AC 4373 GRE 30 THE ANNUAL REPORT madE to THE COUNCIL of thE metropolitan Borough or Greenwich For the Year 1929, 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. 1930. THE ANNUAL REPORT made to THE COUNCIL of the Metropolitan Borough of Greenwich For the Year 1929, 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. 1930. CONTENTS. Pages Public Health Committee 1-2 Maternity and Child Welfare Committee 3 introductory 4-7 Section I.—Natural and Social Conditions of the Area 8 Vital Statistics 9-19 „ II.—General Provisions of Health Services in the Area 20-28 Laboratory Work 25 „ III.—Sanitary Circumstances of the Area 29-42 „ IV.—Housing 43-46 „ V.—Inspection and Supervision of Food 47-55 „ VI.—Prevalence of, and Control Over, Infectious Diseases 56-82 „ VII.—Maternity and Child Welfare 83-95 CONTENTS. pages Pvblic Health Committee 1-2 Maternity and Child Welfare Committee 3 Introductory 4-7 Section I.—Natural and Social Conditions of the Area 8 Vital Statistics 9-19 „ II.—General Provisions of Health Services in the Area 20-28 Laboratory Work 25 „ III.—Sanitary Circumstances of the Area 29-42 „ IV.—Housing 43-46 „ V.—Inspection and Supervision of Food 47-55 „ VI.—Prevalence of, and Control Over, Infectious Diseases 56-82 „ VII.—Maternity and Child Welfare 83-95 1 Public Health Committee during the Year, 1928-9. The Mayor- Alderman R.F. A. Purkiss, J.P., and 13 Members. Alderman W. O. Willis, K.C. Councillors— Mrs. C. R. Turner, J.P. (Chairman). F. Winchcomee (Vice Chairmen) Mrs. F. Carter Engr.-Com. A. R. Kempt J. R. Dabin F. W. Lamley H. C. Gallehawk Mrs. S.H. Mills H. H. Gibbons G.H. Springett S.N. Horne Mrs. C. H. Thackery 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; Food and Drugs (Adulteration) Act, 1928; the sale of Horseflesh, etc., Regulation Act, 1889; such matters arising under the Housing of the Working Classes Acts, 1890 and 1894, and die Working Classes Dwelling 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 Raits and Mice (Destruction) Act, 1919; Marchandise Marks Act, 1926; Agricultural Produce (Grading and Marking) Act, 1928; the powers of the Council under the Orders of the Local Government Board or Ministry of Health dealing with Tuberculosis; Milk and Dairies Order, 1926; and the Milk (Special Designations) Order, 1923; the by-laws and regulations made under the above Acts, or otherwise relating to the public health ahd 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., Acts. London County Council (General Powers) Act, 1902, 1907, 1908, 1922, 1927, 1928, 1929. Rag Flock Act, 1911. Public Health (Tuberculosis) Regulations, 1912, 1921, 1924. 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) Regulations. „ ,, (Smoke Abatement) Act, 1926. Artificial Cream Act, 1929. 3 Materinity and Child Welfare Committee during the year 1928-9. The Mayor- Alderman R.F.A. Purkiss, J.P., and 15 Members. Alderman H. W.H. Icough. Councillors — *Mrs. P. M. Beacham (Chairman) *Miss M. Sherman *Mrs. S. H. Mills *Mrs. C.H. Thackeray (Vice-Chairman) *Mrs. C. R. Turner, J.P. *Mrs. F. Carter *Mrs. M. Woolner M.C. Matthews, MA. D. A. Whitenstall Col. A.C. Ralph, D.S.O. Co-opted Members— *Mrs. E. C. Berry *Mrs. L.M. Jones *Miss C. H. Hervey *Mrs. B. J. T. Lord *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 15 members, 11 of whom shall be members of the Council, and four selected by the Council from outside that Body. 2.—There shall l)e 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. 3.—Powers and duties mentioned in Section 6 of the Widows', Orphans' and Old Age Contributory Pensions Acts, 1925. 4 Public Health Officers, Royal Hill, Greenwich, S.E.10. May, 1930. To the Mayor. Aldermen and Councillors of the Metropolitan Borough of Greenwich. Ladies and Gentlemen, I have the honour to submit herewith the Annual Report as Medical Officer of Health for the year 1929. The Birth-Rate is 15.81 per 1,000, and is the lowest rate ever recorded. The average for the last ten years is 19.70. The Birth-Rate for the County of London is 15.7, and 16.3 for all England and Wales. The Death-Rate is 13.38 per 1,000 of the estimated population and is the highest rate returned since the War year 1917 and 2.45 higher than the average for the previous five years, hut nevertheless compares favourably with the rates far the County of London and England and Wales, which are returned at 13.8 and 13.4 respectively. This increased Death-Rate is in a large measure due to the high mortality from Influenza and diseases of the respiratory and circulatory systems consequent upon the abnormally cold weather experienced during February and March. This statement is confirmed in that the number of deaths recorded in the First Quarter of the year was greater than in any first quarter since the inception of the Council. The Infant Mortality Rate for the Borough, measured by tihe number of deaths under one year to 1,000 births registered, is 70, compared with 55 last year. The Rates in the various Metropolitan Boroughs varied from 41 in Lewisham, 47 in Stoke Newington, 53 in Hampstead, 58 in Hackney, and 61 in Hammersmith, up to 81 in St. Pancras and Southward, 82 in Shoreditch. 84 in Kensington, 89 in Stepney, and 99 in Paddington. 5 The rate for England and Wale is 74 and for the Coutitv of Lontjpn 70. The Zymotic Death-Rate of .52 per l,000 is slightly lower than last year's figure of .59. The figures relating to different constituent parts of the Borough are as follows:- Districts Birth Rate Death Rate Death Rate per 1000 Live Births Zymotic Death Rate Consumption Death Rate Infants under 1 year. Diarrhœa &c. Enteritis (under 2 yrs.) East Greenwich 14.80 12.94 63 3.0 .36 .91 West Greenwich 17.08 13.61 65 4.3 44 1.14 St. Nicholas, Deptford 19.31 16.13 130 13.0 1.48 1.20 Charlton 15.60 13.32 70 14.0 .64 1.24 Kidbrooke 9.63 11.50 — — .30 — Whole Borough 15.81 13.38 70 6.7 .62 1.03 Attack Rates of the various notifiable diseases per 1,000 living in the several districts are as follows:— Districts Small-pox Diphtheria Scarlet Fever Erysipelas Typhoid Fever Puerperal Fever(pe1,000 Births) East Greenwich 0.00 2.56 2.68 .64 .02 — West Greenwich 0.03 2.96 3.48 .44 — 2.16 St. Nicholas, Deptford 0.00 3.61 9.12 1. 34 — — Charlton 0.00 4.99 2.47 .36 .09 5.85 Kidbrooke 0.00 5.12 3.91 .60 .60 31.20 Whole Borough 0.009 3.41 3.35 .58 .04 2.42 Before closing this introductory review I may be pardoned perhaps for referring to an event which does not strictly come within the period covered by this Report. I refer of course to the Local Government Act, 1929. The general principle underlying this Act, which came into force on the 1st April, 1930, is to give greater freedom to local authorities in administering the Health Services. An important provision in the Act is the substitution of block grants for percentage grants. Local authorities are also enabled to extend their existing services without the sanction of the Ministry of Health, such extra expenses, however, being borne by the local authorities. On the 1st April functions hitherto performed by Boards of Guardians, and in the Metropolitan area, the Metropolitan 6 Asylums Board were, with minor exceptions, automatically transferred to the County Councils, thus the L.C.C. are solely responsible now for the control of all Hospitals directly supported by the rates. That admittedly this is a huge task is clear when it is realised that a special provision is made in the Act applying to London only, whereby the Minister of Health may make an Order transferring or delegating any of their existing functions to the Metropolitan Boroughs. At the moment, the only duties transferred to the local authorities are those relating to the registration of Births and Deaths and to Vaccination. Under the existing system of Health administration in London there are still numerous examples of overlapping of duties and of instances of dual control. Thus the County Council which is primarily a supervisory authority is also engaged in administering in an executive capacity functions which can quite easily be performed by the individual local authorities. In support of this, contention 1 would remind the Council that in 1923 the County Council delegated to us for a period of one year certain duties in regard to the inspection of Lying - in Homes under the L.C.C. (General Powers) Act, 1915, and the Children Act, 1908, and at the termination of this arrangement the L.C.C. paid a warm tribute to the manner in which the duties had been carried out, but were not willing to continue the arrangement. Representations have been made from time to time relative to the delegation of such duties and I am certainly of opinion that the Minister of Health should be approached with a view to granting an Order under Section 64 of the Local Government Act, 1929, transferring to the Metropolitan Boroughs the undermentioned powers and duties at present undertaken by the L.C.C. (a) Midwives' Act, 1902/18; Mid wives' Maternity Homes Act, 1926. (b) Children Act, 1908 (part 1). (c) Adoption of Children Act, 1926 (Section. 8). (d) Nursing Homes (Registration) Act, 1927. Should such an Order be granted there is no doubt whatever that the high standard of Health administration would be maintained by the Metropolitan Boroughs with greater economy, and difficulties arising at present on many matters would soon cease. 7 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. Annis, 8 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, 1929 104,430 Density of Population— East Greenwich 34.21 persons per acre West Greenwich 59.52 „ St. Nicholas, Deptford 64.84 Charlton and Kidbrooke 12.59 Average for the Borough 26.94 persons per acre Number of Inhabited Houses— Structurally separate dwellings at Census, 1921 16,526 „ „ „ 1929 18,442 Number of Uninhabited Houses— At Census, 1921 288 Estimated, 1929 110 Number of Families or Separate Occupiers— At Census, 1921 22,972 Rateable Value £824,761 sum represented by a 1d. rate £3,363 9 VITAL AND MORTAL STATISTICS, 1929. POPULATION. The population of the Borough estimated to the middle of the year 1929 us 103,980 for the Death-Raite and 104,430 for the Birth-Rate. 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 1929. For Death Rate. For Birth Rate. East Greenwich 44,647 44,477 44,671 West Greenwich 26,931 26,965 27,084 St. Nicholas, Deptford 7,646 7,475 7,489 Charlton 18,959 21,764 21,855 Kidbrooke 3,217 3,317 3,331 Total 101,400 103,980 104,430 *EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. Births Legitimate 1,589 825 764 Birth Rate 16.1 Illegitimate 44 28 16 Deaths 1,388 708 683 Death Rate 13.8 Number of women dying in, or in consequence of, childbirth From Sepsis — „ otheir causes 2 Deaths of Infants under one year of age per 1,000 births:— Legitimate, 67; Illegitimate, 181. Total Rate = 71. Deaths from Measles (all ages) 7 „ „ Whooping Cough (all ages) 18 „ „ Diarrhœa (under 2 years of age) 14 *These figures, which are supplied by the Registrar-General, differ slightly from those shown in other parts of the Report. MARRIAGES. The Superintendent-Registrar of the Greenwich Registration District has kindly furnished me with the particulars relating to 10 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 vear since 1914:— chartlon & Kidbrooke Year In Churches of England in Greenwich In Churches of Eng land In Non-Conformist Churches 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 1914 279 135 — 72 243 729 96037 1915 472 188 — 95 406 1161 96385 1910 381 145 — 74 324 924 94452 1917 343 128 — 67 653 1191 90440 1918 353 165 — 55 214 817 89939 1919 419 197 — 76 326 1018 102591 1920 384 105 — 64 322 875 104453 1921 344 124 — 57 249 774 100493 1922 304 112 — 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 1928 356 81 3 52 243 738 103900 1929 362 127 5 44 263 801 104430 BIRTHS. The total number of births registered in the Borough during the year was 2,042. Of this number 472 occurred in Greenwich and Deptford Hospital and 531 at various Nursing Homes within the Borough. Of this total of 1,002 Institution births, 482 only belonged to Greenwich, the remainder being transferred to th|e appropriate localities. One hundred and twenty-five births belonging to the Borough took place in Institutions outside the Borough area, thus the actual figure for Greenwich becomes 1,646:— Males, 855; Females, 791. This figure gives a Birth Rate of 15.81 per 1,000 of the population, and is the lowest rate ever recorded. The previous year's Birth Rate was 16.42 and the average for the last ten years 19.70. 11 The Birth Rate for the County of London equals 15.7 per 1,000 of the population. The Birth Rate for all England and Wales was 16.3 and 16.6 for the 107 large towns. Illegitimate births numbered 44, representing 2.6 per cent. of the total births. Sixty-four illegitimate births actually were registered in the Borough. In 22 cases, however, the mothers were ordinarily resident outside the Borough, and these births were consequently allocated to the correct area. Two illegitimate births belonging to Greenwich occurred outside the Borough, thus giving the net figure of 44. Thirty-five illegitimate births occurred in the Greenwich and Depttord Hospital. Under the Births and Deaths Registration Act, 1926, which came into operation on the 1st July, 1927, the registration of stillbirths became compulsory. Forty-six such stillbirths were registered during the year, representing a percentage of 2.7 of the total births registered. Each of such cases is separately investigated with a view to finding out whether what is thought to have been the cause for such stillbirth is of a preventable nature, and if so, an endeavour is made to take such appropriate action as will guard against a recurrence of this condition. Under the provisions of the Notification of Births Act, 1907, intimations have been received from medical men, parents and others, with respect to 2,115 births; 50 were in respect of stillbirths, of which number 17 were referred to other Boroughs. DEATHS. The nett number of deaths registered during 1929 was 1,387, of which 709 were males and 678 females. This gives a crude Death Rate for the Borough of 13.38. This is considerably higher than has been recorded in recent years, but is accounted for solely by the higher mortality arising from Influenza and diseases of the respiratory and circulatory systems during the very severe weather experienced during the earlier part of the year. The Death Rates for the County of London and the 107 large towns are 13.8 and 13.7 respectively. 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. 939.  Deaths at Subjoined ages of " Residents," whether occurring within or without the District. Causes of Death- Sex. 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 Causes M 708 87 15 17 22 32 86 195 139 135 F 680 49 12 11 17 29 63 152 145 202 Enteric Fever M ... ... ... ... ... ... ... ... ... ... F 1 ... ... ... ... ... 1 ... ... ... Small-Pox M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Measles M 5 2 2 1 ... ... ... ... ... ... F 2 ... 1 l ... ... ... ... ... ... Scarlet Fever M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Whooping Cough M 10 5 2 2 1 ... ... ... ... ... F 8 4 1 2 1 ... ... ... ... ... Diphtheria M 5 ... 1 1 3 ... ... ... ... ... F 11 ... ... 2 5 2 1 1 ... ... Influenza M 30 ... ... ... 1 1 6 8 7 7 F 41 2 ... ... ... 1 5 12 8 13 Encephalitis Lethargica M 1 ... ... ... ... ... ... 1 ... ... F 1 ... ... ... ... ... 1 ... ... ... Meningococcal Meningitis M 1 ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System M 63 ... ... ... ... 11 25 26 ... 1 F 47 ... ... ... ... 15 20 9 1 2 Other Tuberculous Diseases M 5 ... ... 2 ... 1 1 ... ... ... F 7 ... ... 1 ... 2 3 1 ... ... Cancer, malignant disease M 83 ... ... 2 ... 1 5 33 22 20 F 73 ... ... ... ... 1 5 31 20 16 Rheumatic Fever M 3 ... 1 ... ... ... 2 ... ... ... F 1 ... ... ... 1 ... ... ... ... ... Diabetes M 5 ... ... ... ... ... ... 1 1 3 F 10 ... ... ... ... ... 1 2 6 1 Cerebral Haemorrhage, &c. M 17 ... ... ... ... ... ... 6 6 5 F 32 ... ... ... ... ... ... 6 7 19 Heart Disease M 131 ... ... ... ... 2 8 34 51 35 F 137 ... ... ... ... 2 9 26 47 53 Arterio-Sclerosis M 21 ... ... ... ... ... 1 6 6 8 F 23 ... ... ... ... ... ... 3 7 13 Bronchitis M 36 3 1 1 1 ... 2 13 3 12 F 39 1 ... ... 1 ... 2 3 9 23 Pneumonia (all forms) M 65 12 7 3 ... 1 8 13 11 10 F 65 15 6 2 2 l 1 8 13 17 Other Respiratory Diseases M 11 1 ... ... 1 ... ... 5 2 2 F 5 ... ... ... ... ... ... 2 1 2 Ulcer of Stomach Duodenum M 12 ... ... ... ... ... 2 7 3 ... F 4 ... ... ... ... ... 1 3 ... ... Diarrhoea, &c. M 8 7 ... ... ... ... ... ... 1 ... F 9 6 1 ... ... ... ... ... 2 ... Appendicitis M 4 ... ... ... 2 2 ... ... ... ... F 1 ... ... ... ... 1 ... ... ... ... Cirrhosis of Liver ... M 2 ... ... ... ... ... ... 1 1 ... F 3 ... ... ... ... ... ... 3 ... ... A. & Cr. Nephritis M 23 ... ... ... ... 4 2 5 7 5 F 15 ... ... ... ... ... 1 7 4 3 Puerperal Sepsis M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition M ... ... ... ... ... ... ... ... ... ... F 2 ... ... ... ... ... 2 ... ... ... Congenital Debility and Malformation, including Premature Birth M 24 24 ... ... ... ... ... ... ... ... F 15 15 ... ... ... ... ... ... ... ... Suicides M 3 ... ... ... ... ... 1 2 ... ... F 7 ... ... ... ... ... 1 5 1 ... Other Deaths from Violence M 45 1 1 2 4 4 9 10 7 7 F 22 ... 1 1 3 1 2 6 4 4 Other Defined Diseases M 95 12 ... 3 6 5 14 24 11 20 F 99 6 2 2 4 3 7 24 15 36 Diseases ill-defined or unknown M ... ... ... ... ... ... ... ... ... ... F ... ... ... ... ... ... ... ... ... ... 12 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. Lewisham 11.7 City of Westminster 13.8 Woolwich 12.5 *Greenwich 13.8 Hampstead 12.8 Poplar 13.8 Deptford 12.9 Hermondsey 14.1 Stoke Newington 13.0 Lambeth 14.4 Wandsworth 13.0 Islington 14.6 Camberwell 13.2 Holborn 14.7 liethnal Green 13.3 Kensington 14.7 Fulham 13.4 Pad dim ton 14.9 Hackney 13.5 St. Pancras 15.0 Hammersmith 13.5 Chelsea 15.2 St. Marylcbone 13.5 Southwark 15.4 Stepney 13.6 Shoreditch 15.5 Battersea 13.8 Finsbury 15.6 * This figure differs slightly from that shewn in other parts of the Report owing to the figure being based on a lower population. Locally the Death Rate varied from 11.50 in Kidbrooke, 12-94 in East Greenwich, 13.32 in Charlton, 13.61 in West Greenwich, up to 16.13 in St. Nicholas, Deptford. Of the total number of deaths, 8 were of illegitimate birth, all of whom were under one year of age. The following table shows the variation in, and average of the Deatih Rates in each of tine five Districts of the Borough in the five years 1924 to 1928 compared with the figures for 1929:— District. 1924 1925 1926 1927 1928 Average for 5 years. 1929 East Greenwich 1114 10.87 10.82 10.59 11 03 10. 89 12.94 West Greenwich 11.84 12.45 12.24 11.48 1210 12. 02 1361 St. Nicholas, Deptford 11.77 12.63 14.22 11.11 11.50 12.24 16.13 Charlton 12.41 11.36 8.89 10.66 10.37 10.74 13.32 Kidbrooke 6.61 6.09 5.45 9.16 8.82 7.22 11.50 Borough 11.47 11.36 10.89 10.83 11.13 11.13 13.38 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 1924 1,200 565 1925 1,173 621 1926 1,130 600 1927 1,115 607 1928 1,148 616 1929 1,387 764 Average 1,192 628 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 39 32 22 23 116 Between 1 and 2 years 16 — 7 5 28 Between 2 and 5 years 12 7 4 3 26 Between 6 and 15 years 16 8 7 8 39 Between 15 and 25 years 21 19 12 11 63 Between 25 and 45 years 60 33 29 25 147 Between 45 and 65 years 125 64 70 88 347 65 years and upwards 277 136 9Z 116 62-1 Total 566 299 243 279 1,387 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 70 per 1,003 births, as compared with 55 last year. The total number of deaths during the year was 116, as compared with 114, 90 and 95, the respective figures for the years 1926, 1927 and 1928. 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 70, compared with 67 in 1928, 59 in 1927, and 61 in 1926. For England and Wales the rate was 74, compared with 65 in 1928, 69 in 1927, and 70 in 1926. Locally the variations were from 63 per 1,000 births in East Greenwich, 65 in West Greenwich, 70 in Charlton, to 130 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. 1928. 1929. East Greenwich 129 106 96 81 62 63 59 60 63 West Greenwich 126 110 112 110 80 66 49 78 65 St. Nicholas, Deptford 179 143 167 138 88 79 63 40 130 Charlton 121 109 76 89 66 48 45 35 70 Kidbrooke 39 79 16 39 13 — — — — Borough 131 111 103 95 66 61 53 55 70 16 REMARKS ON VARIOUS DEATH CAUSES. Infective Diseases. Principal Epidemic Diseases.—There were 126 deaths due to this class of disease, equalling a Death Rate of 1.11 per 1,000; the rate last year was 89, and was 58, 54 and 54 in 1925, 1926 and 1927 respectively. Zymotic.