4373 GRE25 THE ANNUAL REPORT made to THE COUNCIL OF the Metropolitan Borough of Greenwich For the Year 1924, BY ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H Barrister.at.Law, Fellow of the Royal Sanitary Institute, 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.), S, New Head. — 1925 — THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borough of Greenwich For the Year 1924, by ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H. Barrister.at.Law, Fellow of the Royal Sanitary Institute, 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. — 1925 — Contents. Pages Public Health Committee 1-2 Maternity and Child Welfare Committee 3 Introductory 4.5 Section I.—General Statistics 6 „ II.—.Vital and Mortal Statistics, Marriages, Births, Deaths 7-19 „ III.—Infectious Diseases 19-36 „ IV.—Causes of Sickness 37 „ V.—Summary of Nursing Arrangements, Hospitals and other Institutions available for the District 37.40 „ VI.—Laboratory Work 40-41 „ VII.—Sanitary Administration 41-64 „ VIII.—Public Health Staff 64-66 „ IX.—Housing 66-69 „ X.—Maternity and Child Welfare 69-79 Index 80-82 1 Public Health Committee during the year, 1923.4. The Mayor— Councillor S. N. Horne, J.P., and 13 Members. Alderman Mrs. S. A. Kelly, J.P. Councillors— M. G. Byerley, F.R.C.V.S. (Chairman) A. J. Hunt Mrs. C. R. Turner (Vice.Chairman) F. W. Mander, M.A. Mrs. N. Cunis W. W. Middleton Mrs. A. M. Edwards Dr. H. B. Morgan Dr. W. R. Hodgkinson, C.B.E., M.A. G. Redgrove. W. Holland F. C. Selfe Powers and Duties 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 Acts, 1920 and 1923; 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, 1923 ; 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 to 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. Housing, &c., Act, 1923. 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, 1917. Rats and Mice (Destruction) Act, 1919. Rent and Mortgage Interest Restrictions Acts 1920 and 1923. Milk and Dairies (Amendment) Act, 1922. Public Health (Condensed Milk) Regulations, 1923. „ „ (Dried Milk) „ „ 3 Maternity and Child Welfare Committee during the Year 1923.4. The Mayor— Councillor S. N. Horne, J.P., and fourteen Members. Alderman Mrs. S. A. Kelly, J.P. (Chairman) Councillors— S. M. Carpenter W. W. Middleton S. J. Clothier (Vice.Chairman). Mrs. N. Cunis Dr. H. B. Morgan A. J. Hunt Miss M. Sherman M. C. Matthews, M.A. Mrs. C. R. Turner Co.opted Members— Mrs. M. Hamilton Mrs. L. E. Scarr Mrs. A. Purkiss Mrs. C. H. Thackeray 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, 1925. 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 1924 on the health of the Borough. It will be seen from a perusal of the statistical tables that the figures generally are well up to the average, although possibly not comparing with last year which was a record year throughout the country. The Death Rate is 11.47 per 1,000 of the estimated population, which though slightly higher than last year's record figure of 10.95, is .76 lower than the average for the previous 5 years and compares favourably with the rates for the County of London and England and Wales which are 12.1 and 12.2 respectively. The Birth Rate is 20.19 per 1,000. Last year the Birth Rate was 20.54 and the average for the last 10 years, 21.64. The Birth Rate for the County of London is 18.7 and 18.8 for all England and Wales. It would seem therefore that whilst the Birth Rate in most parts of the country is declining in this Borough it remains fairly constant. The Infant Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered is 73, compared with 61 last year. The rate for England and Wales is 75, and for the County of London 69. The Zymotic Death Rate of .69 per 1,000 is somewhat higher than last year's figure of .46. The figures relating to the different constituent parts of the Borough are as follows :— 5 Districts. Birth Rate. Death Rate. Infantile Mortality per 1000 Births. Zymotic Death Rate. Diarrhœa and Enteritis Death Rate (under 2 yrs.) Consumption Death Rate. East Greenwich 19•93 11•14 67 •60 10•8 •93 West Greenwich 16•08 11•84 82 •57 4•4 1•25 St. Nicholas, Deptford 29•50 11•77 116 1•77 21•4 •75 Charlton 16•81 12•41 76 •71 9•1 1•07 Kidbrooke *102•53 6•61 11 •30 •30 †Whole Borough 21•58 11•47 68 •69 9•46 1•01 * This exceptionally high Birth Rate is accounted for by the fact that in this District are the Council's and " Stonefield " Maternity Homes. The " corrected " Birth Rate is 20.19 and the Infantile Mortality Rate 73 per 1,000 Births. Attack Rates of the various notifiable diseases per 1,000 living in the several districts are as follows:— Districts. Small.pox. Diphtheria. Scarlet Fever. Erysipelas. Typhoid Fever. Puerperal Fever. East Greenwich 0•00 3•23 3•36 •43 •08 — West Greenwich 0•00 3•20 2•66 •50 •10 — St. Nicholas, Deptford 0•00 2•53 2•40 1•26 •12 •25 Charlton 0•00 2•46 1•94 •30 •15 •20 Kidbrooke 0•00 0•90 1•80 — — — Whole Borough 0•00 3•04 2•79 •47 •10 •05 In conclusion, it is my privilege again to express my appreciation of the kindness and consideration which has always been shown to me by the members of the Public Health, and Maternity and Child Welfare Committees, and the whole of the members of the Council. I gladly acknowledge also the valuable assistance I have at all times received from every member of my capable and enthusiastic Staff. 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, 1924 102,990 Density of Population— East Greenwich 34.87 persons per acre West Greenwich 60.37 „ St. Nicholas, Deptford 67.60 „ Charlton and Kidbrooke 11.31 ,, Average for the Borough 26.68 persons per acre Number of Inhabited Houses— Occupied houses 16,623 Structurally separate dwellings at Census, 1921 16,526 1924 17,453 Number of Uninhabited Houses— At Census, 1921 288 Estimated, 1924 123 No. of Families or Separate Occupiers— At Census, 1921 22,972 Rateable Value £768,354 Sum represented by a Id. rate £3,141 7 SECTION 2. VITAL AND MORTAL STATISTICS, 1924. POPULATION. The population of the Borough estimated to the middle of the year 1924 is 102,990, and it is upon this figure that the statistics generally in this Report are based. (The Registrar.General's estimate, excluding non.civilians is 102,470). The distribution of the population throughout the Borough is as follows:— Census, 1921. (Adjusted.) Estimated Population at middle of year 1924. East Greenwich 44,647 45,332 West Greenwich 26,931 27,352 St. Nicholas, Deptford 7,646 7,774 Charlton 18,959 19,258 Kidbrooke 3,217 3,274 Total 101,400 102,990 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total. M. F. *Births Legitimate 2,022 1,043 979*Birth rate 20•2 Illegitimate 45 26 19 Deaths 1,200 629 571 *Death Rate 11•4 Number of women dying in, or in consequence of, childbirth From Sepsis 2 „ other causes 2 *Deaths of Infants under one year of age per 1,000 births :— Legitimate, 65 ; Illegitimate, 250 ; Total, 74. Deaths from Measles (all ages) 28 „ ,, Whooping Cough (all ages) 16 ,, „ Diarrhoea (under 2 years of age) 20 *These figures which are supplied by the Registrar-General differ slightly from those shown in other parts of the Report. 8 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 parish of Charlton and Kidbrooke, with the exception, in these latter particulars, that the marriages performed in the Woolwich Superintendent.Registrar's Office of residents in that Parish are not included. It will be noticed there is an appreciable decrease in the number solemnised during the year under review. The following table shows these particulars, giving the number of marriages in Greenwich and St. Nicholas, etc., for each year since 1912:— Year. In Churches of England in Greenwich. Charlton & 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. In Churches of Eng. land In Non.Conformist Churches. 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 1923 336 132 51 222 741 102460 1924 299 127 10 55 200 681 102990 BIRTHS. The total number of births registered in the Borough during the year was 2,258. Of this number 223 occurred in Greenwich and Deptford Hospital and 330 at various Nursing Homes within the Borough. Of this total of 553 Institution births, 246 only belonged to Greenwich, the remainder being transferred to the appropriate localities. 9 One hundred and sixty.two births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 2,113—Males, 1,098 ; Females, 1,015. This figure gives a Birth Rate of 20.19 per 1,000 of the population, which is 1.45 below the average for the last ten years. The Birth Rate for the County of London equals 18.7 per 1,000 of the population. The Birth Rate for all England and Wales was 18.8. Illegitimate births numbered 44, representing 2.0 per cent, of the total births. Eighty.five illegitimate births were registered in the Borough. In 45 cases, however, the mothers were ordinarily resident outside the Borough, and these births were consequently allocated to the correct areas. Four illegitimate births belonging to Greenwich occurred outside the Borough, thus giving the net figure of 44. Twenty.nine illegitimate births occurred in the Greenwich and Deptford Hospital. Under the provisions of the Notification of Births Act, 1907, intimations have been received from medical men, parents and others, with respect to 2,245 births. DEATHS. The nett number of deaths registered during 1924 was 1,200, of which 629 were males and 571 females. The crude Death Rate for the Borough of 11.47 per 1,000 compares favourably with 12.1 the Death Rate for the County of London, and 12.3, the Death Rate for the 105 Large Towns. The Death Rate in the various Metropolitan Boroughs varied from 10.4 in Lewisham, 10.8 in Woolwich, 11.0 in Wandsworth, 11.1 in Fulham, and 11.2 in Hackney, up to 14.10 in Finsbury, 14.0 in Southwark, 13.5 in Bermondsey and Shoreditch, and 13.1 in St. Marylebone. Locally the Death Rate varied from 6.61 in Kidbrooke, 11.14. in East Greenwich, 11.77 in St. Nicholas, Deptford, 11.84 in West Greenwich up to 12.41 in Charlton. Of the total number of deaths, 13 under five years of age were of illegitimate birth, 11 of whom were under one year of age. 10 The following table shows the variation in, and average of the Death Rates in each of the five Districts of the Borough in the five years 1919 to 1923, compared with the figures for 1924:— District. 1919. 1920. 1921 1922. 1923. Average for 5 Years. 1924. East Greenwich 10•58 10•39 12•17 11•26 10•43 10•96 11•14 West Greenwich 18•56 14•84 12•53 15•27 12•97 14•83 11•84 St. Nicholas 12•84 15•61 14•28 17•61 12•58 14•58 11•77 Charlton 13•10 9•39 11•80 11•68 8•74 13•68 12•41 Kidbrooke 6•88 8•90 11•62 12•38 10•47 10•05 6•61 Borough 13•15 11•72 12•41 12•92 10•95 12•23 11•47 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 in Public Institutions. 1919 1,372 603 1920 1,231 535 1921 1,243 553 1922 1,313 600 1923 1,119 546 1924 1,200 565 Average 1,279 567 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 51 32 33 38 154 Between 1 and 2 years 18 9 3 4 34 Between 2 and 5 years 18 12 8 8 46 Between 5 and 15 years 5 9 10 7 31 Between 15 and 25 years 26 22 16 8 72 Between 25 and 45 years 50 42 29 23 144 Between 45 and 65 years 80 61 42 79 282 65 years and upwards 175 100 70 112 457 Total 423 287 211 279 1,200 11 INFANTILE MORTALITY. The Infantile Mortality, measured by the deaths of children under one year of age to the number of births registered, was 73 per 1,000 births, there having been a total of 154 such deaths during the year, as compared with 175, 121, and 129, the respective figures for the years 1921, 1922, and 1923. Measles and Broncho. Pneumonia were the chief causes of the increase in the number of deaths. A further reference to the Infantile Mortality Rate will be found in the Section devoted to the Maternity and Child Welfare Scheme. For the whole of London the rate was 69 in 1924, compared with 60 in 1923, 74 in 1922, and 80 in 1921. For England and Wales the rate was 75, compared with 69 in 1923, 77 in 1922, and 83 in 1921. Locally the variations were from 11 per 1,000 births in Kidbrooke, 67 in East Greenwich, 76 in Charlton, 82 in West Greenwich, to 116 in St. Nicholas, Deptford. The following table shows at a glance these figures 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 live years, 1916-1920. inclusive. 1921. 1922. 1923. 1924. East Greenwich 129 106 96 81 61 46 66 67 West Greenwich 126 110 112 110 87 63 87 82 St. Nicholas, Deptford 179 143 167 138 91 81 68 116 Charlton 121 109 76 89 86 74 28 76 Kidbrooke 39 79 16 39 15 10 5 11 Borough 131 111 103 95 73 56 61 73 ANALYSIS OF DEATH CAUSES. Adopting the Registrar.General's classification of diseases, the following table shows the Death Rates for all persons belonging to the Borough per 1,000 of the population living in the Borough. 12 1924. 1924. Infective Diseases— Local Diseases—continued. Epidemic 0•92 Circulatory System 1•39 Sporadic — Respiratory System 1•87 Venereal 0•02 Digestive System 0•61 Septic 0•08 Lymphatic System 0•04 Malarial 0•03 Urinary System 0•28 Tuberculosis 1•21 Reproductive System 0•01 Parasitic Diseases — Parturition 0•01 Constitutional Diseases 1•22 Bones and Joints 0•01 Developmental Diseases 2•12 Integumentary System 0•01 Dietetic Diseases 0•009 External Causes— Local Diseases— Accidents 0•49 Nervous System 0•91 Homicide — Organs of Special Sense 0•03 Suicide 0•07 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic.—There were 97 deaths due to this class of disease, equalling a Death Rate of .92 per 1,000 ; the rate last year was .58 and was .88, .93, and 1.34 in 1920, 1921, and 1922 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 73 deaths, equalling a Death Rate of .69 per 1,000. Locally the Zymotic Death Rate varied from 009 in Kidbrooke (.00 in 1923), .57 in West Greenwich (.51 in 1923), .60 in Charlton (.15 in 1923) to 1.77 in St. Nicholas, Deptford (1.03 in 1923). Small.Pox.—There were no deaths from Small-Pox, this being the twenty-second year since a death occurred from this cause in the Borough. Measles.—Twenty-eight deaths only were ascribed as due to this disease. 27 being under five years of age. The number of deaths recorded last year was 2, and in the years 1920, 1921 and 1922, 26, 5 and 29 respectively. Eleven deaths occurred in East Greenwich, 5 in West Greenwich, 6 in St. Nicholas, and 6 in Charlton. Scarlet Fever.—This disease occasioned 2 deaths, both of which were under five years, and occurred in East Greenwich. Six such deaths occurred in 1922 and 2 in 1923. Whooping Cough. This disease was given as the cause of 16 deaths with a death rate of .15 per 1000. There were 13, 11 and 10 deaths respectively in the years 1923, 1922 and 1921. Seven deaths occurred in East Greenwich, 1 in West Greenwich, 4 in St. Nicholas, 3 in Charlton, and 1 in Kidbrooke. 13 Diphtheria.—There were 14 deaths during the year. This gives a Death Rate of .14 comparing with .10 for the previous year. Eleven deaths occurred in 1923, and 13, 28 and 42 in 1920, 1921 and 1922 respectively. Ten of the patients were under five years of age. Typhoid Fever.—There was one death ascribed to this disease ; there were 2 in 1920, 1 in 1921, 0 in 1922, and 6 in 1923. Diarrhcea, Dysentery, and Zymotic Enteritis.—Twelve deaths were said to be due to these causes, equalling a rate of .10 per 1,000. Last year there were 13 deaths and 22, 27 and 13 respectively in 1920, 1921 and 1922. Influenza.—Influenza is found to have been the responsible cause of 24 deaths ; 25 was the average of the previous three years. Ten cases were over 65 years of age. Six deaths occurred in East Greenwich, 7 in West Greenwich, 1 in St Nicholas, and 10 in Charlton Sporadic Diseases —There were no deaths from this class of diseases during the year. Venereal. Syphilis.—Three deaths were given as due to Syphilis, as against 7 in 1923 and 2 in 1922. Two occurred in East Greenwich, and 1 in West Greenwich. Of the 3 deceased persons, 2 were in the Greenwich and Deptford Hospital and 1 in Seamen's Hospital. There were no deaths from Gonorrhcea during the year. Septic Diseases. Erysipelas.—One death occurred from this cause in 1924, as compared with 3 last year. There were 2 in 1921, and 1 in 1922. Puerperal Fever.—There were two deaths from this disease during the year. Both cases occurred in Charlton. Pyæmia and Septicemia, &c.—There were 3 deaths from this disease during the year, 1 from Hospital Gangrene, 1 from Infective Endocarditis, and 1 from other Allied Diseases. 14 Malarial. Rheumatic Fever.—There were 3 deaths in 1924 as compared with 3 in 1923. 1 in 1922. and 3 in 1921. Rheumatism of the Heart.—There was one death attributed to this cause. Tuberculosis. This class includes the causes of 127 deaths during the year under review, with a rate of 1.21 ; these figures compare with 138, 141 and 133, the totals of the years 1921, 1922 and 1923 respectively and respective rates of 1.37, 1.38 and 1.30. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 106 attributed to this cause, or a rate of 1.01 per 1,000. Locally the deaths were 1 in Kidbrooke (giving a Death Rate of .30), 6 in St. Nicholas, Deptford (giving a Death Rate of .75), 43 in East Greenwich (Death Rate .93), 21 in Charlton (Death Rate 1.07) and 35 in West Greenwich (Death Rate 1.25). The remaining forms of Tuberculosis were responsible for 21 deaths, 11 of which occurred in East Greenwich, 7 in West Greenwich, and 3 in Charlton. Of these other forms of Tuberculosis, Tuberculosis of the Brain and its membranes were credited with 6 (4 being under five years of age), Tubercle affecting the Intestines 3, General Tuberculosis 10, and other forms of Tuberculosis 2 deaths. Parasitic Diseases.—There were no deaths from this class of disease. Dietetic Diseases.—There was 1 death from this class of disease. Constitutional Diseases.—The deaths from this cause were 128 in number, which gives a rate of 1.22 per 1,000. Of these, 113 were attributed to Cancer, 6 to Diabetes, 4 to Anæmia, 4 to Rheumatoid Arthritis, and 1 to Purpura Hemorrhagica. The deaths from Cancer were distributed as follows 50 occurred in East Greenwich, 31 in West Greenwich, 5 in St. Nicholas, 24 in Charlton, and 3 in Kidbrooke. 15 Cancer. During the year Circulars and Memoranda Nos. 476, 496 and 516 were issued by the Ministry of Health for the guidance of Local Authorities and a Sub-Committee of the Public Health Committee was formed to consider this matter in all its bearings, whereupon the following pamphlet was drawn up and has been generally circulated :— It is vitally important that the following facts about Cancer should be known. It has been brought to the notice of the Public Health Committee that of the number of persons who die each year from Cancer, many could have been saved if they had applied earlier for medical advice. On questioning patients as to why they did not apply to a doctor earlier, the reason almost invariably given is that as the early symptoms were unaccompanied by pain, it was not thought that anything serious was the matter. In order, therefore, to call the attention of the public to the significance of certain symptoms and conditions, and to the vital importance of acting promptly on the occurrence of these, it has been decided to make the following facts public. The only remedy for Cancer, at present known, is its early and complete removal. If neglected, and not removed in its earliest stages, it is invariably fatal. The importance of its early recognition and early removal is therefore evident. For this purpose the assistance both of the public and medical profession is requisite ; and a grave responsibility rests on both. It is only by their mutual co-operation that the ravages of this terrible disease can be lessened. The following information should be of great assistance to the public. It is no exaggeratoin to say, that, if acted upon, the result would be the saving annually of many hundreds of lives, which at present are prematurely sacrificed. 