the 13 weeks ended 30th December, 1922. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per l,000 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhœa. All Causes. Seven Zymotics. During the corresponding period year previous. During the 13 weeks ended 30th Deer., 1922. During the corresponding period year previous. During the 13 weeks ended 30th Deer., 1922. Typhoid. Other. M. M. F. Greenwich East 44213 44873 105 103 59 45 9 8 37 .. .. .. 5 .. .. .. 1 14 3 19 7 10 45 13.97 9.29 1.63 .53 Do. West 26677 27069 61 47 42 44 4 4 46 .. .. .. 3 .. .. .. .. 4 .. 17 8 8 46 13.86 12.75 .73 .44 St. Nicholas, Deptford 7582 7689 24 30 12 6 4 3 6 .. .. .. .. .. .. .. .. .. .. 9 1 2 6 15.34 9.39 .52 .. Charlton 18785 19059 48 34 22 35 7 1 27 .. .. .. 2 .. .. .. .. 4 .. 17 7 3 24 14.95 12.00 .42 .42 Kidbrooke Miller Hospital— 3193 3240 30 40 4 6 .. .. 9 .. .. .. .. .. .. .. .. .. .. 2 .. 2 6 15.17 12.38 .. .. Resident .. .. .. 3 3 1 1 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. 5 .. .. .. .. Non-Resident .. .. .. 7 7 1 1 2 .. .. .. .. .. .. .. .. .. .. 2 .. 3 9 .. .. .. .. Seamen's Hospital— Resident .. .. .. 8 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 3 1 .. .. .. .. Non-Resident Greenwich & Deptford Hospital— .. .. .. 15 .. .. 1 3 .. .. .. .. .. .. .. .. 5 .. 1 1 2 6 .. .. .. .. Resident .. .. .. 23 26 3 2 25 .. .. .. .. .. .. .. .. 3 .. 5 4 7 30 .. .. .. .. Non-Resident .. .. .. 57 38 8 2 43 .. .. .. .. .. .. .. .. 4 2 17 8 10 54 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. . M.A.B. Brook Hospital— .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Resident .. .. .. 5 4 .. 5 .. .. .. 8 .. .. .. .. .. .. .... .. .. 1 .. .. .. .. Non-Resident. . .. .. .. 14 12 1 9 1 .. .. 3 19 .. .. .. .. 1 .. 1 .. .. 2 .. .. .. .. Cottage Hospital — Resident .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. Non-Resident. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. .. 3 .. .. 3 .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. .. .. .. Non-Resident. . .. .. .. 1 5 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 5 .. .. .. .. Outside Institutions .. .. .. 19 17 2 .. 14 .. .. .. 2 .. .. .. 1 4 .. 8 2 3 16 .. .. .. .. 268 254 139 136 Borough 100450 101930 522 275 24 16 125 .. .. .. 10 .. .. .. 1 22 3 64 23 25 127 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 20.55 10.82 .. .. .. .. .. .. 39 .. • • .. .03 .86 .11 2.52 .89 .98 4-99 14.33 10.82 1.03 .43 Deaths of Children under 1 Year per 1,000 births, 45 Death Rate of 105 large English Town3, 11.8; of the County of London, 12.0. previous „ „ „ corresponding 82 period „ „ „ County of London 70 Birth Rate „ „ 19.4 „ 19.5. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 52 weeks ended 30th December, 1922. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1922. Births Registered during the 52 weeks ended 30th December, 1922. Deaths Registered during the 52 weeks ended 30th December, 1922. AGE MORTALITY. Small-Pox. Measles. SEVEN ZYMOTIC DISEASES. Diarrhœa. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rath 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. Typhoid. Other. During the corresponding period year previous. During the 52 weeks ended 30th Deer., 1922. I During the corresponding period year previous. During the 52 weeks ended 30th Deer., 1922. M. f. i M. f. Greenwich East 44213 44873 494 459 272 232 44 45 184 .. 11 3 21 4 .. .. 1 47 10 97 49 46 215 12.17 11.26 .95 .87 Do. West 26677 27069 255 234 204 208 31 41 154 .. 8 1 14 5 •• .. 1 31 9 93 31 42 177 12.53 15.27 .77 1.03 St. Nicholas, Deptford 7582 7689 114 113 67 68 20 28 27 .. 7 .. 4 2 .. .. .. 20 .. 46 11 4 41 14.28 17.61 .26 1.69 Charlton 18785 19059 179 145 122 100 24 9 92 .. 3 1 3 .. .. .. .. 22 1 45 23 19 105 11.80 11.68 .51 .36 Kidbrooke Miller Hospital— 3193 3240 97 95 12 28 2 .. 24 .. .. 1 .. .. .. .. .. .. 1 6 2 4 26 11.62 12.38 .62 .30 Resident .. .. .. 16 21 2 6 3 .. .. .. 1 .. .. .. .. .. 1 7 1 4 23 .. .. .. .. Non-Resident.. .. .. .. 38 34 3 12 7 .. .. .. .. .. .. .. .. 2 4 5 5 10 46 .. .. .. .. Seamen's Hospital— Resident .. .. .. 