—The purely Zymotic class of epidemic diseases is credited with causing a total of 54 deaths, equalling a Death Rate of 52 per 1,000. Locally the Zymotic Death Rate varied from 30 in Kid'brooke (nil in 1928); 36 in East Greenwich (60 in 1928); 44 in West Greenwich (.63 in 1928); 64 in Charlton (.50 in 1928); to 1.48 in St. Nicholas, Deptford (.94 in 1928). Smallpox.—There were no deaths from Smallpox, this being the twenty-eventh year since a death occurred from this cause in the Borough. Measles.—There were 9 deaths ascribed as due to this disease (8 being under five years of age). This is equal to a Death Rate of 08 per 1,000. One occurred in East Greenwich, 4 in West Greenwich, 2 in St. Nicholas and 2 in Charlton. The number of deaths recorded last year was 25, and in the years 1925, 1926 and 1927, 21, 13 and Nil, respectively. Scarlet Fever.—This disease occasioned no deaths during the year. Three such deaths occurred in 1925, 1 in 1926, 2 in 1927, and 1 in 1928. Whooping Cough.—This disease was given as the cause of 17 deaths, with a Death Rate of 16 per 1,000. There were 8, 16, 4 and 15 deaths respectively in the years 1928, 1927, 1926 and 1925. Seven deaths occurred in East Greenwich, 5 in West Greenwich and 5 in St. Nicholas. Diphtheria.—There were 16 deaths during the year. This gives a Death Rate of 15 comparing with 14 for the previous year. Fifteen deaths occurred in 1928, 11 in 1927, 12 in 1926, and 14 in 1925. Four of the patients were under five years of age. 17 Typhoid Fever.—There was one death ascribed to this disease, which occurred in East Greenwich. There were 2 in 1927, and 1 each in 1926 and 1925. Diarrhcea, Dysentery and Zymotic Enteritis.—Eleven deaths were said to be due to these causes, equalling a Death Rate of 10 per 1,000. Last year there were 10 deaths, 8 in 1927 and 12 in 1926. Influenza.—Influenza was particularly prevalent during the first quarter of the year, and was the responsible cause of 70 deaths; 17 was the average for the previous three years. Thirty-four cases were over 65 years of age. Twenty-nine occurred in East Greenwich, 19 in West Greenwich, 5 in St. Nicholas, 15 in Charlton, and 2 in Kidbrooke. Tuberculosis. This class includes the causes of 120 deaths during the year under review, with a rate of 1.15; these figures compare with 117, 97 and 121, the totals of the years 1926, 1927 and 1928, respectively, and the respective rates of 1.12, . 97 and 1.17. Tuberculosis of the Lungs (Consumption) is, as usual, credited with the major portion of these deaths, there being 108 attributed to this cause, or a rate of 1.04 per 1,000, as compared with 1.03 last year. Locally the deaths were 41 in East Greenwich (Death Rate .91), 9 in St. Nicholas (Death Rate 1.20), 27 in Charlton (Death Rate 1.24), and 31 in West Greenwich (Death Rate 1.14.) The remaining forms of Tuberculosis were responsible for 12 deaths, 5 of which occurred in East Greenwich, 4 in West Greenwich, 1 in St. Nicholas, and 2 in Charlton. Cancer. This disease was responsible for a total of 150 deaths for the year, and unfortunately the mortality from this dreaded disease is apparently increasing. The following Table is designed to show the seats of the disease at various ages in the different districts in the Borough : — 18 CANCER. Year 1929 MALE. Buccal Cavity Oesophagus Stomach Liver anu Gall Bladder Intestines Kectum Prostate Glands Other Organs Total 25—45 yrs. 45—65 yrs. 05 & 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. under25yrs 25—45 yrs. 45—65 yrs. 65 & over. East Greenwich ... ... 3 ... 1 3 ... 5 3 ... ... 1 ... 2 1 ... ... ... ... ... 2 ... ... ... ... 1 4 4 31 West Greenwich ... ... 1 ... ... 1 1 ... 4 1 1 ... ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... 4 2 19 St. Nicholas ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 2 5 Charlton ... ... 1 ... 2 1 ... 3 1 ... ... ... ... ... 1 ... ... 3 ... 1 ... ... ... ... 1 2 1 ... 17 Kidbrooke ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 5 Whole Borough 5 4 5 1 8 8 i 3 2 3 3 ... 6 2 2 2 3 10 8 77 FEMALE. (Same age periods) Breast Genital Organs Other Organs East Greenwich 2 2 1 1 3 i 1 2 1 2 3 1 5 4 1 2 3 2 37 West Greenwich 1 2 1 1 ... 2 i 2 1 ... ... 1 2 14 St, Nicholas 1 ... 1 X ... 1 1 5 Charlton 1 1 2 1 1 3 1 1 1 1 1 1 15 Kidbrooke 1 1 ... ... ... 2 Whole Borough ... 1 2 ... 2 ... 2 5 5 1 5 4 1 4 8 ... 1 2 1 7 6 ... 3 3 ... 1 4 5 73 Total Deaths 150. 19 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 1916 is shown below :— Year Drowned Bodies from River Other Bodies Total 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 1928 10 351 361 1929 4 317 321 20 SECTION 2. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Hospitals Provided or Subsidised by Local Authority. (1) Fever and (2) 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, which is situate at Shooter's Hill Road, near the Woolwich boundary, is the Brook Hospital. The nominal accommodation is 550 beds, including 104 in special Wards (Isolation, Separation, etc.). (3) Tuberculosis.—Sanatoria treatment for the area is provided by the London County Council. (4) 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). (5) Children.—No hospital is provided by Council, but arrangements are made with Deptford Fund for the treatment of Greenwich Children. A Grant is also made to the St. John's Hospital, Lewisham, in respect of minor operations performed on children referred to them by the Medical Officer in charge of the Infant Consultations. 21 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, Jit. 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. 22 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 Mission Hall, Woolwich Rd , Charlton. Large Hall consisting of waiting and weighing room and consulting room Ditto Once weekly (4) Pre- Maternity Borough Hall. (See above) Ditto Once weekly 105, Shooter's Hill Road, S.E. Conduit House, Trafalgar Rd., E. Greenwich. ( Do. ) ( Do. ) Ditto Ditto Once weekly (double sessions alternate weeks) Once weekly Charlton Vale Mission Hall, Woolwich Rd., Charlton. ( Do. ) Ditto Once weekly (c) Minor Ailments Armada Street, Deptford. Borough Hall, ( Do ) 1 large room Ditto Ditto Twice monthly Daily (i) Artificial Sunlight Conduit House, Trafalgar Rd., E. Greenwich. 1 large room and dressing room Ditto Daily 23 Clinics and Treatment Centres—Continued Name Situation Nature of Accommodation By whom provided Period when held Nursery School Rachel McMillan Memorial School, 232, Church Street, Deptford, S.E. Extensive Miss Margaret McMillan Daily School Clinics Park Row, Greenwich. Whole House Local Medical Practitioners Daily Ditto Health Clinic, Deptford Green, S.E. Several Rooms Miss Margaret McMillan Daily Tuberculosis Dispensary, 7a, Maze Hill, Greenwich. Consulting Room and Dentist's Surgery. Separate Waiting and Cloak Rooms for Men and Women Patients, Nurse's 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 T umour Diagnostic Consultation Dispensary, 7a, Maze Hill, Greenwich. Consulting and Waiting Rooms Local Authority Once weekly 24 TUMOUR DIAGNOSTIC CLINIC. During 1929 the Clinic was visited by 34 patients (14 males and 20 females), who, together with old patients, made a total of 71 attendances. Of the new patients, 11 were sent by Medical Practitioners, 7 came on the recommendation of former patients, and the remainder (16) applied as a result of propaganda, chiefly from reading the Booklet " Better Health," of which some 2,000 are distributed in the Borough every month. This Booklet contains notices of the various activities of the Public Health Department, including the Tumour Diagnostic Clinic. The procedure adopted remains the same as that described fully in last year's Report, and has worked quite satisfactorily. The problem of attracting patients, however, remains as difficult as ever. A survey of the Death Returns for 1929 shows that 150 deaths were registered in the Borough as due to Malignant Diseases, yet only 34 people were apparently aware that a Clinic existed at their doors for the early diagnosis of such diseases, for it cannot be doubted but that a large proportion of these 150 deaths would have been prevented by early diagnosis and treatment. "Too late and again too late" may be said of almost every case of cancer and sarcoma. It is of course remembered that most patients make for Hospital when a "growth" is suspected, but it seems a pity that with the facilities provided by the Borough Council, patients should spend hours in the waiting rooms of the already overcrowded Hospitals when with but a few minutes interval they can be seen at the Borough Clinic. Of the 34 patients (an increase of 3 on last year), 11 gave a history of cancer in members of the family (8 on the female side and 3 on the male side). The conditions found were classified as follows: — Carcinoma 2 Ulcer of Tongue (non-malignant) 2 Sarcoma 1 Warts 4 Odontoma 1 Mastitis 3 Uterine Fibroids 4 Hernia 2 Lipoma 1 Dyspepsia 6 Sebaceous Cysts 3 Other Conditions 5 Four patients were referred to the Consultant (Mr. Davies-Colley), three of whom were diagnosed as suffering from cancer. Appropriate treatment was advised for all cases and 25 it should be mentioned that all old patients were "followed up" during the year and that in no instance was any case diagnosed as non-malignant found to present any symptom to cause a change of opinion. PUBLIC HEALTH STAFF. The only change in the personnel of the Department was the appointment in March of Mr. F. A. Brown (Grade A Clerk) vice Mr. A. M. Smith, who was transferred to the Borough Engineer's Department. 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 Diarrhaœ, 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 28 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 2,533 specimens have been examined for Diphtheria, 11 for Typhoid Fever, 408 for Tuberculosis, and 18 for other various conditions. Fuller details respecting results of the examinations of these specimens will be found under the different headings of the individual diseases. Thirty Tubes of Diphtheria Anti-toxin, containing a total of 240,000 units of serum, have been supplied during the year to Medical Practitioners for the treatment of patients suffering from this disease. '26 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 496 Greenwich patients for an average of twenty-five days each, as compared with 500 persons with an average of 26 days last year ; in addition to which there have been 4,080 Outpatients, making approximately 26,100 attendances of persons belonging to the Borough of Greenwich. The number of Outpatients for the previous year was 2,900, which shows an increase of 1,180, with a corresponding increase in the number of Out-patient attendances. Miller General Hospital admitted, treated and maintained 465 Greenwich persons for an average of twenty-two days as against 300 last year. 6,531 Out-patients have also been treated, the total attendances being approximately 40,369. With the new ward block, which was formally opened by H.R.H. The Duchess of York on the 14th of May, 1929, the number of available beds was increased to 151. This additional accommodation consists of three wards, named "The Morris Ward," "The William Shepherd Ward," and the " Borough of Deptford War Memorial Children's Ward," each containing 24 beds and two private rooms for paying patients. The Children's Ward is specially constructed with glass parlitions. so that in the event of an outbreak of infectious disease the area of infection may be limited. In the corridor of the new ward block the Borough of Greenwich War Memorial Tablet has been fixed. The other new extensions were the twin theatre suite consisting of two theatres, anæesthetic rooms, sterilizing room, duty room and surgeons' retiring room. The first part of the Nurses' Home, which was greatly needed, is situated in Catherine Grove. Other improvements were the provision of adequate kitchen accommodation and stores. 27 The number of special departments has been increased to 17, and are now as follow:—Medical, Surgical, Children's, Ophthalmic, Nose, Throat and Ear, Gynaecological, Electrical, Orthopaedic, Genito-Urinary, Pathological, Skin, X-Ray, Dental, Venereal, Massage, Swedish Remedial and Ultra-Violet Ray ("Artificial Sunlight"). The work in 1929 shows that even more use is being made by the people in South-East London. No. of In-patients 2,200 No. of Out-patients 31,124 (who made 192,237 attendances—including attendances for Massage, Electrical and Ultra-Violet Ray treatment, and for Casualties). Blackheath and Charlton Cottage Hospital admitted 254 In-patients from Greenwich, the average duration of stay being 21 days ; and also treated 905 Out-patients, who made 4,450 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, 1929: — Greenwich Parish St. Nicholas Deptford Charlton and Kidbrooke Parish Total number of families in receipt of out-door relief 2,913 629 560 Total amount expended in out-door relief £51,788 £12,695 £10,408 Total number of persons treated in Hospital 2,372 283 185 Total number of persons treated medically in their own homes 494 85 375 Total number of persons admitted to the Institution 493 63 33 28 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). — 4th Oct., 1902, and 18th Nov., 1904. By-Laws made under Public Health (London) Act, 1891, Sec. 16 (2). — 28th June, 1893, and 26th Nov., 1901. By-Laws made under Public Health /London) Act, 1891, Sec. 39 (1). — 28th June, 1893, and 3rd Jan., 1905. By-Laws made under Public Health (London) Act, 1891, Sec. 39 (2). — 4th October, 1902. By-Laws made under Public Health (London) Act, 1891., Sec. 45. — 11th July, 1905. Bv-Laws made under Public Health (London) Act, 1891. Sec. 50. — 4th October, 1902. By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Plans). — 20th August, 1903. By-Laws made under Metropolis Local Management Act, 1855, Sec. 202 (Drainage). — 14th June, 1901, and 2nd January, 1924. By-Laws made under London County Council (General Powers) Act, 1903, Sec. 54. — 21st February, 1905. Provisions of London County Council (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. By-Laws made under Public Health (London) Act, 1891, Sec. 19. — 25th Nov., 1907, 22nd March, 1922, 22nd Dec., 1923, 31st July, 1925. By-Laws made under London County Council (General Powers) Act, 1908, Sec. 9. — 18th Sept., 1923, 28th February, 1914, 20th June, 1928. By-Laws made under London County Council (General Powers) Act, 1902, Sec. 53. — 14th August, 1903. By-Laws made under Slaughterhouse, &c. (Metropolis) Act, 1874, and Local Government Act, 1888. — 27th October, 1891. Regulations as to Underground Conveniences — January, 1905. Metropolitan Borough of Greenwich (Measles and German Measles) Regulations, 1920. — 16th June, 1920. 29 SECTION 3. SANITARY CIRCUMSTANCES OF THE AREA. The tables on pages 29 to 31 and 36 to 42 summarise, as far as possible, the Sanitary work of the Department ; from this it will be seen that a total of 20,803 houses and premises have been inspected or re-inspected during the year ; 1,019 intimation notices and 178 statutory notices have been served. • There were altogether throughout the year 565 complaints registered. Factories, Worksh ps and Workplaces.—Three hundred and forty-five inspections have been paid to these premises within the Borough daring the year. The number of factories, etc., on the register at the end of the year was 225 factories, 103 workshops and 37 wharves and quays. Outworkers' Register.—Four lists, containing 14 names and addresses have been received from employers within the district. In addition to this, 55 lists containing 116 names and addresses of Outworkers residing in this Borough were received from Medical Officers of Health of other Boroughs, whilst 4 lists with 6 names and addresses were forwarded to other districts, thus giving a total of 124 Outworkers in the Borough. 110 visits of inspection have been paid to these premises. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES and HOMEWORK. 1.—INSPECTION. Premises Number of Inspections Written Notices Prosecutions Factories (Including Factory Laundries) 129 8 ... Workshops (including Workshop Laundries) 154 12 ... Workplaces (Other than Outworker's Premises) 62 2 ... Total 345 22 ... 30 2.—DEFECTS FOUND. Particulars Number of Defects Found Remedied Referred to H.M. Inspector Number of Prosecut's *Nutsances under the Public Health Acts— Want of Cleanliness 21 21 Want of Ventilation 5 5 ... ... Overcrowding ... ... ... ... Want of Drainage of Floors ... ... ... ... Other Nuisances 2 2 ... ... Sanitary Accommodation— Insufficient 6 6 ... ... Unsuitable or Defective 5 5 ... ... Not Separate for Sexes ... ... ... ... Offences under the Factory and Workshops Act— Illegal Occupation of Underground Bakehouse (s. 101) ... ... ... ... Other Offences 80 30 ... ... Total 69 69 ... ... * Including those specified in Sec ious 2, 3, 7 and 8 of the Factory Act, as remediable under the Public Health Acts. 3.—Outwork in Unwholesome Premises (Section 108). Nature of Work Instances Notices Served- Prosecutions Wearing Apparel — (1) Making, etc. (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 ... ... ... 31 4.—WORKSHOPS AND WORKPLACES ON THE REGISTER AT THE END OF 1929. No. Bakehouses 23 Factory Bakehouses 19 Barge Builders 11 Blacksmiths 5 Boot and Shoe Makers 9 Builders' Yards 2 Carpenters and Joiners 3 Carriage Builders 2 Coopers 1 Cycle Works 4 Dress and Mantle Makers 9 Engineers 4 Electrical Engineers 2 Fuel Works 2 Furniture 1 Laundries 1 Milliners 2 Monumental Mascns 1 Motor Vehicle Repairers 4 Photographers 2 Picture Frame Makers 1 Plumbers 2 Tailors 13 Others 14 137 6.—OTHER MATTERS. Class. No. Matters notified to II.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Other Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5):— Notified by H.M. Inspector 1 Reports (of action taken) sent to H..M. Inspectors 1 Underground Bakehouses (sec. 101):— In use at end of 1929 11 Smoke Nuisances.—Forty-eight observations have been made for smoke nuisances duiring the year, but only in one instance was it found necessary to serve a Statutory Notice. Water Supply. — During the year 323 water supply certificates have been granted under Section 48 of the Public Health (London) Act, 1891. Forty-two water supplies have been reinstated where the supply had been cut off ; water fittings 32 have been amended in 97 cases, and covers to cisterns adapted in 247 cases. Sewers.—The inhabitants of the Borough, as well as the inhabitants of London generally, very much appreciated and enjoyed the beautiful weather and long continuance of sunshine which occurred during the summer. Unfortunately for many of the inhabitants, that enjoyment was considerably marred by offensive smells arising from the sewers, and in the majority of instances the sewers in question were found to be the large main sewers under the control of the London County Council. On enquiry it was found that the London County Council in their wisdom had seen fit to remove a large number of the covering plates from the manholes and thereby allow the offensive emanations from the sewers to permeate the atmosphere in the neighbourhood of those manholes. It was particularly unfortunate that the amount of sewage in the sewers due to an unusual spell of drought was at a minimum, therefore decomposition of the sewage and sluggishness of the flow were at their maximum, hence adding materially to the unpleasant character of the emanations. It was only after the exercise of strong pressure that the London County Council were persuaded to close the manhole openings again, since which time this nuisance has come down to its usual level. Another matter, however, in this connection which might in my opinion be greatly improved, as far as this Borough is concerned, is the method adopted for emptying road gullies. At the present time this material is taken out of the gullies and spread on the roadside adjacent thereto, awaiting the arrival of the cart to collect it. I admit that this material is generally spread over with lime, etc., but this does not abate the nuisance occasioned to any great extent. It would seem to me as if the best plan to adopt would be to use one of the modern suction plants which draw up the material out of the gully, emptying it directly into an airtight container alongside, which I believe is a method similar to that adopted in many boroughs in London. House Drainage.—One hundred and twenty-eight drainage systems have been reconstructed or repaired; 479 such systems have also been opened, cleansed and amended; 52 drains and soil pipes have been ventilated; 259 systems have been tested by smoke, 280 by waiter, of which number 67 were found to be defective; 34 new soil pipes and 196 traps (gully) have been fixed, together with 21 intercepting chambers and fresh-air inlets, and 71 other chambers constructed. 