1. In the early and curable stage, Cancer rarely gives rise to pain or a feeling of ill-health. 2. Nevertheless, in its commonest situations, the signs of it in its early stage are conspicuously manifest. To witness : 3. In case of any swelling occurring in the breast of a woman after 40 years of age, a medical man should at once be consulted. 4. Any bleeding, however trivial, occurring after the change of life almost invariably means Cancer, which is then often curable. If neglected till pain occurs, it is almost always incurable. 16 5. Any irregular bleeding occurring at the change of life should invariably be submitted to a doctor's investigation. It is not the natural method of the onset of the change of life. 6. Any wart or sore occurring on the lower lip in a man over 40 years of age should be seriously regarded, and if possible, removed at once. 7. Any sore or swelling occurring on the tongue or inside of the mouth in a man after 40 years of age should be submitted to investigation without a moment's delay, because neglect or delay might have serious consequences, and lead to a fatal result. If removed at once the prospect of cure is good. 8. Persistent irritation and chronic loss of voice in persons over 40 years of age, should be considered as grave. Avoid irritation of the tongue and cheeks by broken, jagged teeth, and of the lower lip by clay pipes. Many of these irritations, if neglected, may end in Cancer. Daily thorough cleansing and constant supervision over the state of the Teeth are very important. 9. Any bleeding occurring from the bowels after 45 years of age, commonly supposed by the public to be " piles," should be submitted to investigation at once. A large proportion of such cases are at this stage perfectly curable. 10. When warts, moles, or other growths on the skin are exposed to constant irritation, they should be immediately removed. A large number of them, if neglected, terminate in Cancer. 11. Although there is no reliable or conclusive evidence that Cancer is communicable under ordinary circumstances, it is desirable that rooms occupied by a person suffering from Cancer, should be cleansed and disinfected from time to time. (Disinfection is carried out free by the Greenwich Borough Council. Application should be made to the Public Health Department as under.) E. G. ANNIS, Medical Officer of Health. Public Health Department, Borough Hall, Royal Hill, Greenwich, S.E.10. Further copies of this notice may be obtained on application. 17 Developmental Diseases.—There were 222 deaths, equal to a rate of 2.12 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz. :—Congenital defects, 10, and those from causes more or less preventable, viz. :—Premature birth, 24 ; Injury at birth, 1 ; Debility at birth, 8 ; Atrophy, Debility and Marasmus, 18 ; Atelectasis, 7 ; Dentition, 3, and Rickets. 1. The remaining and largest portion of these deaths from developmental diseases, 150 in number, were from Old Age ; in 1923 there were 119 deaths from this cause and 137 in the previous year. Local Diseases. Nervous System.—Ninety-six deaths were attributed to the various nervous diseases, which gives a rate of .91 per 1,000 ; last year the rate was 113 per 1,000. Convulsions were responsible for 3, all of whom were under five years of age ; 4 were from Meningitis, 59 from Apoplexy, 4 from Hemiplegia or Brain Paralysis, 2 from General Paralysis of the Insane, 1 from other forms of Insanity, 2 from Epilepsy, 6 from diseases of the Spinal Cord, 2 from Softening of the Brain, 4 from Locomotor Ataxy, 2 from Encephalitis, 2 from Encephalitis Lethargica, and 5 from other diseases of this system. Organs of Special Sense.—There were 4 deaths from this class of causes, equal to a rate of .03 per 1,000. Circulatory System.—The Death Rate from diseases of this system was 1.39 per 1,000, there being a total of 146 such deaths. Valvular Diseases of the Heart were responsible for 94, 3 from Aneurism, 4 from Embolism, 4 from Angina Pectoris, 2 from Pericarditis, 1 from Phlebitis, and from the remaining diseases of this system, 38. Respiratory System.—One hundred and ninety-six deaths were due to diseases of the Respiratory Organs, as compared with 173 in the preceding year. The Death Rate under this heading equals 1.87 per 1,000. Twenty-one were from Acute and 70 from Chronic Bronchitis, 93 from the various forms of Pneumonia, (43 being under five years of age), 2 from Emphysema, 4 from Pleurisy, 1 from other diseases of the Larynx and Trachea, 1 from Laryngitis, and 4 from other diseases. 18 Digestive System.—There were 64 deaths from diseases of this system, equal to a rate of .61 per 1,000. Of this number, Enteritis were responsible for 14, 10 of whom were under five years of age, 6 to Appendicitis, 8 to Obstruction of Intestine, and 1 to other diseases of the Intestines, 2 to Cirrhosis of Liver, and 2 to other diseases of the Liver, 5 to Peritonitis, 10 to Ulcer of Stomach and Duodenum ; 10 to other diseases of the Stomach, and 3 to other diseases of the Digestive System. Lymphatic System.—There were 5 deaths from diseases affecting this system during the year. Urinary System.—Thirty deaths, equal to a rate of .28 per 1,000, occurred from diseases affecting this system. Seventeen were from Bright's Disease, 9 from diseases of the Bladder and Prostate, and 4 from ill-defined causes of the Urinary system. Reproductive System.—There were only 2 deaths due to diseases of the Generative Organs. Two deaths were attributed to diseases of Parturition. Bones and Joints.—There were two deaths from diseases of bones and joints. Integumentary System.—There were 2 deaths from diseases of Integumentary System. External Causes.—There were 60 deaths given as due to causes grouped under this heading ; 52 were the result of accident or negligence, and the remaining 8 were from Suicide. Five children died from Suffocation by being overlaid in bed (compared with 3 from this cause last year) ; 9 cases were from Drowning, 2 from Burns and Scalds, while accidents on railways, in vehicular traffic and in building operations, falls, etc., were responsible for 36 deaths. The suicides were 1 from Poisoning, 3 by Shooting, 2 by Hanging or Strangulation, 1 by Drowning, and 1 by other and unspecified methods. Ill-Defined Causes.—There were no deaths in 1924. 19 MORTUARY. The number of bodies dealt with in the Mortuary since 1912 is shown below:— Year. Drowned Bodies from River. Other Bodies. Totals. 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 1923 12 170 182 1924 21 182 203 SECTION 3. NOTIFIABLE DISEASES DURING THE YEAR 1924. Disease. Total Cases Notified.* Cases admitted to Hospital. Total Deaths.* Small Pox — — — Diphtheria 319 313 14 Scarlet Fever 292 278 2 Enteric (including paratyphoid) 11 10 1 Puerperal Fever 6 4 2 Pneumonia 112 24 10 Erysipelas 50 12 1 Acute Polio Myelitis 1 1 — Cerebro Spinal Fever 2 1 1 Continued Fever — — — Malaria 8 — — Ophthalmia Neonatorum 5 — — Encephalitis Lethargica 12 10 2 Notifiable Locally. Measles 1874 152 28 Whooping Cough 498 20 16 Diarrhoea 53 20 12 3,243 845 89 * For particulars as to Age Groups see Tables at end of Report. 20 TUBERCULOSIS. Age-Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F 0 - - 5 1 1 4 1 1 .4 1 10 4 1 — 3 4 5 2 5 8 7 — — — — 10 10 11 3 2 2 1 2 2 15 14 12 2 4 10 6 1 2 20 10 15 — 3 7 7 — 1 25 17 30 3 2 7 13 — 1 35 19 18 1 — 13 6 — — 45 17 12 — — 16 7 — — 55 10 2 — — 5 — — — 65 and upwards 4 — 2 — 3 1 — — Totals 107 106 34 23 65 41 10 11 Particulars relating to the above Table are dealt with in the Report of the Tuberculosis Officer on pages 26 to 34. OPHTHALMIA NEONATORUM. Cases. Vision Unimpaired. Vision impaired. Total Blindness Deaths. Notified. Treated. At Home. In Hospital. *6 2 †4 5 — — 1 * Includes 1 case of Inflammation of the Eyes. † 3 cases attended as Out-Patients. Notifications under the Provisions of the Public Health (London) Act, 1891.—During the year 3,516 cases have been notified under the above Act, as compared with 3,227, 3,720 and 2,087 respectively in the preceding years 1921, 1922 and 1923. Small-Pox.—No case of this disease occurred in the Borough during the year. 21 Contacts.—Three intimations were received from overseas by Medical Officers of Health of the Port Sanitary Authorities respecting persons who had been in contact with Small-Pox. In every instance they were kept under observation for the usual period. Details respecting vaccination in the Borough are given in the Supplemental Vaccination Reports on page 36. Diphtheria.—Three hundred and nineteen cases of Diphtheria were notified during the year, as compared with 391, 595, 707 and 275 respectively in the years 1920, 1921, 1922 and 1923. The distribution of these cases was as follows:—149 in East Greenwich, 89 in West Greenwich, 20 in St. Nicholas, 58 in Charlton, and 3 in Kidbrooke. Of this total number, 313 were removed to the Hospital for treatment, amongst which number the Hospital Authorities reported that in 10 cases they considered the diagnosis incorrect. Seven cases were returned to Hospital for further treatment, after being discharged as cured. All these were examined by your Medical Officer of Health. There were 14 fatalities due to this disease, which gives a case mortality of 4.3 per cent. One thousand eight hundred and twenty-seven specimens were forwarded by medical practitioners for bacteriological investigation from cases suspected to be diphtheria. Of this number, 1,648 were reported to give negative or doubtful result, and 179 were positive in character, being dealt with accordingly. The quarterly incidence of the disease for 1924 has been as follows:— lst Quarter—East Greenwich, 23 cases; West Greenwich, 10; St. Nicholas, 2; Charlton, 14; Kidbrooke, 2; a total of 51 cases. 2nd Quarter—East Greenwich, 43 cases; West Greenwich, 17; St. Nicholas, 3; Charlton, 10; Kidbrooke, 1; a total of 74 cases. 3rd Quarter—East Greenwich, 40 cases; West Greenwich, 25; St. Nicholas, 7; Charlton, 8; a total of 80 cases. 4th Quarter—East Greenwich, 43 cases; West Greenwich, 37; St. Nicholas, 8; Charlton, 26; a total of 114 cases. Membranous Croup.—There were no cases of Membranous Croup notified during the year. 22 Erysipelas.—Fifty cases were notified during the year, 20 being in East Greenwich, 14 in West Greenwich, 10 in St. Nicholas and 6 in Charlton. Twelve of these patients were removed to a Public Institution in the district. Scarlet Fever.—Two hundred and ninety-two cases were notified during the year, as compared with 958, 599 and 219 cases respectively in the years 1921, 1922 and 1923, 155 cases were in East Greenwich, 74 in West Greenwich, 19 in St. Nicholas, 38 in Charlton and 6 in Kidbrooke; 278 of these cases were removed to the Hospital for treatment, 2 of which were returned as not suffering from this disease. There were two deaths from this disease during the year, compared with a like number the previous year. Of the 278 cases treated in Hospital, the following were certified to be suffering on discharge from Hospital with chronic disease:— Rhinitis, 3; and Otorrhcea, 2. There were no cases which could be described as "Return Cases." Typhoid Fever.—There were 11 cases of Typhoid or Enteric Fever notified during the year, 4 being in East Greenwich, 3 in West Greenwich, 1 in St. Nicholas and 3 in Charlton. The ages of the patients were: 1 between one and five years, 3 between five and fifteen years, 3 between fifteen and twenty-five years, 2 between twenty-five and forty-five years and 1 between forty-five and sixtyfive years, and 1 sixty-five years and upwards. Ten cases were removed to Hospital for treatment. In the years 1920,1921, 1922 and 1923 there were 15, 11, 3, and 16 cases respectively. The average number for the previous ten years is 13. No case was traceable to the consumption of shellfish; there was only 1 fatality from this disease. Nine specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be Typhoid Fever in character, 2 giving positive results. Puerperal Fever.—Six cases of this disease were notified during the year, 2 in St. Nicholas, and 4 in Charlton. There were 9 cases in 1923, 6 cases in 1922, 11 cases in 1921, and 5 in 1920. There were 2 deaths from this disease during the year. 23 Measles.—This disease was made permanently notifiable by an Order of this Council, approved by the Ministry on the 1st July, 1920. One thousand, eight hundred and seventy four cases were notified during the year, as compared with 706 during the previous year, and 1,286 for the year 1922. One hundred and fifty-two such cases were removed to Hospital for treatment. The ages and incidence of fatality of the disease were as follows: There were 75 cases under 1 year of age, with 8 deaths at this age period, giving a case mortality of 10.6 per cent. Between the ages of one to five years there were 1,090 cases with 19 deaths at this age period, giving a case mortality of 1.07 per cent., and 709 cases between five years and sixty-five with 1 death, giving a case mortality of .14 per cent. The case mortality for the whole district works out at 1.4 per cent. as compared with .28 per cent for the previous year, and 2.25 for the year 1922. Table showing number of Measles Cases reported during the year 1924. Quarter ended 29th March, 1924. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total. East Greenwich 11 183 145 6 1 346 West Greenwich 7 78 86 1 1 173 St. Nicholas, Deptford 8 53 13 1 — 75 Charlton 5 90 75 1 1 172 Kidbrooke — 5 5 — — 10 Total 31 409 324 9 3 776 Quarter ended 28th June, 1924. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total. East Greenwich 16 264 137 5 3 425 West Greenwich 15 224 127 2 3 371 St. Nicholas, Deptford 2 28 2 — — 32 Charlton 3 103 44 — — 150 Kidbrooke — 2 2 1 — 5 Total 36 621 312 8 6 983 24 Quarter ended 27th September, 1924. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total. East Greenwich 3 19 16 1 1 40 West Greenwich 4 19 13 — 1 37 St. Nicholas, Deptford — 2 — — — 2 Charlton 1 14 10 — — 25 Kidbrooke — — 1 — — 1 Total 8 54 40 1 2 105 Quarter ended 3rd January, 1925. Under 1. 1 to 5. 5 to 15. 15 to 25. Total. East Greenwich 2 2 4 West Greenwich — 1 1 - 2 St. Nicholas, Deptford — — — - — Charlton — 3 1 - 4 Kidbrooke — — — - — Total — 6 4 - 10 Total cases in year = 1,874. Zymotic Enteritis or Epidemic Diarrhoea.—Fifty-three cases of Diarrhoea were notified throughout the whole of the Borough, 28 being under one year of age and 25 between one and five. Twenty-three of such notifications related to patients in East Greenwich, 23 in West Greenwich, 4 in St. Nicholas and 3 in Charlton. There were 12 deaths ascribed to this disease. Whooping Cough.—This disease was made permanently notifiable as from 1st November, 1921. Four hundred and ninety-eight cases were notified (compared with 329 in 1923), (54 being under one year of age, 270 from one to five, and 164 from five to fifteen, the districts concerned being East Greenwich, 321; West Greenwich, 42; St. Nicholas, 24; Charlton, 110; and Kidbrooke, 1. Each of these cases was visited and leaflets and instructions left, together with verbal advice lespecting the isolation and care of the patient. 25 Epidemic Cerebro-Spinal Meningitis, Cerebro-Spinal Fever, or Post-Basal Meningitis.—There were 2 cases of this disease notified during the year, both of which occurred in West Greenwich. One case which was sent to Hospital for treatment was subsequently discharged as not suffering from the disease. Acute Polio-Myelitis or Acute Polio-Encephalitis.— There was 1 case notified during the year, as compared with 4 cases in 1923, and 0 in 1922. Ophthalmia Neonatorum.—During the year 5 cases of this disease have been notified, 2 being in East Greenwich, 1 in West Greenwich, and 2 in Charlton. Further particulars of this disease will be found on page 77. Malaria.—There were 8 cases of Malaria notified during the year, 1 occurring in East Greenwich, and 3 in West Greenwich, and 4 in St. Nicholas, compared with 2 last year. Encephalitis Lethargica. There were 12 notifications of cases of this disease. Five of these cases occurred in the eastern part of the Borough, 2 in the western, 2 in Charlton, 2 in Kidbrooke, and 1 in St. Nicholas, Deptford. Of the total number of cases 6 occurred in May, 3 in June, and 1 each in April, July and September, the ages of the patients being 5, 14 years and under, 2 from 14 to 20 years, 2 from 20 to 30 years, 2 from 30 to 40 years, and 1 aged 61 years. Full enquiries were made in connection with every case, but in no case did there appear to have been any trace of infection from one patient to another. In some of the cases the diagnosis of the illness was not definitely established. There were 2 deaths and amongst the other cases up to the present only one case, that of a boy aged 5 years, has not fully recovered. 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, 214 being pulmonary cases, ordinarily known as Consumption, and 59 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 89 pulmonary and 17 non-pulmonary, occurred in East Greenwich, 54 pulmonary and 25 non-pulmonary 26 in West Greenwich, 21 pulmonary and 11 non-pulmonary in St. Nicholas, 46 pulmonary and 6 non-pulmonary in Charlton, and 4 pulmonary and 0 non-pulmonary in Kidbrooke. The various ages of the patients were as follows:—Pulmonary cases under 1, 1; from one to five, 5 cases; five to fifteen, 25 cases; fifteen to twentyfive, 52 cases; twenty-five to forty-five, 87 cases; forty-five to sixtyfive, 39 cases; and 5 cases over sixty-five; whilst the Non-pulmonary were: Under one year of age, 6 cases, one to five, 14 cases; five to fifteen, 22 cases; fifteen to twenty-five, 10 cases; twenty-five to forty-five, 5 cases, forty-five to sixty-five, 1 case; and 1 case over sixty-five. Four hundred and two specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive; 331 were reported to be negative and 71 positive. Disinfection has been offered and carried out in 153 cases, including 210 rooms and 633 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. REPORT OF THE TUBERCULOSIS OFFICER. To the Medical Officer of Health. Sir, There is no great change to be recorded in this, the Twelfth Annual Report, on the work of the Tuberculosis Department. Last year I had the pleasure of reporting that the Incidence and Death Rate for Tuberculosis were the lowest ever recorded in the Borough, and low as these rates were, I have this year to report a further improvement. Thus the notifications and Deaths from Tuberculosis in 1924 were as under :— Notifications. Non- Deaths. Non- Pulmonarv Pulmonary Total Pulmonarv Pulmonary Total 214 59 273 106 21 127 and the averages for the previous ten years (1914-1923) 276 114 136 31 In at least 15 instances (8 pulmonary and 7 non-pulmonary), the diagnosis of Tuberculosis was not confirmed after a period of observation, either in Hospital or at the Dispensary, so that the corrected number of Notifications should read 206 Pulmonary and 52 Non-pulmonary. This gives an Incidence Rate as regards Pulmonary Tuberculosis of 2.04 per 1,000, and as regards NonPulmonary forms of .57 per 1,000, these figures, as before remarked, being the lowest ever recorded in the Borough. 