AC 4373 GRE 28 THE ANNUAL REPORT made to THE COUNCIL of the metropolitan Borough or Greenwich For the Year 1927, 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. Fellow of the Royal Institute of Public Health. Fellow of the Institute of Hygiene. MEDICAL OFFICER OF HEALTH TO THE BOROUGH ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, and EXECUTIVE TUBERCULOSIS OFFICER. London: FREAME, MANNING & CO., LTD., 12a, Lee High Road, S.E.13. 1928. THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borough or Greenwich For the Year 1927, 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. Fellow of the Royal Institute of Public Health. Fellow of the Institute of Hygiene. MEDICAL OFFICER OF HEALTH TO THE BOROUGH, ADMINISTRATIVE MATERNITY AND CHILD WELFARE MEDICAL OFFICER, AND EXECUTIVE TUBERCULOSIS OFFICER. London: FREAME, MANNING & CO., LTD., 12a, Lee High Road, S.E.13. 1928. CONTENTS. Pages Public Health Committee 1-2 Maternity and Child Welfare Committee 3 Introductory 4-6 Section I.—Natural and Social Conditions of the Area 7 Vital Statistics 8-20 „ II.—General Provisions of Health Services in the Area 21-27 Laboratory Work 25 „ III.—Sanitary Circumstances of the Area 28-41 „ IV.—Housing 42-44 „ V.—Inspection and Supervision of Food 45-51 „ VI.—Prevalence of, and Control Over, Infectious Diseases 52-75 „ VII.—Maternity and Child Welfare 76-85 1 Public Health Committee during the Year, 1926-7. The Mayor— G. C. Budd, J.P., and 13 Members. Alderman W. O. Willis, K.C. Councillors— M. G. Byerley, F.R.C.V.S. (Chairman). F. Winchcombe (Vice-Chairmen) W. Holland Mrs. P. M. Beacham Mrs. S. H. Mills Mrs. N. Cunis (Nov. to May) F. C. Selfe H. C. Gallehawk Mrs. C. R. Turner, J.P. H. H. Gibbons (May to Nov.) D. A. White nstall Dr. W. R. Hodgkinson, Mrs. M. Woolner C.B.E., M.A. 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; 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. 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 2 (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, 1927. 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 (Consolidation) Act, 1915. Milk and Dairies (Amendment) Act, 1922. Milk and Dairies Order, 1926. Public Health (Condensed Milk) Regulations, 1923. „ „ (Dried Milk) „ „ „ ,, (Meat) Regulations, 1924. „ ,, (Imported Milk) Regulations, 1926. „ ,, (Preservatives, &c., in Food) Amendment Regulations, 1926 and 1927. „ ,, (Smoke Abatement) Act, 1926. 3 Maternity and Child Welfare Committee during the\ year 1926-7. The Mayor— G. C. Budd, J.P., and 14 Members. Councillors — *Mrs. M. Woolner (Chairman) *Mrs. N. Cunis (May to Nov.) *Miss M. Sherman M. C. Matthews, M.A. (Vice-Chairman) *Mrs. S. H. Mills *Mrs. P. M. Beacham Col. A. C. Ralph, D.S.O. *Mrs. F. Carter *Mrs. C. H. Thackeray J. Cummings (Nov. to March) *Mrs. C. R. Turner, J.P. Co-opted Members— *Mrs. E. C. Berry *Mrs. L. M. Jones *Miss C. H. Hervey *Mrs. S. Pridden *Denotes Members who served on The Assistance Sub-Committee. Powers and Duties of the Maternity and Child Welfare Committee. 1.—The Committee shall consist of 14 members, 10 of whom shall be members of the Council, and four selected by the Council from outside that Body. 2.—There shall be referred to the Committee all matters arising out of the powers and duties of the Council under the Maternity and Child Welfare Act, 1918, or any Act or Acts amending the same, or of any Orders or Regulations made under such Act or Acts, and the Committee shall make recommendations to the Council in relation to the matters aforesaid. 4 Public Health Offices, Borough Hall, Royal Hill, Greenwich, S.E.10. May, 1928. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Greemmch. Ladies and Gentlemen, I have the honour to submit herewith the Annual Report as Medical Officer of Health for the year 1927. The Death-Rate is 10.83 per 1,000 of the estimated population. This is .62 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 returned as 11.9 and 12.3 respectively. It is also pleasing to be able to state that the low DeathRate recorded in recent years is being maintained and now is the second lowest among the London Boroughs. This is a particularly gratifying achievement, for it has been my aim and ideal since coming to Greenwich 27 years ago. when the death-rate was 24.1, that this Borough should become the healthiest borough in London. Although there have been many ups and downs in the interim, generally we have held the position of 6th, 7th or 8th amongst the Metropolitan Boroughs. Now it would appear as if the premier position as the healthiest of all the London Boroughs was almost within our reach, Woolwich holding that position with a death-rate of 10.3 per 1,000, whereas Greenwich is only 0.4 behind with a death-rate of 10.7. 5 I am sure this state of things will be gratifying not only to myself but to the Public Health and Maternity and Child Welfare Committees, and the Council generally, and I am strongly of opinion that this great achievement has really been accomplished through the careful attention and painstaking work during the last few years of the staff of the Maternity and Child Welfare Department, and has been particularly aided by the sympathetic treatment which has been meted out by the members of the Maternity and Child Welfare Committee to all applicants for assistance in the way of milk and special foods for children recommended therefor, and it seems to me that it would be quite worth while for this Council to be willing to pay the whole of the cost of the special milk supply for the children should the Ministry of Health decline to assist in that matter, so that our high position in this respeot may not only be maintained, but if possible improved upon. The Birth Rate is 16.27 per 1,000, and is the lowest ever recorded. Last year the Birth Rate was 17.75 and the average for the last 10 years 20.06. The Birth Rate for the County of London is 16.1 and 16.7 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 53 compared with 61 last year. The rates in the various Metropolitan Boroughs varied from 38 in Holborn, 43 in Woolwich, 45 in Lewisham, 49 in Hampstead, 51 in Finsbury and Wandsworth. 52 in Camberwell, up to 66 in Stepney, 67 in the City of Westminster and Fulham, 73 in Shoreditch, 74 in Chelsea. 78 in Paddington and 96 in the City of London. The rate foi England and Wales is 69. and for the County of London 59. The Zymotic Death Rate of .36 per 1,000 is slightly lower than last year's figure of .40. 6 The figures relating to the different constituent parts of the Borough are as follows:— Districts Birth Rate Death Rate Infantile Mortality per 1000 Births. Zymotic Death Rate Diarrhoea and Enteritis Death Rate (under 2 yrs.) Consumption Death Rate East Greenwich 15·69 10·59 59 ·49 ·13 ·70 West Greenwich 15·76 11·48 49 ·40 ·07 1·14 St. Nicholas, Deptford 24·44 11·11 63 ·38 — ·38 Charlton 16·00 10·66 45 — — ·52 Kidbrooke 9·73 9·16 — — — — Whole Borough 16·27 10·83 53 ·36 ·07 ·75 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 Measles East Greenwich 0· 00 3·82 4·26 ·42 ·06 2·31 West Greenwich 0·00 5·15 5·36 ·44 ·03 ·37 St. Nicholas, Deptford 0·00 5·24 3·59 1·79 — ·14 Charlton 0·00 3·93 4·76 ·62 ·14 5·47 Kidbrooke 0·00 3·64 6·08 1·80 ·30 ·60 Whole Borough 0·00 4·30 4·66 ·61 ·07 2·24 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 of the various Maternity and Child Welfare Centres. I am, Ladies and Gentlemen, Your obedient Servant, E. G. A.nnis. 7 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, 1927 103,700 Density of Population- East Greenwich 34.46 persons per acre West Greenwich 59.85 „ St. Nicholas, Deptford 67.82 ,, Charlton and Kidbrooke 12.04 ,, Average for the Borough ... 26-87 persons per acre Number of Inhabited Houses— Structurally separate dwellings at Census, 1921 16,526 1927 17,987 Number of Uninhabited Houses— At Census, 1921 288 Estimated, 1927 110 Number of Families or Separate Occupiers— At Census, 1921 22,972 Rateable Value £882,636 Sum Represented by a Id. Rate £3,626 8 VITAL AND MORTAL STATISTICS, 1927. POPULATION. The population of the Borough estimated to the middle of the year 1927 is 103,250 for Death Rate and 103,700 for Birth Rate. These figures have been revised and are lower than those which were in operation last year. This has been found necessary in consequence of certain information acquired by the Registrar-General regarding migration. The population according to the Registrar-General's estimate is 101,920 for Death Rate and 102,820 for Birth Rate, which figures in my opinion are too low. The following is the distribution of the population throughout the Borough and upon which the statistics in this Report are based:— Census 1921 (Adjusted) Estimated Population at middle of year 1927. For Death Rate. For Birth Rate. East Greenwich 44,647 44,604 44,798 West Greenwich 26,931 26,996 27,114 St. Nicholas, Deptford 7,646 7,764 7,798 Charlton 18,959 20,603 20,693 Kidbrooke 3,217 3,283 3,297 Total 101,400 103,250 103,700 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. *Births Legitimate 1,623 806 817 *Birth Rate 16·2 Illegitimate 63 27 36 Deaths 1,115 576 539 * Death Rate 10·7 *Number of women dying in, or in consequence of, childbirth From Sepsis 2 „ other causes 2 * Deaths of Infants under one year of age per 1,000 births:— Legitimate, 53; Illegitimate, 47. Total Rate = 53. Deaths from Measles (all ages) — ,, „ Whooping Cough (all ages) 16 ,, „ Diarrhœa (under 2 years of age) 8 * These figures, which are supplied by the Registrar-General, differ slightly from those shown in other parts of the Report. 9 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. The following table shows these particulars, giving the number of marriages in Greenwich and St. Nicholas, etc., for each year since 1914:— Year In Churches of England in Greenwich Charlton & Kidbrooke St. Nicholas Parish Church Marriages in Superintendent - Registrar's Office of parties resident in Greenwich or outside the Registration District, and in Chapels and Roman Catholic Church in St. Nicholas & Greenwich Total Approximate Population of the districts concerned In Churches of England In Non-Conformist Churches 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 1926 382 95 11 48 260 796 104500 1927 388 91 6 45 233 763 103700 BIRTHS. The total number of births registered in the Borough during the year was 1,912. Of this number 335 occurred in Greenwich and Deptford Hospital and 427 at various Nursing Homes within the Borough. Of this total of 762 Institution births, 383 only belonged to Greenwich, the remainder being transferred to the appropriate localities. One hundred and fifty births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 1,683:—Males, 837; Females, 846. 10 This figure gives a Birth Rate of 16.27 per 1,000 of the population, which is 3.79 below the average for the last ten years and the lowest ever recorded. The Birth Rate for the County of London equals 16.1 per 1,000 of the population. The Birth Rate for all England and Wales was 16.7 and 17.1 for the 107 large towns. Illegitimate births numbered 63, representing 3.7 per cent. of the total births. Sixty-five illegitimate births actually were registered in the Borough. In 21 cases, however, the mothers were ordinarilyresident outside the Borough, and these births were consequently allocated to the correct area. 19 illegitimate births belonging to Greenwich occurred outside the Borough, thus giving the net figure of 63. Twenty-nine illegitimate births occurred in the Greenwich and Deptford Hospital. Under the Births and Deaths Registration Act, 1926, which came into operation on the 1st July, 1927, the registration of stillbirths was made compulsory. It is therefore not possible to record any accurate figure for the year under review, but under the Notification of Births Act, 1907, 82 intimations were received of stillbirths occurring in the Borough. Under the provisions of the Notification of Births Act, 1907, intimations have been received from medical men, parents and others, with respect to 1,995 births. DEATHS. The nett number of deaths registered during 1927 was 1,115, of which 579 were males and 536 females. The crude Death Rate for the Borough, 10.83 per 1,000, is the lowest recorded since the inception of the Borough and compares favourably with 11.9 and 12.2, the respective Death Rates for the County of London and the 107 large towns. The Quarterly Tables of Causes of Deaths shown in the Appendix of this Report differ slightly from those hitherto recorded in past years, and follow the classification of the Registrar General's Short List taken from the Manual of the International List of the Causes of Death, a copy of which 11 was circulated to Medical Officers of Health early in the year. It therefore follows that retrospective comparison with certain classes of diseases will not be possible. For example, in the new classification are to be found Cerebral Haemorrhage, Diabetes, Arterio-sclerosis, Ulcer of the Stomach, all of which diseases were formerly included under the heading "other defined diseases." Again, deaths due to myocardial degeneration were similarly placed in the latter category, whereas now they are assigned to Heart Disease, and thus the number of deaths attributable to this cause is increased to an appreciable extent. The Births and Deaths Registration Act, 1926, came into operation on 1st July, 1927, and amends the law relating to certification of deaths and disposal of the dead. A certificate of cause of death can be given only by a registered medical practitioner in the prescribed form supplied by the RegistrarGeneral through the Registrars of Births and Deaths. Formerly a person was required to give the certificate to some person required to give information for the purpose of registering the death. Now, however, the practitioner is required to deliver the cerlificate to the Registrar direct. Changes have been made also relating to the particulars of the cause of death. A new form of Certification of Death was introduced for use by medical practitioners. The form was drawn up after consultation between the Registrar-General and representatives of leading bodies of the medical profession with the object of making the official records of the causes of deaths a more exact summary of the opinions expressed in the certificate than hitherto. Formerly where several causes of death were recorded on the certificate it was sometimes a matter of difficulty in deciding which was the particular cause of death for classification purposes. It is hoped that the new form will assist in remedying this state of affairs, particularly so since a note is made on the form drawing the Medical Practitioner's attention to the fact that the actual cause of death should be certified and not the mode of dying which is so frequently done. The following table showing causes of death at all ages has been supplied by the Registrar-General, and is included in accordance with the request contained in the Ministry of Health's Circular No. 834:— 12 Causes of Death. Sex Deaths at Subjoined ages of "Residents," whether occuring within or without 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 under 75. 75 and over. All Cause M 576 58 15 13 13 27 73 163 108 106 F 539 32 11 14 26 25 62 129 104 136 Enteric Fever M 1 ... ... ... ... ... 1 ... ... ... F ... ... ... ... ... ... ... ... ... ... Small-Pox M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Measles M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Scarlet Fever M 1 ... ... ... 1 ... ... ... ... ... F 1 ... ... ... 1 ... ... ... ... ... Whooping Cough M 7 3 3 1 ... ... ... ... ... ... F 9 3 5 1 ... ... ... ... ... ... Diphtheria M 4 ... ... 3 1 ... ... ... ... ... F 7 ... ... 1 5 1 ... ... ... ... Influenza M 12 1 1 ... ... ... 2 3 3 2 F 15 ... ... ... ... ... 3 5 2 4 Encephalitis Lethargica M 1 ... ... ... ... ... 1 ... ... ... F ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis M ... ... ... ... ... ... ... ... ... ... F 1 ... ... ... 1 ... ... ... ... ... Tuberculosis of Respiratory System M 44 ... ... ... ... 7 23 11 2 1 F 37 ... ... ... 3 8 17 9 ... ... Other Tuberculous Diseases M 10 ... 2 1 1 2 2 2 ... ... F 13 2 ... 2 4 3 1 1 ... ... Cancer, malignant disease M 72 ... ... ... ... ... 10 31 23 8 F 60 ... ... ... ... 1 6 26 17 10 Rheumatic Fever M 2 ... ... ... ... ... 1 1 ... ... F 3 ... ... ... 1 ... 2 ... ... ... Diabetes M 4 ... ... ... 1 1 ... 2 ... ... F 6 ... ... 1 ... ... 1 1 2 1 Cerebral Hæmorrhage, &c. M 19 ... ... ... ... ... ... 5 5 9 F 30 ... ... ... ... ... 1 6 10 13 Heart Disease M 83 ... ... ... 2 2 4 30 23 22 F 85 1 ... ... 2 2 7 21 25 27 Arterio-Sclerosis M 43 ... ... ... ... ... 1 14 13 15 F 20 ... ... ... ... ... ... 4 4 12 Bronchitis M 35 ... 1 1 ... ... 1 9 10 13 F 39 l ... 1 ... ... ... 6 12 19 Pneumonia (all forms) M 45 11 4 4 ... 3 4 9 7 3 F 29 3 4 5 ... 1 4 1 6 5 Other Respiratory Diseases M 5 ... ... ... ... ... 2 2 1 ... F 3 ... ... ... ... ... ... 2 ... 1 Ulcer of Stomach Duodenum M 11 ... ... ... ... ... 3 8 ... ... F 5 ... ... ... ... 3 2 ... ... Diarrhæa, &c. M 6 5 ... ... ... ... ... 1 ... F 8 4 ... ... ... ... ... 2 ... 2 Appendicitis M 4 ... ... ... 2 2 ... ... ... ... F 3 ... ... ... ... 2 1 ... ... ... Cirrhosis of Liver M 2 ... ... ... ... ... ... ... 2 ... F 1 ... ... ... ... ... ... 1 ... ... A. & Cr. Nephritis M 14 ... ... ... ... ... 3 6 3 2 F 15 ... ... ... ... 1 ... 6 7 1 Puerperal Sepis M ... ... ... ... ... ... ... ... ... ... F 2 ... ... ... ... 2 ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturitior. M ... ... ... ... ... ... ... ... ... ... F 2 ... ... ... ... ... 2 ... ... ... Congenital Debility and Malformation, including Premature Birth M 30 29 ... 1 ... ... ... ... ... ... F 13 13 ... ... ... ... ... ... ... ... Suicides M 8 ... ... ... ... ... 4 2 1 1 F 5 ... ... ... ... ... 1 4 ... ... Other Deaths from Violence M 29 1 ... 2 3 5 2 9 4 3 F 14 ... ... 1 3 ... 2 3 3 2 Other Defined Diseases M 84 8 4 ... 2 5 9 19 10 27 F 113 5 2 2 5 4 11 29 16 39 Diseases ill-defined or unknown M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 13 The following table which is compiled by the RegistrarGeneral shows at a glance the relative position occupied by Greenwich with other Boroughs in London:— Borough. Rate per 1000 population Borough. Rate per 1000 Population. Woolwich 10.3 Battersea 11.8 Greenwich 10.7 Stoke Newingtom 11.8 Lewisham 10.8 St. Pancras 11.9 F ulham 11.0 Islington 12.0 Bethnal Green 11.1 Holborn 12.0 Camberwell 11. 1 Lambeth 12.2 Deptford 11.1 Shoreditch 12.2 Wandsworth 11.2 Hammersmith 12.5 Hackney 11.3 Bermondsey 12.6 Stepney 11.4 Paddington 12.8 Poplar 11.5 Finsbury 12.8 City of London 11.5 Southwark 12.9 St. Marylebone 11.5 Kensington 13.1 Hampstead 11.6 Chelsea 13.5 City of Westminster 11.7 Locally the Death Rate varied from 9.16 in Kidbrooke, 10.59 in East Greenwich, 10.66 in Charlton, 11.11 in St. Nicholas, Deptford, up to 11.48 in West Greenwich. Of the total number of deaths, 5 under five years of age were of illegitimate birth, 3 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 1922 to 1926, compared with the figures for 1927. District. 1922 1923 1924 1925 1926 Average for 5 years. 