33 Thirty-four new covers to manholes have been provided; 38 systems have been sealed off or slurried up; 49 yards and forecourts drained; 23 water-closets have been erected; 51 cleansed; 267 w.c. doors and seats repaired or provided; pan and traps have been furnished in 370 cases; and other fittings provided or improved in 256 cases, whilst the flushing apparatus has been amended in 586 instances. Public-house urinals have been cleansed and repaired in 12 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 three occasions and the cleansing of premises duly carried out. Public Sanitary Conveniences. Speaking generally, the Borough is adequately served in the way of public sanitary accommodation. The conveniences are situated in the main arteries of traffic and there is no doubt whatever that the use by the public of such conveniences is on the increase. Appended is a Table showing particulars of the Public Conveniences and Urinals provided and/or maintained by the Council :— Particulars of Public Sanitary Conveniences in the Borough. Convenience Men Women W.C.s Lavatory Basins Urinal Stalls Open Close W.C.s Lavatory Basins Open Close Blackwall Lane, a.m. p.m. a.m. p.m. East Greenwich 5 2 18 7.15 11.30 4 2 9.30 11.0 South Street, 4 1 10 6 .45 11. 0 4 2 9. 0 10.30 Creek Road, St. Nicholas, Deptford 5 2 8 7.15 11.30 4 2 9.30 11.0 Batley Park, Blackheath 8 2 13 6.45 11.0 4 2 9.0 10.30 Blackheath Hill (foot of) 3 ... 10 6.45 11.0 4 ... 9.0 10.30 Totals. 25 7 59 ... 20 8 ... Note.—On Sundays, Conveniences open 10.30 a.m. and close 10.30 p.m. 34 Other Urinals. Accommodation. Woodman p. h. 6 Antigallican p. H. 20 Angerstein P. H. 3 Park Row 6 King William Street 6 King William IV P. H. 2 Straightsmouth 9 Total 62 Houses Let in Lodgings.—The Bye-laws made by the London County Council under Section 6 of the Housing Act, 1925, came into operation on the 5th Mairch, 1926. At the end of 1928 there were ninety-one houses registered. One has been added during the year, making 92 on the Register at the end of the year; 93 inspections were 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. Two hundred and two such 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 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 530 gallons were given to approximately 4,072 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.—One application was received during the year from a tenant for a certificate under these Acts, and the Certificate was duly granted. 35 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 following information relating to the disposal of refuse. The approximate amount of refuse collected in the Borough during the year ended 31st December, 1929, was 21,500 tons, giving an average daily collection of 77 tons. Of the total refuse collected, the Refuse Disposal Plant dealt with approximately 9,700 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. Health Propaganda.—The arrangements made with the Proprietors of " Better Health," whereby they supply us with 2,000 copies of their journal each month, continue to be in force. This magazine, which is issued in the form of a Greenwich Edition with special articles of local interest, serves a very useful purpose in keeping the attention of the public on health matters generally. Copies are distributed to all members of the Greenwich Borough Council, local medical men, midwives, dentists, headmasters and head-mistresses of the various schools, boy scout organisations, to large firms for the issue to their employees, and also, of course, there are copies available at the various Welfare Centres and Tuberculosis Dispensary. 36 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1929. 1st. Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Inspections. Houses Inspected (House to House) 9 88 ... ... 97 ,, ,, Complaints, Nuisance? Other Premises Inspected 523 431 737 763 2454 48 160 35 48 341 Re-inspections, Calls Made, etc. Inspections of Houses Let in Lodgings 4725 3171 3253 3515 14664 18 31 28 16 93 Bakehouses 5 52 6 42 105 „ Factories, Workshops and Workplaces 69 48 56 67 240 ,, Outworkers' Premises ... 34 21 22 33 110 „ Slaughterhouses 12 6 5 8 31 „ Cowhouses ... ... 3 ... 3 „ Stables and Yards 18 3 7 6 34 „ Piggeries 1 1 ... ... 2 „ Courts and Alleys 9 ... 1 ... 10 „ Fields, Lanes, etc. 2 7 5 3 17 „ Urinals 35 7 11 16 69 „ Gipsy Vans 2 1 1 1 5 „ Horse Slaughterhouses ... 3 ... ... 3 ,, Dairies, Cowshed and Milkshops 16 72 38 12 138 „Soap Boilers 2 1 ... 3 ,, Other Oflensive Trades 4 ... 5 7 16 ,, Ice Cream places 3 118 20 ... 141 „ Other places where food is prepared or stored 655 492 396 482 2025 Investigations (Rats and Mice) 52 56 43 51 202 Total 6242 4759 4732 5070 20803 Drains. Intercepting Chamber 2 6 9 4 21 Other Chambers Constructed 13 17 25 16 71 Reconstructions and Additions 28 37 45 18 128 Opened, Cleansed and Amended 100 131 114 134 479 Traps Fixed 24 46 99 27 196 New Soil Pipes 3 14 12 5 34 Soil and Vent Shafts Repaired 7 8 9 9 33 Drains and Soil Pipes Ventilated 2 15 30 5 52 Drains Sealed off, etc. 2 3 30 3 38 Drains tested—by Smoke 61 35 66 97 259 „ by Water 56 68 109 47 280 Found Defective 15 12 20 20 67 New Covers to Manholes 6 14 8 6 34 Yards Drained 9 32 8 49 Washhouses Drained ... 1 1 ... 2 Areas Drained 1 ... 3 ... 4 Cesspools abolished ... 2 ... ... 2 37 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Water Closed and Urinals. Closets erected 2 15 6 10 23 W.C. doors repaired or provided 39 55 103 70 267 Sanitary Conveniences or Improvements effected to Factories. Workshops and Workplaces 7 3 11 10 31 Flushing Apparatus Amended 101 133 135 217 586 Pans or Traps furnished 93 111 108 68 370 Water supply disconnected from Drinking Water Cistern 26 ... ... ... 26 Cleansed ... 12 14 25 51 Ventilation improved 26 44 48 138 256 Public-house Urinals cleansed or repaired 2 1 6 3 12 Other Urinals altered or cleansed 1 1 1 1 4 Other Urinals constructed 2 ... 2 1 5 Ashpits. Provided 102 38 28 73 241 Covers to receptacles ... ... ... ... ... Pavings. Forecourts and Yards 39 47 90 51 227 Areas ... ... 1 2 3 Washhouses 2 3 2 4 11 Mews and Stables 1 1 1 ... 3 General Water Supply. Covers to Cisterns adapted 23 41 48 135 247 Water Fittings amended 22 39 24 12 97 Cisterns cleansed and repaired 1 ... ... ... 1 Water Services altered so as to draw direct from main ... ... ... ... ... Water Supplies reinstated where cut off through defective fittings 21 11 8 2 42 Water Supply Certificates granted (Section 48) 27 55 108 133 323 Other Improvements. Verminous Rooms cleansed 21 33 75 64 193 Ventilation improved 72 68 47 82 269 Staircases repaired, amended, lighted, and ventilated 12 11 9 12 44 Leaky House Roofs and Gutters repaired 170 88 64 216 538 39 Summary of Sanitary Work—continued. 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Othe Improvements-contd. Walls and Ceiling of Premises cleansed and repaired 441 479 309 638 1867 Stoves and Fireplaces repaired 38 26 18 42 124 Washing Coppers repaired 15 14 14 23 66 Sinks provided 12 31 23 39 105 Floors repaired 34 41 36 69 180 Ice Cream places cleansed or improved ... 4 3 ... 7 Other places where food is stored and prepared 7 14 15 ... 36 Provision for Storage of Food 1 ... ... ... 1 Other Nuisances Abated. Illegal use of Underground Room discontinued ... ... ... ... ... Overcrowdings abated Sink, Lavatory and Bath Waste Pipes 1 1 1 1 4 disconnected, trapped or amended... 31 55 48 49 183 Stack Pipes amended 22 35 33 40 130 Nuisances from dampness abated 65 45 48 56 214 Animals Kept in Unfit Places discontinued or removed 2 4 ... ... 6 Dung Receptacles provided 1 1 1 ... 3 Bakehouse Nuisances abated 4 9 6 11 30 Houses abolished, unfit for habitation ... ... 4 20 24 Accumulations of Manure and other obnoxious matter removed 11 18 24 12 65 Inundations abated ... ... 6 1 7 Contents of Rooms cleansed 1 3 11 7 22 Rat Infestation abated 12 20 30 26 88 Smoke Nuisances. Observations 23 8 12 5 48 Statutory Notices served (Sections and 24) 1 ... ... ... 1 Food and Drugs. Samples taken 148 124 95 74 441 Found Adulterated, &c. 6 2 3 4 15 39 Summary of Sanitary Work—continued. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Unwholesome Food Seizures made ... ... ... ... 9 tins Prawn ... 28 lbs. Kippers. 5 stone Conger Eels Voluntarily surrendered 16½ lbs. Rabbi's. 84 lbs. Plaice. 89 lbs. Pork. 656 lbs. Mutton. 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) 240 206 233 340 1019 Notices served— Under Housing Acts ... ... ... ... ... Rats and Mice (Destruction) Act, 1919 ... ... ... ... ... re Verminous Rooms ... 1 1 2 4 Under P.H. (L.) Act and Metropolis Management Act {re combined drainage) W.C.'s (Factories, Workshops and 17 ... ... ... 17 Workplaces) ... 1 ... 1 2 Yards ... ... ... ... ... Miscellaneous 1 ... 3 ... 4 Statutory Notices served under Section 4 16 21 53 46 136 Statutory Notices re Ashpit provision 2 ... 11 2 15 Complaints received and attended to 108 166 147 144 565 Letters written relating to abatement of Nuisances 34 27 58 55 174 Summonses applied for and issued ... ... 4 12 16 Magisterial Orders obtained and enforced ... ... ... 1 1 Drainage Plans received and examined... 17 34 28 23 102 40 Return Made to London County Council. Proceedings during 1929. Premises Number of Places Number of Inspections, 1929 Number of Notices, 1929 Number of Prosecutions, 1929 On Register at end of 1928 Added in 1929 Removed in 1929 On Register at end of 1929 Cowsheds 3 — — 3 3 — — ,, (Licensees) 1 — — 1 — — — Dairies and Milkshops 132 3 a 133 138 6 — Slaughterhouses 3 — — 3 31 — — Other Offensive Trade Premises 2 — — 2 22 — — Ice Cream Premises 144 5 35 114 120 2 — Registered Houses Let in Lodgings 91 1 — 92 93 7 — Restaurants and Eating Houses 56 11 1 66 78 7 — Total Number of Intimation Notices served for all purposes 1,019 „ „ „ Statutory „ „ „ 178 Overcrowding, 1929— Number of Dwelling-rooms overcrowded 9 Number remedied 4 Number of Prosecutions — Underground Rooms— Illegal occupations dealt with during year — Number of Rooms closed — Insanitary Houses— Number closed under the Public Health (London) Act. 1891 _ Number of Closing Orders made — Number demolished in pursuance of Orders 18 Number demolished voluntarily 6 Number repaired or Nuisances remedied under Public Health Act 1,553 41 Housing of the Working Classes— (a) Erected during the year (Municipal) 168 „ ,, ,, ,, (Private Enterprise) 155 (b) In course of erection 50 Number of houses in the Borough 17,597 Number of representations by Medical Officer or other person 1 Number of houses included in such representation 88 Number of Verminous Premises cleansed under Sec. 10 of the London County Council (General Powers) Act, 1922 ... ... ... ... 193 Number of Cleansing Baths given under Cleansing of Persons Act 9 Number of Children cleansed 757 Number of Premises cleansed— (a) After Infectious Diseases 809 (b) For Vermin 32 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. — 42 (c) For the prevention of keeping animals in such a manner as to be injurious to health — (d) As to paving yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. — (f) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. — (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, etc. (Metropolis Management Act, Sec. 202) — (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-Laws) Act, 1899) — Mortuaries— No. of Drowned Bodies 4 ,, ,, Other ,, 317 „ ,, infectious „ — 321 „ ,, Inquests and Post Mortems 295 43 SECTION 4, HOUSING. During the year 152 houses have been completed under the Council's Housing Scheme at Charlton Park, and a further 16 at Pound Park. The total number of houses completed and occupied under the Scheme is therefore 868, including 50 flats situated in various parts of the Borough.. In addition the Council has 31 hutments in Tunnel Avenue, East Greenwich. The portion of the Charlton Park Estate which is being developed by private enterprise is now rapidly reaching completion, and at the end of the year there were 96 houses completed and occupied. Cases of overcrowding continue to come to the notice of the Department and particulars of all acute cases are represented to the Housing Committee in order that priority may be given to such cases when the question of allocation of houses comes before that Committee. In my opinion the housing problem is indeed very far from being solved at the present time, and I almost begin to fear that its solution will not be reached within my time, for the difficulties one meets in connection with this matter among the very poorest classes are as great as ever. I hear that some progressive Councils have actually allocated a certain percentage of their new houses for the use of the families of tuberculous patients and also a certain percentage of the houses for the poorest of the poor, but in neither case were these houses fully occupied for the simple reason that neither of this class of person were able to pay the rent demanded. We have a particularly unusiual case in Greenwich. Certain houses were closed by the order of the stipendiary magistrate as being definitely unfit for human occupation as far back as the early part of 1921. The occupants of some of these houses as time went on have been able to obtain alternative accommodation, but those occupying one of the houses have been unable to obtain such accommodation, although they have applied both to this Council as also the London County Council, and have been continually on the look out for other private accommodation. Up to the present they have not succeeded in obtaining any, and accordingly have been living rent free for the whole of this period. The owner, of course, realises that 4 4 if he collected any rent he would be liable to a penalty, and accordingly has not attempted so to do. The Greenwich Borough Council have, however, regularly collected the rates from the occupying tenants. This tenancy, however, must by the operation of natural causes come to an end at no distant date, four courses of slates only now remaining upon the roof. Therefore the conditions under which these people continue to live are getting very bad indeed. The National Housing and Town Planning Council have definitely adopled the principle of differential renting to meet the cases of large poor families under the name of a children's rent allowance; details of their scheme are set out in the report of a Sub-Committee entitled "Policy for the Slums." The Committee suggest that in cases where there are at least three children and where the total family income does not exceed 55/- per week, a rebate from the rent should be allowed, 3/for the first three children and sixpence per child after with a maximum of 4/-. Where the total family income is below 45/- the rebate to be 4/- for the first three children with a maximum of 5/-. They further recommend that two-thirds of the cost of the Children's Rent Allowance should be borne by the Exchequer and one-third by the rates. It would seem that something on these lines might help to solve this difficulty of the housing of the very poorest families, and it would further appear that the present Housing Bill would permit of some such arrangement being made. It is to be hoped that this Council may see their way to be able to allocate a certain amount of housing accommodation on these lines. I understand that in the City of Vienna very wonderful housing schemes have been not only evolved, but actually carried out, and that large numbers of poor families have been rehoused under what one might almost call palatial conditions, such provision including central heating, hot and cold water supply, electric supply, and a number of other amenities, and yet the cost of the scheme has been what one might term of an economic character. In my opinion it is well worth the consideration of this Council, particularly in view of the proposals in regard to the small area which we ourselves may probably be dealing with at no distant date. During November, I officially represented to the Council under Part II. of the Housing Act, 1925, the condition of certain houses known as the Bell Street Area, comprising the following 88 houses : — 45 Lamb Lane.—Nos. 3, 5, 7, 9, 11, 13, 15, 17, 19, 21a, 21b, 23, 25, 27a, 27b, 29 and 31. Haddo Street.—Nos. 52, 50, 48, 48a, 48b, 48c, 46, 44, 42, 40, 38, 36, 34, 32, 30, 26, 24, 22, 20,118. Bell Street.—Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 and Bell Cottage. Clive Place.—Nos. 1, 2, 3, 4 and 5. Bardsley StTeet.—Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14 and 16. Mary Ann Buildings.—1, 2, 3 and 4. Sexton Buildings.—Nos. 1, 2, 3, 4, 5, 6, 7 and 8. HOUSING RETURN, 1929. Number of new houses erected during the year : — (a) Total 323 (b) With State assistance under the Housing Acts :— (i.) By the Local Authority 168 (ii.) By other persons 155 1.—Unfit Dwelling-houses. Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,292 (2) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 97 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1,553 2.—Remedy of Defects without Service of Formal Notices. 46 Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 603 3.—Action under Statutory Powers. (a) Proceedings under Section 3 of the Housing Act, 1925 :— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were 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 (b) Proceedings under Public Health Acts :— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Intimations 1,019 Statutory 178 (2) Number of dwelling-houses in which defects were remedied after service of formal notice :— (a) By owners 950 (b) By Local Authorities in default of owners Nil (c) Proceedings under sections 11, 14 and 15 of the Housing Act, 1925: — (1) Number of representations made with a view to the making of closing orders Nil (2) Number of dwelling-houses in respect of which closing orders were made Nil (3) Number of dwelling-houses in respect of which closing orders were determined, the dwelling-houses having been rendered fit Nil (4) Number of dwelling-houses in respect of which demolition orders were made Nil (5) Number of dwelling-houses demolished in pursuance of demolition orders Nil 47 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 three cowhouses in the Borough have been visited on three occasions, and the required cleansing duly enforced. Mii.k and Diries (Amendment) Act, 1922.—Milk and Dairies Ori er, 1926.—At the commencement of the year there were 141 purveyors of milk on the Register of Dairies and Milkshops. Twenty new applications have been received during the year and added to the Register, and sixteen names hdve been taken off, thus leaving a total of 145 purveyors of milk now registered. The number of premises registered at the end of the year was 133, and 138 visits of inspections of such premises have been made ; notices were served upon the occupiers in six 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 5 ,, ,, Grade A (Tuberculin Tested) 3 „ ,, Pasteurised 10 ,, „ Grade A 2 Supplementary Licenses 4 (Principal Licenses granted by the Lewisham Borough Council). Milk.—Result of Analytical Examinations.—92 samples of milk were taken during the year, of which only four wene found to be adulterated or below the standard fixed by the Ministry of Agriculture and Fisheries. Of the 92 samples, 15 were taken from handcarts in the streets, and 10 were taken in course of transit at railway stations in the Borough at the request 48 of purveyors from whom samples had previously been taken. Five of such samples were taken from churns during the very severe weather experienced in February, with the result that the contents were frozen and therefore abnormal in composition, the fat percentages ranging from 6.94 to 9.24. 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 26 4.48 8.67 4.58 8.69 3.00 8.5 2nd Quarter 24 3.52 8.76 3.52 8.76 3rd Quarter 20 3.63 9.61 3.67 8.62 4th Quarter 22 3.70 8.70 3.75 8.71 Average for the Year 92 3 .85 8. 69 3.89 8.70 *Excluding frozen *3.59 *8.71 *3.62 *8.72 Milk and Dairies Order, 1926.—This Order was made by the Minister of Health under powers conferred by the Milk and Dairies (Consolidated) Act, 1915, 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. 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: 5 cwts., 3 qrs., 12 lbs. of Mutton; 3 qrs., 5 lbs. of Pork. The Public Health (Meat) Regulations, 1924, which came into 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. 49 There are 111 premises where meat, bacon, etc., are either stored or exposed for sale, such premises being inspected periodically by the Inspectors. Slaughterhouses.—The number of slaughterhouses in use in the Borough is as follows: — In 1920 In January 1929 In December, 1929 Registered — — — Licensed 4 3 3 4 3 3 Thirty-one 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 135 Pigs 972 Sheep 1,239 Calves 22 Other Foods.