27 The 15 cases referred to above comprised: 4 Debility; 2 Syphilis; 2 Chronic Bronchitis. These 8 patients were notified as suffering from Pulmonary Tuberculosis. The 7 cases diagnosed as suffering from Non-Pulmonary Tuberculosis proved: 1 Malignant Disease of the Hip; 1 Suppurative Disease of the Kidney; and 5 Simple Swelling of the Glands due to affections of the throat and scalp. Non-Pulmonary Tuberculosis: The 52 (corrected) Notifications included:— 9 cases of General or Miliary Tuberculosis 18 ,, Tuberculosis of the Glands (Neck) 3 „ „ „ Spine 8 „ „ „ Joints 4„ ,, ,, Abdomen 3 ,, ,, „ Bone 6 „ „ „ Brain (Meningitis) 1 „ „ „ Skin In connection with this form of Tuberculosis, affecting chiefly, children it is interesting to note that 38 of the 52 cases used condensed milk almost exclusively. Many cases of Non-Pulmonary Tuberculosis in children are regarded as due to infection by the Bovine Bacillus as found in cow's milk. With the exception of Tuberculosis of the Neck Glands and of the Brain, the above patients were mostly notified from Hospitals, and their treatment, which formerly was mainly surgical, is now likely to be considerably influenced by the recent advances in Heliotherapy or Sunlight Treatment, either natural or artificial. Encouraging reports are being received of the wonderful results obtained by this treatment, both on the Continent and at home, so that it appears that surgical treatment, as far as operative measures are concerned, will in future be greatly restricted, and that no longer will we see those scars and deformities which are all too often seen to-day on the bodies of our children. In connection with the Light Treatment the Public Health Committee arranged a popular lecture by Dr. Saleeby, which was largely attended by both Council and Public, and it is hoped that ere long Greenwich will follow the lead of some of the other Metropolitan Boroughs, and instal the necessary apparatus. Deaths from Non-Pulmonary Tuberculosis, of which there were 21 (equal to a rate of .20 per 1,000), included 8 cases of Meningitis, 4 of Abdominal Tuberculosis, 4 General Tuberculosis, and 5. other parts. 28 Pulmonary Tuberculosis: Late Notifications and NonNotifications of the total deaths from Pulmonary Tuberculosis in 89 per cent, notification had previously been made under the Regulations; in 11 per cent, it had not. That notification, however, is becoming more efficient every year is exemplified by the fact that the Non-notified cases, which reached 26 per cent, in 1921, dropped to 13 per cent, in 1924. Medical men are still asked to notify every case of Tuberculosis they are called upon to attend, unless they have positive information that notification has been already carried out, and many practitioners enquire at the Dispensary if this has been done, but Hospitals and Institutions still continue in their failure to notify. Thus, of the 11 cases mentioned in the table below, who died before notification was received, 10 had received treatment in Hospital, and the only one instance was the general practitioner in default. As far as could be ascertained in 7 of these cases, the average duration of illness was 3 months. The following table shows the Death Notification interval of 104 patients who died in 1924, and whose deaths were ascribed to Pulmonary Tuberculosis:— Died before notification received 11 Died within one month of notification 17 ,, ,, three months 8 ,, „ six months 9 ,, over six months 59 Deaths: During the year 127 persons died from Tuberculosis (all forms), giving a death rate of 1.21 per 1,000 population; 106 deaths were due to the pulmonary form, equal to a rate of 1.01 per 1,000 population, the lowest ever recorded in the Borough. Notifications and deaths from Pulmonary Tuberculosis, with the Incidence and Death Rates for the previous five years, are recorded below:— Year. Notifications Incidence per 1,000 Deaths Death Kate per 1,000 1919 300 2.9 141 1.35 1920 264 2.5 120 1.14 1921 263 2.6 119 1.18 1922 218 21 120 1.18 1923 213 208 115 1.12 29 Occupation: As indicated last year, there are no industries in the Borough which have any special bearing upon the Incidence of Tuberculosis, but below is given a condensed Table of the occupation of 205 adults notified during the year as suffering from Pulmonary Tuberculosis, together with the number showing a family history of tuberculosis. In connection with occupation, however, it must be borne in mind that very few trades in themselves are injurious; it is the conditions under which they are carried on that rermire consideration. Occupation Number Number with Family History of Tuberculosis Labourer 51 15 Clerks 20 5 Factory Workers 21 14 Mechanics 26 8 Shop Assistants 19 5 Housewives 40 19 Domestics 15 4 Others 13 2 Housing: The Housing condition presents little improvement and much overcrowding exists, many examples of which have been brought to the notice of the Public Health Committee by the Care Committees. It follows that the sleeping arrangements continue a very serious difficulty in the problems of infection. Of 205 patients suffering from Pulmonary Tuberculosis, 106 were sharing a bed. 67 had a separate bed but not a separate room. 32 had a separate room and a separate bed. As a result of much persuasion and perseverance on the part of the Tuberculosis nurses and the Care Committee, 19 patients who were sharing a bed have now separate beds, and 6 patients, who each shared a bed with three others, have had their sleeping arrangements so altered as to have only one partner: not an ideal arrangement, but the best that could be done under the circumstances, and a great improvement on the original state as found by the nurses. The Council has now increased the number of shelters to 6, and these are in constant use. Bedsteads and bedding have been lent or supplied by the Council and other agencies. (See Report of Care Committee.) 30 From careful and frequent revision of the Registers it is estimated that the number of Tuberculous persons residing in the Borough at the close of 1924 amounted to 764, as follows:— Men. Women. Children. Total. Pulmonary Tuberculosis 218 214 126 558 Non-pulmonary 19 19 168 206 Patients who have kept in apparent good health for at least a period of 5 years are now struck off the Register, but are visited periodically and examined if necessary. Dealing with the Dispensary itself, 919 new patients were examined during the year. The sources from which these patients came are as follows:— Doctors 230 Hospitals 16 School Medical Service 32 Ministry of Pensions 14 Own Application 111 Nurses (Contacts) 516 Contacts: Much of the nurses' time is spent endeavouring to secure the examination of every contact. This year, out of a total of 711 Contacts, 581 or 81 per cent, were examined, of whom 49, or 8 per cent., were found to be Tuberculous. In addition, 103 Contacts were examined more than once before arriving at a definite diagnosis. The work of the Dispensary is shown in the statistical table on pages 33 and 34 and explains itself. Duration of Illness: Taking 90 deaths in 1924 from Pulmonary Tuberculosis (54 men, 30 women, 6 children) whose histories were recorded at the Dispensary the average duration of illness for both sexes worked out at 37 months as against 38 months last year, the difference between the males and the females being 3 months against 2.4 months in the preceding year. In the children, the average duration was 6 months, against 6.2 in 1923. Family History: In connection with the 90 deaths alluded to in the previous paragraph, there was a history of Tuberculosis amongst the near relatives (father, mother, brothers, sisters) in 19 instances, and amongst remote relatives (uncles, aunts, etc.) in 12. 31 Sanatorium Treatment.: During the year 203 patients were sent to sanatoria, 118 under the County Scheme, 61 through the Guardians, and 24 through other sources. In addition, 41 children are attending the Open Air Schools. The average duration of residence remains the same, and the same difficulties remain in finding suitable employment for those discharged fit for work. X-ray Examinations: During the year 40 patients were examined, of whom 9 were children. There were 36 examinations of the chest and 4 of other parts. Sputum Examinations: Of 215 sputum specimens bacteriologically examined at the Seamen's Hospital, 37 proved positive and the remainder negative. At the same time, 238 specimens were chemically examined at the Dispensary for Albumen, with very similar results to those mentioned last year. Tuberculosis Care Committee: The Interim Tuberculosis Care Committee, which had accomplished such good work in the past, came to an end on the 6th May when the Permanent Care Committee was formed in accordance with the decision of the Council as indicated last year. Miss Johnston, the Hon. Secretary of the Interim Committee, kindly agreed to act in a similar capacity to the new Committee. This Committee meet every month (except August) at the Borough Hall, but a Sub-Committee consisting of the Chairman, the Medical Officer of Health, the Tuberculosis Officer and the Secretary, meet almost weekly to deal with emergency cases. Miss Johnston gives a short report below, but much of the assistance given has been of such a nature as cannot well be written down. The friendly visits, the kindly advice, and the interest shown in their welfare, have been much appreciated by the patients and also by the Dispensary staff:— "During the year assistance to the extent of over £80 was rendered to patients and their families by the Charity Organisation Society, Greenwich Soldiers and Sailors' Help Society, Soldiers and Sailors' Families' Association, United Services Fund, Invalid Children's Aid Association, British Red Cross Society, Private Donors and other friends, 32 and that, in addition, gifts of clothing, beds and bedding, milk, convalescent letters, etc., were received from various organisations and friends. The Board of Guardians have again been most sympathetic in providing extra nourishment, clothing, etc., to cases recommended by the Committee. A sum of £131 towards the cost of treatment of patients was collected from patients and their relatives for the London County Council. As in former years, several parents saved their money by using the Secretary as their banker, while their children were in Sanatoria, to provide clothes, etc., for them on their return home. Several Conferences of Care Committee secretaries were held during the year at the County Hall and other places, and various subjects dealing with the work of Care Committees discussed, e.g., the need for increased accommodation for advanced cases of Tuberculosis, Housing and Overcrowding, Employment for exSanatorium Patients, etc., etc." The services of the District Nurses in attending and nursing those advanced cases referred to them from the Dispensary must be again gratefully acknowledged. In concluding the Report I would once more thank the members of the Public Health and Dispensary Staff for their assistance and co-operation in carrying out the work entrusted to us. I am, Sir, Your obedient Servant, M. MACDONALD, M.D., D.P.H., Tuberculosis Officer Return of work carried out in connection with the Maze Hill Tuberculosis Dispensary for the Year 1924. Number of Under observation at the Dispensary on Jan. 1st pending diagnosis Examined for the first time during the year Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NoilPulmonary. (a) All persons (including " Contacts ") Adults M. 5 174 179 70 5 101 1 2 F. 10 274 284 55 3 216 5 5 Children under 15 M. 6 229 235 10 10 205 8 2 F. 9 242 251 10 9 225 6 1 Total 30 919 949 145 27 747 20 10 (6) "Contacts" (included in (a) ). Adults M. 1 74 75 15 1 59 - — F. 4 174 178 18 2 155 2 1 Children under 15 M. 4 158 162 4 5 152 1 F. 4 175 179 4 — 172 2 1 (c) Insured per- son3 included in (a) ). M. 5 153 158 60 4 92 1 1 F. 3 73 76 21 1 50 2 2 33 34 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December 440 2. Total number of attendances of patients at the Dispensary during the year—Insured 2,907 Uninsured 3,996 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 302 4. Number of cases in which the period of observation at the Dis- pensary exceeded two months 69 5. Number of insured patients under domiciliary treatment on December 31st 15 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 27 7. Number of persons referred to affiliated hospital for consultation — 8. Number of consultations with Medical practitioners at the homes of patients—Insured 16 Uninsured 11 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 135 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 4,463 11. Number of specimens of sputum examined in connection with the work of the Dispensary 215 DENTAL TREATMENT. The whole of the dental work in connection with the Tuberculosis Department and the Maternity and Child Welfare Clinics is carried out at the Dispensary. Gas is administered by the Tuberculosis Officer where necessary. Mr. G. Francis Ferris, L.D.S. (Lond.), R.C.S. (Engld.), the Council's Dental Surgeon, reports as follows:— The condition of the mouth as a determining factor in the successful treatment of disease, and in particular of Tuberculosis, is universally recognised, and every effort is being made by the Greenwich Public Health Department to extend the work of oral hygiene and to simplify its administration. With this idea in view, the arrangement existing hitherto between the Council and the British Dentists' Hospital (now British Dental Hospital) has been altered, and the dental treatment is now under the direct control of the Borough Council. Furthermore, by arrangement with the Ministry of Pensions, pensioners may now receive oral treatment 35 from the Borough Dental Surgeon. This ensures co-operation between doctor and dental surgeon, which is essential, for an unhealthy or septic mouth may render negligible the most skilful treatment on the part of the medical officer concerned. This statement is endorsed by the Tuberculosis Officer who reports considerable improvement in those patients who have consented to dental treatment. A large percentage of those who attended the clinic were suffering from extensive periodental disease and/or extensive dental caries, which necessitated drastic treatment. Periodental disease or Pyrrhœa Alveolaris results in the formation of pus with a corresponding absorption of the bone which supports the teeth. Without treatment the teeth become loose, and the pus is either swallowed —causing gastric troubles—or is directly absorbed into the blood, causing general rheumatic and nervous conditions. The Tuberculosis Officer administered gas, and it is important and interesting to note that every operation was highly successful. Gas was administered on twelve occasions, the total number of extractions being 164. Unfortunately, on the part of the patients themselves, there seems to be a great aversion to conservative treatment, the opinion being that extractions remove the source of trouble with the minimum of time and discomfort. This idea is erroneous, as fillings can now be done quite painlessly, and should preserve the teeth for a number of years. Extractions result in gaps which must be filled or a deficiency in masticating power will result. Defective health follows defective mastication, and, prevention being better than cure, all patients are instructed in the use of the toothbrush, which is of primary importance in the care of the teeth. In necessitous cases dentifrice has been supplied gratis. Appreciation of the dental clinic is shown by the great increase in the number of patients, and in view of this increase the desirability of an additional session might be considered by the Committee in the near future. During the year 1924-1925 the following tuberculous cases were treated:— Referred to Dentist 195 New Patients 63 Attendances 272 Dentures 4 Fillings and Scalings 31 Extractions (N20) 164 „ (local anaesthetic) 119 Extractions 11 Advice 103 36 Supplemental Vaccination Return for 1923. Return made on or before the 9th of February, 1925, 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, 1923, inclusive:— Registration SubDistricts comprised in the Vaccination Officer's District. No. of Births from 1st Jan to 31st Dec., 1923. Number of these Births duly entered by 31st Jan., 1925 No. of Births which on 31st Jan., 1925 remained unentered in the Vaccination Register on account of- No of these births remaining on 31st Jan., 1925, not accounted for. Total No. of Certificates of successful Primary Vaccination at all ages received during Calendar Year 1924. No. of Declarations of Conscientious Objection actually received by Vaccination Officer during the Calendar Year 1924. Successfully Vaccinated. Insusceptible of Vaccination. Had Small-pox. Certificates of conscientious objection received. Dead, Unvaccinated. Postponement by Medical Certificate Removal to Districts, V.O. of which apprised. Removal to places unknown and cases not found. South Deptford. . 636 340 2 — 183 25 — 14 14 58 .. .. North Doptford. . 905 480 5 — 251 23 2 2 17 125 .. .. East Doptford . . 948 420 4 — 185 49 1 3 67 219 .. .. East Greenwich. . 961 535 3 — 216 70 1 26 41 69 .. .. West Greenwich 475 277 — — 123 22 — 4 9 40 .. .. Total .. 3,925 2,052 14 — 958 189 4 49 148 511 2,229 929 Dated February 4th, 1925. A. E. Rossiter, Vaccination Officer. CHARLTON AND KIDBROOKE. Statutory Declarations of Conscientious Objection 135 Dead Unvaccinated 15 Postponed by Medical Certificate 4 Removed to Districts the Vaccination Officer of which has been duly apprised 23 No. of Births entered in "Birth List Sheets" as registered from 1st January to 31st December, 1923 659 Successfully Vaccinated 459 Insusceptible of Vaccination 3 Had Small-Pox — Removed to placos unknown, or which cannot be found; and cases not traced 17 Not accounted for 3 G. E. Oughton. 37 SECTION 4. CAUSES OF SICKNESS. Apart from the prevalence of Measles in the early part of the year there was no cause of sickness calling for special mention. SECTION 5. SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. Professional Nursing in the Home. (а) General. No provision is made by the Council. (b) For Infectious Diseases. Arrangements are made with the Blackheath and Charlton District Nursing Association : St. John the Divine Home, Deptford. and the Ranyard Nurses for nursing selected cases of Measles, Ophthalmia Neonatorum, Influenza, Dysentery, Epidemic Diarrhoea, Malaria and Pneumonia, upon an intimation from the Public Health Dept. The Council's Health Visitors also give advice and assist as far as possible. Midwives.—No midwives are employed or subsidised by the Council. There are 20 practising in the district. 38 Clinics and Treatment Centres. Name. Situation. Nature of Accommodation. By whom provided. Period when held. Maternity and Child Welfare Centreas. Borough Hall, Royal Hill, Greenwich. 1 large waiting room. 1 large weighing room. 1 Consulting room. Local Authority. Thrice weekly. (a) Infant Consultations Conduit House, Trafalgar Rd., Greenwich. Ditto. Ditto. Thrice weekly. 105, Shooter's Hill Road. Blackheath. Ground floor consisting of large waiting room, large weighing room and consulting room. Ditto. Twice weekly. (b) Maternity. Albany Institute, Creek Road. Deptford. Large hall and consulting room. Ditto. Once weekly. Borough Hall. 105, Shooters Hill Road, S.E. (See above). ( Do. ) Ditto. Ditto. Twice weekly. Once weekly. (c) Minor Ailments. Borough Hall. 1 large room. Ditto. Daily. Nursery School. Rachel McMillan Memorial School, 232, 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. St. John's Hospital, Morden Hill. Lewisham — - Twice weekly. 39 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 Officers' 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 the treatment of Greenwich Children and Grant made by the Council for this purpose. A grant is also made to the St. John's Hospital; Lewisham, in respact of minor operations performed on children referred to them by the Medical Officer in charge of the Infant Consultations. (4) Fever and (5) Small Pox.