50 6 .. 5 5 .. .. .. .. .. .. .. 1 3 3 10 4 8 27 .. .. .. .. Non-Resident .. .. .. 66 2 .. 1 9 .. .. .. .. .. .. .. .. 12 .. 8 5 12 31 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 147 122 17 23 114 .. 6 .. 4 .. .. .. 15 4 56 23 26 135 .. .. .. .. Non-Resident .. .. .. 251 226 32 62 187 .. 19 .. 3 19 .. .. .. 28 9 105 39 41 212 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital— Resident .. .. .. 21 14 .. 20 .. .. 3 4 27 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Non-Resident.. .. .. .. 63 72 5 65 1 .. 10 25 88 2 .. 1 .. 1 1 1 1 .. 5 .. .. .. .. Cottage Hospital— Resident .. .. .. 1 3 .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. 3 .. .. .. .. Non-Resident. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. Other Institutions— Resident .. .. .. 3 9 1 .. 7 .. .. .. .. .. .. .. .. .. .. 5 .. 1 6 .. .. .. .. Non-Resident. .. .. .. 4 8 2 .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 2 9 .. .. .. .. Outside Institutions .. .. .. 95 92 8 18 57 .. 2 2 12 1 .. .. 1 24 3 20 8 21 93 .. .. .. .. 1139 1046 677 636 Borough 100450 101930 2185 1313 121 123 481 .. 29 6 42 11 .. .. 2 120 21 287 116 115 564 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 21.00 12.92 .. .. .. .. .28 .05 .41 .09 .. •• .01 1.18 .20 2-82 1.14 1.12 5.57 12.41 12.92 .76 .86 Deaths of Children under 1 Year per 1,000 births, 56 Death Rate of 105 large English Towns, 13.0 ; of the County of London, 13.4. previous „ „ „ corresponding 74 period „ „ „ County of London 74 Birth Rate „ „ 21.4 ,, „ 21.0 BOROUGH OF GREENWICH, Causes of, and Ages at Death during the 13 weeks ended 1st April, 1922. Causes op 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 Gr'n'ch & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 473 44 33 26 20 22 56 in 161 182 156 56 71 8 105 19 15 .. 11 .. 4 65 408 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 17 3 10 4 .. .. .. .. .. 5 5 6 1 .. 5 .. .. .. 2 .. .. 1 14 Scarlet Fever 2 .. .. 1 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. .. 1 10 Whooping Cough 5 1 3 1 .. .. .. .. .. 2 1 2 .. .. 1 .. .. .. .. .. .. 1 8 Diphtheria and Croup 15 .. .. 5 10 .. .. .. .. 10 3 2 .. .. .. .. 1 .. 8 .. .. 4 32 Influenza 43 1 2 1 1 2 7 15 14 18 12 4 7 2 6 .. .. .. .. .. .. 6 23 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spina! Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 Phthisis (Pul. Tuberculosis) 37 .. .. .. 1 14 14 7 1 15 12 2 8 .. 3 1 .. .. .. .. .. 5 16 Tuberculous Meningitis 2 1 .. .. 1 .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 Other Tuberculous Diseases 1 .. .. .. 1 .. .. .. .. 1 1 .. 1 1 .. 1 1 .. .. .. .. 1 6 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 34 .. .. .. .. .. 7 15 12 12 17 1 4 .. 8 4 1 .. .. .. .. 8 29 Bronchitis 57 5 1 .. .. .. .. 12 39 26 20 6 4 1 19 .. .. .. .. .. 2 3 49 Broncho-Pneumonia 44 13 10 7 1 1 1 4 7 7 16 14 7 .. 4 1 1 .. .. .. .. 3 22 Pneumonia (all other forms) 31 1 4 3 2 1 5 11 4 16 9 4 .. .. 11 .. 3 .. .. .. .. .. 31 Other Diseases of Respira torv Organs 5 .. 1 .. .. 1 1 1 1 2 2 1 .. 1 .. 1 .. .. .. .. 1 3 Diarrhœa and Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Appendicitis and Typhlitis 2 .. .. .. .. 1 1 .. .. 1 .. .. 1 .. 1 1 .. .. .. .. .. .. 3 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 2 Nephritis and Bright's Disease 10 .. .. 1 .. .. 3 3 3 3 5 .. .. .. 1 3 .. .. .. .. .. .. 8 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 .. Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Congenital Debility and Malformation, including Premature Birth 16 16 .. .. .. .. .. .. .. 6 6 2 .. .. 5 .. 1 .. .. .. .. 1 11 Violent Deaths, excluding Suicide 14 1 2 .. 1 .. 4 3 3 4 5 1 4 .. 3 1 .. .. .. .. .. 4 13 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Heart 34 .. .. .. .. .. 4 13 17 10 13 4 6 1 5 1 1 .. .. .. .. 1 19 Other Defined Diseases 99 2 .. 3 1 2 8 23 60 43 25 8 20 3 31 5 5 .. .. .. 2 22 101 Diseases ill-defined or unknown .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473 44 33 26 20 22 56 111 161 182 156 56 71 8 105 19 15 . . 11 . . 