—Places where food is prepared have been visited on 181 occasions, improvements being required in 22 instances as detailed below :— Class of Premises Number of Lists Number of Inspections Number of Instances where matters needed attention At end of 1928 Added 1929 Removed 1929 At end of 1929 Hotel Kitchens 5 3 — 8 8 — Eating Houses 56 3 1 58 70 8 Fried Fish Shops 30 3 1 32 47 8 Pork Butchers and Sausage Manufacturers 28 3 - 31 33 5 Mineral Water Manufacturers 1 — — 1 1 — Others 23 1 2 22 22 1 Totals 143 13 4 152 181 22 50 The 22 instances where matters needed attention included 18 cases where the premises generally, or kitchen and scullery particularly, needed cleansing and lime-washing, 2 where the sanitary arrangements were defective, and 2 where shop fittings such as chopping blocks and gutting benches were either dirtv or defective. In addition to the periodical visits and inspections of food shops, etc., supervision is also exercised on Saturday evenings and Bank Holidays. It is interesting to note that the Borough is again becoming an important centre with regard to the distribution of food. The Cattle Market, Deptford, which was formerly used for the slaughtering, etc., of animals, and its attendant trades, is at present a depot of considerable importance for the landing, storing and distribution of foreign meat. In addition to this, other foods are received and distributed from this depôt. The usual routine has been followed whereby oondemned carcasses have been released only on the certificate of the Medical Officer of Health and on the distinct understanding that such carcasses would not be used for human consumption. Palmers Cold Air Stores, Ltd., who are the principal business house in the Market, have kindly furnished me with information regarding number of carcasses, etc., which passed through their Store during the year:— Lambs 283,316 Sheep 116,074 Crops 7,893 Hinds 19,628 Fores 1,504 Pigs 5,478 Offal (various) 30,000 parcels. Street Traders.—The Regulations made in accordance with the provisions of the London County Council (General Powers) Act, 1927, requiring the licensing by this Council of all persons who are engaged in street trading, continue to operate. 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. 51 At the end of the year 105 licences had been issued, of which 83 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 unlit for the food of man, particulars of which are set out on page Ice Cream Premises.—Under the London County Council (General Powers) Act, 1928, all premises used for the sale or the manufacture for the purpose of sale of ice cream or otheir similar commodity or the storage of same are now compul'sorily registered. Circulars were sent to all Ice Cream Vendors in the Borough informing them of their obligations under the Act, with a result that 114 premises have been duly registered. These premises were inspected on 120 occasions, and insanitary conditions remedied in four cases, whilst five premises required cleansing generally. Unfortunately the Local Authority has no definite power to refuse to place on the register any premises which have been found unsuitable for the manufacture, sale or storage of Ice Cream. Bakehouses.—One hundred and five inspections have been made of the various bakehouses in the Borough, and 30 nuisances found therein have been abated. At the end of the year there were 19 Factory and 23 other Bakehouses on the Register, 11 of which were underground. Food and Drugs Acts. — Four hundred and forty-one samples have been purchased under the provisions of the Food and Drugs (Adulteration) Act, 1928, and submitted to the Public Analyst for analysis, of which 426 were certified to be genuine and 15 adulterated, etc., including 1 informal sample, the adulterations thus being equivalent to 3.5 per oenit. of the samples taken, as compared with 4.3 per cent, last year. Of the total number of samples purchased, 93 were milk, of which 5 were certified to be adulterated (including 1 informal), 56 were butter, all of which were genuine, 43 were rice, of which 3 were found to be adulterated; the remaining adulterated samples were 2 of cake and 1 each of vinegar, sausages, oatmeal, dripping and medicine. It was only considered necessary to take legal proceedings in respect of one of the 15 adulterated cases. 52 Merchandise Marks Act, 1926, and Agricultural Produce (Grading & Marking) Act, 1928.—The supervision of shops, etc., has been regularly carried out by the Inspectors in connection with the various Orders and Regulations dealing with Currants, Sultanas, Raisins, Eggs, Oat Products, Honey; Tomatoes and Cucumbers, Apples and Pears, Broccoli, Wheat Flour, Malt Flour and Malt Extract, and Potatoes, with a view to seeing that the requirements of the Acts have been duly complied with. FOOD AND DRUGS (ADULTERATION) ACT, 1928 Number and Description of Samples purchased for Analysis under the above Act during the Year 1929. Description of Samples Number of Samples Purchased Number Genuine Number Not Genuine Baking Powder 4 4 - Brawn 8 8 — Bread 10 10 — Butter 56 56 — Cake—Currant 3 1 2 ,, —Sponge 1 1 — Cheese 25 25 — Cocoa 2 2 — Coffee 2 2 — Corned Beef 19 19 — Cream 3 3 — Cus'ard Powder 3 3 — Dripping 22 21 1 Fish Paste 9 9 — Flour 11 11 — „ Self-raising 1 1 — Lard 6 6 — Medicine 6 5 1 Milk 93* 88 5* Mustard 2 2 — Oatmeal 1 — 1 Pearl Barley 2 2 — Pepper 8 8 — Rice 43 40 3 Sago 7 7 — Sausages (Preserved) 1 1 — ,, Beef 13 12 1 Breakfast 11 11 — Sugar, Demerara 1 1 — T apioca 21 21 — Vinegar 47 46 1 441 426 15 * including 1 informal (not genuine) 53 Administrative Action Taken Regarding Samples reported to be NOT GENUINE. No. of Sample Description of Sample Nature of Adulteration Result of Proceedings 57 Milk Contained 3.5% of added water. Warning Letter Informal Milk Contained 44% of added water. No action 312 Milk Abstraction of 6% of Fat Warning Letter 372 Milk Deficient in solids not fat to the extent of 1.5% Warning Letter 398 Milk Deficient in fat to the extent of 12% Costs £2 2s. 97 Rice Contained 0. 7% of extraneous mineral matter Warning Letter 103 Rice Contained 0 .57% of extraneous mineral matter Warning Letter 257 Rice Contained 0.68% of extraneous mineral matter Warning Letter 110 Vinegar Deficient in Acetic Acid to the extent of 16% Warning Letter 113 Dripping Contained 4.5% of water Warning Letter 267 Currant Cake Contained a trace of boric acid amounting to less than one hundredth of one per cent Warning Letter 385 Currant Cake Contained 0 01% of Boric Acid. Warning Letter 308 Oatmeal Contained 3% of Barley Meal Warning Letter 321 Beef Sausages Contained 0.15% of Boric Acid Warning Letter 404 Medicine Deficient in sodium bicarbonate to the extent of 48% Warning Letter 54 The Public Health (Preservatives, &c., in Food) Regulations.—These Regulations were made on the 4th August, 1925, and Amending Regulations on the 10th December, 1926, and 25th June, 1927. Only certain articles of food specified in the first schedule of the Regulations may contain preservatives, which must either be sulphur dioxide or benzoic acid in proportions not exceeding that stated in the 3rd column of such schedule. Part 2 of the Regulations specify the colouring matters which must not be added to foods. Of the total samples submitted to the Public Analyst only 3 were found not to comply in all respects with the above Regulations. They were as under: — Cake.—Contained boric acid to the extent of one hundredth of one per cent. Currant Cake.—Contained a trace of boric acid amounting to less than one hundredth of one per cent. Beef Sausages.—Contained 0.03 per cent, of boric acid. With regard to the sample of Currant Cake the infringement has no significance, the boric acid being present in the dried fruit as a natural acid. As I mentioned in last year's Report it is necessary to prove that the preservative has been added, to such article. In the case of the sample of Beef Sausages the Analyst reported that the amount of boric acid present was not sufficient to preserve, the decomposition taking place very quickly. Procedure under the Food and Drugs (Adulteration) Act, Etc. — The following are the principal legal provisions relating to the composition and description of food and drugs (apart from provisions as to poisons and other special drugs) in force on the 1st January, 1929: — (a) Statutory provisions, viz: — The Food and Drugs (Adulteration) Act, 1928. Section 4 of the Milk and Dairies (Amendment) Act, 1922. (b) Orders and Regulations made under repealed Acts and continued in force by the Food and Drugs (Adulteration) Act, viz: — Order as to Registration of Margarine Factories, etc., 1900. 55 Order as to Registration of Butter Factories, etc., 1907. Regulations as to Competency of Analysts, 1900. Sale of Milk Regulations, 1901 and 1912. Sale of Butter Regulations, 1902. (c) Regulations made under the Public Health (Regulations as to Food) Act, 1907, and effective for certain purposes of the Food and Drugs (Adulteration) Act, viz: — Public Health (Condensed Milk) Regulations, 1923 and 1927. Public Health (Dried Milk) Regulations, 1923 and 1927. Public Health (Preservatives, &c., in Food) Regulations, 1925 to 1927. Most of the legal provisions cited above are administered by Food and Drugs Authorities, and it is convenient that they should be treated for the purposes of administration and report as constituting a single group of laws for securing the purity of food. 56 SECTION 6. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Notifications under the Provisions of the Public Health (London) Act, 1891. — During the year 2,387 cases have been notified under the above Act. The following table shows the comparison since 1924 : — No. Year. 3,516 1924 3,555 1925 2,869 1926 2,098 1927 4,832 1928 2,387 1929 Smallpox.—One case of this disease was notified during the year. This case, a girl aged 17 years, actually occurred in Shoreditch, being discovered working in a Factory, and was removed direct to Hospital from that Borough. Another case was admitted to the Seamen's Hospital from Stepney shortly after arrival in England from India. All necessary precautions were taken at the Hospital, contacts examined and kept under the surveillance of the Department. Thorough disinfection was carried out by the Council's Staff and all bedding removed to the Disinfection Station for subsequent treatment. During the year 393 persons residing in the Borough were reported as probable or possible contacts with cases of Smallpox occurring outside the Borough. In every instance they were kept under observation for the extreme period of incubation. Details respecting vaccination in the Borough are given in the Supplemental Vaccination Reports on page 65. Diphtheria .— Three hundred and fifty-six cases of Diphtheria were notified during the year, as compared with 434, 503, 448 and 464 respectively in the years 1925, 1926, 1927 and 1928. The distribution of these cases was as follows:—115 in East Greenwich, 88 in West Greenwich, 27 in St. Nicholas, 109 in Charlton, and 17 in Kidbrooke. Of this number, 351 were removed to the Hospital for treatment, but 26 of these cases were reported by the Hospital Authorities as not suffering from the disease. 57 There were 16 fatalities due to this disease, which gives a case mortality of 4.5 per cent. Two thousand five hundred and thirty-fthree specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be diphtheria. Of this number, 2,288 were reported to give negative or doubtful result, and 245 were Dositive in character, being dealt with accordingly. The quarterly incidence of the disease ior 1929 has been as follows:— 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total East Greenwich 23 23 31 38 115 West Greenwich 16 20 22 30 88 St. Nicholas 11 2 5 9 27 Charlton 33 13 19 44 109 Kidbrooke 7 3 1 6 17 Total 90 61 78 127 356 Membranous Croup.—There were 2 cases of Membranous Croup notified during the year. Erysipelas.—Sixty-one cases were notified during the year, 29 being in East Greenwich, 12 in West Greenwich, 10 in St. Nicholas, 8 in Charlton, and 2 in Kidbrooke. Twentythree of these patients were removed to a Public Institution in the district. Scarlet Fever.—Three hundred and forty-nine cases were notified during the year, as compared with 371, 486 and 376 cases respectively in the years 1926, 1927 and 1928. 120 cases were in East Greenwich, 94 in West Greenwich, 68 in St. Nicholas, 54 in Charlton, and 13 in Kidbrooke ; 343 of these cases were removed to Hospital for treatment, 20 of which were returned as not suffering from this disease. There was no death from this disease during the year, compared with one the previous year. Of the 343 cases treated in Hospital, the following were certified to be suffering on discharge from Hospital with chronic disease :—Otorrhœa 1, Erythema 1. There were no cases which could be described as "Return Cases." Typhoid Fever. — There were 5 cases of Typhoid or Enteric Fever notified during the year, 1 being in East Greenwich, 2 in Charlton, and 2 in Kidbrooke. The ages of the patients 58 were : 2 between fifteen and twenty-five years, 2 between twentyfive and forty-five years, and 1 between forty-five and sixty-five years. All 5 cases were removed to Hospital for treatment ; one however was discharged as not suffering from the disease. In the years 1925, 1926, 1927 and 1928 there were 8, 7, 8 and 12 cases respectively. The average number fo'r the previous ten years is 11. No case was traceable to the consumption of shell fish ; There was only one fatality from this disease. Eleven specimens were forwarded by medical practitioners for bacteriological examination from cases suspected to be Typhoid Fever In character, all giving a negative result. Puerperal Fever. — Four cases of this disease were notified during the year, 1 of whicjh occurred in West Greenwich, 2 in Charlton, and 1 in Kidbrooke. There were 5 cases in 1928, 5 in 1927, 9 in 19'26, and 9 in 1925. Puerperal Pyrexia.—Eleven cases of this disease were notified during the year. Six cases occurred in East Greenwich, 3 in West Greenwich, and 2 in Kidbrooke. Seven 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 of Health on the 1st July, 1920. Five hundred and thirty-seven cases were notified during the year, as compared with 2,934 during the previous year, and 234 for the year 1927. Sixty-three such cases were removed to Hospital for treatment. The ages and incidence of fatality of the disease were as follow :— There were 34 cases under 1 year of age, with 3 deaths at this age period, giving a case mortality of 8.8 per cent, between the ages of one to five years there were 189 casesi, with 5 deaths, giving a case mortality of 2.6 per cent., 262 cases between five and fifteen years, with 1 death, giving a case mortality of 0:4 per cent., and 52 cases between fifteen and sixty-five years. The case mortality for the whole Borough works out at 1.6 per cent., as compared with 0.8 per cent, for the year 1928. 59 Table showing number of Measles Cases reported during the year 1929. Quarter ended 31st March, 1929. Under 1 1 to 5 5 to 15 15 to 25 25& over Total East Greenwich 1 8 10 5 1 25 West Greenwich 3 1 1 5 St. Nicholas, Deptford 1 — 6 — — 7 Charlton 1 1 7 — — 9 Kidbrooke — — —- 1 — l Total 3 9 26 7 2 47 Sources of Notifications:— By Medical Practitioners 37 ,, Parents 1 Males. Females. ,, Health Visitors - 24 23 >, L.C.C. Schools 9 47 Quarter ended 30th June, 1929. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 5 11 30 17 5 68 West Greenwich 2 16 25 2 1 46 St. Nicholas, Deptford 1 12 20 — — 33 Charlton 4 28 65 7 3 102 Kidbrooke — - 3 — — 3 Total 12 62 143 26 9 252 Sources of Notification'.— By Medical Practitioners 191 ,, Parents 7 Males. Females. ,, Health Visitors — 115 137 „ L.C.C. Schools . 54 252 60 Quarter ended 29th September, 1929. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 2 7 8 2 19 West Greenwich 2 16 21 — — 39 St. Nicholas, Deptford _ 4 1 — — 5 Charlton 2 6 5 — 2 15 Kidbrooke — 1 — 1 — 2 Total 6 34 35 3 2 80 Sources of Notification-.— By Medical Practitioners 59 ,, Parents — Males. Females. ,, Health Visitors — 37 43 „ L.C.C. Schools 21 80 Quarter ended 29th December, 1929. Under 1 1 to 5 5 to 15 15 to 25 25 & over Total East Greenwich 3 9 3 2 1 18 West Greenwich 7 53 38 — — 98 St. Nicholas. Deptford 2 18 12 — — 32 Charlton 1 4 3 — — 8 Kidbrooke — — 2 — — 2 Total 13 84 58 2 1 158 Sources of Notification:— By Medical Practitioners 114 ,, Parents 9 Males. Females. „ Health Visitors 3 74 84 „ L.C.C. Schools 32 158 Total Cases in Year 537 Zymotic Enteritis or Epidemic Diarrhœa.—Seventy-nine cases of diarrhoea were notified throughout the whole of the Borough, 45 being under one year of age and 34 between one and five. Fifty of such notifications related to patients in East Greenwich, 2 in West Greenwich, 2 in St. Nicholas, and 25 in Charlton. 61 There were 11 deaths ascribed to Diarrhoea and Enteritis. Whooping Cough.—This disease was made permanently notifiable as from 1st November, 1921. Six hundred and twenty-four cases were notified (compared with 506 in 1928), 78 being under one year of age, 361 from one to five, 179 from five to fifteen, and 6 from twenty-five to sixty-five, the districts concerned being East Greenwich 415 ; West Greenwich 110 ; St. Nicholas 24 ; Charlton 75. Each of these cases was visited and leaflets and instructions left, together with verbal advice respecting the isolation and care of the patient. Fifty-six cases were removed to Hospital for treatment, of which number 1 was returned as not suffering from Whooping Cough. Epidemic Cerebro - Spinal Meningitis, Cerebro - Spinal Fever, or Post-Basal Meningitis.—There was only 1 case of this disease notified during the year, which occurred in the West Greenwich district. Acute Polio-Myelitis.—There were 7 cases notified during the year, as compared with 1 case in 1928, 2 cases in 1927, and 2 in 1926. One case, however, was discharged from Hospital as not suffering from this disease. Ophthalmia Neonatorum.—During the year 15 cases of this disease have been notified, 5 being in East Greenwich, 2 in West Greenwich, 1 in St. Nicholas, and 7 in Charlton. Further particulars of this disease will be found on page 92. Malaria.—There was only 1 case of Malaria notified during the year, as compared with 1 in 1928 and 8 in 1927. Encephalitis Lethargica.—There were 4 cases of this disease notified during the year, 2 being in East Greenwich, 1 in West Greenwich, and 1 in Kidbrooke. The West Greenwich case, however, was returned from Hospital as not suffering from this disease. Glanders.—No case of Glanders has occurred within the Borough. Anthrax and Hydrophobia.—No notification of any case of these diseases in man has been received during the year. Tuberculosis.—During the year there were 179 cases of Tuberculosis notified in the Borough, as compared with 197 for the previous year. Of this number. 152 were pulmonary cases, ordinarily known as Consumption, and 27 non-pulmonary, being Tuberculosis affecting other portions of the body than the lungs. 62 Of this number of cases, 78 pulmonary and 8 non-pulmonary occurred in East Greenwich, 27 pulmonary and 6 non-pulmonary in West Greenwich, 9 pulmonary and 4 non-pulmonary in St. Nicholas, 33 pulmonary and 7 non-pulmonary in Charlton, and 5 pulmonary and 2 non-pulmonary in Kidbrooke. The various ages of the patients were as follow :■—Pulmonary cases from one to five, 1 case ; five to fifteen, 13 cases ; fifteen to twenty-five, 42 cases ; twenty-five to forty-five, 52 cases ; fortyfive to sixty-five, 37 cases : and 7 cases over sixty-five ; whilst the Non-pulmonary were :—Between one and five years, 9 cases ; five to fifteen, 5 cases ; fifteen to twenty-five, 6 cases ; twentyfive to forty-five, 6 cases ; forty-five to sixty-five, 1 case. Four hundred and eight specimens were forwarded by medical practitioners for bacteriological investigation from patients suspected to be consumptive ; 323 were reported to be negative and 85 positive. Disinfection has been offered and carried out in 134 cases, including 185 rooms and 344 articles of bedding, etc. ; disinfectant has also been supplied to patients to disinfect sputum, etc., and sputum pots where such are found necessary. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR 1929. Disease. Total Cases Notified.* Cases admitted to Hospital Total Deaths.* Small Pox 1 1 - Diphtheria 356 351 16 Scarlet Fever 349 343 — Enteric Fever (including Paratyphoid) 5 5 1 Puerperal Fever 4 4 — Puerperal Pyrexia 11 7 — Pneumonia, Acute Primary or Influenzal 151 61 36 Erysipelas 61 23 — Acute Polio Myelitis 7 7 Cerebro Spinal Fever 1 1 Membranous Croup 2 2 Malaria 1 Ophthalmia Neonatorum 15 5 Encephalitis Lethargica 4 3 2 Notifiable Locally. Measles 537 63 9 Whooping Cough 624 56 17 Diarrhoea 79 2 11 * For particulars as to Age Groups see Tables at end of Report. DISINFECTION. The Disinfecting and Cleansing premises were erected in June, 1924, and are situate at Tunnel Avenue, Blackwall Lane, East Greenwich. 