INTELL LIBRARY GRE 26 THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borougb of Greenwich 0 For the Year 1925, by ERNEST GEORGE ANNIS, M.R.C.S., L.R.C.P., L.S.A., D.P.H. Barrieter-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. — 1926 — THE ANNUAL REPORT MADE To THE COUNCIL of the Metropolitan Borough of Greenwich For the Year 1925, 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. — 1926 — Contents. Paces Public Health Committee 1-2 Maternity and Child Welfare Committee 3 Introductory 4-5 Section I.—Natural and Social Conditions of the Area 6-7 Vital Statistics 8-21 ,, II.—General Provisions of Health Services in the Area 21-29 Laboratory Work 27 Public Health Staff 24-26 „ III.—Sanitary Circumstances of the Area 29-42 „ IV.—Housing 43-45 „ V.—Inspection and Supervision of Food 45-50 „ VI.—Prevalence of, and Control Over, Infectious Diseases 51-75 ,, VII.—Maternity and Child Welfare 75-89 public Health Committee during the Year, 1924-5. The Mayor- Councillor W. G. R. Ball, J.P., and 13 Members. Alderman Mrs. S. A. Kelly, J.P. (Vice-Chairman) Councillors— G. Redgrove (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. J. M. Rokes, A.M.I.E.E. W. Holland F. C. Selfe A. J. Hunt Mrs. C. R. Turner, J.P. 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 in 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 the 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) „ „ ,, „ (Meat) Regulations, 1924. 3 Maternity and Child Welfare Committce during the Year 1924-5. The Mayor— Councillor W. G. R. Ball, J.P., and 14 Members. Alderman Mrs. S. A. Kelly, J.P. Councillors— Mrs. C. R. Turner, J.P. (Chairman). F. W. Mander, M.A. Mrs. N. Cunis (Vice-Chairman). M. C. Matthews, M.A. S. J. Clothier W. W. Middleton A. J. Haylock Dr. H. B. Morgan Miss M. Sherman Co-opted Members— Mrs. E. M. Banfield Mrs. M. Hamilton Mrs. E. C. Berry 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. August, 1926. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greenwich. Ladies and Gentlemen, I have the honour to submit herewith the Annual Report as Medical Officer of Health for the year 1925, this being my 25th Report on the health of the Borough. It is perhaps only to be expected that I should make some reference to the many changes that have taken place in the public health administration during this somewhat lengthy period, and I have as far as possible endeavoured to follow the lines indicated in the Ministry of Health's Circular. The Death-Rate is 11.36 per 1,000 of the estimated population. This is '53 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 117 and 12.2 respectively. The Birth Rate is 18.92 per 1,000. Last year the Birth Rate was 20'19 and the average for the last 10 years 20.57. The Birth Rate for the County of London is 18'0 and 18'30 for all England and Wales. The Infant Mortality Rate for the Borough, measured by the number of deaths under one year to 1,000 births registered is 69 compared with 73 last year. The rate for England and Wales is 75, and for the County of London 67. The Zymotic Death Rate of '58 per 1,000 is slightly lower than last vear's figure of .69. The figures relating to the different constituent parts of the Borough are as follows:— 5 Districts Birth Rate. Death Rate. Infantile tality per 1000 Births. Zymotic Death Rate. Diarrhoea and Enteritis Death Rate (under 2 yrs.) Consumption Death Rate. East Greenwich 17.68 10.87 69 .44 6.2 1.07 West Greenwich 18.46 12.45 81 •66 12.2 1.07 St. Nicholas, Deptford 27.26 12.63 84 1.15 14.0 1.53 Charlton 19.15 11.36 67 .63 7.5 .63 Kidbrooke 11.55 6.09 26 — .60 Whole Borough 18.92 11.36 69 .58 8.7 l.00 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 3.87 4.23 .38 .13 .11 West Greenwich 0.00 4.69 2.25 .59 .03 .07 St. Nicholas, Deptford 0.00 2.04 2.42 .89 — — Charlton 0.00 5.42 3.72 l.0l .04 .09 Kidbrooke 0.00 1.52 .60 .60 — — Whole Borough 0. 00 4.16 2.91 .48 .07 .08 A perusal of the undermentioned figures comparing the chief rates with the year 1901 is illuminating 1901 1925. Percent. Improvement. Birth Rate per 1,000 28.94 18.92 — Death Bate per 1,000 15-31 11.36 25 % Zymotic Death Bate per 1,000 2.29 0.58 74% Infant Mortality Bate per 1,000 Births 130 69 46 % 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 support I have at all times received from every member of my capable and enthusiastic Staff, and particularly the voluntary workers at the various Maternity and Child Welfare Centres. I am, Ladies and Gentlemen, Your obedient Servant, E. G. Annis. 6 SECTION 1. NATURAL AND SOCIAL CONDITIONS OF THE AREA. 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, 1925 103,520 Density of Population— East Greenwich 34.40 persons per acre West Greenwich 59.75 St. Nicholas, Deptford 67.68 Charlton and Kidbrooke 12.02 Average for the Borough 26.81 persons per acre Number of Inhabited Houses— Occupied houses 16,623 Structurally separate dwellings at Census, 1921 16,526 ,, 1925 17,735 Number of Uninhabited Houses— At Census, 1921 288 Estimated, 1925 131 7 No. of Families or Separate Occupiers— At Census, 1921 22,972 Rateable Value £786,671 Sum represented by a Id. rate £3,270 The altitude of the Borough varies from a few feet below high water mark on the Marsh Area to 249 feet above sea level on the Shooters Hill Road in the Charlton and Kidbrook area. It is unfortunate that the more densely populated part is situated in the lower portion of the Borough ; on the other hand we are fortunate in having land available for building purposes in the higher and more healthy area of Charlton and Kidbrooke, and it is in this district that the future development of the Borough lies. It may here be interesting to briefly record the changes that have taken place during the last quarter of a century. Greenwich at the beginning of the present century was a shipbuilding and engineering centre giving employment to thousands of men. Competition and inabihty to pay heavy rates and taxes has in many cases been the cause of firms closing down or migrating. Included in the former category were Messrs. Humphreys & Tennant. Deptford Dry Docks, Thames Iron Works (John Penn's), Castle's Shipbreaking Co., etc., whilst Messrs. Yarrows of world wide repute removed their works to Scotland. Since the War the Foreign Animals Wharf, commonly known as the Deptford Cattle Market, has also ceased to function, being acquired by the Government for a Supply Reserve Depot. With the advance of time many of the old buildings and houses in the Borough have been demolished and improvements effected. Another feature which is making itself felt generally in the SouthEastern district of London is the steady increase in factories and commercial undertakings ; very often these premises have been converted from dwelling houses with the consequent movement of the population to districts further out. The breaking up of large estates comprising houses and grounds in the Westcombe Park area and the subsequent conversion into flats and the utilisation of the spacious grounds for the erection of houses of the villa type has been another feature. Up to quite recently the Kidbrooke District has been regarded as a rural area, but a gradual change is now taking place. The Royal Air Force Depot and Wireless Station occupies a considerable area, land formerly used for grazing purposes is now being utilised for sports activities or is being built upon. 8 VITAL AND MORTAL STATISTICS, 1925. POPULATION. The population of the Borough estimated to the middle of the year 1925 is 103,520, and it is upon this figure that the statistics generally in this Report are based. (The Registrar-General's estimate, excluding non-civilians is 103,936 for Birth Rate and 102,936 for Death Rate). It has been found necessary to make a slight adjustment in the local figures consequent upon the movement of families from other parts of the Borough to the Council's Housing Estate at Charlton. This number is computed to be approximately 1,300, of which 845 came from East Greenwich, 425 from West Greenwich, and 30 from St. Nicholas, Deptford. The following is the distribution of the population throughout the Borough:— Census, 1921. (Adjusted.) Estimated Population at middle of year 1925. East Greenwich 44,647 44,720 West Greenwich 26,931 27,068 St. Nicholas, Deptford 7,646 7,784 Charlton 18,959 20,657 Kidbrooke 3,217 3,291 Total 101,400 103,520 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. *Births Legitimate 1,888 1,021 867 *Birth Rate 18.8 Illegitimate 56 27 291 Deaths 1,173 638 535 *Death Rate 11.2 Number of women dying in, or in consequence of, childbirth From Sepsis 1 „ other causese 2 *Deaths of Infants under one year of age per 1,000 births:— Legitimate 67; Illegitimate, 125; Total, 69. Deaths from Measles (all ages) 21 „ „ Whooping Cough (all ages) 15 ,, ,, Diarrhoea (under 2 years of age) 17 *These figures which are supplied by the Registrar General differ slightly from those shown in other parts of the Report. 9 INDUSTRIAL AND PROFESSIONAL OCCUPATIONS OF RESIDENTS. Taking the Census Returns as the latest official data it will be seen from the table shown below that there are 44,319 (31,741 Males and 12,578 Females) Greenwich persons actually engaged in industrial or professional occupations. Persons engaged in Commercial, Finance, Insurance and Public Administration, the majority of which can be reasonably termed sedentary occupations number 11,467, of which 7,199 are Males and 4,268 are Females and is approximately 25 per cent. of the total workers. Among the industries included in Unskilled Workers General Labourers, etc., come first with 5,245 Males and 289 Females. Persons engaged in Personal Service, such as Domestic Servants, Charwomen, Publicans, Barmen, Restaurant Keepers come next with 847 Males and 4,325 Females, followed by Metal Workers with 4,622 Males and 437 Females, and Transport Workers, 4,465 Males and 220 Females. 19,384 (13,778 Males and 5,606 Females) Greenwich residents work outside the Borough, whilst 16,373 (13,802 Males and 2,571 Females) workers belonging to other areas come into the Borough to work. This gives a nett daily outward movement of 3,011 persons. The number of Greenwich residents actually working within the Borough is 16,259 Males and 6,261 Females, a total of 22,520. The industries and sources of employment in the Borough are to be found close to the proximity of the river Thames which forms the Borough Boundary on the North Side. Chief among these are large Cable and Engineering Works, Gas Works, Soap and Candle Works, L.C.C. Generating Station and Tramway Car Repair Depot, London Electric Light Supply Corporation Works, Glass and Bottle Manufacturers, Merryweathers' Works (Fire Engines), etc. 10 Occupations of Greenwich Residents (Aged 12 years and over). Occupation. Males. Females. I. Fishermen 1 II. Agricultural Occupations : Gardeners, Nurserymen, Farm Servants, Labourers 215 19 III. Mining and Quarrying Occupations 17 — IV. Workers in the Treatment of Non-Metalliferous Mine and Quarry Products (excluding workers in gas works) 50 20 V. Makers of Bricks, Pottery and Glass 182 25 VI. Workers in Chemical Processes : Makers of Paints, Oils, etc. 412 40 VII. Metal Workers (not Electro-platers or Precious Metals) 4,622 437 VIII. Workers in Precious Metals and Electro-plate 14 8 IX. Electrical Apparatus Makers and Fitters and Electricians 1,812 653 X. Makers of Watches, Clocks and Scientific Instruments 196 4 XI. Workers in Skins and Leather, etc. 110 26 XII. Textile Workers 51 133 XIII. Makers of Textile Goods and Articles of Dress 289 1,014 XIV. Makers of Foods, Drinks and Tobacco 391 269 XV. Workers in Wood and Furniture 1,185 81 XVI. Makers of and Workers in Paper: Printers, Bookbinders 281 173 XVII. Builders, Bricklayers, Stone and Slate Workers 1,019 2 XVIII. Painters and Decorators 642 9 XIX. Workers in other Materials 136 51 XX. Workers in Mixed or Undefined Materials 390 106 XXI Persons employed in Gas, Water and Electricity Undertaking 645 7 XXII. Persons employed in Transport, Communication, Railways, Omnibus, Tramways, Drivers, Bargemen, Stevedores, Dock Labourers, etc. 4,465 220 XXIII. Commercial, Finance and Insurance Occupations (excluding Clerks) 2,284 1,084 XXIV. Persons employed in Public Administration and Defence (excluding Professional Men, and Typists) 2,468 308 XXV. Professional Occupations (excluding Clerical Staff) 928 1,178 XXVI. Persons employed in Entertainments and Sport 109 54 XXVII. Persons engaged in Personal Service : Domestic Servants, Charwomen, Publicans, Barmen, etc. 847 4,325 XXVIII. Clerks and Draughtsmen (not Civil Service or Local Authority) 1,519 1,698 XXIX. Warehousemen, Storekeepers and Packers 521 345 XXX. Stationary Engine Drivers, Dynamos and Motor Attendants 695 XXXI. Other and Undefined Workers: General Labourers, etc. 5,245 289 31,741 12,578 44,319 11 MARRIAGES. The Superintendent-Registrar of the Greenwich Registration District has kindly furnished me with the particulars relating to the number of marriages solemnised in the Parishes of Greenwich and St. Nicholas. The Superintendent-Registrar for the Woolwich Registration District has also kindly supplied the particulars for the 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 1913:— Charlton & Kidbrooke. Year, In Churches of England in Greenwich. in Churches of Eng- land In Non-Conformist Churches. St. Nicholas Parish Church. Marriages in Superintenden- Registrar's Office of parties resident in Greenwich or outside the Registration District, and in Chapels and Roman Catholic Church in StNicholas& Greenwich. Total. Approximate Population of the districts concerned. 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 55 200 691 102990 1925 265 132 5 48 224 674 103520 BIRTHS. The total number of births registered in the Borough during the year was 2,108. Of this number 243 occurred in Greenwich and Deptford Hospital and 408 at various Nursing Homes within the Borough. Of this total of 651 Institution births, 370 only belonged to Greenwich, the remainder being transferred to the appropriate localities. 12 One hundred and twenty-six births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 1953 Males, 1045 ; Females, 908. This figure gives a Birth Rate of 18.92 per 1,000 of the population, which is 165 below the average for the last ten years. The Birth Rate for the County of London equals 18.8 per 1,000 of the population. The Birth Rate for all England and Wales was 18 3 and 18-8 for the 105 large towns. Illegitimate births numbered 56, representing 2-8 per cent, of the total births. Sixty-one illegitimate births were registered in the Borough. In 17 cases, however, the mothers were ordinarily resident outside the Borough, and these births were consequently allocated to the correct area. 12 illegitimate births belonging to Greenwich occurred outside the Borough, thus giving the net figure of 56. Thirty-one 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 2,257 births. DEATHS. The net number of deaths registered during 1925 was 1,173, of which 638 were males and 535 females. The crude Death Rate for the Borough 11.36 per 1,000 compares favourably with 11-7 the Death Rate for the County of London, and 12-2 the Death Rate for the 105 Large Towns. The following Table shows at a glance the relative position occupied by Greenwich compared with other Boroughs in London. 13 Hampstead 10.1 Hammersmith 11.9 Lewisham 10.2 Bethnal Green 12.0 Battersea 10.4 City of Westminster 12.1 Wandsworth 10.4 Stepney 12.1 Fulham 10.6 Islington 12.2 Woolwich 10.7 Lambeth 12.2 Camberwell 11.0 Holborn 12.3 City of London 1l.l Bermondsey 12.6 Greenwich 11.2 St. Pancras 12.6 Stoke Newington 11.6 Kensington 12.9 Poplar 11.6 Southwark 13.1 St. Marylebone 11.7 Chelsea 13.3 Paddington 11.8 Shoreditch 13.3 Deptford 11.9 Finsbury 13.6 Locally the Death Rate varied from 6.09 in Kidbrooke, 10.87 in East Greenwich, 1136 in Charlton, 12.45 in West Greenwich up to 12.63 in St. Nicholas, Deptford Of the total number of deaths, 10 under five years of age were of illegitimate birth, 7 of whom were under one year of age. The following table shows the variation in, and average of the Death Rates in each of the five Districts of the Borough in the five years 1920 to 1924, compared with the figures for 1925:— District. 1920. 1921 1922. 1923. 1924. Average for 5 Years. 1925. East Greenwich 10.39 12.17 11.26 10.43 11.14 11.08 10.87 West Greenwich 14.84 12.53 15.27 12.97 11.84 13.49 12.45 St. Nicholas 15.61 14.28 17.61 12.58 11.77 14.37 12.63 Charlton 9.39 11.80 11.68 8.74 12.41 10.80 11.36 Kidbrooke 8.90 11.62 12.38 10.47 6.61 9.99 6.09 Borough 11.72 12.41 12.92 10.95 11.47 11.89 11.36 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. 1920 1,231 535 1921 1,243 553 1922 1,313 600 1923 1,119 546 1924 1,200 565 1925 1,173 621 Average 1,213 570 14 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 41 35 27 32 135 Between 1 and 2 years 9 4 2 16 31 Between 2 and 5 years 10 6 8 15 39 Between 5 and 15 years 8 11 7 11 37 Between 15 and 25 years 25 16 20 12 73 Between 25 and 45 years 46 33 31 30 140 Between 45 and 65 years 75 59 65 91 290 65 years and upwards 136 86 83 123 428 Total 350 250 243 330 1,173 INFANTILE MORTALITY. The Infantile Mortality Rate measured by the deaths of children under one year of age to the number of births registered, was 69 per 1,000 births, there having been a total of 135 such deaths during the year, as compared with 121, 129 and 154, the respective figures for the years 1922, 1923, and 1924. 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 67, compared with 69 in 1924, 60 in 1923, and 74 in 1922. For England and Wales the the rate was 75, compared with 75 in 1924, 69 in 1923, and 77 in 1922. Locally the variations were from 26 per 1,000 births in Kidbrooke, 67 in Charlton, 69 in East Greenwich, 81 in West Greenwich, to 84 in St. Nicholas, Deptford. 15 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 five years, 1916-1920, inclusive. Average for five years, 1921-1925, inclusive. East Greenwich 129 106 96 81 62 West Greenwich 126 110 112 110 80 St. Nicholas, 179 143 167 138 88 Deptford Charlton 121 109 76 89 66 Kidbrooke 39 79 16 39 13 Borough 131 111 103 95 66 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. 1925. 1925. Infective Diseases— Local Diseases—continued. Epidemic 0.71 Circulatory System 1.47 Sporadic 0.01 Respiratory System 2.00 Venereal 0.05 Digestive System .. 0.58 Septic 0.11 Lymphatic System 0.03 Malarial 0.06 Urinary System .. 0.29 Tuberculosis 1.12 Reproductive System 0.03 Parasitic Diseases — Parturition 0.01 Constitutional Diseases 1.51 Bones and Joints.. 0.02 Developmental Diseases 1.72 Integumentary System . — Dietetic Diseases — External Causes— Local Diseases— Accidents 0.49 Nervous System 0.79 Homicide — Organs of Special Sense .. 0.01 Suicide 0.10 16 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic.—There were 74 deaths due to this class of disease, equalling a Death Rate of .71 per 1,000; the rate last year was .92 and was .93, 1.34 and .58, in 1921, 1922, and 1923 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 60 deaths, equalling a Death Rate of .57 per 1,000. Locally the Zymotic Death Rate varied from .44 in East Greenwich (.56 in 1924), .62 in Charlton (.50 in 1924).66 in West Green-. wich (.57 in 1924), to 1.15 in St. Nicholas, Deptford (1.77 in 1924). Small-Pox.—There were no deaths from Small-Pox, this being the twenty-third year since a death occurred from this cause in the Borough. Measles.—Twenty-one deaths only were ascribed as due to this disease, 19 being under five years of age. The number of deaths recorded last year was 28, and in the years 1921, 1922 and 1923, 5, 29 and 2 respectively. Two deaths occurred in East Greenwich, 10 in West Greenwich, 8 in St. Nicholas, and 1 in Charlton. Scarlet Feveb.—This disease occasioned 3 deaths, two of which were under five years, and occurred in East Greenwich. Two such deaths occurred in 1923 and 2 in 1924. Whooping Cough. This disease was given as the cause of 15 deaths with a death rate of .14 per 1000. There were 16, 13 and 11 deaths respectively in the years 1924, 1923 and 1922. Five deaths occurred in East Greenwich, 5 in West Greenwich, and 5 in Charlton. Diphtheria.—There were 14 deaths during the year. This gives a Death Rate of .13 comparing with .14 for the previous year. Fourteen deaths occurred in 1924 and 28, 42 and 11 in 1922 and 1923 respectively. Five of the patients were under five years of age. Typhoid Fever.—There was one death ascribed to this disease; there were 1 in 1921, 0 in 1922, 6 in 1923, and 1 in 1924. 17 Diarrhœa, Dysentery, and Zymotic Enteritis.—Six deaths were said to be due to these causes, equalling a rate of 05 per 1,000. Last year there were 12 deaths and 27, 13, and 13 respectively in 1921, 1922 and 1923. Influenza.—Influenza is found to have been the responsible cause of 14 deaths ; 27 was the average of the previous three years. Seven cases were over 65 years of age. Nine deaths occurred in East Greenwich, 2 in West Greenwich, 2 in Charlton, and 1 in Kidbrooke. Sporadic Diseases.—There were 2 deaths from this class of diseases during the year, tetanus being the cause in both cases. One occurred in West Greenwich and 1 in St. Nicholas, Deptford. Venereal. Syphilis.