4 65 408 BOROUGH OF GREENWICH. Causes of, and Ages at Death during the 13 weeks ended 1st July, 1922. 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 Gr'n'ch & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 321 32 11 20 13 26 49 62 108 119 96 42 51 13 67 19 8 .. 7 i 5 40 320 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enterica rever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 12 2 4 5 1 .. .. .. .. 6 3 1 2 .. 1 .. .. .. 1 .. .. 1 21 Scarlet Fever 2 .. .. 1 .. .. 1 .. .. 1 .. .. .. 1 .. .. .. .. 2 .. .. .. 13 Whooping Cough 5 3 1 1 .. .. .. .. .. 1 4 .. .. .. 3 .. .. .. .. .. .. .. 16 Diphtheria and Croup 7 .. 1 5 1 .. .. .. .. 1 3 2 1 .. .. .. .. .. 4 .. .. 3 28 Influenza 2 .. .. .. .. .. .. 2 .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spina! Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 32 .. .. .. 1 13 12 6 .. 10 7 11 4 .. 3 2 .. .. .. .. .. 8 20 Tuberculous Meningitis 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 Other Tuberculous Diseases 6 .. .. 3 1 1 1 .. .. 3 3 .. .. .. 2 1 .. .. .. .. .. 1 7 Rheumatic Fever 1 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 25 .. .. .. .. 1 3 8 13 14 6 .. 4 1 7 .. 1 .. .. .. .. 2 31 Bronchitis 38 3 1 .. .. .. 2 3 29 14 11 5 7 1 8 .. .. .. .. .. .. 1 20 Broncho-Pneumonia 16 4 2 4 1 .. 3 1 1 3 8 3 2 .. 2 4 1 .. .. .. .. 1 10 Pneumonia (all other forms) 14 .. .. .. 1 .. 4 5 4 7 2 2 2 1 3 1 .. .. .. .. .. .. 17 Other Diseases of Respiratory Organs .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diarrhœa and Enteritis 1 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Appendicitis and Typhlitis 5 .. .. .. 1 2 1 1 .. 1 2 .. 1 1 1 1 1 .. .. .. .. 1 6 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Cirrhosis of Liver 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 Nephritis and Bright's Disease 10 .. .. .. 1 1 2 4 2 4 4 .. 2 .. 3 2 2 .. .. .. .. .. 10 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Congenital Debility and Malformation, including Premature Birth 19 18 .. .. .. 1 .. .. .. 11 2 3 3 .. .. .. .. .. .. .. 1 2 5 Violent Deaths, excluding Suicide 12 .. 2 .. 1 1 2 3 3 3 5 2 .. 2 6 1 1 .. .. .. .. 2 17 Suicides 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Heart 35 .. .. .. 1 1 8 11 14 18 5 5 6 1 7 1 .. .. .. .. .. 2 16 Other Defined Diseases 75 1 .. 1 2 3 9 18 41 21 27 8 15 4 21 4 2 .. .. 1 2 15 72 Diseases ill-defined or unknown 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 321 32 11 20 13 26 49 62 108 119 96 42 51 13 67 19 8 .. 7 1 5 40 320 BOROUGH OF GREENWICH. Causes of, and Ages at Death during the 13 weeks ended 30th September, 1922. 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 Gr'n'ch & Dept-| ford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 244 21 4 13 17 13 22 66 87 99 74 19 43 9 48 10 8 .. 8 1 .. 46 218 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Scarlet Fever 2 .. .. 1 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 .. .. 1 3 Whooping Cough 1 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Diphtheria and Croup 10 .. .. 8 2 .. .. .. .. 5 5 .. .. .. .. .. .. .. 7 .. .. 3 35 Influenza 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Erysipelas 1 .. .. .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 Cerebro-Spina! Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 29 .. .. .. 3 8 7 11 .. 8 8 7 6 .. 6 .. .. .. .. .. .. 8 13 Tuberculous Meningitis 3 .. 1 1 1 .. .. .. .. 2 1 .. .. .. 1 .. .. .. .. .. .. 1 3 Other Tuberculous Diseases 2 .. .. .. 1 .. 1 .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. .. 1 Rheumatic Fever 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Cancer, Malignant Disease 31 .. .. .. .. .. 3 14 14 10 11 1 8 1 4 1 2 .. .. .. .. 7 19 Bronchitis 6 .. .. .. .. .. .. 1 5 2 3 .. 1 .. .. .. .. .. .. .. .. 1 3 Broncho-Pneumonia 11 2 .. .. 1 1 .. 4 3 3 4 2 2 .. .. 2 .. .. .. .. .. 2 5 Pneumonia (all other forms) 5 .. .. 1 .. .. 1 1 2 .. 3 1 .. 1 2 .. .. .. .. .. .. .. 