1927 East Greenwich 11· 26 10·43 11·14 10·87 10·82 10·90 10·59 West Greenwich 15·27 12·97 11·84 12·45 12·24 12·95 11·48 St. Nicholas, Deptford 17·61 12·58 11·77 12·63 14·22 13·76 11·11 Charlton 11·68 8·74 12·41 11·36 8·89 10·61 10·66 Kidbrooke 12·38 10·47 6·61 6·09 5·45 8·20 9·16 Borough 12· 92 10· 95 11·47 11·36 10·89 11·51 10·83 14 DEATHS IN INSTITUTIONS. The following table shows the number of deaths of Greenwich residents in Public Institutions during the last six years:— Year Total Deaths of Greenwich Residents Total Deaths of Greenwich Residents in Public Institutions 1922 1,313 600 1923 1,119 546 1924 1,200 565 1925 1,173 621 1926 1,130 600 1927 1,115 607 Average 1,175 589 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 33 20 17 20 90 Between 1 and 2 years 16 5 3 2 26 Between 2 and 5 years 9 7 5 4 24 Between 5 and 15 years 13 10 9 8 40 Between 15 and 25 years. 17 16 12 11 56 Between 25 and 15 years 48 26 25 31 130 Between 46 and 65 years 102 63 53 73 291 65 years and upwards 164 102 77 114 457 Total 402 249 201 263 1,115 15 INFANTILE MORTALITY. The Infantile Mortality Rate measured by the deaths of children under one year of age to the number of births registered, was 53 per 1,000 births, as compared with 62, the figure for last year, and is the lowest yet recorded. The total number of deaths during the year was 90, as compared with 154, 135 and 114, the respective figures for the years 1924, 1925 and 1926. This figure of 90 is even more striking when compared with lhat of ten years ago, when it was over 200. 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 59, compared with 64 in 1926, 67 in 1925 and 69 in 1924. For England and Wales the rate, was 69, compared with 70 in 1926, 75 in 1925 and 75 in 1924. Locally the variations were from 45 per 1,000 births in Charlton, 49 in West Greenwich, 59 in East Greenwich, to 63 in St. Nicholas. Deptford. The following table shows at a glance these figures since the formation of the Borough:— District. Average for five years, 1901-1905, inclusive. Average for five years, 1906-1910, inclusive. Average for five years, 1911-1915, inclusive. Average for five years, 1916-1920, inclusive. Average for five years, 1921-1925, inclusive. 1926. 1927. East Greenwich 129 106 96 81 62 63 59 West Greenwich 126 110 112 110 80 66 49 St Nicholas, Deptinrd 179 143 167 138 88 79 63 Charlton 121 109 76 89 66 48 45 Kidbrooke 39 79 16 39 13 — — Borough 131 111 103 95 66 61 53 16 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Epidemic.—There were 56 deaths due to this class of disease, equalling a Death Rate of .54 per 1,000; the rate last year was .54, and was .71, 1.34 and .58 in 1923, 1924 and 1925 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 38 deaths, equalling a Death Rate of .36 per 1,000. Locally the Zymotic Death Rate varied from .04 in Charlton (.04 in 1926), .38 in St. Nicholas (1.02 in 1926), .40 in West Greenwich (.14 in 1926). to .49 in East Greenwich (.08 in 1926). Small-Pox.—There were no deaths from Small-Pox, this being the twenty-fifth year since a death occurred from this cause in the Borough. Measles.—There were no deaths ascribed as due to this disease, this being the first occasion since the inception) of the Eorough that no deaths have occurred. The number of deaths recorded last year was 13, and in the years 1923, 1924 and 1925, 2, 28 and 21 respectively. Scarlet Fever.—This disease occasioned 2 deaths, both of which occurred in East Greenwich. Two such deaths occurred in 1924, 3 in 1925 and 1 in 1926. Whooping Cough.—This disease was given as the cause of 16 deaths, with a death rate of .15 per 1,000. There were 4, 15 and 16 deaths respectively in the years 1926, 1925 and 1924. Nine deaths occurred in East Greenwich, 3 in West Greenwich, 3 in St. Nicholas and 1 in Charltoni. Diphtheria.—There were 11 deaths during the year. This gives a death rate of .10 comparing with .11 for the previous year. Twelve deaths occurred in 1926, 14 in 1925 and 1924. Four of the patients were under five years of age. Typhoid Fever.—There was one death ascribed to this disease, which occurred in West Greenwich, there were 6 in 1923, 1 in 1924, 1925 and 1906 respectively. 17 Diarrhœa, Dysentery, and Zymotic Enteritis. —Eight deaths were said to be due to these causes, equalling a rate of •07 per 1,0C0. Last year there were 12 deaths, and 12 in 1924 and 1925 respectively. Influenza.—Influenza is found to have been the responsible cause of 18 deaths ; 16 was the average for the previous three years. Eight cases were over 65 years of age. The deaths were equally distributed in East Grce.iwich, West Greenwich and Charlton districts. Tuberculosis. This class includes the causes of 100 deaths during the year under review, with a rate of .97 ; these figures compare with 127, 117 and 117, the totals of the years 1924, 1925 and 1926 respectively, and the respective rates of 1.21 and 1.12. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the ma jor portion of these deaths, there being 78 attributed to this cause, or a rate of .75 per 1,000. Locally the deaths were 3 in St. Nicholas, Deptford (giving a De&th Rate of 38), 32 in East Greenwich (Death Rate 70), 11 in Charlton (Death Rate .52), 31 in West Greenwich (Death Rate 1.14), and 1 in Kidbrooke (.30). The remaining forms of Tuberculosis were responsible for 22 deaths, 8 of which occurred in East Greenwich, 7 in West Greenwich, 4 in Charlton, 2 in St. Nicholas and 1 in Kidbrooke. Cancer. This disease is again the chief cause of death, with a total of 133 deaths for the year. The following Table is designed to show the seats of the disease at various ages in the different districts of the Borough:— 18 CANCER. Year 1927 MALE. Buccal Cavity Oesophagus Stomach Liver and Gall Bladder Intestines Rectum Prostate Glands Other Organs Total 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. 25—45 yrs. 45—65 yrs. 65 & over. East Greenwich ... 2 1 ... 1 2 1 4 2 ... 1 2 ... 1 1 ... 1 ... ... 1 ... 2 2 3 27 West Greenwich ... 3 ... ... 2 1 1 3 4 ... ... ... ... ... ... ... ... 1 ... ... 2 1 ... 2 20 St Nicholas ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 5 Charlton ... 1 1 ... ... 1 1 3 3 ... ... ... ... 1 2 1 1 ... ... ... ... 2 ... 2 19 Kidbrooke ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Whole Borough ... 7 2 ... 4 4 3 11 9 ... 2 2 ... 2 4 1 3 1 ... 1 2 5 2 7 72 FEMALE. (Same age periods) Breast Genital Organs Other Organs East Greenwich ... 1 1 ... 1 ... 1 ... 1 1 ... ... ... 1 2 ... ... 1 2 ... 4 1 2 2 ... 2 ... 23 West Greenwich ... ... 1 ... ... 1 ... 2 1 ... ... ... ... 1 3 ... ... 1 ... 2 ... 1 2 1 ... 1 ... 17 St, Nicholas ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Charlton ... ... ... ... ... ... ... 4 2 ... ... ... ... ... 2 ... 1 ... 1 ... ... ... 3 1 ... ... ... 14 Kidbrooke ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 ... ... ... 5 Whole Borough ... 1 2 ... 1 1 1 8 6 1 ... ... ... 3 7 ... 1 2 3 2 4 2 7 6 ... 3 ... 61 Total Deaths 133. 19 During the year the Public Health Committee took into their serious consideration the circulars which from time to time have been issued by the Ministry respecting Cancer, particularly Circular 716, when it was decided, with the consent of the Ministry of Health that a Tumour Diagnostic Consultation should be started, to be held on one evening weekly at the Tuberculosis Dispensary, Maze Hill, when one of the Council's Medical Officers should be present with a view to seeing patients in the first place, writing up the medical histories, etc., whereupon suitable cases should be seen by Mr. Davies-Colley, C.M.G., one of the Surgeons of Guy's Hospital, either at the Consultation or by special arrangement at the surgeon's own consulting rooms. This Diagnostic Clinic was opened on October 6th, since which date to the end of the year, there have been 19 cases attending for diagnosis. The chief difficulties we have experienced up to the present time are, first, the difficulty of sufficiently and appro priately advertising these facilities, and secondly, the greatest difficulty of all is overcoming the unwillingness of persons thinking there is a possibility of their being the subjects of Cancer in the early stage and definitely having this information given them—what might be termed "cancerphobia." More recently we have been able to adopt an improved system of advertising the clinic and latterly patients have attended in slightly larger numbers. I have again been giving serious consideration to this question, and particularly in view of a paper by Professor W. Blair Bell, B.S., M.D., London, Professor of Obstetrics and Gynaecologist, Liverpool, who is distinctly of opinion that instrumental interference in obstetric practice is a large factor in predisposing to cancer of the womb in women, and I have been anxious to devise some means by which this question could be more thoroughly illustrated in connection with this disease in Greenwich. Unfortunately, one is met with the particular difficulty in London of the dual control, and as I am not able to obtain the necessary assistance from the London County Council in this matter, I have not been able to pursue the enquiries which are desired. I have discussed this matter very thoroughly with our Maternity and Child Welfare Medical Officer, and his suggestion is that useful information might be obtained and probably the harmful practice of unnecessary interference at labour somewhat restricted, if a fee were offered for the notification by medical men of every case of labour attended by them when no operative measures were undertaken by them. 20 MORTUARY. The Council's Mortuary was erected in 1904, and is situate adjacent to the Coroner's Court in Lamb Lane. The number of bodies dealt with since 1915 is shown below:— Year Drowned Bodies from River Other Bodies Total 1915 16 194 209 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 1926 23 214 237 1927 9 275 284 21 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) Two General Wards with 9 beds each. (3) Small Ward with 2 beds. (4) Isolation Ward with 1 bed. (5) Two Labour Wards. (6) Medical Officers' Room, Laundry, etc., together with residential accommodation for Matron. (Nurses, Probationers and Domestic Staffs accommodation is situate at 105, Shooter's Hill Road, which is opposite the Maternity Home). (3) Children.—No hospital is provided by Council, but arrangements are 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, Lewi sham, 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. The only M.A.B. Hospital in the Borough is situate at Shooters Hill Road, near the Woolwich boundary. 22 Institutional Provision for Unmarried Mothers, Illegitimate Infants and Homeless Children. No provision is made by the Council, but Dr. Barnardo's Homes National Incorporated Association have Finchley Lodge, St. John's Park, Blackheath, used for this and similar purposes. Ambulance Facilities. (a) Patients suffering from Infectious Diseases are conveyed 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, Shooter's 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 Armada Street Mission Hall, Deptford. Large Hall and consulting room Ditto Once weekly Charlton Vale Missio-i Hall, Woolwich Rd , Charlton. Large Hall consisting of waiting and weighing room and consulting room Ditto Once weekly (6) Pre- Maternity Borough Hall. (See above) Ditto Once weekly 105, Shooter's Hill Road, S.E. ( Do. ) Ditto Once weekly Conduit House, Trafalgar Rd., E. Greenwich. ( Do. ) Ditto Once weekly Charlton Vale Mission Hall, Woolwich Rd., Charlton. ( Do. ) Ditto Once weekly (c) 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 Park Row, Greenwich. Whole House Local Medical Practitioners Daily Ditto Health Clinic, Deptford Green, S.E. Several Rooms Miss Margaret McMillan Daily Tuberculosis Dispensary, 7a, Maze Hill, Greenwich. Consulting Room and Dentist's Surgery. Separate Waiting and Cloak Rooms for Men and Women Patients, Nurse'5 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 Tumour Diagnostic Consultation Dispensary, 7a, Maze Hill, Greenwich. Consulting and Waiting Rooms Local Authority Once weekly PUBLIC HEALTH STAFF. The following changes in the personnel of the Staff took place during the year. Mr. W. H. Collins was appointed as Sanitary Inspeclor in place of Mr. A. E. Bache, who retired in April on reaching the age limit under the Council's Superannuation Act. Mr. Bache, who was a very conscientious officer, had been in the service of the Council and its predecessors for 34 years. Mr. G. Longley was appointed a Grade "A" Clerk in place of Mr. A. G. Thomas, who resigned on taking up an appointment of Sanitary Inspector at Godstone. 25 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 Diarrhoea, Malaria and Pneumonia, upon an intimation from the Public Health Department. The Council's Health Visitors also give advice and assist as far as possible. Midwives.—No district 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 2,916 specimens have been examined for Diphtheria, 15 for Typhoid Fever, 389 for Tuberculosis, and 50 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. Twenty-eight tubes of Diphtheria Anti-toxin, containing a total of 224,000 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 455 Greenwich persons for an average of seventeen days each, in addition to which there have been 3,240 Out-patients, making approximately 9.720 attendances of persons belonging to the Borough of Greenwich. The number of Out-patients for the previous year was 4,280, which shows a decrease of over 1,000. with a corresponding decrease in the number of Out-patient attendances. 26 Miller General Hospital admitted, treated and maintained 421 Greenwich persons for an average of twenty days as against 339 last year. 7,744 Out-patients have also been treated, the total attendances being approximately 44,165. Blackheath and Charlton Cottage Hospital admitted 255 In-patients from Greenwich, the average duration of stay being 25 days ; and also treated 712 Out-patients who made 3,286 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 31st December, 1927:- Greenwich Parish St. Nicholas Deptford Charlton and Kidbrooke Parish Total number of families in receipt of out-door relief 2,339 951 820 Total amount expended in out-door relief £81,728 £18,277 £16,732 Total number of persons treated in Hospital 2,335 240 175 Total number of persons treated medically in their own homes 1,200 100 371 Total number of persons admitted to the Workhouse 541 65 24 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). 27 By-Laws made under Public Health (London) Act, 1891, Sec. 39 (2). By-Laws made under Public Health (London) Act, 1891, Sec. 50. By-Laws made under Public Health (London) Act, 1891, Sec. 94. By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Plans). By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Drainage). By-Laws made under London County Council (General Powers) Act, 1903, Sec. 54. Provisions of L.C.C. (General Powers) Act, 1902, as to Ice Creams. By-Laws made by London County Council under Public Health (London) Act, 1891, and Sec. 6 of the Housing Act, 1925. 28 SECTION 3. SANITARY CIRCUMSTANCES OF THE AREA. The tables on pages 29 to 31 and 34 to 41 summarise, as far as possible, the Sanitary work of the Department ; from this it will be seen that a total of 19,330 houses and premises have been inspected or re-inspected during the year ; 1,120 intimation notices and 148 statutory notices have been served. It is very gratifying to be able to report that only in five instances was it found necessary to institute Police Court proceedings during the year, particulars of which are contained in the table on page 38- There were altogether,throughout the year 474 complaints registered. Factories, Workshops and Workplaces.—One hundred and eighty-eight 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 214 factories, 118 workshops and 37 wharves and quays. Outworkers' Register.—Eight lists, containing 24 names and addresses have been received from employers within the district. In addition to this 50 lists containing 127 names and addresses of Outworkers residing in this Borough were received from Medical Officers of Health of other Boroughs, whilst 5 lists with 7 names and addresses were forwarded to other districts, thus giving a total of 144 Outworkers in the Borough. 177 visits of inspection have been paid to these premises. 29 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises Number of Inspections Written Notices Prosecutions Factories 64 ... ... Workshops (including Workshop Laundries) 54 3 ... Workplaces (Other than Outworker's Premises) 70 2 ... Total 188 5 ... 2.—DEFECTS FOUND. Particulars Number of Defects Number of Prosecut's Found Remedied Referred to h.m Inspector *Nutsances under the Public Health Acts— Want of Cleanliness 6 6 ... ... Want of Ventilation 1 1 ... ... Overcrowding ... ... ... ... Want of Drainage of Floors ... ... ... ... Other Nuisances 18 18 1 ... Sanitary Accommodation— Insufficient 4 4 ... ... Unsuitable or Defective 2 2 ... ... Not Separate for Sexes. 1 1 ... ... Offences under the Factory and Workshops Act— Illegal Occupation of Underground Bakehouse Is. 101) ... ... ... ... Other Offences 31 31 ... ... Total 63 63 1 ... * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 30 3.—HOME WORK. Nature of Work Outworker's Lists, Section 107. Outwork in unwholesome premises. Sec. 108 Outwork in infected premises. Sees. 109 & 110 Lists received from Employers Notices served on occupiers as to keeping or sending lists Prosecutions Instances Notices served Prosecutions Instances Orders made (Sec. 10) Prosecutions (Sees. 109 & 110) Twice in the Year Once in the Year Failing to keep or permit inspection of lists Failing to send lists Lists Outworkers Lists Outworkers Contractors Wormen Contractors Workmen Wearing Apparel (1) Making, etc. 8 ... 24 ... ... ... ... ... ... ... ... ... ... ... ... (2) Cleaning and Washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, Lace Curtains and Nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur Pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper Bags and Boxes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cotton and Kit Bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Box Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rackets and Tennis Balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed Toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 8 — 24 - — — — — — — — — — — — 31 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1927. No. Bakehouses 37 Factory Bakehouses 5 Barge Builders 11 Blacksmiths 3 Boot and Shoe Makers 9 Builders' Yards 2 Carpenters and Joiners 5 Carriage Builders 5 Coopers 2 Cycle Works 5 Dress and Mantle Makers 8 Engineers 2 Electrical Engineers 2 Fuel Works 1 Furniture 2 Laundries 1 Milliners 2 Monumental Masons 2 Motor Vehicle Repairers 5 Photographers 2 Picture Frame Makers 1 Plumbers 2 Tailors 13 Others 18 145 5.—OTHER MATTERS. Class. No. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5) :— Notified by H.M. Inspector 2 Reports (of action taken) sent to H.M. Inspectors 2 Other 1 Underground Bakehouses (sec. 101):— In use at end of 1927 13 Smoke Nuisances. — Thirty - one observations have been made for smoke nuisances during the year, but in no instance was it found necessary to serve a Statutory Notice. Water Supply.