—Six deaths were given as due to Syphilis, as against 3 in 1924 and 7 in 1923. Two occurred in East Greenwich, 2 in West Greenwich, 1 in St. Nicholas, Deptford, and 1 in Charlton. Of the 6 deceased persons, 1 was in the Greenwich and Deptford Hospital, 1 in Seamen's Hospital, and 4 were in Outside Institutions. There were no deaths from Gonorrhoea during the year. Septic Diseases. Erysipelas.—There were no deaths from this cause in 1925 as compared with 1 last year. There were 1 in 1922, and 3 in 1923. Puerperal Fever.—There were no deaths from this disease during the year, as compared with 2 last year. Pyæmia and Septicemia, &c.—There were 8 deaths from this disease during the year, 1 from Hospital Gangrene, and 3 from other Allied Diseases. Malarial. Rheumatic Fever.—There were 7 deaths in 1925 as compared with 3 in 1924, 3 in 1923, and 1 in 1922. Rheumatism of the Heart.—There were 6 deaths attributed to this cause. 18 Tuberculosis. This class includes the causes of 117 deaths during the year under review, with a rate of 1.12; these figures compare with 141, 133 and 127, the totals of the years 1922,1923 and 1924 respectively, and respective rates of 1.38, 1.30, and 1.21. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 104 attributed to this cause, or a rate of 1.00 per 1,000. Locally the deaths were 2 in Kidbrooke (giving a Death Rate of .60), 12 in St. Nicholas, Deptford (giving a Death Rate of 1.53), 48 in East Greenwich (Death Rate 1.07), 13 in Charlton (Death Rate .63) and 29 in West Greenwich (Death Rate 1.07). The remaining forms of Tuberculosis were responsible for 13 deaths, 9 of which occurred in East Greenwich, 2 in West Green. wich, and 2 in Charlton. Of these other forms of Tuberculosis, Tuberculosis of the Brain and its membranes were credited with 8 (7 being under five years of age), Tubercle affecting the Intestines 3, and General Tuber. culosis, 2. Parasitic Diseases.—There were no deaths from this class of disease. Dietetic Diseases.—There were no deaths from this class of disease. Constitutional Diseases.—The deaths from this cause were 158 in number, which gives a rate of 1.51 per 1,000. Of these, 125 were attributed to Cancer, 18 to Diabetes, 12 to Anaemia, and 3 to Rheumatoid Arthritis. Cancer. This disease as a cause of death has now usurped the place which was formerly taken by Tuberculosis, and in that way is now the premier cause of death, having contributed 125 deaths per year, while Tuberculosis in all its forms has contributed 117. The ideal form of death, viz., old age, comes midway between these two with 120. The deaths from Cancer were distributed as follows:—56 occurred in East Greenwich, 30 in West Greenwich, 9 in St. Nicholas, 28 in Charlton, and 2 in Kidbrooke. Whilst I have no doubt that this increased number of deaths attributed to Cancer is due in some considerable measure to the improved diagnosis of such cases, and therefore is not such a great increase as it would at first sight appear to be, yet on the other hand I feel confident that there is an undoubted increase in this 19 class of disease, although the actual amount of such increase is not distinguishable. It is interesting to be able to record that the British Empire Cancer Campaign and Research Departments at various Hospitals and Institutions are making investigations into the causation of this disease, yet up to the present one regrets to have to record that no definite cause has been distinguished and assigned to this disease, and it would seem as if until such a condition or conditions have been found out that all that the Public Health Authority can do counts for very little in the war against this scourge. Developmental Diseases.—There were 180 deaths, equal to a rate of 1.72 per 1,000. These may roughly be divided into those from causes which would appear to be unavoidable, viz.:—Congenital defects 14, and those from causes more or less preventable, viz.:—Premature birth, 28; Injury at birth, 1; Debility at birth, 5; Atrophy, Debility and Marasmus, 10; Atelectasis, 2. The remaining and largest portion of these deaths from developmental diseases, 120 in number, were from Old Age; in 1924 there were 150 deaths from this cause and 119 in the previous year. Local Diseases. Nervous System.—Eighty-three deaths were attributed to the various nervous diseases, which gives a rate of .79 per 1,000; last year the rate was .91 per 1,000. Convulsions were responsible for 6, all of whom were under five years of age; 4 were from Meningitis, 1 from Cerebro-Spinal Meningitis, 42 from Apoplexy, 2 from Chorea, 3 from General Paralysis of the Insane, 1 from other forms of Insanity, 4 from Epilepsy, 1 from diseases of the Spinal Cord, 4 from Cerebral Tumour, 1 from Locomotor Ataxy, 3 from Encephalitis Lethargica, and 11 from other diseases of this system. Organs of Special Sense.—There were 2 deaths from this class of causes, equal to a rate of .01 per 1,000. Circulatory System.—The Death Rate from diseases of this system was 1.47 per 1,000, there being a total of 154 such deaths. Valvular Diseases of the Heart were responsible for 82, 4 from Aneurism, 3 from Embolism, 5 from Angina Pectoris, 1 from Phlebitis, and from the remaining diseases of this system, 59. Respiratory System.—Two hundred and nine deaths were due to diseases of the Respiratory Organs, as compared with 196 20 in the preceding year. The Death Rate under this heading equals 2 00 per 1,000. Twenty-five were from Acute and 87 from Chronic Bronchitis, 79 from the various forms of Pneumonia (36 being under five years of age), 7 from Emphysema, 6 from Pleurisy, 2 from Laryngitis, and 3 from other diseases. Digestive System.—There were 61 deaths from diseases of this system, equal to a rate of .58 per 1,000. Of this number, Enteritis were responsible for 11, all of whom were under five years of age, 12 to Appendicitis, 7 to Obstruction of Intestine, and 1 to other diseases of the Intestines, 3 to Cirrhosis of Liver, and 3 to other diseases of the Liver, 4 to Peritonitis, 13 to Ulcer of Stomach and Duodenum ; 5 to other diseases of the Stomach, and 2 to other diseases of the Digestive System. Lymphatic System.—There were 4 deaths from diseases affecting this system during the year. Urinary System.—Thirty-one deaths, equal to a rate of .29 per 1,000, occurred from diseases affecting this system. 24 were from Bright's Disease, 3 from diseases of the Bladder and Prostate, 2 from acute Nephritis, and 2 from ill-defined causes of the LTrinary system. Reproductive System.—There were only 4 deaths due to diseases of the Generative Organs. Two deaths were attributed to diseases of Parturition. Bones and Joints.—There were three deaths from diseases of bones and joints. Integumentary System.—There were no deaths from diseases of Integumentary System. External Causes.—There were 63 deaths given as due to causes grouped under this heading; 52 were the result of accident or negligence, and the remaining 11 were from Suicide. It is gratifying to record that there were no deaths amongst young children through suffocation by being overlaid in bed. The previous year there were 5 deaths due to this cause. 10 cases were from Drowning, 4 from Burns and Scalds, while accidents on railways, in vehicular traffic and in building operations, falls, etc., were responsible for 38 deaths. The suicides were 3 from Poisoning, 2 by Asphyxia, 2 by Hanging or Strangulation, 2 by Drowning, 1 by Cut or Stab, and 1 by Precipitation from elevated place. Ill-Defined Causes.—There were no deaths in 1925. 21 MORTUARY. The Council's Mortuary was erected in 1904, and is adjacent to the Coroner's Court in Lamb Lane. The number of bodies dealt with since 1913 is shown below :— Year. Drowned Bodies from River. Other Bodies. Totals. 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 1925 17 204 221 SECTION 2. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. 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. 22 (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. Alterations are now in progress for the addition of a further 10 beds, fuller particulars of which are given on page 82. (3) Children.—No hospital 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 respect 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. Barnado'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 is made by the Council. Facilities afforded by the ambulances of the Metropolitan Asylums Board, London County Council and certain local Hospitals. The L.C.C. ambulances are available free of charge between the hours of 11 p.m. and 8 a.m. for all confinement cases entering the Council's Maternity Home, 78, Shooters Hill Road, S.E.3. 23 Clinics and Treatment Centres. Name. Situation. Nature of Accommodation. By whom provided. Period when held. Maternity and Child Welfare Centres. Borough Hall, Royal Hill, Greenwich. 1 large waiting room. 1 large weighing room. 1 Consulting room. Local Authority. Thrice weekly Conduit House, Trafalgar Rd., E. Greenwich. Ditto. Ditto. Thrice weekly. (a)Infant Consultations 105, Shooter's Hill Road, Blackheath. Ground floor consisting of large waiting room, large weighing room and consulting room. Ditto. Twice weekly. Albany Institute, Creek Road, Deptford. Large hall and consulting room. Ditto. Once weekly. Charlton Vale Mission Hall., Woolwich Rd., Charlton. Large Hall consisting of waiting and weighing room and consulting room. Ditto. Once weekly. (b) Pre- Maternity. Borough Hall. (See above). Ditto. Twice weekly. 105, Shooters Hill Road, S.E. ( Do. ) Ditto. Once weekly. Conduit House, Trafalgar Rd., E. Greenwich. ( Do. ) Ditto. Once weekly. (e) Minor Ailments. Borough Hall. 1 large room. Ditto. Daily. (f) Artificial Sunlight Conduit House, Trafalgar Rd., E. Greenwich. 1 large room and dressing room. Ditto. Daily. Nursery School. Rachel McMillan Memorial School, 232, Church Street, Deptford, S.E. Extensive. Miss Margaret McMillan. Daily. 24 Clinics and Treatment Centres—Continued. Name. Situation Nature of Accommodation. By whom provided. Period when held. School Clinics. Parle 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. PUBLIC HEALTH STAFF. Miss A. Jenkins was appointed as Health Visitor in February and Miss L. D'Oyly Watkins commenced duties as Nurse in Charge of the new Artificial Sunlight Treatment Centre in July. Dr. A. F. Kellett, B.A., M.B., Ch.B., who had acted as part time Medical Officer in connection with this Council's Maternity and Child Welfare Scheme since its inception, and had also acted as Honorary Medical Officer for the Albury Street Babies Home connected with the Deptford Fund, had to enter Guys Hospital for an operation when the illness he was suffering from was found to be of a cancerous nature and proved fatal after a very short period. His services are very much missed by the Department because his sympathetic nature had endeared him not only to the members of the Staff but also to the Mothers who came under his care and attention from time to time. The Committee of the Babies Home 25 are proposing to perpetuate his memory by naming one of the new wards the "Kellett Ward." Mr. Clay, Assistant Disinfector, died in May after 18 years service with the Department. He was a keen, conscientious and zealous worker. Medical Officer of Health and Administrative Medical Officer, Tuberculosis, and Maternity and Child Welfare— *Ernest G. Annis, M.R.C.S., L.R.C.P., D.P.H. (Barrister-at-Law). Assistant Medical Officer of Health and Tuberculosis Officer— *M. Macdonald, M.D., Ch.B., D.P.H. Maternity and Child Welfare Medical Officers. *G. J. Sophian, M.R.C.P. (Lond.), M.R.C.S., L.R.C.P. †H. M. Halliday, M.R.C.S., L.R.C.P., D.P.H. 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— c e *A. E. Bache. a b *W. R. Drake. a b c *S. A. Radford. a b *Miss G. Davis. b c *A. E. Morgan. Infectious Diseases Inspector— a *E. Martin. Health Visitors— afh *Miss M. Molloy. f g h *Miss E. Bailey. f h *Mrs. M. Donald-Morison. f g h *Miss A. M. M. Hadfield. f g h *Miss F. C. Jagot. f h *†Miss H. Foley. f g h *Miss A. Jenkins. TUBERCULOSIS DISPENSARY. Nurses— g *Miss L. Heastman. f g *Miss T. I. Husbands. a f g h *Miss D. M. Wilkins. 26 Dispenser- Caretaker— *E. E. Burrows. *Mrs. Vickery. ARTIFICIAL SUNLIGHT TREATMENT. Nurse— *Miss L. D'Oyly Watkins. MATERNITY HOME. Matron— g h *Miss N. G. Beeham. Clerical Staff— *F. W. Foulger (Principal Clerk). a H. W. Duck. L. A. Westacott. Miss L. Merricks. E. P. Tidman (Temporary). *Mrs. L. E. Wright. A. M. Smith. b A. G. Thomas. *Mrs. N. Furbank (Milk Saleswoman). Disinfecting Staff— J. Forrest. T. Packham. F. Mears. T. G. Griggs. F. Stevens (Motor Driver). Caretaker at Cleansing Station— Mrs. E. Robinson. Mortuary Keeper— G. W. Moss. a Cert. Royal Sanitary Institute. b Cert. Sanitary Inspectors' Examination Board. c Cert. R.S.I., Meat and Other Foods, e P.A.S.I. f Cert. R.S.I. Health Visitors and School Nurses. g General Nursing Training (3 years). h Certified Midwife. All the members of the Staff of the Department are whole time Officers with the exception of those marked †. *Contributions made in respect of salaries of above Officers under Public Health Acts or by Exchequer Grants. 27 Professional Nursing in the Home. (a) 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 Diarrhœa, 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. Laboratory Work.—The long-standing arrangement with the Bacteriological Department of the Seamen's Hospital has been in force throughout the year, whereby that Institution carried out all necessary pathological and bacteriological work for this Department, other than under the Sale of Food and Drugs Act, and in this connection 2,444 specimens have been examined for Diphtheria, 12 for Typhoid Fever, 353 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-eight tubes of Diphtheria Antitoxin, containing a total of 304,000 units of serum, have been supplied during the year to Medical Practitioners for the treatment of patients suffering from this disease. 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 490 Greenwich persons for an average of eighteen days each, being an increase of 191 over last year's figure, in addition to which there have been 3,040 Out-patients, making approximately 9,120 attendances of persons belonging to the Borough of Greenwich, compared with 2,904 out-patients for the previous year. 28 Millek General Hospital admitted, treated and maintained 356 Greenwich persons for an average of twenty-three days as against 243 last year. 7,771 Out-patients have also been treated, the total attendances being approximately 33,245. Blackheath and Charlton Cottage Hospital admitted 240 In-patients from Greenwich, and treated 400 Out-patients making 4,006 attendances for this purpose. POOR-LAW RELIEF. The Clerks of the Greenwich and Woolwich Boards of Guardians have been good enough to furnish me with the following figures for the year ended 2nd January, 1926:- Greenwich Parish. St. Nicholas Deptford Parish. Charlton and Kidbrooke Parish. Total amount expended in out-door relief £81,295 £19,647 £11,246 Total number of persons treated in Hospital 1,648 268 128 Total number of persons treated medically in their own homes 555 147 302 Total number of persons admitted to the Workhouse 480 79 30 LEGISLATION IN FORCE. List of Adoptive Acts, By-laws and Local Regulations Relating to the Public Health, in Force 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. 29 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. SECTION 3. SANITARY CIRCUMSTANCES OF THE AREA. The tables on pages 30 to 32 and 36 to 40 summarise, as far as possible, the Sanitary work of the Department; from this it will be seen that a total of 18,458 houses and premises have been inspected or re-inspected during the year; 1,234 intimation notices and 116 statutory notices have been served. It is very gratifying to be able to report that only in eight instances was it found necessary to institute Police Court proceedings during the year, particulars of which are contained in the table on page 40. There were altogether throughout the year 647 complaints registered. Factories, Workshops and Workplaces.—Two hundred and sixty-six inspections have been paid to these premises within the Borough during the year. According to information kindly furnished me by the Inspector of Factories for the Woolwich District there are 220 factories, 130 workshops and 30 wharves and quays. Outworkers' Register.—Ten lists, containing 45 names and addresses have been received from employers within the district. In addition to this 60 lists containing 138 names and addresses of Outworkers residing in this Borough were received from Medical Officers of Health of other Boroughs, whilst 3 lists with 3 names and addresses were forwarded to other districts, thus giving a total of 180 Outworkers in the Borough. 69 visits of inspection have been paid to these premises. 30 FACTORIES, WORKSHOPS, LAUNDRIES, WORK- PLACES and HOMEWORK. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Factories 76 5 .. (Including Factory Laundries) Workshops 49 9 .. (Including Workshop Laundries) Workplaces 141 6 .. (Other than Outworkers' Premises) Total 266 20 .. 2.—DEFECTS FOUND. Particulars. Number of Detects. Number of Prosecut's. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts :— Want of Cleanliness 51 51 .. .. Want of Ventilation .. .. .. .. Overcrowding .. .. .. .. Want of Drainage of Floors .. .. .. .. Other Nuisances 16 16 .. .. Sanitary Accommodation— Insufficient 6 6 .. .. Unsuitable or Defective 6 6 .. .. Not Separate for Sexes 17 17 .. .. Offences under the Factory and Workshops Act:— Illegal Occupation of Underground Bakehouse (s. 101) .. .. .. .. Other Offences .. .. .. .. Total 96 96 .. •• * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 31 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 (Sees. 109 & 110). Twice in the Year. Once in the Year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. tractors Workmen. Contractors men. Wearing Apparel— — .... (1) Making, &c. 10 .. 18 .. .. .. .. .. .. .. .. .. .. .. .. (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 .. .. 27 .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 10 .- 45 — — — - - - - - - - - - 32 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1925. No. Bakehouses 38 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 56 188 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 — Reports (of action taken) sent to H.M. Inspectors — Other - Underground Bakehouses (sec. 101) :— In use at the end of 1925 13 Smoke Nuisances.—Thirty-five observations have been made for smoke nuisances during the year, but in only 3 instances was it found necessary to serve a Statutory Notice. 33 Water Supply.—During the year 147 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. Defective water fittings have been remedied in 15 cases; 86 water supplies have been reinstated where the supply had been cut off; water fittings have been amended in 143 cases; 3 water supplies have been altered so as to draw direct from the main, and cleansing, repairing and covering cisterns in 5 cases. House Drainage.—Forty-three drains have been constructed, 142 drainage systems have been reconstructed or repaired; 484 such systems have also been opened, cleansed and amended; 45 surface drains have been constructed; 51 drains and soil pipes have been ventilated; 255 systems have been tested by smoke, 326 by water, of which number 118 were found to be defective; 36 new soil pipes and 226 traps have been fixed, together with 26 intercepting chambers and fresh air inlets, and 59 other chambers. Twenty-three new covers to manholes have been provided. Eight systems have been sealed off or slurried up. Two forecourts 5 areas, and 28 yards drained; 3 cesspools abolished; 26 waterclosets have been erected; 123 cleansed and repaired; 47 w.c. doors and seats repaired or provided. A pan, trap and water supply have been furnished throughout in 58 cases; pan and traps only furnished in 140 cases; pans only in 4 cases, and other fittings provided or improved in 227 cases, whilst the water supply has been renewed in 12 instances. Public-house urinals have been cleansed and repaired in 20 instances. Customs and Inland Revenue Acts.—No applications were received during the year for certificates under these Acts. Horse Slaughterer.—The one horse slaughtering premises in the Borough has been inspected on four occasions and the cleansing of the premises duly carried out. Scavenging and Refuse Disposal.