9 Other Diseases of Respiratory Organs 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa and Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Appendicitis and Typhlitis 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 2 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cirrhosis of Liver 1 .. .. ... .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 8 .. .. .. 1 .. 1 2 4 2 3 1 2 .. 1 2 .. .. .. .. .. 1 6 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 Congenital Debility and Malformation, including Premature Birth 14 12 1 1 .. .. .. .. .. 4 8 .. 1 1 1 .. 1 .. .. .. .. .. 3 Violent Deaths, excluding Suicide 12 .. 2 1 3 .. 1 3 2 4 3 2 3 .. 4 2 2 .. .. .. .. 2 12 Suicides 2 .. .. .. .. .. 1 1 2 .. .. .. .. 1 .. .. .. .. .. .. .. 1 Heart 24 .. .. .. .. .. 2 8 14 14 5 1 4 .. 8 .. .. .. .. .. .. 3 27 Other Defined Diseases 76 6 .. .. 2 2 5 21 40 38 15 3 15 5 18 2 2 .. .. 1 .. 16 70 Diseases ill-defined or unknown 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 244 21 4 13 17 13 22 67 87 99 74 19 43 9 48 10 8 .. 8 1 46 218 BOROUGH OF GREENWICH. Causes of, and Ages at Death during the 13 weeks ended 30th December, 1922. Causes or 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 Gr'n'ch & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institution Outside Institution All Causes £ Certified 275 24 6 10 17 9 23 61 125 104 86 18 57 10 49 8 6 .. 9 2 3 36 233 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Croup 10 .. .. 5 5 .. .. .. .. 5 3 .. 2 .. .. .. .. .. 8 .. .. 2 27 Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cerebro-Spina! Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Phthisis (Pul. Tuberculosis) 22 .. .. .. 1 5 9 6 1 14 4 .. 4 .. 3 .. .. .. .. .. .. 4 13 Tuberculous Meningitis 3 .. .. 1 2 .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Tuberculous .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cancer, Malignant Disease 25 .. .. .. .. .. 2 14 9 10 8 2 3 2 7 3 .. .. .. .. .. 3 26 Bronchitis 31 .. 1 .. .. .. 1 9 20 13 .. 2 10 .. 4 .. .. .. .. .. .. 4 10 Broncho Pneumonia 23 7 2 3 .. 1 1 4 5 5 8 3 6 1 1 2 1 .. .. 1 1 1 14 Pneumonia (all other forms) 10 .. 2 .. .. .. .. 2 6 1 3 4 1 1 .. .. .. .. .. .. 1 3 8 Other Diseases of Respiratory Organs 4 .. .. .. .. .. 1 2 1 •• 2 1 .. 1 .. 1 .. .. .. .. .. 1 .. Diarrhœa and Enteritis 1 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 2 Appendicitis and Typhlitis 1 .. .. .. 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 5 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Nephritis and Bright's Disease 1 .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 6 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition 2 .. .. .. .. .. 2 .. .. .. 2 .. .. .. 1 .. .. .. .. .. .. .. 2 Congenital Debility and Malformation, including Premature Birth 10 10 .. .. .. .. .. .. .. 3 2 1 4 .. 1 .. .. .. .. .. .. 1 5 Violent Deaths, excluding Suicide 10 .. .. .. 4 .. .. 2 4 3 5 .. 2 .. 3 .. 3 .. .. .. .. 1 15 Suicides 1 .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Heart 23 2 .. .. .. 1 4 6 10 7 8 1 7 .. 4 2 .. .. .. .. .. 2 15 Other Defined Diseases 96 4 1 1 3 1 2 15 69 37 33 3 18 5 23 .. 2 .. 1 1 1 12 78 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 275 24 6 10 17 9 23 61 125 104 86 18 57 10 49 8 6 .. 9 2 3 36 233 BOROUGH OF GREENWICH. Causes of, and Ages at Death during the 52 weeks ended 30th December, 1922. Causes of Death. Deaths in Whole district at Subjoined Ages. Deaths in Localities at all Ages. Deaths in Public Institutions Total Deaths in blic Institutions in the District Ill Ages I nder 1 1 d under 2 2 d under 5 5 d under 15 15 d under 25 25 d under 45 45 ,d under 65 65 ,d upwards (Grawich East Garwich West St Nicholas, ptford narlton Bbrooke Gr'rh & Dept- for Hospital eamen's Hospital Mir Hospital Heart Military Hospital Brk Hospital M.A.B. Cottage Hospital Other stitutions Outside (stitutions All Causes Certified 1313 121 54 69 67 70 150 301 481 504 412 135 222 40 269 56 37 .. 35 4 12 187 1179 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 29 5 14 9 1 .. .. .. .. 11 8 7 3 .. 6 .. .. .. 3 .. .. 2 36 Scarlet Fever 6 .. .. 3 2 .. 1 .. .. 3 1 .. 1 1 .. .. .. .. 4 .. .. 2 29 Whooping Cough 11 5 4 2 .. .. .. .. .. 4 5 2 .. .. 