—During the year 188 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. 18 water supplies have been reinstated where the supply had been cut off ; water fittings have been amended in 127 cases ; 4 water supplies have been altered so as to draw direct from the main, and covering cisterns in 174 cases. 32 House Drainage. — One hundred and seven drainage systems have been reconstructed or repaired; 399 such systems have also been opened, cleansed and amended; 39 drains and soil pipes have been ventilated; 280 systems have been tested by smoke, 290 by water, of which number 140 were found to be defective; 27 new soil pipes and 210 traps have been fixed, together with 26 intercepting chambers and fresh-air inlets, and 90 other chambers constructed. Thirty-two new covers to manholes have been provided; 33 systems have been sealed off or slurried up; 38 yards and forecourts drained; 84 water-closets have been erected; 59 cleansed; 100 w.c. doors and seats repaired or provided; pan and traps have been furnished in 250 cases ; and other fittings provided or improved in 196 cases, whilst the flushing apparatus has been amended in 436 instances. Public-house urinals have been cleansed and repaired in 31 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 occasioins and the cleansing of the premises duly carried out. Public Sanitary Conveniences. The following are the underground sanitary conveniences in the Borough:— Blackwall Lane, East Greenwich; South Street, Greenwich; Creek Road, St. Nicholas, Deptford; Blackheath Hill (foot of); Batley Park, Blackheath. Houses Let in Lodgings.—The new Bye-laws made by the London County Council under Section 6 of the Housing Act, 1925, came into operation on the 5th March, 1926. One hundred and nineteen houses have been registered and 249 inspections made upon such premises. Rats and Mice (Destruction) Act, 1919.—Complaints as to rat infestation and cases coming to the notice of the Department are forthwith investigated. Advice and assistance are given where necessary. Three hundred and sixty-seven such 33 investigations were made by the Council's Officers, but in no case was it necessary to serve a Notice. The usual procedure was adopted in regard to "Rat Week," particulars of which have been dealt with in previous Reports. Verminous Premises.—As a means of assisting occupiers in the more densely populated parts of the Borough in ridding their premises of vermin, a supply of a special fluid known as "Vermicine," is kept at the Borough Hall, and is supplied, together with the use of a sprayer, to occupiers whose premises have been reported upon by the Sanitary Inspector. Applicants are required to bring their own bottles, and leaflets are distributed stating in simple language the method to be adopted. During the year 160 gallons were given to approximately 1,200 applicants. There is no doubt the procedure outlined above has been of material help in dealing with this difficult problem. Increase of Rent and Mortgage Interest Restrictions Acts, 1920 and 1923.—Four applications were received during the year from tenants for certificates under these Acts. In each case the Certificate was granted. Scavenging and Refuse Disposal.—The collection of house, etc., refuse in the Borough is under the control of the Borough Surveyor, who has kindly supplied me with the the following information relating to the disposal of refuse. The approximate amount of refuse collected in the Borough during the year ended 31st December, 1927, was 20,690 tons, giving an average daily collection of 80 tons. Of the total refuse collected, the Refuse Disposal Plant dealt with approximately 9,965 tons, giving a daily figure of about 38 tons. The remainder of the refuse was disposed of by barging and tipping. A full description of the Screen and Disposal Plant was given in the Annual Report for 1925. 34 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1927. 1st Qtr. 2nd Qtr. 3rd Qtr. 4 th Qtr. Total Inspections. Houses Inspected (House to House) ... 35 12 5 52 ,, ,, Complaints, Nuisances 415 430 632 613 2150 Other Premises Inspected 180 123 100 192 595 Re-inspections, Calls Made, etc. 3650 3937 2651 3411 13649 Inspections of Houses Let in Lodgings 62 94 42 51 249 ,, Bakehouses 13 28 6 41 88 ,, Factories, Workshops and Workplaces 44 32 28 34 138 ,, Outworkers' Premises 45 52 20 60 177 „ Slaughterhouses 10 2 6 19 37 ,, Cowhouses ... ... 1 ... 1 ,, Stables and Yards 14 13 8 15 50 ,, Piggeries ... 1 ... ... 1 „ Courts and Alleys 2 1 ... ... 3 „ Fields, Lanes, etc. 10 8 3 9 30 ,, Urinals 16 10 6 17 49 ,, Gipsy Vans 20 ... ... ... 20 „ Horse Slaughterhouses 1 1 1 1 4 „ Dairies, Cowsheds and Milkshops 14 50 54 14 132 „ Soap Boilers 1 ... ... 1 2 ,, Other Offensive Trades ... 2 7 4 13 „ Ice Cream places ... 35 43 1 79 „ Other places where food is prepared or stored 308 353 310 473 1444 Investigations (Rats and Mice) 70 54 135 108 367 Total 4875 5261 4125 5069 19330 Drains. Intercepting Chamber 8 8 4 6 26 Other Chambers Constructed 22 34 13 21 90 Reconstructions and Additions 35 34 22 16 107 Opened, Cleansed and Amended 52 137 111 99 399 Traps Fixed 70 27 50 63 210 New Soil Pipes 6 10 9 2 27 Soil and Vent Shafts Repaired ... 8 5 11 24 Drains and Soil Pipes Ventilated 21 6 10 2 39 Drains Sealed off, etc. 11 5 10 7 33 Drains tested—by Smoke 78 60 70 72 280 „ by Water 71 94 81 44 290 Found Defective 19 54 50 17 140 New Covers to Manholes 8 13 7 4 32 Yards Drained 34 1 ... 3 38 Washhouses Drained 1 ... ... ... 1 Yards nnd Forecourts Drained 34 1 ... 3 38 Cesspools abolished 1 2 ... 2 5 35 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Water Closets and Urinals. Closets erected 28 21 15 20 84 W.C. doors repaired or provided 23 24 24 29 100 Sanitary Conveniences or Improvements effected to Factories. Workshops and Workplaces 3 4 5 7 19 Flushing Apparatus Amended 125 91 147 73 436 Pans or Traps furnished 78 67 61 44 250 Cleansed 15 15 18 11 59 Ventilation improved 60 31 97 8 196 Public-house Urinals cleansed or repaired 7 12 5 7 31 Other Urinals altered or cleansed 1 1 ... ... 2 Other Urinals constructed ... 1 1 1 3 Ashpits. Provided 91 45 46 255 437 Covers to receptacles ... ... ... 1 1 Dust complaints forwarded to the Surveyor 6 5 6 3 20 Pavings. Forecourts and Yards 59 40 42 61 202 Washhouses 4 5 1 1 11 Mews and Stables ... 3 1 ... 4 General Water Supply. Covers to Cisterns adapted 56 28 90 ... 174 Water Fittings amended 34 27 22 44 127 Cisterns cleansed and repaired ... ... ... ... ... Water Services altered so as to draw direct from main 1 ... 2 1 4 Water Supplies reinstated where cut off through defective fittings 12 ... 4 2 18 Water Supply Certificates granted (Section 48) 54 29 102 3 188 Other Improvements. Verminous Rooms cleansed 29 73 71 42 215 Ventilation improved 42 46 30 85 203 Staircases repaired, amended, lighted, and ventilated 8 12 4 8 32 Leaky House Roofs and Gutters repaired 126 81 81 153 441 36 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Other Improvements—contd. Walls and Ceilings of Preises cleansed and repaired 131 155 115 189 590 Stoves and Fireplaces repaired 28 28 14 81 151 Washing Coppers repaired 8 18 12 22 60 Sinks provided 23 7 30 7 67 Floors repaired 38 32 35 68 173 Ice Cream places cleansed or improved ... 4 7 ... 11 Other places where food is stored and prepared ... 15 15 1 31 Provision for Storage of Food 1 ... ... ... 1 Other Nuisances Abated. Illegal use of Underground Room discontinued ... ... ... 1 Overcrowdings abated 3 2 ... ... 5 Sink, Lavatory and Bath Waste Pipes disconnected, trapped or amended 48 33 45 15 141 Stack Pipes amended 32 24 23 26 105 Nuisances from dampness abated 74 59 46 85 264 Animals Kept in Unfit Places discontinued or removed 3 2 7 1 13 Dung Receptacles provided 2 4 1 2 9 Bakehouse Nuisances abated ... 21 2 12 35 Houses abolished, unfit for habitation ... ... 1 ... 1 Accumulations of Manure and other obnoxious matter removed 5 15 21 11 52 Inundations abated ... ... ... 3 3 Contents of Rooms cleansed 6 8 8 1 23 Rat Infestation abated 28 31 24 41 124 Smoke Nuisances. Observations 7 3 4 17 31 Statutory Notices served (Sections 23 and 24) ... ... ... ... ... Food and Drugs. Samples taken 130 144 130 37 441 Found Adulterated 7 4 3 2 16 37 Summary of Sanitary Work—continued. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Unwholesome Food Seizures made ... ... ... ... 1 box Herrings (3 stone) 2 boxes Haddock (10 stone) 1 trunk Plaice (5½ stone) Shrimps (½ bushel) 1 leg Mutton 1 Rabbit (2½ 1b.) 1 trunk Haddocks (5 stone) 1 trunk Whiting (5 stone) Voluntarily surrendered Pork (2cwt., 2 qrs., 18lb.) Haddocks (20 lb.) 1 box Haddock (5 stone) Whelks (1 cwt ) 1 box Cod (5 stone) 1 trunk Plaice (6 stone) 1 case Pears (lcwt., 2qrs.) Skate (77 lb,) 38 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) 208 253 293 366 1120 Notices served— Under Housing Acts ... ... ... ... ... Rats and Mice (Destruction) Act, 1919 ... ... ... ... ... re Verminous Rooms ... ... 1 ... 1 Under P.H. (L.) Act and Metropolis Management Act (re combined drainage) 8 7 2 ... 17 W.C.'s (Factories, Workshops and Workplaces) 1 ... ... ... 1 Yards ... 4 2 ... 6 Miscellaneos ... ... 1 ... 1 Statutory Notices served under Section 4 19 19 50 17 105 Statutory Notices re Ashpit provision 6 4 4 4 18 Complaints received and attended to 96 112 123 143 474 Letters written relating to abatement of Nuisances 86 42 30 140 298 Summonses applied for and issued 1 ... 5 ... 6 Magisterial Orders obtained and enforced 1 ... 5 ... 6 Drainage Plans received and examined 58 24 38 28 148 Legal Proceedings under the Public Health (London) Act, 1891, and Bye-Laws During the Year 1927. Premises Complaint Result of Proceedings Fine Costs 224, Woolwich Road Non-compliance with Statutory Notice Abatement Order — 10/- 224, Do. Non-compliance with Abatement Order Work done — 5/- 31, Armitage Road Non-compliance with Statutory Notice Do. 10/- 34, Do. Do. Do. — 10/- 36, Lenthorpe Road Do Do. — 10/- 36, Caletock Street Do. Do. — 10/- 39 BOROUGH OF GREENWICH. Proceedings during 1927. Premises Number of Places Number of Inspections. 1927 Number of Notices, 1927 Number of Prosecutions, 1927 On Register at end of 1926 Added in 1927 Removed in 1927 On Register at end of 1927 Dairies, Cowsheds and Milkshops 112 26 10 128 132 2 — Slaughterhouses 5 — — 5 41 — — Other Offensive Trade Premises — 1 - 1 2 - — Ice Cream Premises 154 10 6 158 151 2 — Registered Houses Let in Lodgings 112 7 - 119 249 — — Restaurants and Eating Houses 60 5 6 59 60 4 — Total Number of Intimation Notices served for all purposes 1,120 „ „ ,, Statutory ,, ,, „ 148 Overcrowding, 1927— Number of Dwelling-rooms overcrowded 58 Number remedied 5 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 demolished voluntarily 1 Number repaired or Nuisances remedied under Public Health Act 1,367 Houses of the Working Classes— (a) Erected during the year (Municipal) 170 (Private Enterprise) 23 (b) In course of erection 94 40 Number of Verminous Premises cleansed under Sec. 10 of the London County Council (General Powers) Act, 1922 215 Number of Cleansing Baths given under Cleansing of Persons Act 7 Shelter provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — Number of Tenement Houses provided with Additional Water Supply — Number of Prosecutions ditto — Inland Revenue Acts— Number of Houses for which applications were received during the year — Number of Tenements comprised therein Number of Tenements for which certificates were granted — Number of Prosecutions under By-Laws under Public Health Act, 1891 — (a) For prevention of nuisance arising from snow, ice, salt, filth, 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. — 41 (h) With respect to water closets, earth closets, etc. — (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, etc. (Metropolis Management Act, Sec. 202) — (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-Laws) Act, 1899) — Mortuaries— No. of Drowned Bodies 9 „ „ Other ,, 275 ,, „ Infectious ,, — 284 ,, ,, Inquests 283 42 SECTION 4. HOUSING. In the report for the year 1926, it was stated that contracts had been entered into for the erection of 100 houses on the Twenty-Acre Field Site, of which 32 were completed and occupied during that year, and for the erection of a further 102 houses on a site partially in the Twenty-Acre Field and partly in Charlton Park. These houses are now all completed and occupied, and bring the total houses erected by the Council up to 624, excluding 50 flats situate in various roads in Elackheath and Charlton. In addition to this, the Council has 31 wooden hutments in Tunnel Avenue. A contract has also been entered into for the erection of a further 76 houses on the Charlton Park Site. There would still appear to be a great demand for houses and there are about 1,600 applicants on the Register whose requirements have not yet been satisfied by the Council. HOUSING RETURN, 1927. Number of new houses erected during the year:— (a) Total (b) With State assistance under the Housing Acts:— (i.) By the Local Authority 170 (ii.) By other persons 23 1.—Unfit Dwelling-houses. Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,973 (2) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated1 Regulations, 1925 52 (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 43 (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 1,474 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 379 3.—Action under Statutory Powers. (а) 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 ren- dered 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 (б) Proceedings under Public Health Acts : — (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Intimations 1,120 Statutory 149 (2) Number of dwelling-houses in which defects were remedied after service of formal notice :— (a) By owners 988 (b) By Local Authorities in default of owners Nil (e) Proceedings under sections 11, 14 and 16 of the Housing Act, 1925 :— (1) Number of representations made with a view to the making of closing orders Nil 44 (2) Number of dwelling-houses in respect of which closing orders were made Nil (3) Number of dwelling-houses in respect of which closing orders were determined, the dwelling-houses having been rendered fit Nil (4) Number of dwelling-houses in respect of which demolition orders were made Nil (5) Number of dwelling-houses demolished in pursuance of demolition orders Nil 45 SECTION 5. Inspection and Supervision of Food. Milk Supply.—The majority of milk supplied to this Borough is obtained from farmers and large firms outside the district. There is, however, one farm in the Kidbrooke area where 100 cows are kept, and which is under constant supervision.. Cowhouses.—The four cowhouses in the Borough have been visited on four occasions, and the required cleansing duly enforced. In one case the required license has not been renewed, the premises having been converted into a milk bottling establishment. Milk and Dairies (Amendment) Act, 1922.—Milk and Dairies Order, 1926.—At the commencement of the year there were 112 purveyors of milk on the Register of Dairies and Milkshops. Twenty-six new applications have been received during the year and added to the Register, and ten names have been taken off, thus leaving a total of 128 purveyors of milk now registered. The number of premises registered at the end of the year was 123 and 132 visits of inspections of such premises have been made ; notices were served upon the occupiers in two cases where dairies required lime-washing or were otherwise in an insanitary condition. 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 4 ,, „ Grade A (Tuberculin Tested) 4 ,, ,, Grade A (Pasteurised) 3 ,, ,, Grade A 3 Supplementary Licenses 5 (Principal Licenses granted by the Lewisham Borough Council). 46 Milk and Cream Regulations, 1912 and 1917.—Seventyfive samples of milk were taken during the year, of which eight were adulterated or below the standard fixed by the Ministry of Agriculture and Fisheries. In no case, however, was the presence of a preservative reported upon by the Public Analyst. The following table shows the average composition of milk examined by the Analyst during the year:— Period No. of Samples Examined Average Composition of all Samples, i.e. Genuine and Adulterated Average Composition of Genuine Samples Ministry of Agriculture Standard Per cent. of Milk Fat Per cent. of Solids not Fat Per cent. of Milk Fat Per cent. of Solids not Fat Per cent. of Milk Fat Per cent. of Solids not Fat 1st Quarter 20 3.60 8. 61 3.70 8.69 3.00 8.5 2nd Quarter 26 3.31 8.66 3.32 8.66 3rd Quarter 16 3.62 8.67 3.68 8.69 4th Quarter 13 3.77 8.76 3.79 8.79 75 Average for the Year 3.57 8 .67 3.62 8.70 One sample of preserved cream was taken, which was reported as genuine. The amount of milk fat was 53.2 per cent. and preservative (Boric Acid), 0.33 per cent. Ihe requirements as to labelling or declaration were duly observed. Milk and Dairies Order, 1926.—This Order, with the exception of certain provisions, came into operation on the 1st October, 1926, and revokes the Dairies, Cowsheds and Milkshops Orders of 1885, 1886 and 1889, so far as they relate to England and Wales, and all Regulations made thereunder by Local Authorities. The general object of the Order is to ensure Milk being produced and delivered to the consumer in a clean and pure state. 47 It is the custom of the Department to issue a copy of the Order to all persons applying for registration of dairy premises in the Borough in order that they may be aware of the general provisions regarding the standard of cleanliness required. Meat.—During the year it was not found necessary to seize any animal or meat exposed for sale, or deposited in any place for the purpose of sale, or preparation for sale. The following were voluntarily surrendered and destroyed: —1 Leg of Mutton ; Pork. (2 cwts. 2 qrs. 18 lbs.). The Public Health (Meat) Regulations, 1924, which came inito force on the 1st April, 1925, provide for the better regulation and supervision of slaughter-houses and protection of meat against contamination by dirt, etc. There are 109 premises where meat, bacon, etc., are either stored or exposed for sale. Slaughterhouses.—The number of slaughterhouses in use in the Borough are as follow:— In 1920 In January 1927 In December, 1927 Registered — — — Licensed 4 4 4 4 4 4 Thirty-seven inspections were made by the Inspectors during the year. From information received from the licensees the following is the number of beasts, etc., slaughtered during the year : — Beasts 361 Pigs 454 Sheep 2,323 Calves 182 48 Other Foods.—Places where food is prepared have been visited on 153 occasions, improvements being required in 16 instances as detailed below:— Class of Premises Number of Lists Number of Inspections r of Instances where matters needed attention At end of 1926 Added 1927 Removed 1927 At end of 1927 Hotel Kitchens 6 - - 6 6 1 Eating Houses 54 5 6 53 53 8 Fried Fish Shops 32 2 3 31 34 5 Pork Butchers and Sausage Manu facturers 27 3 1 29 30 1 Mineral Water Manufacturers 1 — — 1 1 - Others 24 — — 24 29 1 Totals 144 10 10 144 153 16 The 16 instances vyhere matters needed attention included 10 cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 5 where the sanitary arrangements were defective, and 1 where offal was stored improperly. In addition to the periodical visits and inspections of food shops, etc., supervision is also exercised on Saturday evenings and Bank Holidays. Street Traders.