—Cases of infectious Diseases are treated at the Hospitals of the Metropolitan Asylums Board. Institutional Provision for Unmarried Mothers, Illegitimate Infants, and Homeless Children. No provision is made by the Council, but Dr. Barnardo's Homes National Incorporated Association have Finchley Lodge, St. John's Park, Blackheath, used for this and similar purposes. Ambulance Facilities. (a) Patients suffering from Infectious Diseases are 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 Metropolitan Asylums Board, London County Council and certain local Hospitals. 40 HOSPITAL AND OTHER FORMS OF GRATUITOUS MEDICAL RELIEF. I am again indebted to the Secretaries of the Hospitals situated in the Borough for kindly giving me information regarding gratuitous medical relief. The Seamen's Hospital have admitted, treated and maintained 299 Greenwich persons for an average of twenty-six days each, being an increase of 43 over last year's figure, in addition to which there have been 2,904 Out-patients, making approximately 8,712 attendances of persons belonging to the Borough of Greenwich, compared with 2,012 out-patients for the previous year. Miller General Hospital admitted, treated and maintained 243 Greenwich persons for an average of twenty-three days as against 359 last year. 6,266 Out-patients have also been treated, the total attendances being approximately 28,820. Blackheath and Charlton Cottage Hospital admitted 291 In-patients from Greenwich, and treated 496 Out-patients making 3,673 attendances for this purpose. POOR-LAW RELIEF. The Clerks of the Greenwich and Woolwich Boards of Guardians have kindly furnished me with the following figures for the year ended 3rd January, 1925:— Greenwich Parish St.. Nicholas Deptford Parish. Charlton and Kidbrooke Parish. Total amount expended in out-door relief £74,430 £ * £11,274 Total number of persons treated in Hospital 1,616 182 94 Total number of persons treated medically in their own homes 792 • 221 „ „ „ „ at Dispensary — — 214 Total number of persons admitted to the Work- house 458 84 29 * Figures are unobtainable. SECTION 6. LABORATORY WORK. The long-standing arrangement with the Bacteriological Department of the Seamen's Hospital has been in force throughout 41 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 1,827 specimens have been examined for Diphtheria, 9 for Typhoid Fever, 402 for Tuberculosis, and 33 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. Thirty-five tubes of Diphtheria Antitoxin, containing a total of 125,000 units of serum, have been supplied during the yearto Medical Practitioners for the treatment of patients suffering from this disease. SECTION 7. SANITARY ADMINISTRATION. 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. 42 Regulations under Dairies, Cowsheds and Milkshops Orders, 1885 and 1886. Further particulars are given under Powers and Duties of the Public Health Committee on pages 1 and 2. The tables on pages 43 to 45 and 48 to 54 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 15,569 houses and premises have been inspected or re-inspected during the year; 1,291 intimation notices and 172 statutory notices have been served. It is very gratifying to be able to report that only in one instance was it found necessary to institute Police Court proceedings during the year, particulars of which arc contained in the table on page 52. There were altogether throughout the year 572 complaints registered. Factories, Workshops and Workplaces.—Two hundred and eighty-six inspections have been paid to these premises within the Borough during the year. There were 183 workshop premises on the Register at the beginning of the year, 7 have been added and 3 taken off, leaving a total now on the Register of 187. This total includes 8 laundries, 14 dressmaking and mantle works, 11 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. Outworkers' Register.—Ten lists, containing 35 names and addresses have been received from employers within the district. In addition to this 54 lists containing 159 names and addresses of Outworkers residing in this Borough were received from Medical Officers of Health of other Boroughs, whilst 11 lists with 17 names and addresses were forwarded to other districts, thus giving a total of 177 Outworkers in the Borough. One hundred and forty-eight visits of inspection have been paid to these premises. 43 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions Factories (Including Factory Laundries) 74 2 .. Workshops (Including Workshop Laundries) 114 11 .. Workplaces (Other than Outworkers' Premises) 98 2 .. Total 286 15 .. 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecut's. Found. Remedied Referred to H.M. Inspector. * Nuisances under the Public Health Acts:— Want of Cleanliness 48 48 .. .. Want of Ventilation 2 2 .. .. Overcrowding .. .. .. .. Want of Drainage of Floors 2 2 .. .. Other Nuisances 20 20 .. .. Sanitary Accommodation— Insufficient 5 5 .. .. Unsuitable or Defective 9 9 .. .. Not Separate for Sexes 3 3 .. .. 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) 34 34 .. .. Other Offences .. .. .. .. Total 123 123 .. .. * 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. Secs. 109 & 110. Lists received from Employers. Notices served on occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 10). Prosecutions (Secs. 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. 10 18 17 .. .. .. .. .. .. .. .. .. .. .. .. (2) Cleaning & Washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, Lace Curtains & Nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur Pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cotton and Kit Bags .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brush Making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Box Making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rackets and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 10 18 17 - - - - - - - - - - - - 45 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1924. No. Bakehouses 36 Factory Bakehouses 5 Barge Builders 14 Blacksmiths 4 Boot and Shoe Makers 8 Builders' Yards 4 Carpenters and Joiners 4 Carriage Builders 2 Coopers 4 Cycle Works 3 Dress and Mantle Makers 14 Fuel Works 11 Laundries 8 Milliners 2 Photographers 3 Picture Frame Makers 1 Printers 1 Tailors 5 Underclothing Makers 1 Others 57 187 5—OTHER MATTERS. Class. No. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5):— Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspectors 1 Other — Underground Bakehouses (sec. 101):— In use at the end of 1924 13 Customs and Inland Revenue Acts.—No applications were received during the year for certificates under these Acts. Scavenging.—The Refuse Destructor foreshadowed for some years past is still in course of construction. Five hundred and sixty-three new ash receptacles have been provided. Horse Slaughterer.—The one horse slaughtering premises in the Borough has been inspected on three occasions and the cleansing of the premises duly carried out. 46 Houses Let in Lodgings.—Very little can be done in the way of systematic inspections until the new By-Laws to be made by the London County Council under Sac. 26 of the Housing and Town Planning Act, 1919, as amended by Sec. 14 of. the Housing, etc., Act, 1923, become law. One hundred and eighty-eight inspections were made of the premises already on the Register. Rats and Mice (Destruction) Act, 1919. Four hundred and thirty-two investigations were made by the Council's Rats Officer, but in no case was if found necessary to serve a notice. The usual " Rat Week " was held during the first week in November, and followed on the lines acted upon in previous years. Circulars were sent out to all business firms and factories in the Borough inviting their co-operation and concerted action towards the extermination of rats and mice. Chemists and Hardware Dealers were also circularised with a view to their laying in larger stocks of raticides. Although there was a falling off in the response to the communication sent out by the Department as to the result of the action taken, investigations subsequently made by the Rats Officer showed that in most cases the efforts put forward by the various owners and occupiers of property in the Borough were carried out in a very satisfactory manner. Increase of Rent and Mortgage Interest Restrictions Acts, 1920 and 1923. Six applications were received during the year from tenants for certificates under these Acts. Four Certificates were granted. In the remaning 2 cases the Certificates were not necessary, the work specified being done by the Landlord. One application was received from a Landlord in respect of his premises; as the required work had been satisfactorily executed the Certificate was granted. Other Scheduled Offensive Trades. The Offensive Trades hitherto carried on at the Foreign Animals' Wharf have not yet been recommenced. A Local Committee has been putting in a great amount of work and devoting a considerable amount of time in the endeavour to obtain a re-opening of the whole or some part of the Foreign Animals' Wharf for its original purposes, i.e., the reception and slaughter of animals from abroad, which re-opening it was considered would materially aid to the amount of work for persons residing in the district, but during this current year this Committee have been informed definitely that the War Office cannot release any portion of the premises for this purpose and accordingly the Committee has been dissolved. 47 Smoke Nuisances.—Thirty observations have been made for smoke nuisances during the year, but in no instance was it found necessary to serve a Statutory Notice. The Council continue to receive complaints from time to time respecting the emission of smoke and grit from the chimneys of the London County Council's Generating Station. Much correspondence has ensued between this Department and the County Council on the subject, and I am now pleased to be able to report that the Tramways Department of that Council have decided definitely to spend a considerable amount of money to put in an up-to-date gritcatching apparatus whereby it is hoped that this serious nuisance will be completely removed. Complaints have also been received respecting the emission of black smuts from a Lamp Black Works in this District, and here again our efforts have resulted in the firm being able to so improve their methods of production as to enable them to retain a much larger proportion of their product and the nuisance suffered by the occupants of the immediate neighbourhood has been perceptibly diminished. Water Supply.—During the year 16 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. Defective water fittings have been remedied in 42 cases; 27 water supplies have been reinstated where the supply had been cut off; water fittings have been amended in 106 cases; 7 water supplies have been altered so as to draw direct from the main; water supply provided in 6 instances, and cleansing, repairing and covering cisterns in 10 cases. House Drainage.—Twenty-one drains have been constructed, 105 drainage systems have been reconstructed or repaired; 350 such systems have also been opened, cleansed and amended; 33 surface drains have been constructed; 58 drains and soil pipes have been ventilated; 205 systems have been tested by smoke, 296 by water, of which number 73 were found to be defective; 35 new soil pipes and 225 traps have been fixed, together with 36 intercepting chambers and fresh air inlets, and 58 other chambers. Ventilation has been improved in 30 cases. Twelve new covers to manholes have been provided. Twentytwo systems have been sealed off or slurried up. Eight forecourts 12 areas, 39 yards, 2 mews and stables drained; 1 cesspool abolished; 26 water-closets have been erected: 125 cleansed and repaired; 82 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 138 cases; pans only in 9 cases, and other fittings provided or improved in 216 cases, whilst the water supply has been renewed in 25 instances. Public-house urinals have been cleansed and repaired in 12 instances. 48 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1924. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Inspections Houses Inspected 434 569 780 546 2329 Other Premises Inspected 68 106 124 107 405 Re-inspections, Calls Made, etc. 2310 2517 2521 2805 10153 Inspections of Houses Let in Lodgings 37 36 57 58 188 „ Bakehouses 1 57 17 34 109 „ Factories and Workshops 40 26 57 68 191 „ Outworkers' Premises 58 47 5 38 148 „ Slaughterhouses 1 8 4 4 17 „ Cowhouses — 3 1 2 6 „ Stables and Yards 9 13 14 25 61 „ Piggeries — 3 .. .. 3 „ Courts and Alleys .. 6 5 .. 11 „ Fields, Lanes, etc. 8 21 20 12 61 Investigations (Rats and Mice) 156 49 45 182 432 Inspections of Urinals 10 6 7 3 26 „ Gipsy Vans .. .. .. .. .. „ Horse Slaughterhouses 1 .. 1 1 3 „ Dairies, Cowsheds and Milkshops 9 89 19 21 138 „ Soap Works 1 .. .. .. 1 „ Other Offensive Trades . . .. .. .. .. „ Ice Cream places 1 98 34 9 142 ,, Other places where food is prepared 270 318 288 269 1145 Total 3414 3972 3999 4184 15569 Drains. Constructed 2 6 1 12 21 Intercepting Chamber, and Fresh Air Inlet 5 9 7 15 36 Other Chambers Constructed 14 17 8 19 58 Reconstructed or Repaired 28 27 24 26 105 Opened, Cleansed, and Amended 64 109 108 69 350 Surface Drains Constructed 1 12 12 8 33 Traps Fixed 55 61 45 64 225 New Soil Pipes 2 9 7 17 35 Soil and Vent Shafts Repaired 7 13 7 7 35 Drains and Soil Pipes Ventilated 4 10 16 28 58 Drains Sealed off, etc. 4 8 2 8 22 Drains tested—by Smoke 45 44 52 64 205 „ by Water 52 54 71 119 296 Found Defective 13 27 17 16 73 New Covers to Manholes 3 3 .. 6 12 Yards Drained 13 5 12 9 39 Mews and Stables Drained .. .. 1 1 2 Washhouses Drained .. .. .. .. .. 49 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Drains—contd. Forecourts Drained .. 1 4 3 8 Areas Drained .. 5 4 3 12 Cesspools abolished .. .. .. 1 1 Privies and Earth Closets abolished .. .. .. .. .. Water Closets and Urinals. Closets erected 3 6 7 10 26 W.C. doors repaired or provided 16 15 22 29 82 Sanitary Conveniences or Improvements effected to Factories, and Workshops 3 3 9 5 20 Pan, Traps and Water Supply furnished 7 10 18 11 46 Pans and Traps only furnished 34 35 38 31 138 Pans only furnished 2 7 .. .. 9 Water Supply Apparatus repaired or provided 40 54 48 74 216 Water Supply renewed 8 7 10 .. 25 Water Supply disconnected from Drinking Water Cistern .. .. 4 .. 4 Soil Pans properly trapped .. .. .. .. .. Cleansed and Repaired 23 30 37 35 125 Newly constructed or better situated 1 2 14 3 20 Ventilation improved 6 2 17 5 30 Public-house Urinals cleansed or repaired 4 2 3 3 12 Other Urinals altered or cleansed .. .. .. .. .. Other Urinals constructed .. 1 .. .. 1 Repaired or water laid on .. .. .. .. .. Ashpits. Provided 38 71 192 262 563 Covers to receptacles .. 3 .. .. 3 Dust complaints forwarded to the Surveyor .. .. .. .. .. Pavings. Yards 44 54 55 56 209 Forecourts 4 4 12 3 23 Areas 3 5 6 1 15 Washhouses 5 4 8 3 20 Mews and Stables .. .. .. .. .. General Water Supply. Covers to Cisterns adapted .. 1 3 3 7 Water Supply provided 2 1 1 2 6 Water Fittings amended 27 12 13 54 106 Cisterns cleansed and repaired 2 .. 1 2 3 Water Services altered so as to draw direct from main .. .. 4 3 7 Water Supplies reinstated where cut off through defective fittings 6 4 15 2 27 50 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. General Water Supply—contd. Defective Water Fittings (causing nuisance from dampness) repaired 7 9 14 12 42 Water Supply Certificates granted (Section 48) 3 2 7 4 16 Other Improvements. Houses generally repaired 127 94 122 132 475 Premises cleansed, lime-washed and repaired 47 78 42 85 252 Verminous Rooms cleansed 21 47 55 42 165 Ventilation improved 70 53 34 60 217 Staircases repaired, lighted and ventilated 14 10 21 11 56 Leaky House Roofs and Gutters repaired 125 115 122 150 512 Walls and Ceilings of Premises cleansed throughout 50 41 28 48 167 Ditto ditto partially 79 113 115 134 441 Stoves, Fireplaces and Flues repaired 52 40 21 34 147 Washing Coppers repaired 29 23 22 20 94 Sinks provided 5 12 13 16 46 Floors repaired 67 67 45 62 231 Cowhouses cleansed .. 3 .. 3 6 Piggeries cleansed .. .. 1 .. 1 Horse Slaughter houses 1 .. .. .. 1 Ice Cream places cleansed or improved .. 7 3 2 12 Other places where food is stored or prepared 5 19 14 6 44 Provision for Storage of Food .. 2 4 .. 6 Other Nuisances Abated. Illegal use of Underground Room discontinued 3 2 .. .. 5 Overcrowdings abated .. .. 1 1 2 Sink, Lavatory and Bath Waste Pipes disconnected, trapped and amended 37 43 30 42 152 Stack Pipes disconnected and amended 42 39 25 42 148 Nuisances from dampness abated 58 34 45 48 185 Animals Kept in Unfit Places discontinued or removed .. 4 2 2 8 Dung Receptacles provided 1 .. 1 1 3 Bakehouse Nuisances abated .. 2 4 4 10 Houses abolished, unfit for habitation .. .. .. .. .. Accumulations of Manure and other obnoxious matter removed 14 17 22 8 61 Dampness of Walls remedied 30 24 29 32 115 Inundations abated 1 11 2 .. 14 Other Nuisances, principally of dilapidations and want of underfloor ventilation 26 21 28 21 96 51 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Other Nuisances Abated.—contd. Contents of Rooms cleansed .. 2 4 7 13 Breaches of By-Laws abated .. .. .. .. .. Rat Infestation abated 21 13 16 22 72 Smoke Nuisances. Observations 8 14 7 1 30 Statutory Notices served (Sections 23 and 24) .. .. .. .. .. Food and Drugs. Samples taken 111 165 96 68 440 Found Adulterated 5 4 2 1 12 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Unwholesome Food. Seizures made — — 7 Stone of Skate. — — Voluntarily surrendered 1 box of Haddock Roes. 1 Bullock. 2 Pigs. 1¼ cwt of Rabbits. 2 Stone of Skate. ½ Case of Norwegian Herrings. ¾ cwt. Whelks. 3 qrs. of Whelks. 6 Stone of Whiting. 1 cwt. Potatoes. 56 cwt. Sultanas. 112 cwt. Currants. 1 ¼ cwt. of Rabbits. 6 Stone of Plaice. 6 Stone of Haddock. 4 lb. Cherries. 52 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) 196 301 429 346 1272 Notices served— Under Housing, Town Planning, etc., Act, 1919 10 9 .. .. 19 Rats and Mice (Destruction) Act, 1919 .. .. .. .. .. re Verminous Rooms .. 2 2 .. 4 Under P.H. (L.) Act and Metropolis Management Act (re combined drainage) .. 17 26 .. 43 W.C.'s (Factories, Workshops and Workplaces) .. .. .. .. .. Yards 1 .. .. 1 2 Miscellaneous .. .. .. 2 2 Statutory Notices served under Section 4 24 25 20 25 94 Statutory Notices re Ashpit provision 3 4 6 14 27 Complaints received and attended to 128 138 154 152 572 Letters written relating to abatement of Nuisances 101 124 51 76 352 Summonses applied for and issued .. 1 .. .. 1 Magisterial Orders obtained and enforced .. 1 .. .. 