4 .. .. .. .. .. .. 1 25 Diphtheria and Croup 42 .. 1 23 18 .. .. .. .. 21 14 4 3 .. .. .. 1 .. 27 .. .. 12 122 Influenza 46 1 2 1 1 2 7 17 15 18 13 4 7 4 6 .. .. .. .. .. .. 7 23 Erysipelas 1 .. .. .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. .. .. .. 2 Cerebro-Spina! Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 2 .. .. .. .. 1 1 .. .. 1 1 .. .. .. .. 1 .. .. .. .. .. 1 1 Phthisis (Pul. Tuberculosis) 120 .. .. .. 6 40 42 30 2 47 31 20 22 .. 15 3 .. .. .. .. .. 25 62 Tuberculous Meningitis 9 1 1 2 4 1 .. .. .. 5 4 .. .. .. 1 1 .. .. .. .. .. 1 7 Other Tuberculous Diseases 12 .. .. 3 3 1 2 3 .. 5 5 .. 1 1 3 2 1 .. .. .. .. 2 15 Rheumatic Fever 2 .. .. .. 2 .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. 2 Cancer, Malignant Disease 115 .. .. .. .. 1 15 51 48 46 42 4 19 4 26 8 4 .. .. .. .. 20 105 Bronchitis 132 8 3 .. .. .. 3 25 93 55 40 13 22 2 31 .. .. .. .. .. 2 9 82 Broncho-Pneumonia 94 26 14 14 3 3 5 13 16 18 36 22 17 1 7 9 3 .. .. 1 1 7 51 Pneumonia (all other forms) 60 1 6 4 3 1 10 19 16 24 17 11 5 3 16 1 3 .. .. .. 3 3 65 Other Diseases of Respiratory Organs 10 .. 1 .. 1 1 2 3 2 3 4 1 1 1 1 1 1 .. .. .. .. 2 4 Diarrhœa and Enteritis 2 2 .. .. .. .. .. .. .. 1 .. .. 1 .. 1 .. .. .. .. .. .. .. 3 Appendicitis and Typhlitis 9 .. .. .. 2 3 2 2 .. 2 3 .. 3 1 3 2 2 .. .. .. .. 1 16 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Cirrhosis of Liver 4 .. .. .. .. .. 2 1 1 1 2 1 .. .. 1 1 .. .. .. .. .. 1 3 Nephritis and Bright's Disease 29 .. .. 1 3 1 6 9 9 9 13 1 6 .. 5 7 2 .. .. .. .. 1 30 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 .. Other Accidents and Diseases of Pregnancy and Parturition 3 .. .. .. .. 1 2 .. .. .. 3 .. .. .. 1 .. .. .. .. .. .. 1 7 Congenital Debility and Malformation, including Premature Birth 59 56 1 1 .. 1 .. .. .. 24 18 6 10 1 7 .. 2 .. .. .. 1 4 24 Violent Deaths, excluding Suicide 48 . 1 6 1 9 1 7 11 12 14 18 5 9 2 16 4 6 .. .. .. .. 9 57 Suicides 4 .. .. .. .. 1 1 2 .. 2 1 1 .. .. 1 .. .. .. .. .. .. .. 4 Heart 116 2 .. .. 1 2 18 38 55 49 31 11 23 2 24 4 1 .. .. .. .. 8 77 Other Defined Diseases 346 13 1 5 8 8 24 77 210 139 100 22 68 17 93 11 11 .. 1 3 5 65 321 Diseases ill-defined or unknown 2 .. .. .. .. 1 .. .. 1 1 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1313 121 54 69 67 70 150 301 481 504 412 135 222 40 269 56 37 35 4 12 187 1179 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the Quarter ended 1st April, 1922. Notifiable Diseases. Cases Notfied in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each Locality. At all Agca. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 241 11 66 123 30 9 2 •• 164 24 14 19 20 158 22 13 18 18 229 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 17 1 .. .. 2 9 2 .. 7 4 1 4 1 1 2 .. 2 1 6 Scarlet Fever 226 2 52 128 34 9 1 .. 113 36 17 51 9 107 35 17 44 .. 212 Malaria 2 .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever 1 .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Measles 528 21 223 277 6 1 .. .. 226 73 95 134 .. 5 1 1 2 .. 9 Whooping Cough 84 9 35 40 .. .. .. .. 28 42 7 5 .. 2 5 1 .. .. 8 Diarrhoea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. Ophthalmia Neonatorum 6 6 .. .. .. .. .. .. .. 4 1 1 .. .. 1 .. 1 2 Tuberculosis, Pulmonary 57 .. 1 9 15 23 8 1 27 10 5 14 1 1 .. .. .. .. 1 ,, Non-Pulmonary 14 1 2 6 1 3 1 .. 5 4 3 1 1 .. 1 .. .. .. 1 Pneumonia, Acute Primary, or Influenzal 84 1 8 19 16 21 14 5 42 22 4 13 3 13 10 3 2 2 30 Totals 1261 52 388 602 104 77 29 9 614 219 149 242 37 288 77 35 69 30 499 * 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 Quarter ended 1st July, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 118 1 29 70 11 7 .. .. 40 58 5 6 9 39 58 5 6 9 117 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 10 .. .. .. 1 3 5 1 4 4 .. 2 .. 1 2 .. .. .. 3 Scarlet Fever 152 1 29 88 26 7 1 .. 71 30 14 24 13 70 29 12 24 12 147 Malaria 4 .. .. .. 1 3 .. .. 3 .. .. .. 1 .. .. .. .. .. .. Enteric Fever 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever 2 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. 