HAC 33 Metropolitan Borough of hackney. REPORT ON THE SANITARY CONDITION OF THE METROPOLITAN BOROUGH OF HACKNEY FOR THE YEAR 1920, BY G. H. DART, M.D., M.R.C.P., Edin.; D.P.H., D.T.M. & H., Camb. Medical Officer of Health. Administrative Maternity and Child Welfare Officer. Executive Tuberculosis Officer London : Chas. Straker & Sons, Ltd., 5-9, Bishopsgate Avenue, E.C.3. 1921. INDEX. page Canal Boats Acts, Report of Inspector 95 Cleansing of Persons Act, 1907 55 Constitutional Diseases 37 Cowhouses, Dairies and Milkshops 91 Disinfection 52 Food— Articles Surrendered to District Inspectors 88 Articles Purchased for Analysis 89 Prosecutions under Sale of Food and Drugs Acts 90 Report of Food Inspector 91 Housing— Public Health (London) Act, 1891 72 Housing Acts 79 Housing Scheme 71 Legal Proceedings 73 Verminous Premises 87 Work of Sanitary Inspectors (Table of Inspections) 96 Industrial Statistics— Factory and Workshop Act, 1901 79 Factories, Nuisances found 79 Factories, General Table of Inspections and Defects found 82 Workshops Inspected 82 Workshops, Analysis of Occupations 81 Home Workers 83 Outworkers 85 List of Industries 79 Infectious Diseases— Anthrax 34 Cerebro Spinal Meningitis 32 Continued Fever 31 Diarrhœa 35 Diphtheria 29 Diphtheria Anti-toxin 30 Dysentery 33 Encephalitis Lethargica 33 Enteric Fever 30 Erysipelas 31 Influenza 34 Malaria 33 Measles and German Measles 32 Ophthalmia Neonatorum 32 Plague 31 Pneumonia 33 Polio-Myelitis 32 Puerperal Fever 31 4 index Infectious Diseases (continued). page Scarlet Fever 28 Small-pox and Vaccination 27 Typhus Fever 31 Whooping Cough 36 Maternity and Child Welfare— General Organisation 59 Contributions to Maternity Hospitals 69 Health Visiting 61 Infant Consultation and Ante-natal Clinics 62 Provision of Milk and Foods 69 Mortuary 24 Offensive Trades 91 Rats and Mice Destruction Act, 1919 87 Shelter 55 Slaughterhouses 92 Tuberculosis— Advanced Cases 47 After Care 47 Description of Dispensaries provided for Treatment 41 Discharged Soldiers and Sailors 41 Dispensary Districts : Population 45 Health Visitors—Visits of 41 Notifications and Deaths 46 Open-air School 48 Public Health (Tuberculosis) Regulations, 1912 39 Summary of Notifications 40 Summary of Deaths, Number and Classification 38 Reports of Dispensary Medical Officers 48 Vital Statistics— Acreage of Borough 12 Births and Birth Rates 13 Deaths and Death Rates 16 Deaths in Public Institutions 19 Density of Population 12 Infantile Mortality 18 Institutions outside the Borough receiving Sick from the Borough 20 Illegitimate Birth Rate 14 Marriage Rate 12 Notification of Births 14 Population 12 Registration of Births 11 Senile Mortality 18 Still Births 14 Tables of Causes of Deaths 104 Table (Comparative) of Rates for years 1911-20 25 „ „ „ year 1920—London Boroughs 11 5 PUBLIC HEALTH DEPARTMENT. Public Health and Maternity and Child Welfare Committees. Public Health Committee. Ex-officio—Herbert Stanley Morrison, Esq., j.p. (Mayor). Chairman—Councillor Mrs. E. Boyce. Vice-Chairman—Councillor T. Chapman, j.p., L.C.C. Councillor Benwell, Mrs. L. C. Councillor Hughes, W. Maternity and Child Welfare Committee. Consisting of Members of the Public Health Committee, and three persons being women and not Members of the Council. Chairman—Councillor H. P. Piggott. Vice-Chairman—Councillor Mrs. E. C. Muirhead. Alderman Elliott, E. Councillor Genese, J. Goold, F. G. Bibbey, T. A. Bowhill, T. A. Boyce, Mrs. E. Capell, H. J. W. Chapman, T., j.p., l.c.c. Loweth, W. E. Muirhead, Mrs. E. Payne, A. W. Piggott, H. P. Rushbrooke, T., j.p., m.a., &c. Sherman, J. Thorpe, W. H. Vardon, A. D., j.p., l.r.c.p. Members of the Committee—as set out above with the addition of Mrs. M. Mylles, Mrs. M. S. Inkpin, and Miss B. W. Payne. 6 STAFF OF PUBLIC HEALTH DEPARTMENT. Sanitary Inspectors. R. H. Ellis. R. H. Bew. W. C. Vobe. A. Sadler. H. Body. G. F. High. R. J. Sheppard. C. F. Long. W. Goldsworthy. W. Peverett. E. A. Hillier. E. S. Crook, also Canal Boats Inspector. J. E. Truslove. J. W. Hall. G. Fowler. A. J. Bobbitt (for Cowhouses, Milkshops, Slaughterhouses,&c.) W. Harvey (Temporary). S. Punter (Temporary). Alice Teebay (for Workshops, Laundries, &c.) Mabel Portlock (for Outworkers' Premises). Health Visitors. Mrs. A. Rhodes. Miss K. Teebay. Mrs. E. A. Cowley. Mrs. L. Harrison. Miss M. Chitson. Miss K. O'Neil Fisher. Mrs. L. E. Bartholomew. Miss D. F. Vidal. Miss A. K. Roche. Miss G. M. Servante Miss M. Clarke for Tuberculosis cases. Medical Officers (Temporary Staff) Municipal Infant Welfare Centres. Elizabeth Wilks, m.d. Reginald Brown, m.r.c.s., l.r.c.p. J. H. Porter, m.r.c.s., l.r.c.p. Tuberculosis Dispensary Medical Officers (Metropolitan and City of London Hospitals.) L. Unwin Young, M B. H. Tylford Howell, m.r.c.s. Public Analyst—Leo Taylor, f.i.c. Dust Inspectors. E. J. Tietjen. T. Saunders. Disinfecting Station and Shelter Caretakers. E. G. Hasler. Mrs. E. Hasler. Mortuary Keeper—S. W. Boxell. Messenger—H. Storey. Clerical Staff. J. D- Wilde. A. Higgins. P. A. Hitch. V. Welham. L. W. Harvf.y. H. C. Bowman. E. Whittaker. H. R. Sandford. Medical Officer of Health. G. H. Dart, m.d., m.r.c.p. Edin., d.p.h. , d.t.m. & h. Camb. 7 metropolitan Borough of hackney REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1920. PUBLIC HEALTH DEPARTMEI Town Hall, Hackney, E.8. To the Mayor, Aldermen and, Councillors of the Metropolitan Borough of Hackney. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit, in accordance with the instructions of the Ministry of Health, the Annual Report on the health of the Metropolitan Borough of Hackney for the year 1920. The report is presented in the form and sequence of subjects suggested by the Ministry of Health ; but before proceeding to a detailed description of the sanitary work of the Borough, a short statistical summary and a comparative table as regards the Death, Birth, Zymotic and Infantile Mortality Rates of Metropolitan Boroughs will be found convenient for immediate reference. A comparative table for the Borough showing the Birth, Death and Infantile Mortality Rates for the past ten years is set out on page 25. The birth-rate is 26.6 per 1,000 for Hackney, as compared with 26.5 for the whole of the County of London. The Infantile Mortality Rate for the Borough, measured by the number of deaths under one year of age per thousand births registered, is 81 as compared with 85, the figure for last year, the Borough average during the last five years (1915 to 1919), is 96, and the figure for all London is 75, as compared with 85 in 1919. 8 The Maternity and Child Welfare Centres operating in Hackney are five in number; three Municipal and two voluntary. The Municipal Infant Consultation Centres are open once weekly. One Voluntary Centre is open twice weekly, and the remaining Voluntary Centre is open once weeldy. There are two Ante-natal Centres in the Borough, open once fortnightly, and two Day Nurseries are working in the Borough under voluntary control. The Borough is divided for Health Visiting purposes into 11 districts, two of the districts being placed in the care of Voluntary Associations approved and partly financed by the Council; the work of these Associations being in every particular co-ordinated, as regards Maternity and Child Welfare, with the work of the Public Health Department. For particulars of Maternity and Child Welfare Work, see page 59. The death-rate for Hackney is 12.7, as compared with 124 for the County of London, and is slightly higher than the death-rate of 15 of the Metropolitan Boroughs. The Zymotic death-rate is 1.09, as compared with .77, the figure for 1919, this increase being entirely due to the increased number of deaths from measles and whooping cough, the number of deaths from measles having increased by 73, and from whooping cough by 40 during 1920. In spite of the fact that the number of scarlet fever cases notified during 1920 was 1,077, as compared with 643 during 1919, and the number of diphtheria cases notified during 1920 was 764, as compared with 669 during 1919, the number of deaths from each of these diseases was diminished; deaths from scarlet fever being two less, and deaths from diphtheria 21 less than in 1919. Table II., page 36, gives the number of cases of infectious diseases notified and removed to hospital during 1920. The tuberculosis death-rate shows a slight decrease, the mortality being 1.1 per 1,000 of the population, as compared with 9 1.2 for 1919, the number of deaths being fewer by 22 than in 1919, and there were also 77 fewer primary notifications as compared with 1919. The dispensary treatment of tuberculous persons is carried on at dispensaries controlled by the Metropolitan and City of London Hospitals; the Metropolitan Hospital Tuberculosis Dispensary being financed jointly by the Boroughs of Hackney and Stoke Newington, and the City of London Hospital Tuberculosis Dispensary being financed jointly by the Boroughs of Hackney and Bethna Green. Reports to the Hospital Committees of Management by the Dispensary Medical Officers appointed by the hospitals clearly show the valuable character of the work being carried out by the dispensaries. Details from the reports and a description of the dispensary service are set out on pages 41-51. The Borough is divided for purposes of Sanitary Inspection into 14 districts, and, in addition, sanction has been obtained for the appointment of three inspectors for work under the Housing and Town Planning Act Regulations. Housing difficulties in Hackney are those common to most London Boroughs, and are by this time well-known to the public in general. Briefly, much of the housing property is in poor condition, repairs are expensive, and in many cases owners are barely able to meet the cost, while owing to the age of many of the houses frequent repairs are essential. Alternative accommodation is scanty or lacking, so that Closing Orders cannot be put into force. The Council's Housing Scheme is progressing, and temporary measures have been adopted to alleviate overcrowding : a description of the scheme can be found on page 71. Particulars with regard to the comprehensive work of "Sanitary Inspection," comprising, as it does, so many and varied services essential to the health of the community such as inspection with regard to housing conditions, unsound food and preparation of food, infectious diseases, drainage work, factories and workshops, outworkers, etc., 10 can be found by referring to the general index. The table on pages 96-103, setting out the number of inspections made is not intended as a description of " Sanitary Inspection " as the mere number of visits paid cannot convey an adequate impression of the manifold activities connected with this work. I must take this opportunity of expressing my gratitude to Dr. Fletcher for the kind assistance given to me on the occasion of my taking over the duties of my appointment. Dr. Fletcher, owing to the death of the late Medical Officer of Health—Dr. KingWarry—was appointed Acting Medical Officer of Health, and carried out those duties so admirably as to earn the special thanks of the Committee and the Council for the services rendered by him to the Borough at a time of special stress and difficulty. My thanks are also due to the Public Health and Maternity and Child Welfare Committees for their kind support, and to the members of my staff for the manner in which their duties have been performed. I am, Yours obediently, G. H. Dart, Medical Officer of Health. 11 COMPARATIVE TABLE, YEAR 1920—LONDON BOROUGHS Cities and Boroughs. Estimated population to the middle of 1920. Births. Annual rate per 1,000 persons living. Zymotic deaths. Annual rate per 1,000 persons living. Deathrate per 1,000 living. Deaths of Infants under one year to 1,000 births. LONDON 4,531,971 26.5 0.9 12.4 75 West Districts. Paddington 149,673 22.7 0.7 11.1 78 Kensington 164,177 24.3 0.9 13.0 81 Hammersmith 136,200 24.3 0.8 11.2 65 Fulham 158,621 27.2 0.8 11.3 74 Chelsea 68,500 20.3 0.04 11.9 52 City of Westminster 132,615 16.1 0.4 11.6 71 North Districts. St. Marylebone 101,856 21.5 0.5 12.5 65 Hampstead 91,519 17.1 0.2 9.0 48 St. Pancras 228,178 25.4 0.9 12.3 72 Islington 335,907 28.1 1.0 13.3 71 Stoke Newington 52,984 23.1 0.7 12.8 80 HACKNEY 225,372 26.6 1.09 12.7 80 Central Districts. Holborn 39,676 20.8 0.6 14.9 64 Finsbury 78,291 32.4 0.9 14.5 76 City of London 12,200 14.9 0.4 13.3 71 East Districts. Shoreditch 101,000 36.9 1.4 15.4 91 Bethnal Green 114,471 33.7 1.9 14.7 95 Stepney 241,770 31.2 1.1 14.4 87 Poplar 159,766 34.1 1.3 14.6 82 South Districts. Southwark 187,142 31.8 1.0 14.4 86 Bermondsey 129,189 31.8 1.2 13.0 84 Lambeth 293,592 27.8 0.9 13.0 67 Battersea 165,664 28.1 1.1 12.3 82 Wandsworth 342,808 21.0 0.6 10.0 62 Camberwell 284,712 26.5 0.8 11.5 70 Deptford 115,636 28.3 0.8 12.0 79 Greenwich 104,453 24.6 0.9 11.9 72 Lewisham 174,438 22.8 0.4 10.8 65 Woolwich 141,666 24.7 0.5 10.4 60 12 VITAL AND OTHER STATISTICS. Population and Density. Area=3,287 acres Population—Census, 1901 = 219,780 „ —Census, 1911 = 222,674 The population of the Borough at the middle of the year 1920 is estimated by the Registrar-General to number:— For death-rate 225,372 For birth-rate 225,542 This gives a density of population for the whole Borough of 68.5 persons per acre, varying from 51.2 persons per acre in the Northern Sub-district to 98.4 persons per acre in the South-western Sub-district. The following table gives the estimated population and density of population per acre for each of the Registration Sub-districts in the Borough :— Table showing Estimated Population, Area and Density of the Registration Sub-Districts in Hackney at middle of 1920. North Central Southwest SouthEast Total for Hackney Total for London Estimated population 55,397 55,216 57,673 57,086 225,372 4,531,971 Area in square acres 1,081 857 586 764 3,288 74,816 Density, persons per acre 51.2 64.4 98.4 74.8 68.5 60.5 *Marriages and Marriage-rates.—During 1920 there were 2,380 marriages solemnised in the Borough of Hackney. The annual * I have here to acknowledge my indebtedness to Mr. H. Brougham Loney, Superintendent Registrar, who has kindly abstracted the number of marriages for the year 1920. 13 rate for persons married during this period is therefore 21.1 per 1,000 of the population. The following table gives the number of marriages and marriagerates for the Borough of Hackney and London during the 10 years, 1910-1920 :— Year. Borough of Hackney. London. Marriages. Marriage rate. Marriage rate. 1910 1,700 14.3 16.0 1911 1,919 17.2 17.8 1912 1,967 17.6 18.6 1913 1,941 17.4 16.1 1914 1,970 17.6 19.2 1915 2,723 25.0 25.8 1916 2,206 21.0 20.3 1917 1,962 180 18.5 1918 2,011 18.3 21.0 1919 2,571 22.8 23.0 Average, 1910-1919 2,097 18.9 19.6 1920 2,380 21.1 21.7 Births and Birth-rate.—The births registered in the Borough of Hackney during the year 1920 numbered 6,486, of which 3,399 were males and 3,087 females. The total shows an increase of 1,738 compared with the numbered registered during 1919 ; but of these a certain number must be transferred to other districts, and certain births, which occurred in out-lying districts, must be transferred to Hackney in order to get an accurate birth-rate for the Borough. The Registrar-General has supplied the number of these transferable births, viz., 775 births to be transferred to other districts and 299 to Hackney. After these necessary corrections have been made, the correct total of registered births amongst Hackney residents is 6,010. From this figure the birth-rate for Hackney during 1920 has been calculated to be 26.6 per 1,000 of the population. The birth-rate for all London for the same period is 26.5 per 1,000 of the population. 14 Notification of Births Act, 1907.—Under the provisions of this Act 6,442 notifications of births were received during 1920. This total includes notifications from medical practitioners, midwives, parents and others. It also includes still-births. The total is 44 less than the number registered by the Registrar of Births. Still-Births.