—The new Refuse, Screening and Disposal Plant and Buildings which have been in the course of construction during the last few years are now duly completed, but up to Christmas the plant was only used for experimental purposes. As a matter of fact they were taken into full use on 22nd April of this current year and are now disposing of approximately 30 tons per diem of the house refuse of this Borough out of an approximate total of 40 tons collected daily. The general principle underlying the whole system is that of a thorough and detailed selection and sorting of the whole of the refuse, it being put through various mechanical screening 34 cesses and much hand picking in order to abstract from it anything that could be put to any possible use such as waste paper, bone, metal, and fine material which it is hoped may be used for brick making, etc. Out of an average of 30 tons per diem dealt with approximately 18 tons are sorted out for sale or disposal in this way, and about 1 ton of small pieces of coal, coke and other combustible material which is used solely for the firing of the boiler, which with the assistance of coke or coal purchased for the purpose raises the steam necessary to provide the energy for driving the whole of the screening plant leaving about 11 tons of real refuse and otherwise non-disposable material to be dealt with in the destructor furnaces pure and simple. The furnaces consist of 2 cells of what might be termed a Greenwich Borough Council design into which the refuse is burnt at no very great heat. This results in a very mixed lot of clinker being produced which is larger in volume, and in my opinion, inferior quality to clinker which would be produced if a greater heat were raised. The whole of the system will need very great care in its operation to ensure that persistent nuisances are not occasioned, for the process is a very unsavoury one, and the suggestion of storing any large quantity of this sort of material until arrangements are made for its disposal to brickmakers and others is likely to give rise to considerable nuisance. Public Sanitary Conveniences.—There are at present 4 underground sanitary conveniences in the Borough, situated at— Blackwall Lane, East Greenwich. South Street, West Greenwich, Creek Road, St. Nicholas, Deptford, and Blackheath Hill. 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 Section 6 of the Housing Act, 1925, become law. Two hundred and twenty-two inspections were made of the premises already on the Register. Rats and Mice (Destruction) Act, 1919.—Complaints as to rat infestation and cases coming to the notice of this Department are forthwith investigated. Advice and assistance are given where necessary. The result of the propaganda of the last few years has resulted in a greater general knowledge of methods employed in the extermination of these pests. Four hundred and sixty-one such investigations were made by the Council's Officers but in no case was it found necessary to serve a notice. 35 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. Increase of Rent and Mortgage Interest Restrictions Acts, 1920 and 1923. Eight applications were received during the year from tenants for certificates under these Acts. Five Certificates were granted. Of the remaining 3 cases the Certificates were not necessary; in 2 instances the work specified was done by the Landlord, whilst the other application was refused. Other Scheduled Offensive Trades. Now that the Foreign Animals' Wharf, generally referred to as the Deptford Cattle Market, is permanently in the occupation of the Army Authorities for the purposes of a Reserve Supply Depot no offensive trades are carried on. Verminous Premises.—In order to assist owners and occupiers to deal with this ever increasing difficulty, a well known and tried fluid preparation is supplied upon request, together with the use of a sprayer. It is needless to add the sprayers have been in constant demand and there is no doubt the means adopted has been very efficacious. 36 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1925. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Inspections Houses Inspected 611 716 751 637 2715 Other Premises Inspected 114 231 244 186 775 Re-inspections, Calls Made, etc. 2873 2884 2971 3276 12004 Inspections of Houses Let in Lodgings 72 58 34 58 222 „Bakehouses 1 40 11 32 84 „ Factories, Workshops and Workplaces 32 21 21 78 152 ,, Outworkers' Premises. 9 22 14 24 69 „ Slaughterhouses 8 8 6 14 36 ,, Cowhouses . . 4 .. 3 7 „ Stables and Yards 12 20 25 15 72 „ Piggeries .. 2 .. 1 3 „ Courts and Alleys 1 1 2 1 5 „ Fields, Lanes, etc. 10 5 11 8 34 Investigations (Rats and Mice) 114 112 77 158 461 Inspections of Urinals 9 8 8 2 27 ,, Gipsy Vans .. 1 .. .. 1 „ Horse Slaughterhouses 1 1 1 1 4 ,, Dairies, Cowsheds and Milkshops 21 89 27 10 147 „ Soap Boilers 1 1 1 1 4 ,, Other Offensive Trades 1 .. 1 1 3 ,, Ice Cream places 1 71 57 .. 129 ,, Other places where food is prepared or stored 275 503 339 387 1504 Total 4166 4798 4601 4893 18458 Drains. Constructed 3 8 16 16 43 Intercepting Chamber, and Fresh Air Inlet 6 10 6 4 26 Other Chambers Constructed 14 12 15 18 59 Reconstructed or Repaired 34 42 43 23 142 Opened, Cleansed, and Amended 43 172 119 150 484 Surface Drains Constructed 5 24 3 13 45 Traps Fixed 49 59 74 44 226 New Soil Pipes 8 13 8 7 36 Soil and Vent Shafts Repaired 7 7 12 9 35 Drains and Soil Pipes Ventilated 13 13 17 8 51 Drains Sealed off, etc. .. 3 2 3 8 Drains tested—by Smoke 50 65 70 67 252 „ by Water 62 94 85 85 326 Found Defective 25 49 29 15 118 New Covers to Manholes 8 3 8 4 23 Yards Drained 17 1 8 2 28 Mews and Stables Drained .. .. .. .. .. Washhouses Drained .. .. .. .. .. 37 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Drains—contd.. Forecourts Drained .. 2 .. .. 2 Areas Drained 2 2 .. 1 5 Cesspools abolished .. 1 2 .. 3 Privies and Earth Closets abolished 1 .. .. .. 1 Water Closets and Urinals. Closets erected 4 2 6 14 26 W.C. doors repaired or provided 12 11 12 12 47 Sanitary Conveniences or Improvements effected to Factories, and Workshops and Workplaces 1 1 2 24 28 Pan, Traps and Water Supply furnished 4 7 20 27 58 Pans and Traps only furnished 34 37 50 19 140 Pans only furnished 3 .. 1 .. 4 Water Supply Apparatus repaired or provided 62 59 48 58 227 Water Supply renewed 2 3 7 .. 12 Water Supply disconnected from Drinking Water Cistern .. 1 .. .. 1 Soil Pans properly trapped .. .. .. .. .. Cleansed and Repaired 23 22 39 39 123 Newly constructed or better situated 1 3 5 3 12 Ventilation improved 31 28 11 3 73 Public-house Urinals cleansed or repaired 4 3 9 4 20 Other Urinals altered or cleansed .. 2 .. 4 6 Other Urinals constructed .. .. .. 1 1 Repaired or water laid on .. 1 .. .. 1 Ashpits. Provided 147 79 81 105 412 Covers to receptacles 2 1 .. .. 3 Dust complaints forwarded to the Surveyor .. .. .. * * .. Pavings. .. .. .. .. .. Yards 37 47 62 31 177 Forecourts 4 10 2 1 17 Areas 2 4 .. 2 8 Washhouses .. 4 3 5 12 Mews and Stables 1 1 1 .. 3 General Water Supply. Covers to Cisterns adapted 26 64 8 .. 98 Water Supply provided .. .. .. .. .. Water Fittings amended 32 34 43 34 143 Cisterns cleansed and repaired 1 2 .. 2 5 Water Services altered so as to draw direct from main 1 1 .. 1 3 Water Supplies reinstated where cut off through defective fittings 18 4 49 15 86 38 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 5 2 2 6 15 Water Supply Certificates granted (Section 48) 12 89 31 15 147 Other Improvements. Houses generally repaired 104 93 150 128 475 Premises cleansed, lime-washed and repaired 40 43 51 47 181 Verminous Rooms cleansed 20 56 70 54 200 Ventilation improved 60 43 32 39 174 Staircases repaired, amended, lighted, and ventilated 8 8 8 9 33 Leaky House Roofs and Gutters repaired 130 74 123 100 427 Walls and Ceilings of Premises cleansed throughout 9 21 39 27 96 Ditto ditto partially 101 113 101 123 438 Stoves and Fireplaces repaired 33 17 25 38 113 Washing Coppers repaired 16 15 18 18 67 Sinks provided 15 27 14 23 79 Floors repaired 42 45 49 38 174 Cowhouses cleansed .. 4 .. 1 5 Bakehouses cleansed .. 11 .. .. 11 Horse Slaughter houses cleansed 1 1 1 1 4 Ice Cream places cleansed or improved .. 7 1 .. 8 Other places where food is stored or prepared 8 31 10 3 52 Provision for Storage of Food 1 1 5 5 12 Other Nuisances Abated. Illegal use of Underground Room discontinued .. 1 .. .. 1 Overcrowdings abated 1 1 1 .. 3 Sink, Lavatory and Bath Waste Pipes disconnected, trapped and amended 34 44 49 40 167 Stack Pipes disconnected and amended 28 33 23 30 114 Nuisances from dampness abated 44 37 29 40 150 Animals Kept in Unfit Places discontinued or removed .. 7 4 5 16 Dung Receptacles provided .. 2 1 4 7 Bakehouse Nuisances abated.. .. 19 4 9 32 Houses abolished, unfit for habitation .. .. .. .. .. Accumulations of Manure and other obnoxious matter removed 14 17 17 18 66 Dampness of Walls remedied 30 25 36 26 117 Inundations abated 2 11 3 2 18 Other Nuisances, principally of dilapidations and want of underfloor ventilation 17 16 12 8 53 39 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total. Other Nuisances Abated.—contd. Contents of Rooms cleansed .. 8 8 5 21 Breaches of By-Laws abated .. .. .. 2 2 Bat Infestation abated 16 19 18 34 87 Smoke Nuisances. Observations 3 12 9 11 35 Statutory Notices served (Sections 23 and 24) .. .. .. 3 3 Food and Drugs. Samples taken 142 132 117 50 44 1Found Adulterated 3 5 3 1 12 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Unwholesome Food. Seizures made — — — — Voluntarily surrendered 3 cases Dried Milk. (168 lbs.) 1 trunk of Haddock. 1 trunk Whiting. 1 trunk Haddock (84 lbs.). 2 boxes Haddock (168 lbs.). 9½ lbs. Apples. 3 Pigs' Plucks. 98 lb. Beef. 1 Pig's Carcase. 6 stone Haddock. Pork (22 lbs.). 2 trunks Haddock (168 lbs.). 7 Sheep's Liver. 5 stone Herrings. 17 lb Tomato. 2 Sheep's Carcase. 3 qrts. Winkles. 2 trunks Mixed Fish (168 lbs.). 2 bushel Winkles. 1 box Skate (84 lbs.). 1 trunk Cod (168 lbs.) 40 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) 297 277 275 385 1234 Notices served— Under Housing, Town Planning, etc., Act, 1919 .. .. .. .. .. Rats and Mice (Destruction) Act, 1919 .. .. .. .. .. re Verminous Rooms .. .. .. .. .. Under P.H. (L.) Act and Metropolis Management Act (re combined drainage) .. 4 .. 13 17 W.C.'s (Factories, Workshops and Workplaces) .. 4 .. .. 4 Yards .. .. .. .. .. Miscellaneous. .. .. .. .. .. Statutory Notices served under Section 4 13 29 21 12 75 Statutory Notices re Ashpit provision 5 7 6 2 20 Complaints received and attended to . 121 149 194 183 647 Letters written relating to abatement of Nuisances 138 102 78 43 361 Summonses applied for and issued .. 4 3 1 8 Magisterial Orders obtained and enforced .. 1 .. .. 1 Drainage Plans received and examined 19 32 21 34 106 Legal Proceedings under the Public Health (London) Act, 1891, and Bye-Laws During the Year 1925. Premises. Complaint; Result of Proceedings. Fine. Costs. 70, Church Lane, Charlton. Non-deposit of drainage plans. Withdrawn. Plans supplied before hearing. -- 5/- 31, Fairfield Road Non-compliance with Statutory Notice. Withdrawn. Work done. - 5/- 66, Church Lane, Charlton. Do. Do. - 5/- 19, Roan Street, Greenwich. Underground room occupied as a dwelling. Abatement Order - - 35, Mauritius Road, Greenwich. Non-compliance with Statutory Notice. Withdrawn. Work done. - 10/- 37, do. Do. Do. - 39, do. Do. Do. - 19, Swallowfield Road, Charlton. Do. Do. - 5/- 41 BOROUGH OF GREENWICH. Proceedings during 1925. Premises. Number of Places. Number of Inspections, 1925. Number of Notices. 1925. Number of Prosecutions, 1925. On Register at end of 1924. Added in 1925. moved in 1925. On Register at end of 1925. Dairies, Cowsheds and Milkshops 102 29 12 119 147 1 — Slaughterhouses 5 — — 5 36 — — Other Offensive Trade Premises - - - - - - - Ice Cream Premises 138 29 41 126 129 4 - Registered Houses Let in Lodgings 247 — — 247 222 — - Total number of Intimation Notices served for all purposes 1,234 Overcrowding, 1925— Number of Dwelling-rooms overcrowded 12 Number remedied 3 Number of Prosecutions — Underground Rooms— Illegal occupations dealt with during year 1 Number of Rooms Closed 1 Insanitary Houses— Number Closed under the Public Health (London) Act, 1891 - Number closed voluntarily under the Housing of the Working Classes Acts — Number of Verminous Premises cleansed under Sec. 10 of the London County Council (General Powers) Act, 1922 200 Number of Cleansing Baths given under Cleansing of Persons Act 11 Shelter provided under Sec. (50 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — 42 Number of Tenement Houses provided with Additional Water Supply 1 Number of Prosecutions ditto — Inland Revenue Acts— Number of Houses for which applications were received during the year — Number of Tenements comprised therein — Number of Tenements for which certificates were granted — Number of Prosecutions under By-Laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping 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) 1 Mortuaries— Total number of bodies removed 221 Total number of infectious bodies removed — 221 43 SECTION 4. HOUSING. Overcrowding still continues to a greater or less extent throughout the whole of the Borough. Only cases of a gross character, i.e. 6 or more persons occupying one room are reported to the Public Health Committee. Even then the service of the necessary notices with threats of prosecution, etc., whilst very often causing great distress to the persons concerned, does not in any way assist them in obtaining alternative accommodation. It often happens that these very cases are the ones not desired by any Landlord as Tenants. This fact was particularly exemplified in the case of a family of man and wife and 4 children of all ages and both sexes occupying one cellar room, and after having endeavoured to assist this family to obtain alternative accommodation in this Council's Housing Estate and the London County Council's Estate without any good result, it was then deemed desirable to proceed against the persons for their default in not removing from the cellar dwelling, and it was only after the case had been heard in the Police Court and adjourned from time to time up to a period of 4 months before the occupants were able to obtain the necessary accommodation elsewhere and remove from the cellar. This Council at their meeting in January, 1925, brought forward proposals to erect 300 houses on the Charlton Park Estate and 100 houses on what is called the 20 Acre Field. In July it was reported that 98 houses on the No. 3 Section of the Council's Estate at the rear of Little Heath and Kinveachy Gardens, Charlton, and 12 Maisonettes at East Greenwich were completed and occupied. In December instructions were given for the Ministry of Health to be approached with a view to their approval being obtained to the proposal to proceed with a further 120 houses, i.e. 100 on the Charlton Park Estate and 20 on the Pound Park Site. The total accommodation provided by the Council since 1920 to the end of the year under review is 472 tenements and houses. HOUSING RETURN, 1925. Number of new houses erected during the year:— (a) Total 149 (b) With State assistance under the Housing Acts :— (i.) By the Local Authority 98 ,, ,, (Maisonettes) 12 (ii.) By other persons — 44 I.—Unfit Dwelling-houses. Inspection. (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2,639 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing consolidated Regulations No figures available (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 2,605 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 637 3.—Action under Statutory Powers. (a) Proceedings under Section 3 of the Housing Act, 1925— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notice— (a) By owners Nil (b) By Local Authority in default of owners. Nil (3) Number of dwelling-houses in respect of which closing orders became operative in pursuance of declarations by owners of intention to close Nil (b) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Intimations 1,113 Statutory 116 45 (2) Number of dwelling houses in which defects were remedied after service of formal notice— (a) By owners 1,968 (b) By Local Authority in default of owners — SECTION 5. Inspection and Supervision of Food. Cowhouses.—The four cowhouses in the Borough have been visited on 7 occasions, and the required cleansing duly enforced. Milk and Dairies (Amendment) Act, 1922.—Dairies, Cowsheds and Milkshops Order.—At the commencement of the year there were 102 premises on the Register of Dairies and Milkshops; 29 new applications have been received during the year and added to the Register, and 12 names have been taken off, thus leaving a total of 119 premises now registered. During the year 147 visits of inspection have been paid to these premises; notices were served upon the occupiers in 7 cases where dairies required lime-washing or were otherwise in an insanitary condition. Two applications for registration were refused on the ground of unsuitability of the premises. Milk and Dairies Consolidation Act, 1915.—The operation of this Act was intended to come into force not later than one year from the termination of the war, but was postponed by the Milk and Dairies (Amendment) Act, 1922. By an Order made by the Minister of Health, the date was fixed as the 1st September, 1925. There is no doubt whatever that, generally, the operation of this Act should be the means of providing a much higher standard of milk. More powers are given for protecting the public against the ravages of tuberculosis by the consumption of tuberculous milk. Section 9 affects the procedure with regard to the sampling of milk. Where a warranty defence is pleaded by a purveyor of milk, a sample from a corresponding milking must be taken in course of transit or delivery to the purveyor, and if the owner of the cow so requests, a further sample must be taken at the dairy at which the cows are kept. The warranty defence will not be available where the sample is a mixture of milk obtained from more than one seller or consignor. A further provision that must be complied with is for the purveyor to request the local authority within sixty hours from the time the first sample was procured, to take a corresponding sample. If the local authority do not comply with the purveyor's request, no proceedings can be instituted against the said purveyor. Milk Supply.—The majority of milk supplied to this Borough is obtained from farmers and large firms outside the district. 46 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 the following licenses were granted for the sale of graded milk. Distribution of Certified Milk 5 ,, „ Grade A (Tuberculin Tested) 4 ,, ,, Grade A (Pasteurised) 3 „ „ Grade A 2 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. It was not found necessary to take a sample during the past year. Milk and Cream Regulations, 1912 and 1917.—One hundred and five samples of milk were taken during the year. In one case the presence of a trace of preservative was reported upon by the Public Analyst, and a warning letter sent to the defaulting vendor. Two samples of cream were taken one of which was found to contain 0.3 per cent. of Boric Acid. A warning letter was sent to the Vendor of such sample. 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 :— 981bs. of Beef. 1 Pig's Carcase. 2 Sheep's Carcase. 7 Sheep's Liver. 3 Pig's Plucks. 221bs. of Pork. The Public Health (Meat) Regulations 1924, came into force on the 1st April, 1925, and provides for the better regulation and supervision of slaughter-houses and protection of meat against contamination by dirt, etc. The proprietors of 109 premises where meat, bacon, etc., are either stored or exposed for sale were notified as to the general provisions of the Regulations. Slaughterhouses.—The number of slaughterhouses in use in the Borough are as follow :— 47 In 1920. In January, 1925. In December, 1925. Registered — — — Licensed 4 4 4 4 4 4 Thirty-six inspections were made by the Inspectors during the year. Other Foods.—Places where food is prepared have been visited on 166 occasions, improvements being required in 18 instances as detailed below :— Class of Premises. Number of Lists. Number of Inspections. Number of instance where matters needed attention. At end of 1924. Added 1925. Removed 1925. At end of 1925. Hotel Kitchens 6 — — 6 6 — Eating Houses 51 1 1 51 54 7 Fried-Fish Shops 33 3 4 32 36 7 Pork Butchers and Sausage Manufacturers 25 - - 25 45 - Mineral Water Manufacturers 1 — — 1 1 — Others 19 6 1 24 24 4 Totals 135 10 6 139 166 18 The 18 instances where matters needed attention included 4 cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 9 where the sanitary arrangements were defective, 2 where the gutting sheds were not satisfactory and 2 where the yard was foul. The trade of gutting and curing was stopped in one case owing to the premises being unsuitable. 48 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 39. Ice Cream Premises.—There were 138 premises known at the commencement of the year where the manufacture of this commodity was carried on; 29 have been added during the year and 41 taken off, leaving a total of 126 premises. These premises were inspected on 129 occasions, improvement required by way of cleansing of the premises in 4 cases, and insanitary conditions remedied in 6 instances. In 1 case the sale of ice cream was forbidden and removed from the lists owing to the generally dirty condition of the premises. Monkeys were also kept where the ice cream was prepared. Bakehouses.—Eighty-four inspections have been made of the various Bakehouses in the Borough and 11 nuisances found therein have been abated. At the end of the year there were 5 Factory and 38 other Bakehouses on the Register, 13 of which are underground. Food and Drugs Acts.—Four hundred and forty-one 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 429 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, 105 were milk, of which 5 were certified to be adulterated; the remaining adulterated samples were 4 of vinegar, 1 of Pepper, 1 of Cream, and 1 of Jonathan Apples. Proceedings were taken in 1 case resulting in fines and costs amounting to 67s. 49 Sale of Food and Drugs Acts. Administrative Action Taken Regarding Samples reported to be NOT GENUINE. No. of Sample. Description of Sample. Nature of Adulteration. Result of Proceedings. 