1 Drainage Plans received and examined 23 18 21 29 91 Legal Proceedings under the Public Health (London) Act, 1891, and By-Laws during the year 1924. Premises. Complaint. Result of Proceedings. Fine. Costs. The Cottage, "Bramhope," Charlton Road Non Compliance with Statutory Notice Closing Order made — 11/- 53 BOROUGH OF GREENWICH. Proceedings during 1924. Premises. Number of Places. Number of Inspections, 1924. Number of Notices 1924. Number of Prosecutions, 1924. On Register at end of 1923. Added in 1924. Removed in 1924. On Register at end of 1924. Dairies, Cowsheds and Milkshops 103 10 11 102 138 9 — Slaughterhouses 5 — — 5 20 — — Other Offensive Trade Premises — - — — — — Ice Cream Premises 133 17 12 138 142 11 — Registered Houses Let in Lodgings 247 — — 247 188 — — Total number of Intimation Notices served for all purposes 1291 Overcrowding, 1924— Number of Dwelling-rooms overcrowded 6 Number remedied 2 Number of Prosecutions — Underground Rooms— Illegal occupations dealt with during year 5 Number of Rooms Closed 5 Insanitary Houses— Number Closed under the Public Health (London) Act, 1891 1 Number closed voluntarily under the Housing of the Working Classes Acts — Number of Verminous Premises cleansed under Sec. 10 of the London County Council (General Powers) Act, 1922 165 Number of Cleansing Baths given under Cleansing of Persons Act 15 Shelter provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — 54 Number of Tenement Houses provided with Additional Water Supply 5 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 Prsoecutions 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 animals in such a manner as to be injurious to health — (d) As to paving 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) — Mortuaries— Total number of bodies removed 203) Total number of infectious bodies removed — 55 FOOD. Cowhouses.—The four cowhouses in the Borough have been visited on 6 occasions, and the required cleansing duly enforced. Dairies, Cowsheds and Milkshops Order.—At the commencement of the year there were 103 premises on the Register of Dairies and Milkshops; 10 new applications have been received during the year and added to the Register, and 11 names have been taken off, thus leaving a total of 102 premises now registered. During the year 138 visits of inspection have been paid to these premises; notices were served upon the occupiers in 9 cases where dairies required limewashing or were otherwise in an insanitary condition. 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. Milk (Special Designations) Order, 1923.—This Order was made by the Minister of Health under the powers conferred on him by Section 3 of the Milk and Dairies (Amendment) Act, 1922, Under the Order, the Council, as the local authority, may grant licenses to distributors such licenses to be valid only for a period ending on the 31st December in the year in respect of which it is granted. During the year 4 Dealers' licenses were granted for the sale of ''Certified'' Milk and 1 license for the sale of "Grade A'' (Tuberculin Tested.) No applications were received for licenses to sell "Grade A " or " Pasteurised " Milk. Public Health (Dried Milk) Regulations, 1923.—These regulations came into force on the 1st May, 1924, and prescribe the conditions laid down with regard to the labelling and composition of dried milk. Section 6 provides that any officer of the Local Authority duly authorised in writing shall have power to enter at all reasonable times any premises where dried milk is prepared, packed, labelled or stored and to inspect any process carried on therein, and to take samples of any article used or capable of being used in the preparation of dried milk and of any labels designed to be used for affixing to tins or other receptacles of dried milk. This is, in my opinion, a most useful provision. 56 During the routine inspections of the wharves situated on the Riverside it was found that large cases of dried milk were being broken up and repacked and labelled ready for distribution. It was also observed that these same premises were used for the storage of such materials as, cement, old iron, raw cowhide ; furthermore, deposits of dried horse manure were also discovered, and there was considerable evidence of rat infestation. Prominently displayed near the dried milk was a Notice warning workers of the danger of Anthrax arising from the handling of hides. Further enquiry elicited the fact that the workers on one particular article might be transferred at a moment's notice to the handling of the dried milk. An embargo was placed on the whole of the consignment of the milk pending a thorough examination. As a result, 76 cases (3 tons, 16 cwt.) were found unfit for human consumption and dealt with accordingly and the firm in question have now discontinued the process of repacking dried milk on these premises. Milk and Cream Regulations, 1912 and 1917.—One hundred and seven samples of milk were taken during the year. In no case, however, was the presence of a preservative reported upon by the Public Analyst. Two samples of cream were taken both of which were found to be free from preservatives. One sample of Preserved Cream was reported as genuine, the amount of Boric Acid preservative being 0 25 per cent. The condition as to proper declaratory label was duly observed. Owing to complaints being received concerning certain infringements under the Regulations a Circular was addressed to all Milk and Cream vendors in the Borough especially drawing attention to the prohibition of preservatives in Milk and Cream. Milk for Expectant and Nursing Mothers and Young Children.—During the year 52,937 lbs. of dried milk of various kinds have been supplied 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 :— 1 Bullock. 2 Pigs. 57 Slaughterhouses.—The number of slaughterhouses in use in the Borough are as under:— In 1914. In January, 1924. In December, 1924. Registered — — — Licensed 4 4 4 4 4 4 Seventeen inspections were made by the Inspectors during the year. Other Foods.—Places where food is prepared have been visited on 158 occasions, improvements being required in 24 instances as detailed below:— Class of Premises. Number or Lists. Number of Inspections. Number of instances where matters needed attention. At end of 1923. Added 1924. Removed 1924. At end of 1924. Hotel Kitchens 6 - - 6 6 — Eating Houses 50 5 4 51 63 7 Fried-Fish Shops 31 2 — 33 39 14 Pork Butchers and Sausage Manufacturers 24 1 - 25 30 3 Mineral Water Manufacturers 1 — — 1 1 — Others 16 3 — 19 19 — Totals 128 11 4 135 158 24 The 24 instances where matters needed attention included 14 cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 5 where the sanitary arrangements were defective, 2 where the gutting sheds were not 58 satisfactory, and 1 where the yard was foul. One eating house has been removed from the Lists owing to the continued dirty condition of the premises. In addition to the periodical visits and inspections of food shops, etc., supervision is also exercised on Saturday evenings and Bank Holidays. 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 Ice Cream Premises.—There were 133 premises known at the commencement of the year where the manufacture of this commodity was carried on; 17 have been added during the year and 12 taken off, leaving a total of 138 premises. These premises were inspected on 142 occasions, improvement required by way of cleansing of the premises in 12 cases, and insanitary conditions remedied in 3 instances. In 1 case the sale of ice cream was discontinued owing to the unsuitability of the storage arrangements. Bakehouses.—One hundred and nine inspections have been made of the various Bakehouses in the Borough and 10 nuisances found therein have been abated. At the end of the year there were 5 Factory and 36 other Bakehouses on the Register, 13 of which are underground. Food and Drugs Acts.—Four hundred and forty 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 428 were certified to be genuine and 12 adulterated, the adulterations thus being equivalent to 2.72 per cent. of the samples taken. Of the total number of samples purchased, 107 were milk, of which 5 were certified to be adulterated; the remaining adulterated samples were 4 of mustard and 3 of vinegar. Proceedings were taken in 4 cases resulting in fines and costs being imposed in 3 instances. The remaining case was dismissed owing to Warranty being proved. 59 Sale of Food and Drugs Acts. Administrative Action regarding Samples reported to be NOT GENUINE. No. of Sample Description of Sample. Nature of Adulteration. Result of Proceedings. 4 Milk Deficient in Fat to the extent of 30% Dismissed; Warranty proved 30 Do. Admixed with 8% of water Fine £10; Costs 32/- 79 Do. Deficient in Fat to the extent of 3% Warning letter 268 Do. Do. do. of 18% Fine 20/-; Costs 21/- 29 Separated Milk Deficient in Solids not Fat to the extent of 1.2% Warning letter 10 Mustard Admixed with 3% of Wheat Flour and a trace of Turmeric Warning letter. 145 Do. Do. with 10% of Wheat Flour coloured with Turmeric Warning letter 225 Do. Do. with 27% do. Do. 387 Do. Do. with 5% do. Do. 249 Vinegar Deficient in Acetic Acid to the extent of 7% Do. 339 Do. Do. of 9% Do. 361 Do. Do. of 18% Fine—; Costs 27/- 60 Sale of Food and Drugs Acts.—Number and Description of Sample purchased for Analysis under the above Acts during the Year 1924. Description of Samples Number of Samples Purchased. Number Genuine. Number Not Genuine. Baking Powder 12 12 - Bread 6 6 - Breakfast Sausage 19 19 - Brawn 1 1 - Butter 92 92 - Cheese 1 1 - Coffee 4 4 - Cream 2 2 - Cream (Preserved) 1 1 - Dripping 1 1 - Flour 1 1 - Flour (Self-Raising) 4 4 - Lard 2 2 - Lunch Sausage 1 1 - Margarine 5 5 Medicine 4 4 - Milk 105 101 4 Milk (Separated) 2 1 1 Mustard 18 14 4 Pearl Barley 19 19 - Pepper 40 40 - Rice 29 29 - Saveloy 1 1 - Vinegar 70 67 3 440 428 12 DISINFECTION. The erection of the new Disinfecting and Cleansing premises was carried out by the National Building Guild, Ltd. (London Regional Council) in accordance with a plan and specification prepared by the Borough Engineer for the sum of £2,150. As the present Disinfecting Machine has been in use for many years a new Washington Lyon's Disinfector and Vacuum Pump was purchased for the sum of £637. 61 The following Tables summarise the work carried out by the Disinfecting Staff during the year:— Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 53 weeks ended 3rd January, 1925. Infectious Diseases. Rooms. Premises Entered. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. Quilts. Odd Articles. Total No. Articles Disinfected Polio-Myelitis 1 1 .. .. 1 .. 2 1 .. .. 1 .. 5 Encephalitis Lethargica 14 9 3 .. 3 4 10 4 .. 4 3 2 33 Scarlet Fever 314 271 174 3 98 140 403 454 36 25 132 211 1676 Diphtheria 285 228 123 2 47 87 250 275 26 11 67 59 947 Enteric Fever 10 7 3 .. 4 5 15 15 .. 2 2 4 50 Puerperal Fever 5 5 4 1 3 3 15 8 .. .. 2 56 92 Tuberculosis 210 153 62 3 36 52 162 75 26 35 27 155 633 Other Diseases* 71 50 32 2 166 62 312 234 20 75 15 764 1682 Measles 20 15 .. .. 3 .. 3 2 .. .. 2 36 46 From Verminous Premises 14 10 9 1 30 10 31 79 6 3 10 68 247 Scabies 2 2 .. .. 2 1 1 10 5 .. 1 37 57 Influenza and Pneumonia 8 8 1 3 1 7 .. .. 1 6 2 1 22 Cerebro-Spinal Meningitis 2 2 2 .. .. 1 1 1 .. .. .. .. 5 Total 956 761 413 15 394 372 1205 1158 120 161 264 1393 5495 *Includes:—Cancer; 25 Rooms; 302 Articles. 62 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 53 weeks ended 3rd January, 1925. Infectious Diseases. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. Quilts. Odd Pieces. Total No. Articles Destroyed. Small-pox .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 1 1 .. .. .. .. .. .. .. 3 Diphtheria .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. Tuberculosis 7 1 2 3 5 .. 2 8 .. 1 29 Other Diseases 4 1 3 2 5 1 .. .. .. 500 516 For Verminous Premises 1 1 2 .. 2 .. .. .. .. 30 36 Influenza .. .. .. .. .. .. .. .. .. .. .. Total 13 4 8 5 12 1 2 8 .. 531 584 63 In addition to the ordinary routine work performed by the Staff the whole of the Boys' Section and a portion of the Infants' Section of the Blackheath Road Council School was fumigated after an outbreak of Diphtheria. HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made by Infectious Disease Inspector 695 Number of Re-visits 2,560 The Health Visitors also visited 2,806 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease:— Central Libraries, 96 ; School Libraries, 6 ; Total, 102. CLEANSING STATION, BLACKWALL LANE. The new Cleansing Station which forms part of the Disinfecting premises was formally opened in June. Provision is made for separate slipper baths for adults and children of both sexes, together with separate waiting rooms, drying rooms, and a room for the use of the nurse in attendance. The arrangements made with the London County Council for reserving the use of the 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 214 2nd 150 3rd 117 4th 231 Total 712 64 An interesting feature is the diminution in the number of attendances during the past few years, as the following figures will indicate:— Year. No. of Children Cleansed. 1920 1,508 1921 1,396 1922 957 1923 868 1924 712 This would seem to suggest that the co-operation of the School Medical Service and the following up work performed by officers of this Department has had the desired effect. Fifteen adults suffering from vermin were also given cleansing baths. In every case the infested clothing was disinfected. Public Sanitary Conveniences.—There are at present 3 underground sanitary conveniences in the Borough, situated at— Blackwall Lane, East Greenwich. South Street, West Greenwich, and Creek Road, St. Nicholas, Deptford. Tenders were invited for the erection of an additional underground convenience situate at the foot of Blackheath Hill. Only one Tender, however, was received. This was probably due to the fact that no quantities were furnished. Instructions were therefore given for quantities to be prepared and for the work to be readvertised. Six Tenders were received in response to the advertisements, but having regard to the amounts of such tenders it was decided to accept the Borough Engineer's Estimate to carry out the work by direct labour for the sum of £2,500. SECTION 8. PUBLIC HEALTH STAFF. The only change in the personnel of the Staff was the appointment in October of Mr. L. A. Westacott in place of Mr. W. H. Collins who was transferred the Town Clerk's Department. 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). 65 Assistant Medical Officer of Health and Tuberculosis Officer— *M. Macdonald, M.D., Ch.B., D.P.H. Maternity and Child Welfare Medical Officer— *G. J. Sophian, M.R.C.P. (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—†*Geo- F. Ferris. L.D.S., R.C.S. (Eng.). Sanitary Inspectors— *A. E. Bache. *W. R. Drake. *S. A. Radford. *Mrss G. Davis. *A. E. Morgan. Infectious Diseases Inspector— *E. Martin. Health Visitors— *Miss M. Molloy. *Miss E. Bailey. *Mrs. M. Donald-Morison. *Miss A. M. M. Hadfield. *Miss F. C. Jagot. *Miss H. Foley. TUBERCULOSIS DISPENSARY. Nurses— *Miss L. Heastman. *Miss T. I. Husbands. *Miss D. M. Wilkins. Dispenser— Caretaker— *E. E. Burrows. *Mrs. Vickery. MATERNITY HOME Matron— *Miss N. G. Beeham. Clerical Staff— *F. W. Foulger (Principal Clerk). H. W. Duck. L. A. Westacott. Miss L. Merricks. E. P. Tidman (Temporary). *Mrs. L. E. Wright. F. Jennings do. A. G. Thomas *Mrs. N. Furbank (Milk Saleswoman) 66 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 †. Full particulars as to qualifications of the Staff are given in the Annual Report for 1922. *Contributions made in respect of salaries of above Officers, under Public Health Acts or by Exchequer Grants. SECTION 9. HOUSING. The Housing conditions generally remain very much the same as they have been for many years past. The Department still continues to hear of very many cases of overcrowding; cases of 3 and 4 persons eating, living, and sleeping in one room being common, and it is only when we come to the more gross cases still, i.e., 6, and 7 in one room or where grown up boys sleep at one end of the bed and adult girls at the other end with the father and mother in the same room that cases are reported to the Public Health Committee and by them sent on to the Housing Committee with a view to that Committee being given an opportunity of providing accommodation for the family in one of the Council's houses if possible. The difficulty is that so frequently persons living under these conditions are for various reasons found to be unsuitable as tenants for the Council's new houses. The unhealthy areas which have been scheduled and represented to the London County Council are still in as bad a condition and as thickly populated as ever. There are, however, grounds for hoping that one of the areas, viz., that in St. Nicholas' Ward, will be 67 dealt with by the London County Council probably during the next two or three years, but there is no immediate prospect of any of the other Areas receiving any such attention at present. A small Area in the North West Ward has been inspected by the Public Health and Housing Committees and reported upon as being in need of demolition and rebuilding, and representations have been made to the London County Council asking if they have any objection to this Council carrying out a reconstruction scheme on this site, but nothing further has materialised at the present time. I very much fear that unless drastic measures are adopted within a few years the housing conditions of Greenwich generally will have deteriorated so much that the whole of the lower portion of Greenwich will have become one huge slum area. It is interesting to review briefly the steps which have been taken with respect to the provision of working-class houses during the last few years. In 1919 the Greenwich Borough Council proposed a scheme for new houses and conversions of larger houses into tenements, providing for 464 families. When this scheme was brought to the notice of the Housing Board of the Ministry of Health in 1920 we were seriously taken to task for having been so modest in our proposals and it was then agreed between the Ministry and the Council that the needs of the Borough would approximately be met by the provision of 6,000 houses and that it should be the aim of the Council to provide at least 1,000 houses per annum. A large amount of time and effort has been expended by Committees in furthering such proposals and various schemes have been placed before the Ministry; from time to time tenders have been applied for, received, and agreed upon for the erection of various blocks of houses and in 1921 there were 73 such houses built and occupied, together with larger houses which were bought and converted into tenements thus providing accommodation for 50 additional families. In 1922 there were a further 159 houses so built and occupied. In 1923, 80 more houses were erected and occupied but in 1924, the year under review, there were no new houses actually ready for occupation. There has certainly been some increase in this respect during the early months of this present year, the result will, however, appear in my next Report, so that during the 5 years 362 tenements and houses have been provided by the Council in lieu of the 1,000 per annum which it had been agreed should be aimed at. 68 HOUSING RETURN, 1924. Number of new houses erected during the year:— (а) Total 16 (b) With State assistance under the Housing Acts, 1919, 1923 or 1924:By the Local Authority Nil I.—Unfit Dwelling-houses. Inspection. (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2,329 (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 1 (4) Number of dwelling houses (exclusive of those ferred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1,791 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 570 3.—Action under Statutory Powers. (a) Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919— (1) Number of dwelling-houses in respect of which notices were served requiring repairs *19 (2) Number of dwelling-houses which were dered fit— (a) By owners 19 (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. 