63 The following returns show in detail the amount of work performed during the year by the Disinfecting Staff : — Number of Articles and Rooms Disinfected in connection with the Undermentioned Diseases for the Year ended 28th December, 1929. Diseases, &c. Rooms Premises Entered Beds Palliasses Mattresses Bolsters Pillows Blankets Sheets Cushions Quills Odd Articles Total No. ' Articles Disinfected Cancer 24 26 9 1 13 7 54 39 7 7 9 95 241 Smallpox 6 2 2 — 22 2 57 69 50 3 42 52 299 Encephalitis Lethargica 2 2 — — — — — 2 — — — 2 Scarlet Fever 366 311 198 1 104 156 496 587 86 46 227 382 2,283 Diphtheria 372 334 193 — 107 156 481 506 62 32 183 273 1,993 Enteric Fever & Paratyphoid 4 4 2 — 2 5 6 10 6 — 5 9 45 Puerperal Fever and Pyrexia 7 7 2 — 15 3 27 21 5 5 4 5 87 Tuberculosis 185 134 39 — 17 26 97 87 23 9 29 17 344 Other Diseases 106 76 18 — 70 18 184 272 87 16 8 65 738 Measles 13 5 — — 1 — — — — — — — 1 From Verminous Premises 27 32 21 2 36 20 61 65 6 — 7 7 225 Scabies 3 5 13 — 14 3 7 67 4 - 4 22 134 Influenza and Pneumonia 3 4 2 — — 1 11 1 2 — — — 17 Cerebro-Spinal Meningitis 6 6 2 — — — 3 3 2 — 2 9 21 Total 1,123 948 501 4 401 397 1,484 1,729 340 118 520 936 6,430 64 Number of Articles Destroyed in connection with the Undermentioned Diseases during the Year ended 28th December, 1929. Diseases, &c. Beds Palliasses Mattresses Bolsters Pillows Bankets Sheets Cushions Quilts Odd Pieces Total No. Articles Destroyed Cancer 6 — 3 3 11 3 2 — 1 1 30 Scarlet Fever 1 3 1 2 2 — — 3 5 17 Diphtheria — — 2 — - - — — — — 2 Tuberculosis 5 — 4 — - 2 — — — 7 18 Other Diseases 3 — 5 — 3 1 — — — 20 32 For Verminous Premises 4 6 — — 1 — — — — 50 61 Total 19 6 17 4 17 8 2 — 4 83 160 65 Supplemental Vaccination Returns for 1928. Return made on or before the 9th of February, 1930, 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, 1928, inclusive :— Registration SubDistricts comprised in the Vaccination Officer's District. No. of Births from 1st Jan. to 31st Dec., 1928. Number of these Births duly entered by 31st Jan., 1930. No. of Births which on 31st Jan.1930, remained unentered in the Vaccination Register on account of— No. of these births remaining on 31st Jan., 1930, not accounted for Total No. of Certificates of successful Primary Vaccination at all ages received during Calendar Year, 1929. No. of Declarations of Conscientious Objection actually received by Vaccination Officer during the Calendar Year 1929. Successfully Vaccinated. Insusceptible of Vaccination. Had Smallpox. 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 513 268 2 — 176 20 12 6 15 14 North Deptford 528 235 1 — 182 28 8 3 23 48 East Deptford 672 213 1 — 202 42 25 9 45 135 East Greenwich 862 420 — — 238 39 15 18 38 94 West Greenwich 290 139 1 - 82 16 6 5 11 30 Total 2,865 1,275 5 — 880 145 66 41 132 321 1,389 945 Total number of Certificates for year 1929 sent to other Vaccination Officers, 149 (not included in figures above). Dated February 3rd, 1930. E. S. Elliott, Vaccination Officer. CHARLTON AND KIDBROOKE. No. of Births entered in "Birth Statutory Declarations of ConRemoved to places unknown, or List Sheets" as registered from sciertious Objection 187 which cannot be found ; and 1st January to 31st December, Dead Unvaccinated 15 cases not traced 10 1928 685 Postponed by Medical Certificate 3 Not accounted for 7 Successfully Vaccinated 400 Removed to Districts the Insusceptible of Vaccination 2 tion Officer of which has been Had Small-Pox — duly apprised 61 G. E. Oughton. 66 HOUSES VISITED AND INQUIRIES MADE IN CONNECTION WITH INFECTIOUS DISEASE. Number of Houses Visited and Inquiries made by Infectious Disease Inspector 1,223 Number of Re-visits 3,236 The Health Visitors also visited 1,455 cases, and re-visited when required. The following books belonging to the Libraries, etc., were destroyed in consequence of Infectious Disease: — Central Library (Woolwich Road) 87 Branch Library (West Greenwich) 68 Branch Library (Charlton) 79 Total 234 The Ford van which has been in constant use since April, 1921, for carrying out the work of disinfection was replaced in June by a new one ton flat-topped "Morris" chassis, which has been fitted to take the existing removable bodies. CLEANSING STATION, BLACKWALL LANE. The Cleansing Station which forms part of the Disinfecting premises was opened in June, 1924, and is situate 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. 67 The following table shows the number of children cleansed during the year:— 1st Quarter 168 2nd „ 244 3rd „ 178 4th „ 167 Total 757 Nine adults suffering from verminous conditions were also given cleansing baths. In every case the infested clothing was disinfected. 68 REPORT OF THE TUBERCULOSIS OFFICFR. To the Medical Officer of Health. Sir, During 1929 there has been no material change in the work of the Department, and the following Report calls for no special comment this year. The Notifications and Deaths were as follow:— Notifications. Deaths. Pulmonary Non- Pulmonary Total. Pulmonary Non- Pulmonary Total. 152 27 179 108 12 120 and the averages for the previous ten years:— 215 84 110 21 These figures give an Incidence Rate for all forms of the disease of 1.72 per 1,000 of the population (1.46 pulmonary and .26 ron-pulmonary), with a Death Rate for all forms of 1.13 per 1,000 population (1.04 pulmonary and .10 non-pulmonary). In 5 instances (4 pulmonary and 1 non-pulmonary) the diagnosis of Tuberculosis was not confirmed after observation at Dispensary or Hospital, so that the above Incidence Rates should be read at a slightly lower figure. The Death Notification Interval of 79 patients (77 pulmonary and 2 non-pulmonary) who died of Tuberculosis in 1929 is shown below: — Information from Death Returns 2 Died within One Month of Notification 2 Died within Three Months of Notification 7 Died within Six Months of Notification 11 Died with Over Six Months of Notification 57 Revised Diagnoss.—The 5 cases in which diagnosis was not confirmed comprised:—3 Bronchitis and 1 Heart Disease, notified as suffering from Pulmonary Tuberculosis; and 1 case of simple enlargement of the neck glands notified as Nonpulmonary Tuberculosis. Deaths.—During the year 120 persons died from Tuberculosis (all forms), giving a Death Rate of 1.13 per 1,000 population; 108 were due to the pulmonary form, equal to a rate of 1.04 per 1,003 which is .01 higher than the figure recorded last year. 69 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 perl,000 1923 213 2.08 115 1.12 1924 214 2.01 104 1.00 1925 197 1.90 104 1.00 1926 177 1.70 93 .89 1927 146 1.41 78 .75 1928 160 1.54 108 1.03 Deaths from Non-pulmonary Tuberculosis, of which there were 12 (equal to a rate of .10 per 1.000), included 8 Meningitis and 4 Bones and Joints. The 26 (corrected) Notifications of Non - Pulmonary Tuberculosis included: — 11 cases of Tuberculosis of the Glands (Neck). 4 „ „ ,, Joints and Bones. 3 „ ,, ,, Abdomen. 8 „ „ Other forms. Artificial Sunlight Clinic (Tuberculosis Section). At the beginning of the year there were 34 patients under treatment; during the year 53 new cases were admitted from the Dispensary, making a total of 87. Discharges numbered 60, leaving 27 under treatment at the close of the year. During the latter half of the year, treatment was greatly interrupted owing to the prevalence of Measles and other infectious diseases. Of the new cases 48 were under 15 years of age and 5 over that age. The cases were classified as follows: — Malnutrition 32 Tuberculous Adenitis 9 Tuberculous Peritonitis 1 Tuberculous Hip 1 Bronchitis and Asthma 5 Various 5 Owing to lack of accommodation patients could only have two treatments per week and the total average duration of treatment was 3 months, although in 5 instances this was extended to 6 months. Speaking generally the results were very good and similar to our experience as given in previous reports. No ill effects have ever been noticed probably because exposure is 70 very gradual and with no desire to rush a "cure." The beneficial results of artificial sunlight treatment have been fully confirmed. The number of treatments totalled 1,402 and the procedure adopted remains as before. Occupation.—There are no industries in the Borough which have any special bearing upon the Incidence of Tuberculosis, and the occupations of notified cases in 1929 show no marked difference to those quoted in previous Reports. 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 to continue to be a very serious difficulty in the problems of infection, but it is realised that the patients most in need of extra accommodation are frequently those unable to pay the necessary rent. Of 212 patients suffering from Pulmonary Tuberculosis: — 120 were sharing a bed. 42 had a separate bed but not a separate room. 50 had a separate bed and a separate room. As a result of much persuasion and perseverance on the part of the Tuberculosis nurses and the Care Committee, 5 patients who were sharing a bed have now separate beds. 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). At the close of 1929 the estimated number of persons suffering from Tuberculosis and residing in the Borough was as follows :- Men. Women. Children. Total. Pulmonary Tuberculosis 244 206 168 618 Non-Pulmonary Tuberculosis 31 43 171 245 giving a total of 863 as against 907 in the previous year. Dealing with the Dispensary itself, 637 new patients were examined during the year. The sources from which these patients came were as follow:— Doctors 219 Hospitals 16 School Medical Service 23 Ministry of Pensions 4 Own Application 55 Nurses (Contacts) 320 71 Contacts.—363 Contacts were examined of whom 37 were found tuberculous and 8 doubtfully so. These latter are still under observation. The work of the Dispensary is shown in the statistical table on page 80 and explains itself. Sanatorium Treatment.—During the year 144 patients were sent to sanatoria, 101 under the County Scheme, and 43 through the Guardians. The average duration of residence was three and a half months, but the same difficulties remain in finding suitable employment for those discharged fit for work. In addition, 85 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. A new and modern Open-Air School is being built in Charlton Park and is expected to be opened early in I he new year. It will be much more conveniently situated for Greenwich children. X-Ray Examinations.—During the year. 291 patients were examined at the Greenwich and Deptford Hospital. Of these, 227 were adults, and 64 children. The parts examined were Chest 260, Other 31. Sputum Examinations.—Of 183 sputum specimens bacteriologically examined at the Seamen's Hospital. 40 proved positive. At the same time, 91 specimens were examined at the Dispensary for Albumen, 29 being positive. Tuberculosis Care Committee. The work of the Care Committee seldom varies and never ends, and there is always more work than Helpers. The Public Health Committee continues to act as the Care Committee, but as that Committee confines itself to 'Assessments' the problem of finding means for 'caring and assisting' necessitous patients falls mainly on Miss Johnston, the Honorary Secretary, who is indefatigable in her efforts in this direction, and the Dispensary Staff. Through the kind assistance of several friends and again of the various Societies mentioned in previous Reports, 19 72 patients received gifts of clothing, etc., on proceeding to Sanatorium; 10 beds or bedding to relieve sleeping accommodation at home were given, and 14 patients were given letters for convalescent treatment. A sum of £119 5s. 0d.. was collected from patients and their relatives on behalf of the London County Council towards the cost of treatment. Handicraft Class.-—This class has now been established 15 months and the success which has attended it is due, in most part, to the great enthusiasm of Miss Johnston, the Honorary Secretary of the Tuberculosis Care Committee. She has been untiring in her efforts to promote Concerts, Dramatic Entertainments, Garden Parties, etc. Without the financial aid obtained from such sources it would have been impossible to carry on the work, for there is no official grant of any kind. To all those who sold or bought tickets or assisted in any way, our appreciation and thanks are due. At the same time acknowledgment must be made of the services of Miss Forth, the excellent teacher who has been with the class since its formation. Her manner towards the patients, in all of whom she appears to take a separate and special interest, makes her services most valuable. She spares no pains to interest them in their work. The work of the class and the methods adopted were fully explained last year, but it may be mentioned that the variety of articles for sale has been greatly extended and now includes glove-making, pewter work and pottery painting. During the year several "sales of work'" were held (one in conjunction with the adjoining Boroughs of Deptford and Lewisham), and the results were fairly successful. The difficulty still remains, however, for obtaining a "good market," and every information will be gladly given to any who would like to assist in this direction. The number of patients on the Register at the end of the year was 23 with an average attendance of from 17 to 18. The London County Council, who provide the teacher, limit the class to 20 members. The benefit to the patients is obvious and considerable to all who know them. They are invariably cheerful and interested and free from that depression which is one of the most difficult problems a patient suffering from Pulmonary Tuberculosis has to fight against. 73 Although the "funds" are not official, a statement of accounts for the first year of working, ending 30th September, 1929, is appended: — Greenwich Tuberculosis Handicraft Centre. Statement of Capital Outlay. £ s. d. Provision of Hut 146 0 0 Lighting and Fittings 15 0 0 Furniture and Lino 11 7 0 Tables 8 0 0 Washstand 1 1 0 District Surveyor's Fee 2 6 10 £183 14 10 74 GREENWICH TUBERCULOSIS HANDICRAFT CENTRE. WORKING ACCOUNT Year ended 30th SEPTEMBER, 1929. £ s. d. £ s. d £ s. d. To Purchases:— By Sales ... 50 4 a Leather (raw material, etc.) 26 14 0 Stock in hand. 30th September, 1929 22 10 9 Sea Grass 5 14 9 Balance, (deficit) 6 9 2 Stools 17 17 2 50 5 11 Light and Insurance 5 2 11 Mairtenance and Cleaning 11 4 10 Awards to Patients 12 10 6 £79 4 2 £79 4 2 75 Dental Treatment.—The subjoined Report has been forwarded by G. Francis Ferris, Esq., L.D.S. I am, Sir, Your obedient servant, M. Macdonald, M.D., Ch.B., D.P.H. TUBERCULOSIS. Age-Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F M F 0 1 1 — 6 4 — — 2 — 6 3 5 3 1 — — — — 10 4 2 2 — — — 1 — 15 15 10 2 2 4 9 — 2 20 10 15 1 3 7 7 1 — 25 20 15 1 7 9 10 2 1 35 14 16 1 2 15 9 — 2 45 20 7 — — 16 5 — 1 55 11 2 — 1 9 4 — — 65 and upwards 5 4 - — 1 3 — — Totals 103 76 16 20 61 47 6 6 Particulars relating to the above Table are dealt with in the Report of the Tuberculosis Officer on pages 68 to 71. 76 (a) PULMONARY TUBERCULOSIS—Annual Return showing in summary form the condition of all Patients whose case records are in the possession of the Dispensary at the end of 1929, arranged according to the years in which patients first came under Public Medical Treatment for pulmonary tuberculosis, and their classification as shown on Form A. Condition at the time of the last record made during the year to which the Return relates Previous to 1926 1926 1927 1928 1929 Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B. plus Class T.B. minus Class T.B plus Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Group 1 Group 2 Group 3 Total (Class T.B plus) Group 1 Group 2 Group 3 Total (Class T.B. plus) Alive Discharged as cured Adults M. 53 6 2 8 F. 77 2 2 4 Children M. 111 F. 82 Disease arrested Adults M. 13 7 1 8 F. 40 4 4 Children M. 9 F. 13 77 Alive Disease not arrested Adult M. 23 17 13 8 38 8 9 7 2 18 7 9 10 5 24 11 2 14 4 20 13 20 19 4 43 F. 36 14 12 2 28 13 1 1 9 3 3 1 7 12 4 8 12 13 15 6 2 23 Children M. 15 1 1 18 5 8 8 F. 8 9 8 3 3 Condition not ascertained during the year 42 2 1 3 Lost Sight of or otherwise Removed from Dispensary Register 221 52 38 29 119 11 3 4 4 11 6 2 8 2 12 6 3 2 5 2 2 2 Dead 1 Adults M. 87 23 110 141 274 3 11 10 21 1 7 4 7 18 1 6 7 10 23 1 2 4 2 8 F. 51 34 67 102 203 2 1 3 5 9 3 3 9 4 16 4 2 3 7 12 2 1 4 5 Children M. 16 F. 31 5 5 1 1 1 1 1 2 Totals 928 161 244 290 695 65 14 25 22 61 39 25 34 19 78 45 17 34 21 72 44 40 29 12 81 78 (b) NON-PULMONARY TUBERCULOSIS.—Annual Return showing in summary form the condition of all Patients whose case records are in the possession of the Dispensary at the end of 1929, arranged according to the years in which the Patients first came under Public Medical Treatment, and their classification as shown on Form A. Condition at the time of the last record made during the year to which the Return relates Previous to 1926 1926 1927 1928 1929 Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Bones and Joints Abdominal Other Organs Peripheral Glands Total Alive . Discharged as cured Adults M. 7 5 12 F. 7 1 7 15 Children M. 10 7 5 243 265 F. 11 2 1 176 190 Disease arrested Adults M. 4 4 F. 2 1 1 1 5 Children M. 4 1 1 17 23 1 1 F. 6 3 1 7 17 79 Alive Disease not arrested Adults M. 2 1 3 3 3 4 l 1 6 I 2 3 3 1 4 F. 1 4 5 2 2 4 3 1 1 5 1 1 2 5 5 10 Children M. 4 1 12 17 3 5 8 1 3 2 6 5 6 11 1 1 1 3 F. 4 1 4 9 2 1 3 2 1 3 2 1 4 7 1 2 3 Transferred to Pulmonary 2 1 7 10 1 1 Condition not ascertained during the year 22 22 Lost sight of or otherwise Removed from Dispensary Register 20 3 5 104 132 1 2 1 4 3 1 4 1 1 1 1 Dead Adults — M. 11 2 13 1 1 1 3 1 1 2 F. 4 3 3 10 1 1 Children M 1 2 4 4 11 F. 4 2 3 8 17 Totals 104 22 28 626 780 12 1 5 9 27 15 5 2 5 27 9 2 2 11 24 4 3 8 6 21 80 Return of work carried out in connection with the Maze Hill Tuberculosis Dispensary for the Year 1929. diagnosis. Pulmonary. Non-pulmonary. Total Adults. Children. Ad"lts. 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 48 24 2 4 3 6 3 3 51 30 5 7 (b) Doubtfully tuberculous — — — — — — — — 3 3 - 1 (c) Non-tuberculous — — — — — — — — 34 49 48 32 B.—Contacts examined during the year:— (a) Definitely tuberculous 15 13 5 1 3 15 16 5 1 (b Doubtfully tuberculous — — — — — — — — — 2 4 2 (c) Non-tuberculous — — - — — — — — 44 108 68 98 C.—Cases written off the Dispensary Register as (a) Cured - - - - - - - - - - - {b) Diagnosis not confirmed or non - tuberculous (including cancellation of cases notified in error) — — — — — — — — 84 171 124 144 D.—Number of persons on Dispensary Register on December 31st :— (a) Diagnosis completed 245 211 72 49 23 31 83 50 268 242 15 99 (b) Diagnosis not completed — — - — — — — — 2 2 2 — 81 1. Number of persons on Dispensary Register on January 1st 750 2. Number of patients transferred from other areas and of "lost sight of" cases returned 16 3. Number of patients transferred to other areas and cases " lost sight of'" 14 4. Died during the year 80 6. Number of observation cases under A (b) and 13 (b) above in which period of observation exceeded 2 months 6. Number of attendances at the Dispensary (including Contacts) 4, 10 7. Number of attendances of non-pulmonary cases at Orthopaedic Out- 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 6 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 58 10. Number of consultations with medical practitioners :— (a) At Homes of Applicants 28 (£) Otherwise 230 11. Number of other visits by Tuberculosis Officers to Homes ... 