382 Cream. Contains Fat 52.2%, Boric Acid, 0.3%. Warning letter. 438 J onathan Apples Contained Arsenic to the extent of 1.150th of a grain per lb. Warning letter. 1 Milk Slightly deficient in Solids not Fat. No action. 119 Do. Deficient in Fat to the extent of 24%. Fined 40/-; Costs 27/-. 245 Do. Contains a trace of Boric Acid amounting to less than 1-100th of 1%. Warning letter. 328 Do. Admixed with 4% of Water Warning letter. 344 Do. Admixed with 2% of Water Warning letter. 152 Pepper Admixed with 10% of Oatmeal. Warning letter. 6 Vinegar Deficient in Acetic Acid to the extent of 3%. Warning letter. 181 Do. Deficient in Acetic Acid to the extent of 3%. Warning letter. 202 Do. Deficient in Acetic Acid to the extent of 4%. Warning letter. 269 Do. Deficient in Acetic Acid to the extent of 5.5%. Warning letter. 50 Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1925. Description of Samples. Number of Samples Purchased. Number Genuine. Number Not Genuine. Apples, Jonathan 1 - 1 Baking Powder 6 6 — Beef, Lunch 1 1 — Bloater Paste 1 1 Brawn 10 10 — Bread 8 8 Butter 85 85 Cheese 1 1 Chicken Roll 1 1 Cocoa 2 2 — Coffee 6 6 — Corned Beef 1 1 — Cream 2 1 1 Dripping 3 3 — Fish Paste 1 1 — Flour 3 3 — Lard 15 15 — Margarine 5 5 — Milk 105 100 5 Mustard 18 18 — Pearl Barley 4 4 — Pepper 31 30 1 Rice 18 18 — Sago 2 2 — Salmon and Shrimp Paste 1 1 — Sausage, Breakfast 16 16 — Sausage 1 1 — Self-raising Flour 9 9 — Tapioca 6 6 — Veal and Ham 1 1 — Vinegar 77 73 4 441 429 12 51 SECTION 6. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Notifications under the Provisions of the Public Health (London) Act, 1891.—During the year 3,555 cases have been notified under the above Act. The following table shows the comparison since 1920. No. Year. 2,116 1920 3,227 1921 3,720 1922 2,087 1923 3,516 1924 3,555 1925 Small-Pox.—No case of this disease occurred during the year. Contacts.—Eleven 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 58. Diphtheria.—Four hundred and thirty-four cases of Diphtheria were notified during the year, as compared with 595, 707, 275 and 319 respectively in the years 1921 1922, 1923 and 1924. The distribution of these cases was as follows :—173 in East Greenwich, 127 in West Greenwich, 16 in St. Nicholas, 113 in Charlton, and 5 in Kidbrooke. Of this total number, 429 were removed to the Hospital for treatment amongst which number the Hospital Authorities reported that in 7 cases they considered the diagnosis incorrect. Five 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 3.2 per cent. Two thousand four hundred and forty-four specimens were forwarded by medical practitioners for bacteriological investigation from cases suspected to be diphtheria. Of this number, 2,219 were reported to give negative or doubtful result, and 225 were positive in character, being dealt with accordingly. 52 The quarterly incidence of the disease for 1925 has been as follows :— lst Quarter—East Greenwich, 46 cases; West Greenwich, 35; St. Nicholas, 2; Charlton, 20; a total of 103 cases. 2nd Quarter—East Greenwich, 28 cases; West Greenwich, 22; St. Nicholas, 11; Charlton, 13; a total of 74 cases. 3rd Quarter—East Greenwich, 48 cases; West Greenwich, 33; St. Nicholas, 2; Charlton, 20; Kidbrooke, 2; a total of 105 cases. 4rd Quarter—East Greenwich, 51 cases; West Greenwich, 37; St. Nicholas, 1; Charlton, 60; Kidbrooke, 3; a total of 152 cases. Membranous Croup.—There were no cases of Membranous Croup notified during the year. Erysipelas.—Fifty one cases were notified during the year, 17 being in East Greenwich, 16 in West Greenwich, 7 in St. Nicholas, 9 in Charlton, and 2 in Kidbrooke. Seven of these patients were removed to a Public Institution in the district. Scarlet Fever.—Three hundred and four cases were notified during the year, as compared with 599, 219, and 292 cases respectively in the years 1922, 1923 and 1924, 189 cases were in East Greenwich, 61 in West Greenwich, 19 in St. Nicholas, 33 in Charlton and 2 in Kidbrooke; 292 of these cases were removed to the Hospital for treatment, 4 of which were returned as not suffering from this disease. There were 3 deaths from this disease during the year, compared with two the previous year. Of the 292 cases treated in Hospital, the following were certified to be suffering on discharge from Hospital with chronic disease :—Rhinitis, 4; and Otorrhæa, 2. There were no cases which could be described as "Return Cases." Typhoid Fever.—There were 8 cases of Typhoid or Enteric Fever notified during the year, 6 being in East Greenwich, 1 in West Greenwich, and 1 in Charlton. The ages of the patients were: 2 between five and fifteen years, 1 between fifteen and twenty-five years, 4 between twenty-five and forty-five years and 1 between forty-five and sixty-five years. Five cases were removed to Hospital for treatment. In the years 1921, 1922, 1923 and 1924 there were 11, 3, 16 and 10 cases respectively. The average number for the previous ten years is 13. 53 No case was traceable to the consumption of shell fish; there was only 1 fatality from this disease. Twelve specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be Typhoid Fever in character, 5 giving positive results. Puerperal Fever.—Nine cases of this disease were notified during the year, 5 in East Greenwich, 2 in West Greenwich, and 2 in Charlton. There were 6 cases in 1924, 9 cases in 1923, 6 cases in 1922, and 11 cases in 1921. There was 1 death from this disease during the year. Measles.—This disease was made permanently notifiable by an Order of this Council, approved by the Ministry on the 1st July. 1920. One thousand six hundred and ten cases were notified during the year, as compared with 1874 during the previous year, and 706 for the year 1923. One hundred and eight such cases were removed to Hospital for treatment. The ages and incidence of fatality of the disease were as follows : There were 53 cases under 1 year of age, with 5 deaths at this age period, giving a case mortality of 9 4 per cent. Between the ages of one to five years there were 656 cases with 14 deaths at this age period, giving a case mortality of 2.1 per cent, and 901 cases between five years and sixty-five with 2 deaths, giving a case mortality of .02 per cent. The case mortality for the whole district works out at 1.3 per cent. as compared with 1.4 per cent. for the previous year, and .28 for the year 1923. Table showing number of Measles Cases reported during the year 1925. Quarter ended 4th April, 1925. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total. East Greenwich 2 10 25 1 1 39 West Greenwich 1 2 4 14 3 24 St. Nicholas, Deptford — — — — — Charlton — 12 54 4 3 73 Kidbrooke — — 1 11 1 13 Total 3 24 84 30 8 149 54 Quarter ended 4th July, 1925. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total East Greenwich 3 30 87 23 5 148 West Greenwich 5 21 3 1 30 St. Nicholas, Deptford — 8 8 — — 16 Charlton 1 7 62 16 4 90 Kidbrooke — 3 4 12 4 23 Total 4 53 182 54 14 307 Quarter ended 3rd October, 1925. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 & over Total East Greenwich 23 39 2 1 65 West Greenwich 3 7 14 1 — 25 St. Nicholas, Deptford — 7 4 — — 11 Charlton — 9 15 1 — 25 Kidbrooke — — — — — — Total 3 46 72 4 1 126 Quarter ended 2nd January, 1926. Under 1. 1 to 5. 5 to 15. 25 & over Total. East Greenwich 16 236 209 4 465 West Greenwich 16 170 128 3 317 St. Nicholas, Deptford 9 91 59 2 161 Charlton 2 35 43 2 82 Kidbrooke — 1 2 — 3 Total 43 533 441 11 1028 Total cases in year = 1,610. Zymotic Enteritis or Epidemic Diarrhœa.—Eighty-nine cases of diarrhoea were notified throughout the whole of the Borough, 43 being under one year of age and 46 between one and five. Sixtyone of such notifications related to patients in East Greenwich, 18 in West Greenwich, 3 in St. Nicholas and 7 in Charlton. There were 18 deaths ascribed to Diarrhœa and Enteritis, but only 6 were certified as Zymotic or Epidemic. Whooping Cough.—This disease was made permanently notifiable as from 1st November, 1921. 55 Six hundred and fifty-five cases were notified (compared with 898 in 1924), 94 being under one year of age, 350 from one to five, and 206 from five to fifteen, the districts concerned being East Greenwich, 300 ; West Greenwich, 195 ; St. Nicholas, 36; Charlton, 117; and Kidbrooke, 7. Each of these cases was visited and leaflets and instructions left, together with verbal advice respecting the isolation and care of the patient. Epidemic Cerebro-Spinal Meningitis, Cerebro-Spinal Fever, or Post-Basal Meningitis.—There were 3 cases of this disease notified during the year, 2 of which occurred in East Greenwich, and 1 in West Greenwich. One specimen was forwarded by a local medical practitioner for bacteriological examination in respect of a case suspected to be cerebro Spinal Fever, which was subsequently found to be negative in character. Acute Polio-Myelitis or Acute Polio-Encephalitis.— There was 1 case notified during the year, as compared with 4 cases in 1923, and 1 in 1924. Ophthalmia Neonatorum.—During the year 15 cases of this disease have been notified, 6 being in East Greenwich, 2 in West Greenwich, 2 in St. Nicholas, Deptford, 4 in Charlton, and 1 in Kidbrooke. Further particulars of this disease will be found on page 86. Malaria.—There were 2 cases of Malaria notified during the year, 1 occurring in West Greenwich, and 1 in St. Nicholas, compared with 8 last year. Encephalitis Lethargica.—There were 11 notifications of cases of this disease. Four of these cases occurred in the eastern part of the Borough, 1 in the western. 3 in St. Nicholas, Deptford, and 3 in Charlton. 56 All the cases were removed to hospitals as shown below :— Date Notified. Sex. Age in years. Treatment— Home or Hospital. Results. 1925 Feb. 7 F 19 S.E. Hospital Returned—Not Encephalitis. Mar. 21 F 16 Seamen's Hospital Recovery complete. Mar. 31 F 14 mths. S.E. Hospital Died.. Apr. 28 M 66 G. and D. Hospital Died.. May 28 F 6 Park Hospital Recovered partially. Under supervisory treatment. June 28 F 50 Miller Hospital Died.. July 25 M 38 Park Hospital Complete recovery. July 21 F 13 Lewisham Hospital Died.. July 31 M 9 G. and D. and S.E. Hospital. Still under supervisory treatment. Aug. 27 F 21 Home. O.P., Miller Hospital. Acute Rheumatism. Still under treatment. Sept. 16 M 49 Guys Hospital and Plumstead Hospital. Still inmate of Hospital. 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 265 cases of Tuberculosis notified in the Borough, 197 being pulmonary cases, ordinarily known as Consumption, and 68 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 72 pulmonary and 28 non-pulmonary, occurred in East Greenwich, 54 pulmonary and 14 non-pulmonary in West Greenwich, 28 pulmonary and 8 non-pulmonary in St. 57 Nicholas, 40 pulmonary and 15 non-pulmonary in Charlton, and 3 pulmonary and 3 non-pulmonary in Kidbrooke. The various ages of the patients were as follows Pulmonary cases from one to five 3 cases; five to fifteen, 24 cases; fifteen to twenty-five, 43 cases; twenty-five to forty-five, 85 cases; forty-five to sixty-five, 38 cases; and 4 cases over sixty-five; whilst the Non-pulmonary were: Under one year of age, 1 case; one to five, 16 cases; five to fifteen, 28 cases; fifteen to twenty-five, 15 cases; twenty-five to forty-five, 7 cases, and forty-five to sixty-five, 1 case. Three hundred and fifty-three specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive; 287 were reported to be negative and 66 positive. Disinfection has been offered and carried out in 142 cases, in eluding 217 rooms and 504 articles of bedding, etc.; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. 58 Supplemental Vaccination Return for 1924. Return made on or before the 9th of February, 1926, by Mr. E. S. Elliott, Vaccination Officer of tho several Districts of the Greenwich Union, respecting the vaccination of children whose births were registered in his District from 1st January to 31st December, 1924, inclusive:— Registration SubDistricts comprised in the Vaccination Officer's District. No. of Births fron 1st Jan. to 31st Dec., 1924. Number of these Births duly entered by 31st Jan., 1926 No. of Births which on 31st Jan., 1926, remained unentered in the Vaccination Register on account of— No. of these births remaining or. 31st Jan., 1926, not accounted for. Total No. of Certificates of successful Primary Vaccination at all ages received during Calendar Year 1925. No. of Declarations of Conscientious Objection actually received by Vaccination Officer during the Calendar Year 1925. Successfully Vaeeinated. 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 un known and cases not found. South Deptford 574 309 — — 184 22 6 10 5 38 .. .. North Deptford 882 407 6 — 287 35 15 4 11 117 .. .. East Deptford 930 396 6 — 190 50 40 11 17 220 .. .. East Greenwich 896 511 2 — 190 48 16 23 22 84 .. .. West Greenwich 433 256 - — 95 14 12 7 8 41 .. .. Total 3,715 1,879 14 — 946 169 89 55 63 500 1,864 1,081 Dated February 9th, 1926. No. of Births entered in "Birth List Sheets" as registered from 1st January to 31st December, 1924 661 Successfully Vaccinated 442 Insusceptiblo of Vaccination — Had Small-Pox — CHARLTON AND KIDBROOKE. Statutory Declarations of Conscientious Objection 135 Dead Unvaccinated 24 Postponed by Medical Certificate 11 Removed to Districts the Vaccination Officer of which has been duly apprised 34 E. S. Elliott, Vaccination Officer. Removed to places unknown, or wliich cannot bo found; and cases not traced 14 Not accounted for 1 G. E. Oughton. 59 DISINFECTION. The work of the Disinfecting Staff has been greatly facilitated by the erection of the new premises at Tunnel Avenue, Blackwall Lane, E. Greenwich, which were opened in June, 1924. The following returns show in detail the amount of work performed during the year. Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 52 weeks ended 2nd January, 1926. 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 .. .. .. 1 1 .. .. 1 .. 4 Encephalitis Lethargica 10 9 2 .. .. 2 3 3 2 .. 1 .. 13 Scarlet Fever 364 292 201 .. 103 140 496 438 38 40 148 417 2,221 Diphtheria 421 346 196 .. 73 144 412 401 30 20 102 56 1,434 Enteric Fever 14 13 3 .. 4 4 15 19 2 4 3 5 59 Puerperal Fever 5 5 3 1 3 3 9 7 4 .. 4 .. 34 Tuberculosis 217 142 65 .. 30 40 161 58 23 22 13 92 504 Other Diseases* 88 58 33 2 126 38 248 183 21 53 20 52 776 Measles 15 7 .. .. 4 1 9 6 .. .. .. 20 40 From Verminous Premises 8 5 8 2 14 6 22 45 1 .. 2 16 116 Scabies .. .. .. .. .. .. .. .. .. .. .. .. .. Influenza and Pneumonia 3 3 .. .. 2 2 3 .. .. .. .. .. 7 Cerebro-Spinal Meningitis 3 2 .. .. 1 1 2 3 2 .. 2 .. 11 Total 1,149 883 512 5 360 381 1,381 1,164 123 139 296 858 5,219 *Includes :—Cancer; 20 Rooms ; 65 Articles. 60 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 52 weeks endec 2nd January, 1926. Infectious Diseases. Beds. Palliasses. Mattresses. Bolsters. Pillows. Blankets. Sheets. Cushions. I Quilts. Odd Pieces. | Total No. Articles Destroyed. ScarletFever .. .. .. .. 3 1 .. .. .. .. 4 Diphtheria 2 .. 4 .. .. .. .. .. .. .. 6 Tuberculosis 4 .. 2 .. 2 4 .. 2 .. .. 14 Other Diseases 2 1 3 .. 2 .. .. .. .. 540 548 For Verminous Premises 2 1 1 1 3 1 .. .. .. 50 59 Total 10 2 10 1 10 6 .. 2 .. 590 631 61 HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made by Infectious Disease Inspector 815 Number of Re-visits 2,325 The Health Visitors also visited 2441 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease Borough Council Libraries, 108; School Libraries, 18; Total, 126. CLEANSING STATION, BLACKWALL LANE. The new Cleansing Station which forms part of the Disinfecting premises was opened in June, 1924. 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 160 2nd 200 3rd 149 4th 218 Total 727 That more care and attention is paid by parents and others is indicated in the gradual falling off in the number of attendances made. This is clearly shown when comparing last year's total of 727 with 1,088, the average number for the previous 5 years. Eight adults suffering from verminous conditons were also given cleansing baths. In every case the infested clothing was disinfected. 62 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR 1925. Disease. Total Cases Notified.* Cases admitted to Hospital. Total Deaths. * Small Pox - Diphtheria 434 429 14 Scarlet Fever 304 292 3 Enteric (including paratyphoid) 8 5 1 Puerperal Fever 9 9 1 Pneumonia 97 21 — Erysipelas 51 7 — Acute Polio Myelitis 1 1 Cerebro Spinal Fever 3 1 1 Continued Fever — — — Malaria 2 2 Ophthalmia Neonatorum 15 7 Encephalitis Lethargica 11 9 3 Dysentery 1 1 - Notifiable Locally. Measles 1610 108 21 Whooping Cough 655 23 15 Diarrhoea 89 12 17 3290 927 76 * For particulars as to Age Groups see Tables at end of Report. REPORT OF THE TUBERCULOSIS OFFICER. To the Medical Officer of Health. Sir, During 1925 there has been no material change in the Antituberculosis Campaign. The work has been carried out on established lines. The figures submitted are very satisfactory and are evidence that our scheme is founded on sound principles. Notifications and Deaths. Both the Incidence Rate and the Death Rate are the lowest ever recorded in the Borough, and it is particularly satisfactory that the decline in the Pulmonary rate which commenced some years ago has continued in 1925, and this despite causes acting in favour of the spread of this disease, such as the wide spread unemployment and lack of housing. In 1925 the Notifications and Deaths were as follows :— Notifications. Deaths. Non- Non- Pulinonary Pulmonary Total. Pulmonary Pulmonary Total 197 68 265 104 13 117 and the averages for the previous ten years (1915-1924) 266 112 133 28 63 These figures give an Incidence Rate for all forms of 2.59 per 1,000 of the population (1.91 pulmonary and .68 non-pulmonary), and a Death Rate for all forms of 1.13 per 1,000 (1.00 pulmonary and .12 non-pulmonary). In several instances (10 pulmonary and 5 non-pulmonary) the diagnosis of Tuberculosis was not confirmed so that the above rates should be read at a slightly lower figure. Further improvement in the figures may be looked for if and when the unemployment and housing problems are more satisfactory. Late Notification and Non-Notification.—In the Public Health (Tuberculosis) Regulations, 1924, which came into force in January, 1925, it is stated that "in some instances formal notification of Tuberculosis has not been made until after the death of the patient has occurred. It is pointed out that in notifying a case of Tuberculosis the medical attendant is required to certify that the 'person is suffering from Tuberculosis. The Minister of Health is advised that notification which is made after the notifying practitioner is aware of the death of the patient is not a notification duly made under the regulations or one which entitles the practitioner to the payment of the prescribed fee." Steps were taken to inform the medical men practising in the district of this new measure, and although this provision may encourage earlier notification, it is gratifying to find that each year shows an advance in this direction. Thus while in 1921 we note that 26 per cent, of the pulmonary cases were not notified, this year out of 197 notifications of Pulmonary Tuberculosis, only 9 or 4.6 per cent. were un-notified. As some explanation of this low figure it may be recalled that for the past three years the medical men in the Borough have been asked to notify every case of Tuberculosis they may be called upon to treat for the first time, unless they have definite evidence that notification has been already carried out. Further, for the same period it has been the practice at the dispensary in connection with cases sent by medical men for diagnosis, for the Tuberculosis Officer when a diagnosis of Tuberculosis has been arrived at, to request the medical attendant to notify the case. Should he fail to do so within a week, the Tuberculosis Officer himself notifies. Unsatisfactory Notification means of course that many infectious cases remain uncontrolled by any Public Health measures, and so attempts to combat the disease remain incomplete. The following table shows the Death Notification interval of 104 patients in 1925, and whose deaths were ascribed to Pulmonary Tuberculosis. 64 Of the 9 cases where the information was derived from the Death Returns, 4 had been treated in hospitals, 4 by general practitioners, and in the remaining case the information came from the coroner. Information from Death Returns 9 Died within One Month of Notification 11 Died within Three Months of Notification 10 Died within Six Months of Notification 11 Died with Over Six Months of Notification 63 104 Requests are constantly received from Hospitals desiring Sanatorium Treatment for patients evidently suffering from Tuberculosis, but who have not been notified, and what is more difficult to understand is that the County Council have accepted such patients directly before notification has been carried out. This matter has been the subject of much correspondence between the various parties concerned. Our policy now is to take no steps to deal with such applications until the regulations have been complied with. Obesrvation cases, i.e. cases where the diagnosis is doubtful, are on a different footing and are promptly dealt with. Revised Diagnosis.