2 Measles 560 25 217 307 9 2 .. .. 283 176 11 82 8 4 1 .. 1 .. 6 Whooping Cough 136 15 51 69 1 .. .. .. 65 27 1 39 4 .. .. .. .. .. .. Diarrhœa 9 4 5 .. .. .. .. .. 3 6 .. .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 5 5 .. .. .. .. .. .. 3 2 .. .. .. 3 1 .. .. .. 4 Tuberculosis, Pulmonary 64 .. 1 12 15 23 13 .. 33 17 8 5 1 1 .. .. .. 1 2 „ Non-Pulmonary 13 .. 4 8 1 .. .. .. 4 7 2 .. .. .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 39 3 6 6 10 6 7 1 20 10 1 6 2 2 3 .. 1 2 8 Totals 1113 56 342 561 75 51 26 2 532 337 42 164 38 123 94 17 32 24 290 *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 30th September, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to25 25 to 45 45 to 65 65 and upward Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 148 5 33 86 13 8 1 2 51 54 11 20 12 51 54 11 15 12 143 Encephalitis Lethargica 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. 1 Erysipelas 8 .. .. 1 .. 2 2 3 3 2 .. 1 2 1 1 .. .. .. 2 Scarlet Fever 112 1 26 65 11 6 2 1 63 18 12 12 7 60 18 12 12 5 107 Malaria 4 .. .. .. .. 3 1 .. .. 4 .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 3 .. .. .. 1 2 .. .. 2 .. 1 .. .. 1 .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 88 4 36 47 1 .. .. .. 34 47 .. 2 5 .. 1 .. 1 .. 2 Whooping Cough 115 6 42 63 1 2 1 .. 49 41 8 17 .. .. .. .. .. .. .. Diarrhœa 16 6 10 .. .. .. .. .. 5 9 1 1 .. .. .. .. .. .. .. Ophthalmia Neonatorum 3 3 .. .. .. .. .. .. 1 .. .. 2 .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 36 .. 1 6 10 11 8 .. 17 8 5 6 .. .. .. .. .. .. .. ,, Non-Pulmonary 17 .. 2 7 5 2 1 .. 6 6 2 2 1 .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 21 .. 1 3 3 7 4 3 4 12 .. 2 3 1 1 .. 1 2 5 Totals 573 25 151 278 46 43 21 9 235 202 40 65 31 115 76 23 29 19 262 *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 30th December, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke..* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox 169 13 52 96 5 3 .. .. 101 46 1 21 .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 200 5 51 118 19 6 1 .. 87 65 14 25 9 85 62 14 24 9 194 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 8 1 .. .. .. 1 4 2 7 1 .. .. .. 2 .. .. .. .. 2 Scarlet Fever 109 1 25 60 15 8 .. .. 43 20 24 13 9 40 18 23 12 8 101 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 2 .. .. .. 1 1 .. .. 2 .. .. .. .. 2 .. .. .. .. 2 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. Measles 110 1 46 60 3 .. .. .. 67 39 .. 3 1 .. .. .. .. 1 1 Whooping Cough 73 10 25 37 .. 1 .. .. 37 24 4 8 .. 1 .. .. .. .. 1 Diarrhœa 4 2 2 .. .. .. .. .. .. 3 1 .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 4 4 .. .. .. .. .. .. 2 1 .. 1 .. 2 .. .. .. .. 2 Tuberculosis, Pulmonary 61 .. .. 12 17 21 8 3 31 15 6 8 1 .. .. .. .. .. .. „ Non-Pulmonary 11 .. 3 3 3 2 .. .. 6 4 .. .. 1 .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 21 1 5 7 1 5 2 .. 11 7 1 2 .. 1 1 1 .. .. 3 Totals 773 38 209 393 64 49 15 5 395 225 51 81 21 134 81 38 36 18 307 * 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 30th December, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox 169 13 52 96 5 3 .. .. 101 46 1 21 .. .. .. .. .. .. •• Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. Diphtheria 707 22 179 397 73 30 4 2 342 201 44 70 50 333 196 43 63 48 683 Encephalitis Lethargica 1 •• .. .. .. .. 1 •• .. 1 •• .. .. .. 1 .. •• •• 1 Erysipelas 43 2 .. 1 3 15 13 9 21 11 1 7 3 5 5 .. 2 1 13 Scarlet Fever 599 5 132 341 86 30 4 1 290 104 67 100 38 277 100 64 92 34 567 Malaria 10 .. .. .. 1 7 2 .. 3 4 2 .. 1 .. .. .. .. .. .. Enteric Fever 3 .. .. 1 1 1 .. .. 2 .. .. .. 1 2 .. .. .. .. 2 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 6 .. .. .. 2 4 .. .. 5 .. 1 .. .. 3 .. .. .. .. 3 Cerebro-Spinal Fever 3 2 1 .. .. .. .. .. 3 .. .. .. .. 3 .. .. .. .. 3 Measles 1286 51 522 691 19 3 .. .. 610 335 106 221 14 9 3 1 4 1 18 Whooping Cough 408 40 153 209 2 3 1 .. 179 134 20 69 6 3 5 1 .. •• 9 Diarrhœa 29 12 17 .. .. .. .. .. 8 18 2 1 .. .. .. .. .. •• .. Ophthalmia Neonatorum 18 18 .. .. •• .. .. .. 6 7 1 4 .. 6 2 .. 1 .. 