—Amongst the births notified 171 were still-born. This is equal to 2.6 per cent. of those notified. A table is here given showing the number of notifications received, with other details in connection with the same. NOTIFICATION OF BIRTHS ACT, 1907. Notifications of Births (Live and Still-born) received during the year 1920. Year 1920. Medical Practitioners. Midwives. Parents and Others. Total. Live. Still. Live. Still. Live. Still. Live. Still. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Totals. 767 701 20 18 2,007 1,869 73 49 490 437 3 8 3,264 3,007 96 75 Illegitimate Births and Birth-rate.—The total number of illegitimate births registered in the Borough during the year 1920 was 416; but of these, the Registrar-General states that 272 should be transferred to districts outside the Borough, as the mothers were not Hackney residents, and 24 births which took place in other districts, should be transferred to Hackney. These corrections having been made, there remain 144 illegitimate births amongst Hackney residents. This is equivalent to an illegitimate birth-rate of 24.0 per 1,000 births. 15 The following table gives the number of registered births, birth-rates, etc., for the Sub-districts in the Borough:— Registration District of Hackney Registration Sub-district All London North Central SouthWest SouthEast Total No. of births. 6,486 1,146 2,286 1,366 1,688 120,529 Rate per 1,000 living 28.7 20.6 41.3 23.6 29.5 26.5 No of illegitimate births 144 — — — — — Rate per 1,000 births 24.0 — — — — — It will be noticed that the birth-rate is abnormally high in the Central District compared with other Registration Sub-districts. This is accounted for by reason of 1,008 births occurring during the year at the Salvation Army Mothers' Hospital, which Institution is situate in the Central District. Of this number 641 births are transferable to districts outside Hackney. The following table shows the birth-rates for the Borough and its Sub-districts during the years 1910 1920 inclusive:— Birth-rate for the Borough of Hackney and. its Sub-districts for the years 1910-1920 compared with that of London. Year Borough of Hackney North SubDistrict Central SubDistrict South-West SubDistrict South-East SubDistrict London 1910 23.1 17.6 22.9 26.7 24.6 23.6 1911 24.3 18.8 24.8 28.0 25.2 24.8 1912 24.3 18.7 23.9 28.4 25.7 24.5 1913 25.6 18.9 26.6* 30.3 26.5 24.5 1914 25.5 18.0 32.5 24.4 27.1 24.3 1915 23.0 17.0 28.7 22.3 23.3 22.6 1916 23.9 16.9 32.5 21.6 24.5 230 1917 18.9 12.4 29.7 15.4 18.0 17.5 1918 17.2 9.5 30.7 12.7 15.8 16.1 1919 210 13.2 33.9 16.5 20.6 18.3 Average 1910-1919 22.6 16.1 28.6 22.6 23.1 21.9 1920 28.7 20.6 41.3 23.6 29.5 26.5 * The Salvation Army's Mothers' Hospital was opened in 1913. 16 Deaths.—The deaths registered in the Borough during 1920 numbered 3,030 ; but of these 679 were deaths of non-residents who died inside the Borough. There were, however, 510 residents of Hackney who died during the year outside the Borough. On making the necessary corrections, the corrected number of deaths amongst Hackney residents is 2,861. This is an increase of 14 upon the number of deaths occurring during 1919. The general death-rate from all causes for the year 1920 is 12.7 per 1,000 of the population. Amongst the Registration Sub-districts the death-rate was lowest in the North Sub-district (11.5 per 1,000), and highest in the South-east Sub-district (14.2 per 1,000). Subdistrict. Population (estimated). No. of Births. * Birthrate. Uncorrected. Total Deaths. Deathrate. Deaths under 1 year. * Infant Mortality per 1,000 Births. Uncorrected. Birthrate. Deathrate. N orth 55,437 55,397 1,146 20.6 639 11.5 68 59 Central 55,256 55,216 2,286 41.3 644 11.6 130 56 South - west 57,723 57,673 1,366 23.6 784 13.6 123 90 South - east 57,126 57,086 1,688 29.5 794 14.2 164 97 All Hackney 225,542 225,372 6,486 28.7 2.861 12.7 485 75 * The uncorrected figure counts in all births and Infant deaths relating to the whole Borough ; but some of these having occurred in Institutions, &c., are referred to other districts. For corrected figures see page 25. The following shows the death-rate of Hackney from all causes per 1,000, compared with London during the last decade :— Year. Hackney. London. Year. Hackney. London. 1911 15.0 15.8 1916 13.8 14.3 1912 12.3 13.6 1917 14.6 15.0 1913 13.7 14.2 1918 18.9 18.9 1914 13.9 14.4 1919 13.0 13.4 1915 14.9 16.1 1920 12.7 12.4 17 The relative position from a health point of view occupied by Hackney as compared with other Metropolitan Boroughs may be seen from the following table, compiled from figures supplied by the Registrar-General, showing the death-rates from all causes and the death-rates of infants under 1 year of age for the year 1920 :— Boroughs. Death-rate from all causes per 1,000 Living. Deaths under 1 year to 1,000 Births. Hampstead 9.0 48 Wandsworth 10.0 62 Woolwich 10.4 60 Lewisham 10.8 65 Paddington 11.1 78 Hammersmith 11.2 65 Fulham 11.3 74 Camberwell 11.5 70 City of Westminster 11.6 71 Chelsea 11.9 52 Greenwich 11.9 72 Deptford 120 79 St. Pancras 12.3 72 Battersea 12.3 82 St. Marylebone 12.5 65 HACKNEY 12.7 81 Stoke Newington 12.8 80 Lambeth 13.0 67 Kensington 13.0 81 Bermondsey 13.0 84 City of London 13.3 71 Islington 13.3 71 Southwark 14.4 86 Stepney 14.4 87 Finsbury 14.5 76 Poplar 14.6 82 Bethnal Green 14.7 95 Holborn 14.9 64 Shoreditch 15.4 91 Infantile Mortality.—The deaths under 1 year of age in the Borough during 1920 numbered 485. This is an increase of 130 upon the number of infants' deaths recorded during 1919. The infant mortality rate for the year is 81 per 1,000 births. B 18 The causes of death are set out in the following table :— INFANT MORTALITY. 1920. Nett deaths from stated causes at various ages under 1 Year of age. CAUSE OF DEATH. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 1 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 2 2 4 12 20 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... 1 3 4 3 7 8 5 27 Diphtheria and Croup ... ... ... ... ... ... ... ... 3 3 Erysipelas ... ... ... ... ... 1 1 ... ... 2 Tuberculous Meningitis ... ... ... 1 1 ... 2 1 ... 4 Abdominal Tuberculosis ... ... ... ... ... 1 ... ... ... 1 Other Tuberculous Diseases ... ... ... ... ... 1 ... 1 ... 2 Meningitis (not Tuberculous) ... ... ... ... ... 2 ... 1 ... 3 Convulsions 1 3 1 2 7 3 6 3 1 20 Laryngitis ... ... ... 1 1 ... ... ... ... 1 Bronchitis 1 1 1 1 4 20 10 2 5 41 Pneumonia (all forms) 1 1 2 1 5 19 23 23 15 85 Diarrhœa ... ... 1 ... 1 2 5 ... 1 9 Enteritis ... ... ... ... ... 4 10 3 2 19 Gastritis ... ... 1 ... 1 2 ... ... ... 3 Syphilis ... 1 1 1 3 4 2 ... ... 9 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) 3 1 ... ... 4 2 1 ... ... 7 Injury at Birth 3 ... ... ... 3 ... ... ... ... 3 Atelectasis 14 1 ... ... 15 1 ... ... ... 16 Congenital Malformations 12 2 1 1 16 7 3 2 ... 28 Premature Birth 61 6 13 5 85 11 3 ... ... 99 Atrophy, Debility and Marasmus 7 2 3 1 13 10 9 5 ... 37 Other Causes 7 2 4 1 14 8 11 9 4 46 Total 120 20 29 18 177 103 95 62 48 485 Senile Mortality.—The deaths which occurred in Hackney at 65 years of age and upwards during 1920 numbered 866, and of these 407 were between the ages of 65 and 75 years, 363 between 75 and 85 years, and 96 at 85 and upwards. The annual mortality rate of persons at 65 years and upwards is 3.8 per 1,000 inhabitants. 19 Deaths in Public Institutions.—There were 1,593 deaths in public institutions in the Borough during 1920; of these 679 were residents of other districts, and the remaining 914 were residents of Hackney. The following lists give the names of the institutions within the Borough receiving persons from both within and without the Borough, and also the institutions outside the Borough, receiving sick and infirm persons from the Borough, with the number of deaths in each institution during the year 1920 :— Institutions within the Borough receiving persons both from and without the Borough. Brooke House, Upper Clapton Road 6 City of London Infirmary, Clifden Road 47 Eastern Fever Hospital, Homerton 201 French Hospital, Victoria Park Road 4 German Hospital, Dalston 133 Hackney Union Infirmary, Homerton 900 „ „ Workhouse, Homerton 5 Metropolitan Hospital, Kingsland 161 Nursing Home, 46, Amhurst Park 3 „ „ 26, Amhurst Park 1 „ „ 256, Amhurst Road 1 „ „ 47, Nightingale Road 2 „ „ 18 and 20, South wold Road 2 „ 157, Richmond Road 4 St. Joseph's Hospice, Mare Street 58 Salvation Army Nursing Home, 29, Devonshire Road 4 „ „ 4, Clapton Common 4 Salvation Army Maternity Hospital, Lower Clapton Road 54 „ Homes, Springfield 3 1,593 B 2 20 Institutions outside the Borough receiving sick and infirm persons from the Borough. Banstead Mental Hospital 5 Caterham Asylum 4 Cancer Hospital, Chelsea 2 Central London Throat and Ear Hospital 1 Children's Hospital, Great Ormond Street 8 City of London Lunatic Asylum, Stone 2 City of London Maternity Hospital 4 City Police Hospital 2 Claybury Mental Hospital 29 Colindale Hospital 10 Colney Hatch Mental Hospital 15 Dartford Heath Mental Hospital 2 Darenth Industrial Colony 1 Elizabeth Garrett Anderson Hospital 1 Great Northern Hospital 2 Hampstead General Hospital 1 Homoeopathic Hospital 2 Home and Hospital for Jewish Incurables, Tottenham 2 Hanwell Mental Hospital 6 Joyce Green Hospital 1 King's College Hospital 1 Leavesden Asylum 11 London Hospital 89 Middlesex Hospital 11 Mildmay Memorial Hospital 2 Mildmay Mission Hospital 4 Northern Hospital, Winchmore Hill 1 North-Eastern Fever Hospital 16 National Hospital, Queen's Square 1 North-Western Fever Hospital 6 Park Hospital 6 Poplar Hospital 3 21 Peckham House 2 Prince of Wales'General Hospital, Tottenham 13 Queen Charlotte's Hospital 3 Queen's Hospital for Children 54 Queen Mary's Hospital, Carshalton 1 Royal Chest Hospital, City Road 1 Royal Free Hospital 4 St. Bartholomew's Hospital 20 St. Luke's House, Kensington 2 St. Peter's Hospital 2 St. George's Home, Chelsea 5 Shoreditch Infirmary 6 South-Eastern Fever Hospital 10 Sick Asylum, Bromley 1 St. George's Hospital 1 Tooting Bec Mental Hospital 19 University College Hospital 3 Victoria Park Chest Hospital 13 Miscellaneous Institutions 99 510 22 TABLE III—HACKNEY BOROUGH. Causes of, and Ages at, Death during the Year 1920. CAUSES OF DEATH. Deaths in whole Districts at Subjoined Ages. Deaths in Public Institutions. 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. Enteric Fever 1 ... ... ... ... ... 1 ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Measles 79 20 27 26 6 ... ... ... ... 31 Scarlet Fever 6 ... 2 1 2 1 ... ... ... 14 Whooping-cough 56 27 13 15 1 ... ... ... ... 30 Diphtheria and Croup 70 3 7 26 32 1 ... 1 ... 154 Influenza 85 2 ... ... 1 7 36 25 14 40 Erysipelas 16 2 ... ... ... 1 4 4 5 12 Dysentery 3 ... ... ... ... ... ... 1 2 1 Phthisis (Pulmonary Tuberculosis) 190 ... 2 ... 3 43 86 55 1 89 Tuberculous Meningitis 25 4 4 7 5 5 ... ... ... 16 Other Tuberculous Diseases 34 3 3 4 6 4 6 6 2 21 Cancer, Malignant Disease 246 ... ... 1 ... 3 28 121 93 134 Rheumatic Fever 3 ... ... 1 ... ... ... 1 1 ... Meningitis 10 3 1 1 2 ... ... 3 ... 5 Organic Heart Disease 281 1 ... ... 8 12 41 88 131 189 Bronchitis 238 41 3 3 ... 11 46 134 51 Pneumonia (all forms) 276 85 25 22 16 11 28 54 35 120 Carried forward 1,619 191 87 107 82 88 241 405 418 907 23 TABLE III.—HACKNEY BOROUGH—continued. Causes of, and Ages at, Death during the Year 1920. CAUSES OF DEATH. Deaths in whole Districts at Subjoined Ages. Deaths in Public Institutions. 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. Brought forward 1,619 191 87 107 82 88 241 405 418 907 Other Diseases of Respiratory Organs 57 2 ... 1 1 ... 9 27 17 24 Diarrhoea and Enteritis 34 28 4 1 ... 1 ... ... ... 17 Appendicitis and Typhlitis 17 ... ... 2 5 4 2 4 ... 10 Cirrhosis of Liver 8 ... ... ... ... ... 1 4 3 3 Alcoholism ... ... ... ... ... ... ... ... ... ... Nephritis and Bright's Disease 92 ... ... ... 2 1 16 41 32 60 Puerperal Fever 9 ... ... ... ... ... 2 ... ... 8 Other Accidents and Diseases of Pregnancy and Parturition 16 ... ... ... ... 1 15 ... ... 25 Congenital Debility and Malformation, including Premature Birth 182 180 2 ... ... ... ... ... ... 58 Violent Deaths, excluding Suicide 82 3 2 5 9 5 9 27 22 42 Suicides 28 ... ... ... ... ... 7 14 7 6 Other Defined Diseases 717 81 7 9 16 18 62 160 364 433 Diseases ill-defined or unknown 7 ... ... ... 1 ... 1 2 3 ... Totals 2,861 485 102 125 116 118 365 684 866 1,593 Sub Entries (included in above figures)— Cerebro-Spinal Meningitis 9 6 3 ... ... ... ... ... ... 3 Polio Myelitis ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargics 5 ... ... ... ... 2 3 ... ... 2 24 MORTUARY, 1920. Number of bodies deposited in Mortuary 322 1. To await Inquests—(a) Infectious 6 (b) Non-infectious 293 2. To await Burial 23 Number of Post Mortems 149 INQUESTS. Vrdicts. Sex. Male. Female. Natural causes 96 74 Accidental death 37 24 Suicide 23 8 Open Verdict 8 10 Manslaughter — — Murder — 1 Misadventure 13 5 Totals 177 122 Table showing nature of above Suicidal and Accidental Deaths in the Borough of Hackney during the year 1920. Nature of Suicide. No. Nature of Accidental Death. No. . Hanging 4 Shock from burns 5 Poisoning 4 Shock from fall 16 Cut throat 7 Suffocation in bed 5 Shooting 1 Drowning 4 Drowning 14 Run over 19 Run over 1 Fracture of skull 3 Fracture of ribs 2 Injury to arm 1 Shock from scalds 2 Others 4 31 61 25 TABLE I.—HACKNEY BOROUGH. Vital Statistics of Whole District during 1920 and Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett Number. Rate. of Nonresidents registered in the District. of residents not registered in the District. Under 1 Year of Age. At all Age. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1911 222,674 5,410 5,243 23.5 3,546 15.9 779 443 633 120 3,210 14.4 1912 223,022 5,425 5,267 23.6 2,952 13.2 663 431 426 79 2,720 12.2 1913 223,369 5,733 5,523 24.7 3,156 14.1 665 563 549 99 3,054 13.6 1914 223,718 5,708 5,460 25.5 3,233 14.4 662 557 492 85 3,128 13.9 1915 217,883 5,091 4,827 22.1 3,402 15.6 723 552 520 107 3,231 14.8 1916 209,636 5,331 5,026 22.0 2,917 13.9 617 581 423 84 2,881 13.7 1917 196,598 4,207 3,750 17.1 2,929 14.9 661 585 345 92 2,S53 14.6 1918 For Deaths, 195,804 13,828 3,266 14.8 3,836 19.5 820 692 365 111 3,708 18.9 For Births. 219,391 1919 For Deaths, 216,736 4,748 4,141 21.0 2,990 13.7 673 530 355 85 2,847 13.0 For Births. 225,774 1920 For Deaths. 225,372 6,486 6,010 26.6 3,030 13.4 679 510 485 81 2,861 12.7 For Births. 225,542 26 SPECIFIC INFECTIOUS DISEASE. During 1920 there were 2,202 cases of acute infectious disease compulsorily notified in the Borough, as set out in Table II; of these 28 were found subsequently not to be suffering from any notifiable infectious disease, thus reducing the number of genuine cases to 2,174. This total shows a decrease of 277 upon those notified during 1919. The attack-rate in respect of the acute notifiable infectious diseases for the year is 9.6 per 1,000 inhabitants. In addition there were 410 notifications received of pulmonary tuberculosis and 139 notifications of other forms of tuberculosis. The deaths from the chief zymotic diseases numbered 246. This is equivalent to a zymotic death-rate of 1.09 per 1,000 living in the Borough. NOTIFIABLE INFECTIOUS DISEASES. Small-pox.—There was not any notification of small-pox in the Borough during 1920. 27 SMALL POX, Summary of Proceedings under the Vaccination Acts, 1867 to 1898, during the Year 1920. Registration Sub-District. No. of Cases in Birth Lists received during Year. No. of Certificates of Vaccination received. No. of Certificates of Postponement owing to No. of Certificates under Section 2 of Vaccination Act, 1898. and No. of Statutory Declarations under Section 1 of the Vaccination Act, 1907. No. of Certificates of Insusceptibility or of having had Smallpox. No. of Cases No. of Entries in Lists sent to Public Vaccinator. Health of Child. Condition of House. Prevalence of Infectious Disease. Parents Removed out of District Otherwise not found. North 1,166 600 51 — — 469 5 30 18 321 Central 2,357 744 43 — — 1,006 6 443 34 473 South-East 1,719 512 28 — — 830 2 58 46 584 South-West 1,417 596 33 — — 619 3 9 22 550 Total 6,659 2,452 155 — — 2,924 16 540 120 1,928 28 Scarlet Fever or Scarlatina.