—During the year Regulations made in accordance with the provisions of the London County Council (Genera! Powers) Act, 1927, came into force, requiring the licensing by this Council of all persons who are engaged in street trading. This licence shows the place where the trader not only sells his goods, but also where they are stored, and in this way we are able to pay particular attention to the premises and the manner in which articles of food intended for sale from barrows and stalls in the streets are stored and prepared for sale. 49 Fifty-eight licences have been issued during the year, of which 31 refer to premises above-mentioned. Unsound Food.—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, particulars of which are set out on page 37. Ice Cream Prem-ses.— There were 154 premises known at the commencement of the year where the manufacture or sale of this commodity was carried on; 10 have been added during the year and 6 taken off, leaving a total of 158 premises. These premises were inspected on 151 occasions, improvement required by way of cleansing of the premises in 4 cases, insanitary conditions remedied in 5 instances, arid 3 cases where the ice cream was improperly stored. Bakehouses.—Eighty-one inspections have been made of the various Bakehouses in the Borough, and 35 nuisances found therein have been abated. At the end of the year there were 5 Factory and 37 other Bakehouses on the Register, 13 of which are underground. Food and Drugs Acts. — Four hundred and 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 425 were certified to be genuine and 16 adulterated, the adulterations thus being equivalent to 3.6 per cent, of the samples taken, as compared with 2.03 per cent, last year. In accordance with a request contained in the Ministry of Health's Memo. 36 / Foods (January, 1927), the quarterly reports of the Public Analyst are now submitted in slightly different form than hitherto, a special classification termed "adulterated samples, etc.," being adopted. This includes samples below standard or otherwise not complying with the prescribed requirements. As the Public Health (Preservatives, &c., in Food) Regulations (with certain exceptions) came into force on the 1st January, 1927, it was anticipated that a somewhat higher percentage of adulterated samples would be shown ; the total number of actual cases found was 16 as against 9 for the previous year. 50 Of the total number of samples purchased, 75 were milk, of which 8 were certified to be adulterated ; the remaining adulterated samples were 2 of vinegar, 1 of turpentine, 1 of fish paste and 1 of brawn. It was only considered necessary to take legal proceedings in respect of one of the 16 adulterated cases. Sale of Food and Drugs Acts.—Number and Description of Samples purchased for Analysis under the above Acts during the Year 1927. Description of Samples Number of Samples Purchased Number Genuine Number Not Genuine Baking Powder 3 3 - Brawn 6 6 - ,, Pork 4 3 1 ,, Veal 3 - 3 Bread 7 7 - Butter 60 60 - Cheese 14 14 - Coffee 1 1 — Corne Beef 16 16 — Dripping 5 5 — Egg Powder 1 1 — ,, ,, Substitute 1 1 — Fish Paste 5 4 1 Flour 10 10 - Honey 2 2 — Lard 33 33 — Lunch Beef 1 1 - Milk 75 67 8 Mustard 6 6 - Pearl Barley 18 18 — Pepper 15 15 — Preset ved Cream 1 1 — Rice 40 40 — Sago 10 10 — Sausage (Breakfast) 12 12 — Sausages 4 4 — Self Raising Flour 6 6 — Tapioca 33 33 — Turpentine 1 — 1 Vinegar 48 46 2 441 425 16 51 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 61 Turpentine No Turpentine. Consisted of Petroleum Products Fined 20/-; Costs 40/- 70 Milk 6% Deficiency in Fat Warning Letter 72 Do. 2% Added Water Warning Letter 85 Do. 2.5% do. Warning Letter 97 Do. 2% do. Warning Letter 144 Do. Abstraction of 2% of fat Warning Letter 358 Do. Abstraction of 6% of fat Warning Letter 392 Do. Slight Deficiency in non-fatty solids Warning Letter 438 Do. Ditto Warning Letter 112 Veal Brawn Contained 01% of Boric Acid Warning Letter 126 Do. Ditto Warning Letter 131 Do. Contained 0.05% of Boric Acid Warning Letter 146 Pork Brawn Contained 0.04% of Boric Acid Warning Letter 151 Vinegar Deficiency in Acetic Acid amounting to 36% Warning Letter (Vendor summoned in connection with Sample No. 61) 436 Do. Deficiency in Acetic Acid amounting to 21% Warning Letter 378 Fish Paste Contained a trace of Boric Acid amounting to less than l/100th of 1% No Action Taken 52 SECTION 6. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Notifications under the Provisions of the Public Health (London) Act, 1891.—During the year 2,098 cases have been notified under the above Act. The following table shows the comparison since 1922:— No. Year. 3,720 1922 2,087 1923 3,516 1924 3,555 1925 2,869 1926 2,098 1927 Small-Pox.—No case of this disease occurred during the year. Contacts.—Seven intimations were received from Medical Officers of Health of the Port Sanitary Authorities respecting persons who had been in contact with Small-Pox and Bubonic Plague whilst on board ship. 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 63. Diphtheria. — Four hundred and forty - eight cases of Diphtheria were notified during the year, as compared with 217, 319, 431 and 503 respectively in the years 1923, 1924, 1925 and 1926. The distribution of these cases was as follows :—174 in East Greenwich, 139 in West Greenwich, 41 in St. Nicholas. 82 in Charlton, and 12 in Kidbrooke. Of this number, 446 were removed to the Hospital for treatment, but 24 of these cases were reported by the Hospital Authorities as not suffering from the disease. There were 11 fatalities due to this disease, which gives a case mortality of 2-4 per cent. Two thousand nine hundred and sixteen specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be diphtheria. Of this number, 2,664 were reported to give negative or doubtful result, and 252 were positive in character, being dealt with accordingly. 53 The quarterly incidence of the disease for 1927 has been as follows:— 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total East Greenwich 44 34 26 70 174 We t Greenwich 33 31 19 56 139 St. Nicho'as 8 14 8 11 41 Charlton 20 15 13 34 82 Kidbrooke 2 . 5 — 5 12 Total 107 99 66 176 448 During the year the following report was presented on the subject of the adoption of the Schick test and preventive inoculation. After giving serious consideration to this question, the matter was adjourned for the present, and will be brought forward again at an early opportunity. Scheme of pro-posed Schick testing and inoculation for the prevention of Diphtheria. The Committee. I am sure, will be aware of the large number of cases of diphtheria which continue to occur not only throughout London generally, but in this Borough in particular. In the Metropolitan area between 1904 and 1910, there were over 50,000 notifications of diphtheria and 4,504 deaths. Between 1911 and 1917 there were 57,000 notifications and 4,084 deaths. Between 1918 and 1924, there were 84,410 notified cases and 5,895 deaths. From which it will be seen that the disease is increasing in London generally in spite of all the present methods adopted for dealing therewith. As far as Greenwich is concerned, here again the following figures will similarly show the state of the case — Between 1901 and 1905, there were 862 notifications and 91 deaths. Between 1921 and 1925, there were 2,272 notifications and 109 deaths. 54 As a result of experience it is found that persons, over about 14 or 15 years of age have acquired (a certain degree of immunity, and as age advances this immunity increases. Children under six years have seldom acquired any immunity at all, and children between 6 and 15 only to a slight extent. In 1913, Dr. Bela Schick discovered a test by which the degree of immunity to diphtheria could be judged in any person submitting to the test, whereupon persons who were found not to be immune could then be inoculated to produce a condition, of immunity, and it is accordingly on these lines that it would appear as if in the future our best method of procedure against this disease will be found to lie. Considering this matter in the light of brilliant results which have been achieved by similar measures in connection, with Typhoid Fever, I judge that the general adoption of methods on these lines would be of far-reaching importance and great benefit to the public health, for I think there will be— 1.A saving of some 300 or 400 lives annually in London alone ; 2. A very great reduction in the amount of post-diphtheretic ill-health, i.e., paralysis, heart disease, etc., etc. ; 3. The financial factor, viz., an ultimate saving to the ratepayers of Greenwich of some £10,000 annually by reason of the less number of cases needing treatment in hospital, this latter figure being based on an average stay in hospital per patient of say, 5 weeks, at a cost of £5 per week. This multiplied by 400, the average of the number of cases removed to hospital, being £10,000. I would accordingly suggest that with the sanction of the Ministry of Health, this Council decide to hold one afternoon session per week for carrying out this work, make it thoroughly well known throughout the Borough what is being done in this respcct, and in this way use all possible means to provide and invite parents to bring their children to be tested and if found necessary, for further immunisation. The expenditure would be comparatively trilling, viz., the services of a competent medical practitioner, who was experienced and interested in such work, the use of one of the rooms, say at the Borough Hall, and the services of a nurse to be in attendance during this weekly session, together with the necessary testing and immunisation material and instruments. I should estimate the actual out-of- 55 pocket expenditure, not including propaganda work, for one year would be approximately £100, which I am sure the Committee will realise is practically nothing at all compared with the present cost of the cases of Diphtheria, and I anticipate that) if there is anything like a satisfactory response on the part of the public, that within three or four years a noticeable reduction should take place in the incidence of cases of Diphtheria. Membranous Croup.—There were 2 cases of Membranous Croup notified during the year. One, however, was discharged from Hospital, the diagnosis not being confirmed. Erysipelas.—Sixty-four cases were notified during the year, 19 being in East Greenwich, 12 in West Greenwich, 14 in St. Nicholas, 13 in Charlton, and 6 in Kidbrooke. Twentytwo of these patients were removed to a Public Institution in the district. Scarlet Fever.—Four hundred and eighty-six cases were notified during the year, as compared with 292, 304 and 371 cases respectively in the years 1924, 1925 and 1926, 194 cases were in East Greenwich, 145 in West Greenwich, 28 in St. Nicholas, 99 in Charlton, and 20 in Kidbrooke ; 481 of these cases were removed to Hospital for treatment, 35 of which were returned as not suffering from this disease. There were two deaths from this disease during the year, compared with one the previous year. Of the 481 cases treated in Hospital, the following were certified to be suffering on discharge from Hospital with chronic disease :—Rhinitis, 1 ; Otorrhoea, 4 ; and Rhinorhcea, 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, 3 being in East Greenwich, 1 in West Greenwich, 3 in Charlton, and 1 in Kidbrooke. The ages of the patients were : 1 between one and five years, 3 between five and fifteen years, 3 between fifteen and twentyfive years, and 1 between twenty-five and forty-five years. Five of the cases were removed to Hospital for treatment ; one, however, was discharged as not suffering from the disease. In the years 1923. 1924, 1925 and 1926, there were 16, 10, 8 and 7 cases respectively. The average number for the previous ten years is 12. No case was traceable to the consumption of shell fish; There was only one fatality from this disease. 56 Fifteen specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be Typhoid Fever in character, 3 giving a positive result. Puerperal Fever — Five cases of this disease were notified during the year, all of which occurred in the East Greenwich district. There were 9 cases in 1926, 9 in 1925, 6 cases in 1924 and 9 cases in 1923. Puerperal Pyrexia.—There were 10 cases of this disease notified during the year. Eight cases occurred in East Greenwich, 1 in St. Nicholas, and 1 in Charlton. Nine of the cases were removed to Hospital for treatment. Measles.—This disease was made permanently notifiable by an Order of this Council, approved by the Ministry on the 1st July, 1920. In June last a Circular was received from the Metropolitan Asylums Board, pointing out that the former practice of admitting cases of Scarlet Fever in preference to Measles has been abandoned and that in lieu thereof there will be a definite allocation of beds for the two diseases, and further that the allocation shall be revised periodically in relation to the requirements of the moment, and that in time of Measles prevalence the larger proportion of accommodation shall be given to Measles. The effect of this decision is that when the number of beds available becomes short, and say, 75 per cent, of the accommodation set apart for the two diseases is exhausted, any medical practitioner desiring the admission of a case of either Measles or Scarlet Fever will be referred to the Medical Officer of Health with a view to his selecting those pises which, in his opinion, should be removed to Hospital having regard to all the circumstances. Fortunately, owing to the comparatively small number of cases of Measles during the year, it only became necessary to apply for admission to Hospital in 10 cases. Two hundred and thirty-four cases were notified during the year, as compared with 1,299 during the previous year, and 1,610 for the year 1925. Ten such cases were removed to Hospital for treatment. 57 There were 6 cases under 1 year of age. Between the ages of one to five years there were 78 cases, and 150 cases between five years and sixty-five years. It is pleasing to be able to record there were no deaths during the year, this being the first instance since the inception of the Borough. Table showing number of Measles Cases reported during the year 1927. Quarter ended 2nd April, 1927. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 1 3 7 2 - 13 West Greenwich — - 2 1 - 3 St. Nicholas, Deptford 2 — — — — 2 Charlton 1 9 26 1 — 37 Kidbrooke — — — 1 — 1 Total 4 12 35 5 — 56 Sources of Notification :— By Medical Practitioners 27 ,, Parents 2 Males. Females. ,, Health Visitors 4 21 35 ,, L.C.C. Schools 23 56 Quarter ended 2nd July, 1927. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 1 7 15 2 1 26 West Greenwich — 1 2 - — 3 St. Nicholas, Deptford — — — — — — Charlton 1 25 41 1 — 68 Kidbrooke — — — — 1 1 Total 2 33 58 3 2 98 Sources of Notification :— By Medical Practitioners 58 ,, Parents 7 Males. Females. ,, Health Visitors 6 39 59 ,, L.C.C. Schools 27 98 58 Quarter ended 1st October, 1927. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich — 2 1 - — 3 West Greenwich — 1 1 — — 2 St. Nicholas, Deptford — — — — — — Charlton — 2 3 — - 5 Kidbrooke — — — — — — Total — 5 5 — — 10 Sources of Notification :— By Medical Practitioners 8 „ Health Visitor — Males. Females. ,, L.C.C. Schools 2 4 6 10 Quarter ended 31st December, 1927. 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 27 35 - 1 63 West Greenwih 1 1 — — 2 St. Nicholas, Deptford — 1 — — 1 Charlton — 3 1 — 4 Kidbrooke — — — — — Total 28 40 1 1 70 Sources of N otification :— By Medical Practitioners 43 ,, Health Visitors 5 Males. Females. „ L.C.C. Schools 22 31 39 70 Total Cases in Year 234 Zymotic Enteritis or Epidemic Diarrhcea. — Seventy-two cases of diarrhoea were notified throughout the whole of the Eorough, 37 being under one year of age and 35 between one and five. Sixty-two of such notifications related to patients in East Greenwich. 5 in West Greenwich, 3 in St. Nicholas, and 2 in Charlton. There were 8 deaths ascribed to Diarrhoea and Enteritis. Whooping Cough.—This disease was made permanently notifiable as from 1st November, 1921. 59 Four hundred and one cases were notified (compared with 126 in 1926), 51 being under one year of age, 194 from one to five, 153 from five to fifteen, 2 from twenty-five to fortyfive and 1 from forty-five to sixty-five, the districts concerned being East Greenwich 250 ; West Greenwich, 66 ; St. Nicholas. 46 ; Charlton, 35 ; and Kidbrooke, 4. Each of these cases was visited and leaflets and instructions left, together with verbal advice respecting the isolation and care of the patient. Thirty-one cases were removed to Hospital for treatment, of which number 3 were returned as not suffering from Whooping Cough. Epidemic Cerebro-Spinal Meningitis, Cerebro-Spinal Fever, or Post-Basal Meningitis.—There were only 2 cases of this disease notified during the year, both occurring in the East Greenwich district. Acute Pol:o-Myelitis.—There were 2 cases notified during the year, as compared with 2 cases in 1926, 1 in 1925, and 1 in 1924. Ophthalmia Neonatorum.—During the year 17 cases of this disease have been notified, 6 being in East Greenwich, 1 in St. Nicholas, 9 in Charlton, and 1 in Kidbrooke. Further particulars of this disease will be found on page Malaria.—There were 8 cases of Malaria notified during the year, 3 occurring in West Greenwich, 2 in East Greenwich, 2 in St. Nicholas, and 1 in Charlton. Encephalitis Lethargica.—There was only 1 case of this disease notified during the year, as compared with 6 last year. Glanders.—No case of Glanders has occurred within the Borough. 60 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 192 cases of Tuberculosis notified in the Borough, as compared with 231 for the previous year. Of this number, 146 were pulmonary cases, ordinarily known as Consumption, and 46 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. Of this number of cases, 62 pulmonary and 20 noivpulmonary occurred in East Greenwich, 36 pulmonary and 12 non-pulmonary in West Greenwich, 13 pulmonary and 6 non-pulmonary in St. Nicholas, 33 pulmonary and 8 non-pulmonary in Charlton., and 2 pulmonary in Kidbrooke. The various ages of the patients were as follows :—Pulmonary cases from one to five, 1 case ; five to fifteen, 22 cases ; fifteen to twenty-five, 34 cases ; twentyfive to forty-five, 47 cases ; forty-five to sixty-five, 37 cases ; and 5 cases over sixty-five ; whilst the Non-pulmonary were:— Under one year, 2 cases ; one to five, 9 cases ; five to fifteen, 19 ca9es ; fifteen to twenty-five, 10 cases ; twenty-five to fortyfive, 4 cases ; and forty-five to sixty-five, 2 cases. Three hundred and forty-nine specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive ; 289 were reported to be negative and 60 positive. Disinfection has been offered and carried out in 128 cases, including 181 rooms and 275 articles of bedding, etc. ; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. 