—The 15 cases in which the diagnosis of Tuberculosis was not confirmed comprised: 2 pneumonia, 4 chronic bronchitis, 1 cancer, 2 debility, 1 goitre. These 10 patients were notified as suffering from Pulmonary Tuberculosis. The 5 cases notified as non-pulmonary proved: 1 malignant disease of hip, 2 simple glandular swellings, 1 enteritis, 1 congenital defect. In this connection it is very gratifying to note that the number of cases sent by general practitioners to the Dispensary (before notification) for an opinion as to diagnosis is increasing year by year. Deaths.—During the year 117 persons died from Tuberculosis (all forms) giving a death rate of 1.13 per 1000 population, 104 were due to the Pulmonary Form equal to a rate of 1.00 per 1,000 of the population, which is the lowest ever recorded in the Borough. Several of these pulmonary deaths were notified from Mental Hospitals and concerned patients who had not resided in the Borough for many years. Notifications and deaths from Pulmonary Tuberculosis, with the Incidence and Death Rates for the previous five years, are recorded below :— 65 Year. Notifications Incidence per 1,000 Deaths Death Rate 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 2.1 120 1.18 1923 213 2.08 115 1.12 1924 214 2.04 104 1.00 Deaths from Non-pulmonary Tuberculosis, of which there were 13 (equal to a rate of .12 per 1,000) included 8 Meningitis, 3 of Abdominal Tuberculosis, and 2 other parts. The 47 (corrected) Notifications of non-pulmonary Tuberculosis included 3 cases of General or Miliary Tuberculosis. 26 ,, Tuberculosis of the Glands (Neck). 4 „ „ „ Spine. 7 „ ,, ,, Joints. 2 ,, ,, ,, Abdomen. 4 ,, ,, ,, Brain (Meningitis). 1 „ „ „ Skin. In connection with this form of Tuberculosis, affecting chiefly children, it is interesting to note that 36 of the 47 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. In mentioning this subject of milk and Infection it may be interesting to state here that perhaps the most important advance in Public Health Tuberculosis legislation in recent years is contained in Section 4 of the Public Health (Tuberculosis) Regulations, 1925, which reads as follows :— " No person who is aware that he is suffering from tuberculosis of the respiratory tract shall enter upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk." This is a reform long called for and it is to be hoped that before long the Section may be extended so as to prevent any one suffering from Pulmonary Tuberculosis from taking any part in the handling not only of milk but of all food. The regulation of course removes the protection hitherto afforded to sufferers from Tuberculosis by which their notification of disease was not allowed in any way to affect their employment, but it must be realised that the protection of the public must always 66 be a matter of greater importance than the inconvenience or even the hardship of any individual. In previous reports I have given examples of persons suffering from Tuberculosis engaged in the production and distribution of such foods as milk, fish, bread and greengroceries, and against whom no action could be taken. This danger is now averted. Besides Section 6 provides that "Any person deeming himself aggrieved by a requirement of a local authority under these regulations, he may, within fourteen days after the service of notice of the requirement, appeal to a court of summary jurisdiction and shall in that event give written notice to the Clerk to the local authority of his intention to appeal and the ground thereof." Further, Section 7 reads :— " The provisions of Section 308 of the Public Health Act, 1875 (which relates to compensation for damages sustained by reason of the exercise of the powers of the Act) shall apply to any person who sustains any damage by reason of the exercise of any of the powers of these regulations in relation to any matter as to which he is not himself in default." Artificial Sunlight Treatment.—In connection with NonPulmonary Tuberculosis mention was made last year of the recent advances in treatment by means of Artificial Sunlight and there is no question now but what sunlight treatment is well established as a therapeutic measure in dealing with certain non-pulmonary forms of Tuberculosis. In this country where the number of days on which Sunlight is available is small, it is necessary to supplement the sun's rays by artificial sunlight, and the methods commonly adopted are powerful Carbon Arcs and Mercury Vapour Lamps. In July the Borough Council fitted out a room at Conduit House Welfare Centre with an installation consisting of 2 Carbon Arc Lamps of 30 amperes each. Current is alternating: voltage 100. The advantage of carbon arc lamps is that a number of patients can be treated at the same time. Each lamp is surrounded by a wire cage at a distance of 2 ft., so as to prevent children touching or tampering with them. By the courtesy and kind permission of the Maternity and Child Welfare Committee I have been allowed to treat suitable cases examined at the Dispensary, and for the period ending December 31st, 1925, 132 Dispensary patients have been so treated. The majority of the cases consisted of children in the so-called Pretubercular Stage, with also cases of definite tuberculosis of the 67 glands, abdomen and skin. An attempt to treat a few cases of Pulmonary Tuberculosis in Adults had to be abandoned for lack of accommodation. Preference has been always given to the children. The technique employed is simple. The patients are treated either in a sitting or standing position, naked except for drawers. They are arranged round each lamp. Front and back are exposed alternately, care being taken when the anterior surface is exposed that the eyes are adequately protected by suitable shades or glasses. From 6 to 8 patients per lamp can be treated at a time. The length of exposure begins at 5 minutes, gradually increased according to reaction to 1½-2 hours. Temperature and pulse are taken before and after exposure. Owing to lack of accommodation treatment can only be given twice weekly. At the end of the year 26 patients had completed treatment and 4 had been discharged for irregular attendance. After such a short time and with such a small number of patients one has no desire to exaggerate the benefits derived, but one thing, however, can be said, and that is that no bad results have to be recorded. On the contrary the general condition of the children has improved to a remarkable extent and it is earnestly hoped that the installation may be extended in the near future. Occupation.—As indicated last year, there are no industries in the Borough which have any special bearing upon the Incidence of Tuberculosis, and the occupations of notified cases in 1925 shows no marked difference to those quoted last year. Housing.—The Housing condition presents little improvement and much overcrowding exists, many examples continue to be brought to the notice of the Public Health Committee by the Care Committee. It follows that the sleeping arrangements continue a very serious difficulty in the problems of infection. Of 266 patients suffering from Pulmonary Tuberculosis, 160 were sharing a bed. 58 had a separate bed but not a separate room. 48 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, 18 patients w ho were sharing a bed have now separate beds, and 4 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. 68 Apart from overcrowding, many sanitary defects have been reported to and dealt with by the Public Health Department. The Council has now increased the number of shelters to 6, and these are in constant use. Another 2 have been ordered. Bedsteads and bedding have been lent or supplied by the Council and other agencies. (See Report of Care Committee.) By careful and frequent revision the Registers have been considerably curtailed by the removal of names of persons who were found to be showing no evidence of active disease over a period of 5 years or more. By this means a large amount of home visitation where such is not required has been obviated, and it will now be possible to concentrate the energies of the Dispensary staff upon the closer supervision of persons who are suffering from active disease. At the close of 1925 the estimated number of persons suffering from Tuberculosis and residing in the Borough was as follows :— Men. Women. Children. Total. Pulmonary Tuberculosis 221 223 134 578 Non Pulmonary 29 30 167 226 giving a total of 804 as against 764 in the previous year. Dealing with the Dispensary itself, 881 new patients were examined during the year. The sources from which these patients came are as follows :— Doctors 247 Hospitals 17 School Medical Service 39 Ministry of Pensions 3 Own Application 77 Nurses (Contacts) 498 Contacts.—Much of the nurses' time is spent endeavouring to secure the examination of every contact. This year, out of a total of 690 Contacts, 530 or 76 per cent. were examined, of whom 44 were found to be Tuberculous. In addition, 91 Contacts were examined more than once before arriving at a definite diagnosis. The work of the Dispensary is shown in the statistical table on page 73 and explains itself. Sanatorium Treatment.—During the year 162 patients were sent to sanatoria, 111 under the County Scheme, 37 through the Guardians, and 14 through other sources. The average duration of residence remains the same, and the same difficulties remain in finding suitable employment for those discharged fit for work. 69 The finding of suitable employment is probably the greatest problem which Care Committees have to face. It would be a great boon if sick payment could be graded according to the patients' capacity to undertake light work or part time employment. As far as Tuberculosis is concerned, sickness benefit simply means that the patient degenerates into a state of chronic invalidism. Grateful acknowledgment must be made of the Council's action in providing part time work for 8 male patients during the summer months at Charlton House. In addition 45 children are attending the Open Air Schools at Shooters Hill and Forest Hill, and are all doing remarkably well. The Open Air School brings practically all the advantages of the Sanatorium to the immediate homes of the children without in any way breaking with the home life or interrupting their education. They are or should be the schools of the future. The children are all periodically examined at the Dispensary, in addition to the supervision of the School Medical Officer. X-Ray Examinations.—During the year 55 patients were so examined, of whom 5 were children. The arrangements for these examinations at the Seamen's Hospital are not very satisfactory, as there is a considerable delay in receiving films and reports. Proposals have been made to the Board of Guardians to allow the Tuberculosis Officer the use of their very fine X-Ray Installation, and are at present under consideration. It need hardly be stated that these examinations are of great assistance in supplementing the usual Clinical Examination. Sputum Examinations —Of 176 sputum specimens bacteriologically examined at the Seamen's Hospital, 37 proved positive and 139 negative. At the same time, 196 specimens were chemically examined at the Dispensary for Albumen, with very similar results to those mentioned last year. In closing this Section of the Report it might be mentioned that the relations with the other authorities concerned in the work (the Board of Guardians, the Ministry of Pensions, the British Red Cross Society, the School Authorities, and the Various Hospitals) have been cordial and the co-operation well maintained. The same can be said about the relations with the medical men practising in the district, and as previously remarked, it is very satisfactory to find that many cases are sent to the Dispensary (before notification) for an opinion as to diagnosis. The Tuberculosis Officer is always glad to assist in any way in the investigation and diagnosis of any cases referred to him by the family medical attendant, and every effort is made to arrive at an early decision, either by means 70 of X-ray examination, Tuberculin Test, etc., in addition to the ordinary Clinical Examination. The "following up" of "doubtful" cases, and indeed of all patients is diligently pursued by the Nursing Staff, a diary being kept to ensure regular attendance. Diagnosis.—In connection with the diagnosis of these doubtful cases the standard adopted in 1921 have been followed and the confirmatory tests used, viz. :— 1. Tuberculin Cutaneous Test (Ellis). 2. X-Ray. 3. Chemical Examination of Sputum. 4. Blood pressure. This procedure has fully proved its usefulness and is being continued. Treatment.—Sodium Morrhuate and Raw's Vaccine were each tried in several cases during the past two years, but abandoned, the patients making no material progress. At the earnest request of one patient, a course of "John Bull or the Newell" treatment was administered for a period extending over 3 months with no advantage to the patient who himself provided the material. Another patient under Domicilary treatment had a similar experience, the drugs being administered by his own medical attendant. Tuberculin is now the only specific treatment employed at the Dispensary and continues to give very satisfactory results especially in children, where possibly its immunising effects are more valuable than the therapeutic results. Extra nourishment to the extent of £26 was given to 18 persons, but to prevent overlapping, many more patients were referred to the Guardians who never failed to promptly afford relief. The various District Nursing Associations have again rendered willing and valuable aid in the nursing of advanced cases in their own homes. In this connection the Council has lent beds, mattresses, air cushions, sputum flasks, mugs, etc., and carried out disinfection as often as required. Non pulmonary cases requiring residential treatment are recommended for this to the County Council and also to the Guardians. Should surgical apparatus as boots, splints, etc., be required, application is made to various charitable organisations such as the Invalid Children's Aid Association, the Charity Organisation Society, etc., generally through the medium of the Care Committee acting on the information of the Tuberculosis Officer. 71 Tuberculosis Care Committee.—The permanent committee formed last year has met regularly, and below is a very brief statement supplied by Miss Johnston, the Hon. Secretary, as to its activities during 1925. Such a statement gives no real indication as to the volume of work performed, and as a mere matter of fact, the real care and after-care of the patients is practically carried out by the Hon. Secretary and the Dispensary Staff. The chief function of the Committee as a Committee has been to assess the various cases recommended to the County Council for sanatorium treatment . By real after-care I mean the visitation of the patients at their homes, the provision of extra nourishment, the provision of financial and other assistance, e.g. clothing, bedding, etc., the finding of suitable employment, and the hundred and one other things which help and encourage the patient to bear up against his disease so that it will be realised that the annexed report is far from complete, and is merely a short record of some of the assistance rendered by various organisations. Indeed much of the after care work could not be put into words, but the poor of Greenwich and especially the tuberculous poor, are under a deep debt of gratitude to Miss Johnston, the Hon. Secretary who has laboured so incessantly on their behalf. Miss Johnston reports as follows :— "During the year assistance was obtained for patients and their families from various Societies to whom they were referred. The Charity Organisation Society helped to the extent of £91 1s. 2d. for six patients, more than half of that amount being spent upon one patient in the form of an allowance made to supplement the family income while he was waiting for treatment and then to help to provide for his wife and four children until he was able to support them again. Of the other five cases the parents of four patients contributed £11 13s. 4d. by instalments towards the total amount spent. The United Services Fund, through their local Representatives assisted with £18 4s. 6d. besides taking children into their Homes while mothers were at sanatorium, and admitting 3 men to their Home of Rest, Bournemouth. Help was also granted from the same Fund through their Charlton Branch. The Royal Naval Benevolent Trust helped through the Sailors, Soldiers and Airmen's Families Association with grants of clothing for two patients to the value of £5 and Regimental Funds also assisted through the Soldiers and Sailors Help Society and the Families Association. The Society for the Relief of Distress helped in one case and private donors gave clothing and in one instance blankets. 72 The Vicar of Greenwich gave Convalescent Letters for an observation case where the patient was found to be non-tubercular. The British Red Cross Society and the Greenwich Board of Guardians supplied clothing, etc., to various patients. During the year and on behalf of the London County Council the sum of £265 12s. 3d. was collected from patients and their relatives towards the cost of treatment, but £58 of this was afterwards refunded to the patients." The Report on Dental Treatment will be found in the succeeding pages, and I have now only to acknowledge once more my indebtedness to every member of the Public Health and Dispensary Staff for their assistance and co-operation in carrying out the work. I am, Sir, Your obedient Servant, M. MACDONALD, M.D., Ch.B., D.P.H., 73 Return of work carried out in connection with the Maze Hill Tuberculosis Dispensary for the Year 1925. 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. NonPulmonary. (a) All persons (including " Contacts ") Adults M. 1 189 190 68 7 111 4 — F. 5 287 292 56 6 224 5 1 Children under 15 M. 8 218 226 8 15 196 7 — F. 6 187 193 7 11 175 — — Total 20 881 901 139 39 706 16 1 (b)"Contacts" (included in (a) ). Adults M. — 77 77 15 3 59 — F. 2 167 169 13 3 151 1 1 Children under 15 M. — 153 153 2 3 145 3 — F. 2 133 135 1 4 130 — — (c) Insured per-{ sons included{ in (a) ). { M. 1 163 164 58 5 97 4 — F. 2 81 83 26 4 50 2 1 74 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December 502 2. Total number of attendances of patients at the Dispensary during the year—Insured 2,881 Uninsured 3,925 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 278 4. Number of eases in which the period of observation at the pensary exceeded two months 17 5. Number of insured patients under domiciliary treatment on December 31st 27 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 40 7. Number of persons referred to affiliated hospital for consultation — 8. Number of consultations with Medical practitioners at the homes of patients—Insured 13 Uninsured 8 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 153 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 4,473 11. Number of specimens of sputum examined in connection with the work of the Dispensary 178 TUBERCULOSIS. Age-Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F 0 - — — 2 — — 1 2 1 3 — 10 8 — — 6 1 5 8 9 7 7 1 1 — — 10 6 2 7 7 — 2 — 15 10 14 4 4 7 9 — 1 20 10 12 4 2 9 9 — — 25 21 23 4 I 11 9 — — 35 21 17 - 2 10 10 — — 45 17 8 — 1 9 5 1 1 55 10 3 - - 6 1 — — 65 and upwards 2 3 —. — 3 2 — — Totals 108 91 36 34 56 48 8 5 Particulars relating to the above Table are dealt with in the Report of the Tuberculosis Officer on pages 62 to 72. 75 TUBERCULOSIS. Dental Treatment for the Year 1925. During the past year the number of patients referred for dental treatment by the Tuberculosis Officer has increased. In comparing the mouths of the tuberculous patients with the maternity patients it is found that the former are in a better condition on the whole. An effort has been made to save as many teeth as possible, but the prejudice towards conservative treatment still remains. However, more fillings have been completed than in former years, but if the good results following this conservative treatment are to continue, and if this method is to be more widely adopted, the Council would be well advised to consider the possibility of another Session. The necessity for this can be realised if it is remembered that a simple tilling may take fifteen minutes and that a complex filling may sometimes take double the time. Details of treatment are as follows :— Number of patients 64 ,, ,, attendances 180 Dentures supplied 13 Fillings and scalings 44 Advice 37 Extractions (N20) 9 patients (24 teeth). Extractions (local anaesthetic) 50 patients (111 teeth). Extractions (ordinary) 7 patients (8 teeth). Gas administered on 12 occasions. Regulating plate supplied 1 Patients referred to Dentist 80 SECTION 7. MATERNITY AND CHILD WELFARE. In order that the Council, and particularly the newly elected members thereof, might be fully conversant with the various activities of the Council's Maternity and Child Welfare Scheme, I circulated in November, 1925, a report covering the whole of the facilities which were available, and as the scheme generally seems now to have assumed definite and permanent form, I thought it would be useful to include this report, which is as follows:— 76 The persons coming within the purview of the Maternity and Child Welfare Committee are Expectant and Nursing Mothers, and children under five years of age. Infant Welfare Consultations.