—The number of cases of scarlet fever notified during 1920 was 1,085, but of these eight were found afterwards not to be suffering from this disease, thus the number of genuine cases was reduced to 1,077. This is an increase of 433 cases upon the number of genuine cases notified during 1919. The disease was normal during the first eight months of the year, and rose after the school holidays, in September, and the incidence of the disease remained high during the remainder of the year. The attack rate for scarlet fever was 4.7 per 1,000 persons living. The number of cases removed to hospital during the year was 984. This is equal to 91 per cent. of the total notified. The following table shows the distribution of scarlet fever in the respective Sub-districts of the Borough:— Sub-districts. North. Central. South-west. South-east. Number of cases of Scarlet Fever 257 354 218 248 Attack-rate per 1,000 living 4.6 6.4 3.7 4.3 It will be seen from the above that scarlet fever was most prevalent in the Central Sub-district. The deaths from scarlet fever during 1920 numbered 6, which is equal to a case mortality of 0.55 per cent. attacked, and a scarlet fever death rate of 0.026 per 1,000 inhabitants. The mortality rate for London from scarlet fever during the same year was 0.05 per 1,000 inhabitants. Diphtheria and Membranous Croup.—There were 774 cases of diphtheria and 10 cases of membranous croup notified during the year ; but of these 20 cases of diphtheria were found subsequently 29 not to be suffering from this disease, thus the total of genuine cases of diphtheritic disease was reduced to 764. This is an increase of 95 upon the number of genuine cases notified during 1919. The incidence of the disease was above the normal at the beginning of the year and remained so during the first four months; the disease was normal during the months of June, July and August, but rose after the school holidays and remained somewhat high during the remainder of the year. The Asylums Board were pressed for accommodation during October and November, but it is very gratifying to record that the Board provided accommodation in nearly every instance of cases of a severe type when application was made from the office. Where cases could not be removed immediately, the medical attendant was advised to administer the maximum dose of anti-toxin in accordance with the recommendations contained in a memorandum circulated by the Asylums Board during times of pressure. The attack rate for diphtheria was 3.38 per 1,000 inhabitants. There were 702 cases removed to hospital during the year. This is equal to 94 per cent. of the cases notified. The following table shows the distribution of diphtheria in the respective Sub-districts of the Borough:— Sub-districts. North. Central. South-west. South-east. Number of cases of Diphtheria and Membranous Croup 129 196 265 174 Attack-rate per 1,000 living 2.3 3.5 4.6 3.0 From the above it will be seen that diphtheritic disease was more acute in the Central and South-Western Sub-districts of the Borough than in the Northern and South-Eastern Sub-districts. 30 The deaths from diphtheria and membranous croup during the year numbered 70. This mortality is equal to a death-rate of 9.1 per cent. attacked and 0.31 per 1,000 inhabitants. The death rate from diphtheria for London during the same period is 0.22 per 1,000 inhabitants. During the year 654 swabbings from throats of persons suspected to be suffering from diphtheria were bacteriologically examined, of which 194 gave positive results, 435 negative results, and 5 were returned as doubtful. Diphtheria Anti-toxin.—In accordance with the Anti-toxin Order of 1910, a supply of diphtheria anti-toxin was provided during the year, and issued as required to medical practitioners applying for it in cases of diphtheria or suspected cases of diphtheria amongst the poorer inhabitants of the Borough. During the year 82 bottles of anti-toxin of 2,000 units each were supplied to medical practitioners, most of which was used for prophylactic purposes. Typhoid or Enteric Fever.—During the year under consideration, 14 cases of enteric fever were notified. This shows a decrease of 8 on the number of genuine cases notified during 1919. The attack rate was 0.06 per 1,000 inhabitants. Of the 14 cases notified, 11 were removed to hospital. This is equal to 78 per cent. of the total notified. The table below gives the distribution of the notified cases in the Sub-districts of the Borough:— Sub-districts. North. Central. South-west. South-east. Number of cases of Typhoid Fever 4 4 3 3 31 The deaths from enteric fever in the Borough last year numbered 1. This is equal to a mortality rate of 7.1 per cent. attacked. During 1920 specimens of blood from 41 persons suspected to be suffering from enteric fever were submitted to Widal's test. Of these, 10 gave a positive and 31 a negative reaction. The mortality from enteric fever for the same period in London was .01 per 1,000 inhabitants. Continued Fever.—There were no notifications of continued fever in the Borough during the year. Typhus Fever.—There was not any notification of typhus fever in the Borough during the year. Puerperal Fever.—There were 23 cases of puerperal fever notified during 1920; 19 cases were removed to hospital. The deaths from puerperal fever and septicaemia numbered 13. The attack-rate for the year was 3.8 per 1,000 births, and the deathrate 2.1 per 1,000 births. Plague.—There was not any plague in the Borough during the year. Erysipelas.—There were 120 cases of erysipelas notified during 1920. This is equal to an attack-rate of 0.5 per 1,000 inhabitants. Of the 120 cases notified, 47 were removed to hospital. The deaths from erysipelas numbered 16. This gives a mortality-rate of 13.3 per cent. attacked, and of .07 per 1,000 inhabitants. 32 The following table shows the distribution of the disease in the Sub-districts of the Borough Sub-districts. North. Central. South-west. South-east. Number of cases of Erysipelas 25 32 27 36 Rate per 1,000 living .45 .57 .47 .63 Cerebro-spinal Meningitis.—During 1920 there were 7 cases of this disease notified in the Borough. Of these 5 were removed to hospital. All the cases notified were fatal. Polio-myelitis.—There was not any notification of poliomyelitis in the Borough during the year. Ophthalmia Neonatorum.—There were 33 cases of this disease notified during the year. 3 of these were removed to hospital. All the cases recovered without any impairment of sight, with the exception of one case where a scar of an ulcer on both of pupils remained. Measles and German Measles.—The Public Health (Measles and German Measles) Regulations, 1915, were withdrawn by Order in Council on 31st December, 1919. Seventy-nine deaths were recorded from this disease. The annual mortality is therefore .35 per 1,000 inhabitants, compared with London .22 per 1,000 inhabitants. Information of 2,481 cases of measles and of 2 German measles was received from headmasters of elementary schools in the Borough. Many of the cases were visited by the Health Visitors, and parents advised (in the event of no medical attendant) as to isolation and Nursing. When the nursing was considered inadequate a nurse was provided at the expense of the Council through the King's Home for Nurses. 33 Encephalitis Lethargica.—The Public Health (Acute Encephalitis Lethargica and Acute Polio Encephalitis) Regulations, 1918, came into operation on 1st January, 1919. During the year 1920 10 cases were notified, of which number 5 were fatal. Eight of the patients were removed to hospital. The Ministry of Health and the London County Council were in the majority of cases supplied with full histories of the course of each patient's illness, but in several instances the medical practitioners in attendance on cases certified by them definitely refused to furnish the details desired upon the grounds that there was no statutory obligation cast upon them to do so and no fees were paid to them for writing the reports. In view of the great importance of collecting as much information as possible relating to this obscure disease, the withholding of details as to symptoms, etc., is to be regretted; it ought to be obtained, and to be paid for. Influenzal Pneumonia and Pneumonia.—There were 42 cases of influenzal pneumonia and 55 of primary pneumonia notified. As provided in the Regulations, where the nursing was found to be inadequate a nurse was sent from the King's Home for Nurses in accordance with an arrangement made with the Superintendent at a fee of 1s. 3d. per visit. During the year 969 visits were so made at a cost to the Council of £61 1s. 3d. Influenza, unless complicated by pneumonia, is not notifiable. Malaria.—The total number of cases of malaria certified was 21, all of which, it was ascertained upon enquiry, had been contracted out of England. Dysentery.—There were 7 cases of dysentery certified, all being contracted abroad ; 3 deaths were registered. c 34 Anthrax.—One notification of anthrax was received during the year. The patient worked for a firm of tanners in Bermondsey. Shortly before he fell ill he noticed a pimple on his neck, and subsequently a swelling, and he consulted bis medical attendant, who sent him to the London Hospital, where he was detained, The patient had been engaged on transferring East Indian hides from water to the lime pits; at that time his employers were dealing with out 1,000 hides a day. Formerly hides from China were also imported; but fearing importation of anthrax, the firm abandoned the China skins, and it was a great surprise to them when this case occurred in connection with East India skins. These skins are not in such a cleanly condition as hides obtained from Java. The East India hides arrive in a thoroughly dried state and consist of two kinds, viz., those dried and treated with arsenic, and those dried and salted—just common salt—as much as the hides can take. The firm was not acquainted with any instance among their employees of symptoms of arsenical poisoning. The patient remained under treatment at the London Hospital and eventually recovered. LONDON (NOTIFICATION OF GLANDERS) ORDER, 1907. One notification of glanders in animals in the Borough was received from the Veterinary Inspectors of the London County Council during 1920. NON-NOTIFIABLE INFECTIOUS DISEASES. Influenza.—During 1920 there were 85 deaths in the Borough. This is a decline of 80 on the deaths from this cause registered during 1919. The annual mortality rate from influenza is 0.37 per 1,000 inhabitants. Influenza, unless complicated by pneumonia, is not notifiable. 35 Diarrhœa.—There was a slight decrease in the number of deaths due to diarrhœal disease in the Borough during 1920. The total number of deaths from this cause was 34, and of these 28 were under 1 year of age. The annual mortality for diarrhoea and enteritis during the year is 0.15 per 1,000 inhabitants. The distribution of this disease in the Borough may be seen from the following table:— Sub-districts. North Central. South-west. South-east. No. of deaths from diarrhoea and enteritis 3 9 6 16 Whooping Cough.—The deaths from this cause during the year numbered 56. This is an increase of 40 upon the number registered during 1919. No less than 27 of the deaths occurred in children under five years of age. The mortality for Hackney is equal to .17 per 1,000 inhabitants, and that for all London, T6 per 1,000 inhabitants. One case was removed to the Metropolitan Asylums Board's Hospitals. Information was received from the head masters and head mistresses of elementary schools in Hackney of 118 cases of whooping cough occurring among their scholars during the year. c2 36 TABLE II—HACKNEY BOROUGH. Cases of Infectious Disease Notified during the Year 1920. Notifiable Disease. Cases Notified in whole Districts. Total Cases Notified in each Locality. Total cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. North. Central. South-East. South-West. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax 1 ... ... ... ... 1 ... ... 1 ... ... ... 1 Diphtheria (including Membranous Croup) 764 23 185 417 89 44 6 ... 129 196 174 265 702 Erysipelas 120 5 3 10 10 32 50 10 25 32 36 27 47 Scarlet Fever 1,077 10 189 748 83 45 2 ... 257 354 248 218 984 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 14 ... ... 1 1 6 6 ... 4 4 3 3 11 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 23 ... ... ... 4 19 ... ... 4 6 7 6 19 Cerebro-Spinal Meningitis 7 3 3 1 ... ... ... ... 1 3 1 2 4 Polio Myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 33 33 ... ... ... ... ... ... 5 8 9 11 3 Pulmonary Tuberculosis 410 1 4 45 87 183 83 7 74 78 126 132 259 Other forms of Tuberculosis 139 5 19 74 22 14 3 2 16 29 44 50 46 Encephalitis Lethargica 10 ... ... 1 3 3 3 ... 5 1 3 1 8 Influnezal Pneumonia 42 1 1 2 5 26 5 2 12 5 4 21 8 Pneumonia 55 3 12 15 4 9 11 1 12 8 27 8 10 Malaria 21 ... ... ... 4 17 ... ... 6 7 4 4 3 Dysentery 7 ... ... ... 2 5 ... ... 4 1 1 1 1 Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 2,723 84 416 1,314 314 404 169 22 555 732 687 749 2,106 37 CONSTITUTIONAL DISEASES. For table of Deaths, see pages 104-112. Cancer.—There were 246 deaths during 1920 due to the different varieties of malignant disease. This is an increase of 28 on the number registered during 1919. The annual mortality rate from malignant disease for last year is therefore 1.09 per 1,000 inhabitants. The following table gives the distribution of the deaths from this disease in the different sub-districts of the Borough :— Sub-districts. North. Central. South-West. South-East. No. of Deaths from Cancerous Disease. 72 50 71 53 Mortality-rate per 1,000 inhabitants. 1.3 0.9 1.2 1.9 Below is given a table showing the number of deaths and death rates due to malignant disease in this Borough for the 10 years ending 1920:— Borough of Hackney. Years. 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Deaths from Cancer. 217 213 250 256 276 245 230 236 274 246 Death-rate per 1,000. .97 .95 1.11 1.14 1.26 1.16 1.17 1.07 1.26 1.09 London. Death-rate per 1,000. 1.05 1.11 1.10 1.13 1.16 1.18 1.25 1.26 1.20 1.20 ALCOHOLISM Alcoholism.—During the year under consideration there were no deaths from acute alcoholic poisoning ; there were, however, 8 38 deaths registered as due to cirrhosis of the liver, a condition regarded, as a rule, to be due to excessive indulgence in alcohol, extending over lengthy periods. TUBERCULOSIS. During 1920, 549 primary notifications of tuberculosis were received, details of which are given on page 40 of this Report. Bacteriological examination of sputa from 290 cases was made by the Council's Bacteriologist during the same period. In 52 of these examinations the specific organism of the disease was discovered, and in the remainder the result was negative. The number of deaths from tuberculous disease in Hackney during 1920, was 249, a decrease of 22 upon the deaths during 1919. These deaths are classified as follows:— Tuberculous phthisis 176 Phthisis 14 General tuberculosis16 Tuberculous meningitis 25 Tuberculous peritonitis 4 Tabes mesenterica 1 Tubercle of other organs 13 249 This number of deaths gives an annual mortality of 1.1 per 1,000 inhabitants. In the following table the yearly deaths from tuberculous disease in the Borough for the last 22 years are shown, grouped in periods of three years:— Three year periods Annual average number of deaths from Tuberculous Disease. Percentage decrease on the period 1898-1900. Per cent. 1898-1900 483 — 1901-1903 452 6.4 1904-1906 417 13.7 1907-1909 382 21.0 1910-1912 363 24.8 1913-1915 360 25.4 1916-1918 363 24.8 1919-1920 260 44.7 39 It will be seen from this that the average annual number of deaths from tuberculosis has progressively decreased during the period in question, the decline from the period 1898-1900 to 1920, being equal to 44.7. There is good reason to believe that the Borough Council's Tuberculosis Scheme is doing valuable work. The deaths are distributed in the sub-districts of the Borough as shown below:— Sub-districts. North. Central. South-West. South-East. No. of deaths from Tuberculous Disease 40 56 79 74 Mortality rate per 1,000 inhabitants .72 1.0 1.3 1.3 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Under these Regulations 948 notifications of tuberculosis were received during the year, of which 766 were pulmonary and 182 non-pulmonary notifications. 