61 DISINFECTION. The new Disinfecting and Cleansing premises were opened in June, 1924, and are situate at Tunnel Avenue, Blackwall Lane, East Greenwich. The following returns show in detail the amount of work performed during the year by the Disinfecting Stall : — Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the 52 weeks ended 31st December, 1927. Infectious Diseases Rooms Premises Entered Beds Palliasses Mattresses Bolsters Pillows Blankets Sheets Cushions Quills Odd Articles Total No. Articles Disinfected Polio-Myelitis 2 2 — — 1 — 3 3 — 3 — — 10 Encephalitis Lethargica — — — — — — — — — — — — — Scarlet Fever 484 423 276 2 163 230 681 805 54 44 231 187 2,673 Diphtheria 416 368 226 — 104 174 507 655 40 36 142 57 1,941 Enteric Fever 10 9 2 — 3 3 9 17 4 3 3 1 45 Puerperal Fever 11 6 4 — 10 7 24 15 15 2 8 65 150 Tuberculosis 181 128 31 — 27 40 78 39 8 5 19 28 275 Other Diseases* 90 67 49 4 127 50 310 445 13 62 18 327 1,405 Measles 2 2 — — 2 1 1 4 2 — 2 8 20 From Verminous Premises 14 10 36 9 26 16 48 93 8 1 3 37 277 Scabies 2 2 3 — 2 2 5 2 — — 1 6 21 Iufluenza and Pneumonia 3 3 — — — — — — — — — — — Cerebro-Spinal Meningitis 2 2 1 — 1 1 6 5 — — 1 — 15 Total 1,217 1,022 628 15 466 524 1,672 2,083 144 156 428 716 6,832 *Includes *—Cancer ; 25 Rooms ; 193 Articles. Private Books Disinfected and Returned 200. 62 Number of Articles Destroyed in connection with the Undermentioned Diseases during the 52 weeks ended 31st December, 1927. Infectious Diseases. Beds Palliasses Mattresses Bolsters Pillows Blankets Sheets Cushions Quilts Odd Pieces Total No. Articles Destroyed Scarlet Fever 2 1 — — — — — — — — 5 Diphtheria 2 1 — — 1 — — — — — 4 Tuberculosis 2 — 3 — 4 6 1 — 2 — 18 Other Diseases 12 3 8 4 18 2 — 2 — 654 703 For Verminous Premises 2 1 6 — 5 3 — 1 1 20 39 Total 20 6 18 5 28 11 1 3 3 674 769 63 Supplemental Vaccination Returns for 1926. Return made on or before the 9th of February, 1928, by Mr. E. S. Elliott, Vaccination Officer of the several Districts of the Greenwich Union, respecting the vaccination of children whose births were registered in his District from 1st January to 31st December, 1926, inclusive:— Registration SubDistricts comprised in the Vac cioatioo Officer's District. No. of Births from 1st Jan. to 31st Dec., 1920. Number of these Births duly entered by 31st Jan., 1928. No. of Births which on 31st Jan.. 1928, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31st Jan., 1928, not accounted for Total No. of Certificates of successful Primary Vaccination at all ages received during Calendar Year, 1927. No. of Declarations of Conscientious Objection actually received by Vaccination Officer during the Calendar Year 1927. Successfully Vaccinated. Insusceptible of Vaccination. Had Smaltpox. Certificates of conscientious objection received. Dead, Unvaccinated. Postponement by Medical Certificate Removal to Districts, V.O. of which apprised. Removal to places unknown and cases not found. South Deptford 574 299 2 — 200 14 18 8 3 30 - North Deptford 675 278 4 — 249 32 19 2 10 83 East Deptford 819 292 4 — 208 37 40 11 18 209 East Greenwich 869 429 1 — 245 45 21 8 30 90 West Greenwich 348 171 2 — 118 18 5 4 3 27 Total 3,285 1,469 11 — 1,020 146 103 33 64 439 1,644 897 Dated February 1th, 1928. E. S. Elliott, Vaccination Officer. No. of Births entered in " Birth List Sheets" as registered from 1st January to 31st December, 1926 626 Successfully Vaccinated 345 Insusceptible of Vaccination Had Small-Pox — CHARLTON AND KIDBROOKE. Statutory Declarations of Con- sciertious Objection 194 Dead Unvaccinated 15 Postponed by Medical Certificate 9 Removed to Districts the Vaccination Officer of which has been duly apprised 54 Removed to places unknown, or which cannot be found and cases not traced 4 Not accounted for 2 G. E. Oughton. 64 REPORT OF THE TUBERCULOSIS OFFICER. To the Medical Officer of Health. Sir, During 1927 there has been no change of procedure in the work of the Tuberculosis Department. Notifications and Deaths.—For the past three years I have been able each year to report that the Incidence and Death Rates were the lowest ever recorded in the Borough, and I am again in the same happy position of reporting that despite the continued unsatisfactory economic conditions, both these Rates show a still further decrease. The cause ar causes of this decline are not very evident and, it must be confessed, cannot be attributed solely to the measures which have been taken against Tuberculosis, although at the same time there can be no doubt biit that these measures must be exercising some influence towards this end. Some contribute this decline to increased immunity ; others that Tuberculosis is subject to periodic variation and that we have now struck the downward curve ; but neither of .these theories-satisfactorily explains the cause as to why Tuberculosis has declined to such an extent during the. past 50 years. The notifications and deaths were as follows:— Notifications. Deaths. Non- Non- Pulmonary Pulmonary Total. Pulmonary Pulmonary Total. 146 46 192 78 22 100 and the averages for the previous ten years:— 238 100 124 23 These figures give an Incidence Rate for all forms of 1.92 per 1,000 of the population (1.41 pulmonary and .44 non-pulmonary), and a Death Rate for all forms of .96 per 1,000 of the population (.75 pulmonary and .21 non-pulmonary). In 7 instances (6 pulmonary and 1 non-pulmonary) the diagnosis of Tuberculosis was not confirmed, so that the above Incidence Rates should be read at a slightly lower figure. 65 Notification.—The following table shows the Death Notification interval of 61 patients in 1927, and whose deaths were ascribed to Pulmonary Tuberculosis:— Information from Death Returns 2 Died within One Month of Notification 7 Died within Three Months of Notification 2 Died within Six Months of Notification 6 Died with Over Six Months of Notification 44 Revised Diagnosis.—The 7 cases in which the diagnosis of Tuberculosis was not confirmed comprised: 2 heart disease; 1 aneurysm; 1 emphysema; 1 chronic bronchitis; 1 pleurisy: all six notified as Pulmonary Tuberculosis; and one case notified Tuberculous Meningitis proved to be pneumonia. Deaths.—During the year 100 persons died from Tuberculosis (all forms), giving a Death Rate of .96 per 1,000 population; 78 were due to the pulmonary form, equal to a rate of -75 per 1,000, which, as above mentioned, is the lowest ever recorded in the Borough. 'It is interesting to compare this statement with the death rates of other Respiratory Diseases, as shown in the following table, for it has been said that a low Death Rate in Tuberculosis would show a high Death Rate in Respiratory Diseases, implying of course that many cases of Tuberculosis are "missed," or put under some other name. It will be observed that both rates have fallen. Year. Bronchitis. Pneumonia. Other Respiratory Diseases. Total. Respiratory System Rate per 1,000 1920 98 115 10 223 2.11 1921 98 108 11 217 2.16 1922 132 154 10 296 2.91 1923 75 86 12 173 1.69 1924 91 93 12 196 1.87 1925 112 79 18 209 2.00 1926 119 79 13 211 2.03 1927 102 84 11 197 1.91 66 Notifications and deaths from Pulmonary Tuberculosis, with the Incidence and Death Rates for the previous five years, are recorded below:— Year. Notifications Incidence per 1,000 Deaths Death Rate per 1,000 1922 218 2.1 120 1.18 1923 213 2.08 115 1.12 1924 214 2.04 104 1.00 1925 197 1.90 104 1.00 1926 177 1.70 93 .89 Deaths from Non-pulmonary Tuberculosis, of which there were 22 (equal to a rate of .21 per 1,000), included 7 Meningitis, 7 of Abdominal Tuberculosis, 9 Bones and Joints, and 1 Genitourinary. The 45 (corrected) Notifications of Non-pulmonary Tuberculosis included: 1 case of General or Miliary Tuberculosis. 16 cases of Tuberculosis of the Glands (Neck). 3 ,, ,, ,, Spine. 9 „ „ „ Joints. 7 „ „ ,, Abdomen. 6 „ „ ,, Brain (Meningitis). 3 „ „ ,, Other. SUNLIGHT TREATMENT (Tuberculosis Section). The Installation and method of procedure remain the same, pending the building of more commodious premises. At the close of 1926 there were 60 patients under treatment. During the year 99 new cases were sent from the Dispensary. The total treated during 1927 therefore amounted to 159. Of these. 103 were discharged, leaving 56 on the books at the end of the year. The 99 new cases comprised 6 children under 5 years of age, 81 between 5 and 15 years, and 8 others over 15 years. These patients were further classified as follows : — Tuberculous Glands 28 Tuberculous Abdomen 5 Pulmonary Tuberculosis 12 Pretubercular and Malnutrition 47 Other 7 67 More would have been sent had accommodation been available, and on this account treatment was confined to children. The average number of treatments remains about the same, viz., 20, but many received longer treatment. As reported before, gland cases (adenitis) did best and glands with discharging sinuses best of all. Where the glands are not broken down improvement is slow. The most noticeable result, however, is the feeling of well-being experienced by most of the patients after their light bath, and perhaps the most satisfactory evidence on this point is the unsolicited testimony of the mothers themselves, who quite frequently inform the nurse how much brighter and resitful their children are after treatment. The school teachers also remark on the increased mental activity shown by these children. 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 1927 show 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 214 patients suffering from Pulmonary Tuberculosis : 134 were sharing a bed. 35 had a separate bed but not a separate room. 45 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, 12 patients who were sharing a bed have now separate beds, and 3 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. Apart from overcrowding, many sanitary defects have been reported to and dealt with by the Public Health Department. The eight shelters are in constant use. Bedsteads and bedding have been lent or supplied by the Council and other agencies. (See Report of Care Committee). 68 At the close of 1927 the estimated number of persons suffering from Tuberculosis and residing in the Borough was as follows :— Men. Women. Children. Total. Pulmonary Tuberculosis 234 216 164 614 Non-Pulmonary 36 33 179 248 giving a total of 862 as against 868 in the previous year. Dealing with the Dispensary itself, 686 new patients were examined during the year. The sources from which these patients came were as follow : — Doctors 209 Hospitals 15 School Medical Service 26 Ministry of Pensions 3 Own Application 72 Nurses (Contacts) 361 Contacts.—Much of the nurses' time is spent endeavouring to secure the examination of every contact. This year, out of a total of 582 contacts, 400 were examined, or almost 70 per cent., of whom 23 were found to be tuberculous, and 2'1 doubtfully so, these latter bsing still under observation. The work of the Dispensary is shown in the statistical table on page 74 and explains itself. Sanatorium Treatment.—During the year 133 patients were sent to sanatoria, 84 under the County Scheme, 48 through the Guardians, and 1 through other sources. The average duration of residence was two months, but the same difficulties remain in finding suitable employment for those discharged fit for work. Two patients entered more than once. In addition, 65 children are attending the Open-Air Schools at Shooters Hill and Brent Knoll, 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, 290 patients were examined at the Greenwich and Deptford Hospital. Of these., 210 were adults, and 80 children. The parts examined were Chest 272, Other 18. 69 Sputum Examinations.—Of 150 sputum specimens bacteriologically examined at the Seamen's Hospital, 32 proved positive. At the same time, 189 specimens were chemically examined at the Dispensary for Albumen, with very similar results to those reported previously—58 being positive. 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. Tuberculosis Carf. Committee.—The Public Health Committee acted as this Committee during the year, and Miss Johnston, the Honorary Secretary, supplies the following brief information, which by no means indicates the amount of work and worry undertaken :— The following Societies rendered financial and other assistance to patients and their families during 1927, viz. :— Charity Organisation Society. United Services Fund. Soldiers', Sailors' and Airmen's Families Association. Soldiers' and Sailors' Help Society. Society for Relief of Distress. Also several voluntary helpers who kindly provided letters, etc., for Hospital or Convalescent Homes. The Borough Council also found work for one or two patients, and two private employers. have from time to time found "light jobs" for several others. Negotiations are in progress with the object of inaugurating a Handicraft Class for the Dispensary patients, and there is good hope that such will shortly be established. The Greenwich Board of Guardians continue to consider most sympathetically cases referred to them from the Dispensary, either for treatment or material assistance. A sum of £135 1s. 6d. was collected from patients and their relatives on behalf of the London County Council towards the cost of treatment. 70 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. TUBERCULOSIS DENTAL CLINIC. The number of patients seen during the current year is slightly below that of the previous year, although the average number of fillings has increased. Naturally, patients referred by the Tuberculosis Officer are in a low state of health, and therefore are more susceptible to diseases of the gums, Ulcerative Stomatitis, etc. Such patients are encouraged to visit the dentist regularly, so that the early symptoms, e.g., marginal gingivitis, may be recognised and the cause removed. These patients, for the most part, have been most amenable to reason, and have carried out the treatment indicated in a very enthusiastic manner. Here again, the importance of extreme cleanliness must be emphasised. Oral sepsis is known to have caused many terrible diseases, e.g., Septicaemia, Endocarditis, Neurasthenia, Meningitis, and even Insanity, in persons who otherwise would be called healthy. It can easily be understood that the presence of oral sepsis in those attending a Tuberculosis Dispensary is particularly' dangerous, and may render the task of the Tuberculosis Officer well-nigh impossible. Details of Dental Treatment. Sessions 25 No. of patients 52 Attendances 202 Dentures supplied 3 Fillings, Scalings, etc.22 Extractions (No2) 35 Extractions (Local Anaesthetic) 85 Extractions (Ordinary) 4 Patients for ( No2) 14 Advice 38 Referred 74 X-Ray 5 I am, Sir, Your obedient Servant, M. MACDONALD, M.D., Ch.B., D.P.H. 71 HOUSES INSPECTED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Inspected and Inquiries made by Infectious Disease Inspector 1,121 Number of Re-visits 3,220 The Health Visitors also visited 1,022 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease:— Central Library 131 Branch Library 45 School Libraries 14 Total 190 CLEANSING STATION, BLACKWALL LANE. The new Cleansing Station which forms part of the Disinfecting premises was opened in June, 1924, and is situate at at Tunnel Avenue, Blackwall Lane, East Greenwich. 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 235 2nd „ 195 3rd „ 162 4th „ 283 Total 875 Six adults suffering from verminous conditions were also given cleansing baths. In every case the infested clothing was disinfected. 72 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR 1927. Disease. Total Cases Notified.* Cases admitted to Hospital Total Deaths.* Small Pox — — — Diphtheria 448 446 11 Scarlet Fever 486 481 2 Enteric (including paratyphoid) 8 5 1 Puerperal Fever 5 4 1 Puerperal Pyrexia 10 9 — Pneumonia 145 68 12 Erysipelas 64 22 - Acute Polio Myelitis 2 — 1 Cerebro Spinal Fever 2 2 - Membranous Croup 2 1 - Malaria 8 - - Ophthalmia Neonatorum 17 10 - Encephalitis Lethargica 1 1 — Dysentery 1 1 — Notifiable Locally. Measles 234 10 — Whooping Cough 401 31 16 Diarrhœa 72 1 8 * For particulars as to Age Groups see Tables at end of Report. 73 TUBERCULOSIS. Age-Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F M F 0 — — — 2 — — — 2 1 1 — 5 6 — — 3 2 5 3 8 8 1 — — — 1 10 1 10 2 8 — 2 1 4 15 8 8 8 4 1 3 1 2 20 11 10 2 2 6 5 — 1 25 20 13 4 3 13 10 1 — 35 15 10 — 1 8 7 1 1 45 21 11 1 — 7 7 1 — 55 6 5 1 — 4 2 1 — 65 and upwards 3 2 — — 3 — — — Totals 89 77 31 27 42 36 9 13 Particulars relating to the above Table are dealt with in the Report of the Tuberculosis Officer on pages 64 to 70. 74 Return of work carried out in connection with the Maze Hill Tuberculosis Dispensary for the Year 1927. DIAGNOSIS. Pulmonary . Non-Pulmonary. TOTAL. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 37 29 1 6 6 4 3 2 43 33 4 8 (b) Doubtfully tuberculous — — — — — — — — 10 7 6 7 (c) Non-tuberculous — — — — — — — — 29 48 45 33 II.—Contacts examined during the year:— (a) Definitely tuberculous 9 8 — 1 — 1 3 1 9 9 3 2 (b) Doubtfully tuberculous — — — — — — — — 3 6 7 5 (c) Non-tuberculous — — — — — — — — 40 112 104 100 C.—Cases written off the Dispensary Register as (a) Cured — — — — — — — — — — — — (b) Diagnosis not confirmed or non - tuberculous (including cancellation of cases notified in error) — — — — — — — — 74 167 159 154 D.—Number of persons on Dispensary Register on December 31st:— (a) Diagnosis completed 197 147 67 36 39 26 89 39 239 173 156 75 (b) Diagnosis not completed - - - - - - - - 12 9 9 8 75 1. Number of persons on Dispensary Register on January 1st 628 2. Number of patients transferred from other areas and of "lost sight of" cases returned 13 3. Number of patients transferred to other areas and cases " lost sight of 29 4. Died during the year 62 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months 9 6. Number of attendances at the Dispensary (including Contacts) 6,061 7. Number of attendances of non-pulmonary cases at Orthopaedic stations for treatment or supervision— 8. Number of attendances at General Hospitals or other Institutions approved for the purpose, of patients for (a) " Light" treatment— (b) Other special forms of treatment 28 9. Number of patients to whom Dental Treatment was given, at or ill connection with the Dispensary 52 10. Number of consultations with medical practitioners :— (a) At Homes of Applicants 20 (£) Otherwise 190 11. Number of other visits by Tuberculosis Officers to Homes 204 12. Number of visits by Nurses or Health Visitors to Homes for sary purposes 3,880 13. Number of (a) Specimens of sputum, &c., examined 150 (b) X-ray examinations made 290 in connection with Dispensary work. 14. Number of Insured Persons on Dispensary Register on 31st December 279 15. Number of Insured Persons under Domiciliary Treatment on 31st Dec. 65 16. Number of reports received during the year in respect of Insured persons :—{a) Form G.P. 17 13 (b) Form G.P. 36 32 76 SECTION 7. Maternity and Child Welfare The various activities under the Council's Maternity and Child Welfare Scheme have been conducted on similar lines as heretofore. 