197 12. Number of visits by Nurses or Health Visitors to Homes for sary purposes 3,046 13. Number of (a) Specimens of sputum, &c., examined 183 (b) X-ray examinations made 291 14. Number of Insured Persons on Dispensary Register on 31st December 331 15. Number of Insured Persons under Domiciliary Treatment on 31st Dec. 36 16. Number of reports received during the year in respect of Insured persons :—(a) Form G.P. 17 5 (b) Form G.P. 36 27 Mr. G. F. Ferris, the Council's Dentist, reports on the work performed at the Dispensary during the year. The number of patients under treatment was considerably less than the previous year, but it is pleasing to record the increase in the number of attendances of such patients. There was still, however, a reluctance on the part of some patients to undergo fillings. The following are the particulars of the treatment carried out: — No. of Sessions 25 „ ,, Patients 58 Attendances 130 Dentures supplied 4 Fillings and scalings 6 Extractions: — Gas 50 Local Anaesthetic 78 Ordinary 10 Advice given 33 Referred 54 82 The increased and increasing amount of attention which is being paid by the general public to the question of Tuberculosis is undoubtedly all for the public good, and the success which attended the combined Fete held in the Trinity College grounds by the kind permission of the Drapers' Co. and with the very able assistance of the Warden, L. Collyer, Esq., to whom our thanks are due, shews that this interest locally is being stimilated. The total receipts from this Fete amounted to over £100, and the actual sales from the stalls produced for Lewisham £33 5s. 5d., Greenwich £8 1s. 6d., Deptford £6 11s. 11d., and was in every respect considered to be a very successful function, and it would be invidious indeed to mention any particular names for special thanks. The greatest difficulty in connection with tuberculosis work in my opinion is the inertia of the higher authorities from the Government downwards. Professor W. M. Crofton, M.D., Pathologist, University College, Dublin, in the following extract from a recent paper of his, indicates the urgency of the problem of immunity from tuberculosis from the national point of view: — "Now supposing tuberculosis was a dramatic disease, quick in its onset and acute in its course as enteric is, and that it killed in this way twenty thousand people a year, leaving another large number of people crippled, miserable, and inefficient for the rest of their lives, do you think such a milk supply would be tolerated for a moment? Tuberculosis is so sly and so undramatic that it does not excite alarm, but it is none the less as certain a death dealer or crippler. There can be no doubt at all about it, this question of a tuberculosis free milk supply is a most urgent problem and that it would be a triumph for any government to put the means we have at our disposal into operation." 83 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 We si cyan 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 Charl ton Vale Total Attendances 11,283 11,399 5,966 3,158 4,999 36,805 New Cases 400 351 240 104 150 1,245 Medical Consultations 4,824 4,062 2,624 1,285 2,363 15,158 Nursing Mothers seen by Doctors 1,516 1,618 1,115 454 641 5,344 All babies are weighed and advice given to the mothers at every attendance. 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 Armada Street Mission Hall. Deptford First and third Thursdays in each month. 84 Owing to the increased attendances at the Shooters Hill Road Centre it was found necessary to hold an additional session on Friday afternoons, commencing as from 28th August. The number of new cases together with total attendances for the year were as follow: — New Cases. Total Attendences. Borough Hall 201 889 Conduit House 208 785 Shooters Hill Road 183 888 Charhton Vale 37 230 Armada Street 53 168 682 2,960 The attendances show an increase of 578 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., 1929. Table A. Visits Re-Visits Total Infants undt-r 1 year 1.870 4,329 6,199 Children, 1—5 years 193 4,352 4,545 Measles 526 98 624 Whooping Cough 776 171 947 Pneumonia 35 28 63 Puerperal Fever 2 4 6 Puerperal Pyrexia 7 4 11 Diarrhoea 77 33 110 Ophthalmia Neonatorum 33 41 74 3,519 9,060 12,579 Table B. Dental Treatment 72 6 78 Milk Scheme 114 36 150 Pre-Maternity Cases 366 69 435 Infant Consultations attended 1,010 — 1,010 Pre-Maternity Clinics attended 292 — 292 Miscellaneous 159 — 159 In addition 'to the above, 1,037 persons were seen by the Health Visitors at the office, chiefly in connection with milk, applications. 85 Infantile Mortality in Greenwich during 1929. During the year 1929 there were 116 deaths of children below the age of one year. This figure, unfortunately, is 21 higher than the figure for 1928 and represents an Infantile Mortality rate of 70 per thousand births as against 53 for 1928 and an average of 67 for the past ten years. It is disappointing to be unable to record a more satisfactory condition of affairs, and it is not easy to account satisfactorily for the whole of this increase. Admittedly the Infantile Mortality rates both for London and the Country generally were higher than they were during the preceding few years, and this is accounted for mainly by the exceptionally severe cold which was experienced during the first quarter of the year 1929. So far as Greenwich is concerned. Pneumonia and Bronchitis accounted for a total of 28 deaths (compared with a total of 12 only for the preceding year) the majority of which occurred during the first quarter of the year. Whooping Cough too was prevalent during 1929 and this was the cause of death in 9 instances, as compared with 3 only in 1928. A rather disturbing feature was the relatively large number of deaths due to premature birth, the 1929 figure being 26 as compared with 18 only in 1928. It is hoped in the near future, to adopt measures which will result in a more exhaustive study of the causes of premature birth, from which it is hoped to reduce very greatly the mortality from this cause. Every case of Infantile Mortality is the subject of a special enquiry, more particularly as to the extent to which use has been made by the mother of the Council's Ante-natal and Infant Welfare Centres. During the year under review, the largest group, 47 out of the 116, comprised those mothers who had not attended either an Ante-natal or Infant Welfare Centre. In one case the report is very significant, being to the effect that although the mother was intelligent, the husband greatly discouraged her attending the Centre, preferring the advice of the Grandmother (who was of an ignorant type). Happily one very rarely hears now of prejudice against Welfare Centres. It was apparent, however, in several other cases that ignorant but wellmeant advice from relatives, was followed with disastrous results. In the next group are included those mothers who had attended Ante-natal Centres, but not Welfare Centres. These numbered 11, in 5 of which cases the baby's death took place within a day or so of birth; the remaining 6 cases did not call for special comment except that in one instance prematurity, which was the cause of death, was due to a fall sustained by the mother. In another instance the baby was suffocated in bed; 86 incidentally this was the only case of its kind during the year, which is a marked improvement upon previous experience in regard to this class of death. In 13 cases the mother had attended Welfare Centres with previous children. In practically all these cases the babies lived only for an hour or two, the causes of death not suggesting any special circumstances. In 17 cases attendance at Welfare Centres had been irregular. These cases again did not appear to present any special features, and so one comes to the group where attendance at the Centres had been reasonably regular; these numbered 27. In the majority of these cases, the causes of death were such that Welfare Centre care could scarcely have exercised any influence, the majority of the infants being delicate cur ill from birth, succumbing in the main to Pneumonia or allied conditions. There is one very potent feature which still, unfortunately, exerts its evil influence in regard particularly to the well-being of the very young, and that is the shortage of housing accommodation. In quite a number of instances, limited housing facilities were suggested as a contributing cause to the infantile deaths, a case in point being a family of seven whose sleeping accommodation was one room only. Unemployment too, in several cases resulted in a condition of extreme poverty and as a consequence, the children were inadequately nourished despite the assistance which is obtainable in the way of milk, etc., from the Centres for nursing and expectant mothers and young children in necessitous circumstances. Convalescent Home Treatment. — Such cases as are recommended by the Medical Officers in charge of the various Welfare Centres as being in need of convalescent home treatment are in the first place dealt with by the Committee and then referred either to the Invalid Children's Aid Association, or to the Guardians to make the necessary arrangements for such treatment. The I.C.A.A. collect from the parents such proportion of the cost as the families' circumstances will allow and further help is obtained from voluntary societies, the balance being borne by the Council. During the year 43 children have been sent away for convalescence for periods varying from three weeks to six months. Arrangements were also made with the Littlestone-on-Sea Convalescence Home for a month's convalescence for five mothers, together with their babies. 87 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, 23G, 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, and is conducted on similar Lines to that recorded in previous reports. During the year 1929, 423 new cases were treated, these being as follows:— Rickets, and Prevention of Rickets 170 Underweight and Malnutrition 107 Bronchial 32 Anaemia 19 Enlarged Tonsils and Cervical Glands 10 Convalescent from Infectious Diseases 8 Constipation 7 Insomnia 6 Skin Diseases 6 Marasmus Babies 5 Chorea 2 Chilblains 1 Rheumatism 1 Other Cases 7 Nursing Mothers 32 Ante-Natal Cases 10 Dr. Morton reports in regard to cases referred from the Ante-Natal Centres, excellent results obtained in Anaemia of Pregnancy, Neurotic Hyperemesis, Varicose Ulcers, and cases with a previous history of Uterine Inertia, and Post-Partum Haemorrhage. The following case is noteworthy:— Mrs. B., aged 32. Previous Obstetric History— 1927—Miscarriage at 2 months. 1928—Full-time Still-Birth. 88 She attended Ante-Natal Clinic in January, 1929—4 months pregnant—pale, emaciated woman, with bad varicose ulcer on right leg. She complained of sleeplessness, and was terrified at the thought of pregnancy. She was put on Sunlight Treatment and after a few attendances there was a marked improvement in her general condition. She slept better, her colour improved, and nervousness disappeared. The varicose ulcer on her leg completely healed. She continued with Sunlight throughout pregnancy. In May, 1929, she was admitted to the Maternity Home for the confinement. She had a very easy labour lasting 5 hours, and was delivered of a full-time healthy male child, weighing 8-lbs. 11½-ozs. The puerperism was normal. The mother and child have since attended the Child Welfare Clinic. She was able to breast-feed her baby for 9 months and both are doing well. In regard to cases referred from the Infant Welfare Centres, the following conditions reacted very well to Sunlight Treatment:—Early Rickets, Anaemia, Marasmus, and Debility following Infectious Diseases. The best results were obtained in cases of Early Rickets and Anaemia. These babies came usually from the poorest overcrowded homes and their condition was primarily due to absence of fresh air and sunlight. We had as controls many cases where the mothers were unable to find time to bring the babies to the Sunlight Centre, and had to depend on Medicinal Measures only for treatment. In comparison the Sunlight babies showed much better results. Very satisfactory results were obtained in cases of Bronchitis and Anaemia. The most noticeable result is the increased sleep of the babies from the commencement of the treatment. The following notes of certain cases will be of interest: — 1. Child 2 years 9 months.—Sent for treatment anaccount of continuous colds. During treatment from October to March she had only one cold. 2. Child 1 year.—Under weight, gaining slowly, constipated. In two months treatment gained 2-libs., cut 4 teeth, constipation improved. 3. Child 1 year 1 month.—Debility and Anaemia. In 3 months treatment gained 2-1bs., and became much firmer. Treatment was discontinued for a month, during which time the child lost 6-ozs. On recommencing treatment 14-ozs. were gained in a month. 89 4. Child 2 years 7 months.—Bronchial, Underweight— 24-lbs. 10-ozs.—had only gained 6-ozs. in three months. 2½ months' treatment, 10-ozs. gained in first month, 9-ozs. in second month, and 8-ozs. in last fortnight. Appetite, sleep and activity all greatly increased, bronchial condition improved, the child only had one cold during treatment, and that was quickly thrown off. 5. Child 7 months.—Weight 18-lbs. 8-ozs. Signs of Rickets in right leg. After 9 weeks' treatment there were no signs of Rickets, the child was standing and had three teeth. 6. Child 4 months.—Weight 10-lbs. 12-ozs. No gain in weight for 2 months previous to having treatment. In 5 weeks' treatment child gained 2½-lbs. and cut two teeth. 7. Child 10 months.—Weight 22-lbs. 12-ozs. Child was not able to sit upright and had only two teeth. At the end of 3 months treatment she was able to walk., and at 16 months old she had nine teeth. 8. Child 8 months.—Bottle-fed, no teeth, not able to sit up. After 6 weeks' treatment child was trying to stand and had three teeth. 9. Child 10 months.—Not able to sit, two teeth, had severe head-sweating. After 2 months' treatment child was standing and trying to walk, and head-sweating had decreased. 10. Nursing Mother, aged 19. Baby 6 months old.—Had frequent fainting attacks which gradually ceased while under treatment. 11. Child 3 months. Marasmus. Weight 8-lbs. 4-ozs.— Had 4 months' treatment and gained 1-lb. each month. 12. Child 5 months. Weight 12-lhs. 2-ozs. Very fretful. —At end of 3 months' treatment child weighed 17-lbs. 2-ozs., and was much more cheerful and contented. 13. Child 6 months. Marasmus. Weight 10-lbs. 8-ozs. —Had not gained any weight for a month. During first month's treatment child gained 1-1lb., and during the 5 months that treatment was given he gained 7-lbs. 14. Child 14 months.—Treatment for delayed dentition. only five teeth. After 2 months' treatment he had ten teeth, and at the end of 4 months' treatment he had fifteen teeth. 15. Child 7 months. Weight 17-lbs. 2-ozs.—Treatment given for prevention of Rickets, Bronchitis and Anaemia. Was bottle-fed and very flabby. After 2 months' treatment was much 90 firmer and had two teeth. Child had no colds or bronchitis while under treatment from February to May. At 10 months old child had cut six teeth and was trying to walk. 16. Child 2 years. Weight 21-lbs. 2-ozs.—Convalescent from Pneumonia ; gained 3¼1bs, in 2 months' treatment. Maternity Home. During the year 1929, 368 patients were admitted to the Maternity Home, which is the largest number accommodated during any one year since the opening of the Home in February, 1922. Up to the end of 1929 there had been a total of 2,086 patients admitted, the yearly figures being as follows:— 1922 (part of) 121 1923 228 1924 220 1925 295 1926 256 1927 270 1928 328 1929 368 Of these 368 cases, 8 only required medical delivery, the remaining 360 being dealt with by the Midwives of the Home. Five cases required medical assistance for the following reasons:— Ruptured Perineum (2); Rise of Temperature (1); Post-Part urn Haemorrhage (1); Albuminuria (1). In regard to the case in which medical assistance was required for rise of temperature, this was of a slight character only and cleared up within a couple of days. The whole of the patients were able to breast-feed their babies with two exceptions, heart disease being the incapacitating cause. A large number of letters from those who had been patients in the Home were received during the year, expressing in the warmest possible terms their appreciation of the care and attention which they had received. 91 Other Health Activities.—The following continue their good work in the Borough:— Local Medical Practitioners' School Clinic. Health Centre, Deptford Green. Rachel McMillan Memorial Nursery School. Deptford Fund—Babies' Hospital.—The arrangement made with the Deptford Fund still operates whereby they receive in their Hospital such Greenwich cases as are recommended by the Medical Officer for treatment (debility and dietetic disorders). NOTIFICATION OF BIRTHS ACT, 1907. The following table gives the number and character of the intimations received respecting births in the Borough:— 1921 1922 1923 1924 1925 1926 1927 1928 1929 Total Number of Births notified in each year 2,564 2,257 2,348 2,245 2,257 2,096 1,995 2,063 2,115 (a) Attended by Midwives 1,452 1,434 1,591 1,563 1,668 1,660 1,592 1,727 1,812 (b) Attended by Doctors 1,112 773 757 649 589 436 403 336 303 Numbers of Still Births notified each year 52 53 50 32 32 49 82 71 50 Number of Births registered in each year 2,366 2,185 2,276 2,258 2,108 2,027 1,912 1,939 2,042 Puerperal Fever and Puerperal Pyrexia Regulations, 1926.—These Regulations came into force on the 1st October, 1926. Four cases of Puerperal Fever were notified during the year, all of whom were admitted to Hospital for treatment. Unfortunately, one proved fatal, this case being one transferred from the Council's Maternity Home. Eleven cases of Puerperal Pyrexia were notified. 92 Ten notifications were received from Medical Practitioners in charge of Institutions and Nursing Homes and 5 from Private Practitioners. Two of the latter cases were subsequently admitted bo Hospital. There were only two cases in which the services of the Council's Obstetric Specialist was sought by private practitioners. Ophthalmia Neonatorum.—Fifteen cases of this disease were notified during the year, and in addition there were 7 slight inflamation of the eyes reported; 5 cases were removed to Hospital for treatment. Both eyes were affected in 10 cases and one eye only in the remaining cases. Measles.—See pages 58 to 60. 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 26 tons, 16 cwts., 1 qr., 26 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. Cases. Notified Treated At Home In Hospital Vision Unimpaired Vision impaired Total Blindness Deaths 15 10 5 15 — — — 36 (a) Milk, Virol, &c., Distributed free. Quarter ended Milk Virol Malt & Oil Cod Liver Oil lbs. No. of Persons lbs. No. of Persons lbs. No. of Persons lbs. No. of Persons March, 1929 10,796 9,717 363½ 727 2 ,908 3,199 4 8 June, 9,981 8,983 347 694 2,341 2 ,575 - - Sept. ,, 9,086 8,187 317 634 1,873 2,060 1 2 Dec. ,, 9,395 8,456 332½ 665 2,626 2,889 1½ 3 Totals 39,258 35,343 1,360 2,720 9,748 10,723 6½ 13 (b) Milk, Virol, &c., Sold at Full or Reduced Prices. Quarter ended Milk Virol Malt & Oil Cod Liver Oil Total Amount Received lbs. lbs. lbs. lbs. £ s. d March, 1929 4,290 206 321 7 310 18 0 June, ,, 4,725 149½ 185 2 317 19 11 Sept., ,, 5,494 165½ 133 2 373 14 3 Dec., „ 5,311 174 345 6 385 18 8 Totals 19,820 695 984 17 £1,388 10 10 94 Dental Clinic. Mr. Ferris reports the procedure with regard to patients referred from the Welfare Clinics remains the same as in previous years. Patients still require a good deal of persuasion where fillings are concerned, although the opposition to this form of treatment is not so great as heretofore. The number of dentures supplied has fallen off as compared with recent years. This may be due to the fact that many patients apparently cannot afford to pay the charge fixed by the Council, and therefore do not continue their treatment. It is with concern that I have to emphasize again the objectionable habit of "dummy sucking" which is still rife, and feel sure that if this could be stopped, much would have been achieved in the prophylaxis of oral hygiene. The number of patients and attendances are as follow:— Number of patients 162 Number of attendances 462 Number of Sessions 25 Dentures supplied 18 Scalings and fillings 26 Gas extractions 243 Local Anaesthetic extractions 366 Nursing Homes Registration Act, 1927.—This Act came into force on the 1st July, 1928, and all persons in charge of Nursing Homes must be registered with the Local Supervising Authority. Although the Council has no definite powers imposed on them we continue to keep in touch with all Nursing Homes in the District. Health Week and Exhibition.—Celebrations of Greenwich Health Week this year took place at the Borough Hall on the 25th to 29th June. Generally speaking, the arrangements made were similar to the very successful Exhibition held two years ago, with the exception that this year advantage was taken of the old disused Baths which were in process of demolition. In this building a very interesting Sanitary Engineering Section was shown. Briefly, the usual trade exhibits were displayed in the Large Hall and the exhibits of the following organisations shown in the remaining portions of the building:—Institute of 95 Hygiene, the Dental Board of the United Kingdom, the I.C.A.A., the British Social Hygiene Council, the St. John's Ambulance Brigade, the National Milk Publicity Council, and the special exhibit dealing with the work of Maternity and Child Welfare. The Small Concert Hall was utilised for continuous cinema displays and popular health lectures. It is estimated that about ten thousand members of the general public attended the Greenwich Health Week, in addition to 750 mothers with their babies from the Welfare Centres and 1,500 senior school children. The event attracted not only a great amount of local interest, but many representatives of other Authorities made a point of attending. Maternal Mortality.