40 The following table gives the age and sex distribution of the notified cases:— Summary of Notifications during the period from the 5th January, 1920, to the 1st January, 1921. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications. Pulmonary Males 1 — 10 10 15 25 57 46 35 18 5 222 258 „ Females — 4 5 8 16 31 47 33 22 8 2 176 224 Non-pulmonary Males 3 13 23 16 10 5 4 2 2 — — 78 83 „ „ Females 2 6 11 15 5 2 3 5 — 1 2 52 58 Age-periods Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form B. Poor Law Institutions. Sanatoria. Under 5 5 to 10 10 to 15 Total Primary Notifications. Pulmonary Males — 2 4 6 8 7 155 „ Females — 3 3 6 7 18 89 Non-pulmonary Males — 3 — 3 4 1 13 „ „ Females — 4 2 6 8 1 14 41 VISITS PAID BY TUBERCULOSIS VISITORS. New Cases. Contacts. Soldiers and Sailors. Other Persons. Total. Insured. Noninsured. Miss Servant 235 71 556 1,779 2,641 1,449 1,192 Miss Clarke 238 116 514 1,426 2,294 1,043 1,251 Miss N. Priddle* 97 33 244 1,113 1,487 669 818 570 220 1,314 4,318 6,422 3,161 3,261 * This Health Visitor resigned her appointment in October. 1920. DISCHARGED TUBERCULOUS SOLDIERS AND SAILORS. Arrangements were made at the commencement of 1919 with the Ministry of Pensions for the home visiting and after care of discharged soldiers and sailors suffering from tuberculosis. The Tuberculosis Health Visitors visit the homes of these patients and advise them of any alterations which they deem desirable in the sleeping accommodation, sanitary conditions, cleanliness, etc., and also encourage them to carry out the instructions of the doctor in attendance, or the Tuberculosis Officer, as to their mode of living. During the year the number of discharged men visited was 475, and the total number of visits of this kind made was 1,314. The proportion of the number of visits of such cases to the total number of visits made by Tuberculosis Health Visitors to tuberculous cases in the Borough was as one is to three. TREATMENT OF TUBERCULOSIS. The scheme for providing dispensary treatment for tuberculous persons in London is set out in the Circular letter of the Local Government Board, dated 19th December, 1913. 42 The expenditure of the Borough Council on their dispensary scheme, after deducting the payment made by the Insurance Committee in respect of the treatment of insured persons or any other contribution, being made as follows:— (а) 50 per cent. from the Board (now the Ministry of Health). (b) 25 „ „ the London County Council. (c) 25 „ out of the rates of the Borough. The functions of the Insurance Committee as regards the provision of treatment for insured persons are shortly to be transferred to the London County Council both in respect to the dispensaries and the provision of sanatorium treatment, so that the London County Council will be entirely responsible for the provision of sanatorium treatment and partly responsible for the provision of dispensary treatment, although the direct responsibility for providing the dispensaries is laid upon the Borough Council. The Council has entered, as previously reported, into contracts for the provision of treatment for tuberculosis with the Metropolitan and City of London Hospitals; the Boroughs of Bethnal Green and Stoke Newington also contracting with these institutions for the part use of the dispensary services. It is evident that the difficulty of dealing with a problem so complicated as the best means of preventing and treating tuberculosis, admittedly one of the most difficult of the problems with which the Public Health service is called upon to deal at the present time, is not lessened by the fact that in order to make any improvement in the arrangements for the treatment of tuberculous patients living in one section of the Borough, the following authorities have to arrive at an agreement:— Hackney Borough Council, Stoke Newington Borough Council, Ministry of Health, London County Council, Metropolitan Hospital Management Committee. 43 while in order to make any alterations in the arrangements for the treatment of patients living in the remaining portions of the Borough, the following authorities have to arrive at an agreement:— Hackney Borough Council, Bethnal Green Borough Council, Ministry of Health, London County Council, Victoria Park Hospital Management Committee. The problem, moreover, is not rendered less difficult by the fact that the real control of the dispensaries giving the treatment which the Borough has been directed to provide, is vested in authorities entirely unconnected with the Council, and it should also be borne in mind that the three Tuberculosis Officers appointed at the two dispensaries are required to carry out the treatment of tuberculosis in three Metropolitan Boroughs containing in 1919 a total population of 386,813, with 547 deaths from tuberculosis and with 1,019 primary cases of tuberculosis during the year. The actual treatment of patients at the dispensaries has been most ably and carefully carried out, and the immense amount of useful work done is tabulated in the reports of the medical officers attached to the dispensaries. There are, however, two directions in which anti-tuberculosis work should be extended, not only in Hackney, but generally throughout London. These particular requirements are that after-care of persons returned from sanatorium should be efficiently dealt with in order that the money expended upon "cure" should not be wasted, and that efficient means should be taken for preventing the spread of infection by advanced cases, admittedly the principal source of infection. 44 The Interim Report of the Departmental Committee on Tuberculosis states that "In a general way the efficiency of the Tuberculosis Dispensary should be to serve as (1) Receiving House and Centre of Diagnosis ; (2) Clearing House and Centre of Observation; (3) Centre for Curative Treatment ; (4) Centre for the examination of Contacts; (5) Centre for "after-care " ; (6) Information Bureau and Educational Centre. The reports of the medical officers of the dispensaries show the increasing extent to which the dispensaries are carrying out the first three functions, and as regards the examination of contacts the following figures show the number of these examinations; moreover there is evidence that the percentage examined is steadily increasing. During 1920, 549 primary cases were notified, and the contacts to these cases number in all 1,667 persons, and of these 566 contacts were examined making the number examined slightly over 33 per cent. As one must bear in mind that adult contacts generally refuse examination unless in ill-health, under the circumstances already recorded, this percentage is very fair. During the year 1920, 249 deaths were registered—199 pulmonary and 50 non-pulmonary; but of these 33 pulmonary and 18 non-pulmonary were not originally notified under the regulations and enquiries as to contacts could not be made in these cases; this, however, is a matter requiring, and receiving, attention. Of the remaining 166 pulmonary deaths, there were 467 contacts of which 262 were examined, representing 56 per cent. examined; and of the 32 non-pulmonary deaths there were 87 contacts of which 39 were examined, representing 44 per cent. examined. 45 DISPENSARY DISTRICTS. Estimated Population in Electoral Wards. Metropolitan Hospital Area— Stamford Hill 33,233 West Hackney 19,275 Kingsland 23,357 Downs 17,307 93,172 Estimated Population (1920)— Borough of Stoke Newington 52,984 146,156 Victoria Park Hospital Area— Clapton Park 43,028 Homerton 37,714 South Hackney 23,476 Hackney 28,152 132,370 Estimated Population (1920)— Borough of Bethnal Green 114,471 246,841 392,997 Estimated Population (1920) Hackney 225,542 46 Wards. Notifications—Forms A & B. Deaths. Notifications and Deaths (Hackney). Pulmonary Nonpulmonary. Total. Attack rate per 1,000 living. Pulmonary Nonpulmonary. Total. Deathrate. Metropolitan Hospital Area. Stamford Hill 35 6 41 1.2 13 5 18 0.54 West Hackney 49 16 65 3.3 16 3 19 0.98 Kingsland 69 20 89 3.7 29 6 35 1.5 Downs 25 3 28 1.6 16 1 17 0.98 Total 178 45 223 2.4 74 15 89 0.95 Victoria Park Hospital Area. Clapton Park 67 32 99 2.3 38 16 54 1.25 Homerton 70 25 95 2.5 29 10 39 1.03 South Hackney 50 21 71 3.0 22 7 29 1.23 Hackney 45 16 61 2.1 27 11 38 1.35 Totals 232 94 326 2.4 116 44 160 1.2 Totals for Borough 410 139 549 2.4 190 59 249 1.1 47 After Care.—Practically no steps have been taken as regards after-care of tuberculous patients returned from sanatorium with the exception of the steps taken by the Hackney and Stoke Newington Care Committee in the direction of imploring the assistance of voluntary and charitable organisations, as the machinery and means for providing adequately for necessary expenditure does not exist. Much useful work as regards arranging sanatorium treatment and collecting payments from the parents of children granted sanatorium treatment by the London County Council has been carried by the Committee, which is thoroughly in touch with the tuberculosis work of the Borough. Advanced Cases.—The following table shows the place of death of Hackney inhabitants, and it is apparent from this table what a large proportion of deaths occur in the patients' homes. Place where death occurred. Phthisis and Pulmonary Tuberculosis. Other forms of Tuberculosis. Totals. At Patient's Homes 90 21 1ll At Hackney Infirmary 37 22 59 At other Institutions 63 16 79 190 59 249 It should be remembered that the deaths which occur in institutions cannot be considered to represent a number of persons who were prevented while in an advanced stage from spreading infection, as, at least, the majority of these persons have been treated on several occasions in the Infirmary and similar institutions, entering and leaving while in an infective condition, before death occurred. The result of this is placed on record in the Final Report of the Departmental Committee on Tuberculosis: 48 "Infection is frequently disseminated by persons suffering from advanced pulmonary tuberculosis who are in the habit of entering and leaving Poor Law Institutions, having regard merely to their own convenience, and not to the interests of their family or of the community in which they live." DAY SANATORIUM (OPEN AIR SCHOOL) FOR TUBERCULOUS CHILDREN. The work of the Stormont House School, which was opened by the London County Council on 8th September, 1919, is of increasing value to the tuberculosis service. The number of children on the register is now 83, as compared with 35 at the end of 1919. Dr. Howell, Tuberculosis Officer to the City of London Hospital Tuberculosis Dispensary is responsible for the medical care of the children, and visits the School once weekly. CITY OF LONDON HOSPITAL TUBERCULOSIS DISPENSARY. (Dr. Howell.) HACKNEY CASES TREATED. 1.— The Totals of New Cases. Males 437 Females 448 Total 885 2.—The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 176 92 Local Practitioners 131 56 London War Pensions Committee 45 16 Contact cases 435 18 London Insurance Committee 31 18 London County Council 22 9 Victoria Park Hospital 22 20 Other sources 23 14 49 3.— The Diagnosis of the New Cases. Diagnosis. Insured. Uninsured. Total. Males. Females. Children under 16. Males. Females. Pulmonary Tuberculosis 77 33 15 13 41 179 Non-pulmonary Tuberculosis 10 6 43 0 5 64 Non-tuberculous 121 81 302 14 86 604 Doubtful 16 4 13 I 4 38 Total 224 124 373 28 136 885 4.—The Diagnosis of Contact Cases. Pulmonary tuberculosis 9 Non-pulmonary tuberculosis 9 Non-tuberculous 404 Doubtful 13 Total 435 5.—Sputum Examinations of Insured and Uninsured Patients. Insured. Uninsured. Total. Tubercle Bacilli present 83 23 106 Tubercle Bacilli absent 398 175 573 50 6.—Other Figures. Insured. Uninsured. Total number of attendances 4,147 4,169 Systematic examinations at the above 1,070 1,154 Number of letters written 1,844 Number of visits to patients at their homes 44 29 Number of patients sent to hospital or sanatorium 147 43 Number of patients referred to:— X-ray Department 55 37 Other Departments 30 20 METROPOLITAN HOSPITAL TUBERCULOSIS DISPENSARY. (Dr. L. U. Young.) Hackney Cases Treated. TABLE I. Return showing the Result of the Examination of Persons for the purpose of Diagnosis. Original cases found pulmonary tuberculosis 137 Contact cases found pulmonary tuberculosis 3 140 Original cases found non-pulmonary tuberculosis 22 Contact cases found non-pulmonary tuberculosis 13 35 Original cases found doubtful 31 Contact cases found doubtful 21 52 Original cases found not tubercular 33 Contact cases found not tubercular 188 221 Total new cases 448 51 TABLE II. Classification and Detailed, Statistics of Attendances, etc. Insured Persons. Male. Insured Persons. Female. Uninsured Persons. Male. Uninsured Persons. Female. Contacts. Total. Male. Female. I. U. I. U. New Patients attending 88 38 38 53 18 61 21 125 442 Attendances of Old Patients 1,213 420 454 660 42 275 98 355 3,517 Home Consultations 8 1 3 8 3 — 4 — (new) (old) 6 + 21 = 27 Sputum Examined 130 32 26 57 2 2 6 11 266 d2 52 DISINFECTION. (a) Rooms.—During 1920, there were 2,642 rooms fumigated and 577 rooms cleansed in the Borough by the staff of the Public Health Department. In these totals are included disinfections after measles, whooping cough and tuberculosis, in addition to those in connection with the present notifiable infectious diseases. The number of rooms fumigated and cleansed each month is set out in the following table:— Number of rooms fumigated and cleansed each month during 1920. Month. Rooms fumigated Rooms cleansed. January 228 48 February 182 30 March 239 30 April 155 28 May 160 29 June 168 37 July 156 29 August 150 36 September 239 40 October 347 64 November 349 97 December 269 109 Total 2,642 577 (b) Articles of Clothing, Furniture, etc.—The number of articles under this head disinfected during last year was 14,548. This is an increase of 1,419 upon the number disinfected during 1919. A table is here given showing details of the articles disinfected each month. 53 Articles Disinfected, 1920. Description of Articles. January. February. March. April. May. June. July August. September. October. November. December. Total. House linen and furniture 1,242 932 1,132 789 820 857 844 672 1,204 1,486 1,240 1,458 12,676 Men's clothing 8 1 ... ... ... ... 3 2 5 3 1 ... 23 Women's clothing ... 3 2 ... 3 4 13 9 8 6 ... ... 48 Children's clothing ... ... ... 2 ... ... 1 2 2 ... ... ... 7 Other articles 154 175 167 155 96 92 75 120 199 172 200 189 1,794 Total 1,404 1,111 1,301 946 919 953 936 805 1,418 1,667 1,441 1,647 14,548 54 In addition to these, there were 39 articles destroyed on request from the owners. These are set out in the following table:— Articles Destroyed. Beds 12 Pillows 6 Bolsters .1 Sundry articles 8 Mattresses 12 To t al 39 (c) Public Library Books.—During the past year 531 books from homes in which infectious diseases had occurred were disinfected. The method of disinfection of books practised is to expose the books in a closed chamber to the action of formic aldehyde gas, which is generated in a lamp from formalin tablets. Books Disinfected. Month. Number. January 52 February 30 March 14 April 23 May 26 June 21 July 27 August 14 September 53 October 71 November 135 December 65 531 55 ISOLATION SHELTER. During the year there were 32 persons admitted to the Shelter whilst their homes were being disinfected. This total consisted of 10 men, 13 women and 9 children. The cost of maintenance of these persons admitted was £7 1s. 6d , CLEANSING OF PERSONS ACT, 1897. The baths provided by the Borough Council under the above Act for the cleansing of verminous persons, were in constant use during last year. 190 adults and 2,410 children received baths and the number of baths given during that period was 7,780. This total shows an increase of 4,356 upon the number given during 1919. Of the 7,780 baths given, 6,521 were sulphur baths for scabies, and 1,259 for pediculi. The great majority of those persons presenting themselves for baths were children from the elementary schools in the Borough. These children received 7,128 baths, an increase of 3,935 upon the number given during 1919. The following are the Schools from which children were sent to the Cleansing Station, with the number of baths given:— Schools. Number Cleansed. Hot Baths. Sulphur Baths. Ballance Road, R.C 7 4 Benthal Road 33 119 Berkshire Road 43 516 Berger Road 31 199 Bay Street — 9 Cassland Road 1 41 Church Street 8 220 College Lane — 56 Craven Park 3 — Dalston Central — 1 Daubeney Road 209 197 Detmold Road 121 112 Carried forward 456 1,474 56 Schools. Number Cleansed. Hot Baths. Sulphur Baths. Brought forward 456 1,474 Eleanor Road — 67 Enfield Road 4 53 Gainsborough Road — 6 Gayhurst Road 20 60 Glyn Road 44 148 Gopsall Street — 37 Hackney Parochial 61 14 Haggerston Road 1 167 High Street — 95 Holy Trinity 2 51 Homerton Row 69 457 Lamb Lane 22 — Laura Place — 1 Lauriston Road — 13 London Fields — 11 Mandeville Street 126 398 Morning Lane 49 173 Millfields Road 6 170 Newington Green 1 195 Northwold Road 33 5 Oldfield Road — 31 Orchard Street 76 127 Percy Road 27 — Princess May Road — 324 Paragon Road — 3 Queen's Road - 35 Rushmore Road 55 94 St. James' — 10 St. John the Baptist 7 109 St. Joseph's 2 7 Carried forward 1,061 4,335 57 Number Cleansed Brought forward Hot Baths. Sulphur Baths. 