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 Armada Street, Deptford Thursday Charlton Vale Wesleyan School Room, Woolwich Road Wednesday The following table shows at a glance the work undertaken at the various Infant Consultation Centres during the year:— Borough Hall Conduit House 105. Shooter's Hill Rd. Armada Street Charlton Vale Total Attendances 8.918 11,074 5,311 2,941 4,325 32,569 New Cases 358 368 234 163 155 1,278 Medical Consultations 3,385 3,709 1,862 1,324 1,840 12,120 Nursing Mothers seen by Doctors 1 161 1,357 775 525 578 4,396 All babies are weighed and advice given to the mothers at every attendance. The attendances at the Centres continue to show an increase in numbers. Pre-Maternity Clinics.—These are held at 10 a.m., as follow :— Borough Hall, Royal Hill Tuesday. Conduit House, 236, Trafalgar Road Wednesday. 105, Shooters Hill Road Friday. Charlton Vale Mission Hall, Woolwich Road Wednesday. 77 The attendances for the year were as follow:— Borough Hall 573 Conduit House 535 Shooters Hill Road 744 Charlton Vale 103 1,955 This figure of 1,955 shows an increase of 91 over last year's total. 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. Health Visitors' Visits, &c., 1927. Table A. Visits Re-Visits Total Infants under 1 year 2,000 4,798 6,798 Children, 1—5 years 169 5,262 5.431 Measles 312 36 348 Whooping Cough 546 113 659 Pneumonia 49 53 102 Puerperal Fever 13 14 27 Diarrhæa . 76 51 127 Ophthalmia Neonatorum 26 36 62 3,191 10,363 13,554 Table B Dental Treatment 102 3 105 Milk Scheme 163 41 204 Pre-Maternity Cases 436 65 501 Infant Consultations attended 957 Pre-Maternity Clinics attended — — 201 Miscellaneous 197 11 208 In addition to the above, 1,117 persons were seen by the Health Visitors at the office, chiefly in connection with milk applications. Infantile Mortality.—Unquestionably the work performed under the Maternity and Child Welfare Scheme during the last few years has been the chief factor in the continued drop in the Infant Mortality Rate. This contention is borne out on reference to the Infant Mortality figures. Last year the number of babies dying under 1 year of age was 90, which is equivalent to an Infant Mortality Rate of 53 per 1,000 births. In 1918 (the year of the passing of the Maternity and Child Welfare Act), the number of deaths was 210, with an Infant Mortality Rate of 119 per 1,000 births. 78 Convalescent Home Treatment.—With the exception of 14 cases referred to the Guardians and two cases dealt with through the United Services Fund, all the children recommended by the medical officers in charge of the Welfare Centres as requiring convalescent treatment have been sent away through the Invalid Children's Aid Association, and I should like to express my appreciation of the kindly, efficient, and, it may be added, economical services which have been rendered by this Association in this connection. Prior to the present arrangement, it was left to me to make arrangements with Homes direct and it was only on rare occasions that any assistance towards the cost of the treatment was forthcoming other than contributions, usually small, from the parents. The I.C.A.A., however, through theiT very comprehensive organisation, are in a position to utilise every possible source of assistance, with the result that in many cases the cost of the treatment to the Borough is negligible. At the most, the charge made per week is substantially less than would have been the case had arrangements been made direct with the Home. One also acknowledges with many thanks, the substantial monetary help towards the cost of convalescent treatment of selected cases given by the Rotary Club of Greenwich. This amounted during the year to £17 17s. 6d., in respect of thirteen children. The total number of children sent away during the year was 58, the average length of stay being eight weeks. 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. Artificial Sunlight Treatment Centre.—This Centre which was opened on the 24th September, 1925, at Conduit House, 236, Trafalgar Road, 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. 79 The following conditions were treated during the year 1927:— Rickets and prevention of Rickets 158 Underweight 69 Debility and Anæmia 37 Bronchial and Catarrhal 29 Cervical Glands 8 Premature babies. Marasmus babies 8 Convalescent from infectious diseases 5 Other cases 4 Ante-natal and Nursing Mothers 17 335 Total number of treatments given during the year 8,427 Procedure and duration of treatments remain the same, except that one of the Medical Officers prefers "interrupted treatment." i.e., that her patients should receive say 12 exposures, then stop for a month and resume again. The results are practically identical with the ordinary procedure. General improvements are shown in appetite, increasing weight, and .especially vitality of children is improved. Amongst the older children, the teacher often sends reports saying how the child's mentality has improved since undergoing treatment. During winter months an increased number of bronchial and catarrhal conditions were treated with satisfactory results. The children keep free from colds and coughs for much longer periods than before, and when attacked, recover more quickly and the attacks are less severe. The majority of cases are sent for prevention of rickets, being between the ages of 6 to 12 months. An increased number of cases of nursing mothers with insufficiency of milk, were treated. These cases showed much improvement in the amount of milk and general condition of the mothers, and steady increase in the weight of their babies. As mentioned last year, one of the two lamps is now being used with tungsten cored-carbons, being stronger in ultraviolet rays than the white-flame carbons originally used. The length of exposure is thus shortened, allowing more patients to be treated. All patients commence treatment on the white-flame carbon lamp, and after about ten treatments are changed to the cored-carbon lamp. 80 MATERNITY HOME. In my Report for the year 1926, I mentioned that towards the end of that year the extensions at the Maternity Home had been completed, and the year 1927, therefore, is the first calendar year during which the increased accommodation has been available. Although the Home has not been fully occupied during the whole of the period in question, the increased accommodation and the better facilities generally which are now available have been much appreciated by both patients and staff alike. The accommodation now consists of two General Wards each with nine beds and a Private Ward with two beds, making a total of 20 beds. In addition, there is an Isolation Ward and two Labour Wards. The number of patients admitted during the year was 270, the Matron and nursing staff being responsible for all the deliveries, with the exception of ten which were undertaken by doctors. Happily, one is able to report a year entirely free of any serious conditions arising in connection with the patients accommodated. Three infants were not entirely breast-fed while in the Home owing to physical deficiency on the part of the mothers. Three babies died within 10 days of birth and there were 5 cases of still-birth. The total number of patients accommodated in the Maternity Home up to the end of 1927 was 1,390, the figures each year being as follow:— 1922 (part of) 121 1923 228 1924 220 1925 295 1926 256 1927 270 1,390 Reviewing the work of the Home generally since its inception in 1922, one has not the slightest hesitation in affirming that the Home has unquestionably proved of very great benefit to the mothers of Greenwich. One has only to be familiar with the housing conditions in many parts of the Borough to realise the need for an Institution of the nature of the Maternity Home. The following continue their good work in the Borough:— Local Medical Practitioners' School Clinic. Health Centre, Ueptford Green. Rachel McMillan Memorial Nursery School. 81 Deptford Fund—Babies' Hospital.—The arrangement made with the Deptford Fund still operates whereby they receive in tiheir Hospital such Greenwich cases as are recommended by the Medical Officer for treatment (debility and dietetic disorders). NOTIFICATION OF BIRTHS ACTS, 1907. The following table gives the number and character of the intimations received respecting births in the Borough:- 1919 1920 1921 1922 1923 1924 1925 1926 1927 Total Number of Births notified in each year 2,085 2,714 2,564 2,257 2,348 2,245 2,257 2,096 1,995 (a) Attended by Midwives 1,159 1,494 1,452 1,494 1,591 1,563 1,668 1,660 1,592 (b) Attended by Doctors 926 1,220 1,112 773 757 649 589 436 403 Numbers of Still Births notified in each year 59 78 52 53 50 32 32 49 82 Number of Births registered in each year 1,968 2,648 2,366 2,185 2,276 2,258 2,108 2,027 1,912 Puerperal Fever and Puerperal Pyrexia Regulations, 1926.—These Regulations came into force on the 1st October, 1926. Five cases of Puerperal Fever were notified during the year, 4 of whom were admitted to Hospital for treatment. Unfortunately, one proved fatal. Ten cases of Puerperal Pyrexia were notified. Six notifications were received from Medical Practitioners in charge of Institutions and Nursing Homes and 4 from Private Practitioners. Three of the latter cases were subsequently admitted to Hospital. There was only one case in which the services of the Council's Obstetric Specialist was sought by private practitioners. 82 OPHTHALMIA NEONATORUM. Seventeen cases of this disease were notified during the year, and in addition there were six cases of slight inflammation of the eyes reported ; 10 cases were removed to hospital. Both eyes were affected in 13 cases, and one eye only in the remaining cases. At the end of the year, one of the cases was still under treatment at hospital. Cases Vision Unimpaired Vision impaired Total Blindness Deaths Notified Treated At Home In Hospital 17 7 10 16 1 — 1 (Marasmus) Measles.—See pages 56 to 58. Milk, Virol, &c., Supplied to Nursing and Expectant Mothers and Young Children.—In accordance with Circular 185 of the Ministry of Health, where the income falls within the Council's scale, milk may be granted either free or at reduced cost to:— (a) Nursing Mothers ; (b) Expectant Mothers in the last 3 months of pregnancy; (c) Children up to 3 years of age. In addition dinners may also be given to Nursing and Expectant Mothers who are in necessitous circumstances. The whole of the milk supplied at our Centres is Full Cream Dried Milk, and the same procedure has been adopted with regard to the distribution as in previous years. The total amount of such Milk sold or distributed free to Nursing and Expectant Mothers and Young Children during the year was 54,282 lbs. (24 tons, 4 cwts., 2 qrs., 18 lbs.). The following tables show (a) the amount of milk, etc., given away and number of applicants receiving same, and (b) quantities sold each quarter. 83 (a) Milk, Virol, &c., Distributed Free. Quarter ended Milk Virol Malt & Oil Cod Liver Oil lbs. No. of Applicants lbs. No. of Applicants lbs. No. of Applicants lbs. No. of Applicants March, 1927 9,774 4,936 276 552 2,091 2,091 19 38 JUNE, 8,736 5,213 339 678 1,791 1,791 9 18 Sept., 8,481 4,232 386 772 1,571 1,571 13 26 Dec., 9,627 4,470 435 870 1,999 1,999 14 28 Totals 36,568 18,851 1,436 2,872 7,452 7,452 55 110 (b) Milk, Virol, &c., Sold at Full or Reduced Prices. Quarter ended Milk Virol Oil & Malt Cod Liver Oil Total Amount Received lbs. lbs. lbs. lbs. £ s d. March, 1927 3,380 339 520 29 374 11 2 June, ,, 4,533 300 190 19 332 17 7 Sept , ,, 4,811 364 231 17 383 8 11 Dec., ,, 4,990 447 363 20 386 7 5 Totals 17,714 1,450 1,304 85 £1,477 5 1 84 MATERNITY AND CHILD WELFARE DENTAL CLINIC. During the year 1927 the number of patients referred for dental treatment is well up to the average. Much trouble is experienced still in getting patients to agree to conservative treatment, which would eliminate all necessity for extractions. The general idea on the part of the patient is to remove the teeth regardless of their value to the digestion and general health. There are also many cases where attention to simple hygiene of the mouth (viz., care and cleanliness), would have rendered treatment unnecessary. Continued efforts are being made to instruct the patients in the thorough use of the toothbrush and in the adoption of a suitable diet. In many cases the expectant mother indulges in too many sweet and starchy foodstuffs, whereas the harder and more fibrous foods would be advantageous, both to dental hygiene and general health. To summarise, the patient should:— (i.) Consistently follow out a daily routine of simple dental hygiene; (ii.) Realise the value of her natural teeth, and the necessity for keeping them, and take advantage of the opportunity afforded by conservative treatment, i.e., gum treatment, scaling and polishing, and fillings; (iii.) Adopt a suitable diet which will conform to the requirements of the Maternity Officer while affording the exercise which Nature demands for the upkeep of a healthy mouth. Finally, it is essential that the expectant mother should visit the dentist as early and as often as possible in order that her mouth may be put in a healthy condition and kept so. It is desirable that all treatment—especially that of a surgical nature —should be completed before the final month of pregnancy. The following shows attendances, operations, etc. : — No. of Sessions 26 No. of Patients 136 No. of Attendances 361 Dentures and Repairs 45 Extractions 303 Patients for Extractions 45 Extractions by locil anaesthetic 313 Impressions 28 Bite 31 Try in 27 Scaling. Polishing and Fillings 26 Health and Infant Welfare Week.—In previous years "Baby Week" had consisted generally either of baby shows for the babies connected with the Council's several Welfare Centres, or some form of entertainment with tea for the mothers associated 85 with our Maternity and Child Welfare scheme. In 1927, however, the Maternity and Child Welfare Committee, in association with the Public Health Committee, decided to arrange a five days exhibition consisting, briefly, of a commercial side from which the income necessary would be derived, and an instructional side represented by exhibits of educational societies, public lectures, suitable film displays, etc. T he Council kindly placed at the disposal of the Committee the whole of the Borough Hall premises and this fact contributed not a little to the general success which attended the effort. The Exhibition was held from July 5th to 9th, and from the opening each day at 2.30, large numbers of the general public attended, the evening sessions being packed to capacity. It is estimated that during the five days, from 12 to 15 thousand people attended. In addition to the very attractive commercial side, interesting exhibits were contributed by the Health and Cleanliness Council, British Social Hygiene Council, Dental Board of the United Kingdom, National Milk Publicity Council. College of Pestology, etc. Popular lectures were delivered by Mr. W. G. Kershaw, M.B.E., Chief Sanitary Inspector, Hampstead; Dr. Elizabeth Foley, of the Health and Cleanliness Council; Dr. E. B. Turner, of the British Social Hygiene Council; Mr. B. P. Tustin, (he authority on milk; Mr. Hugh Davies, F.R.C.S., and Mr. G. Fisher, Meat Inspector, Southwark Borough Council. Films were kindly loaned by the British Social Hvgiene Council, the Health and Cleanliness Council, and other organisations. The mothers associated with the several Welfare Centres were entertained to tea during the afternoons, and arrangements were also made for parties of children from the Greenwich L.C.C. schools to visit the Exhibition and listen to a brief lecture on health matters by the Medical Officer of Health, prior to the official opening. These children afterwards wrote essays on the subject, " What I have learned from the Greenwich Health Week," and many exceedingly well-written essays were received. The Health Week necessitated, of course, an immense amount of effort, and the success which attended the venture is a tribute to the enthusiasm and efficiency of the Public Health Department staff. The Exhibition involved a gross expenditure of over £500, the balance sheet showing a small margin on the right side. 86 Index of Contents. Page. Adoptive Acts, By-laws and Local Regulations 1-3, 26, 27 Age Mortality 14 Ambulance Facilities 22 Anthrax 60 Area of Borough 7 Articles and Rooms Disinfected 61 Articles Destroyed 62 Artificial Sunlight Treatment 23, 66-67, 78-79 Baby Week Competitions 84, 85 Bacteriological Examinations 25 Bakehouses 49 Births 9, 10 Blackheath and Charlton Cottage Hospital 26 Books Destroyed 71 Cancer 17-19 Clinics and Centres 23, 24, 76 Cerebro-Spinal Fever 59 Cleansing Children 71 Complaints 28 Consumption 6, 17 Contacts 68 Convalescent Treatment 78 Cowhouses 45 Customs and Inland Revenue Acts 32 Dairies, Cowsheds and Milkshops 45 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 14 Deptford Fund Babies' Hospital 81 Density of Population 7 Dental Work 70, 84 Diarrhoea and Zymotic Enteritis 17, 58 Diphtheria 17, 52-55 Diphtheria Anti-Toxin 25 Disinfection 61, 62 Duties and Powers of the Public Health Committee1, 2 Duties and Powers of the Maternity and Child Welfare Committee 3 Elevation of Borough 7 Encephalitis Lethargica 59 Enteritis 17, 58 Epidemic Cerebro-Spinal Meningitis 59 Epidemic Diseases 16 Erysipelas 55 Factories and Workshops 28-31 Fever Hospitals 21 Food and Drugs—Samples of 49, 51 Food—Premises for Preparation of, etc. 48 Glanders 59 Health Centres 23 Health Visitors, Visits, etc. 77 Health Week 84-85 Home Work 80 Horse Slaughterer 32 87 INDEX—continued. Hospital and other forms of Gratuitous Medical Relief 25 House Drainage 32 Houses Inspected re Infectious Diseases 71 Houses Let in Lodgings 32 Housing 42-44 Hydrophobia 60 Ice Cream Premises 39, 49 Increase of Rent and Mortgage Interest (Restriction) Acts, 1920 and 1923 33 Infant Consultations 23, 76 Infantile Mortality 15, 77 Influenza 17 Inhabited Houses 7 Inland Revenue Acts 32 Insanitary Areas 43 Institution Deaths 14 Introductory Review 4-6 Laboratory Work 25 Legal Proceedings 38 Marriages 9 Maternity and Child Welfare 76-85 Maternity Home 21, 80 Measles 16, 56-58 Meat 47 Mid wives 25 Milk and Cream Regulations 46 Milk and Dairies (Amendment) Act, 1922 45 Milk and Dairies (Order), 1926 45 Milk Supply 45 Milk Supply for Expectant and Nursing Mothers 82 Milk (Special Designations) Order, 1923 45 Miller General Hospital 26 Minor Ailment Centre 78 Mortuary 20, 41 Notices, etc. 38 Notifications 52-60 Notification of Births Act 81 Nursing Arrangements 25 Offensive Trades Ophthalmia Neonatorum 59. 