—Consultations are held at two Centres on each afternoon from 2 to 5 p.m. as follows :— Borough Hall, Royal Hill Monday, Tuesday and Thursday Conduit House, 236, Trafalgar Road Monday, Wednesday and Friday 105, Shooters Hill Road Tuesday and Friday. Albany Institute, Creek Road Thursday. Charlton Vale Wesleyan School Room, Woolwich Road Wednesday. Each Centre is attended by a Medical Officer, a Health Visitor in charge, and a Health Visitor assisting, also a Lady Clerk working either voluntarily, or on the Council's salaried staff, a milk saleswoman, and at some of the Centres ladies kindly attend voluntarily to endeavour to educate the mothers in making infants' clothing, etc. All Centres are not yet provided with this latter facility. Further voluntary assistance on these lines will be appreciated. Any rate payer in the Borough is entitled to attend the Infant Consultation Centres, obtain the advice and assistance of the Health Visitor, and Medical Officer if required, also obtain Dried Milk or simple medicaments on payment for the same, and take advantage of the clothing facilities. Those mothers in regular attendance at the Clinic who desire Milk, etc., at reduced price, are required to fill inaform setting out in full their financial condition. These applications are then considered by a small Sub-Committee, together with this Council's Finance Officer and the Health Visitors concerned, fortnightly. Necessitous Expectant and Nursing Mothers are also supplied, in special cases, with free dinners three times weekly by arrangement with certain local dining room proprietors. All cases so dealt with are duly reported to the Assistance Sub-Committee of the Maternity and Child Welfare Committee. Artificial Sunlight Treatment Centre.—This Council has recently fitted up and opened a Light Treatment Centre at Conduit House, 236, Trafalgar Road, which is in use every day from 10 to 12.30, and 1.30 to 5 p.m. for cases referred to the Centre by the Medical Officers attending the Infant Welfare Consultations. The treatment is given by a fully trained and specially certificated nurse. 77 Ante-Natal Clinics.—These are held at 10 a.m. as follows :— Borough Hall, Royal Hill Tuesday. Conduit House, 236, Trafalgar Road Wednesday. 105, Shooters Hill Road Friday. Application has also been made to the Ministry of Health for permission to hold an additional Clinic at the Charlton Vale Wesleyan School-room, Woolwich Road. Each of these Centres is attended by a Medical Officer together with a Health Visitor in charge, and a Clerk, either a lady working voluntarily, or a member of the staff. All ratepayers in the Borough are entitled to attend these Clinics, and obtain the benefit of this Council's Maternity expert. In fact, it is hoped that much greater advantage will be taken of these facilities in the future as, in my opinion, this line of attack holds out the greatest hope in connection with the future work of the Public Health Department, seeing that by its means, prospective mothers may have many serious conditions prevented, whilst in connection with others which are not preventable but are thus foreseen, particular arrangements are able to be made for dealing with the same, and thus very often much pain, suffering and lifelong misery may be prevented. Maternity Home.—This Council's Maternity Home is situate at Kidbrooke House, 78, Shooters Hill Road. At present we are authorised for 12 beds. The Home up to the present has been much appreciated, so much so, that on occasions we have had 25 mothers with their babies in the Home at one time, and a scheme for extension of the Home up to 22 beds has been approved both by the Council and the Ministry of Health, and is in process of being carried out. The Maternity Home is open to all ratepayers in the Borough on payment. No cases are admitted free, the lowest charge being at the rate of one guinea per week, whilst those patients who can afford it, or desire special accommodation in the way of a private bed, can obtain the same on payment of five guineas per week or upwards, in accordance with their requirements. All persons desiring accommodation, except those who propose to come in as private patients paying the full fee, have to make application on a special form. All these applications are considered week by week at the Sub-Committee before mentioned, and the charges to be 78 made are assessed in accordance with the Council's scheme at charges already agreed upon. All cases dealt with during the period are duly reported to the Assistance Sub-Committee of the Maternity and Child Welfare Committee. Convalescent Treatment.—Cases of mothers and children who, in the opinion of the Medical Officer would be materially benefited by a course of convalescent treatment, are dealt with from time to time by the Committee as required. The Committee set aside the sum of £100 per annum for such cases. Minor Ailments.—Quite trifling minor ailments are dealt with by the Health Visitor. Other cases requiring hospital attention are dealt with by arrangement with St. John's Hospital, Lewisham, to which Hospital the Council makes a contribution of £50 per annum for this service. Home Nursing.—Children found by the Health Visitors to be in need of special nursing at their homes, are dealt with by the various Nursing Associations in the Borough to whom the Council make appropriate payment for such services. Dental Treatment.—A qualified Dentist attends at the Tuberculosis Dispensary, Maze Hill, once a fortnight to deal with cases under the purview of the Maternity and Child Welfare Committee, which are referred to the Dentist by the Medical Officers of the Clinics. Extractions, scalings and such minor conditions are dealt with free, but when the provision of teeth is necessary, the Dentist draws up an estimate, the patient is assessed a certain amount, and assistance from outside sources is obtained as far as possible. The matter is then brought to the notice of the Assistance Sub-Committee to decide how much the Council shall give towards making up this amount, and for this purpose the sum of £60 per annum is set aside in this Committee's estimate. The report is slightly abridged, it not being considered necessary to reproduce the several application forms, etc., in use. 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. 79 Health Visitors Visits, &c., 1925. Table A. Visits Re-Visits Total Infants under 1 year 2198 2645 4843 Children, 1-5 years 215 3518 3733 Measles 1621 217 1838 Whooping Cough 678 132 810 Pneumonia 25 27 52 Puerperal Fever 7 8 15 Ophthalmia Neonatorum 13 65 78 Diarrhœa 97 64 161 4854 6676 11530 Table B. Dental Treatment 53 2 55 Dinners 18 18 Milk Scheme 80 8 88 Pre-Maternity Cases 254 28 282 Infant Consultations attended — — 906 Pre-Maternity Clinics attended — — 186 Miscellaneous — — — In addition to the above, 1,318 persons were seen by the Health Visitors at the office, chiefly in connection with milk applications. The total number of visits paid by the Health Visitors under table "A" shows an increase of 1705 over the 1924 figures and this increase is seen particularly in the case of first visits to infants under one year. This means that with the additional Health Visitor who commenced her duties on 2nd March, 1925, it is now possible to make visits in connection with births with much less delay than was formerly the case. The following table shows at a glance the work undertaken at the various Infant Consultation Centres during the year :— Borough Hall. Conduit House. 105, Shooters Hill Rd. Albany Institute *Charlton Vale. Total. Attendances 9,319 9,077 4,909 2,612 2,667 28,584 New Cases 424 477 278 148 192 1,519 Medical Consultations 4,500 3,842 2,094 1,554 1,178 13,174 Nursing Mothers seen by Doctors 1,369 1,222 859 382 405 4,237 * Opened 14th January, 1925. 80 As in previous years the children are weighed and advice given to the Mothers at every attendance. It will be noted that the above table includes the 5th Welfare Centre which was opened as indicated in the early part of the year. This Centre, which started with a small number of mothers in attendance, gradually increased in popularity, the attendance now being scarcely less than the attendances at the older established Centres. Baby Week Celebrations.—The considerable local interest which was evinced in the Council's purchase of Charlton House and Park, encouraged the Special Committee, which was formed to arrange the Baby Week Celebrations, to entertain there the whole of the mothers attending the Welfare Centres to tea and entertainment on July 23rd. It is estimated that over a thousand mothers with some fifteen hundred children attended. Tea and entertainment in the way of dancing displays, conjuring, music, etc., was provided together with races and other competitions. One regrets to have to report that the somewhat inclement weather greatly handicapped the efforts of the members of the Special Committee as the tea, instead of being served on the spacious lawn in front of Charlton House, as was intended, had to be distributed inside the house, the accommodation proving somewhat inadequate for the large numbers which attended. ARTIFICIAL SUNLIGHT CENTRE. In my report for the year 1924, brief reference was made to the proposal to establish an Artificial Sunlight Treatment Centre, and the approval of the Ministry of Health to the proposition was received in March, 1925. It was considered that as an initial temporary measure, one of the first floor rooms at Conduit House would be suitable for the lamps. The Committee made a point of inspecting a number of Artificial Sunlight installations at several large Hospitals and other Centres, and as a result it was decided to install two Carbon Arc lamps. The Council were fortunate in securing the services of Professor Leonard Hill, F.R.S., the eminent authority on Artificial Sunlight Treatment as consultant, and he supervised the treatment during the first few weeks, whilst the nurse who was appointed had already had special experience in the duties. The lamps were first brought into use on July 14th, and from that time until the end of the year there were always about 200 patients regularly receiving treatment. 81 The principal conditions treated were Rickets, Under-weight, Wasting, etc., and Anaemia. There were also the following cases :— Convalescent from Infectious Diseases, Pre-tubercular, Premature babies, Rheumatism, Congenital Heart, Enlarged Glands, Chronic Bronchitis, Post Encephalitis, Pyelitis, Congenital Paralysis, Tonsils and Adenoids. The routine course of dosage for children commences from three minutes, increasing approximately by one minute per week according to the reaction. For adults, e.g. nursing and expectant mothers, an initial dosage of six minutes increasing by three minutes per week according to reaction. There is no question whatever that definite improvement was seen in the very large majority of cases, and this improvement was not only confined to the particular conditions which were the subject of treatment, but reports were received that young children who were patients were more contented, got over teething difficulties easier and slept better. The following table gives the figures relating to the Centre in detail. It will be noticed that in addition to the patients referred from the Maternity and Child Welfare Centres, there were a certain number of Tuberculous cases which received treatment at different times. Maternity Cases. Tuberculosis Cases. Total. Under 5 years. Over 5 years. Under 5 years. Over 5 years. No. of Patients under Treatment 454 24 23 307 808 No. of Treatments given 1,964 175 133 1,884 4,156 The Centre was formally opened by the Mayor, Councillor W. G. R. Ball, J.P., on September 24th, when many members of the Council, together with other interested friends, had the opportunity of seeing the lamps in operation and listening to an address by Professor Leonard Hill. It is interesting to notice that Metropolitan Boroughs as well a-i a number of provincial councils are now proceeding to establish an Artificial Sunlight Centre. / 82 MATERNITY HOME. As foreshadowed in my report for the year 1924, the number of admissions during the year under review showed a very marked increase. The actual figure was 295 and the following table shows the total admissions since the Home was opened at the end of February, 1922 :— 1922 (part of) 121 1923 228 1924 220 1925 295 Total cases admitted since opening of Home 864 The maximum number of patients which can be accommodated during a year may be regarded as 312, which figure is arrived at by taking the accommodation as 12 beds and allowing a fortnight's stay throughout the year for each patient. The figure of 295 for 1925 gives a percentage therefore of 94 5, but actually it was found that in no less than half the year there was an average of more than 12 patients in the Home, and during a short period the very high level of 20 was reached. Upon such occasions it was possible to accommodate patients only by utilising the receiving ward and the open air balcony which latter I may say has been of great service and much appreciated. Again it is my pleasure to report the absence of any maternal deaths during the year. Brief particulars of the year's record are as follows :— No. of cases delivered by midwives 264 ,, „ ,, doctors 31 ,, where medical assistance was sought by the midwife 3 (during labour 1, for the infant 2). No. of foetal deaths 9 (stillborn 2, within 10 days of birth, 7). In one case only was the infant not entirely breast fed and this was due to the patient's mental condition being below the average. For some considerable time it had been evident that if the Home was to be in every way efficient and of a sufficient size to accommodate all cases likely to require accommodation, a substantial increase in the number of beds available was necessary, and this matter received the special consideration of the Maternity and Child Welfare Committee in the early part of the year, with the result that in July, 1925, the Council agreed to extend the Home by the addition of 10 beds. This was to be accomplished by utilising the top floor 83 of the Home, which hitherto had been used by the nursing staff as sleeping quarters, as an extra ward and second labour room, and it was estimated that the cost of this work together with the provision of the necessary furniture, would total £1370, to which proposal the Ministry of Health have now given their final approval. The nurses' sleeping quarters would be transferred to the available accommodation at No. 105, Shooters Hill Road which is the Council's Welfare Centre opposite the Home. I shall hope, therefore, in my report for 1926 to be able to state that the capacity of the Home is 22 patients, and that this extra accommodation has been fully taken advantage of by the mothers of Greenwich. The total amount of fees received from patients during the year was £1,411 18s. 6d., whilst £43 2s. was received from pupil midwives. Pre-Maternity Clinics.—During the year there have been very welcome signs of increased demand for Ante-Natal facilities and the extra Ante-Natal Clinic at Conduit House was opened in April. It will be seen that the following attendances show a considerable advance on the 1924 total which was 1278 :— Borough Hall 987 Conduit House 365 Shooters Hill Road 705 2,057 It is pleasing to be able to report that with a few exceptions, the whole of the patients who booked for the Maternity Home, attended the Ante-Natal Clinics as often as was necessary, and to this reason one can confidently attribute to a large extent the consistently satisfactory results associated with the Home. In former reports I have laid special stress upon the importance of Ante-Natal care, and I make no apology for including in this report the following extract from a paper read by Dr. Henry Russell Andrews, M.B., B.S., F.R.C.P., Senior Obstetric Physician to the London Hospital. "Whether as general practitioners or as obstetric members of hospital staffs, we all have one object in view, viz. diminishing the difficulties and dangers of childbirth. 'Obstetrics' is the art of standing by in case you are wanted, and is one of the most important branches of preventive medicine. If it could be carried out in an ideal manner the number of abortions would be greatly reduced, 84 the number of dead-born infants and of deaths during the first few days after delivery would be enormously reduced, the deaths of women in labour and the puerperium would be reduced to a fraction of the present rate, and the numerous disabilities that handicap women as a result of child bearing would almost disappear. Apart from the mortality from puerperal sepsis, exhaustion, shock, rupture of the uterus, &c., how many women would be saved from misery and disability if prolapse, ruptured perineum, torn cervix, and partial incontinence of urine became rare instead of filling every gynaecological out-patient department! The majority of these troubles are due to difficult labour, most of them are preventable, and it is our business to see that they are, as far as possible, prevented." Prevention of Difficulties.—The old proverb that "prevention is better than cure" is never more true than in difficult cases of midwifery. The old method was to find out the difficulty only when it was actually present, when mother and child, one or both of them, were in some degree of danger, and when it was too late to avoid the difficulty, the only possible course being to overcome it with all the skill possessed by the accoucheur. Only too often skill was not enough, and a good deal of brute force had to be used, with consequences more or less disastrous, not necessarily because of the inherent difficulties of the case, but because they were present in an emergency case. It used to be quite common to hear a doctor talk almost as if he had a grievance against Providence, for having been singled out to be afflicted with the care of a large child with the breech in advance in a fat primigravida, or with an occipito-posterior position persistent to obstinacy, or some degree of contraction of the pelvis in an otherwise well-built woman, not apparent until labour had been in progress several hours. It is no exaggeration to say that in a great many of these causes the doctor, honestly reviewing the case afterwards, was able to satisfy himself that he was in no way to blame for a dead baby, and the more or less severely damaged mother. In the ideal conditions at which we are all aiming, a man who complains that he has had a very difficult labour case will be less likely to get sympathy than to be asked: Why did you allow yourself to have such a difficult case ? Convalescent Home Treatment.—During the year 13 children have been sent away for Convalescent Home treatment making an aggregate stay of 29 weeks. In 11 cases this Convalescent Home treatment was arranged direct by the Committee at suitable Homes. In the remaining cases advantage was taken of the Homes under the control of the National League for Health, Maternity and Child Welfare. Speaking generally, these children derived 85 siderable benefit from the treatment, although in certain cases the treatment could with advantage have been more prolonged. The outstanding feature of the treatment in certain cases was the falling off in health after the child had been back at home for a few weeks. There is no question that the very poor housing accommodation of very many of the residents of Greenwich, referred to at greater length elsewhere, not only produces a sickly child who is in great need of convalescent treatment, but almost at once nullifies, owing to unhealthy surroundings, the benefit derived from change of air and suitable food. Several children, however, were sent away from houses in the better parts of the Borough, including some of the houses on the Council's Estates, and in such cases the benefits derived have been much more permanent in character. 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 (debility and dietetic disorders). During the year 57 babies were admitted of which 31 were discharged cured, 10 relieved, 8 in statu quo, whilst 8 unfortunately died. NOTIFICATION OF BIRTHS ACT, 1907. The following table gives the number and character of the intimations received respecting births in the Borough :— 1917. 1918. 1919. 1920. 1921. 1922. 1923. 1924. 1925. Total Number of Births notified in each year 1,992 1,730 2,085 2,714 2,564 2,257 2,348 2,245 2,257 (a) Attended by Midwives 1,095 990 1,159 1,494 1,452 1,484 1,591 1,563 1,668 (6) Attended by Doctors 897 745 926 1,220 1,112 773 757 649 589 Number of Still Births notified in each year 47 44 59 78 52 53 50 32 32 Number of Births registered in each year 1,907 1,753 1,968 2,648 2,366 2,185 2,276 2,258 2,108 86 Puerperal Fever.—Nine cases of this disease were notified during the year, one of which unfortunately proved fatal. There did not appear to be any common source of infection amongst these cases, as they occurred in different districts and at different times all over the Borough. Ophthalmia Neonatorum.