9 Tuberculosis, Pulmonary 218 .. 3 39 57 78 37 4 108 50 24 33 3 2 .. .. .. 1 3 „ Non-Pulmonary 55 1 11 24 10 7 2 .. 21 21 7 3 3 •• 1 •• .. .. 1 Pneumonia, Acute Primary, or Influenzal 165 5 20 35 30 39 27 9 77 51 6 23 8 17 15 4 4 6 46 Totals 3720 171 1090 1834 289 220 91 25 1776 983 282 552 127 660 328 113 166 91 1358 *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 1922. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week 1—2 Weeks 2—3 Weeks 3—4 Weeks Total under 1 Month 1—3 Months 3—6 Months 6—9 Months 9—12 Months Total Deaths under 1 Year All Causes. Certified 37 5 6 3 51 22 12 17 19 121 Uncertified .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-Pox .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. 2 3 5 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 2 1 1 1 5 Diphtheria—Croup .. .. .. .. .. .. .. .. .. .. Erysipelas • • .. .. .. .. .. .. .. .. .. Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. .. .. .. 1 1 Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. 1 .. 1 Convulsions .. .. .. .. .. .. .. 1 1 2 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. 1 1 2 1 2 2 8 Pneumonia, all forms .. .. 1 1 2 6 4 8 7 27 Diarrhaœl Diseases. Diarrhœa, all forms .. .. •• .. .. .. .. .. .. .. Enteritis .. .. 1 .. 1 .. 1 .. 1 3 Gastritis .. .. .. .. .. 1 .. .. .. 1 Syphilis .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying .. .. 1 .. 1 .. .. .. .. 1 Injury at Birth 2 .. .. .. 2 .. .. .. .. 2 Actelectasis 1 .. .. .. 1 .. • • .. .. 1 Congenital Malformations 3 1 .. .. 4 3 .. .. .. 7 Premature Birth 27 4 1 1 33 3 1 1 .. 38 Atrophy, Debility and Marasmus 3 .. 1 .. 4 2 1 .. 1 8 Other Causes 1 .. 1 .. 2 3 3 1 2 11 Totals 37 5 6 3 51 22 12 17 19 121 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the Quarter ended 1st July, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 118 1 29 70 11 7 .. .. 40 58 5 6 9 39 58 5 6 9 117 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 10 .. .. .. 1 3 5 1 4 4 .. 2 .. 1 2 .. .. .. 3 Scarlet Fever 152 1 29 88 26 7 1 .. 71 30 14 24 13 70 29 12 24 12 147 Malaria 4 .. .. .. 1 3 .. .. 3 .. .. .. 1 .. .. .. .. .. .. Enteric Fever 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever 2 2 .. .. .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. 2 Measles 560 25 217 307 9 2 .. .. 283 176 11 82 8 4 1 .. 1 .. 6 Whooping Cough 136 15 51 69 1 .. .. .. 65 27 1 39 4 .. .. .. .. .. .. Diarrhœa 9 4 5 .. .. .. .. .. 3 6 .. .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 5 5 .. .. .. .. .. .. 3 2 .. .. .. 3 1 .. .. .. 4 Tuberculosis, Pulmonary 64 .. 1 12 15 23 13 .. 33 17 8 5 1 1 .. .. .. 1 2 „ Non-Pulmonary 13 .. 4 8 1 .. .. .. 4 7 2 .. .. .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 39 3 6 6 10 6 7 1 20 10 1 6 2 2 3 .. 1 2 8 Totals 1113 56 342 561 75 51 26 2 532 337 42 164 38 123 94 17 32 24 290 *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 30th September, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to25 25 to 45 45 to 65 65 and upward Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 148 5 33 86 13 8 1 2 51 54 11 20 12 51 54 11 15 12 143 Encephalitis Lethargica 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. 1 Erysipelas 8 .. .. 1 .. 2 2 3 3 2 .. 1 2 1 1 .. .. .. 2 Scarlet Fever 112 1 26 65 11 6 2 1 63 18 12 12 7 60 18 12 12 5 107 Malaria 4 .. .. .. .. 3 1 .. .. 4 .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 3 .. .. .. 1 2 .. .. 2 .. 1 .. .. 1 .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 88 4 36 47 1 .. .. .. 34 47 .. 2 5 .. 1 .. 1 .. 2 Whooping Cough 115 6 42 63 1 2 1 .. 49 41 8 17 .. .. .. .. .. .. .. Diarrhœa 16 6 10 .. .. .. .. .. 5 9 1 1 .. .. .. .. .. .. .. Ophthalmia Neonatorum 3 3 .. .. .. .. .. .. 1 .. .. 2 .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 36 .. 1 6 10 11 8 .. 17 8 5 6 .. .. .. .. .. .. .. ,, Non-Pulmonary 17 .. 2 7 5 2 1 .. 6 6 2 2 1 .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 21 .. 1 3 3 7 4 3 4 12 .. 2 3 1 1 .. 1 2 5 Totals 573 25 151 278 46 43 21 9 235 202 40 65 31 115 76 23 29 19 262 *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 30th December, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke..* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox 169 13 52 96 5 3 .. .. 101 46 1 21 .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 200 5 51 118 19 6 1 .. 87 65 14 25 9 85 62 14 24 9 194 Mem. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 8 1 .. .. .. 1 4 2 7 1 .. .. .. 2 .. .. .. .. 2 Scarlet Fever 109 1 25 60 15 8 .. .. 43 20 24 13 9 40 18 23 12 8 101 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 2 .. .. .. 1 1 .. .. 2 .. .. .. .. 2 .. .. .. .. 2 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. Measles 110 1 46 60 3 .. .. .. 67 39 .. 3 1 .. .. .. .. 1 1 Whooping Cough 73 10 25 37 .. 1 .. .. 37 24 4 8 .. 1 .. .. .. .. 1 Diarrhœa 4 2 2 .. .. .. .. .. .. 3 1 .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 4 4 .. .. .. .. .. .. 2 1 .. 1 .. 2 .. .. .. .. 2 Tuberculosis, Pulmonary 61 .. .. 12 17 21 8 3 31 15 6 8 1 .. .. .. .. .. .. „ Non-Pulmonary 11 .. 3 3 3 2 .. .. 6 4 .. .. 1 .. .. .. .. .. .. Pneumonia, Acute Primary, or Influenzal 21 1 5 7 1 5 2 .. 11 7 1 2 .. 1 1 1 .. .. 3 Totals 773 38 209 393 64 49 15 5 395 225 51 81 21 134 81 38 36 18 307 * 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 30th December, 1922. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke.* Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke* Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox 169 13 52 96 5 3 .. .. 101 46 1 21 .. .. .. .. .. .. •• Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. Diphtheria 707 22 179 397 73 30 4 2 342 201 44 70 50 333 196 43 63 48 683 Encephalitis Lethargica 1 •• .. .. .. .. 1 •• .. 1 •• .. .. .. 1 .. •• •• 1 Erysipelas 43 2 .. 1 3 15 13 9 21 11 1 7 3 5 5 .. 2 1 13 Scarlet Fever 599 5 132 341 86 30 4 1 290 104 67 100 38 277 100 64 92 34 567 Malaria 10 .. .. .. 1 7 2 .. 3 4 2 .. 1 .. .. .. .. .. .. Enteric Fever 3 .. .. 1 1 1 .. .. 2 .. .. .. 1 2 .. .. .. .. 2 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 6 .. .. .. 2 4 .. .. 5 .. 1 .. .. 3 .. .. .. .. 3 Cerebro-Spinal Fever 3 2 1 .. .. .. .. .. 3 .. .. .. .. 3 .. .. .. .. 3 Measles 1286 51 522 691 19 3 .. .. 610 335 106 221 14 9 3 1 4 1 18 Whooping Cough 408 40 153 209 2 3 1 .. 179 134 20 69 6 3 5 1 .. •• 9 Diarrhœa 29 12 17 .. .. .. .. .. 8 18 2 1 .. .. .. .. .. •• .. Ophthalmia Neonatorum 18 18 .. .. •• .. .. .. 6 7 1 4 .. 6 2 .. 1 .. 9 Tuberculosis, Pulmonary 218 .. 3 39 57 78 37 4 108 50 24 33 3 2 .. .. .. 1 3 „ Non-Pulmonary 55 1 11 24 10 7 2 .. 21 21 7 3 3 •• 1 •• .. .. 1 Pneumonia, Acute Primary, or Influenzal 165 5 20 35 30 39 27 9 77 51 6 23 8 17 15 4 4 6 46 Totals 3720 171 1090 1834 289 220 91 25 1776 983 282 552 127 660 328 113 166 91 1358 *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 1922. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week 1—2 Weeks 2—3 Weeks 3—4 Weeks Total under 1 Month 1—3 Months 3—6 Months 6—9 Months 9—12 Months Total Deaths under 1 Year All Causes. Certified 37 5 6 3 51 22 12 17 19 121 Uncertified .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-Pox .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. 2 3 5 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 2 1 1 1 5 Diphtheria—Croup .. .. .. .. .. .. .. .. .. .. Erysipelas • • .. .. .. .. .. .. .. .. .. Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. .. .. .. 1 1 Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. 1 .. 1 Convulsions .. .. .. .. .. .. .. 1 1 2 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. 1 1 2 1 2 2 8 Pneumonia, all forms .. .. 1 1 2 6 4 8 7 27 Diarrhaœl Diseases. Diarrhœa, all forms .. .. •• .. .. .. .. .. .. .. Enteritis .. .. 1 .. 1 .. 1 .. 1 3 Gastritis .. .. .. .. .. 1 .. .. .. 1 Syphilis .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying .. .. 1 .. 1 .. .. .. .. 1 Injury at Birth 2 .. .. .. 2 .. .. .. .. 2 Actelectasis 1 .. .. .. 1 .. • • .. .. 1 Congenital Malformations 3 1 .. .. 4 3 .. .. .. 7 Premature Birth 27 4 1 1 33 3 1 1 .. 38 Atrophy, Debility and Marasmus 3 .. 1 .. 4 2 1 .. 1 8 Other Causes 1 .. 1 .. 2 3 3 1 2 11 Totals 37 5 6 3 51 22 12 17 19 121