82 Outworkers' Register Overcrowding 39 Persons Cleansed 71 Polio-myelitis Poor Law Relief 26 Population Public Health Committee Public Health (Meat) Regulations, 1924 47 Public Health (Preservatives, &c., in Food) Regulations 49 Public Sanitary Conveniences 32 Puerperal Fever 56, 81 Puerperal Pyrexia 56, 81 Rats and Mice (Destruction) Act, 1919 32 Remarks on Death Causes 16-19 Sale of Food and Drugs Act 49-51 Sanitary Work—Summaries, etc. 34-41 Scarlet Fever 16, 55, 56 88 INDEX—continued. Scavenging and Refuse Removal 33 School Clinic 24 Seamen's Hospital 25 Slaughterhouses 47 Small-pox 16, 52 Smoke Nuisances 31 Staff of Public Health Department 24 Statistical Tables Appendix Street Traders 48 Tuberculosis 17, 60 Tuberculosis Dispensary—Return of Attendances 74 Tuberculosis Care Committee 69 Tuberculosis Officer's Report 64-70 Typhoid Fever 16, 55 Underground Bakehouses 31 Underground Rooms 39 Unwholesome Food 49 Uninhabited Houses 7 Vaccination Particulars 63 Verminous Premises 33, 40 Verminous Children 71 Virol 83 Vital Statistics 7, 8 and Appendix Water Supply 31 Whooping Cough 15, 58, 59 Workshops and Factories 28-31 Zymotic Enteritis 17, 58 Zymotic Diseases 16 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 2nd April, 1927. DISTRICTS Census Population, 1921. Estimated Population at the middle or the Year 1927. Births Registered during the 13 weeks ended 2nd April, 1927. Deaths Registered during the 13 weeks ended 2nd April, 1927. age mortality. seven zymotic diseases. Tuberculosis, (Pulmonary.) All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhoea and Dysentery. All Causes. f Seven Zymotics. Typhoid. Other. During the corresponding period year previous During the 13 weeks ended 2nd April, 1927. During the corresponding period year previous. During the 13 weeks ended 2nd April, 1927. M. F. M. F. Greenwich East 44213 45179 93 89 83 73 12 8 62 ... ... ... ... 4 ... ... 1 12 ... 36 11 16 76 10.80 13.85 •35 .44 Do. West 26677 27344 65 61 65 54 9 8 37 ... ... ... 2 3 ... ... ... 12 1 31 9 8 53 15.77 17.61 •73 •73 St. Nicholas, Deptford 7582 7864 28 24 17 16 6 2 10 ... ... ... ... 1 ... ... ... ... 1 9 5 1 16 23.59 16.83 4.09 .51 CHARLTON 18785 20868 52 48 46 38 6 7 49 ... ... ... ... 1 ... ... ... 2 1 19 10 9 42 9.85 16.15 .19 .16 Kidbrooke 3193 3325 6 3 2 8 ... ... 6 ... ... ... ... ... ... ... ... ... ... 3 ... 1 6 6.06 12.07 ... ... Miller Hospital— Resident ... ... ... 2 4 ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 5 ... ... ... ... Non-Resident ... ... ... 13 7 1 1 3 ... ... ... ... ... ... ... ... 1 ... 3 2 2 12 ... ... ... ... Seamen's Hospital— Resident ... ... ... 20 1 ... ... 1 ... ... ... ... ... ... ... ... 2 ... 8 ... 5 6 ... ... ... ... Non-Resident ... ... ... 16 2 ... ... 4 ... ... ... ... ... ... ... ... ... ... 5 2 7 4 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... 54 36 11 4 29 ... ... ... ... ... ... ... 1 5 ... 23 7 6 48 ... ... ... ... Non-Resident ... ... ... 92 65 15 5 64 ... ... ... ... ... ... ... ... 9 3 40 12 17 76 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 5 4 1 5 ... ... ... ... 1 5 ... ... ... ... ... 1 ... 1 1 ... ... ... ... Non-Resident ... ... ... 8 10 2 11 ... ... ... 1 6 8 ... ... ... ... ... 3 ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... 2 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... Other Institutions— Resident ... ... ... 1 8 2 ... 4 ... ... ... ... ... ... ... ... ... ... 1 ... 1 7 ... ... ... ... Non-Resident ... ... ... 4 6 2 ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... 1 7 ... ... ... ... Outside Institutions ... ... ... 35 34 3 4 23 ... ... ... 1 3 ... ... ... 6 2 7 4 7 39 ... ... ... ... 244 225 213 189 Borough 100450 104580 469 *402 33 25 164 ... ... ... 2 9 ... ... 1 26 3 98 35 35 193 ... ... ... ... Rate per 1,000 of Estimated Population ... ... 18.03 15.42 ... ... ... ... ... ... .07 .34 ... ... •03 .99 •11 3.76 1.33 1.33 7.39 12.72 15.42 .69 .45 Deaths of Children under 1 Year per 1,000 births, 70 Death Rate of 105 large English Towns, 17.4 ; of the County of London, 18.0 previous) Gross Births Registered, 530 ,, ,, corresponding60 (20.33 per 1000). period ) „ „ „ County of London 76 Birth Rate „ „ 17.2 „ „ 16 8. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 2nd July, 1927. DISTRICTS Census Population, 1921. Estimated ePopulation at the middle of the Year 1927. Births Registered during the 13 weeks ended 2nd July, 1927. Deaths Registered during the 13 weeks ended 2nd July, 1927. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Tuberculosis, (Pulmonary.) All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,000. Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhoea and Dysentery. All Causes. Seven Zymotics. Typhcid. Other. During the corresponding period year previous. During the 13 weeks ended 2nd July, 1927. During the corresponding period year previous. During the 13 weeks ended 2nd July, 1927. M. F. M. F. Greenwich East 44213 45179 78 94 60 46 10 8 44 ... ... ... 4 4 ... ... ... 9 2 7 18 6 56 10.07 9.41 .26 .70 Do. West 26677 27344 53 44 43 31 6 1 21 ... ... ... 2 ... ... ... 1 7 1 9 8 13 33 12.39 10.54 .14 .43 St. Nicholas, Deptford 7582 7864 30 17 10 5 4 1 6 ... ... ... ... 1 ... ... ... ... ... 7 2 1 4 12.30 7.64 ... 51 charlton 18785 20868 40 51 20 27 ... 2 28 ... ... ... ... ... ... ... ... 6 1 5 5 12 18 8.69 8.03 ... ... Kidbrooke 3193 3325 1 6 2 5 ... ... 3 ... ... ... ... ... ... ... ... 1 ... 2 ... 3 1 7.27 8.44 ... ... Miller Hospital— Resident ... ... ... 2 3 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 4 ... ... ... ... Non-Resident ... ... ... 9 4 ... 2 1 ... ... ... ... ... ... ... ... ... 2 ... ... 1 10 ... ... ... ... Seamen's Hospital— Resident ... ... ... 12 ... ... 1 4 ... ... ... ... ... ... ... ... ... ... 1 1 4 6 ... ... ... Non-Resident ... ... ... 15 ... ... ... 2 ... ... ... ... ... ... ... ... 2 1 2 ... 5 5 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... 36 27 8 3 24 ... ... ... ... ... ... ... ... 7 1 7 6 6 36 ... ... ... Non-Resident ... ... ... 44 41 8 3 31 ... ... ... ... ... ... ... 1 6 2 16 10 11 39 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 1 6 1 3 ... ... ... ... 4 2 ... ... ... ... ... 1 ... ... ... ... ... ... Non-Resident ... ... ... 3 7 ... 8 ... ... 1 ... 2 5 ... ... ... ... 1 ... ... ... 1 ... ... ... ... Cottage Hospital— Resident ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Non-Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... 2 2 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 ... ... ... ... Non-Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Outside Institutions ... ... ... 22 21 5 2 8 ... ... ... 1 ... ... ... I 7 1 3 4 6 20 ... ... ... ... 202 212 135 114 Borough 100450 104580 *414 249 20 12 102 ... ... ... 6 5 ... ... I 23 4 30 33 35 112 ... ... ... ... Rate per 1,000 of Estimated Population ... ... 15.58 9.55 ... ... ... ... ... ... •22 .19 ... ... .03 •88 •15 1.14 1.25 1.33 4.28 10.49 9.55 .15 .45 Deaths of Children under 1 Year per 1,000 births, 50 Death Rate of 107 large English Towns, 10.7 ; of the County of London, 10.0 previous • Gross Births Registered, 535 „ „ „ corresponding 49 (20 6 per 1000). period „ „ „ County of London 50 Birth Rate „ „ 18.2 „ „ „ 17.4. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 1st October, 1927. DISTRICTS Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the 13 weeks ended 1st October, 1927. Deaths Registered during the 13 weeks ended 1st October, 1927. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Tuberculosis, (Pulmonary). All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1,0u0 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhoea and Dysentery. All Causes. Seven Zymctics. Typhcid. Other. During the corresponding period year previous. During the 13 weeks ended 1st October, 1927. During the corresponding period year previous. During the 13 weeks ended 1st October, 1927. for Death Rate for Birth Rate M. F. M. F. Greenwich East 44213 44604 44798 86 79 47 48 8 4 36 ... ... 1 1 1 ... ... 2 6 4 9 7 16 48 9.99 8.44 .53 .44 Do. West 26677 26996 27114 49 57 28 22 4 1 18 ... ... ... ... ... 1 ... 1 5 3 5 7 4 24 8.96 7.43 ... .29 St. Nicholas, Deptford 7582 7764 7798 22 24 9 8 2 1 4 ... ... ... ... 1 ... ... ... 1 5 1 4 5 6.66 8.78 .51 .51 Charlton 18785 20603 20693 38 32 20 14 3 2 17 ... ... ... ... ... ... ... ... 1 1 3 6 6 17 7.73 6.62 .19 ... Kidbrooke 3193 3283 3297 2 4 2 3 ... ... 2 ... ... ... ... ... ... ... ... ... 1 ... 2 ... 2 2.42 6.11 ... ... Mii.i.er Hospital— Resident ... ... ... ... 4 6 ... ... 3 ... ... ... ... ... ... ... ... ... ... 2 3 2 3 ... ... ... ... Non-Resident ... ... ... ... 15 5 1 1 2 ... ... ... ... ... ... ... ... 1 ... ... 1 ... 14 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 9 ... ... ... 1 ... ... ... ... ... 1 ... ... 2 1 1 ... 4 ... ... ... ... Non-Resident ... ... ... ... 13 2 ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... 5 8 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 31 26 5 2 23 ... ... ... ... ... ... ... 2 2 3 8 2 8 32 ... ... ... ... Non-Resident ... ... ... ... 43 30 1 2 26 ... ... ... ... ... ... ... ... 10 ... 9 5 13 36 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ..... 1 4 1 1 ... ... ... 1 1 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... ... 4 7 3 3 ... ... ... 1 4 4 ... ... ... 1 ... 1 ... ... ... ... ... ... ... cottace hospital— Resident ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 2 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... Non-Resident ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Outside Institutions ... ... ... ... 28 20 4 1 18 ... ... ... 1 ... ... ... 1 9 2 3 4 6 22 ... ... ... ... 197 196 106 95 Borough 100450 103250 103700 *393 201 17 8 77 ... ... 1 1 2 1 ... 3 13 9 22 23 30 96 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 15.24 7.80 ... ... ... ... ... .03 .03 .07 .03 ... .11 .50 .34 .85 .88 1.16 3.71 8.52 7.80 .23 .30 Deaths of Children under 1 Year per 1,000 births, 43 Death Rate of 107 large English Towns, 9.2; of the county of London, 8.7. previous * Gross Births Registered, 450 „ „ ,, corresponding 62 (1746 per 1000). period 16.4 „ „ „ County of London 43 Birth Rate „ ,, 17.2 „ „ BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 13 weeks ended 30th December, 1927. districts Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the 13 weeks ended 30th December, 1927. Deaths Registered during the 13 weeks ended 30th December, 1927. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Tuberculosis, (Pulmonary). 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. Fevers All Causes. Seven Zymctics Whooping Cough. Typhoid. Other. Diarrhoea and Dysentery. During the corresponding period year previous. During the 13 weeks ended 30th December, 1927. During the corresponding period year previous. During the 13 weeks ended 30th December. 1927. for Death Rate for Birth Rate M. F. M. F. Greenwich East 44213 44604 44798 96 86 45 69 12 1 47 ... ... 1 ... ... ... ... 3 5 2 13 13 12 65 12.40 10.24 .53 .35 Do. West 26677 26996 27114 37 60 38 28 2 1 29 ... ... ... 1 ... ... ... ... 7 2 7 5 12 32 12.83 9.80 .29 .14 St. Nicholas, Deptford 7582 7764 7798 23 22 11 10 ... 1 10 ... ... ... ... ... ... ... ... 2 1 5 4 1 8 14.35 10.84 1.53 ... Charlton 18785 20603 20693 33 36 26 28 6 3 26 ... ... ... ... ... ... ... ... 2 1 11 11 6 23 9.28 10.51 .19 ... Kidbrooke 3193 3283 3297 4 6 5 3 ... ... 2 ... ... ... 1 ... ... ... ... ... ... ... 1 2 4 6.06 9 77 ... 1.22 Miller Hospital— Resident ... ... ... ... 2 7 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 3 1 4 ... ... ... ... Non-Resident ... ... ... ... 13 5 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 3 14 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 8 1 ... ... 1 ... ... ... ... ... ... ... ... 3 1 1 ... 2 2 ... ... ... ... Non-Resident ... ... ... ... 23 ... ... 1 1 ... ... ... ... ... ... ... ... 4 ... ... 6 ... 13 ... ... ... ... Greenwich &- Deptford ... ... ... ... 23 ... ... 1 1 ... ... ... ... ... ... ... ... 4 ... ... 6 ... 13 ... ... ... ... Hospital— Resident ... ... ... ... 36 27 3 3 26 ... ... ... ... ... ... ... ... 4 2 10 4 11 32 ... ... ... ... Non-Resident ... ... ... ... 58 38 5 1 35 ... ... ... ... 1 ... ... 1 10 2 20 6 14 42 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... 2 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... 16 8 6 11 ... ... 13 3 5 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 2 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... Non-Resident ... ... ... ... 2 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... Outside Institutions ... ... ... 25 25 2 1 20 ... ... ... 1 ... ... ... ... 2 2 1 7 8 29 ... ... ... ... 193 210 125 138 Borough 100450 103250 103700 *403 263 20 6 114 ... ... 1 2 ... ... ... 3 16 6 36 34 33 132 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 15.59 10.20 ... ... ... ... ... 03 07 ... ... ... .1 62 •22 1.9 1.32 1.36 5.12 11.83 10.19 .46 .22 Deaths of Children under 1 Year per 1,000 births, 49 * Gross Births Registered. 445 previous } (17 22 per 1000). " " " corresponding} 74 „ „ „ County of London 57 Death Rate of 107 large English Towns, 11.9 of the County of London, 11.7 Birth Rate „ „ 161 „ „ ,, 15.2, BOROUGH OF GREENWICH. Return of Births and Deaths registered during the 52 weeks ended 30th December, 1927. DISTRICTS Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during he 52 weeks ended 31st December, 1927. Deaths Registered during he 52 weeks ended 31st December, 1927. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Tuberculosis, (Pulmonary). All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate of Mortality per 1.000 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhoea and Dysentery. All Causes. Seven Zymotics Typhoid. Other. During the corresponding period year previous. During the 52 weeks ended 31st December, 1927. During the corresponding period year previous. During the 52 weeks ended 3lst December, 1927. for Death Rate for Birth Kate M F. M. F. Greenwich East 44213 44604 44798 354 350 235 236 42 21 189 ... ... 2 5 9 ... 6 32 8 65 49 50 245 10.82 10.59 .02 .49 Do. West 26677 26996 27114 204 222 174 135 21 11 105 ... ... ... 5 3 1 ... 2 31 7 52 29 37 142 12.24 11.48 .14 .40 St. Nicholas, Deptford 7582 7764 7798 103 87 47 39 12 5 30 ... ... ... ... 3 ... ... ... 3 2 26 12 7 33 14.22 11.11 1.02 .38 Charlton 18785 20603 20693 163 168 112 107 15 14 120 ... ... ... ... 1 ... ... ... 11 4 38 32 33 100 8 89 10.66 .04 .04 Kidbrooke 3193 3283 3297 13 19 11 19 ... ... 13 ... ... ... 1 ... ... ... ... 1 1 5 3 6 13 5.45 9.16 ... .30 Miller Hospital— Resident ... ... ... ... 10 20 ... 2 3 ... ... ... ... ... ... ... ... ... 1 4 6 3 16 ... ... ... ... Non-Resident ... ... ... ... 50 21 2 4 8 ... ... ... ... ... ... ... ... 2 2 3 4 10 50 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 49 2 ... 1 7 ... ... ... ... ... 1 ... ... 7 1 11 2 11 18 ... ... ... ... Non-Resident ... ... ... ... 67 4 ... 1 8 ... ... ... ... ... ... ... ... 7 2 7 8 17 30 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 157 116 27 12 102 ... ... ... ... ... ... ... 3 18 6 48 19 31 148 ... ... ... ... Non-Resident ... ... ... ... 237 174 29 11 156 ... ... ... ... 1 ... ... 2 35 7 85 33 55 193 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... 9 14 3 9 ... ... ... 2 7 9 ... ... ... ... ... 2 ... 1 2 ... ... ... ... Non-Resident ... ... ... ... 31 32 11 33 ... ... 13 6 17 18 ... ... 1 1 1 5 ... ... 1 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... Non-Resident ... ... ... ... 2 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 7 10 4 1 8 ... ... ... ... ... ... ... ... ... ... 1 2 2 12 ... ... ... ... Non-Resident ... ... ... ... 7 8 2 ... 5 ... ... ... ... ... ... ... 1 ... 1 ... 2 3 8 ... ... ... ... Outside Institutions ... ... ... ... 110 100 14 8 69 ... ... ... 4 3 ... ... 2 24 7 14 19 27 110 ... ... ... ... 837 846 579 536 Borough 100450 103250 103700 *1683 1115 90 51 457 ... ... 2 11 16 1 ... 8 78 22 186 125 133 533 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 16.27 10.83 ... ... ... ... ... .01 .10 .15 .009 ... .07 .75 .21 1.80 1.21 1.28 5.17 10.89 10.83 .40 .36 Deaths of Children under 1 Year per 1,000 births, 53 previous } * Gross Births Registered, 1912 „ „ „ corresponding 61 (18.48 per 1000). period) „ „ „ County of London 59 Death Rate of 107 large English Towns, 12.2 of the County of London, 119 Birth Rate „ „ 17.1 „ „ „ 16.1. BOROUGH OF GREENWICH. Causes of, and Ages at. Death during the 13 weeks ended 2nd April, 1927. 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 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Whooping Cough 9 1 6 2 ... ... ... ... ... 4 3 1 1 ... ... ... ... ... 5 ... ... 3 16 Diphtheria and Croup 2 ... ... ... 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 ... ... 1 7 Influenza 15 1 ... ... ... 1 3 4 6 5 4 ... 6 ... 1 ... ... ... ... ... 1 1 3 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Meningococcal Meningitis 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Tuberculosis of Respiratory System 26 ... ... ... ... 4 17 5 ... 12 12 ... 2 ... 5 2 ... ... ... ... ... 6 17 Other Tuberculous Diseases 3 ... 1 ... ... 1 ... 1 ... ... 1 1 1 ... ... ... 1 ... ... ... ... 2 5 Cancer, malignant disease 35 ... ... ... ... ... 4 19 12 16 8 1 9 1 5 5 ... ... 1 ... 1 7 40 Rheumatic Fever 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... Diabetes 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... Cerebral Haemorrhage, &c 17 ... ... ... ... ... 2 4 11 7 4 2 3 1 5 ... ... ... ... ... 1 5 13 Heart Disease 35 ... ... ... ... 1 ... 16 18 11 9 5 10 ... 7 ... ... ... ... ... ... 4 25 Arterio-Sclerosis 11 ... ... ... ... ... ... 2 9 3 3 ... 4 1 3 ... ... ... ... ... 1 ... 16 Bronchitis 62 ... 2 3 ... 2 2 11 42 26 20 2 11 3 11 4 ... ... ... ... 1 2 47 Pneumonia (all other forms) 36 7 5 3 ... 2 4 7 8 10 11 7 8 ... 11 3 ... ... 2 ... ... 5 38 Other Respiratory Diseases 7 ... ... ... ... 1 1 4 1 2 3 1 1 ... 1 1 ... ... ... ... ... ... 5 Ulcer of Stomach or Duodenum 5 ... ... ... ... ... 3 2 ... 1 1 1 1 1 1 1 3 ... ... ... ... 1 10 Diarrhoea, &c 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Appendicitis 2 ... ... ... ... 2 ... ... ... 1 1 ... ... ... 2 ... ... ... ... ... ... ... 4 Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Ac. & Cr. Nephritis 12 ... ... ... 2 ... 2 5 3 5 6 ... 1 ... 4 2 1 ... ... ... ... 3 11 Puerperal Sepis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 21 20 ... 1 ... ... ... ... ... 7 6 3 5 ... 6 ... ... ... ... ... 2 1 18 Violent Deaths, excluding Suicide 14 ... ... ... 4 2 1 4 3 7 1 ... 4 2 4 1 ... ... ... ... ... 6 15 Suicides 3 ... ... ... ... ... 1 2 ... 2 ... ... 1 ... ... ... ... ... ... ... ... ... 2 Other Defined Diseases 81 3 2 ... 3 1 6 16 50 32 23 9 16 1 21 2 ... ... ... ... 2 22 63 Diseases ill-defined or unknown 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 402 33 16 9 13 17 48 102 164 156 119 33 84 10 90 21 6 ... 9 ... 9 69 361 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 1st July, 1927. 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 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Whooping Cough 5 3 2 ... ... ... ... ... ... 4 ... 1 ... ... ... ... ... ... 2 ... ... ... 7 Diphtheria and Croup 6 ... ... 3 3 ... ... ... ... 4 2 ... ... ... ... ... ... ... 4 ... ... 1 6 influenza 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 23 ... ... ... 1 6 10 6 ... 9 7 ... 6 1 7 ... ... ... ... ... ... 7 15 Other Tuberculous Diseases 4 1 ... 1 1 1 ... ... ... 2 1 ... 1 ... 1 ... ... ... ... ... ... 