—Fifteen cases of this disease were notified during the year, and in addition there were 6 cases of slight inflammation of the eyes reported, 7 cases were removed to hospital. Both eyes were effected in 6 cases, and one eye only in the remaining 9 cases. Unfortunately 1 case died in Hospital. All the others subsequently recovered. OPHTHALMIA NEONATORUM. Notified. Cases. Vision Unimpaired. Vision impaired. Total Blindness Deaths. Treated. At Home. In Hospital. 15 8 7 14 - - 1 Measles.—See pages 53 and 54. Milk, Virol, &c., Supplied to Nursing and Expectant Mothers and Young Children.—The total amount of Milk sold or distributed free to Nursing and Expectant Mothers and Young Children during the year was 48,5271bs. (21 tons, 13 cwt. 31 lbs.). The following tables show (a) the amount of milk, etc., given away and number of applicants receiving same, (b) quantities sold each quarter, and (c) milk supplied during the last 5 years. 87 (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, 1925 7520 4233 1641 329 28 28 June, „ 7876 4434 195 390 15½ 31 — — Sept., „ 7778 4385 201 402 - - - - Dec., ,, 8319 5094 233½ 467 3 6 — — 31493 18146 794 1588 18½ 37 28 28 Quarter ended Oil and Malt Cod Liver Oil lbs. No. of Applicants lbs. No. of Applicants March, 1925 1177 1177 7½ 15 June, ,, 1079 1079 6½ 13 Sept., „ 1066 1066 7 14 Dec., „ 1614 1614 3 6 4936 4936 24 48 88 (b) Milk, Virol, Etc., Sold at Cost or Reduced Prices. Quarter ended Milk Virol Emulsion Malt Oil and Malt Cod Liver Oil Total Amount Received. lbs. lbs. lbs. lbs. lbs. lbs. March, 1925 4938 283 — 35 226 11½ £ 8. d. 381 12 0 June, „ 3849 211 1½ 4 157 11½ 296 11 7 Sept., „ 4004 195 2 — 182 7 304 2 8 Dec., „ 4243 217½ 4½ 263 20 323 9 6 17034 906½ 8 40 828 50 £1305 15 9 89 (c) Milk Supplied During Last 5 Years. Year. Distributed Free. Sales. Total. lbs. lbs. lbs. 1921 24,047 28,646 52,693 1922 38,361 23,854 62,215 1923 37,997 23,232 61,229 1924 27,759 25,178 52,937 1925 31,493 17,034 48,527 It will be observed there has been a large decrease in the Milk sales, with a corresponding increase in the quantity of milk distributed free. This is to a large extent due to increased unemployment in the district. MATERNITY AND CHILD WELFARE CENTRE. Dental Treatment. 1925. The number of patients referred for dental treatment remains about the same. The age of these patients is greater than that of the patients referred by the Tuberculosis Officer and thus Periodontal Disease is usually well marked; in such cases extractions are clearly indicated. This is regrettable, as such an unhealthy condition of the mouth is the result of neglect on the part of the patient. Gum treatment has also been adopted, but here again the results have been only fair, and in some cases disappointing owing to the lack of enthusiasm on the part of the patients, who forget that they are expected to carry out such daily treatment as is directed bv the Dentist. The following list shows the work completed during the year :— Number of Sessions 27 ,, ,, attendances 477 ,, ,, patients 160 for N20 57 ,, ,, teeth extracted 269 „ „ patients for local anaesthetic 139 „ „ teeth extracted 364 Extractions (ordinary) 10 Dentures supplied 43 Impressions taken 33 Patients advised 90 Fillings 10 Scaling, polishing 22 90 Index of Contents. Page Adoptive Acts, By-laws and Local Regulations 1, 2, 28 & 29 Age Mortality 14 Ambulance Facilities 22 Analysis of Death Causes 15 Anthrax 56 Area of Borough 6 Articles and Rooms Disinfected 59 Articles Destroyed 60 Artificial Sunlight Treatment 23, 76, 80, 81 Baby Week Competitions 80 Bacteriological Examinations 27 Bakehouses 48 Births 11,12 Blackheath and Charlton Cottage Hospital 28 Bones and Joints 15, 20 Books Destroyed 61 Cancer 18 Causes of Death 16-20 Clinics and Centres 23, 24, 76 Cerebro-Spinal Fever 55 Circulatory System 15, 19 Cleansing Children 61 Complaints 40 Constitutional Diseases 15, 18 Consumption 5, 18 Contacts 51 Convalescent Treatment 78, 84 Cowhouses 45 Customs and Inland Revenue Acts 33 Dairies, Cowsheds and Milkshops 41 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 12-14 Deptford Fund Babies' Hospital 85 Density of Population 6 Dental Work 75, 78, 89 Developmental Diseases 15,19 Diarrhoea and Zymotic Enteritis 17 Dietetic Diseases 15, 18 Digestive System 15,20 Diphtheria 16,51 Diphtheria Anti-Toxin 27 Disinfection 59-60 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 87, 88 Encephalitis Lethargica 55, 56 Enteritis 54 Epidemic Cerebro-Spinal Meningitis 55 Epidemic Diseases 15, 16 Erysipelas 17, 52 91 INDEX—continued. Page External Causes 15,20 Factories and Workshops 29-32 Food and Drugs—Samples of 48--50 Food—Premises for Preparation of, etc. 47 Glanders 56 Gonorrhoea 17 Health Centres 76 Health Visitors, Visits, etc. 79 Home Work 31 Horse Slaughterer 33 Hospital and other forms of Gratuitous Medical Relief 27, 28 House Drainage 33 Houses Inspected re Infectious Diseases 61 Houses Let in Lodgings 34 Housing 43-45 Hydrophobia 56 Ice Cream Premises 41,48 Ill-defined Causes 20 Increase of Rent and Mortgage Interest (Restriction) Acts, 1920 and 1923 35 Infant Consultations 76 Infantile Mortality 14 Influenza. 17 Inhabited Houses 6 Insanitary Areas 41 Institution Deaths 13 Integumentary System 15, 20 Introductory Review 4,5 Laboratory Work 27 Legal Proceedings 40 Local Diseases 15, 19 Lymphatic System 15, 20 Malarial Diseases 15, 17, 55 Marriages 11 Maternity and Child Welfare 75-89 Maternity Home 77, 82, 83 Measles 16, 53, 54 Meat 46 Milk and Cream Regulations 46 Milk Supply 45 Milk Supply for Expectant and Nursing Mothers 86 Milk and Dairies (Amendment) Act, 1922 45 Milk and Dairies Consolidation Act, 1915 45 Milk (Special Designations) Order, 1923 46 Miller General Hospital 28 Minor Ailment Centre 78 Mortuary 21,42 Nervous System 15, 19 Notices, etc 40 Notifications 51—57 Notification of Births Act 85 Nursing Arrangements 27 Offensive Trades 35 Ophthalmia Neonatorum 55, 86 Organs of Special Sense 15, 19 92 INDEX—continued. Page Outworkers' Register 29 Overcrowding 41 Parasitic Diseases 15, 18 Persons Cleansed 61 Polio-encephalitis 55 Polio-myelitis 55 Poor Law Relief 28 Population 6, 8 Public Health Committee 1,2 Public Health (Dried Milk) Regulations, 1923 46 Public Health (Meat) Regulations, 1924 46 Public Sanitary Conveniences 34 Puerperal Fever 17,53,86 Pyæmia and Septicaemia 17 Rats and Mice (Destruction) Act, 1919 34-35 Remarks on Death Causes 16-20 Reproductive System 15-20 Respiratory System 15,19 Rheumatic Fever 17 Sale of Food and Drugs Act 48-50 Sanitary Work—Summaries, etc. 29-42 Scarlet Fever 16-52 Scavenging and Refuse Removal 33, 34 School Clinic 24 Seamen's Hospital 27 Septic Diseases 15,17 Slaughterhouses 41,46 Small-pox 16,51 •Smoke Nuisances 32 Sporadic Diseases 15, 17 Staff of Public Health Department 24-26 Statistical Tables 6-10 and Appendix Suffocation 20 Suicide 15, 20 Syphilis 17 Tuberculosis 15, 18,56 Tuberculosis Dispensary—Return of Attendances 73-74 Tuberculosis—Care Committee 71-72 Tuberculosis Officer's Report 62-74 Typhoid Fever 16,52 Underground Bakehouses 32 Underground Rooms 41 Unwholesome Food 39 Uninhabited Houses 6 Urinary System 15, 20 Vaccination Particulars 58 Venereal Diseases 15, 17 Verminous Premises 35,41 Verminous Children 61 Virol 87,88 Vital Statistics 6-10 and Appendix Water Supply 33 Whooping Cough 16,54 Workshops and Factories 32 Zymotic Enteritis 17,54 Zymotic Diseases 16 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 4th April, 1925. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1925. Births Registered during the 13 weeks ended 4th April, 1925. Deaths Registered during the 13 weeks ended 4th April, 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 13 weeks ended 4th April. 1925. During the corresponding period year previous. During the 13 weeks ended 4th April, 1925. Typhoid. Other. M. F. M. F. Greenwich East 44213 44720 126 82 77 69 16 7 57 •• •• •• 3 3 •• •• •• 17 1 39 6 16 61 15•40 13.10 •70 •53 Do. West 26677 27068 66 68 63 36 10 6 39 •• •• •• 1 3 •• •• 1 9 1 24 6 7 47 17•31 14•68 1•02 •74 St. Nicholas, Deptford 7582 7784 26 19 15 10 5 1 3 •• •• •• •• •• •• •• •• 4 •• 4 2 •• 15 19•10 12•89 3•61 •• Charlton 18785 20657 52 48 41 33 10 5 32 •• •• •• •• 4 1 •• •• 3 1 15 7 6 37 27•03 14•37 •20 •97 Kidbrooke 3193 3291 3 4 2 4 •• .. 5 •• •• •• •• •• •• •• •• •• •• 1 1 1 3 12•25 7•31 •• •• Miller Hospital— Resident •• •• •• 3 4 2 1 •• •• •• •• •• 2 •• •• •• •• •• 1 1 •• 3 •• •• •• •• Non-Resident •• •• •• 19 8 3 2 2 •• •• •• •• •• •• •• •• •• 4 •• 3 4 16 •• •• •• •• Seamen's Hospital— Resident •• •• •• 14 •• •• •• 2 •• •• •• •• •• •• •• •• 1 •• 3 1 •• 9 •• •• •• •• Non-Resident •• •• •• 17 .. •• •• 1 •• •• •• •• •• •• •• •• 2 •• 4 1 6 4 •• •• •• •• Greenwich & Deptford Hospital— Resident •• •• •• 40 33 5 2 27 •• •• •• •• •• •• •• •• 10 •• 17 2 7 37 •• •• •• Non-Resident •• •• •• 78 52 7 2 52 •• •• •• •• •• •• •• •• 6 •• 29 5 14 76 •• •• •• •• Herbert Hospital— Resident •• •• •• .. .. •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Non-Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• M.A.B. Brook Hospital- Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Non-Resident •• •• •• •• •• .. •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Cottage Hospital— Resident •• •• •• 3 •• .. •• •• •• •• •• •• •• •• •• •• •• •• 2 •• •• 1 •• •• •• •• Non-Resident •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Other Institutions— Resident •• •• •• 1 5 2 •• 1 •• •• •• •• •• •• •• •• •• 1 •• •• 1 4 •• •• •• •• Non-Resident •• •• •• 3 3 1 •• 3 •• •• •• • • •• •• •• •• •• •• •• •• 1 5 •• •• •• •• Outside Institutions •• •• •• 40 27 13 5 19 •• •• •• 4 5 1 •• 1 3 •• 6 1 8 38 •• •• •• •• 273 221 198 152 Borough 100450 103520 *494 350 41 19 136 •• •• •• 4 10 1 •• 1 33 3 83 22 30 163 •• •• •• •• Rate per 1,000 of Estimated Population •• •• 19•15 13•56 •• .. •• •• •• •• •15 •38 •03 •• •03 1•27 •11 3•21 85 1•16 6•31 16•48 13•56 •89 •62 Deaths of Children under 1 Year per 1,000 births, 75 *Gross Births Registered, 544. previous (21.08 per 1000). „ „ „ corresponding 87 period „ „ „ County of London 73 Death Rate of 105 large English Towns, 14.6 ; of the County of London, 141. Birth Rate „ „ 19•3 " " 19•1 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 4th duly, 1925. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1925. Births Registered during the 13 weeks ended 4th July, 1925. Deaths Registered during the 13 weeks ended 4th July, 1925. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Phthisis. A11 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. Typhoid. Other. During the corresponding period year previous. During the 13 weeks ended 4th July, 1925. During the corresponding period year previous. During the 13 weeks ended 4th July, 1925. M. F. M. F. Greenwich East 44213 44720 105 87 50 53 11 5 35 .. .. 1 2 2 .. .. 1 11 5 7 6 10 58 10•53 9•24 •70 •53 Do. West 26677 27068 74 63 38 35 11 1 25 .. .. .. 1 2 .. .. .. 7 1 9 4 5 44 12•17 10•82 •58 •44 St. Nicholas, Deptford 7582 7784 23 35 7 12 4 2 4 .. .. .. 1 .. .. .. .. 4 .. 1 3 2 8 13•42 9•79 •51 •51 Charlton 18785 20657 61 49 21 29 8 2 19 .. .. .. 2 .. .. .. .. 5 1 7 2 6 27 11•25 9•70 1•04 •38 Kidbrooke 3193 3291 6 3 2 3 1 .. 3 .. .. .. .. .. .. .. .. .. .. .. 1 .. 4 6•2 6•09 .. .. Miller Hospital— Resident .. .. .. 2 3 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 4 .. .. .. .. Non-Resident .. .. .. 9 8 .. 2 3 .. .. .. .. .. .. .. .. .. .. .. 1 3 12 .. .. .. .. Seamen's Hospital— Resident .. .. .. 10 1 .. .. .. .. .. .. .. .. .. .. .. 3 1 .. 1 1 5 .. .. .. .. Non-Resident .. .. .. 20 2 .. 1 3 .. .. .. .. .. .. .. .. 4 .. 2 5 4 7 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 32 28 4 2 24 .. .. .. .. .. .. .. .. 9 1 4 4 5 37 .. .. .. .. Non-Resident .. .. .. 52 36 2 3 25 .. .. .. .. .. .. .. .. 6 3 13 5 10 51 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cottage Hospital— Resident .. .. .. .. 2 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Instititions- Resident .. .. .. 1 3 .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 2 .. .. .. .. Non-Resident .. .. .. .. 5 .. .. 3 .. .. .. .. .. .. .. .. .. .. 1 .. .. 4 .. .. .. .. Outside Institutions .. .. .. 26 27 9 4 13 .. .. 1 6 3 .. .. 1 3 4 3 .. 3 29 .. .. .. .. 269 237 118 132 Borough 100450 103520 *506 250 35 10 86 .. .. 1 6 4 .. .. 1 27 7 24 16 23 141 .. .. .. •• Rate per 1,000 of Estimated Population .. .. 19•61 9•69 .. .. .. .. .. •03 •23 •15 .. .. •03 1•04 •27 •93 •62 •89 5•46 11•18 9•06 •70 •46 Deaths of Children under 1 Year per 1,000 births. 63 *Gross Births Registered, 550. previous 1 (21•32 per 1000). „ ,, ,, corresponding 57 period „ ,, ,, County of London 49 Death Rate of 105 large English Towns, 11•4; of the County of London, 10.1 Birth Rate „ „ 19•9 „ ,, 19•3 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 3rd October, 1925. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1925. Births Registered during the 13 weeks ended 3rd October, 1925. Deaths Registered during the 13 weeks ended 3rd October, 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 13 weeks ended 3rd Octob 1925. During the corresponding period year previous. During the 13 weeks ended 3rd October, 1925. Typhoid. Other. M. F. M. f. Greenwich East 44213 44720 110 99 62 39 10 2 39 .. .. .. 1 .. .. .. 2 11 1 6 7 10 63 8•23 9•23 •70 •26 Do. West 26677 27068 50 60 46 23 8 4 21 .. .. .. .. .. .. .. .. 7 .. 8 8 9 37 8•36 10•22 •29 .. St. Nicholas, Deptford 7582 7784 30 24 9 15 4 1 4 .. 1 .. .. .. .. .. .. 2 .. 2 .. 3 16 6•19 12•37 •51 •51 Charlton 18785 20657 53 42 24 19 5 3 18 .. .. .. 1 1 .. .. .. 1 .. .. 1 9 30 9•79 8•34 .. •38 Kidbrooke 3193 3291 9 7 3 3 .. .. 1 .. .. .. .. .. .. .. .. 2 .. 1 1 .. 2 2•45 7•31 .. .. Milter Hospital- Resident .. .. .. 6 3 1 1 .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 7 .. .. .. .. Non-Resident .. .. .. 11 12 3 .. 2 .. .. .. .. .. .. .. .. .. .. 2 1 6 14 .. .. .. .. Seamen's Hospital— Resident .. .. .. 11 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 3 1 6 .. .. .. .. Non-Resident .. .. .. 24 .. .. .. 5 .. .. .. .. .. .. .. .. 3 .. 3 3 2 13 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 36 31 7 1 23 .. 1 .. .. .. .. .. 1 7 1 2 2 8 45 .. .. .. .. Non-Resident .. .. .. 50 39 4 1 38 .. .. .. .. .. .. .. 1 6 1 6 3 15 57 .. .. .. .. HERBERT HOSPITAL- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . .. .. .. .. Cottage Hospital— Resident .. .. .. 1 2 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. .. Non-Resident .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. Other Institutions— Resident .. .. .. .. 2 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. Non-Resident .. .. .. 7 3 2 .. 3 .. .. .. .. .. .. .. .. .. .. 1 1 2 6 .. .. .. .. Outside Institutions .. .. .. 33 16 5 5 11 .. .. .. 2 1 .. .. 1 3 .. 3 1 6 32 .. .. .. .. 252 232 144 99 Borough 100450 103520 *484 243 27 10 83 .. 1 .. 2 1 .. .. 2 23 1 17 17 31 148 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 18•76 9•41 •• •• •• •• •03 • • •06 •03 .. .. •06 •89 •03 •65 •65 1•55 5•73 8•22 9•41 •42 •23 Deaths of Children under 1 Year per 1,000 births. 53 *Gross Births Registered, 529. previous 1 (20.5 per 1000). „ ,, „ corresponding 55 period. „ ,, „ County of London 68 Death Rate of 105 large English Towns, 9.6; of the County of London, 9.1 Birth Rate „ 19.0 " " 18.0 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 2nd January, 1926. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1925. Births Registered during the 13 weeks ended 2nd January, 1926.. Deaths Registered during the 13 weeks ended 2nd January. 1926. 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 13 weeks ended 2nd January, 1926. During the corresponding period year previous. During the 13 weeks ended 2nd January. 1926. Typhoid. Other. M. K M. K Greenwich East 44213 44720 105 90 69 66 12 6 60 .. 2 2 .. .. .. .. 1 9 2 26 10 20 63 10•43 12•10 •32 •44 Do. West 26677 27068 62 56 52 43 11 10 34 .. 10 .. .. .. .. .. .. 6 .. 20 4 9 46 9•67 14•07 •40 1•48 St. Nicholas, Deptford 7582 7784 29 27 18 12 5 7 3 .. 7 .. .. .. .. .. .. 2 .. 6 3 4 8 8•62 15•46 2•39 3•60 Charlton 18785 20657 49 45 36 31 4 8 25 .. 1 .. 2 .. .. .. 1 4 .. 15 9 7 28 11•22 13•01 1•04 •77 Kidbrooke 3193 3291 6 .. 3 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 1 1 5•69 3•65 1•13 .. Miller Hospital— Resident .. .. .. 5 2 2 .. 1 .. .. .. .. .. .. .. 1 .. .. 1 .. 1 4 .. .. .. .. Non-Resident .. .. .. 16 5 .. 1 2 .. .. .. .. .. .. .. .. .. .. .. 1 6 14 .. .. .. .. Seamen's Hospital— Resident .. .. .. 11 1 1 1 .. .. .. .. .. .. .. .. .. 2 .. 1 2 1 6 .. .. .. .. Non-Resident .. .. .. 25 .. .. .. 3 .. .. .. .. .. .. .. .. 3 1 2 4 2 13 .. .. .. .. Greenwich & Deptford Hospital Resident .. .. .. 36 33 7 3 27 .. 5 .. .. .. .. .. 1 3 1 12 3 9 35 .. .. .. .. Non-Resident .. .. .. 77 46 6 9 54 .. 7 .. .. .. .. .. .. 6 .. 21 7 17 65 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. M.A.B. BROOK HOSPITAL Resident .. .. .. 4 2 1 5 .. .. 5 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non Resident .. .. .. 15 7 6 14 .. .. 16 .. 5 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. COTTAGE HOSPIAT- Resident .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. Non-Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Institutions— RESIDENT .. .. .. 3 6 2 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 1 5 .. .. .. .. NON- RESIDENT- .. .. .. 5 3 1 .. 3 .. .. .. .. .. .. .. .. 1 .. 2 .. .. 5 .. .. .. .. Outside Institutions .. .. .. 38 29 9 6 15 .. 1 2 1 .. .. .. .. 4 .. 9 6 5 39 .. .. .. .. 251 218 178 152 Borough 100450 103520 *469 330 32 31 123 .. 20 2 2 .. .. 2 •2 21 2 67 27 41 146 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 17•18 12•77 .. .. .. .. •77 •07 07 .. .. •07 .. •80 •07 2•59 1•04 1•58 5•65 10•09 12•77 •75 1•00 Deaths of Children under 1 Year per 1,000 births. 65 *Gross Births Registered, 480. previous (18.9 per 1000). „ „ „ corresponding 73 period . „ „ „ County of London 88 Death Rate of 105 large English Towns, 13.4; of tho County of London. 13.6. 17.6 „ „ 169. Birth Rate „ „ BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 52 weeks ended 2nd January, 1926. DISTRICTS. Census Population, 1921. Estimated Population at the middle of the Year 1925. Births Registered during the 52 weeks ended 2nd January, 1926. Deaths Registered during the 52 weeks ended 2nd January, 1926. 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 52 weeks ended 2nd January, 1926. During the corresponding period year previous. During the 52 weeks ended 2nd January, 1926. Typhoid. Other. M. F. M. F. Greenwich East 44213 44720 446 358 258 227 49 20 191 .. 2 3 6 5 .. .. 4 48 9 78 29 56 245 11•4 10•87 •60 •44 Do. West 26677 27068 252 247 199 137 40 21 119 .. 10 .. 2 5 .. .. 1 29 2 61 22 30 174 11•84 12•45 •57 •66 St. Nicholas, Deptford 7582 7784 108 105 49 49 18 11 14 .. 8 .. 1 .. .. .. .. 12 .. 13 8 9 47 11•77 12•63 1•77 1•15 Charlton 18785 20657 215 184 122 112 27 18 94 .. 1 .. 5 5 1 .. 1 13 2 37 19 28 122 12•41 11•36 •71 •63 Kidbrooke 3193 3291 24 14 10 10 1 .. 10 .. .. .. .. .. .. .. .. 2 .. 2 4 2 10 6•61 6•09 •30 .. Miller Hospital— Resident .. .. .. 16 12 5 2 2 .. .. .. .. 2 .. .. 1 .. .. 3 2 2 18 .. .. ... .. Non-Resident .. .. .. 55 33 6 5 9 .. .. .. .. .. .. .. 1 .. 4 2 6 19 56 .. .. .. .. Seamen's Hospital— Resident .. .. .. 46 3 1 2 2 .. .. .. .. .. .. .. .. 7 1 5 7 3 26 .. .. .. .. Non-Resident .. .. .. 86 2 .. 1 12 .. .. .. .. .. .. .. .. 12 1 11 13 14 37 .. .. .. .. Greenwich & Deptford Hospital— Resident .. .. .. 144 125 23 8 101 .. 6 .. .. .. .. .. 2 29 3 35 11 29 154 .. .. .. .. Non-Resident .. .. .. 257 173 19 15 169 .. 7 .. .. .. .. .. 1 24 4 69 20 56 249 .. .. .. .. Herbert Hospital— Resident .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. M.A.B. Brook Hospital- Resident .. .. .. 4 2 1 5 .. .. 5 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Non-Resident .. .. .. 15 7 6 14 .. .. 16 .. 5 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Cottage hospital- Resident .. .. .. 5 5 .. .. 2 .. .. .. .. .. .. .. .. .. .. 2 1 1 6 .. .. .. .. Non-Resident .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. ... 1 .. .. .. .. .. Other Institutions— Resident .. .. .. 6 16 4 .. 4 .. .. .. .. .. .. .. .. 1 2 1 3 3 12 .. .. .. .. Non-Resident .. .. .. 15 14 4 .. 12 .. .. .. .. .. .. .. .. 1 .. 4 1 3 20 .. .. .. .. Outside Institutions .. .. .. 137 99 36 20 58 .. 1 3 13 9 1 .. 3 13 4 21 8 22 138 .. .. .. .. 1045 908 638 535 Borough 100450 103520 *1953 1173 135 70 428 .. 21 3 14 15 1 .. 6 104 13 191 82 125 598 .. .. .. .. Rate per 1,000 of Estimated Population .. .. 18•92 11•36 .. .. .. .. •20 •02 •13 •14 •009 . . •05 1•00 •12 1•85 •78 1•21 5•80 11•47 11•36 •69 •58 Deaths of Children under I Year per 1,000 births. 69 *Gross Births Registered, 2,108. previous (18.9 per 1000). „ ,, „ corresponding 73 period „ ,, „ County of London 67 Death Rate of 105 large English Towns, 12.2; of the County of London, 11.7. Birth Rate „ ,, 18.8 „ 18. 0. BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 4th April, 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 occurring in or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "Non- Rcsidents' in Public Institutions in the District. All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Greenwich East Greenwich West St. Nicholas, Deptford Charlton Kidbrooke Gr'n'ch & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 350 41 9 10 8 25 46 75 136 146 99 25 74 6 74 14 7 4 7 67 283 UnCertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 10 3 4 3 .. .. .. .. .. 3 3 .. 4 .. .. .. 2 .. .. .. .. 5 2 Diphtheria and Croup 4 .. .. 