69 lb) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Intimations 1,221 Statutory 129 (2) Number of dwelling houses in which defects were remedied— (а) By owners 1,791 (б) By Local Authority in default of owners - (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 SECTION 10. MATERNITY AND CHILD WELFARE. The work carried out under the Maternity and Child Welfare scheme during the year has been conducted on similar lines to that recorded in my previous Reports. The Centres at which the Infant Consultations are held are as under:— Centre. Day Time. Remarks. Borough Hall Monday Tuesday Thursday 2-4.30 p.m. " " Attended by Mothers living in West Greenwich area Conduit House Monday Wednesday Friday " " " Do. East Greenwich and portion of Charlton area 105, Shooters Hill Road Tuesday Friday " " Do. Charlton and Blackheath area. Albany Institute Thursday " Do. St. Nicholas Deptford Area 70 The following tables show (a) the number of visits made by the Health Visitors during the year in connection with Births and cases of Infectious Diseases; and (b) number of Infant Consultations and Pre-Maternity Clinics attended and also visits of a miscellaneous nature. Health Visitors Visits, &c., 1924. Table A. Visits Re-Visits Total Infants under 1 year 1794 1722 3516 Children, 1—5 years 234 2777 3011 Measles 2155 287 2442 Whooping Cough 549 109 658 Pneumonia 48 44 92 Puerperal Fever 6 5 11 Ophthalmia Neonatorum 6 13 19 Diarrhoea 42 34 76 4834 4991 9825 Table B. Dental Treatment 57 7 64 Dinners 16 16 Milk Scheme 164 16 180 Pre-Maternity Cases 226 26 252 Infant Consultations attended 889 — 889 Pre-Maternity Clinics attended 162 — 162 Miscellaneous 80 — 80 1594 49 1643 In addition to the above, 2,023 persons were seen by the Health Visitors at the office, chiefly in connection with milk applications. The prevalence of Measles in the earlier part of the year necessarily took up a considerable portion of the Health Visitors' time, and seriously interfered with the routine work generally. In this connection consideration had been given to a Report by one of the Ministry of Health's Medical Inspectors in which it was pointed out the need for an additional Health Visitor, and in view of the fact that it had been decided to open a new Centre for the benefit of the Mothers residing in the lower area of Charlton, the Council agreed to such appointment. (Appointed February, 1925.) The following table shows at a glance the work undertaken at the various Infant Consultation Centres during the year:— 71  Borough Hall. Conduit House. 105, Shooters Hill Rd. Albany Institute. Total. Attendances 8,487 9,588 5,304 2,689 26,068 New Cases 378 367 211 164 1,120 Medical Consultations 3,256 3,062 1,630 1,538 9,486 Nursing Mothers seen by Doctors 1,057 961 568 356 2,942 As in previous years the children are weighed and advice given to the Mothers at every attendance. That the Centres continue to be appreciated is shown by the steady increase in the number of attendances: In 1922 there were 22,218, in 1923 24,261, whilst last year the number increased to 26,068. Arrangements are now being made to acquire suitable premises for an additional Centre to serve the needs of those residents in the vicinity of lower Charlton. Minor Ailment Centre, Borough Hall.—Facilities are afforded at this Centre for the treatment of children suffering from minor ailments arising from ear, nose and throat trouble, eczema, etc. Only a comparatively small number of cases, however, were dealt with during the year. 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' Hospital.—The arrangement made with the Deptford Fund still operates whereby they receive in their Hospital such Greenwich cases as are recommended by the Medical Officer for treatment. During the year 83 babies were admitted of which 51 were discharged cured, 15 relieved, 6 were discharged suffering from an Infectious disease, 2 were taken away by their Mothers, whilst 9 unfortunately died. Baby Week Competitions.—In view of the success of the Infant Welfare Competitions last year the Maternity and Child Welfare Committee decided to hold competitions of a similar nature under the direction of a Special Committee of local ladies. 72 The Competitions took place at the Borough Hall on the 22ncl and 23rd July, 1924, and consisted of the following classes:— (1) Knitted and Crochet garments. (2) Garments made from material. (3) Adapted garments (garments made for a child from an old adult garment). (4) (a) Patching and darning. (b) Boot repairing. (5) Father's competition—cots, chairs, fireguards, etc. (6) Written answers to simple questions relative to infant care. Valuable prizes were presented to the winners and the articles were afterwards exhibited. During the afternoon musical items, etc., were given, and tea and cakes handed round by voluntary workers. Artificial Sunlight Treatment. The Maternity Committee have given serious consideration to the question of providing treatment of some of the cases of mal nutrition, rickets, etc., attending the Centres by means of artificial sunlight and in order to educate and form public opinion on the subject an arrangement was made for Dr. Saleeby to give his popular lecture on "Sunlight and Health" which was very well attended by an appreciative audience and the Committee have now obtained the sanction of the Ministry of Health to fit up the necessary apparatus at one of the Centres and appoint a qualified nurse and this matter is now well in hand. At the time of writing this Report it is hoped that the Artificial Sunlight Centre will be shortly opened. Maternity Home. During the year 220 cases were admitted (these admissions represented a total number of 222 babies as there were two pairs of twins) and the following brief particulars of these cases are submitted:— Average duration of stay, 14'3 days. Number of cases delivered by midwives, 203. Number of cases delivered by doctors, 17. Medical assistance was sought in 7 instances, under the following conditions:— (a) During labour, 4. (b) After labour, 2. (c) For infant, 1. Happily there were no cases of puerperal sepsis, and also no cases of ophthalmia neonatorum or slight inflammation of the eyes during the year. 73 Nine infants were either stillborn or died within 10 days of birth. With only 4 exceptions all the infants were entirely breast-fed. It was hoped that the number of cases admitted would show an advance on the very satisfactory figure of 228 last year but, as will be seen, the present figure falls short of the 1923 total by 8. It is interesting to note, however, that the actual number of cases booked during 1924 was 265, compared with 225 for the preceding year, and the number of cases admitted during 1924 would certainly have shown an advance upon the 1923 figure had all the patients who had contemplated requiring accommodation in December entered the Home during that month. During the last 3 months of the year an average of 11 patients continuously in the Home was maintained and it may be added that during the whole of the early months of the present year the accommodation of the Home was taxed to its utmost capacity, in fact, it would certainly appear that unless we are to have to refuse Maternity Home accommodation to many applicants in the near future it will be essential that some considerable extension is carried into effect. As will be remembered, the Home was opened at the end of February, 1922, and at the close of 1924 569 patients had been admitted. The figures prepared by the Ministry of Health in regard to the several Maternity Homes in the Metropolitan Area show that the nett cost per patient per week during the period under review was lowest with two exceptions, another point of interest being that, taking the whole period, 75 per cent. of the beds were occupied which percentage is highest, again with two exceptions only. The total amount of fees received from patients during the year was £1,167. Pre-Maternity Clinics. Centres are held at the Borough Hall on Tuesday and Thursday mornings and on Friday morning at Shooters Hill Road. It will be recollected that towards the end of 1923, owing to the increasing numbers attending the Borough Hall Clinic, it became necessary to have the additional Centre at Shooters Hill Road. This arrangement has worked very satisfactorily, for, in addition to relieving the pressure at the Clinic, it has provided for the needs of the eastern end of the Borough. The attendances f or the year were:— Borough Hall 886 Shooters Hill Road 392 Total 1,278 74 These figures are, of course, a considerable advance on those recorded during the years 1923 and 1922, which were 807 and 609 respectively. There is no doubt that, steadily but surely, the immense importance of ante-natal examination and, if necessary, treatment is being recognised and a very satisfactory feature in connection with the patients who were accommodated in the Council's Maternity Home is the fact that, with very few exceptions, regular attendance at the Ante-Natal Centres preceded admission. As a consequence, the Maternity and Child Welfare Medical Officer was already familiar with the individual requirements of the patients and this fact contributed not a little to the very satisfactory results produced at the Maternity Home. During the year arrangements were made for midwives to attend our various Ante-Natal Clinics, such facilities being made use of by a large proportion of midwives in the district, several of whom have expressed their appreciation of the facilities offered. Infantile Mortality. It is a matter of considerable disappointment to have to record a rise in the Infant Mortality Rate of 12 per thousand births, the figure for 1924 being 73, whereas last year's figure was 61. Comparing the actual causes of death between the two years the increase in Infantile Mortality is at once apparent. During the first quarter of 1924, as will be seen from the appropriate Table, the actual number of infants who died under one year of age was 154 compared with 129 in the previous year, i.e., an increase of 25. Of these, unfortunately, measles accounted for 8 deaths last year, compared with none in the previous year, and pneumonia 22 against 10 only in 1923. This regrettable mortality took place during the first quarter of the year during a time when the weather was exceptionally cold and damp, which period coincided with a widespread and severe epidemic of Whooping Cough which was the forerunner of these chest complications. It will, of course, be appreciated that to arrive at a correct estimation of the Borough's improved conditions affecting infants it is necessary to take a rather wider view than is represented solely by considering the figures for one particular year. There is no possible question of doubt that the Maternity and Child Welfare Schemes which came into operation as a result of the Maternity and Child Welfare Act, 1918, have had a most widespread and beneficial effect upon the health and well-being of those infants and young children for whom the Act provides, and this is best demonstrated perhaps by averaging the Infantile Mortality Rate during the past 4 years, i.e., approximately during the time of such Maternity and Child Welfare Schemes have been in operation and comparing the figure thus obtained with the preceding 5 years. The figures, so far as Greenwich is concerned, estimated on this basis, are 65 as against 95 for the preceding 5 years, earlier average figures steadily increasing as one goes back into history. 75 Dental Treatment in Maternity. Mr. G. F. Ferris, L.D.S., R.C.S. (Eng.), reports as follows:- Maternal love and the instinct to do the best for the child are proverbial, yet many children are handicapped at the outset by the ignorance of the mother, upon whom rests not only the responsibility as to the care of her baby, but also its actual physique when born. From the earliest months of pregnancy it is necessary that the mother should receive foodstuffs calculated to aid the calcification of both bones and teeth, for the formation of the teeth actually commences at the forty-second day of intra-uterine life. Presuming that the correct diet is available its beneficial properties will be lost if the mouth of the mother is unhealthy. The mouth is the commencement of the alimentary tract, and, as mentioned in my remarks dealing with Tuberculosis, any pus exuding from the gums must mix with the food and pass into the stomach, resulting in a grave lowering of the health and resisting power of the patient. At six to seven months after birth the first deciduous tooth erupts, and on no account should the mother resort to the lazy and highly dangerous use of the teething powder. Thumb-sucking and "dummy-sucking" are also harmful, but the child may be given a chicken-bone or hard crust of suitable size to gnaw and thus exercise the jaws. This brings more blood to the growing bone and with it the necessary calcific salts for the formation of the jawbone which should now be growing rapidly. With deficient growth of either mandible or maxilla, undue crowding of the teeth must result, thereby acting as a predisposing cause of Pyrrhœa in later life. As soon as possible the child should be made to clean his own teeth, thus eliminating the most common cause of decay. Should dental caries be present, conservative treatment should be adopted, for if the deciduous teeth are well-preserved, the permanent teeth which follow must be well-placed in the jaw. Mothers must be warned, therefore, against the injudicious extraction of the temporary teeth before they have completed this work of aiding and adjusting the growth of the permanent teeth. Each individual must have his own tooth-brush. The deplorable practice of "the family tooth-brush" is all too frequent and is often followed by grave results, e.g., a patient referred for dental treatment was pregnant and her general condition was most unhealthy. One child of the family was receiving treatment at the Tuberculosis Dispensary, and her husband was suffering from chest trouble, yet all were using the one tooth-brush with no attempt at sterilisation. It would be most helpful indeed if this type of 76 patient could be supplied with toothbrush and dentifrice free of charge. To summarise, the health of the greater part of the community is largely dependent upon the information and care received at the Maternity and Child Welfare Clinics. An organisation with such widespread influence for good should have the utmost support of all who are far-sighted enough to realise the enormous possibilities of a healthy and virile nation. The following figures indicate the amount of work performed at the fortnightly sessions during the year:— No. of Patients 101 „ Sessions 26 „ Attendances 297 „ Patients received gas 46 „ Extractions under gas 239 „ Patients under local anaesthetic 115 „ Extractions do. 216 „ Fillings, etc. 20 „ Ordinary extractions 10 „ Dentures 21 Advice given 100 The circumstances of each applicant for dentures are enquired into by the Health Visitor and reported to the Maternity and Child Welfare Committee, who make the necessary assessment. Twentyone Dentures were provided during the year at a total cost of £72 18s. 6d. towards which amount the patients paid £42 14s. Od. 77 NOTIFICATION OF BIRTHS ACT, 1907. The following table gives the number and character of the intimations received respecting births in the Borough:— 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. 1924. Total Number of Births notified in each year 2,497 1,992 1,735 2,085 2,714 2,564 2,257 2,348 2,245 (a) Attended by Midwives 1,314 1,095 990 1,159 1,494 1,452 1,484 1,591 1,563 (6) Attended by Doctors 1,183 897 745 926 1,220 1,112 773 757 649 Number of Still Births notified in each year 61 47 44 59 78 52 53 50 32 Number of Births registered in each year 2,354 1,967 1,753 1,968 2,648 2,366 2,185 2,276 2,258 Puerperal Fever.—Six eases of this disease were notified during the year, two 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.—Five cases of this disease were notified during the year, and in addition there was 1 case of slight inflammation of the eyes reported. Both eyes were effected in 3 cases, and one eye only in the remaining 2 cases. Unfortunately 1 case died in Hospital. All the others subsequently recovered. Measles.—See pages 23 and 24. Milk, Virol, &c., Supplied to Nursing and Expectant Mothers and Young Children.—The amount of Milk distributed free under the Council's Scheme was 10,238 lbs. less than the previous year. This reduction is due to the new scale which was adopted towards the latter part of the previous year, and also to the more stringent methods in dealing with the applications. The following tables show (a) the amount of milk, etc., given away and number of applicants receiving same, and (b) quantities sold each quarter. 78 (a) Milk, Virol, Etc., Distributed Free. Quarter ended Milk Virol Emulsion Malt lbs. No. of Applicants lbs. No. of Applicants lbs. No. of Applicants lbs. No. of Applicants March, 1924 6127 3895 112½ 225 102½ 205 June, ,, 7433 4273 117 234 54½ 109 Sept., „ 6946 3874 72 144 29 58 10 10 Dec., „ 7253 4111 136 272 6 12 43 43 27759 16153 437½ 875 192 384 53 53 Quarter ended Oil and Malt Marylebone Cream Cod Liver Oil lbs. No. of Applicants lbs. No. of Applicants lbs. No. of Applicants March, 1924 664 664 96½ 187 - - June, ,, 700 700 89½ 179 — — Sept., 489 489 8 16 64 64 Dec., ,, 810 810 - - 18 18 2663 2663 194 382 82 82 79 (b) Milk, Virol, Etc., Sold at Cost or Reduced Prices. Quarter ended Milk Virol Emulsion Malt Oil and Malt Marylebone Cream Cod Liver Oil Total Amount Received. lbs. lbs. lbs. lbs. lbs. lbs. lbs. March, 1924 6661 345½ 70 — 322 70½ — £ 552 s. 11 d. 4 June, „ 7098 260½ 26 — 257 34 — 553 0 7 Sept., „ 6099 193 12 — 174 3½ 54 481 15 3 Dec., „ 5320 354 2½ 32 235 — 29 421 12 11 25178 1153 110½ 32 988 108 34½ 2019 0 1 80 Index of Contents. Page Adoptive Acts, By-laws and Local Regulations 41 Age Mortality 10 Ambulance Facilities 39 Analysis of Death Causes 11, 12 Anthrax 25 Area of Borough 6 Articles and Rooms Disinfected 61 Articles Destroyed 62 Artificial Sunlight Treatment 72 Baby Week Competitions 71 Bacteriological Examinations 40, 41 Bakehouses 58 Births 8,9 Blackheath and Charlton Cottage Hospital 40 Bones and Joints 18 Books Destroyed 63 Cancer 14-16 Causes of Death 12-18 Causes of Sickness 37 Clinics and Centres 38, 69—71 Cerebro-Spinal Fever 25 Circulatory System 17 Cleansing Children 63, 64 Complaints 42 Constitutional Diseases 14 Consumption 14 Contacts 21 Cowhouses 55 Customs and Inland Revenue Acts 45 Dairies, Cowsheds and Milkshops 55 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 10 Deptford Fund Babies' Hospital 71 Density of Population 6 Dental Work 34,35,75,76 Developmental Diseases 17 Diarrhcea and Zymotic Enteritis 13,24 Dietetic Diseases 14 Digestive System 18 Diphtheria 13,21 Diphtheria Anti-Toxin 41 Disinfection 60-63 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 78, 79 Encephalitis Lethargica 25 Enteritis 13,24 Epidemic Cerebro-Spinal Meningitis 25 Epidemic Diseases 12 Erysipelas 13, 22 81 INDEX—continued. Page External Causes 18 Factories and Workshops 42-45 Food and Drugs—Samples of 58—60 Food—Premises for Preparation of, etc. 57 Glanders 25 Gonorrhoea 13 Health Centres 38, 69-71 Health Visitors, Visits, etc. 70 Home Work 44 Horse Slaughterer 45 Hospital and other forms of Gratuitous Medical Relief 40 House Drainage 47 Houses Inspected re Infectious Diseases 63 Houses Let in Lodgings 46 Housing 66 Hydrophobia 25 Ice Cream Premises 58 Ill-defined Causes 18 Increase of Rent and Mortgage Interest (Restriction) Acts, 1920 and 1923 46 Infant Consultations 69-71 Infantile Mortality 11,74 Influenza 13 Inhabited Houses 6 Inland Revenue Acts 45 Insanitary Areas 66, 67 Institution Deaths 10 Integumentary System 18 Interim Tuberculosis Care Committee 31, 32 Introductory Review 4—5 Laboratory Work 40 Legal Proceedings 52 Local Diseases 17 Lymphatic System 18 Malarial Diseases 14, 25 Marriages 8 Maternity and Child Welfare 69-79 Maternity Home 39, 72, 73 