1,061 4,335 St. Jude's — 100 St. Matthias 2 205 St. Michael's — 8 St. Paul's — 66 St. Scholastica's — 73 Shacklewell — 143 Sidney Road 168 89 Sigdon Road 7 95 Tottenham Road 2 107 Wilton Road 5 222 Wordsworth Road — 92 Other young children — 348 1,245 5,883 58 The following table gives particulars of the number, etc., of persons who were bathed and cleansed for parasitic disease at the Disinfecting Station during the year. January. February. March. April. May. June. July. August. September. October. November. December. Totals. Receiving Hot Baths. Men 1 1 1 ... ... 1 2 ... 1 2 1 ... 10 Women ... ... ... ... ... ... 2 ... ... 2 ... ... 4 Children 29 81 78 47 32 108 146 17 285 190 160 72 1245 Receiving Sulphur Baths. Men 28 34 71 38 26 30 44 30 36 20 9 20 386 Women 17 17 38 25 27 22 14 24 22 23 8 15 252 Children 563 587 803 522 495 537 431 343 409 447 373 373 5883 59 MATERNITY AND CHILD WELFARE. The work carried out during 1920 can be conveniently reported under the following descriptive titles:— 1. General Organisation; 2. Health Visiting; 3. Consultation and Ante-natal Clinics; 4. Contributions to Maternity Hospitals providing Midwifery assistance to necessitous mothers; 5. Provision of milk and other foods to necessitous mothers and children. 1. General Organisation. The Borough is divided for health visiting purposes into 11 districts, each of the voluntary organisations of the district—Eton Mission and Hackney Grove Centres—being allotted a district, the remaining nine districts being allotted to health visitors on the Public Health Department staff. Eton Mission and Hackney Grove conduct consultation clinics but not ante-natal clinics, the two ante-natal clinics in the Borough being municipal, and there are, in addition, three municipal infant consultation clinics; giving a total of five consultation clinics, municipal and voluntary, and two municipal ante-natal clinics for the 11 districts of the Borough. The voluntary organisations appoint and control their own staff, both medical and health visiting, but the Maternity and Child Welfare Committee is represented on the Executive Committees of these institutions, and the work is carried on in the closest cooperation and co-ordination with the municipal maternity and child welfare work. The municipal consultation centres are staffed and administered through the Public Health Department. Part-time (temporary, i.e., not on the permanent staff) medical officers have been appointed to conduct the work of the 60 tion centres, the duties of medical officers having been arranged as follows:— 1. Attend the centre one afternoon per week. 2. To examine all infants brought to the centre, of parents living in the Borough. 3. To advise the parents as to the feeding and care of their infants. 4. Treat minor ailments in the infant when circumstances indicate the need for this. 5. To enter on a case paper to be provided for each infant, certain particulars, with notes on advice and treatment given, and the condition and progress of the infant. 6. To furnish monthly, a return to the Medical Officer of Health as to the number of infants seen and treated at the centre. N.B.—If the ailment of the infants is such as to necessitate continuous medical supervision and treatment, the medical officer must refer the case either to the usual medical attendant or to a hospital for children, such as the Queen's Hospital for Children, Hackney Road. The centre is not intended or fitted to take the place either of the general practitioner or the outpatient department of the hospitals. o Miss M. Chitson Mrs. A. Rhodes Miss K. Fisher MissD.F. Vidal Mrs. L. E. Bartholomew Miss A. Roche Mrs.E.A. Cowley Miss K. Teebay Mrs. L. Harrison Totals 2.—Health Visiting. The following table gives details of the visits made by the Council's Health Visitors during the year:— Number of visits to infants under 1 year of age 615 526 436 221 169 96 564 527 664 3,818 Number of visits to children 1-5 years of age 289 177 224 153 53 334 124 595 71 2,020 Number of secondary visits to infants and children 822 888 739 230 200 316 368 595 746 4,904 Total number of infants and children visited 1,726 1,591 1,399 604 422 746 1,056 1,717 1,481 10,742 Number of visits to Measles cases 70 172 190 - - - 97 117 90 736 Number of visits to Pneumonia cases 20 16 18 1 - 3 7 11 10 86 Number of visits to Ophthalmia Neonatorum cases 4 11 11 3 4 6 4 6 49 Number of special visits 324 286 235 92 149 114 319 353 108 1,980 Total number of visits paid during the year 2.144 2,076 1,853 700 575 863 1,485 2,202 1,695 13,593 Total number of Clinics attended during the year 121 111 151 37 33 24 122 93 110 62 Conditions found by the Visitors. No. of Infants visited. Method of Feeding. Separate cot provided for Infant. Use of Comforter. Home conditions. Secondary visits. Breast. Artificial. Mixed. Yes. No. Yes. No. Satisfac tory. Unsatis factory. 3,818 3,918 372 248 1,923 1,895 1,735 2,083 3,455 363 4,904 3.—Infant Consultation and Ante-natal Clinics. The increasing popularity of this work, which is undoubtedly due to the benefit obtained by the mothers and children, is shown by the fact that the total attendances at all the Centres exceeded those of 1919 by 11,854, and those under one year of age by 12,530, but the number of children over one year was 676 less, this being undoubtedly due to the fact that accommodation at the Centres is limited, so that attention is given primarily to infants, as advice is more urgently needed as regards feeding, etc., than is the case with the older children. (Infant Consultation.) 1—OVERBURY STREET (Dr. Elizabeth Wilks). Number of times Centre open 52 Number of primary cases brought to Centre 598 Repeated visits to Centre 5,068 Total attendances 5,666 Total attendances of infants under one year 4,396 Total attendances of children over one year 1,270 Dr. Wilks is of opinion that— (1) The greatest need is for dental treatment ; (2) More teaching should be provided for the mothers ; (3) More teaching should be given to elder girls from the schools, who might attend the Centre and gain knowledge of such skilled work as the bringing up of babies ; 63 (4) Greater attention should be given to training of parents in order that they may realise the importance of periodic examination of older children. (Ante-natal.) Number of times Centre opened 27 Number of expectant mothers attending 212 Number of repeated attendances at Centre 330 Number of visits to expectant mothers at their homes by the Health Visitors:— Number of cases 212 Number of visits 73 Dr. Wilks states that many cases of importance, in her opinion, would not have been seen by a doctor had the Centre not existed. Several cases of syphilis, tuberculosis and malformation were examined and received treatment. Dr. Wilks states that such cases and many other were of great interest, but the value of the Ante-natal Centre as an educational institution is, in her opinion of greater importance than the individual cases receiving relief; not by any means that the suffering and loss of life prevented should be under-estimated, but that the knowledge of mothercraft and the educational value in general of the information spread through the Centres is so far reaching that the importance of the work can hardly be over-estimated. 2.—BROOKSBY'S WALK (Dr. Reginald Brown). Number of times Centre open 52 Number of primary cases brought to Centre 736 Repeated visits to Centre 5,012 Total attendances 5,748 Total attendances of infants under one year 5,135 Total attendances of children over one year 613 64 Dr. Reginald Brown reports that every child is examined at its first attendance and on subsequent occasions as often as is necessary. In all 1,536 examinations were carried out. Dr. Brown states that several cases of unusual interest presented themselves during the year:— Two cases of congenital nystagmus: these were referred to Mr. Elmore Brewerton, F.R.C.S. at the Westminster Ophthalmic Hospital, who kindly wrote in regard to their condition: the mothers were advised in regard to their treatment. Two cases of mongolian imbecility: the mothers were advised about the future of these metally defective children. One case of congenital heart disease: the mother was advised about the matter and also in regard to the treatment of the child as it grew older. Two cases of congenital syphilis: these were sent to the I.ondon Hospital and were seen by Dr. Sequeira who wrote about them, had the diagnosis verified by the Wasserman test and undertook their treatment. Several doubtful cases of congenital syphilis were also examined at the same hospital but the results of the test were negative. One case of hydrocephalus: the mother was advised as to the nature of the condition. One case of tetany: this case was referred to the Queen's Hospital for Children and treated there, making a good recovery from a dangerous condition. Very many mothers were advised in regard to feeding their children. A large number of children also had their foreskins dilated and also a large number had their abdomens strapped to prevent or rather to cure umbilical hernia. 65 (Ante-natal Centre). Number of times Centre open 26 Number of expectant mothers attending 158 Number of repeated attendances at Centre 158 Number of visits to expectant mothers at their homes by the health visitors 51 Dr. Brown states that two cases requiring Caesarian section were discovered at the clinic. Both were operated upon, with the result that both made splendid recoveries with living children. Advice is given and medicines to suitable cases. Every woman is carefully measured and thorough examination carried out. Dr. Brown points out that the numbers are increasing rapidly. At the last attendance at the centre 24 expectant mothers presented themselves. 3.—MAYFIELD ROAD (Dr. J. H. Porter). Number of times Centre open 92 Number of primary cases brought to Centre 696 Repeated visits to Centre 4,881 Total attendances 5,577 Total attendances of infants under one year 4,621 Total attendances of children over one year 956 Dr. Porter states that a considerable number of cases arose in which hospital treatment was needed, and that sucn cases were referred to the Metropolitan Hospital. E 66 A considerable number of cases of middle ear disease were sent for treatment, and Dr. Porter states that in all probability without routine attendance at a centre the parents if they realised the need, for treatment at all, would often defer it indefinitely and lose the opportunity for cure presented by the earlier stages of the disease. Dr. Porter states that chronic middle ear disease is so common, so slow and difficult to cure, and attended by so many serious consequences that the opportuniry for its early recognition and treatment which occurs at these centres is worthy of special mention. *4.—HACKNEY MOTHERS' AND BABIES' WELCOME. (Dr. J. M. Laughton.) Number of times Centre open 102 Number of primary cases brought to the Centre 535 Repeated visits to Centre 5,804 Total attendances 6,339 Total attendances of infants under one year 5,811 Total attendances of children over 1 year 528 Dr. Laughton states that the work of the Hackney Mother's and Babies' Welfare Centre has been continued on the same lines as hitherto. The mothers have been instructed as to the best methods of feeding their infants, breast feeding being encouraged whenever possible, and bottle feeding has been regulated where it is necessary. Owing to the increase of unemployment towards the end of the year, many mothers suffered from insufficiency of milk supply and had to get assistance in the form of free milk. Only a few simple remedies, such as are required to improve the mothers' supply of milk, or to combat slight ailments like constipation or sickness, are used at the centre. Cases requiring medical attention were referred to their own medical attendant or in a few instances to hospital. • Voluntary Centre. 67 *5.—ETON MISSION (Dr. E. J. F. Moore). Number of times Centre open 99 Number of primary cases brought to Centre 280 Repeated visits to Centre 3,788 Total attendances 4,068 Total attendances of infants under one year 3,060 Total attendances of children over one year 1,008 Dr. Moore states that in the greatest number of cases advice is sought on account of failure of the infants to gain in weight, and this is often due to some remedial error in feeding, the result is satisfactory. The cases of most difficulty are those fed artificially. Breast feeding is encouraged, and in many instances where babies of two or three months had been almost weaned when first brought to the Centre, a return to entire breast feeding was effected in a few weeks under advice of a simple nature. Dried milk has been largely used, and with good results. The Superintendent gives short talks to the mothers each week on health matters. ♦ Voluntary Centre. e2 68 Summary of Centre Work. Infant Consultation Centres. Centre. No. of times Centre open. No. of primary cases brought to Centre. Repeated visits to Centre. Total attendances Total attendances of Infants under 1 year. Total attendance of children over 1 year. 1. Overbury Street 52 598 5,068 5,666 4,396 1,270 2. Brooksbys Walk 52 736 5,012 5,748 5,135 613 3. Mayfield Road 92 696 4,881 5,577 4,621 956 4. *Hackney Mothers' and Babies', Hackney Grove. 102 535 5,804 6,339 5,811 528 6.*Eton Mission, Gainsborough Road. 99 280 3,788 4,068 3,060 1,008 Total 397 2,845 24,553 27,398 23,023 4,375 *These are Voluntary Centres and are co-ordinated with the inlant wellare work in the Borough. The Hackney Mothers' and Babies' Welfare Centre receives an annual grant of £-00 from the Council and the Eton Mission Centre £50. Ante-natal Welfare Centres. Overbury Street Brooksby's Walk. dumber of times Centre opened 27 20 dumber of expectant mothers attending 212 158 dumber of repeated attendances at Centre 330 158 Total attendances 542 316 Number of visits to expectant mothers at their homes by the Health Visitors :— Number of cases 212 158 Number of visits 73 51 69 4.—Contributions to Maternity Hospitals providing Midwifery Assistance to Necessitous Mothers. The Council has agreed to contribute towards the general expenses of the City of London Maternity Hospital and the Salvation Army Mothers' Hospital the sum of one guinea in respect of each necessitous case admitted from the Borough for treatment at either of these institutions. A necessitous case being considered a patient who by reason of poverty or other causes is unable to pav, for the treatment received, an amount equal to one-ha'f the average cost per patient of the maintenance and administration charges for the year ended December 31st, 1918. Necessitons Cases. Cases. Cost. £ s. d. Salvation Army Mothers' Hospital 72 75 12 0 City of London Lying-in-Hospital 89 93 9 0 Cases 61 £169 1 0 5.