1 1 2 .. .. .. 3 1 .. .. .. .. .. .. .. .. .. .. 4 Influenza 9 .. .. .. .. .. .. 6 3 5 1 .. 2 1 .. .. .. .. .. .. 1 1 2 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• 1 Cerebro-Spinal Fever 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Post Basic Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 33 .. .. .. 1 9 16 5 2 17 9 4 3 .. 10 1 .. .. .. .. .. 3 19 Tuberculous Meningitis 2 1 .. 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. •• 1 Other Tuberculous Diseases 1 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. 4 Rheumatic Fever 1 .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 30 .. .. .. .. .. 3 6 21 16 7 .. 6 1 7 .. .. .. .. .. 1 8 33 Bronchitis 51 8 .. .. 1 1 5 15 21 23 15 3 9 1 10 .. .. .. • • 2 .. 3 30 Broncho-Pneumonia 15 5 4 1 1 •• .. 1 3 10 4 .. 1 .. 2 1 .. .. .. .. .. 1 8 Pneumonia (all other forms) 17 1 .. 1 2 3 4 2 4 6 5 1 5 .. 5 2 1 .. .. .. .. 2 18 Other Diseases of Respiratory Organs 3 .. .. .. .. .. .. 1 2 2 1 .. .. .. .. .. .. .. .. .. .. .. 1 Diarrhœa and Enteritis 3 3 .. .. .. .. .. .. .. 1 1 .. 1 .. .. .. .. .. .. .. .. 2 1 Appendicitis and Typhlitis 4 .. .. 1 .. .. 2 1 .. 2 2 .. .. .. 2 1 .. .. .. .. .. 1 6 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Cirrhosis of Liver 1 .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 3 Nephritis and Bright's Disease 7 .. .. .. .. .. 2 4 1 3 3 .. 1 .. 1 2 .. .. .. .. .. 1 3 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 3 Congenital Debility and Malformation, including Premature Birth 15 15 .. .. .. .. .. .. .. 6 2 3 4 .. 3 .. .. .. .. .. 1 6 8 Violent Deaths, excluding Suicide 10 .. .. .. 1 3 .. 2 4 3 2 2 3 .. 5 .. .. .. .. .. .. 4 15 Suicides 2 .. .. .. .. 1 1 .. .. 1 .. .. 1 .. .. 1 .. .. .. .. .. .. 1 Heart Disease 22 .. .. .. .. 1 3 8 10 6 6 2 7 1 2 1 1 .. .. .. .. 1 13 Other Defined Diseases 107 4 1 .. .. 5 8 24 65 38 33 10 24 2 25 5 3 .. .. 2 2 24 110 Diseases ill-defined or unknown 350 41 9 10 8 25 46 75 136 146 99 25 74 6 73 14 7 .. .. 4 7 67 283 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 4th July, 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 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 <fc Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 250 35 4 6 11 16 33 59 86 103 73 19 50 5 60 11 5 .. .. 2 4 53 214 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1 .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 •• Diphtheria and Croup 6 .. 1 .. 4 1 .. .. .. 2 1 1 2 .. .. .. .. .. .. .. .. 6 .. Influenza 1 .. •• .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica 2 .. .. .. .. .. .. 1 1 .. 2 .. .. .. 1 .. 1 .. .. .. .. .. 2 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Post Basic Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 27 .. .. .. .. 8 9 10 .. 11 7 4 5 .. 9 3 .. .. .. .. .. 3 22 Tuberculous Meningitis 5 1 2 1 .. 1 .. .. .. 3 1 .. 1 .. 1 1 .. .. .. .. •• 2 4 Other Tuberculous Diseases 2 .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 Rheumatic Fever 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 23 .. .. .. .. .. 2 12 9 10 5 2 6 .. 5 1 1 .. .. .. 1 3 25 Bronchitis 10 .. .. 1 •• .. 1 .. 8 4 3 1 2 .. 2 .. .. .. .. .. .. 1 6 Broncho-Pneumonia 8 3 1 1 .. .. .. 3 .. 1 4 .. 3 .. 1 .. .. .. .. .. .. 1 7 Pneumonia (all other forms) 6 .. .. .. 2 .. 1 2 1 2 2 .. 2 .. 1 .. .. .. .. .. .. 1 7 Other Diseases of Respiratory Organs 2 .. .. .. .. .. 1 .. 1 2 .. .. .. .. 1 .. .. .. .. .. .. 1 3 Diarrhœa and Enteritis 2 1 .. .. .. 1 .. .. .. 1 •• 1 .. .. .. .. .. .. .. .. .. 1 1 Appendicitis and Typhlitis 3 .. .. .. 1 .. 1 1 .. 1 1 .. 1 •• 1 .. .. .. .. .. .. 1 3 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Nephritis and Bright's Disease 6 .. .. .. 1 1 .. 3 1 2 2 .. 2 .. 1 .. .. .. .. .. .. 3 5 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Congenital Debility and Malformation, including Premature Birth 19 19 .. .. .. .. .. .. .. 6 6 1 6 .. 3 .. .. .. .. .. 1 4 6 Violent Deaths, excluding Suicide 13 1 .. .. 1 1 4 4 2 9 1 2 .. 1 2 1 1 .. .. 1 .. 3 11 Suicides 3 .. .. .. .. .. .. 1 2 1 .. .. 2 .. .. .. .. .. .. .. .. 1 .. Heart Disease 16 .. .. .. .. .. 6 4 6 6 4 3 2 1 4 1 .. .. .. .. 1 .. 17 Other Defined Diseases 90 8 .. .. 1 3 8 16 54 38 29 4 16 3 28 4 2 .. .. 1 1 16 90 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 250 35 4 6 11 16 33 59 86 103 73 19 50 5 60 11 5 .. .. 2 4 53 214 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 3rd October, 1925. 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. Causes of Death. All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Greenwich East Greenwich West St. Nicholas, Deptford Charlton Kidbrooke Gr'n'ch & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 243 27 2 8 7 20 31 65 83 101 69 24 43 6 67 12 9 .. .. 3 2 49 240 UnCertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small Fox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1 .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 1 .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. Diphtheria and Croup 2 .. •• 1 1 .. .. .. .. 1 .. •• 1 .. .. .. .. .. .. .. .. 2 .. Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica 1 .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Post Basic Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 23 .. .. .. .. 11 8 3 1 11 7 2 1 2 7 1 .. .. .. .. .. 3 17 Tuberculous Meningitis 1 .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 31 .. .. 1 •• 2 11 17 10 9 3 9 .. 8 1 .. .. .. 1 6 36 Bronchitis 10 .. .. .. .. .. .. 3 7 5 5 .. .. .. 1 .. .. .. .. .. .. 1 3 Broncho-Pneumonia 3 1 1 .. .. 1 .. .. .. 1 1 1 .. .. 1 .. .. .. .. .. .. 2 3 Pneumonia (all other forms) 4 .. .. 1 .. .. .. 3 .. .. 2 1 .. 1 .. 1 1 .. .. .. .. .. 10 Other Diseases of Respiratory Organs 8 .. .. 1 .. 1 .. 3 3 4 1 1 2 .. .. 1 .. .. .. .. .. 3 4 Diarrhœa and Enteritis 8 8 .. .. .. .. .. .. .. 2 3 2 1 .. 1 .. 1 .. .. .. .. 3 5 Appendicitis and Typhlitis 5 .. .. .. 2 1 2 .. .. 1 1 2 1 .. 2 1 1 .. .. .. .. 1 6 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. •• .. 1 .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 2 Nephritis and Bright's Disease 6 .. .. .. .. .. .. 3 3 1 .. 1 4 .. .. .. .. .. .. .. .. 2 6 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Accidents and Diseases of Pregnancy and Parturition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Congenital Debility and Malformation, including Premature Birth 15 15 .. .. .. .. .. .. .. 7 3 1 4 .. 5 .. .. .. .. .. .. 2 12 Violent Deaths, excluding Suicide 20 .. .. 3 2 4 2 5 4 10 6 2 1 1 6 1 3 .. .. 1 .. 6 14 Suicides 4 .. .. .. .. .. 1 1 2 2 2 .. .. .. 1 .. .. .. .. .. .. .. 4 Heart Disease 17 .. .. .. .. 1 6 6 4 7 8 .. 1 1 2 3 1 .. .. .. 1 1 15 Other Defined Diseases 82 3 .. .. 1 .. 10 26 42 38 20 6 17 1 30 3 2 .. .. 1 1 15 99 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 243 27 2 8 7 20 31 65 83 101 69 24 43 6 67 12 9 .. .. 3 2 49 240 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 2nd January, 1926. 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 & Deptford Hospital Seamen's Hospital Miller Hospital Herbert Military Hospital Brook Hospital M.A.B. Cottage Hospital Other Institutions Outside Institutions All Causes Certified 330 32 16 15 11 12 30 91 123 135 95 30 67 3 69 12 7 .. 6 2 9 67 305 Un Certified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Entsric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Measles 20 5 8 6 1 .. .. .. .. 2 10 7 1 •• 5 .. .. .. 5 .. .. 1 33 Scarlet Fever 2 .. 1 •• 1 .. •• •• 2 .. .. .. .. .. .. .. .. .. .. .. 2 •• Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Croup 2 •• •• 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 •• •• 1 6 Influenza 4 .. .. .. .. .. 1 .. 3 4 .. .. .. .. 1 .. .. .. .. .. .. .. 1 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Post Basic Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pul. Tuberculosis) 21 .. .. .. 2 6 8 3 2 9 6 2 4 •• 3 2 .. .. .. .. .. 4 16 Tuberculous Meningitis 1 •• 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 2 Other Tuberculous Diseases 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 •• .. Rheumatic Fever 1 .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 41 .. .. .. .. .. 3 20 18 20 9 4 7 1 9 1 1 .. .. .. 1 5 37 Bronchitis 41 4 .. .. .. .. 4 9 24 18 10 3 10 .. 8 .. .. .. .. .. .. 1 19 Broncho-Pneumonia 18 5 3 5 2 .. 1 1 1 5 7 3 3 .. 4 .. 1 .. .. .. .. 5 13 Pneumonia (all other forms) 8 1 2 .. 1 .. 1 1 2 3 3 .. 2 .. .. 1 .. .. .. .. 1 3 8 Other Diseases of Respiratorv Organs 4 .. 1 .. .. .. 1 2 .. 2 2 .. .. .. .. .. .. .. .. .. .. .. 10 Diarrhœa and Enteritis 5 5 .. .. .. .. .. .. .. 2 2 .. 1 .. 2 1 1 .. .. .. .. 1 6 Appendicitis and Typhlitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 2 Nephritis and Bright's Disease 7 .. .. .. .. .. .. 5 2 3 2 .. 2 .. 1 1 .. .. .. .. .. 3 6 Puerperal Fever 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 Other Accidents and Diseases of Pregnancy and Parturition 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 Congenital Debility and Malformation, including Premature Birth 9 9 .. .. .. .. .. .. .. 4 2 2 1 .. 2 .. .. .. .. .. 1 2 7 Violent Deaths, excluding Suicide 9 .. .. 1 .. 1 1 4 2 5 2 .. 2 .. 4 1 .. .. .. .. .. 4 15 Suicides 2 .. .. .. .. .. .. 2 .. .. 1 .. 1 .. .. .. .. .. .. .. 2 .. Heart Disease 27 .. .. .. 2 1 3 10 11 10 4 3 9 1 3 2 .. .. .. 1 .. 6 19 Other Defined Diseases 104 3 .. 1 2 3 5 33 57 42 35 6 20 1 24 3 4 .. .. 1 5 26 99 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 330 32 16 15 11 12 30 91 123 135 95 30 67 3 69 12 7 .. 6 2 9 67 305 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 52 weeks ended 2nd January, 1926. Causes of Death. Deaths at Subjoined ages of "Residents" wheather occurring within or without the district Deaths at all Ages of "Resident" 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 In stitutions 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 Ur'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 1,173 135 31 39 37 73 140 290 428 485 336 98 234 20 269 49 28 .. 6 11 22 236 1,042 UnCertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 •• Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 21 5 8 6 1 1 .. .. .. 2 10 8 1 .. 6 .. .. .. 5 .. .. 1 34 Scarlet Fever 3 .. 1 • • 2 .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 .. Whooping Cough 15 5 4 6 .. .. .. .. .. 5 5 .. 5 .. .. .. 2 .. .. .. .. 9 2 Diphtheria and Croup 14 .. 1 4 6 3 .. .. .. 6 2 1 5 .. .. .. .. .. 1 .. .. 13 6 Influenza 14 .. .. .. .. .. 1 6 7 9 2 .. 2 1 1 .. .. •• .. • • 1 1 3 Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• 2 Cerebro-Spinal Fever 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica 3 .. .. .. 1 .. .. 1 1 .. 2 1 .. •• 1 .. 1 .. .. .. .. 1 2 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Post Basic Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis (Pill. Tuberculosis 104 .. .. .. 3 34 41 21 5 48 29 12 13 2 29 7 .. .. .. .. .. 13 74 Tuberculous Meningitis 9 2 4 2 .. 1 .. .. .. 6 1 .. 2 •• 3 1 .. .. .. .. •• 2 8 Other Tuberculous Diseases 4 1 .. 1 .. .. .. 2 •• 3 1 .. .. .. .. •• .. .. .. .. 2 2 6 Rheumatic Fever 3 .. .. .. 1 .. .. 1 1 1 1 .. 1 .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Disease 125 .. .. 1 .. •• 10 49 65 56 30 9 28 2 29 3 2 .. .. 1 3 22 131 Bronchitis 112 12 .. 1 1 1 10 27 60 50 33 7 21 1 21 .. .. .. .. 2 .. 6 58 Broncho-Pneumonia 44 14 9 7 3 1 1 5 4 17 16 4 7 .. 8 1 1 .. .. .. .. 9 31 Pneumonia (all other forms) 35 2 2 2 5 3 6 8 7 11 12 2 9 1 6 4 2 .. .. .. 1 6 43 Other Diseases of Respira torv Organs 17 .. 1 1 .. 1 2 6 6 8 6 1 2 .. 1 1 .. .. .. .. .. 4 18 Diarrhoea and Enteritis 18 17 .. .. .. 1 .. .. .. 6 6 3 3 .. 3 1 2 .. .. .. .. 7 13 Appendicitis and Typhlitis 12 .. .. 1 3 1 5 2 .. 4 4 2 2 .. 5 2 1 .. .. .. .. 3 19 Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cirrhosis of Liver 3 .. .. .. .. .. 2 1 .. 1 2 .. .. .. 3 .. .. .. .. .. .. .. 9 Nephritis and Bright's Dis ease 26 .. .. .. 1 1 2 15 7 9 7 1 9 .. 3 3 .. .. .. .. .. 9 20 Puerperal Fever 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 2 Other Accidents and Dis eases of Pregnancy ant Parturition 2 .. .. .. .. 1 1 .. .. .. .. .. 2 .. .. .. .. .. .. .. 1 1 5 Congenital Debility ant Malformation, including Premature Birth 58 58 .. .. .. .. .. .. .. 23 13 7 15 .. 13 .. .. .. .. .. 3 14 33 Violent Deaths, excluding Suicide 52 1 .. 4 4 9 7 15 12 27 11 6 6 .. 17 3 4 .. .. 2 .. 17 55 Suicides 11 .. .. .. .. 1 2 4 4 4 3 .. 4 .. 1 1 .. .. .. .. .. 3 5 Heart Disease 82 .. .. .. 2 3 18 28 31 29 22 8 19 4 11 7 2 .. .. 1 2 8 64 Other Defined Diseases 383 18 1 1 4 11 31 99 218 156 117 26 77 7 107 15 11 .. .. 5 9 81 398 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1,173 135 31 39 37 73 140 290 428 485 336 98 234 20 269 49 28 .. 6 11 22 236 1,042 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. Cases of Infectious Disease notified during the 13 weeks ended 4th April, 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. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 15 13 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 103 .. 30 56 12 5 .. .. 46 35 2 20 .. 46 33 2 20 .. 101 Encephalitis Lethargica 3 .. 1 .. 2 .. .. .. 2 .. .. 1 .. 2 .. .. 1 .. 3 Erysipelas 12 .. .. 1 .. 6 3 2 2 5 2 2 1 .. 2 1 .. .. 3 Scarlet Fever 73 .. 23 45 2 2 .. .. 40 24 6 3 .. 39 23 6 2 .. 70 Typhus Fever •• .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Enteric Fever 2 .. .. 1 .. .. 1 .. 1 .. .. 1 .. 1 .. .. 1 .. 2 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 4 .. .. .. 1 3 .. .. 3 .. .. 1 .. 3 .. .. 1 .. 4 Cerebro-Spinal Fever 2 .. 1 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. Malaria 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Dysentery .. .. .. .. •• •• .. .. .. •• .. .. .. .. .. .. .. .. .. Measles 149 3 24 84 30 8 .. .. 39 24 .. 73 13 .. 9 .. .. 11 20 Whooping Cough 414 66 210 135 .. 2 .. 1 184 103 28 95 4 2 9 1 3 .. 15 Diarrhœa 2 1 1 .. .. .. .. .. .. 2 .. .. .. .. 1 .. .. .. 1 Ophthalmia Neonatorum 1 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 Tuberculosis, Pulmonary 44 .. .. 5 11 18 8 2 19 12 8 5 .. 2 1 2 1 .. 6 „ Non-Pulmonary 16 1 4 4 4 3 •• •• 6 5 3 2 .. 2 1 •• 2 .. 5 Pneumonia, Acute Primary, or Acute Influenzal 24 .. 3 5 4 7 2 3 6 5 4 8 1 1 1 1 2 .. 5 Totals 850 73 297 337 66 55 14 8 349 217 54 211 19 98 81 14 33 11 237 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 4th July, 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. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 74 1 22 38 13 .. .. .. 28 22 11 13 .. 28 22 11 13 .. 74 Encephalitis Lethargica 3 .. .. 1 .. .. 1 1 2 1 .. .. .. 1 1 .. .. .. 2 Erysipelas 17 .. .. 2 2 3 8 2 7 6 1 2 1 1 1 .. .. .. 2 Scarlet Fever 65 .. 26 31 7 1 .. .. 31 19 3 11 1 29 19 3 10 1 62 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. 1 Cerebro-Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Measles 307 4 53 182 .. 14 .. .. 148 30 16 90 23 1 3 .. .. 12 16 Whooping Cough 175 16 96 62 .. 1 .. .. 81 75 5 11 3 2 .. .. 2 .. 4 Diarrhœa 7 5 2 •• .. .. .. .. 4 1 1 1 .. .. .. 1 .. .. 1 Ophthalmia Neonatorum 2 2 .. .. .. .. .. .. 1 1 .. .. .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 62 .. 1 11 12 22 16 .. 27 14 8 13 .. 2 .. .. 1 .. 3 „ Non-Pulmonary 16 .. 3 9 4 .. .. .. 4 3 2 5 2 1 1 1 1 .. 4 Pneumonia, Acute Primary, or Acute Influenzal 23 1 1 3 4 7 5 2 7 3 1 11 1 2 1 .. 2 .. 5 Totals 753 29 204 339 96 50 30 5 340 176 48 158 31 68 49 16 30 13 176 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 3rd October, 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. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 105 1 .. 60 7 5 .. .. 48 33 2 20 .. 47 33 2 20 .. 102 Encephalitis Lethargica 5 .. .. 2 1 1 1 .. .. .. 3 2 .. .. .. 2 2 .. 4 Erysipelas 6 .. .. .. 1 2 2 .. 3 2 1 .. .. .. 1 .. .. .. 1 Scarlet Fever 68 1 30 36 .. 1 .. .. 44 14 1 9 .. 39 13 1 9 .. 62 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Enteric Fever 2 .. .. .. .. 2 .. .. 1 1 .. .. .. 1 1 .. .. .. 2 Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 3 .. .. .. 2 1 .. .. 2 1 .. .. .. 2 1 .. .. .. 3 Cerebro- Spinal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 126 3 46 72 4 1 .. .. 65 25 11 25 .. 2 1 1 .. .. 4 Whooping Cough 44 8 27 8 .. 1 .. .. 19 17 1 7 .. 2 .. .. .. .. 2 Diarrhœa 54 21 33 .. .. .. .. .. 41 8 2 3 .. 3 2 2 .. .. 7 Ophthalmia Neonatorum 7 7 .. .. .. .. .. .. .. 1 1 4 1 .. 1 1 2 .. 4 Tuberculosis, Pulmonary 46 .. 2 2 12 22 6 2 14 15 5 10 2 2 3 1 .. .. 6 „ Non-Pulmonary 13 .. 4 7 2 •• .. •• 7 1 2 3 .. 2 .. .. .. .. 2 Pneumonia, Acute Primary, or Acute Influenzal 11 .. 5 1 .. 3 1 1 3 3 2 3 .. .. •• •• .. .. .. Totals 490 41 179 188 29 39 10 4 247 121 31 86 5 100 56 10 33 .. 199 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ended 2nd January 1926. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 16 15 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis 1 .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• Diphtheria 152 4 31 101 12 3 1 .. 51 37 1 60 3 51 37 1 60 3 152 Encephalitis Lethargica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 16 .. .. .. 3 5 6 .. 5 3 3 5 .. 1 .. .. .. .. 1 Scarlet Fever 98 1 28 58 8 2 1 .. 74 4 9 10 1 74 .. 9 10 1 98 Typhus Fever •• .. .. •• .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 4 .. .. 1 1 2 .. .. 4 .. .. .. .. 1 .. •• •• .. 1 Continued Fever .. .. .. .. .. •• .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Cerebro-Spinal Fever 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. •• •• .. 1 Malaria 1 .. .. •• .. 1 .. .. .. .. 1 .. .. .. .. 1 •• .. 1 Dysentery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 1,028 43 533 441 10 1 .. .. 465 317 161 82 3 26 24 15 3 .. 68 Whooping Cough 22 4 17 1 .. .. .. .. 16 .. 2 4 .. 2 .. .. .. .. 2 Diarrhœa 26 16 10 .. .. .. .. .. 16 7 .. 3 .. 2 .. .. 1 .. 3 Ophthalmia Neonatorum 5 5 •• .. .. .. .. .. 6 .. .. .. .. 1 .. .. .. .. 1 Tuberculosis, Pulmonary 45 .. .. 6 8 23 8 .. 12 13 7 12 1 3 .. .. 1 .. 4 „ Non-Pulmonary 23 .. 5 8 5 4 1 .. 11 5 1 5 1 1 1 1 .. .. 3 Pneumonia, Acute Primary, or Acute Influenzal 39 3 14 9 6 7 .. .. 10 9 3 17 .. 2 2 1 6 .. 11 Totals 1,462 77 638 626 53 49 17 2 671 396 188 198 9 166 69 28 81 4 348 BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 52 weeks ended 2nd January 1926. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Greenwich East. Greenwich West. St. Nicholas, Deptford. Charlton. Kidbrooke. Total. Under 1 1 to 5 5 to 15 15 to 25 j 25 to 45 45 to 65 65 and upwards Polio Myelitis 1 .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 Small-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 434 6 115 255 44 13 1 .. 173 127 16 113 5 172 125 16 113 3 429 Encephalitis Lethargica 11 .. 1 3 3 1 2 1 4 1 3 3 .. 3 1 2 3 .. 9 Erysipelas 51 .. .. 3 6 16 19 7 17 16 7 9 2 2 4 1 .. .. 7 Scarlet Fever 304 .. 107 170 17 6 1 .. 189 61 19 33 2 181 59 19 31 .. 292 Typhus Fever •• .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. .. Enteric Fever 8 .. .. 2 1 4 1 .. 6 1 .. 1 .. 3 1 .. 1 .. 5 Continued Fever .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. .. .. .. Puerperal Fever 9 .. .. .. 3 6 .. .. 5 2 .. 2 .. 5 2 .. 2 .. 9 Cerebro-Spinal Fever 3 1 1 1 .. .. .. .. 2 1 .. .. .. 1 .. .. .. .. 1 Malaria 2 .. .. .. .. 2 .. .. .. 1 1 .. .. .. 1 1 .. .. 2 Dysentery 1 .. .. •• 1 .. .. .. 1 •• .. .. .. 1 .. •• .. 1 Measles 1,610 53 656 779 98 24 .. .. 717 396 188 270 39 29 37 16 3 23 108 Whooping Cough 655 94 350 206 .. 4 .. 1 300 195 36 117 7 8 9 1 5 .. 23 Diarrhœa 89 43 46 .. .. .. .. .. 61 18 3 7 .. 5 3 3 1 .. 12 Ophthalmia Neonatorum 15 15 .. .. .. .. .. .. 6 2 2 4 1 2 1 2 2 .. 7 Tuberculosis, Pulmonary 197 .. 3 24 43 85 38 4 72 54 28 40 3 9 4 3 3 .. 19 „ Non-Pulmonary 68 1 16 28 15 7 1 .. 28 14 8 15 3 6 3 2 3 .. 14 Pneumonia, Acute Primary, or Acute Influenzal 97 4 23 18 14 24 8 6 26 20 10 39 2 5 4 2 10 .. 21 Totals 3,555 220 1,318 1,490 244 193 71 19 1,607 910 321 653 64 432 255 68 177 28 960 BOROUGH OF GREENWICH. INFANTILE MORTALITY DURING THE YEAR 1925. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week 1—2 Weeks 2—3 Weeks 3—4 Weeks Total under 1 Month 1—3 Months 3—6 Months 6—9 Months 9—12 Months Total Deaths under 1 Year All Causes. Certified 37 8 8 4 57 17 24 22 15 135 Uncertified .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-Pox .. .. .. .. .. .. .. .. .. .. Chicken-Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. 4 1 5 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 1 3 1 1 6 Diphtheria—Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Pulmonary Tuberculosis .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. 1 .. 1 2 Tuberculous Diseases. Abdominal Tuberculosis 1 .. .. .. 1 .. .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. 1 .. .. 1 Convulsions 1 1 1 .. 3 1 1 1 .. 6 Diseases of Trachea .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. 1 .. 1 6 1 3 1 12 Pneumonia, all forms .. .. 1 .. 2 1 2 6 6 16 Diarrhœal Diseases. Diarrhœa, all forms .. 1 .. .. 1 2 4 3 4 14 Enteritis .. .. .. .. .. 1 1 1 .. 3 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. 1 1 1 .. 3 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlaying .. .. .. .. .. .. .. .. .. .. „ otherwise 1 .. .. .. 1 .. .. .. .. 1 Injury at Birth 1 .. .. .. 1 .. .. .. .. 1 Actelectasis 2 .. .. .. 2 .. .. .. .. 2 Congenital Malformations 6 2 .. 1 11 .. 2 1 .. 14 Premature Birth 19 3 2 1 25 .. 2 .. .. 27 Atrophy, Debility and Marasmus 6 .. I .. 7 3 3 1 1 15 Other Causes .. 1 .. 1 2 1 2 1 .. 6 Totals 37 8 8 4 57 17 24 22 15 135 Boys 83 Girls 52 135