Measles 23 Meat 56 Milk and Cream Regulations 56 Milk Supply 55 Milk Supply for Expectant and Nursing Mothers 56, 77, 78 Milk (Special Designations) Order 1923 55 Miller General Hospital 40 Minor Ailment Centre 71 Mortuary 19 Nervous System 17 Notices, etc. 52 Notifications 20-25 Notification of Births Act 77 Nursing Arrangements 37 Offensive Trades 46 Ophthalmia Neonatorum 20, 25, 77 Organs of Special Sense 17 82 INDEX—continued. Page Outworkers' Register 42 Overcrowding 53, 66 Parasitic Diseases14 Persons Cleansed 53 Polio-encephalitis25 Polio-myelitis 25 Poor Law Relief40 Population 7 Public Health Committee1 Public Health (Dried Milk) Regulations, 1923 55 Public Sanitary Conveniences 64 Puerperal Fever 13,22,77 Pyaemia and Septicaemia 13 Rats and Mice (Destruction) Act, 1919 46 Remarks on Death Causes 12-18 Reproductive System 18 Respiratory System 17 Rheumatic Fever 14 Sale of Food and Drugs Act 58-60 Sanitary Work—Summaries, etc. 48-54 Scarlet Fever 22 Scavenging and Refuse Removal 45 School Clinic 38 Seamen's Hospital 40 Septic Diseases 13 Slaughterhouses 57 Small-pox 12,20,21 Smoke Nuisances 47 Sporadic Diseases 13 Staff of Public Health Department 64-66 Statistical Tables 6, 7 and Appendix Suffocation 18 Suicide 18 Syphilis 13 Tuberculosis 14,20,25 Tuberculosis Dispensary—Return of Attendances 33, 34 Tuberculosis—Interim Care Committee 31,32 Tuberculosis Officer's Report 26-32 Typhoid Fever 13, 22 Underground Bakehouses 45 Underground Rooms 53 Unwholesome Food 51 Uninhabited Houses 6 Urinary System 18 Vaccination Particulars 36 Venereal Diseases 13 Verminous Premises 53 Verminous Children 63 Virol 78, 79 Vital Statistics 4-7 and Appendix Water Supply 47 Whooping Cough 12,24 Workshops and Factories42-45 Zymotic Enteritis 13,24 Zymotic Diseases 12 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 29th March, 1924. Notifiable Diseases. Oases 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 16 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. • • .. .. .. .. • • • • • • • • •• Cholera • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Diphtheria 51 4 21 18 6 2 • • • • 23 10 2 14 2 21 10 2 13 2 48 Encephalitis Lethargica • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Erysipelas 12 • • 1 1 3 2 3 2 5 4 3 • • • • • • 1 • • • • • • 1 Scarlet Fever 55 • • 11 38 4 1 1 • • 28 13 4 • • • • 26 14 4 10 • • 54 Typhus Fever • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • Enteric Fever • • • • • • 2 • • • • • • • • • • 2 • • • • • • • • 1 • • • • • • 1 Continued Fever • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Puerperal Fever • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • Cerebro-Spinal Fever •• • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • Relapsing Fever • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Malaria 1 • • • • • • • • 1 • • • • • • 1 • • • • • • • • • • • • • • • • • • Dysentery • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Measles 776 31 409 324 • • 3 • • • • 346 174 74 172 10 27 23 • • • • • • 59 Whooping Cough 77 15 46 16 • • • • • • • • 58 13 4 2 • • 1 3 • • • • • • 4 Diarrhoea 5 1 4 • • • • • • • • • • 1 4 • • • • • • • • • • • • • • • • • • Ophthalmia Neonatorum 3 3 • • • • • • • • • • • • 1 • • • • 2 • • • • • • • • • • • • • • Tuberculosis, Pulmonary 52 1 2 3 18 21 7 • • 17 14 8 13 • • 2 • • • • • • • • 2 „ Non-Pulmonary 9 1 1 2 3 1 •• 1 4 1 2 2 • • 2 • • • • • • • • 2 Pneumonia, Acute Primary, or Acute Influenzal 55 4 17 7 6 7 10 4 17 8 6 23 1 5 1 • • 4 • • 10 Totals 1098 60 512 411 49 38 21 7 500 244 103 238 13 84 53 14 28 2 181 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 28th June, 1924. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1924. Births Registered during the 13 weeks ended 28th June, 1924. Deaths Registered during the 13 weeks ended 28th June, 1924. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. 1 All other Forms of Tuberculosis. j Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. Typhoid. Other. Diarrhcea and Dysentery. During the corresponding period year previous. During the 13 weeks ended 28th June. 1924. During the corresponding period year previous. During the 13 weeks ended 28th June, 1924. M. F. M. F. Greenwich East 44213 45332 101 101 61 58 11 7 48 • • 7 1 • • • • • • • • • • 11 4 10 7 13 66 9-96 10-53 -52 -70 Do. West 26677 27352 60 60 51 32 9 7 28 • • 2 • • 2 • • • • • • • • 12 1 11 2 8 45 14-01 12-17 -58 -58 St. Nicholas, Deptford 7582 7774 26 31 16 10 7 1 5 • • 1 • • • • • • • • • • • • 3 • • 3 4 • • 15 12-45 13-42 1-55 -51 Charlton 18785 19258 40 47 28 26 5 6 17 • • 5 • • • • • • • • • • • • 7 1 9 3 7 22 7-96 11-25 -20 1-04 Kidbrooke 3193 3274 46 47 • • 5 • • • • 2 • • • • • • • • • • • • • • • • • • • • • • 1 1 3 12-32 6- 12 • • • • Miller Hospital— Resident • • • • • • • • 3 1 • • • • 1 • • • • • • • • • • • • • • • • • • • • • • • • 1 3 • • • • • • • • Non-Resident.. • • • • • • • • 15 6 • • 2 3 • • • • • • • • • • • • • • • • • • 1 • • 2 4 13 • • • • • • • • Seamen's Hospital— Resident • • • • • • • • 11 • • • • 1 • • • • • • • • • • • • • • • • • • 2 • • 2 1 1 5 • • • • • • • • Non-Resident • • • • • • • • 15 3 • • • • 2 • • • • • • • • • • • • • • • • 4 .. 1 2 3 8 • • • • • • • • Greenwich & Deptford Hospital— Resident • • • • • • • • 36 28 6 1 25 • • • • • • • • • • • • • • • • 8 2 6 3 2 43 • • • • • • • • Non-Resident • • • • • • • • 61 43 2 3 43 • • 1 • • • • • • 1 • • • • 14 1 lo 5 9 57 • • • • • • • • Herbert Hospital— Resident • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Non-Resident. . • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • M.A.B. Brook Hospital- Kesident • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • " • • • • • • • • • • • • • • • • • • Non-Resident.. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Cottage hospital— Resident • • • • • • • • • • 1 • • • • • • • • • • • • • • • • • • • • • • • • 1 • • • • • • • • • • • • • • • • Non-Resident.. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Other institutions— Resident • • • • • • • • 2 2 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1 3 • • • • • • • • Non-Resident • • • • • • • • • • 2 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 2 • • * * • • • • Outside Institutions • • • • • • • • 28 25 4 10 8 • • 7 1 2 • • • • • • • • 8 1 4 1 4 2 5 • • • • • • • • 273 286 156 131 Borough 100450 102990 559 287 32 21 100 • • 15 1 2 • • •• • • • • 33 6 33 17 29 151 • • • • •• •• Rate per 1,000 of Estimated Population • • • • 21 •78 11 8 • • • • • • • • • ••58 -03 •07 • • • • • • • • 1-28 •23 1-28 •66 112 5-87 10-92 11-18 •54 •70 Deaths of Children under 1 Year per 1,000 births. 57 previous " " corresponding 49 period " " County of London 53 Death Rate of 105 large English Towns, 11-8; of the County of London, 10-7. Birth Rate „ „ 20-1 „ 19-5. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 27th September 1924. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1924. Births Registered during the 13 weeks ended 27th September, 1924. Deaths Registered during the 13 weens ended 27th September, 1924. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortamty per 1,000. Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. All Causes. Seven Zymotics. Typhoid. Other. Diarrhcea and Dysentery. During the corresponding period year previous. During the 13 weeks ended 27th Sept.. 1924. During the corresponding period year previous. During the 13 weeks ended 27th Sept., 1924. M. F. M. F. Greenwich East 44213 45332 115 128 43 50 17 6 35 • • 1 • • 2 2 • • • • 3 10 1 4 7 9 54 7-91 8-23 •35 •70 Do. West 26677 27352 73 39 33 24 9 4 15 • • • • • • • • 1 • • • • 1 7 3 4 4 6 31 9-73 8-36 -44 •29 St. Nicholas, Deptford 7582 7774 27 27 6 6 4 • • 1 • • • • • • • • • • • • • • 1 • • • • 2 1 2 6 12-97 6-19 1-53 -51 Charlton 18785 19258 47 39 23 24 3 1 18 • • • • • • • • • • • • • • • • 4 2 3 3 7 28 7-75 9-79 • • • • Kidbrooke 3193 3274 57 45 1 1 • • • • 1 • • • • • • • • • • • • • • • • • • • • • • • • 1 1 8-62 2-45 • • • • Miller Hospital—• Resident • • • • • • • • 6 2 5 • • 1 • • • • • • • • • • • • • • 1 • • • • 1 • • 1 5 • • • • • • • • Non-Resident • • • • • • • • 6 3 • • • • 1 • • • • • • • • • • • • • • • • 1 • • • • • • 3 5 • • • • • • • • Seamen's Hospital— Resident • • • • • • • • 11 • • • • • • 1 • • • • • • • • • • • • • • 1 4 • • • • 1 2 2 • • • • • • • • Non-Resident • • • • • • • • 8 .. • • • • 1 • • • • • • • • • • • • • • • • • • • • 1 1 2 4 • • • • • • • • Greenwich & Deptford Hospital—- Resident • • • • • • • • 25 23 6 3 20 • • • • • • • • • • • • • • • • 2 2 1 2 8 33 • • • • • • • • Non-Resident • • • • • • • • 35 29 4 • • 31 • • • • • • • • • • • • • • , . 6 .. 4 5 17 32 • • • • • • • • Herbert Hospital— Resident • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • Non-Resident.. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • M.A.B. Brook Hospital- Resident • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • Non-Resident.. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Cottage Hospital— Resident • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • Non-Resident • • • • • • • • • • • •. .• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Other Institutions— Resident • • • • • • • • • • 3 1 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 2 •. • • • • • • Non-Resident • • • • • • • • i 4 1 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 5 • • • • • • • • Outside Institutions • • • • • • • • 23 25 6 6 13 • • 1 • • 2 1 • • • • 1 3 2 3 2 8 25 • • • • • • • • 319 278 106 105 Borough 100450 102990 597 211 33 11 70 • • 1 • • 2 3 • • • • 5 21 6 13 15 25 120 • • • • • • • • Rate per 1,000 of Estimated Population • • • • 23-16 8-22 • • • • • • • • •03 • • •07 •11 • • • • •19 •81 •20 •40 •43 97 4-75 8-77 8-22 -39 •42 Deaths of Children under 1 Year per 1,000 births. 55 previous " " corresponding 45 period " " County of London 48 Death Rate of 105 large English Towns, 9-1; of the County of London, 8 6. Birth Rate" 19.8 „ „ 19-3. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 14 weeks ended 3rd January, 1925. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1924. Births Registered during the 14 weeks ended 3rd January, 1925. Deaths Registered during the 14 weeks ended 3rd January, 1925. 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 Yea re. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhœea and Dysentery. All Causes. Seven Zymotics. During the corresponding period year previous. During the 14 weeks ended 3rd January, 1925. During the corresponding period year previous. During the 14 weeks ended 3rd January, 1925. Typhoid. Other. M. F. M F. Greenwich East 44213 45332 105 112 74 53 14 5 51 .. .. 1 .. 3 .. .. .. 10 2 14 11 11 75 11.03 10.43 •44 •32 Do. West 26677 27352 45 47 39 32 6 2 31 .. .. .. 3 .. .. .. .. 8 1 11 6 8 34 12.98 9.67 •88 •40 St. Nicholas, Deptford 7582 7774 26 20 12 6 5 2 7 .. .. .. .. 2 .. .. 3 .. .. 3 1 1 8 11.41 8.62 •51 2.39 Charlton 18785 19258 43 38 30 28 11 3 21 .. .. .. 3 3 1 .. 1 5 .. 13 4 4 24 9.00 11.22 .. 1.04 Kidbrooke 3193 3274 43 38 3 2 2 .. 2 .. .. .. .. 1 .. .. .. .. .. .. 1 .. 3 13.55 5.69 .. 1.13 Miller Hospital— Resident .. .. .. 1 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 .. .. .. .. Non-Resident .. .. .. 20 10 5 3 5 .. .. .. .. 1 .. .. 1 .. .. 2 .. 8 18 .. .. .. .. Seamen's Hospital— Resident .. .. .. 8 .. .. .. 3 .. .. .. .. .. .. .. .. .. .. 1 2 1 4 .. .. .. .. Non-Resident .. .. .. 26 .. .. .. 5 .. .. .. .. .. .. .. .. 2 .. 1 1 10 12 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 39 23 1 1 24 .. .. .. .. .. .. .. .. 6 2 12 4 4 34 .. .. .. .. Non-Resident .. .. .. 51 52 5 8 39 .. .. .. .. .. .. .. .. 7 3 12 4 11 66 .. .. .. .. Herbert Hospital— Resident .. .. .. . . 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cottage Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. 3 3 3 .. 2 .. .. .. .. .. .. .. .. .. .. .. .. 1 5 .. .. .. .. Non-Resident .. .. .. 2 3 .. .. 3 .. .. .. .. .. .. .. .. .. .. 1 .. 1 3 .. .. .. .. Outside Institutions .. .. .. 24 17 8 5 10 .. .. 1 6 .. 1 .. 4 2 .. 6 .. 1 20 .. .. .. .. Borough 100450 102990 262 255 158 121 38 12 112 .. .. 1 6 9 1 .. 4 23 3 41 23 24 144 .. .. .. .. 517 279 Rate per 1,000 of Estimated Population •• .. 18.70 10.09 •• •• •• •• .. •03 •21 •33 •03 .. •14 •83 •10 1.48 •83 87 5.21 11.28 10.09 .46 .75 Deaths of Children under 1 Year per 1,000 births. 73 previous „ ,, „ corresponding 52 period „ „ ,,County of London 71 Death Rate of 105 large English Towns, 11-4; of the County of London, 11 .1. Birth Rate „ ,, 18.1 „ ,, 17.6. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 53 weeks ended 3rd January, 1925. DISTRICTS. Census'Population, 1921. Estimated Population at the middle of the Year 1924. Births Registered during the 53 weeks ended 3rd January, 1925. Deaths Registered during the 53 weeks ended 3rd January, 1925. 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 and Dysentery. All Causes. Seven Zymotics. During the corresponding period year previous. During the 53 weeks ended 3rd January, 1925. During the corresponding period year previous. During the 53 weeks ended 3rd January, 1925. Typhoid. Other. M. F. M. F. Greenwich East 44213 45332 459 459 254 259 62 29 210 .. 11 2 4 7 .. .. 4 43 11 68 43 50 270 10.43 11.14 •48 •60 Do. West 26677 27352 248 199 180 149 37 22 118 .. 5 .. 7 1 .. .. 3 35 7 47 21 31 172 12.97 11.84 •51 •57 St. Nicholas, Deptford 7582 7774 118 105 56 37 26 13 20 .. 6 .. .. 4 .. .. 4 6 .. 18 9 5 41 12.58 11.77 1.03 1.77 Charlton 18785 19258 161 168 130 113 25 16 98 .. 6 .. 3 3 1 .. 1 21 3 50 19 24 112 8.74 12.41 .15 •71 Kidbrooke 3193 3274 181 160 9 13 4 . . 11 .. .. .. .. 1 .. .. .. 1 .. 1 2 3 14 10.47 6.61 .. •30 Miller Hospital— Resident .. .. .. 11 11 5 1 3 .. .. .. .. .. .. .. 1 .. 1 2 2 2 14 .. .. .. .. Non-Resident .. .. .. 52 25 9 6 11 .. .. .. .. 2 .. .. 1 1 2 5 4 17 45 .. .. .. .. Seamen's Hospital— Resident .. .. .. 49 .. .. 1 8 .. .. .. .. .. .. .. 2 8 .. 6 6 7 20 .. .. .. .. Non-Resident .. .. .. 69 4 .. .. 14 .. .. .. .. .. .. .. .. 7 .. 5 8 17 36 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 135 120 23 13 113 .. 1 .. 1 1 .. .. 1 19 6 35 10 22 159 .. .. .. .. Non-Resident .. .. .. 242 188 26 21 179 .. 2 .. .. 1 2 .. .. 34 7 76 19 50 239 .. .. .. .. Herbert Hospital— Resident .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cottage Hospital— Resident .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. 7 12 7 .. 7 .. .. .. .. .. .. .. .. 1 .. 2 1 3 12 .. .. .. .. Non-Resident .. .. .. 6 12 1 .. 10 .. .. .. .. .. .. .. .. 1 .. 3 .. 1 13 .. .. .. .. Outside Institutions .. .. .. 111 103 29 30 52 .. 12 2 13 2 1 .. 6 20 5 20 7 20 106 .. .. .. .. Borough 100450 102990 1167 1091 629 571 154 80 457 .. 28 2 14 16 1 .. 12 106 21 184 94 113 609 .. .. .. .. 2258 1200 Rate per 1,000 of Estimated Population .. .. 21.58 11.47 .. .. .. .. •26 •01 •14 •15 •009 .. •10 1.01 •20 1.75 •89 1.07 5.82 10.95 11.47 •86 •69 Deaths of Children under 1 Year per 1,000 births. 73 previous „ ,, „ corresponding 61 period „ „ „ County of London 69 Death Rate of 105 large English Towns, 12-3 ; of the County of London, 12.1. Birth Rate ,, ,, 19.4 „ „ 12.3 BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 29th March, 1924. Causes of Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages of "Residents" belonging to Localities, whether occurring in or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "NonResidents ' 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 423 51 18 18 5 26 50 80 175 174 118 37 84 10 81 19 7 .. .. .. 6 77 316 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 12 4 2 6 .. .. .. .. .. 3 3 5 1 .. 1 .. .. .. .. .. .. 4 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 4 1 .. 3 .. .. .. .. .. 2 .. 2 .. .. 1 .. .. .. .. .. .. 1 2 Diphtheria and Croup 4 .. 2 2 .. .. .. .. .. 2 2 .. .. .. 1 .. .. .. .. .. .. 3 1 Influenza 21 .. .. 1 .. 1 6 4 9 5 6 1 9 .. 1 .. .. .. .. .. .. 5 2 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 Meningitis 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Phthisis (Pul. Tuberculosis) 29 .. .. .. 1 9 14 5 .. 12 8 3 5 1 3 2 .. .. .. .. .. 9 15 Tuberculous Meningitis 2 .. 1 1 .. .. .. .. .. 2 .. .. .. .. .. .. 1 .. .. .. .. .. 1 Other Tuberculous Diseases 4 1 .. 1 .. 2 .. .. .. 2 2 .. .. .. .. 1 .. .. .. .. .. 2 5 Rheumatic Fever 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 35 .. .. .. .. 1 3 17 14 17 9 2 6 1 8 3 .. .. .. .. 1 7 29 Bronchitis 55 3 1 .. .. .. 3 16 32 21 13 3 18 .. 8 .. .. .. .. .. .. 2 29 Broncho-Pneumonia 33 10 8 4 .. .. 1 1 9 13 7 6 6 1 8 1 .. .. .. .. 2 4 32 Pneumonia (all other forms) 9 2 1 .. .. 1 1 2 2 6 1 1 1 .. .. .. .. .. .. .. .. 1 9 Other Diseases of Respiratory Organs 6 .. .. .. .. .. 2 2 2 4 1 1 .. .. 3 .. 1 .. .. .. .. .. 5 Diarrhœa and Enteritis 2 1 1 .. .. .. .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. 1 3 Appendicitis and Typhlitis 2 .. .. .. .. 1 .. .. 1 2 .. .. .. .. 1 .. 1 .. .. .. .. .. 3 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 7 .. .. .. .. 3 .. 2 2 4 .. .. .. .. 1 1 .. .. .. .. .. 2 7 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Dis eases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 21 20 1 .. .. .. .. .. .. 6 8 2 4 1 6 .. .. .. .. .. 1 5 14 Violent Deaths, excluding Suicide 14 2 .. .. .. 3 4 .. 5 5 7 1 1 .. 2 3 .. .. .. .. .. 4 11 Suicides 3 .. .. .. .. .. .. 1 2 .. 1 .. 2 .. 1 .. .. .. .. .. .. 1 2 Heart Disease 39 .. .. .. 2 4 5 12 16 18 9 3 9 .. 1 1 2 .. .. .. 1 4 17 Other Defined Diseases 117 7 1 .. 1 1 10 16 81 47 35 7 22 6 34 6 2 .. .. .. 1 22 123 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 423 51 18 18 5 26 50 80 175 174 118 37 84 10 81 19 7 .. .. .. 6 77 316 Note. All "Transferable Deaths" of residents, i.e., persons resident in the Borough who died outside it have been included. The transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded. BOROUGH OF GREENWICH. Causes of and Ages at, Death during the 13 weeks ended 28th June, 1924. Causes of Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages of "Residents" belonging to Localities, whether occurring in or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "NonResidents ' in Public Institutions in the District. All Ages Under 1 1 and under 2 2 and under 5 5 and under 16 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 287 32 9 12 9 22 42 61 100 119 83 26 54 5 64 1 4 .. .. 1 4 53 229 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 15 4 3 7 1 .. .. .. .. 7 2 1 5 .. .. .. .. .. .. .. .. 7 1 Scarlet Fever 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diphtheria and Croup 2 .. 1 1 .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. 2 .. Influenza 3 .. .. .. 1 .. .. 1 1 1 1 .. 1 .. .. .. .. .. .. .. .. 1 1 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica 2 .. .. .. .. 1 1 .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 2 1 Phthisis (Pul. Tuberculosis) 33 1 1 .. 1 8 12 9 1 11 12 3 7 .. 8 2 .. .. .. .. .. 8 28 Tuberculous Meningitis 2 2 .. .. .. .. .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. .. 1 Other Tuberculous Diseases 4 .. .. .. .. 3 1 .. .. 3 .. .. 1 .. 1 .. .. .. .. 1 .. 1 4 Rheumatic Fever 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Cancer, Malignant Disease 29 .. .. .. .. .. .. 13 16 13 8 .. 7 1 2 2 1 .. .. .. 1 4 21 Bronchitis 11 1 .. .. .. .. .. 4 6 5 2 1 3 .. 1 .. .. .. .. .. .. .. 7 Broncho-Pneumonia 10 2 2 2 .. .. .. 2 2 2 6 .. 2 .. .. 1 .. .. .. .. .. 1 8 Pneumonia (all other forms) 12 1 .. .. .. 3 5 3 .. 3 3 2 4 .. 5 .. .. .. .. .. .. 3 11 Other Diseases of Respiratory Organs 2 1 .. .. .. .. .. 1 .. .. 2 .. .. .. .. .. .. .. .. .. .. 1 2 Diarrhœa and Enteritis 3 2 .. .. .. .. .. .. 1 2 .. 1 .. .. 1 .. .. .. .. .. .. .. 2 Appendicitis and Typhlitis 2 .. .. .. .. .. 2 .