—In accordance with the request of the Ministry of Health to be furnished with information respecting Maternal Mortality your Medical Officer of Health investigated the cause of five deaths which were certified to be due to or associated with pregnancy or childbirth, and reports were forwarded to the Maternal Mortality Committee on every case. The following Table shows the Mortality of Women in Childbirth per 1,000 Children born alive, distinguishing Septic and Other Causes for the last five years. Year. Puerperal Sepsis. Other Accidents and diseases of Pregnancy. All Causes No. of Deaths. Rate per 1,000 live births. No. of Deaths. Rate per 1,000 live births. No. of Deaths. Rate per 1,000 live births. 1924 2 0 .9 2 0.9 4 1.8 1925 1 0.5 2 1.0 3 1.5 1926 — -— 7 3.8 7 3.8 1927 1 0.6 3 1.8 4 2.3 1928 2 1.1 6 3.5 8 4.7 1929 — — 4 2.5 4 2.5 96 Index of Contents. Page. Adoptive Acts, By-laws and Local Regulations 1-2, 28 Age Mortality 14 Ambulance Facilities 21 Anthrax 61 Area of Borough 8 Articles and Rooms Disinfected 63 Articles Destroyed 64 Artificial Sunlight Treatment 22, 69-70, 87-90 Bacteriological Examinations 25 Bakehouses 51 "Better Health" 24.35 Births 10-11 Blackheath and Charlton Cottage Hospital 27 Books Destroyed 66 Cancer 17-18, 24-25 Clinics and Centres 22-23, 83 Cerebro-Spinal Fever 61 Cleansing Children 66-67 Complaints 29 Consumption 5, 17 Contacts 56 Convalescent Treatment 86 Cowhouses 47 Customs and Inland Revenue Acts 33 Dairies, Cowsheds and Milkshops 40, 47 Deaths, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Deaths, with Age Mortality 12, 14 Deptford Fund Babies' Hospital 91 Density of Population 8 Dental Work 81, 94 Diarrhoea and Zymotic Enteritis 17, 60 Diphtheria 16, 56-57 Diphtheria Anti-Toxin 25 Disinfection 62-66 Duties and Powers of the Public Health Committee 1-2 Duties and Powers of the Maternity and Child Welfare Committee 3 Elevation of Borough 8 Encephalitis Lethargica 61 Enteritis 17, 60 Epidemic Cerebro-Spinal Meningitis 61 Epidemic Diseases 16 Erysipelas 57 Factories and Workshops 29 31 Fever Hospitals 20 Food and Drugs—Samples of 51-53 Food and Drugs (Adulteration) Act 54-55 Food—Premises for Preparation of, etc. 49 Glanders 61 Handicraft Centre 72-74, 82 Health Centres 22-23, 83 Health Propaganda 35 Health Visitors, Visits, etc. 84 Health Week and Exhibition 94-95 97 INDEX—continued. Home Nursing 87 Horse Slaughterer 33 Hospital and other forms of Gratuitous Medical Relief 26-27 House Drainage 32 Houses Inspected re Infectious Diseases 66 Houses Let in Lodgings 34 Housing 43-46 Hydrophobia 61 Ice Cream Premises 51 Increase of Rent and Mortgage Interest (Restriction) Acts, 1920 and 1923 34 Infant Consultations 22-23,83 Infantile Mortality 15, 85-86 Influenza 17 Inhabited Houses 8 Inland Revenue Acts 33 Insanitary Areas 44-45 Institution Deaths 4-7 Laboratory Work 25 Legal Proceedings 51, 53 Marriages 9-10 Maternal Mortality 95 Maternity and Child Welfare 83-95 Maternity Home 20, 90 Measles 16, 58-60 Meat 48 Midwives 25 Milk, Analysis of 47-48 Milk and Dairies (Amendment) Act, 1922 47 Milk and Dairies (Order), 1926 48 Milk Supply 47 Milk Supply for Expectant and Nursing Mothers 92, 93 Milk (Special Designations) Order, 1923 47 Miller General Hospital 26, 27 Minor Ailment Centre 87 Mortuary 19, 42 Notices, etc 40 Notifications 56-62 Notification of Births Act 91 Nursing Arrangements 25 Offensive Trades 40 Ophthalmia Neonatorum 61, 92 Outworkers' Register 29 Overcrowding 40 Persons Cleansed 41, 67 Polio-myelitis 61 Poor Law Relief 27 Population 8 Public Health Committee 1 Public Health (Meat) Regulations, 1924 48-49 Public Health (Preservatives, &c., in Food) Regulations 54-55 Public Sanitary Conveniences 33-34 Puerperal Fever, &c. 58, 91 Rats and Mice (Destruction) Act, 1919 34 Remarks on Death Causes 16-17 98 index—continued.. Sanitary Work-Summaries, etc. 36-42 Scarlet Fever 16, 57 Scavenging and Refuse Removal 35 School Clinic 23 Seamen's Hospital 26 Sewers 32 Slaughterhouses 49 Small-pox 16,56 Smoke Nuisances 38 Staff of Public Health Department 25 Statistical Tables Appendix Street Traders 50 Tuberculosis 17, 61, 62 Tuberculosis Dispensary—Returns 76-81 Tuberculosis Care Committee 71 Tuberculosis Officer's Report 68-75 Tumour Diagnostic Clinic 24 Typhoid Fever 17, 57-58 Underground Bakehouses 31 Underground Rooms 40 Unwholesome Food 30 Uninhabited Houses 8 Vaccination Particulars 65 Verminous Premises 34 Verminous Children 66-67 Virol 93 Vital Statistics 8-9 and Appendix Water Supply 31 Whooping Cough 16, 61 Workshops and Factories 29-31 Zymotic Enteritis 17, 60 Zymotic Diseases 17 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the Quarter ended 30th March, 1929. districts Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the Quarter ended 30th March, 1929. Deaths Registered during the Quarter ended 30th March, 1929. 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 All Causes. Seven Zymotics. Typhcid. Others. Diarrhoea. During the corres- ponding period year previous. During the Quarter ended 30th March, 1929. During the corresponding period year previous. During the Quarter end»d 30th March 1929. for Death Rate for Birth Rate M. F. M. F. Greenwich East 44213 44477 44671 96 76 105 132 13 10 120 ... ... ... 3 4 ... ... ... 15 2 45 43 13 112 12.60 21.47 .54 .53 Do. West 26677 26965 27084 60 67 84 70 9 7 83 ... ... ... ... 1 ... ... ... 18 1 36 30 8 60 13.31 19.84 .44 .14 St. Nicholas, Deptford 7582 7457 7489 22 24 21 29 11 5 19 ... ... ... ... 4 ... ... 1 3 ... 20 3 3 16 13.52 26 91 1.08 2.69 Charlton 18785 21764 21855 41 47 54 57 7 5 51 ... 1 ... 3 ... ... ... 1 12 ... 24 16 4 50 1316 20 46 .18 .92 Kidbrooke 3193 3317 3331 4 5 4 10 ... ... 4 ... ... ... 1 ... ... ... ... ... ... 1 5 2 5 13.37 16 94 ... 1.21 Miller Hospital— Resident ... ... ... ... 3 3 1 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 ... ... ... ... Non-Resident ... ... ... ... 23 3 3 1 4 ... ... ... ... ... ... ... ... 1 1 9 2 5 13 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 15 3 1 1 3 ... ... ... ... 1 ... ... ... 1 1 9 ... 3 3 ... ... ... ... Non-Resident ... ... ... ... 21 ... ... ... 3 ... ... ... ... ... ... ... ... 4 7 3 1 6 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 82 74 7 10 79 ... ... ... 1 1 ... ... ... 15 ... 28 27 8 76 ... ... ... ... Non-Resident ... ... ... ... 97 113 15 13 108 ... ... ... ... ... ... ... 1 7 ... 48 42 7 105 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Hrook Hospital— Resident ... ... ... ... 4 7 ... 6 ... ... ... ... 5 4 ... ... ... ... ... 1 1 ... ... ... ... ... ... Non-Resident ... ... ... ... 27 24 10 30 ... ... ... 3 9 29 ... ... ... ... 5 4 ... ... 1 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 3 6 1 .... 8 ... ... ... ... ... ... ... ... ... ... 2 1 1 5 ... ... ... ... Non-Resident ... ... ... ... 2 6 1 ... 7 ... ... ... ... ... ... ... ... ... ... 2 ... ... 6 ... ... ... ... Outside Institutions ... • • • ... ... 51 53 5 3 41 ... 1 ... ... ... ... ... ... 12 1 12 14 5 59 ... ... ... ... 223 219 268 298 Borough 100450 103980 104430 442 566 40 27 277 ... 1 ... 7 9 ... ... 2 48 3 126 97 30 243 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 16.21 21.84 ... ... ... ... .03 ... .26 .34 ... ... .07 1.86 .11 4.89 3.75 1.15 9.37 12.99 21.84 .45 .73 Gross Births Registered 526. Deaths of Children under 1 Year per 1,000 births, 90 (20.19 per 1000). previous ,, „ „ corresponding 65 period „ „ „ County of London 106 Death Rate of 10.7 large English Towns, 22.7 of the County of London, 24.1 Birth Rate „ „ 17.1 ,, ,, „ 16.3 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the Quarter ended 29th June, 1929. DISTRICTS Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the Quarter ended 29th June, 1929. Deaths Registered during the Quarter ended 29th June, 1929. 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. All Causes. Seven Zymotics. Typhcid. Others During the corresponding period year previous. During the Quarter ended 29th June, 1929. Duting the corresponding period year previous. During the Quarter ended 29th June, 1929. for Death Rate for Birth Rate M. F. M. F. Greenwich East 44213 44477 44671 91 82 65 58 15 2 56 ... 1 ... ... 3 1 ... 1 13 1 10 15 13 65 11.70 11.10 1.35 1.3 Do. West 26677 26965 27084 59 38 42 33 3 ... 37 ... ... ... ... 3 ... ... ... 4 2 12 14 10 30 12.70 11.16 1.04 .44 St. Nicholas, Deptford 7582 7457 7489 16 24 14 18 6 1 11 ... ... ... 1 1 ... ... ... 2 1 2 5 4 16 12.43 17.22 1.08 1.08 charlton 18785 21764 21855 36 34 34 25 3 4 26 ... ... ... 2 ... ... ... 1 6 1 6 8 13 22 8.52 10 88 .74 .55 Kidbrooke 3193 3317 3331 6 2 6 4 ... ... 6 ... ... ... ... ... ... ... ... ... ... ... 3 1 6 9.73 12.10 ... ... Miller Hospital— Resident ... ... ... ... 4 4 3 ... 1 ... ... ... ... ... ... ... ... ... ... 2 ... ... 6 ... ... ... ... Non-Resident ... ... ... ... 12 12 ... 1 3 ... ... ... ... ... ... ... ... 1 2 ... 1 7 13 ... ... ... ... Seamen s Hospital— Resident ... ... ... ... 10 ... ... ... 2 ... ... ... ... ... ... ... ... 1 2 1 1 ... 5 ... ... ... ... Non-Resident ... ... ... ... 13 2 ... ... 2 ... ... ... ... ... ... ... ... 2 1 1 1 2 8 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 47 37 4 1 44 ... ... ... ... ... 1 ... ... 8 ... 7 14 13 41 ... ... ... ... Non-Resident ... ... ... ... 75 48 10 1 48 ... ... ... ... ... 1 ... 5 7 ... 15 22 16 56 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... ... 3 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... ... 4 12 5 9 ... ... ... ... ... 9 ... ... ... ... ... ... ... ... 2 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... Non-Resident ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Other Institutions— Resident ... ... ... ... 6 1 4 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 7 ... ... ... ... Non-Resident ... ... ... ... 1 5 ... ... 4 ... ... ... ... ... ... ... ... ... ... ... 1 1 4 ... ... ... ... Outside Institutions ... ... ... ... 31 18 5 5 15 ... 1 ... 3 1 ... ... 1 3 2 6 3 7 22 ... ... ... ... 208 180 161 138 Borough 100450 103980 104430 388 299 32 7 136 ... 1 ... 3 7 1 ... 2 25 5 30 45 41 139 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 14.90 11.54 ... ... ... ... .04 ... .11 .27 .04 ... .07 .97 .19 1.16 1.64 1.58 5.37 11.28 11.54 1.09 .54 Gross Births Registered 514 Deaths of Children under 1 Year per 1,000 births, 82 19.75 per 1000) previous „ „ „ corresponding 57 period „ „ „ County of London 63 Death Rate of 10 7 large English Towns, 11.8 of the County of London, 11.4 Birth Rate „ ,, 17.5 „ „ „ 16.4 BOROUGH OF GREENWICH. Return of Births and Deaths registered during the Quarter ended 30th September, 1929. DISTRICTS Census Population, 1921. .Estimated Population at the middle of the Year. Births Registered during the Quarter ended 30th September, 1929. Deaths Registered during the Quarter ended 30th September, 1929. AGE MORTALITY. SEVEN ZYMOTIC DISEASES. Tuberculosis, (Pulmonary). All other Forms of Tuberculosis. Bronchitis, Pneumonia. Heart Disease. Cancer. All other Diseases. Rate or Mortality per 1,000 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhœa. All Causes. Seven Zymotics. Typhcid. Others. During the corresponding period year previous. During the Quarter ended 30th Sept. 1929. During the corresponding period year previous. During the Quarter ended 30th Sept. 1929. for Death Rate for Birth Rate M. F. M. F. Greenwich East 44213 44477 44671 65 85 47 53 4 2 38 ... ... ... 1 ... ... ... 1 6 1 11 14 20 46 9.43 9.02 .09 .18 Do. West 26677 26965 27084 63 74 35 29 9 5 23 ... ... ... 1 1 ... ... 2 3 ... 9 11 4 33 10.03 9.52 .74 .59 St. Nicholas, Deptford 7582 7457 7489 20 13 12 8 2 2 9 ... ... ... 1 ... ... ... 1 1 ... 3 4 2 8 6.73 10.76 ... 1.07 Charlton 18785 21764 21855 52 40 28 26 7 2 19 ... ... ... 1 ... ... ... 2 6 ... 3 7 9 26 10.00 9.95 .55 .55 Kidbrooke 3193 3317 3331 5 4 4 1 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... 2 2 1 7.29 6.05 ... ... Miller Hospital— ... ... ... Resident ... ... ... ... 8 2 2 2 1 ... ... ... ... ... ... ... 1 ... ... ... ... 2 7 ... ... ... ... Non-Resident ... ... ... ... 13 9 1 ... 3 ... ... ... ... ... ... ... ... ... 1 ... 2 4 15 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 11 ... ... 1 3 ... ... ... ... ... ... ... ... ... ... 2 1 4 4 ... ... ... ... Non-Resident ... ... ... ... 15 1 ... ... 4 ... ... ... ... ... ... ... ... 2 ... ... 3 6 5 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 29 30 3 1 23 ... ... ... ... ... ... ... 2 3 ... 5 12 9 28 ... ... ... ... Non-Resident ... ... ... ... 62 29 4 2 28 ... ... ... ... ... ... ... 2 8 4 7 15 8 47 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... 9 9 11 6 ... ... 10 ... 1 3 ... ... ... ... ... 1 ... ... ... ... ... ... ... Cottage Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... Other Institutions— Resident ... ... ... ... ... 2 l ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... Non-Resident ... ... ... ... 2 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... Outside Institutions ... ... ... ... 29 26 8 2 19 ... ... ... 3 1 ... ... 2 5 ... 4 5 6 29 ... ... ... ... 205 216 126 117 Borough 100450 103980 104430 421 243 22 11 92 ... ... ... 4 3 ... ... 6 16 1 26 38 37 114 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 15.99 9.37 ... ... ... ... ... ... .15 .03 ... ... .23 .61 .03 1.0 1.47 1.44 4.39 9.01 9.37 .34 .42 Gross Births Registered 517 19.85 per 1000), Deaths of Children under 1 Year per 1,000 births, 52 previous ,, ,, ,, corresponding 42 period „ „ „ County of London 46 Death Rate of 107 large English Towns, 9.3; of the County of London, 8.9. Birth Rate „ ,, 16.6; „ ,, ,, 15.7. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the Quarter ended 31st December, 1929. districts Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the Quarter ended 81st December, 1929. Deaths Registered during the Quarter ended 31st December, 1929. age mortality. seven zymotic diseases. Tuberculosis, (Pulmonary). All other Forms of Tuberculosis. Bronchitis, Pneumonia. | Heart Disease. Cancer. All other Diseases. Rate of Mortality per l,000 Under 1 year. Over 1 and under 5 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhœa. All Causes. Seven Zymotics. Typhcid. Others. During the corresponding period year previous. During the Quarter ended 31st Dec. 1929. During the corresponding period year previous. During the Quarter ended 31st Dec. 1929. for Death Rate for Birth Rate m. f. m. f. Greenwich East 44213 44477 44671 92 72 61 53 10 1 54 ... ... ... 1 ... ... ... ... 7 1 7 19 22 57 11.33 10.28 .36 .09 Do. West 26677 26965 27084 53 47 42 31 4 3 28 ... 4 ... ... ... ... ... ... 6 1 13 10 11 28 12.30 10.85 .29 .59 St. Nicholas, Deptford 7582 7457 7489 19 16 11 7 1 3 4 ... 2 ... ... ... ... ... ... 3 ... 1 4 1 7 12.97 9.69 1.62 1.07 Charlton 18785 21764 21855 51 39 35 30 8 1 26 ... 1 ... 1 ... ... ... 1 3 1 8 9 6 35 9.81 11.98 .55 .55 Kidbrooke 3193 8317 3331 4 2 5 4 ... ... 4 ... ... ... ... ... ... ... ... ... ... 2 ... 2 5 4.86 10.89 ... ... Miller Hospital— Resident ... ... ... ... 4 4 ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 1 2 3 ... ... ... ... Non-Resident ... ... ... ... 21 11 ... 3 8 ... ... ... ... ... ... ... ... ... 1 2 5 6 18 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 1 5 ... ... ... ... Non-Resident ... ... ... ... 14 1 ... ... 4 ... ... ... ... ... ... ... ... 1 ... 1 2 4 7 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 46 31 5 1 30 ... ... ... ... ... ... ... ... 8 ... 4 11 17 37 ... ... ... ... Non-Resident ... ... ... ... 68 47 7 2 45 ... ... ... ... 1 ... ... 1 6 1 11 25 16 54 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... 2 3 1 3 ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Non-Resident ... ... ... ... 5 12 8 4 ... ... 6 ... 5 ... 4 ... ... ... ... ... ... ... 2 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 2 2 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 ... ... ... ... Non-Resident ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Other Institutions— Resident ... ... ... ... 1 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... Non-Resident ... ... ... ... 1 3 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... Outside Institutions ... ... ... ... 31 22 6 3 15 ... 5 ... ... ... ... ... 1 3 1 3 11 3 26 ... ... ... ... 219 176 154 125 Borough 100450 103980 104430 395 279 23 8 116 ... 7 ... 2 ... ... ... 1 19 3 31 42 42 132 ... ... ... ... Rate per 1,000 of Estimated Population ... ... ... 15.17 10.80 ... ... ... ... .26 ... .07 ... ... ...... .03 .73 .11 1.18 1.61 1.61 5.11 11.24 10.80 .46 .38 Gross Births Registered 485 18.62 per 1000). Deaths of Children under 1 Year per 1,000 births, 58 previous „ „ „ corresponding 56 period „ „ „ County of London 64 Death Rate of 107 large English Towns, 11.3; of the County of London, 11.1. Birth Rate „ ,, 15.5; ,, ,, „ 14.6. BOROUGH OF GREENWICH. Return of Births and Deaths registered during the Year ended 31st December, 1929. DISTRICTS Census Population, 1921. Estimated Population at the middle of the Year. Births Registered during the Year ended 81st December, 1929. Deaths Registered during the Year ended 81st December. 1929. 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 6 Years. Persons aged 65 Years and upwards. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fevers Diarrhoea. All Causes. Seven Zymotics. Typhoid. Others. During the corresponding period year previous. During the Year ended 31st Dec. 1929. During the corresponding period year previous. During the Year ended 31st Dec. 1929. for Death Rate for Birth Rate m. f. M. f. Greenwich East 44213 44477 44671 344 315 278 296 42 15 268 ... 1 ... 5 7 1 ... 2 41 5 73 91 68 280 11.03 12.94 .60 .36 Do. West 26677 26965 27084 235 226 203 163 30 15 171 ... 4 ... 1 5 ... ... 2 31 4 70 65 33 151 12.10 13.61 .63 .44 St. Nicholas, Deptford 7582 7457 7489 77 77 58 62 20 11 43 ... 2 ... 2 5 ... ... 2 9 1 26 16 10 47 11.50 16.13 .94 1.48 Charlton 18785 21764 21855 180 160 151 138 24 13 122 ... 2 ... 7 ... ... ... 5 27 2 41 40 32 133 10.37 13.32 .50 .64 Kidbrooke 3193 3317 3331 19 13 19 19 ... ... 17 ... ... ... 1 ... ... ... ... ... ... 3 10 7 17 8.82 11.50 .30 Miller Hospital— Resident ... ... ... ... 19 13 6 3 4 ... ... ... ... ... ... ... 1 ... 1 4 1 4 21 ... ... ... ... Non-Resident ... ... ... ... 69 40 4 5 18 ... ... ... ... ... ... ... ... 2 5 11 10 22 59 ... ... ... ... Seamen's Hospital— Resident ... ... ... ... 47 3 1 2 8 ... ... ... ... 1 ... ...... ... 2 3 15 4 8 17 ... ... ... ... Non-Resident ... ... ... ... 63 4 13 ... ... ... ... ... ... ... ... 9 1 9 9 13 26 ... ... ... ... Greenwich & Deptford Hospital— Resident ... ... ... ... 204 172 19 13 176 ... ... ... 1 1 1 ... 2 34 ... 44 64 47 182 ... ... ... ... Non-Resident ... ... ... ... 302 237 36 18 229 ... ... ... ... 1 1 ... 9 28 6 81 104 47 262 ... ... ... ... Herbert Hospital— Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Resident ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... M.A.B. Brook Hospital— Resident ... ... ... ... 6 14 3 9 ... ... 2 ... 8 6 ... ... ... ... ... 1 1 ... 2 ... ... ... ... Non-Resident ... ... ... ... 45 57 24 49 ... ... 16 ... 23 41 4 ... ... ... 5 5 ... ... 5 ... ... ... ... Cottage Hospital— Resident ... ... ... ... 4 3 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 5 ... ... ... ... Non-Resident Other Institutions— ... ... ... ... 1 3 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 3 ... ... ... ... Resident ... ... ... ... 10 11 6 ... 13 ... ... ... ... ... ... ... ... ... ... 2 1 3 15 ... ... ... ... Non-Resident ... ... ... ... 6 15 1 ... 15 ... ... ... ... ... ... ... ... ... ... 2 5 1 13 ... ... ... ... Outside Institutions ... ... ... ... 142 119 24 13 90 ... 7 ... 6 2 ... ... 4 23 4 25 33 21 136 ... ... ... ... 855 791 709 678 Borough 100450 103980 104430 1646 1387 116 54 621 9 15 17 1 11 108 12 213 222 150 628 ... ... ... ... Rate per 1.000 of Estimated Population ... ... ... 15.81 13.38 ... ... ... ... .08 ... .15 .16 .009 ... .10 1.04 .10 2.02 2.13 1.44 6.06 11.13 13.38 .59 .52 Gross Births Registered 2042, (19.60 per 1000), Deaths of Children under 1 Year per 1,000 births, 70 previous ,, „ „ corresponding 55 period ,, ,, „ County of London 70 Death Rate of 107 large English Towns, 13.7; of the County of London, 13.3. Birth Rate „ ,, 16 6; , „ ,, 15.7. BOROUGH OF GREENWIC Causes of, and Ages at, Death during the Quarter ended 30 RRATUM.. Congenital Debility should read: Under 1 year 14, Between 2 and 5, 1. Totals ,, ,, ,, ,, 39,,, ,, ,, 12. 