—Provision of Milk and other Foods to Necessitous Mothers and Children. Milk (Mothers and Children) Order, 1919. Local Authorities Milk (Mothers and Children) Order, 1919. The two Orders re-enacted the Milk (Mothers and Children) Order, 1918, and the Local Authorities (Food Control) Order (No. 1), 1918, with the following modifications:— (1) The Orders relate to milk only and not to food. (Powers with regard to food will be found in M.C.W. 4 under the Maternity and Child Welfare Act.) (2) The power of the Local Government Board to require local authorities to make arrangements for the supply of milk is omitted. (3) Local authorities are empowered to supply milk free, or at less than cost price, not merely in necessitous cases, but also 70 where such supply is necessary because of the retail price of milk in any area. (4) The maximum quantity to be supplied is prescribed— (а) Children under 18 months—1½ pints daily ; (б) Children between 18 months and five years—1 pint daily (c) Expectant and nursing mothers—the quantity prescribed by the doctor. The scale set out below was adopted by the Council during 1919 :— Families with an incomc of 10s. and upwards per head—No allowance. „ „ „ 9s. to 10s. To pay 75% „ „ „ 8s. to 9s. „ 50 „ „ „ „ 7s. to 8s. „ 25 „ „ „ „ Under 7s. Given free. Daring the year it was found desirable to discontinue the practice of granting milk direct from the Centres, and all recommendations are now dealt with through the Health Department. Milk supplied free of cost to necessitous cases involved the Council in an expenditure of £2,044 12s. 1d. Dried Milks, Foods, Medicines, etc. (a) Supplied free of charge to necessitous mothers— £ s. d. Glaxo 354 9 9 Cow and Gate 33 1 6 Virol 16 1 0 Marylebone Cream 6 18 6 Cod Liver Oil and Malt 2 15 0 Sundries 4 8 4 £417 14 1 71 (b) Supplied at cost price— £ s. d. Glaxo 2,473 10 3 Cow and Gate 240 2 6 Mellins' Food 3 12 0 Virol 117 15 0 Sugar 11 11 3 Lactagol 33 4 8 Marylebone Cream 34 6 6 Petroleum Emulsion 31 7 4 Syrup Ferri 14 8 2 Malt 2 11 6 Cod Liver Oil and Malt 25 2 0 Sundries 88 17 6 £3,076 8 8 HOUSING AND WORK OF SANITARY INSPECTION. Housing Scheme. Considerable progress has been made during the year as regards the provision by the Council of the additional housing accommodation needed in the Borough. 1. Conversion into Tenements. Nine houses have been purchased by the Council and converted. Three of these houses being let to 3 families and the remainder to 2 families each, accommodation being thus provided for 21 families altogether. Nine Army huts have been purchased as a temporary measure, and converted into 12 tenements. 2. Erection of Cottages. The Council have adopted a scheme for the erection of 80 cottages in Casimer, Cleveleys and Gunton Roads. 72 3. Erection of Maisonettes. The Council have adopted a scheme for the erection of 62 maisonettes in Daubeney Road, Adley Street and Rock Road. The actual details with regard to the construction of the cottages and maisonettes have not yet been settled.. The great difficulty in dealing with much of the housing property in the Borough arises out of the cost of carrying out repairs, and also to the fact that, owing to the age of many of the houses, frequent repairs are necessary. It has become impossible in many instances for an owner to recompense himself for expenditure on property by money received in rent, and the property has become in consequence by no means an asset, but a difficulty and an expense; in other words, the juice of the orange has been squeezed and there is no profit left in the rind. Thus appeals have been made to the Council to have Closing Orders made, but this, of course, cannot be done except in grave circumstances, during the present lack of alternative accommodation. SANITARY INSPECTION. PUBLIC HEALTH (LONDON) ACT, 1891. (a) Complaints of nuisances.—During the year 1920 there were 4,662 complaints of nuisances made to the Public Health Department and investigated by the Sanitary Inspectors of the Borough. Defects or nuisances were discovered in 3,835 of the complaints. Notices for the remedy or abatement of these were served upon the owner or person responsible under the above Act. (b) Infectious Disease.—The occupied dwellings inspected during the year after infectious disease numbered 2,075. This is an increase of 467 upon the number inspected during 1919. Any nuisances or sanitary defects found were dealt with under the provisions of the above Act. 73 (c) General Inspections.—The number of other inspections made by the Inspectors during the year was 1,028. These inspections are in addition to those made under (a) and (b). The nuisances or sanitary defects found were dealt with in the same manner as those under (a) and (b). Nuisances or defects found on inspection were remedied in most cases on service of an intimation notice only. The total number of such notices served during 1920 was 6,781. The number af statutory notices served was 982; and summonses were issued in 116 cases. Prosecutions under the Public Health (London) Act, 1891, during the year 1920. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. d. 8, Nesbit Street General insanitary Order to abate in — 1 15 6 condition. 14 days. 11, Church Road, Homerton. ,, ,, ,, ,, — 1 15 6 7, Banister Street ,, ,, ,,,, ,, - 2 2 0 6, Banister Street Rooms dirty and dilapidated. ,, ,, — 2 2 0 5,Banister Street General insanitary condition. ,, ,, — 2 2 0 26, Victoria Park Road. W.C. soil pipe and eaves gutters defective. Withdrawn. (Work done). - 1 13 6 36 Spurstowe Road Non-compliance with Magistrate's Order Fined 1 2 0 2 2 0 19, Brampton Road ,,, ,, ,, ,, 3 0 0 1 1 0 53, Amhurst Road ,,, ,, Withdrawn — — 9,Hindrey Place ,, ,, Fined 1 16 0 2 2 0 5,Hindrey Place ,, ,, ,, ,, 1 16 0 2 2 0 24, London Road... Roof defective Withdrawn. (Work done). — 2 2 0 1585, Sandringham Road. Smoke nuisance Order to abate in 14 days. — 1 15 6 1,Hindrey Place Rooms dirty Withdrawn. (Work done). 2 2 0 Carried forward 7 14 0 24 17 0 74 Prosecutions under the Public Health (London) Act, 1891, during the year 1920—continued. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s d. Brought forward 7 14 0 24 l7 0 170, Rushmore Rd. Rooms dirty; roof and scullery floor defective. Order to abate in 14 days. - 2 0 49, EUingfort Road Work Room dirty Order to abate in 7 days. — 2 2 0 32, Walsingham Rd. No dustbin Withdrawn. (Dustbin supplied). - 1 13 6 33, Ballance Road General insanitary condition. Order to abate in 14 days. — 0 4 0 14, Church Road Homerton. ,, ,, Withdrawn. (Work done). — 2 2 0 10, Bradbury Street Rooms dirty ,, ,, — 1 15 6 58, Ravensdale Rd. General insanitary condition. Order to abate in 28 days. — 2 2 0 12b, Australian Av. Rooms dirty ,, ,, — 1 15 6 Block " B " „ Burst water pipes... ,, ,, - 1 15 6 A, B, C, Roofs defective ,, ,, - 1 15 6 29, Church Crescent No gutters to house, and walls of rooms dirty. Withdrawn. (Work done). — 1 13 6 30. Church Crescent ,, ,, ,, ,, — 1 13 6 36a, Duncan Square Workshop dirty Order to abate in 28 days. — 2 2 0 126, Wick Road General insanitary condition. Withdrawn. (Work done). — 1 13 6 19, Berger Road ,, ,, Order to abate in 14 days. 5 0 0 1 15 6 100, Bentham Road Ground floor room damp. Withdrawn. (Work done). — 1 13 6 68, Brunswick St. Dust bin defective Withdrawn. (New dust bin supplied). - 1 13 6 76, Rendlesham Rd. Damp walls Withdrawn. (Work done). — 1 18 6 34, Southwold Road Room dirty; steps leaking. ,, ,, — 1 13 6 54, Paragon Road Rooms dirty; wall damp; no dust bin. Withdrawn. (Owner dead). - - Carried forward 12 14 0 58 1 6 75 Prosecutions under the Sale of Food and Drugs Acts during the year J920—continued. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. d. Brought forward 12 14 10 58 1 6 40, Well Street General insanitary condition. Withdrawn. (Work done). - 1 11 6 32, Tresham Avenue ,, ,, ,, ,, - 1 13 6 170, Rushmore Rd. Non-compliance with Magistrate's Order Fined 5 0 0 2 2 0 147, Stamford Hill Peaches deposited for sale unfit for food. ,, ,, 3 0 0 1 11 6 2, Shacklewell Lane Cocoa deposited for sale unfit for food. ,, ,, 5 3 0 1 3 0 122, Hertford Road Damp walls Withdrawn. (Work done). — 1 13 6 3S, Well Street Workrooms dirty ,, ,, — 1 11 6 171, Graham Road Drains defective Order to abate in 21 days. — 2 2 0 2,Welbury Street Roof defective, rooms dirty. Withdrawn. (Work done). - 1 13 6 469, Kingsland Rd. Basement walls damp. ,, ,, - 1 13 6 3, De Beauvoir Rd. Rooms dirty; dust bin dilapidated. Order to abate in 21 days. - 1 15 6 245, Rushmore Rd. Roof and yard paving defective. ,, ,, - 1 15 6 100, Sandringham Road. Eaves gutters defective. Order to abate in 7 days. - 1 15 6 1, Sigdon Road Roof defective; rooms dirty. Withdrawn. (Work done). — 1 13 6 58, Spurstowe Road Rooms dirty; dust bin dilapidated. ,, ,, - 1 13 6 151, Sandringham Road. General insanitary condition. Order to abate in 14: days. - 3 3 0 6, Lenthall Road Rooms dirty; sashes defective. Withdrawn. (Work done). - 1 15 6 8, Lenthall Road General insanitary condition. ,, ,, - 1 15 6 30, De Beauvoir Square. Eaves gutters and rain-water pipe defective. Order to abate in in 21 days. - 1 15 6 65, Templar Road General insanitary condition. Dismissed. (Work done). — - 67, Templar Road Roof defective, flank wall damp. ,, ,, — - 240, Glyn Road Rear eaves gutter defective. Withdrawn. (Work done). - 0 10 6 Carried forward 25 17 0 92 10 6 76 Prosecutions under the Public Health (London) Act, 1891, during the year 1920—continued. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. d. Brought forward 25 17 0 92 10 6 242, Glyn Road Rear eaves gutter defective. Withdrawn. Work done). - 0 10 6 244, Glyn Road „ „ „ „ „ - 0 10 6 44, Harrington Hill Roof, yard paving and w.c. defective. Withdrawn. (Work done). - 1 15 6 46, Harrington Hill Roof and dust bin defective. „ „ - 1 15 6 48, Harrington Hill Eaves gutters and seat of w.c. defective. „ „ - 1 15 6 100, Sandringham Road Non-compliance with Magistrate's Order „ „ - 1 15 6 399, Wick Road Room dirty; w.c. defective. Order to abate in 10 days. - 2 2 0 7, Spurstowe Road Rooms dirty Withdrawn. (Work done). - 1 15 6 10, Mortimer Road Rooms dirty, roof and rain-water pipe defective. „ „ - 1 15 6 98, Buckingham Rd. Drain and roof defective; rooms dirty. „ „ - 1 15 6 100, Buckingham Road. Drain defective; staircase dirty. „ „ - 1 15 6 6, Frampton Park Road. W.C.'s defective „ „ - 1 11 6 182, Stoke Newington Road. Drain defective; rooms dirty. „ „ - 1 15 6 150, Lower Clapton Road. Roof defective Order to abate in 7 days. - 2 0 6 1, Elizabeth Place Roof and eaves gutters defective: rooms dirty. Withdrawn. (Work done). - 2 2 0 2, Elizabeth Place „ „ „ „ - - 3, Elizabeth Place „ „ „ „ - - 4, Elizabeth Place Roof leaking, ceiling dilapidated. „ „ - - 5, Elizabeth Place Roof and eaves gutters defective; rooms dirty. „ „ - - 33, Ballance Road Non-compliance with Magistrate's Order Withdrawn. - - Carried forward 25 17 0 117 7 0 77 Prosecutions under the Public Health (London) Act, 1891, during the year 1920—continued. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. d. Brought forward 25 17 0 117 7 0 92, Richmond Rd. Drain defective Order to abate in 14 days. - 1 15 6 151, Sandringham Road Non-compliance with Magistrate's Order. Fined 5 0 0 3 3 0 22, Ardleigh Road General insanitary condition. Order to abate in 21 days. - 1 15 6 479, Kingsland Rd. „ „ Withdrawn. (Work done). - 2 2 0 Ash Grove Works Ash Grove. Smoke nuisance Order to abate in 6 weeks. - 3 3 0 2, Pembury Road Rooms dirty Order to abate in 28 days. - 2 2 0 187, Well Street General insanitary condition. Order to abate in 7 days. - 1 15 6 242, Morning Lane Dust bin defective Withdrawn. (Dust bin supplied. - 1 15 6 2, Mortimer Road General insanitary condition. Order to abate in 14 days. - 1 15 6 4, Mortimer Road „ „ „ „ - 1 15 6 77,Mandeville Street Dust bin defective Withdrawn. (Work done). - 1 13 6 85,MandeviUe Street No dust bin Withdrawn. (Dust bin supplied). - 1 13 6 187, Glyn Road Rooms dirty; no dust bin. Withdrawn. (Work done)- - 1 15 6 53, London Road Rooms dirty and verminous. „ „ - 0 15 6 28, Rendlesham Rd. General insanitary condition. „ - 0 10 6 ABC Block, Australian Avenue. Non-compliance with Magistrate's Order. Fined 1 17 9 3 3 0 92, Richmond Rd. „ „ „ 1 10 0 2 2 0 Stalls in Kingsland Road. Sardines exposed for sale unfit for food. „ 3 0 0 0 16 6 171, Graham Road Non-compliance with Magistrate's Order. „ 13 10 0 2 2 0 15, Marsh Hill Ceilings of passage and staircase dirty. Withdrawn. (Work done). - 1 15 6 158, Morning Lane Rooms dirty „ „ - 1 13 6 Carried forward 50 14 9 158 11 0 78 Prosecutions under the Public Health (London) Act, 1891, during the year 1920—continued. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. d. Brought forward 50 14 9 158 11 0 30, Retreat Place Roof defective Withdrawn. (Work done). - 1 13 6 Council's Laundry, Upper Clapton. Smoke nuisance Order to abate in 7 days. - 3 3 0 162, Graham Road Rooms dirty, flooring defective. Order to abate in 21 days. - 1 15 6 17a, Gransden Av. W.C. choked; gutter defective. Order to abate in 7 days. - 1 15 6 22, Wick Road Yard paving and eaves gutters defective. Withdrawn. (Work done). - 1 13 6 151, Sandringham Road. Non-compliance with Magistrate's Order. Fined 4 3 0 1 1 0 Stall, Chatsworth Road. Condensed milk exposed for sale unfit for food. Dismissed under Probation Act. - 5 5 0 27, Kenton Road General insanitary condition. Withdrawn. (Work done). - 1 13 6 37, Kenton Road Sink waste pipe untrapped. „ „ - 1 1 13 15 6 55, London Road Roof and gutter defective. Order to abate in in 7 days. - 6 11, Laura Place Walls damp, kitchen flue defective. Order to abate in 28 days. - 3 3 0 19, Presburg Street Roof leaky, chimney flue defective. Withdrawn. (Work done). - 2 0 0 43, Pedro Street Rooms dirty; yard paving, eaves gutters and rain-water pipe defective. Order to abate in 7 days. - 1 15 6 45, Pedro Street Rooms dirty; eaves gutters choked; damp walls. Order to abate in 14 days. - 1 15 6 0 148-150, Mare St. Smoke nuisance Order to abate in 3 months. - 5 5 £54 17 9 194 1 6 79 HOUSING AND TOWN PLANNING ACTS. It has not hitherto been possible to carry out systematic inspection under the Housing and Town Planning Regulations. The appointment, now sanctioned, of three Sanitary Inspectors for the purpose will permit systematic inspection to be made and an accurate card indexed record to be compiled of the housing conditions of the Borough. FACTORY AND WORKSHOP ACT, 1901, Factories.—During the year, 162 factories were inspected by the officers of the Public Health Department, 9 being factory laundries, 92 factories in which articles of clothing, etc. were made and altered, and 61 in which articles other than wearing apparel were manufactured. In 34 factories the sanitary accommodation for women was defective, unsuitable or insufficient, or not separate from that for men. Nuisance. Found. Abated by Workshop Inspector. Abated by District Inspector. Outstanding. Unsuitable or defective w.c.'s 31 22 v 9 Insufficient w.c.'s 1 — — 1 Not separate for sexes 1 — — 1 LIST OF INDUSTRIES IN THE BOROUGH OF HACKNEY. The chief staple industries are the manufacture of boots, shoes, and pianos, but there are also extensive productions of the following:— Tailored clothes for males and females; dresses, shirts, ties, clothing and underclothing generally, millinery, hats, etc.; cabinets, upholstery and furniture generally; lead pencils, brushes, boxes, artificial flowers, toys, leather goods, gas 80 mantles, dolls, rubber goods, scents, drugs, dyes, paints and varnishes, artists' colours, joinery, foundry work (iron), electric signals, electrical instruments, glass, surgical instruments silk-weaving and embroidery, chemicals, aeroplanes; also there are several furriers, and a number of laundries. Workshops.