1 7 Cancer, malignant disease 35 ... ... ... ... ... 3 14 18 6 13 1 12 3 6 4 ... ... ... ... 1 6 29 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 3 ... ... ... 1 ... ... 2 ... 1 1 ... ... 1 1 ... ... ... ... ... ... 1 2 Cerebral Haemorrhage, &c 10 1 ... ... ... ... ... 2 7 4 2 1 3 ... 3 ... ... ... ... ... ... 1 5 Heart Disease 33 ... ... ... 2 1 7 6 17 18 8 2 5 ... 6 1 ... ... ... ... ... 4 17 Arterio-Sclerosis 12 ... ... ... ... ... ... 3 9 9 2 ... 1 ... 5 1 ... ... ... ... 1 ... 11 Bronchitis 14 1 ... ... ... ... ... 5 8 3 4 4 3 ... 4 ... ... ... ... ... ... 2 13 Pneumonia (all other forms) 16 1 2 ... 1 1 1 3 7 4 5 3 2 2 3 1 1 ... 1 1 ... 1 17 Other Respiratory Diseases 2 ... ... ... ... ... ... 2 ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 5 Ulcer of Stomach or Duodenum 3 ... ... ... ... ... 1 2 ... 2 1 ... ... ... 1 ... ... ... ... ... ... 1 2 Diarrhoea, &c 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 Appendicitis 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 4 Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Ac. & Cr. Nephritis 3 ... ... ... ... ... ... ... 3 1 ... 1 1 ... ... ... ... ... ... ... ... 1 9 Puerperal Sepis 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 8 8 ... ... ... ... ... ... ... 6 2 ... ... ... 6 ... ... ... ... ... 1 1 10 Violent Deaths, excluding Suicide 10 ... ... 2 1 ... 1 4 2 5 3 ... 2 ... 2 2 ... ... ... ... ... 2 8 Suicides 5 ... ... ... ... ... 2 2 1 1 4 ... ... ... 1 1 1 ... ... ... ... 2 5 Other Defined Diseases 52 4 1 1 ... 5 1 11 29 24 15 2 11 ... 15 2 3 ... ... ... 1 11 43 Diseases ill-delined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 249 20 5 7 10 16 26 63 102 106 74 15 47 7 63 12 5 ... 7 1 4 43 218 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 30th September, 1927. 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 Enteric Fever 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 2 Whooping Cough 2 2 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 2 ... ... ... 6 Diphtheria and Croup 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 5 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Tuberculosis of Respiratory System 13 ... ... ... ... 2 5 4 2 6 5 1 1 ... 3 2 ... ... ... ... ... 3 14 Other Tuberculous Diseases 9 1 1 2 2 1 1 1 ... 4 3 ... 1 1 3 ... ... ... ... 1 ... 1 7 Cancer, malignant disease 30 ... ... ... ... ... 5 10 15 16 4 4 6 ... 8 ... 2 ... ... ... ... 8 35 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 2 ... ... ... ... ... ... ... 2 2 ... ... ... ... 1 ... ... ... ... ... ... ... 2 Cerebral Haemorrhage, &c. 10 ... ... ... ... ... ... 2 8 2 5 1 1 1 2 ... ... ... ... ... ... 2 9 Heart Disease 23 ... ... ... 1 1 4 11 6 7 7 1 6 2 2 1 3 ... ... ... 1 4 15 Arterio-Sclerosis 4 ... ... ... ... ... ... 1 3 1 1 ... 2 ... 1 ... ... ... ... ... ... 1 2 Bronchitis 5 ... 1 ... ... ... ... 1 3 1 1 1 2 ... ... ... ... ... ... ... ... 1 3 Pneumonia (all other forms) 17 1 1 ... ... 2 3 6 4 8 4 4 1 ... 8 1 2 ... ... ... ... 4 20 Other Respiratory Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ulcer of Stomach or Duodenum 4 ... ... ... ... ... 1 3 ... 2 1 ... 1 ... 2 1 1 ... ... ... ... ... 6 Diarrhoea, &c 3 3 ... ... ... ... ... ... ... 2 1 ... ... ... 2 ... ... ... ... ... ... ... 2 Appendicitis 2 ... ... ... 2 ... ... ... ... 2 ... ... ... ... ... 1 1 ... ... ... ... ... 2 Cirrhosis of Liver 3 ... ... ... ... ... ... 1 2 3 ... ... ... ... ... 1 ... ... ... ... ... 1 2 Ac. & Cr. Nephritis 8 ... ... ... ... ... 1 2 5 6 1 1 ... ... 6 ... ... ... ... ... ... ... 12 Puerperal Sepis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 2 ... ... ... ... 1 1 ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 10 9 ... 1 ... ... ... ... ... 4 3 1 2 ... 2 ... ... ... ... ... 1 3 5 Violent Deaths, excluding Suicide 6 ... ... ... ... 2 ... 2 2 3 3 ... ... ... 2 ... ... ... ... ... ... 3 11 Suicides 2 ... ... ... ... ... ... 1 1 1 1 ... ... ... 1 1 ... ... ... ... ... 1 2 Other Defined Diseases. 42 1 ... 1 2 3 3 8 24 20 8 2 11 1 12 ... 1 ... 1 ... ... 16 39 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 201 17 3 5 9 12 25 53 77 95 50 17 34 5 57 9 10 ... 5 1 2 48 204 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., person resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded. BOROUGH OF GREENWICH. Causes of, and Ages at, Death during the 13 weeks ended 30th December, 1927. 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 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Scarlet Fever 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 5 Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Diphtheria and Croup 2 ... ... ... 1 1 ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... 1 6 lnfluenza 2 ... ... ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 16 ... ... ... 1 3 7 4 1 5 7 2 2 ... 4 3 ... ... ... ... ... 2 21 Other Tuberculous Diseases 6 ... ... ... 3 1 2 ... ... 2 2 1 1 ... 2 1 ... ... ... ... ... 2 5 Cancer, malignant disease 33 ... ... ... ... ... 5 13 15 12 12 1 6 2 11 2 1 ... ... ... ... 8 32 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 2 ... ... 1 ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... 1 2 Cerebral Haemorrhage, &c. 15 ... ... ... ... ... ... 6 9 2 7 4 1 1 2 ... ... ... ... ... ... 6 9 Heart Disease 34 1 ... ... 1 ... 4 11 17 13 5 4 11 1 4 ... 3 ... ... 1 1 7 24 Arterio-Sclerosis 8 ... ... ... ... ... ... 1 7 3 2 ... 3 ... 1 ... ... ... ... ... ... ... 3 Bronchitis 21 ... ... ... ... ... 1 4 16 7 5 3 6 ... 5 1 ... ... ... ... ... ... 14 Pneumonia (all other forms) 15 4 1 2 ... ... 1 3 4 6 2 2 5 ... 5 ... 1 ... ... ... ... 1 21 Other Respiratory Diseases 2 ... ... ... ... ... ... 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Ulcer of Stomach or Duodenum 3 ... ... ... ... ... 2 1 ... 3 ... ... ... ... 1 1 ... ... ... ... 1 ... 10 Diarrhoea, &c. 3 3 ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... 2 Appendicitis 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... .... ... 3 Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ac. & Cr. Nephritis 13 ... ... ... ... ... ... 8 5 7 2 ... 3 1 3 ... ... ... ... ... ... 4 10 Puerperal Sepis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 7 7 ... ... ... ... ... ... ... 4 2 ... 1 ... 2 ... ... ... ... ... ... ... 5 Violent Deaths, excluding Suicide 14 1 ... 1 1 2 1 3 5 8 3 ... 2 1 6 1 1 ... ... ... ... 3 21 Suicides 3 ... ... ... ... ... 2 1 ... ... 2 ... 1 ... ... ... 1 ... ... ... ... ... 2 Other Defined Diseases 62 4 1 ... ... 3 6 15 33 36 11 4 11 ... 17 ... 1 ... ... ... ... 15 39 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 263 20 2 4 8 11 31 73 114 114 66 21 54 8 63 9 9 ... 2 1 2 50 250 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 31st December, 1927. 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 Outsidede Institutions Enteric Fever 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Scarlet Fever 2 ... ... ... 2 ... ... ... ... 2 ... ... ... ... ... ... ... ... 2 ... ... ... 9 Whooping Cough 16 6 8 2 ... ... ... ... ... 9 3 3 1 ... ... ... ... ... 9 ... ... 3 31 Diphtheria and Croup 11 ... ... 4 6 1 ... ... ... 5 5 ... ... 1 ... ... ... ... 7 ... ... 3 24 Influenza 18 1 ... ... ... 1 3 5 8 6 6 ... 6 ... 1 ... ... ... ... ... 1 1 3 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Meningococcal Meningitis 2 ... ... ... 2 ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... 2 Tuberculosis of Respiratory System 78 ... ... ... 2 15 39 19 3 32 31 3 11 1 19 7 ... ... ... ... ... 18 67 Other Tuberculous Diseases 22 2 2 3 6 4 3 2 ... 8 7 2 4 1 6 1 1 ... ... ... ... 6 24 Cancer, malignant disease 133 ... ... ... ... ... 17 56 60 50 37 7 33 6 30 11 3 ... 1 1 2 29 136 Rheumatic Fever 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... Diabetes 8 ... ... 1 1 ... 1 3 2 4 2 ... ... 2 3 ... ... ... ... ... ... 2 6 Cerebral Haemorrhage, &c. 52 1 ... ... ... ... 2 14 35 15 18 8 8 3 12 ... ... ... ... ... 1 14 36 Heart Disease 125 1 ... ... 4 3 15 44 58 49 29 12 32 3 19 2 6 ... ... 1 2 19 81 Arterio-Sclerosis 35 ... ... ... ... ... ... 7 28 16 8 ... 10 1 10 1 ... ... ... ... 2 1 32 Bronchitis 102 1 3 3 ... 2 3 21 69 37 30 10 22 3 20 5 ... ... ... ... 1 5 77 Pneumonia (all other forms) 84 13 9 5 1 5 9 19 23 28 22 16 16 2 27 5 4 ... 3 1 ... 11 96 Other Respiratory Diseases 11 ... ... ... ... 1 1 7 2 4 5 1 1 ... 2 1 ... ... ... ... ... ... 10 Ulcer of Stomach or Duodenum 15 ... ... ... ... ... 7 8 ... 8 3 1 2 1 5 3 4 ... ... ... 1 2 28 Diarrhoea, &c. 8 8 ... ... ... ... ... ... ... 6 2 ... ... ... 3 ... ... ... ... ... ... 1 6 Appendicitis 6 ... ... ... 2 4 ... ... ... 4 1 ... 1 ... 3 1 2 ... ... ... ... ... 13 Cirrhosis of Liver 4 ... ... ... ... ... ... 2 2 3 1 ... ... ... ... 1 ... ... ... ... ... 1 3 Ac. & Cr. Nephritis 36 ... ... ... 2 ... 3 15 16 19 9 2 5 1 13 2 1 ... ... ... ... 8 42 Puerperal Sepis 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 3 ... ... ... ... 1 2 ... ... 2 1 ... ... ... 2 ... ... ... ... ... ... ... 4 Congenital Debility and Malformation, including Premature Birth 46 44 ... 2 ... ... ... ... ... 21 13 4 8 ... 16 ... ... ... ... ... 4 5 38 Violent Deaths, excluding Suicide 44 1 ... 3 6 6 3 13 12 23 10 ... 8 3 14 4 1 ... ... ... ... 14 55 Suicides 13 ... ... ... ... ... 5 6 2 4 7 ... 2 ... 2 2 2 ... ... ... ... 3 11 Other Defined Diseases ... 237 12 4 2 5 12 16 50 136 112 57 17 49 2 65 4 5 ... 1 ... 3 64 184 Diseases ill-defined or unknown 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1115 90 26 25 40 56 130 291 457 471 309 86 219 30 273 51 30 ... 23 3 17 10 1033 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 1st Quarter ending 2nd April, 1927. 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. (h) Greenwich East Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke. (h) Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 107 5 26 55 10 11 ... ... 44 33 8 20 2 44 33 8 20 2 107 Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 31 ... 2 2 4 5 6 2 7 5 5 1 3 3 ... ... ... 2 5 Scarlet Fever 123 1 24 72 19 7 ... ... 57 23 7 28 8 57 23 7 28 8 123 Poliomyelitis 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Membranous Croup 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ,, Pyrexia 2 ... ... ... 1 1 ... ... 2 ... ... ... ... 2 ... ... ... ... 2 Cerebro-Spinal Fever 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Malaria 5 ... ... ... ... 4 1 ... 1 2 2 ... ... ... ... ... ... ... ... Measles 56 4 12 35 5 ... ... ... 13 3 2 37 1 ... 1 ... ... ... 2 Whooping Cough 201 23 93 82 ... 2 1 ... 130 36 16 19 ... 10 7 ... 1 ... 21 Diarrhœa 10 4 6 ... ... ... ... ... 7 3 ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 4 4 ... ... ... ... ... ... 1 ... ... 3 ... 1 ... ... 2 ... 3 Tuberculosis, Pulmonary 11 ... 1 7 9 15 9 ... 22 12 2 4 1 7 3 ... ... ... 10 „ Non-Pulmonary 8 ... 2 3 1 1 1 ... 2 3 1 2 ... ... ... ... 1 ... 1 Pneumonia, Acute Primary, or Acute Influenzal 58 6 14 5 5 17 9 2 17 14 9 18 ... 6 9 3 7 ... 25 Totals 639 48 181 262 54 63 27 4 804 136 52 132 15 131 77 21 59 13 103 (h) Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 2nd Quarter ending 2nd July, 1927. 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. (h) Greenwich East Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke. (h) Total. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Poliomyelitis 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 99 ... 15 66 16 1 ... ... 34 31 14 15 5 34 31 14 15 5 99 Membranous Croup 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 13 ... ... ... 2 3 7 1 4 2 1 6 3 1 1 3 ... 8 Scarlet Fever 139 ... 36 82 10 9 1 1 61 47 4 20 7 61 47 4 19 7 138 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... 1 ... 2 ... ... ... ... 1 ... 2 ... ... 1 ... 2 ... 3 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... 1 1 ... ... 2 ... ... ... ... 1 ... ... ... ... 1 ,, Pyrexia 3 ... ... ... 1 2 ... ... 1 ... 1 1 ... 2 ... ... 1 ... 3 Malaria 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... Measles 98 2 33 58 3 2 ... ... 26 3 68 ... 1 2 ... 1 1 ... 4 Whooping Cough 149 14 84 51 ... ... ... ... 92 26 21 8 2 3 1 2 ... ... 6 Diarrhœa 16 9 7 ... ... ... ... ... 16 ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 8 8 ... ... ... ... ... ... 4 ... 1 2 1 3 ... ... 2 ... 5 Tuberculosis, Pulmonary 36 ... ... 5 7 9 13 2 15 8 2 11 ... 2 2 ... ... ... 4 ,, Non-Pulmonary 7 1 ... 3 ... 2 1 ... 4 1 1 1 ... 2 ... 1 ... ... 3 Pneumonia, Acute Primary, or Acute Influenzal 27 ... 5 8 4 5 4 1 6 6 6 8 1 2 3 2 6 ... 13 Totals 603 35 183 273 46 35 26 5 266 126 120 74 17 115 86 25 49 12 287 (h) Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situate BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending 1st October, 1927. 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. (h) Greenwich East Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke. (h) Total. Under 1 1 to 5 5 to IS 15 to 25 25 to 45 45 to 65 65 and upwards Small-Pox ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 66 2 11 41 7 4 1 ... 26 19 8 13 ... 25 19 8 13 ... 65 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 16 ... 1 1 3 4 5 ... 3 1 8 4 ... ... ... ... 3 ... 3 Scarlet Fever 107 ... 26 70 8 3 ... ... 42 38 3 21 3 39 38 3 21 3 104 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 2 ... ... 1 1 ... ... ... 1 ... ... ... 1 1 ... ... ... 1 2 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 ... ... ... 1 2 ... ... 3 ... ... ... ... 3 ... ... ... ... 3 ,, Pyrexia 3 ... ... ... ... 3 ... ... 3 ... ... ... ... 2 ... ... ... ... 2 Cerebro-Spinal Fever 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Malaria 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Measles 10 ... 5 5 ... ... ... ... 3 2 ... 5 ... ... 1 ... ... ... 1 Whooping Cough 35 5 14 16 ... ... ... ... 16 2 9 6 2 1 ... ... 1 ... 3 Diarrhœa 23 14 9 ... ... ... ... ... 18 1 3 1 ... 1 ... ... ... ... 1 Ophthalmia Neonatorum 3 3 ... ... ... ... ... ... ... ... ... 3 ... ... ... ... 1 ... 1 Tuberculosis, Pulmonary 32 ... ... 5 9 7 8 3 15 7 4 6 ... 2 2 2 4 ... 10 „ Non-Pulmonary 17 1 5 7 3 1 ... ... 8 4 2 3 ... 5 1 ... 2 ... 8 Pneumonia, Acute Primary, or Acute Influenzal 22 2 8 2 3 5 2 ... 5 4 5 8 ... 2 1 3 6 ... 12 Totals 341 27 80 149 35 29 16 5 144 78 42 71 6 82 62 17 51 4 216 (h) Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 13 weeks ending 31st December, 1927. 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. (h) Greenwich East Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke. (h) Total. Under 1 1 to 5 to 15 15 to25 25 to 45 45 to 65 65 and upwards Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 176 2 39 118 10 7 ... ... 70 56 11 34 5 69 56 11 34 5 175 Dysentery 1 ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Encephalitis Lethargica 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Erysipelas 14 1 ... ... 2 4 6 1 5 4 ... 2 3 1 ... ... 2 3 6 Scarlet Fever 117 ... 24 84 8 1 ... ... 34 37 14 30 2 34 37 14 29 2 116 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... 2 ... 1 ... ... 2 ... ... 1 ... 1 ... ... 1 ... 2 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ,, Pyrexia 2 ... ... ... ... 2 ... ... 2 ... ... ... ... 2 ... ... ... ... 2 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Measles 70 ... 28 40 ... 1 ... ... 63 2 1 4 ... 3 ... ... ... ... 3 Whooping Cough 16 9 3 4 ... ... ... ... 12 2 ... 2 ... ... 1 ... ... ... 1 Diarrhœa 23 10 13 ... ... ... ... ... 21 1 ... 1 ... ... ... ... ... ... ... Ophthalmia Neonatorum 2 2 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... 1 Tuberculosis, Pulmonary 37 ... ... 5 9 10 7 ... 10 9 5 12 ... 4 ... 3 2 ... 9 „ Non-Pulmonary 14 ... 2 6 6 ... ... ... 6 4 2 2 ... 4 1 1 ... ... 6 Pneumonia, Acute Primary, or Acute Influenzal 38 ... 11 11 4 5 4 3 10 7 10 11 ... 2 4 6 6 ... 18 Totals 515 24 120 270 40 40 17 4 238 123 43 100 11 121 100 35 75 10 341 (H) Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in kidbrooke. BOROUGH OF GREENWICH. Cases of Infectious Disease notified during the 52 weeks ending 31st December, 1927. 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. (h) Greenwich East Greenwich West St. Nicholas, Deptford. Charlton. Kidbrooke. (h) Total. Under 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Polio Myelitis 2 1 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 1 ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Diphtheria 448 10 91 280 43 23 1 ... 174 139 41 82 12 172 139 41 82 12 446 Membranous Croup 2 ... 2 ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... 1 Encephalitis Lethargica 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Erysipelas 64 1 3 3 11 16 24 6 19 12 14 13 6 7 1 1 8 5 22 Scarlet Fever 486 1 110 308 45 20 1 1 194 145 28 99 20 191 145 28 97 20 481 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 8 ... 1 3 3 1 ... ... 3 1 ... 3 1 1 1 ... 3 ... 5 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 5 ... ... 1 3 1 ... ... 5 ... ... ... ... 4 ... ... ... ... 4 ,, Pyrexia 10 ... ... ... 2 8 ... ... 8 ... 1 1 ... 8 ... ... 1 ... 9 Cerebro-Spinal Fever 2 ... ... 2 ... ... ... ... 2 ... ... ... ... 2 ... ... ... ... 2 Malaria 8 ... 1 ... ... 6 1 ... 2 3 2 1 ... ... ... ... ... ... ... Measles 234 6 78 138 9 3 ... ... 105 10 71 46 2 5 2 1 1 1 10 Whooping Cough 401 51 194 153 ... 2 1 ... 250 66 46 35 4 14 9 6 2 ... 31 Diarrhœa 72 37 35 ... ... ... ... ... 62 5 3 2 ... 1 ... ... ... ... 1 Ophthalmia Neonatorum 17 17 ... ... ... ... ... ... 6 ... 1 9 1 4 ... ... 6 ... 10 Tuberculosis, Pulmonary 146 ... 1 22 34 47 37 5 62 36 13 33 2 15 7 5 6 ... 33 „ Non-Pulmonary 46 2 9 19 10 4 2 ... 20 12 6 8 ... 11 2 2 3 ... 18 Pneumonia, Acute Primary, or Acute Influenzal 145 8 38 26 16 32 19 6 38 31 30 45 1 12 17 14 25 ... 68 Totals 2098 134 564 955 176 165 86 18 952 463 257 377 49 448 325 98 234 38 1143 (h) Cases of Infectious Disease are treated in the Hospitals of the Metropolitan Asylums Board, whose Brook Hospital is situated in Kidbrooke. BOROUGH OF GREENWICH. INFANTILE MORTALITY DURING THE YEAR 1927 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 I Month 1—3 Months 3—6 Months 6—9 Months 9—12 Months Total Deaths under 1 Year Common Infectious Diseases. Small-Pox ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 2 1 2 6 Diphtheria—Croup ... ... ... ... ... ... ... ... ... ... Acute Polio Myelitis ... ... ... ... ... ... ... ... 1 1 Tuberculous Diseases. Tuberculous Meningitis ... ... ... ... ... 1 ... ... ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... 1 ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions 1 ... ... ... 1 ... ... ... 1 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 1 ... ... ... 1 Pneumonia, all forms ... ... ... ... ... 2 5 4 2 13 Diarrhœal Diseases. Diarrhoea, all forms ... ... ... ... ... ... 2 1 ... 3 Enteritis ... ... ... ... ... ... 2 2 1 5 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlaying ... ... ... ... ... ... ... ... ... ... ,, otherwise 2 ... ... ... 2 1 ... ... ... 3 Injury at Birth ... ... ... ... ... ... ... ... ... ... Actelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations 6 3 1 1 11 1 2 ... ... 14 Premature Birth 17 1 1 ... 19 ... ... ... ... 19 Atrophy, Debility and Marasmus 2 ... ... ... 2 5 1 ... ... 8 Other Causes 3 1 1 ... 5 1 2 3 1 12 Totals 32 5 3 1 41 13 16 12 8 90 Boys 59 Girls 31 90