9. 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 o istitutions 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 Offier— Institutions Outside Institutions Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles i ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Whooping Cough 9 2 3 4 ... ... ... ... ... 4 1 4 ... ... 1 ... ... ... 35 Diphtheria and Croup 7 ... 1 4 1 ... 1 ... 3 ... ... 3 1 1 ... ... ... 15 Influenza 64 2 ... 1 1 2 9 17 32 25 17 5 15 2 18 ... 1 14 50 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 48 ... ... ... ... 10 23 12 3 15 18 3 12 ... 15 ... ... 12 28 Other Tuberculous Diseases 3 ... ... ... ... 2 1 ... ... 2 1 ... ... ... ... ... ... .1 7 Cancer, malignant disease 30 ... ... ... ... ... 1 11 18 13 8 3 4 2 8 3 ... ... ... ... 1 5 25 Rheumatic Fever 3 ... ... ... ... 1 1 ... 1 1 ... 1 1 ... 1 ... ... ... ... ... ... ... 2 Diabetes 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Cerebral Haemorrhage, &c. 12 ... ... ... ... ... ... 2 10 6 1 ... 5 ... 1 ... ... ... ... ... 1 3 11 Heart Disease 97 ... ... ... 1 1 7 29 59 43 30 3 16 5 27 ... ... ... 1 1 1 14 77 Arterio-Sclerosis 24 ... ... ... ... ... ... 2 22 17 4 1 2 ... 11 ... ... ... ... ... ... 3 33 Bronchitis 53 1 ... ... 1 ... 4 12 35 17 18 7 11 ... 6 3 ... ... ... ... 2 5 26 Pneumonia (all oilier forms) 73 15 10 3 1 2 4 9 29 28 18 13 13 1 22 6 l ... l ... ... 7 85 Other Respiratory Diseases 12 ... ... ... ... ... 1 5 6 6 5 ... 1 ... 1 ... l ... ... ... ... 2 3 Ulcer of Stomach or Duodenum 7 ... ... ... ... ... 1 5 1 3 2 ... 1 1 4 ... ... ... ... ... ... 3 5 Diarrhoea, &c. 2 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 Appendicitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Ac. & Cr. Nephritis 9 ... ... ... ... ... 3 1 5 2 1 ... 6 ... 1 ... ... ... ... ... ... 5 5 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Debility and Malformation, including Premature Birth 16 15 1 ... ... ... ... ... ... 6 7 1 2 ... 4 ... ... ... ... ... 1 2 15 Violent Deaths, excluding Suicide 17 ... 1 1 2 ... 1 3 9 11 3 1 1 1 9 ... 3 ... ... ... 1 5 30 Suicides 4 ... ... ... ... ... 1 2 1 1 1 1 1 ... ... ... ... ... ... ... ... 2 ... Other Defined Diseases 73 3 1 ... 6 2 3 12 46 32 19 6 15 1 26 3 1 ... ... ... 1 20 65 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 566 40 16 11 16 21 60 125 277 237 154 50 111 14 156 18 6 ... 11 1 9 104 522 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 Quarter ending 29th June, 1929. 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 ... ... ... ... ... ... ... 2 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 7 6 ... ... 1 ... ... ... ... 3 3 1 ... ... ... ... ... ... 2 ... ... 1 11 Diphtheria and Croup 3 ... ... 1 1 1 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... 3 5 Influenza 3 ... ... ... ... ... ... 1 2 2 1 ... ... ... ... ... ... ... ... ... ... ... 4 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 25 ... ... ... ... 6 11 7 1 13 4 2 6 ... 8 1 ... ... ... ... ... 3 19 Other Tuberculous Diseases 5 ... ... 2 1 ... 2 ... ... 1 2 1 1 ... ... 2 ... ... ... ... ... 2 6 Cancer, malignant disease 41 ... ... 1 ... 1 4 14 21 13 10 4 13 1 13 ... ... ... ... ... ... 7 39 Rheumatic Fever 2 ... ... ... 1 ... 1 ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... 3 Diabetes 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... 2 Cerebral Hæmorrhage, &c. 9 ... ... ... ... ... ... 3 6 5 1 ... 3 ... 2 1 ... ... ... ... ... 1 5 Heart Disease 45 ... ... ... ... 1 1 11 32 15 14 5 8 3 14 1 ... ... ... ... ... 3 40 Arterio-Sclerosis 13 ... ... ... ... ... ... 1 12 7 3 1 ... 2 3 ... ... ... ... ... 1 1 14 Bronchitis 13 ... ... ... ... ... ... 1 12 2 5 1 5 ... 3 ... ... ... ... ... ... 2 8 Pneumonia (all other forms) 17 4 ... 1 ... ... 1 3 8 8 7 1 1 ... 4 ... 2 ... ... ... ... 4 18 Other Respiratory Diseases 2 ... ... ... ... ... 1 1 ... ... ... ... 2 ... ... ... 1 ... ... ... ... 1 3 Ulcer of Stomach or Duodenum 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 5 Diarrhœa, &c. 2 2 ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 1 5 Appendicitis 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 4 Cirrhosis of Liver 2 ... ... ... ... ... ... 1 1 2 ... ... ... ... 1 ... ... ... ... ... ... ... 2 Ac. & Cr. Nephritis 12 ... ... ... ... 2 ... 3 7 6 1 2 3 ... 4 1 ... ... ... ... ... 1 8 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 3 ... ... ... ... 1 2 ... ... 2 ... ... 1 ... ... ... ... ... ... ... ... 1 ... Congenital Debility and Malformation, including Premature Birth 14 14 ... ... ... ... ... ... ... 8 2 3 1 ... 2 ... 1 ... ... ... 4 2 11 Violent Deaths, excluding Suicide 17 1 ... 1 1 1 3 7 3 8 5 1 2 1 10 ... 2 ... ... ... ... 3 22 Suicides 3 ... ... ... ... ... 1 2 ... 2 1 ... ... ... 1 ... ... ... ... ... ... ... 2 Other Defined Diseases 56 4 ... 1 3 5 4 8 31 21 15 8 9 3 16 4 1 ... 1 2 2 11 61 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 299 32 ... 7 8 19 33 64 136 123 75 32 59 10 84 10 8 ... 3 ... 7 49 299 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 Quarter ended 30th September, 1929. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 3 Diphtheria and Croup 4 ... 1 ... 2 ... 1 ... ... 1 1 1 1 ... ... ... ... ... 1 ... ... 3 5 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 16 ... ... ... ... 7 3 6 ... 6 3 1 6 ... 3 ... ... ... ... ... ... 5 13 Other Tuberculous Diseases 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 Cancer, malignant disease 37 ... ... ... ... ... 2 21 14 20 4 2 9 2 9 3 2 ... ... ... ... 6 33 Rheumatic Fever 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Diabetes 4 ... ... ... ... ... ... 1 3 ... 1 ... 3 ... 1 ... ... ... ... ... ... ... 2 Cerebral Hæmorrhage, &c. 9 ... ... ... ... ... ... 2 7 5 4 ... ... ... 3 ... ... ... ... ... ... 1 5 Heart Disease 38 ... 1 ... ... ... 5 13 19 14 11 4 7 2 12 1 ... ... ... ... ... 5 35 Arterio-Sclerosis 9 ... ... ... ... ... ... 4 5 7 2 ... ... ... 4 ... ... ... ... ... ... 1 13 Bronchitis 10 3 ... 1 1 ... ... 3 2 4 4 1 1 ... 2 1 ... ... ... ... ... ... 4 Pneumonia (all other forms) 16 2 1 ... ... 1 2 3 7 7 5 2 2 ... 4 1 ... ... ... ... ... 4 11 Other Respiratory Diseases 1 ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 3 Ulcer of Stomach or Duodenum 5 ... ... ... ... ... 2 2 1 2 3 ... ... ... 1 ... ... ... ... ... ... 1 8 Diarrhœa, &c. 6 6 ... ... ... ... ... ... ... 1 2 1 2 ... 2 ... 1 ... ... ... ... 2 5 Appendicitis 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Ac. & Cr. Nephritis 6 ... ... ... ... 1 ... 1 4 2 2 ... 2 ... 1 ... ... ... ... ... ... 2 4 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 9 7 1 1 ... ... ... ... ... 4 3 ... 2 ... ... ... 2 ... ... ... 1 3 6 Violent Deaths, excluding Suicide 20 ... 1 1 2 2 4 3 7 8 3 2 6 1 6 2 2 ... ... ... ... 6 19 Suicides 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Other Defined Diseases 46 3 1 ... 2 ... 8 9 23 17 11 6 12 ... 10 2 2 ... ... ... ... 13 46 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 243 22 7 4 7 12 29 70 92 100 64 20 54 5 59 10 9 ... 1 ... 1 55 235 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 Quarter ended 31st December, 1929. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 7 ... 3 1 1 ... ... ... ... ... 4 2 1 ... ... ... ... ... 2 ... ... 5 8 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Diphtheria and Croup 2 ... ... 1 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... 2 ... ... ... 7 Influenza 3 ... ... ... ... ... 1 2 ... 2 1 ... ... ... 1 ... ... ... ... ... ... ... 2 Encephalitis Lethargica 2 ... ... ... ... ... 1 1 ... ... 1 ... ... 1 1 ... ... ... ... ... ... ... 2 Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 19 ... ... ... ... 4 6 9 ... 7 6 3 3 ... 8 ... ... ... ... ... ... 3 16 Other Tuberculous Diseases 3 ... ... ... ... 1 1 1 ... 1 1 ... 1 ... ... ... 1 ... ... ... ... 1 3 Cancer, malignant disease 42 ... ... ... ... 1 3 17 21 22 11 1 6 2 17 1 2 ... ... ... 2 3 48 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diabetes 3 ... ... ... ... ... ... 1 2 2 ... ... ... 1 ... ... ... ... ... ... ... ... ... Cerebral Haemorrhage, &c. 16 ... ... ... ... ... ... 6 10 6 1 1 8 ... 2 1 ... ... ... ... ... 5 13 Heart Disease 42 ... ... ... 1 1 4 11 25 19 10 4 9 ... 11 2 1 ... ... ... ... 11 48 Arterio-Sclerosis 26 ... ... ... ... ... 1 7 18 9 7 2 7 1 8 ... 1 ... ... ... 1 3 22 Bronchitis 10 1 ... ... ... ... ... 6 3 1 7 ... 2 ... ... ... 1 ... ... ... ... 1 2 Pneumonia (all other forms) 21 2 2 ... ... ... 2 5 10 6 6 1 6 2 4 3 ... ... ... ... ... 2 21 Other Respiratory Diseases 5 1 ... ... 1 ... ... 3 ... 1 ... ... 3 1 2 ... ... ... ... 1 ... 1 5 Ulcer of Stomach or Duodenum 2 ... ... ... ... ... ... 1 1 ... ... .... 2 ... 1 ... 1 ... ... ... ... 8 Diarrhoea, &c. 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Appendicitis 3 ... ... ... 1 2 ... ... ... 1 1 ... ... 1 ... 1 ... ... ... 1 ... 1 4 Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ac. & Cr. Nephritis 5 ... ... ... ... ... ... 3 2 3 ... ... 2 ... ... ... ... ... ... ... ... 3 1 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Congenital Debility and Malformation, including Premature Birth 11 11 ... ... ... ... ... ... ... 5 2 1 3 ... 2 ... ... ... ... ... ... 3 2 Violent Deaths, excluding Suicide 12 1 ... 1 3 1 1 3 2 5 2 1 4 ... 4 2 1 ... 1 1 ... 1 15 Suicides 2 ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... Other Defined Diseases 42 4 ... ... ... 1 5 10 22 22 12 2 6 ... 16 1 ... ... ... 1 ... 9 58 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 279 23 5 3 8 11 25 88 116 114 73 18 65 9 77 11 8 ... 5 4 3 53 292 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 Year ended 31st December, 1929. 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 ... ... ... ... ... ... ... 6 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 9 3 3 2 1 ... ... ... ... 1 4 2 2 ... ... ... ... ... 2 ... ... 7 18 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Whooping Cough 17 9 3 4 1 ... ... ... ... 7 5 5 ... ... 1 1 ... ... 6 ... ... 2 50 Diphtheria and Croup 16 ... 1 3 8 2 1 1 ... 5 1 2 7 1 1 ... ... ... 8 ... ... 6 32 Influenza 70 2 ... 1 1 2 10 20 34 29 19 5 15 2 19 ... ... ... ... ... 1 14 56 Encephalitis Lethargica 2 ... ... ... ... ... 1 1 ... ... 1 ... ... 1 1 ... ... ... ... ... ... ... 2 Meningococcal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis of Respiratory System 108 ... ... ... ... 27 43 34 4 41 31 9 27 ... 34 2 ... ... ... ... ... 23 76 Other Tuberculous Diseases 12 ... ... 2 1 3 5 1 ... 5 4 1 2 ... ... 3 1 ... ... ... ... 4 21 Cancer, malignant disease 150 ... ... 1 ... 2 10 63 74 68 33 10 32 7 47 7 4 ... ... ... 3 21 145 Rheumatic Fever 6 ... 1 ... 1 1 2 ... 1 2 2 1 1 ... 2 ... ... ... ... ... ... ... 6 Diabetes 9 ... ... ... ... ... 1 3 5 4 1 ... 3 1 1 ... 1 ... ... ... ... ... 5 Cerebral Haemorrhage, &c. 46 ... ... ... ... ... ... 13 33 22 7 1 16 ... 8 2 ... ... ... ... 1 10 34 Heart Disease 222 ... 1 ... 2 3 17 64 135 91 65 16 40 10 64 3 1 ... 1 1 1 33 200 Arterio-Sclerosis 72 ... ... ... ... ... 1 14 57 40 16 4 9 3 26 ... 1 ... ... ... 2 6 82 Bronchitis 86 5 ... 1 2 ... 4 22 52 24 34 9 19 ... 11 4 1 ... ... ... 2 8 40 Pneumonia(all other forms) 127 23 13 4 1 3 9 20 54 49 36 17 22 3 34 11 3 ... 1 ... ... 17 185 Other Respiratory Diseases 20 1 ... 1 1 ... 2 9 6 7 6 ... 6 1 3 ... 2 ... ... 1 ... 5 14 Ulcer of Stomach or Duodenum 15 ... ... ... ... ... 3 9 3 5 5 1 3 1 7 ... 1 ... ... ... ... 4 26 Diarrhoea, &c. 11 11 ... ... ... ... ... ... ... 2 2 2 5 2 ... 1 ... ... ... ... 4 12 Appendicitis 5 ... ... ... 1 4 ... ... ... 1 2 ... 1 1 ... 1 ... ... ... 1 ... 3 10 Cirrhosis of Liver 4 ... ... ... ... ... ... 3 1 3 1 ... ... ... 1 ... ... ... ... ... ... ... 2 Ac. & Cr. Nephritis 32 ... ... ... ... 3 3 8 18 13 4 2 13 ... 6 1 ... ... ... ... ... 11 18 Puerperal Sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Diseases of Pregnancy and Parturition 4 ... ... ... ... 1 3 ... ... 3 ... ... 1 ... 1 ... ... ... ... ... ... 1 2 Congenital Debility and Malformation, including Premature Birth 50 46 2 2 ... ... ... ... ... 23 14 5 8 ... 8 ... 3 ... ... ... 6 10 34 Violent Deaths, excluding Suicide 66 2 2 4 8 4 9 16 21 32 13 5 13 3 29 4 8 ... 1 1 1 15 86 Suicides 10 ... ... ... ... ... 2 7 1 4 3 1 2 ... 1 ... ... ... ... ... ... 2 3 Other Defined Diseases 217 14 2 1 11 8 20 39 122 92 57 22 42 4 68 10 4 ... 1 3 3 53 230 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1387 116 28 26 39 63 147 317 621 574 366 120 289 38 376 49 31 ... 20 7 20 261 1348 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 Quarter ended 30th March, 1929. 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Membranous Croup 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Diphtheria 90 2 28 42 13 3 2 ... 23 16 11 33 7 22 16 11 33 7 89 Encephalitis Lethargica 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Erysipelas 23 ... 2 ... 4 3 10 ... 11 3 6 2 1 4 3 4 ... ... 11 Scarlet Fever 89 ... 26 45 13 5 ... ... 26 28 16 17 2 26 28 16 17 2 89 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Polio Myelitis 5 ... 2 3 ... ... ... ... ... 2 3 ... ... ... 2 3 ... ... 5 Puerperal Fever 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 Puerperal Pyrexia 7 ... ... ... 3 4 ... ... 3 2 ... ... 2 3 1 ... ... 1 5 Cerebro-Spinal Fever 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 47 3 9 26 7 2 ... ... 25 5 9 7 1 2 2 ... 1 ... 5 Whooping Cough 401 42 230 126 ... 2 1 ... 275 52 14 60 ... 8 10 5 ... ... 23 Diarrhoea 9 5 4 ... ... ... ... ... 5 ... ... 4 ... ... ... ... ... ... ... Ophthalmia Neonatorum 6 6 ... ... ... ... ... ... 2 ... ... 4 ... ... ... ... 1 ... 1 Tuberculosis, Pulmonary 42 ... 1 8 9 15 8 1 17 8 1 15 1 2 5 ... 2 ... 9 „ Non-Pulmonary 7 ... ... 3 1 3 ... ... 3 1 ... 3 ... ... 1 ... 1 ... 2 Pneumonia, Acute Primary, or Acute Influenzal 94 4 16 5 10 19 23 17 39 19 7 28 1 16 8 5 7 1 37 Totals 824 62 320 259 60 57 44 22 430 137 67 175 15 83 77 44 ! 64 11 279 (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 Quarter ending 29th June, 1929. 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 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Diphtheria 61 1 16 31 10 3 ... ... 23 20 2 13 3 23 20 2 13 2 60 Encephalitis Lethargica 1 ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... 1 Erysipelas 4 ... ... ... 2 1 ... 1 ... 2 ... 2 ... ... ... ... ... ... ... Scarlet Fever 82 ... 20 39 18 3 2 ... 29 20 17 11 5 29 20 17 10 4 80 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... ... 2 1 ... ... 1 ... ... ... 2 1 ... ... ... 2 3 Polio Myelitis 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Puerperal Fever 2 ... ... ... 2 ... ... ... ... 1 ... ... 1 ... 1 ... ... 1 2 Puerperal Pyrexia 1 ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Measles 252 12 62 143 26 9 ... ... 68 46 33 102 3 1 3 4 ... ... 8 Whooping Cough 151 29 89 31 ... 2 ... ... 102 37 10 2 ... 17 4 ... ... ... 21 Diarrhoea 18 11 7 ... ... ... ... ... 10 ... ... 8 ... ... ... ... ... ... ... Ophthalmia Neonatorum 5 5 ... ... ... ... ... ... 2 ... 1 2 ... 1 ... ... 1 ... 2 Tuberculosis, Pulmonary 43 ... ... 2 11 16 11 3 26 7 1 9 ... 3 2 ... 2 ... 7 NNon-Pulmonary 11 ... 4 1 4 1 1 ... 3 3 2 2 1 ... 2 1 2 1 6 Pneumonia, Acute Primary, or Acute Influenzal 20 ... 4 4 2 5 3 2 9 1 1 8 1 5 1 1 5 ... 12 Totals 657 58 203 251 78 43 17 7 276 138 67 160 16 82 54 25 34 10 205 (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 Quarter ended 28th September, 1929. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. Number or 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 78 1 15 40 12 10 ... ... 31 22 5 19 1 30 21 5 19 1 76 Encephalitis Lethargica 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... 1 Erysipelas 15 ... 1 2 ... 6 2 4 6 4 2 2 1 2 3 1 ... I 7 Scarlet Fever 56 ... 11 37 5 1 2 ... 14 9 18 13 2 14 7 18 12 2 53 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Polio Myelitis 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia 1 ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 80 6 34 35 3 2 ... ... 19 39 5 15 2 7 6 ... ... ... 13 Whooping Cough 33 1 23 8 ... 1 ... ... 18 14 ... 1 ... 1 3 ... 1 ... 5 Diarrhoea 30 19 11 ... ... ... ... ... 17 2 2 9 ... ... 1 1 ... ... 2 Ophthalmia Neonatorum 2 2 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... Tuberculosis, Pulmonary 30 ... ... ... 11 13 4 2 15 6 2 5 2 4 3 ... 1 1 9 „ Non-Pulmonary 5 ... 2 1 1 1 ... ... 1 1 1 2 ... 1 1 1 2 ... 5 Pneumonia, Acute Primary, or Acute Influenzal 11 ... 1 1 3 3 3 ... 4 2 ... 5 ... 2 ... ... 2 ... 4 Totals 343 29 99 124 36 37 12 6 126 102 35 72 8 61 47 26 37 5 176 (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 Quarter ended 28th December, 1929 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Membranous Croup 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Diphtheria 127 ... 35 74 ... 8 ... ... 38 30 9 44 6 38 30 8 44 6 126 Encephalitis Lethargica 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 1 Erysipelas 19 ... 2 1 ... 5 ... ... 12 3 2 2 ... 3 2 ... ... ... 5 Scarlet Fever 122 ... 29 67 18 8 ... ... 51 37 17 13 4 51 36 17 13 4 121 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 2 ... ... ... ... 1 1 ... ... ... ... 2 ... ... ... ... 2 ... 2 Polio Myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Puerperal Pyrexia 2 ... ... ... ... 2 ... ... 1 1 ... ... ... ... 1 ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 158 13 84 58 ... 1 ... ... 18 98 32 8 2 10 10 16 1 ... 37 Whooping Cough 39 6 19 14 ... ... ... ... 20 7 ... 12 ... 2 4 ... 1 ... 7 Diarrhoea 22 10 12 ... ... ... ... ... 18 ... ... 4 ... ... ... ... ... ... ... Ophthalmia Neonatorum 2 2 ... ... ... ... ... ... 1 1 ... ... ... 1 1 ... ... ... 2 Tuberculosis, Pulmonary 37 ... ... 3 11 9 12 2 21 7 5 3 1 4 1 ... ... ... 3 „ Non-Pulmonary 4 ... 3 ... ... 1 ... ... 1 1 1 ... 1 ... 1 ... ... ... 1 Pneumonia, Acute Primary, or Acute Influenzal 26 1 6 1 3 4 5 6 11 ... 1 13 1 3 ... ... 5 ... 8 Totals 563 33 190 219 43 41 25 12 192 186 67 102 16 112 90 41 67 11 321 (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 Year ended 28th December, 1929. 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 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Membranous Croup 2 ... 1 1 ... ... ... ... ... 1 ... 1 ... ... 1 ... 1 ... 2 Diphtheria 356 5 94 187 44 24 2 ... 115 88 27 109 17 113 87 26 109 16 351 Encephalitis Lethargica 4 ... 1 ... ... 1 1 1 2 1 ... ... 1 1 1 ... ... 1 3 Erysipelas 61 ... 5 3 6 15 19 13 29 12 10 8 2 9 8 5 ... 1 23 Scarlet Fever 349 ... 86 188 54 17 4 ... 120 94 68 54 13 120 91 68 52 12 343 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 5 ... ... ... 2 2 1 ... 1 ... ... 2 2 1 ... ... 2 2 5 Polio Myelitis 7 ... 4 3 ... ... ... ... ... 3 3 1 ... ... 3 3 1 ... 7 Puerperal Fever 4 ... ... ... 2 2 ... ... ... 1 ... 2 1 ... 1 ... 2 1 4 Puerperal Pyrexia 11 ... ... ... 4 7 ... ... 6 3 ... ... 2 4 2 ... ... 1 7 Cerebro-Spinal Fever 1 ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 Malaria 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... Measles 537 34 189 262 38 14 ... ... 130 188 79 132 8 20 21 20 2 ... 63 Whooping Cough 624 78 361 179 ... 5 1 ... 415 110 24 75 ... 28 21 5 2 ... 56 Diarrhoea 79 45 34 ... ... ... ... ... 50 2 2 25 ... ... 1 1 ... ... 2 Ophthalmia Neonatorum 15 15 ... ... ... ... ... ... 5 2 1 7 ... 2 1 ... 2 ... 5 Tuberculosis, Pulmonary 152 ... 1 13 42 53 35 8 79 28 9 32 4 13 14 ... 5 1 33 „ Non-Pulmonary 27 ... 9 5 6 6 1 ... 8 6 4 7 2 1 5 2 5 1 14 Pneumonia, Acute Primary, or Acute Influenzal 151 5 27 11 18 31 34 25 63 22 9 54 3 26 9 6 19 1 61 Totals 2387 182 812 853 217 178 98 47 1024 563 236 509 55 338 268 136 202 37 981 (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 1929. 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 ... ... ... ... ... ... ... 2 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 3 2 3 9 Diphtheria—Croup ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... Tuberculous Diseases. Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... 1 1 Convulsions ... ... ... ... ... ... ... ... 1 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 ... ... ... 1 1 1 1 1 5 Pneumonia, all forms ... ... ... ... ... 3 7 6 7 23 Diarrhœal Diseases. Diarrhœa, all forms ... ... ... ... ... ... 1 3 1 5 Enteritis ... ... 1 ... 1 3 2 ... ... 6 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... 1 1 ... 1 ... ... 2 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlaying ... ... ... ... ... ... 1 ... ... 1 ,, otherwise ... ... ... ... ... ... ... ... ... ... Injury at Birth 5 ... ... ... 5 ... ... ... ... 5 Actelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Malformations 1 1 ... ... 2 ... 1 ... ... 3 Premature Birth 21 ... 1 2 24 2 ... ... ... 26 Atrophy, Debility and Marasmus 2 1 2 ... 5 3 1 2 ... 11 Other Causes 1 ... 1 ... 2 1 3 3 2 11 Totals 35 2 5 3 45 14 21 19 17 116 Boys 67 Girls 49 116