—The number of workshops registered in Hackney at the end of 1920, was 1,014, an increase of 6 on the number registered at the end of 1919. Of this total, 697 were workshops in which females were employed. Of these latter, 460 were workshops in which articles of wearing apparel were manufactured, altered or prepared for sale, etc., 207 in which other articles were manufactured, etc., and 30 were domestic workshops. Amongst the workshops in which wearing apparel is manufactured, there were 300 in which females alone and 160 in which both males and females were employed. In workshops of other occupations, there were 120 in which females alone, and 87 in which both males and females were employed. Of the domestic workshops, females alone were employed in 17, and both males and females in 13. During the year notices and complaints were received from H.M. Inspectors of Factories, as follows:— Complaints—Factories 29 Complaints—Workshops 97 Notices—Workshops 65 81 Analysis of Occupations Carried on in the Registered Workshops of Hackney. (a) Wearing Apparel. Occupations. No. of Workshops. Occupations. No. of Workshops Artifical Flower Makers 8 Hats 9 Baby Linen 2 Infants' Millinery 8 Beading 1 Mantles 45 Belts 0 Millinery 28 Blouses 42 Needlework 0 Boot and Shoe Manufacturers 55 Pinafores 0 Shirts 1 Boot Machinists 111 Stays 8 Children's Costumes 7 Tailoring 88 Clerical Robes 1 Ties 29 Clothing 5 Trimmings 9 Collars 1 Underclothing 16 Dressmakers 60 Vests 9 Dressing and Tea Gowns 4 Waterproofs 4 Fancy Bows on Shoes 5 618 Fall Net Chenilling 0 Furriers 62 (b) Other Occupations. Bakers and Confectioners 39 Rubber Goods 5 Baskets 4 Toy Makers 10 Box Makers 19 Trunk and Bag Makers 9 Brush Makers 12 Umbrella Makers 2 Cabinet Makers 66 Upholsterers 13 Doll Manufacturers and Dressers 8 Upholsterers' Trimmings 4 Miscellaneous 116 Fancy Leather Goods 32 396 Laundries 36 Pianoforte Makers 21 During 1920, Miss Teebay, the Workshops Inspector, made 2,390 inspections and re-inspections of factories and workshops where females are employed. In connection with these inspections, 428 intimation and 51 statutory notices were served for the abatement of the nuisances found. In four instances legal proceedings were taken against owners of premises. f 82 THE FACTORY AND WORKSHOPS ACT, 1901. Factories, Workshops, Workplaces and Homework. I.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. cutions. Factories (Including Factory Laundries) 166 41 ... Workshops (Including Workshop Laundries) 2,469 752 5 Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 3 1 ... Total 2,638 794 5 2.—DEFECTS FOUND. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of cleanliness 298 356 ... 5 Want of ventilation 43 41 ... ... Overcrowding 8 12 ... ... Want of drainage of floors 6 4 ... ... Other nuisances 97 116 ... ... Sanitary accommodation— Insufficient 3 0 ... ... Unsuitable or defective 130 137 ... ... Not separate for sexes 10 15 ... ... Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 43 43 ... ... Other offences ... ... ... ... (Excluding offences relating to outwork which are included in Part 3 of this Report.) Total 638 726 ... 5 *Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901. as remediable under the Public Health Acts. 83 3,—HOME WORK. Nature of Work. Outworkers' Lists, Section 107. Outwork in Unwholesome Pre¬. mises, Section 108 Outwork in Infected Premises Sections 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or ending Lists. Prosecutions. Instances. Notices Served. Prosecutions. Instances. Orders Made (Section 110). Prosecutions (Sections 109, 110) Twice in the year. Once in the year. Failing to keep or permit inspection of Lists. Failing to send Lists. Lists. Outworkers. Lists. Outworkers. Contractors. Wormen. Contractors Workmen. Wearing Apparel— (1) Making, &c. 334 56 3,041 15 ... 42 233 ... ... 1 ... ... ... ... ... (2) Cleaning and Washing 2 ... 2 1 ... 2 1 ... ... ... ... ... ... ... ... Lace, Lace Curtains and Nets 2 ... 9 ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery 6 6 72 ... ... ... 2 ... ... ... ... ... ... ... ... Fur Pulling 16 ... 16 ... ... ... 9 ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers 12 ... 108 ... ... ... 4 ... ... 1 ... ... ... ... ... Racquet and Tennis falls 4 ... 13 ... ... ... 2 ... ... ... ... ... ... ... ... Paper, &c., Boxes, Paper Bags 38 ... 560 ... ... ... 23 ... ... ... ... ... ... ... ... Brush Making 26 ... 693 ... ... ... 10 ... ... ... ... ... ... ... ... Stuffed Toys 16 ... 70 ... ... ... 12 ... ... ... ... ... ... ... ... Basket taking ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... Cosaques, Christmas crackers, Christmas stockings, &c. 2 ... 32 ... ... ... 2 ... ... 1 ... ... ... ... ... Total 458 62 4,616 17 ... 44 299 ... ... 3 ... ... ... ... ... F 2 84 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses may be enumerated here. Total number of Workshops on Register 1,014 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Acts (S. 133, 1901) 9 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (S. 5,1901) , Notified by H.M. Inspector 126 Reports (of action taken) sent to H.M. Inspector 173 Other Underground Bakehouses (S. 101) In use at the end of the year 45 85 Outworkers.—The number of outworkers on the register at the end of 1920 was 2,993, against 3,025 at the end of 1919. There were thus 32 outworkers removed from the register during the past year. The following analysis shows the trades followed by these outworkers:— Trade. No. of Outworkers. Trade. No. of Outworkers Artificial Florist 74 Jewel Cases 1 Baby Linen 22 Lace Goods 337 Belts 31 Leather Goods 8 Blouses 214 Mantles and Costumes 191 Boots and Shoes 566 Millinery 165 Boxes 329 Paper Bags 24 Braces 8 Pyjama Making 12 Brushes 285 Shirts 40 Children's Costumes 35 Shoe Bows 38 Children's Millinery 22 Skirts 16 Clothiers and Outfitters 101 Tailoring 153 Collars and Bibs 18 Tennis Ball Covering 7 Confectionery Packing 15 Ties and Neckwear 170 Dolls and Toys 40 Trimmings 102 Dressing Gowns 16 Umbrellas 22 Embriodery 13 Underclothing 72 Envelope folding 3 Upholsterer's Trimmings 15 Fancy Goods 8 Christmas Crackers 6 Feather Trade 5 Miscellaneous 39 Fur Trade 70 2,993 Gaiters 10 Hats 12 Hosiery 8 2,616 names and addresses of outworkers residing in Hackney and receiving work from other districts were forwarded by the local authorities concerned. On examination of the lists of outworkers 86 sent in by employers in this Borough, addresses of 2,448 were found to be in other districts, and these names and addresses were forwarded to the local authorities of the respective districts. During the year 1920, Miss Portlock, the Inspector appointed for the inspection of Outworker's premises, made 1,463 inspections and 1,037 re-inspections. She also made 384 visits, without inspections, the outworkers having left the premises (69), or having given up home work (51), or being out at the time of visit (185), or owing to a wrong address being given (43), or the premises being workshops (36). Miss Portlock also discovered 8 new workshops and handed in their addresses for registration. During her visits of inspection she found 517 premises with sanitary defects. For the abatement of these she served 261 intimation notices. Of the 1,463 premises inspected, in only 5 was a room set apart entirely for the work. In the remainder, work was carried on in rooms used for other purposes, as under:— Workroom, bedroom, kitchen and living rooms 61 „ „ and living room 82 „ „ „ kitchen 168 „ and kitchen 915 „ „ bedroom 203 „ „ parlour 20 „ scullery 6 „ bath room 1 „ landing 2 „ provided separately 5 1,463 87 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1904. During the year attention was drawn by the Medical Officer (Education) of the London County Council to 327 homes in the Borough from which children were attending school in a verminous condition, asking that steps be taken to deal with them under the above Act. These homes were inspected, with the following results:— No. of Homes Inspected. No. of Homes where Rooms alone were found Verminous. No. of Homes where Bedding or Clothes and Rooms were found Verminous. No. of Homes. not Verminous 327 14 15 298 The verminous bedding and clothing were taken to the disinfecting station and steamed, and the verminous rooms fumigated and, where necessary, notices were served upon the owners to cleanse and strip the rooms if vermin was afterwards found apparent. RATS AND MICE DESTRUCTION ACT, 1919. This Act came into operation on January 2nd, and 1,000 posters notifying penalties for failure to destroy rats and mice on premises were posted in the Borough. The Council delegated the duties of enforcing this Act to the Public Health Committee. An agreement has been entered into with a local firm of rat catchers, Messrs. Howard & Sons,. for the destruction of rats in any cases where the Council might be held responsible for having this work carried out, and in this connection and for the convenience of householders of the Borough, a scale of fees was agreed upon with Mr. Howard so that persons responsible for the destruction of 88 rats could be referred to a reputable firm and at the same time informed of the scale of charges. £ s. d. Small houses 1 1 0 each. Warehouses, according to size, say on the average 5 0 0 „ Railway arches 1 1 0 „ Stables, up to 10 horses 1 5 0 „ During the year the following premises have been cleared of rats:— 2 stables, The Old Pond Gardens, 30 houses. Enquiries are of course made, in all cases where information of the presence of rats is received, into the condition of the drains. After a premises has been cleared of rats by ferrets, etc., the rat catcher fills in any openings with cement as necessary and carries out any small repairs required to defective footings. After dealing with each house he keeps it under observation for one month to ascertain if there should be any re-invasion by rats. Drains found to be defective are dealt with in the ordinary way by the Sanitary Inspectors. ARTICLES OF FOOD SEIZED OR SURRENDERED AS UNFIT FOR FOOD. During the year the following articles of food were seized by the inspectors, with the exception of Mr. Bobbitt (Food Inspector), or surrendered to them as being unfit for food, viz., Fish, 10 cwts.; Meat, 2 cwts.; fruit and vegetables, 6 cwts.; milk, 22 tins ; and cheese, 106 lbs. 89 SALE OF FOOD AND DRUGS ACTS, 1875-1907. SAMPLES PURCHASED DURING 1920. Articles Purchased. Number Purchased. Number Adulterated. Number where Proceedings taken. Milk 609 24 17 Do. (separated) 1 — — Margarine 122 — 5 (served in plain wrapper). 1 (exposed for sale unlabelled). Cocoa 34 1 1 Lard 16 — — Coffee 23 — — Pepper 6 — — Mustard 7 — — Olive Oil 9 — — Custard Powder 6 — — Baking Powder 6 — — Dripping 5 — — Butter 45 — — Malt Vinegar 3 1 — Vinegar 2 1 1 Cornflour 3 — — Arrowroot 3 — — Totals 900 27 25 90 Prosecutions under the Sale of Food and Drugs Acts during the year 1920. No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fine. Costs. £ s. d. £ s. d. 42w Milk 8.24% added water Dismissed (Warranty proved) - - 68 „ 16.6% fat abstracted Withdrawn on payment of - 5 5 0 84w „ 26.47% added water Dismissed (Warranty proved - - 95w „ 5.53% added water Dismissed on payment of - 2 4 0 42w „ Gave alleged false warranty to milk vendor. Dismissed - - 84w „ „ „ „ - —- 148w „ 2.83% added water Fined 1 0 0 2 2 0 147w „ 1.77% added water Fined 1 0 0 2 2 0 161w „ 21% fat abstracted Dismissed. (Warranty proved). - - 161w „ Gave alleged false warranty to milk vendor. Dismissed - - 214w „ 23.3% fat abstracted „ - - 215w „ „ „ - - 101x „ 7.52% added water Withdrawn (3rd sample burst) - - 255x Cocoa 16% sugar Fined 0 5 0 0 10 6 28y Margarine Exposed for sale unlabeled. „ 1 0 0 1 1 0 28y „ Served in plain wrapper. „ 1 0 0 1 1 0 36y Vinegar 22.5% added water „ 10 0 0 3 3 0 88y Milk 5.88% added water Ordered to pay - 5 5 0 118y „ 2.35% added water Withdrawn - - 123y Margarine Served in plain wrapper. Fined 1 0 0 1 1 0 145y Milk 32.7% fat abstracted Dismissed. (Warranty proved.) - 145y „ Gave alleged false warranty to milk vendor. Dismissed - Carried forward 15 5 0 23 14 6 91 Prosecutions unader the Sale of Food and Drugs Acts during the year 1920. No. of Sample. Article. Adulteration of Offence. Result of Legal Proceedings. Fine. Costs. £ s. d. £ s. d. Brought forward 15 5 0 23 14 6 32z Margarine Served in plain wrapper Fined 0 2 6 0 4 0 33z „ „ „ „ 0 2 6 0 4 0 66z Milk 93.3% fat abstracted Dismissed on payment of — 6 6 0 67z „ 26.83% added water Fined 1 0 0 2 2 0 76z „ 4% added water „ 0 10 0 — 114z Margarine Served in plain wrapper. „ 0 7 6 0 12 6 148z Milk 6.34% added water „ 2 0 0 2 2 0 £19 7 6 35 5 0 REPORT OF FOOD INSPECTOR FOR THE YEAR 1920. Milksliops and Dairies.—1,366 inspections were made during the year. Four notices were served for cleansing and repairs, all of which have been complied with. In 5 cases vendors were warned for having dirty or unwashed measures in use. 31 new millcsellers have been registered. Cowhouses.—There are now 10 licensed cowkeepers with 11 sheds. Three licenses were not renewed at the last meeting of the Licensing Committee. 128 inspections were made during the year. Offensive Trades.—Four visits were made to the one offensive business in the Borough. This has now ceased to exist, the occupier having decided to close up and the boiler and coppers have been dismantled and removed. Glanders.—During the year enquiries were made into two cases of glanders. 92 Slaughterhouses and Meat Inspection.—284 visits were made to these during the usual slaughtering times when I examined the carcases and organs of 168 oxen, 14 cows and bulls, 63 calves, 1,102 sheep and lambs, 45 pigs and 12 goats. The allocation of live cattle to butchers holding " live " permits ceased at the end of June, and the butchers after that date were free to buy what they pleased ; consequently the class of animal now being slaughtered is much better than during the period when they had to take whatever was allotted to them, and now no old cows, bulls or ewes are being slaughtered, as the whole of the butchers who have slaughterhouses only buy prime animals for their own trade and no carcasing is done for market. The following I found diseased and had removed and destroyed:— Carcases and all the organs of 3 cows affected with tuberculosis. Fore quarters head, pluck and liver of an ox affected with tuberculosis. Head and tongue of an ox affected with tuberculosis. Carcase and all the organs of a sow in a dying condition when bled. Carcase and all the organs of a calf in a dying condition when bled. Portions of the hind quarters of a cow for extreme bruising. Livers of 2 cows and 5 oxen affected with abcess. Liver of 1 cow and 8 oxen affected with distomatosis. Livers of 28 sheep affected with distomatosis. Livers and lungs of 10 sheep affccted with abcess. Livers and lungs of 8 sheep affected with parasitic cysts. 93 Wholesale Preserved Provision Factories.—48 visits were made to these and on each occasion I found the carcases, ox and pigs heads, and other meat of various kinds to be sound and free from disease, and the premises kept in a cleanly condition. Miscellaneous Inspections and Unsound Fond.—522 visits and inspections have been made on complaint and in connection with the sale of food. The amount of faulty Government bacon and hams coming into the Borough has diminished compared with previous years, but I have had to condemn 1 ton 14 cwt. 3 qrs. 4 lbs. which was sent to the fat melters to be rendered down for soap making. The market thoroughfares have been frequently visited and the goods on the costers' stalls inspected. Four prosecutions have been taken during the year for exposing unsound food for sale and a conviction obtained in each. The following foodstuffs have been condemned and destroyed:— 40 fowls. 11 partridges. 345 English rabbits. 87 lbs. imported rabbits. 1 carcase imported mutton. 4 legs and 4 fore quarters imported lamb. 1 barrel of pork trimmings. 1 bale of pork bones and tails: 1 imported ox liver. 1 tub of pig's hearts. Rump and loin of imported beef. Rump and buttock of imported beef. 2 flanks of imported beef. 121 tins of corned beef. 11 tins of ox tongues. 74 lbs. of imported cheese. 94 275 eggs. 3 lbs. butter. 317 tins of condensed milk. 5 cwt. cornflour. 1 box of apples. 20 lbs. of apples. 1 bag of imported cucumbers. 2 boxes of skate wings. 1 box of roker wings. 8 stone of roker wings. 21 boxes of kippers. 3 boxes of bloaters. 3 boxes of haddocks. 2 boxes of plaice. 6 stone of plaice. 1 barrel of herrings. 2 boxes of mackerel. Articles seized and condemned at the Police Court:— 17 tins of condensed milk. 186 tins of sardines. 14 lbs. of pears. 14 peaches. Total weight of all foodstuffs destroyed:— Meat, 3 tons 5 cwt. 2 qrs. 9 lbs. Bacon, 1 ton 14 cwt. 3 qrs. 4 lbs. Fish, 14 cwt. 2 qrs. 7 lbs. Fruit, 2 qrs. 2 lbs. Provisions, 9 cwt. 0 qrs. 25 lbs. Arthur J. Bobbitt, Inspector of Meat aval other Foods. 