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. 1 5 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease 3 .. .. .. .. .. .. 2 1 .. 2 1 .. .. 1 .. .. .. .. .. .. .. 5 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 10 10 .. .. .. .. .. .. .. 7 2 1 .. .. 2 .. .. .. .. .. 2 2 4 Violent Deaths, excluding Suicide 15 1 1 1 4 3 1 1 3 6 5 .. 4 .. 5 1 2 .. .. .. .. 1 16 Suicides .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Disease 17 .. .. .. .. 1 5 5 6 7 2 4 3 1 3 1 .. .. .. .. .. 1 13 Other Defined Diseases 110 7 1 .. 2 2 15 20 63 50 31 12 15 2 34 4 1 .. .. .. 1 17 96 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 287 32 9 12 9 22 42 61 100 119 83 26 54 5 64 11 4 .. .. 1 4 53 229 Note. All "Transferable Deaths" of residents, i.e., persons resident in the Borough who died outside it have been included. The transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded. BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 27th September, 1924. Causes or Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages of "Residents" belonging to Localities, whether occurring in or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "NonResidents ' 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 M ilitary Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Tnstiti'tinnfi All Causes Certified 211 33 3 8 10 16 29 42 70 93 57 12 47 2 48 11 8 .. .. .. 3 48 158 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 3 2 .. 1 .. .. .. .. .. 2 1 .. .. .. .. .. .. .. .. .. .. 1 .. Diphtheria and Croup 2 1 .. .. .. .. 1 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 .. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 21 .. .. .. 1 7 9 3 1 10 7 .. 4 .. 2 4 .. .. .. .. 1 3 14 Tuberculous Meningitis 1 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. Other Tuberculous Diseases 5 .. 1 3 1 .. .. .. .. 1 3 .. 1 .. 2 .. .. .. .. .. .. 2 2 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 25 .. .. .. .. 1 1 13 10 9 6 2 7 1 8 2 1 .. .. .. .. 8 32 Bronchitis 6 .. .. 1 .. .. 1 2 2 1 1 1 3 .. .. .. .. .. .. .. .. 2 1 Broncho-Pneumonia 5 2 1 .. .. .. .. 1 1 3 1 1 .. .. .. .. 1 .. .. .. .. 1 3 Pneumonia (all other forms) 2 .. .. .. .. .. 1 .. 1 .. 2 .. .. .. 1 1 .. .. .. .. .. .. 5 Other Diseases of Respiratory Organs 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. Diarrhœa and Enteritis 11 10 .. .. 1 .. .. .. .. 7 .. 2 2 .. 1 .. 3 .. .. .. .. 1 4 Appendicitis and Typhlitis 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 2 Alcoholism 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 4 Nephritis and Bright's Disease 2 .. .. .. .. .. .. 1 1 1 .. .. 1 .. 1 .. .. .. .. .. .. .. 3 Puerperal Fever 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 1 Other Accidents and Diseases of Pregnancy and Parturition 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 4 Congenital Debility and Malformation, including Premature Birth 15 15 .. .. .. .. .. .. .. 8 5 1 1 .. 4 .. .. .. .. .. 1 3 9 Violent Deaths, excluding Suicide 14 1 .. 1 4 3 2 3 .. 5 2 3 4 .. 2 1 1 .. .. .. .. 5 6 Suicides 3 .. .. .. .. .. 1 1 1 1 2 .. .. .. .. .. .. .. .. .. .. .. .. Heart Disease 15 .. .. .. 1 1 3 2 8 7 4 1 3 .. 2 1 .. .. .. .. .. 1 9 Other Defined Diseases 73 2 1 .. 1 3 7 15 44 34 19 .. 19 1 22 .. 2 .. .. .. 1 16 58 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 211 33 3 8 10 16 29 42 70 93 57 12 47 2 48 11 8 .. .. .. 3 48 158 Note. -All "Transferable Deaths" of residents, i.e., persons resident in the Borough who died outside it have been included. The transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded. BOROUGH OF GREENWICH. Causes of. and Ages at, Death during the 14 weeks ended 3rd January, 1925. Causes of Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages of "Residents" belonging to Localities, whether occurrinc in or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Realdenti" or " NonResidents ' 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 Hospltnl Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospltnl Other Institutions Outside Institutions All Causes Certified 279 38 4 8 7 8 23 79 112 127 71 18 58 5 62 8 3 1 .. .. 6 41 244 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Whooping Cough 9 5 1 3 .. .. .. .. .. 3 .. 2 3 1 .. .. .. 1 .. .. .. 1 2 Diphtheria and Croup 6 .. .. 3 3 .. .. .. .. .. 3 .. 3 .. .. .. .. .. .. .. .. 6 1 Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Post Basic Meningitis 1 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 23 .. .. .. .. 4 6 12 1 10 8 .. 5 .. 6 .. .. .. .. .. .. 2 14 Tuberculous Meningitis 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases 2 2 .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. .. .. .. 5 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 24 .. .. .. .. .. 1 10 13 11 8 1 4 4 1 .. .. .. .. 1 1 36 Bronchitis 19 1 .. .. .. .. 1 8 9 6 6 2 5 .. 8 .. .. .. .. .. .. 2 15 Broncho- Pneumonia 14 5 2 .. .. 1 .. 2 4 5 4 .. 5 .. 2 1 1 .. .. .. .. 2 8 Pneumonia (nil otlier forms) 8 .. .. .. 2 1 .. 2 3 3 1 .. 3 .. 2 .. .. .. .. .. .. 2 7 Other Disease of Reepirntory Organs 2 .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 2 Dlarrlucu and Enteritis 8 5 1 .. .. 1 .. .. 1 2 1 3 2 .. 2 .. .. .. .. .. .. 5 7 Appendicitis mill Typhlitis 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 4 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nephritis anI Bright's Disease 5 .. .. .. .. .. .. 4 1 3 1 .. 1 .. .. .. .. .. .. .. .. .. 8 I'uerpend fever 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 2 Other Accident and Diseases of Pregnancy and Parturition 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. Congential Debility and Malformation, Including Premature Birth 16 16 .. .. .. .. .. .. .. 8 2 1 4 1 .. .. .. .. .. .. 3 .. 7 violent Death, excluding Suicide 16 1 .. .. .. .. 1 6 2 6 4 .. .. .. 3 1 .. .. .. .. .. 1 16 Suicides 2 .. .. .. .. .. 2 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. Heart Disease 23 .. .. .. .. .. 3 7 13 11 6 1 4 1 4 2 .. .. .. .. .. .. 11 Other Defined Diseases 101 2 .. 1 2 .. 6 25 65 52 24 7 17 1 29 3 1 .. .. .. 2 14 102 Disease ill-defined or known .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 279 38 4 8 7 8 23 79 112 127 71 18 58 5 62 8 3 1 .. .. 6 41 244 Note All "Transferable Deaths" of residents, i.e person resident in the Borough who died outside it have been included. The transferable deaths of non-resident, i.e of person resident elsewhere in england and wales, and who died in the borough in like manner have been excluded. BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 53 weeks ended 3rd January, 1925. Causes of Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages ot "Residents" belonging to Localities, whether occurring in or beyond the'District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "NonResidents ' in Public Institutions in the District. All Ages Under 1 1 and under 2 2 and under 6 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Greenwich East Greenwich West St. Nicholas Deptford Charlton Kidbrooke 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 1200 154 34 46 31 72 144 262 457 513 329 93 243 22 255 49 22 .. .. 1 19 219 947 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 2 Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 28 8 5 14 1 .. .. .. .. 11 5 6 6 .. 1 .. .. .. .. .. .. 12 3 Scarlet Fever 9 .. .. 2 .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 .. Whooping Cough 16 8 1 7 .. .. .. .. .. 7 1 4 3 .. 1 .. .. .. .. .. .. 3 5 Diphtheria and Croup 14 1 3 6 3 .. 1 .. .. 4 7 .. 3 .. 1 .. .. .. .. .. .. 13 2 Influenza 24 .. .. 1 1 1 6 5 10 6 7 1 10 .. 1 .. .. .. .. .. .. 6 3 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica 2 .. .. .. .. 1 1 .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 2 4 Dysentery 2 .. .. .. .. 1 1 .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. .. 2 Post Basic Meningitis 2 1 .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 106 1 1 .. 3 28 41 29 3 43 35 6 21 1 19 8 .. .. .. .. 1 22 71 Tuberculous Meningitis 6 2 1 1 1 1 .. .. .. 4 1 .. 1 .. 1 .. 1 .. .. .. .. 1 2 Other Tuberculous Diseases 15 3 1 4 1 5 1 .. .. 7 6 .. 2 .. 5 1 .. .. .. 1 .. 5 16 Rheumatic Fever 2 .. .. .. .. 1 .. 1 .. 1 1 .. .. .. .. .. .. .. .. .. .. .. 1 Cancer, Malignant Disease 113 .. .. .. .. 2 5 53 53 50 31 5 24 .. 22 8 2 .. .. .. 3 20 118 Bronchitis 91 5 1 1 .. .. 5 30 49 33 22 7 29 .. 17 .. .. .. .. .. .. 6 52 Broncho-Pneumonia 62 19 13 6 .. 1 1 6 16 23 18 7 13 1 10 3 2 .. .. .. 2 8 51 Pneumonia (all other forms) 31 3 1 .. 2 5 7 7 6 12 7 4 8 .. 8 1 .. .. .. .. .. 6 32 Other Diseases of Respiratory Organs 11 1 .. 1 .. .. 2 5 2 5 4 1 .. 1 3 .. 1 .. .. .. .. 3 9 Diarrhœa and Enteritis 24 18 2 .. 1 1 .. .. 2 12 2 6 4 .. 5 .. 3 .. .. .. .. 7 16 Appendicitis and Typhlitis 6 .. .. .. .. 1 3 1 1 2 2 1 1 .. 2 .. 2 .. .. .. .. 1 14 Alcoholism 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 2 .. .. .. .. .. .. 2 .. .. 2 .. .. .. .. 1 .. .. .. .. .. .. 4 Nephritis and Bright's Disease 17 .. .. .. .. 3 .. 9 5 8 6 1 2 .. 3 1 .. .. .. .. .. 2 23 Puerperal Fever 2 .. .. .. .. .. 2 .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. 1 3 Other Accidents and Diseases of Pregnancy and Parturition 2 .. .. .. .. .. 2 .. .. 1 1 .. .. .. 1 .. .. .. .. .. .. 1 4 Congenital Debility and Malformation, including Premature Birth 62 61 1 .. .. .. .. .. .. 29 17 5 9 2 12 .. .. .. .. .. 7 10 34 Violent Deaths, excluding Suicide 53 5 1 2 8 9 8 10 10 22 18 4 9 .. 12 6 3 .. .. .. .. 11 43 Suicides 8 .. .. .. .. .. 3 2 3 3 3 .. 2 .. 1 .. .. .. .. .. .. 1 2 Heart Disease 94 .. .. .. 3 6 16 26 43 43 21 9 19 2 10 5 2 .. .. .. 1 6 50 Other Defined Diseases 401 18 3 1 6 6 38 76 253 183 109 26 73 10 119 13 6 .. .. .. 5 69 379 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1200 154 34 46 31 72 144 262 457 513 329 93 243 22 255 49 22 .. .. 1 19 219 947 Note.—All "Transferable Deaths" of residents, i.e., persons resident in the Borough who died outside it have been included. The transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 29th March, 1924. DISTRICTS. Census Population, 1921.. Estimated Population at the middle of the Year 1924. Births Registered during the 13 weeks ended 29th March, 1924. Deaths Registered during the 13 weeks ended 29th March, 1924. 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 i Years. Persons aged 65 Years ! and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers. Diarrhoea and Dysentery. All Causes. Seven Zymotics. During the corresponding period year previous. During the 13 weeks ended 29th March, 1924. During the corresponding period year previous. During the 13 weeks ended 29th March, 1924. Typhoid. Other. M. F. M. Greenwich East 44213 45332 138 118 76 98 20 11 76 .. 3 .. 2 2 .. .. 1 11 4 40 18 17 76 12.81 15.40 .61 .70 Do. West 26077 27352 70 53 57 61 13 9 44 .. 3 .. 2 .. .. .. 2 9 1 21 9 9 62 15.19 17.31 .14 1.02 St. Nicholas, Deptford 7582 7774 39 27 22 15 10 10 7 .. 5 .. .. 2 .. .. .. 3 .. 10 3 2 12 13.49 19.10 .51 3.61 Charlton 18785 19258 31 44 49 35 6 6 42 .. 1 .. .. .. .. .. .. 5 .. 25 9 6 38 10.26 27.03 .41 .20 Kidbrooke 3193 3274 35 30 5 5 2 .. 6 .. .. .. .. .. .. .. .. 1 .. 1 .. 1 7 7.39 12.25 .. .. Miller Hospital— Resident .. .. .. 1 6 .. 1 1 .. .. .. .. .. .. .. .. .. 1 .. 2 .. 4 .. .. .. .. Non-Resident .. .. .. 11 6 4 1 2 .. .. .. .. .. .. .. .. .. 1 3 2 2 9 .. .. .. .. Seamen's Hospital— Resident .. .. .. 19 .. .. .. 4 .. .. .. .. .. .. .. 1 2 .. 2 2 3 9 .. .. .. .. Non-Resident .. .. .. 20 1 .. .. 6 .. .. .. .. .. .. .. .. 1 .. 2 4 2 12 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 35 46 10 8 44 .. 1 .. 1 1 .. .. 1 3 .. 16 1 8 49 .. .. .. .. Non-Resident .. .. .. 95 64 15 10 66 .. 1 .. .. 1 1 .. .. .. 3 44 5 13 84 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cottage Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— Resident .. .. .. 2 4 1 .. 4 .. .. .. .. .. .. .. .. .. .. 2 1 1 2 .. .. .. .. Non-Resident .. .. .. 3 3 .. .. 4 .. .. .. .. .. .. .. .. 1 .. 2 .. .. 3 .. .. .. .. Outside Institutions .. .. .. 36 36 11 9 21 .. 4 .. 3 1 .. .. 1 7 2 7 4 7 36 .. .. .. .. Borough 100450 102990 313 272 209 214 51 36 175 .. 12 .. 4 4 .. .. 3 29 5 97 39 35 195 .. .. .. .. 585 423 Rate per 1,000 of Estimated Population .. .. 22.79 16.48 .. .. .. .. .46 .. .15 .15 .. • • .11 1.13 .19 3.78 1.51 1.36 7.59 12.84 16.48 .42 .89 Deaths of Children under 1 Year per 1,000 births, 87 previous „ ,, ,, corresponding 79 period „ „ ,, County of London 96 Death Rate of 105 large English Towns, 17 00 ; of the County of London, 1700 Birth Rate „ 20-00 „ „ 19,80. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 28th June, 1924. notifiable Diseases. cases Notified is 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. Chariton. Kidbrooke. Greenwich East. Greenwich Weet. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Uuder 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 74 5 27 37 3 2 .. .. 43 17 3 10 1 43 17 3 10 1 74 Encephalitis Lethargica 10 .. .. 3 3 3 1 .. 5 1 1 1 2 3 1 1 1 2 8 Erysipelas 7 .. .. .. .. 4 3 .. 5 .. 1 1 .. 3 .. .. .. .. 3 Scarlet Fever 70 1 24 42 1 2 .. .. 35 16 5 12 2 36 15 5 8 1 65 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. 1 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 983 36 621 312 8 6 .. .. 425 371 32 150 5 29 48 2 4 2 85 Whooping Cough 66 10 36 20 .. .. .. .. 60 3 .. 3 .. 3 .. .. .. .. 3 Diarrhœa 6 2 4 .. .. .. .. .. 1 4 1 .. .. .. .. .. .. .. .. Ophthalmia Neonatorum 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 49 .. 2 10 12 19 6 .. 22 9 1 15 2 .. .. .. .. .. .. „ Non-Pulmonary 25 3 8 9 4 .. 1 .. 4 13 6 2 .. .. .. .. .. .. .. Pneumonia, Acute Primary, or Acute Influenzal 25 1 2 6 6 8 1 1 8 3 3 8 3 2 1 2 .. .. 8 Totals 1319 59 724 439 37 46 13 1 609 439 54 202 15 120 83 14 26 6 249 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 27th September, 1924. 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 Weet. 1 St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 16 15 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 80 .. 17 52 3 5 .. .. 40 25 7 8 .. 40 24 7 8 .. 79 Encephalitis Lethargica 2 .. .. 2 .. .. .. .. .. 1 .. 1 .. .. 1 .. 1 .. 2 Erysipelas 9 .. .. 1 1 3 2 2 5 2 1 1 .. 3 .. .. .. .. 3 Scarlet Fever 80 .. 24 45 4 6 1 .. 47 18 6 6 3 45 17 6 6 2 76 Typhm Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 4 .. 1 1 2 .. .. .. 3 .. 1 .. .. 3 .. 1 .. .. 4 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 2 .. .. .. 2 .. .. .. .. .. .. 2 .. .. .. .. .. .. .. Cerebro-Spinal Fever 1 .. 1 .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 Malaria 4 .. .. .. .. 4 .. .. .. 1 3 .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 106 8 54 41 1 2 .. .. 40 38 2 25 1 1 7 .. .. .. 8 Whooping Cough 132 16 67 49 .. .. .. .. 101 15 5 11 .. 5 2 .. .. .. 7 Diarrhœa 23 16 7 .. .. .. .. .. 11 10 2 .. .. 2 2 1 .. .. 5 Ophthalmia Neonatorum .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tuberculosis, Pulmonary 43 .. .. 1 10 15 14 3 16 9 9 7 2 .. .. .. .. .. .. „ Non-Pulmonary 11 .. 3 4 1 3 .. .. 2 6 2 1 .. .. .. .. .. .. .. Pneumonia, Acute Primary, or Acute Influenzal 10 .. 3 3 1 2 .. 1 4 3 .. 3 .. .. 3 .. .. .. 3 Totals 508 43 178 199 26 40 17 6 269 130 38 65 6 99 58 15 15 2 189 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 14 weeks ended 3rd January, 1925. 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. j Greenwich Weet. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to «5 65 and upward? Polio Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 114 2 28 72 7 3 2 .. 43 37 8 26 .. 43 36 8 25 .. 112 Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 22 .. 2 1 2 8 9 .. 5 8 5 4 .. .. 4 1 .. .. 5 Scarlet Fever 87 .. 25 56 6 .. .. .. 45 27 4 10 1 42 27 4 9 1 83 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 4 .. .. .. 1 2 .. 1 1 .. .. 3 .. 1 .. .. 3 .. 4 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 3 .. .. .. 1 2 .. .. .. .. 1 2 .. .. .. 1 2 .. 3 Cerebro-Spinal Fever 1 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Malaria 2 .. .. .. 1 1 .. .. 1 .. 1 .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 9 .. 6 3 .. .. .. .. 4 1 .. 4 .. •• .. •• .. .. .. Whooping Cough 223 23 121 79 .. .. .. .. 102 11 15 94 1 4 1 .. 1 .. 6 Diarrhœa 19 9 10 .. .. .. .. .. 10 5 1 3 .. 10 3 1 1 .. 15 Ophthalmia Neonatorum 1 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Tuberculosis, Pulmonary 70 .. 1 11 12 32 12 2 34 22 3 11 .. .. .. 1 1 .. 2 „ Non-Pulmonary 14 2 2 7 2 1 .. .. 7 5 1 1 .. 1 2 .. .. .. 3 Pneumonia, Acute Primary, or Acute Influenza! 22 2 7 4 3 2 3 1 13 .. 1 8 .. 1 •• 1 1 .. 3 Totals 591 40 202 233 35 51 26 4 265 118 40 166 2 102 73 17 43 1 236 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 53 weeks ended 3rd January, 1925. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Ncmber 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 1 45 to 65 65 and upwards- Polio Myelitis 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 319 14 93 179 19 12 2 .. 149 89 20 58 3 147 87 20 56 3 313 Encephalitis Lethargica 12 .. .. 5 3 3 1 .. 5 2 1 2 2 3 2 1 2 2 10 Erysipelas 50 .. 3 3 6 17 17 4 20 14 10 6 .. 6 5 1 .. .. 12 Scarlet Fever 292 1 84 181 15 9 2 .. 155 74 19 38 6 149 73 19 33 4 278 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 11 .. 1 3 3 2 1 1 4 3 1 3 .. 4 2 1 3 .. 10 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 6 .. .. .. 3 3 .. .. .. .. 2 4 .. .. .. 2 2 .. 4 Cerebro-Spinal Fever 2 1 1 .. .. .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 Malaria 8 .. .. .. 1 7 .. .. 1 3 4 .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1874 75 1090 680 18 11 .. .. 815 584 108 351 16 57 78 10 5 2 152 Whooping Cough 498 64 270 164 .. .. .. .. 321 42 24 110 1 13 6 .. 1 .. 20 Diarrhœa 53 28 25 .. .. .. .. .. 23 23 4 3 .. 12 5 2 1 .. 20 Ophthalmia Neonatorum 5 5 .. .. .. .. .. .. 2 1 .. 2 .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 214 1 5 25 52 87 39 5 89 54 21 46 4 2 .. 1 1 .. 4 „ Non-Pulmonary 59 6 14 22 10 5 1 1 17 25 11 6 .. 3 2 .. .. .. 5 Pneumonia, Acute Primary, or Acute Influenzal 112 7 29 20 16 19 14 7 42 14 10 42 4 8 5 3 8 .. 24 Totals 3516 202 1616 1282 146 175 77 18 1643 931 235 671 36 405 267 60 112 11 855 BOROUGH OF GREENWICH. INFANTILE MORTALITY DURING THE YEAR 1924. Deaths from stated Causes in Weekand 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—0 Months 6—9 Months 9—12 Months Total Deaths under 1 Year All Causes. Certified 45 4 4 4 57 28 24 25 20 154 Uncertified .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-Pox .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. 1 1 .. 1 2 4 8 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 1 2 3 2 8 Diphtheria—Croup .. .. .. .. .. .. .. 1 .. 1 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Diseases. Pulmonary Tuberculosis .. .. .. .. .. .. .. 1 .. 1 Tuberculous Meningitis .. .. .. .. .. .. 1 .. 1 2 Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. 2 . . 1 3 Meningitis (not Tuberculous) .. .. .. .. .. .. 1 .. .. 1 Convulsions 1 .. .. .. 1 1 .. 1 .. 3 Diseases of Trachea .. .. .. .. .. .. .. .. .. .. Bronchitis .. 1 .. .. 1 1 .. 1 2 5 Pneumonia, all forms .. .. 1 1 2 6 3 5 6 22 Diarrhoeal Diseases. Diarrhœ, all forms .. .. .. .. .. 2 4 2 .. 8 Enteritis .. .. .. .. .. 2 1 6 1 10 Gastritis .. .. .. .. .. 1 .. .. .. 1 Syphilis .. 1 .. .. 1 .. .. .. .. 1 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying 2 .. .. .. 2 1 2 .. .. 5 „ otherwise .. .. .. .. .. .. .. .. .. .. Injury at Birth 1 .. .. .. 1 .. .. .. .. 1 Actelectasis 6 .. .. 1 7 .. .. .. .. 7 Congenital Malformations 5 1 .. .. 6 2 2 .. .. 10 Premature Birth 18 .. 3 .. 21 2 .. 1 .. 24 Atrophy, Debility and Marasmus 10 1 .. .. 11 9 4 1 .. 25 Other Causes 2 .. .. 1 3 .. 1 1 3 8 Totals 45 4 4 4 57 28 24 25 20 154 Boys 2 Girls 2 154