95 REPORT OF THE CANAL BOATS INSPECTOR FOR THE YEAR 1920. Number of visits to waterways 45 „ boats inspected 23 „ boats not registered 2 „ boats conforming to Acts 15 „ boats infringing Acts 4 „ certificates not produced 3 „ interiors requiring repainting 7 „ certificates examined 17 Number of persons for which boats were registered— Adults 57 Children Nil. Number of persons living on boats so registered— Men 42 Women Nil. Children Nil. The boats required to be repainted included one which had been sunk for some days, and which was inspected on its journey to be docked for repairs immediately after it had been raised. These boats have been put in order. The other boats were found to be in good condition. No legal proceedings were taken. Edwin S. Crook, Canal Boats Inspector. 96 97 INSPECTIONS BY SANITARY INSPECTORS, 1920. Mr. F.llis, No. 1 District. Mr. Bew, No. 2 District. Mr. Vobe, No. 3 District. Mr. Sadler, No. 4 District. Mr. Body, No. 5 District. Mr. High, No. 6 District. Mr. Sheppard, No. 7 District. Mr. Long, No. 8 District. Mr. Goldsworthy, No. 9 District. Mr. Peverett, No. 10 District. Mr. Hillier, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove, No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Harvey, Special. Mr. Punter, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. INSPECTIONS. On Complaint— No. of premises inspected 275 309 372 145 448 413 568 83 271 412 78 260 82 437 16 138 296 — 59 — 4,662 No. of premises in which defects were discovered 238 295 292 141 280 360 420 81 199 356 78 244 72 364 14 135 214 — 52 — 3,835 Builder's Notices— No. of premises inspected 2 — 11 6 — 5 — — 14 12 — 16 2 8 — 6 5 — — — 87 General Inspections— No. of premises inspected — 14 42 83 28 — 98 83 180 95 67 66 44 63 154 — 11 — — — 1,028 No. of premises in which defects were discovered — 14 36 80 22 — 82 82 175 88 55 64 41 46 138 — 8 — — — 931 Infectious Disease— No. of premises inspected 138 221 107 80 225 152 178 20 201 136 24 87 76 169 5 142 114 — — — 2,075 No. of premises in which defects were discovered 45 72 31 24 90 80 52 9 130 58 9 31 69 102 2 78 25 — — — 907 No. of re-inspections. (All forms of inspection) 1,677 1,969 2,429 1,585 2,432 2,416 2,239 740 1848, 2,701 S13 2,357 1,015 1,565 778 2,292 2,174 — 1,321 1,037 33,388 No. of premises in which defects were discovered (All forms of inspection). 285 390 393 342 410 477 604 176 527 523 142 355 184 576 163 218 274 4 406 517 6,966 No. of premises in which defects were abated (All forms of inspection). 264 345 381 298 378 425 578 120 480 616 70 350 55 453 71 213 285 4 477 475 6,338 Total number of Intimation Notices served 287 404 395 342 434 477 604 179 527 523 142 348 179 581 174 218 274 4 428 261 6,781 Total number of Final Notices served 100 84 20 — — — 28 39 — 49 — — — 34 5 21 42 — 111 48 581 Total number of Statutory Notices Served 46 46 80 26 44 79 48 18 111 161 16 78 34 61 39 15 29 — 51 — 982 Proceedings before Magistrate under Public Health (London) Act 1 12 21 2 14 10 7 — 9 15 — 10 — — 2 2 4 3 4 — 116 Housing. Town Planning, etc., Act, 1909— No. of premises inspected — — 1 — — — — — — — — — — — — — — — — — 1 No. of premises in which defects were discovered — — 1 — — — — — — — — — — — — — — — — — 1 No. of premises in which defects were abated — — 1 — — — — — — — — — — — — — — — — — 1 Factories and Workshops— No. of inspections (other than laundries) 3 — — 2 11 6 6 — 4 11 — — — 7 — 42 — — 1,044 — 1,136 No. of inspections (laundries) — — — — — — — — — — — — — — — — — — 25 — 25 No. of inspections (other workplaces) — — 2 — — — — — — 2 — — — — — — — — — — 4 No. of premises in which defects were discovered 2 — 2 2 11 6 — — 4 7 — — — 4 — 18 — — 406 — 462 G 98 99  Mr. Ellis, No. 1 District. Mr. Bew, No. 2 District. Mr. Vobe, No. 3 District. Mr. Sadler, No. 4 District. Mr. Body, No. 5 District. Mr. High, No. 6 District. Mr. Sheppard, No. 7 District. Mr. Long, No. 8 District. Mr. Goldsworthy, No. 9 District. Mr. Peverett, No. 10 District. Mr. Hillier, No. 11 District. Mr. Crook, No. 12 District. Mr. Trsulove, No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Harvey, Special. Mr. Punter Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Inspections—continued— Factories and Workshops—continued— No. of premises in which defects were abated — — 2 2 11 6 — — 4 7 — — — 4 — 18 — — 477 — 531 Bakehouses— No. of inspections 11 10 12 14 20 11 16 3 7 26 — 4 — — — 9 12 — — — 155 No. of Notices 3 6 4 10 1 2 — 3 2 10 — 1 — — — — 6 — — — 47 No. of prosecutions — — — — — — — — — — — — — — — — — — — — Food Adulteration— Samples collected for analysis 66 60 66 42 60 60 60 12 65 66 12 66 12 60 12 68 60 53 — — 900 Proceedings taken before Magistrate 2 1 1 2 4 — — — 6 3 — — — 3 — 4 1 2 — — 29 Houses Let in Lodgings— No. of inspections — — — 63 — — — — — — — — — — — — — — — — 63 No. of Notices — — — 63 — — — — — — — — — — — — — — — — 63 No. of prosecutions — — — — — — — — — — — — — — — — — — — — — Insanitary Houses Closed— No. closed under Public Health (London) Act, 1891 — — — — — — — — — — — — — — — — — — — — — No. closed under Housing of Working Classes Act, 1890 — — — — — — — — — — — — — — — — — — — — — Outworkers' Premises— No. of premises inspected — — — — — — — — — 1 — — — — — — — — — 1,463 1,464 No. of premises in which defects were discovered ... — — — — — — — — — — — — — — — — — — — 517 517 No. of premises in which defects were abated — — — — — — — — — — — — — — — — — — — 475 475 Verminous Premises Cleansed— On notice from London County Council 6 8 3 2 7 3 48 — 14 — — 1 3 12 12 — — — — — 119 On complaint — 16 29 58 — 2 — — 87 55 — 115 — 57 — — 20 — — — 439 Underground Rooms— Illegal occupation dealt with — — — — — — — — — — — — — — — — — — — — — No. of rooms closed ... — — — — — — — — — — — — — — — — — — — — — Places where Food Prepared for Sale (Restaurants, Coffee Shops), etc.— No. of inspections 8 — — 16 — — — — 14 4 — 5 — — — — — — — — 58 No. of Notices 3 — — 15 — 1 — — 1 4 — 1 — — — — — — — — 25 G 2 100 101  Mr. Ellis, No. 1 District. Mr. Bew, No. 2 District. Mr. Vobe, No. 3 District. Mr. Sadler, No. 4 District. Mr. Body, No. 5 District. Mr. High, No. 6 District. Mr. Sheppard, No. 7 District, Mr. Long, No. 8 District. Mr. Goldsworthy, No. 9 District. Mr. Peverett, No. 10 District. Mr. Hillier, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove, No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Harvey, Special. Mr. Punter, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Inspections—continued. Ice Cream Premises— No. of inspections 21 15 16 4 12 5 13 — 9 9 — 14 — — — 9 14 — — — 141 No. of Notices — 2 2 2 2 — 1 — 1 — — 2 — — — — — — — — 12 No. of prosecutions — — — — — — — — — — — — — — — — — — — — — Tenement Houses— No. provided with additional water supply — — — — — — — — — 1 — — — — — — — — — — 1 Overcrowding— No. of houses overcrowded — 3 4 9 — — 1 — 1 3 — 2 — — — — — — — — 23 No. remedied — — 4 — — — 1 — 1 1 — — — — — — — — — — 7 No. of prosecutions — — — — — — — — — — — — — — — — — — — — — Dairies. Cowsheds and Milkshops Order— No. of cowsheds inspected — — — — — — — — — — — — — — — — — 128 — — 128 No. of dairies inspected — — — — — — — — — — — — — — — — — 1366 — — 1,366 No. of dirty utensils discovered — — — — — — — — — — — — — — — — — 5 — — 5 No. of premises where infringements of bye-laws discovered — — — — — — — — — — — — — — — — — 4 — — 4 No. of new registrations — — — — — — — — — — — — — — — — — 31 — — 31 Slaughterhouses— No. of inspections — — — — — — — — — — — — — — — — — 284 — — 284 No. of premises where infringements of bye-laws discovered — — — — — — — — — — — — — — — — — — — — — Miscellaneous Inspections— Mews and stables 1 — 5 6 — — — — 3 5 — 2 — — — 14 2 — — — 38 Urinals 1 — 27 6 15 21 14 7 10 24 — 10 — 17 3 7 14 — — — 176 Canal boats — — — — — — — — — — — 23 — — — — — — — — 23 Visits to waterways — — — — — — — — — — — 45 — — — — — — — — 45 Animals improperly kept 4 — 4 — — — 1 2 2 — — 5 — — 4 — 2 — — — 24 Offensive trades — — — — — — — — — — — — — — — — — — — — — New buildings (water certificates) — — — — — — — — — — — — — — — — — — — — — Floodings — — — — — — — — — — — — — — — — — — — — — Special inspections 23 300 420 65 115 31 80 33 3 164 — 32 — 89 69 95 36 522 — — 2,077 102 103  Mr. Ellis, No. 1 District. Mr. Bew, No. 2 District. Mr. Vobe, No. 3 District. Mr. Sadler, No. 4 District. Mr. Body, No. 5 District. Mr. High, No. 6 District. Mr. Sheppard. No. 7 District. Mr. Long, No. 8 Distr.ct. Mr. Goldsworthy, No. 9 District. Mr. Peverett, No. 10 District. Mr. Hillier, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove, No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Harvey, Special. Mr. Punter, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Inspections—continued— Miscellaneous Inspections — continued— Drains relaid or repaired 35 32 53 12 38 26 28 11 34 16 — 37 — 66 10 16 15 — — — 429 Attendances at Police Court 6 28 33 2 24 36 8 — 22 44 1 26 3 6 4 6 21 — 7 — 277 Condemned as Unfit for Human Food— Fish — — — — — — 2 cwt. — 2 cwt. 4 cwt. — — — 2 cwt. — — — 15cwt. — — 25cwt. Fruit and vegetables — — — — — — 2 cwt. — 2 cwt. 2 cwt. — — — 181bs. — — — — — — 6cwt. Meat — — — — — — — — 3 qrs. 1 cwt. — — — — — — 5tns — — 18 lbs. 5 tons 1 cwt. 3 qrs. Tinned foods — — — — — — — — — 22 tins — — — — — — — — — — 22 tins Other articles — — — — — — — — — 1 cwt. — — — — — — — 9 cwt. — — 10cwt. Smoke Nuisances— No. of observations ... — — 2 10 — — 52 — — 8 7 22 — — — — — — — — 101 No. of Intimation Notices served — — 2 3 — — 2 — — 7 1 4 — — — — — — — — 19 No. of Statutory Notices served — — — — — — 2 — — 1 — 1 — — — — — — — — 4 No. of prosecutions — — — — — — 2 — — — — 1 — — — — — — — — 3 GENERAL INFORMATION. Bakehouses— No. on Register at end of 1919 8 9 9 7 12 9 10 — 7 13 — 2 — 12 — 2 6 — — — 106 No. of Register at end of 1920 8 10 9 7 10 6 8 — 7 13 — 2 — 12 — 9 6 — — — 107 No. above ground 7 6 3 7 8 2 4 — 5 11 — — — 2 — 2 5 — — — 62 No. under ground 1 4 6 — 2 4 4 — 2 2 — 2 — 10 — 7 1 — — — 45 Houses Let in Lodgings— No. of Register at end of 1919 — — — 227 — — 243 — — — — — — — — — — — — — 470 No. on Register at end of 1920 — — — 227 — — 243 — — — — — — — — — — — — 470 Ice Cream Premises— No. on Register at end of 1919 21 8 33 3 12 16 20 — 16 9 — 12 — — — 14 13 — — — 177 No. on Register at end of 1920 21 15 16 4 12 4 13 — 9 9 — 14 — 21 — 9 13 — — — 160 Places where Food Prepared for Sale— No. on Register at end of 1919 3 5 14 — 12 14 10 — 14 12 — 4 — — 5 4 — — — 97 No. on Register at end of 1920 3 4 14 16 12 3 10 — 7 6 — 5 — — — 5 4 — — — 89 104 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st Jan. and 31st Dec., 1920 AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All Ages. Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... Not „ ... ... ... ... ... ... ... ... ... ... ... ... ... Doubtful ... ... ... ... ... ... ... ... ... ... ... ... ... Cowpox, Effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox 1 ... ... ... ... ... ... ... ... ... ... ... 1 Measles (Morbilli) 20 27 26 6 ... ... ... ... ... ... ... ... 79 Epidemic Rose Rash, German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... 2 1 2 1 ... ... ... ... ... ... ... 6 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza 2 ... ... 1 7 22 14 14 11 8 3 3 85 Whooping Cough 27 13 15 1 ... ... ... ... ... ... ... ... 56 Mumps 1 ... ... ... ... ... ... ... ... ... ... 1 Diphtheria, Membranous Croup 3 7 26 32 1 ... ... 1 ... ... ... ... 70 Cerebro Spinal Fever 6 3 ... ... ... ... ... ... ... ... ... ... 9 Simple Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... 1 Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... 2 ... 3 ... ... ... ... ... 5 Epidemic Diarrhœa, Epidemic (or Zym.) Enteritis 28 4 1 ... 1 ... ... ... ... ... ... ... 34 105 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All Ages. Diarrhoea, Choleraic Diarrhoea ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Dysentery ... ... ... ... ... ... ... 1 ... 1 1 ••• 3 Malarial Fever ... ... ... ... ... ... 1 ... ... ... ... ... 1 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders, Farcy ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax Splenic Fever... ... ... ... ... ... ... ... ... ... ... ... ... ... Tetanus ...... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... 9 ... ... ... ... ... 1 1 ... ... ... ... 11 Gonorrhæa, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Septicaemia, Sapramia ... ... ... ... 1 7 3 ... ... ... ... ... 11 Puerperal Pyaemia ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Phlegmasia Dolens ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... 2 ... ... ... ... ... ... 2 Infective Endocarditis ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Pneumonia, Pneumonia Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 ... ... ... 1 1 3 2 2 5 ... ... 16 Septicemia (not Puerperal) 1 ... ... ... 1 ... ... ... ... ... ... ... 2 Pyæmia (not Puerperal) ... ... ... ... ... ... ... ... ... ... ... ... ... Phlegmon, Carbuncle (not Anthrax) ... ... ... ... ... ... ... ... ... ... ... ... ... Phagedæna ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 106 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. j 15 to 25. 25 to 35 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All Ages. Tuberculous Phthisis (Pulm. Tuberculosis). ... 2 ... 3 40 42 40 33 16 ... ... ... 176 "Phthisis" ... ... ... ... 3 1 3 5 1 1 ... ... 14 Tuberculous Meningitis 4 4 7 5 5 ... ... ... ... ... ... ... 25 Tuberculous Peritonitis ... 1 ... 2 ... ... 1 ... ... ... ... ... 4 Tabes Mesenterica 1 ... ... ... ... ... ... ... ... ... ... ... 1 Lupus ... ... ... ... ... ... ... ... ... ... ... ... ... Tubercle of other Organs ... 1 1 1 3 1 2 1 1 2 ... ... 13 General Tuberculosis ... 2 1 3 3 1 2 ... 2 2 ... ... ... 16 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism, Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... Opium, Morphia Habit ... ... ... ... ... ... ... ... ... ... ... ... ... Ptomaine Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... Industrial Poisoning by Lead ... ... ... ... ... ... ... ... ... ... ... ... ... ... by Phosphorus ... ... ... ... ... ... ... ... ... ... ... ... ... by Arsenic and other Metals ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatic Fever, Acute Rheumatism ... ... 1 ... ... ... ... 1 ... ... 1 ... 3 Rheumatism of Heart... ... ... ... 1 2 ... 2 ... ... 1 ... ... 6 Chronic Rheumatism ... ... ... ... ... ... ... ... 2 2 1 2 ... 1 107 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All Ages. Rheumatic Arthritis, Rheumatic Gout ... ... ... 1 ... 2 ... 1 1 4 1 ... 10 Gout ... ... ... ... ... ... ... ... ... ... 1 ... 1 Carcinoma ... ... ... ... 1 5 11 36 46 43 24 2 168 Sarcoma ... ... 1 ... 2 3 5 3 6 1 1 ... 22 Malignant Diseases, Cancer ... ... ... ... ... 1 3 11 19 15 6 1 56 Rickets ... 1 ... ... ... ... ... ... ... ... ... ... 1 Purpura ... ... ... ... ... ... ... ... ... ... ... ... ... Hæmophilia, Hæmorrhagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... Anæmia, Leucocythæmia ... ... ... ... ... ... 1 1 6 4 ... 1 13 Diabetes Mellitus ... ... ... ... 2 1 ... 1 4 3 1 ... 12 Premature Birth 99 ... ... ... ... ... ... ... ... ... ... ... 99 Congenital Defects 28 1 ... ... ... ... ... ... ... ... ... ... 29 Injury at Birth 3 ... ... ... ... ... ... ... ... ... ... ... 3 Atlectasis 16 ... ... ... ... ... ... ... ... ... ... ... 16 Want of Breast Milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... Teething 2 ... ... ... ... ... ... ... ... ... ... ... 2 Suffocation-Overlaying 7 ... ... ... ... ... ... ... ... ... ... ... 7 Disease of Nervous System. Meningitis, Inflammation of Brain 3 1 1 2 ... ... ... 1 2 ... ... ... 10 Softening of Brain ... ... ... 1 ... ... ... ... ... 1 1 ... 3 General Paralysis of Insane ... ... ... ... ... ... 3 7 5 1 ... ... ... 16 108 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35 35 to 45. 15 to 55. 55 to 65. 65 to 75 75 to 85. 85 and upwards. All Ages. Insanity (not Puerperal) ... ... ... ... ... ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... Epilepsy... ... ... 1 2 ... 2 3 2 ... ... 1 1 12 Convulsions 20 ... ... ... ... ... ... ... ... ... ... ... 20 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy ... ... ... ... ... ... ... 1 1 ... ... ... 2 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Paraplegia and Disease of Cord ... ... ... ... ... ... ... 1 1 2 ... ... 4 Neuritis. Periph, PolyNeuritis ... ... ... ... ... ... ... ... ... ... ... ... ... Brain Tumour (not specific) ... ... ... 1 ... ... 1 5 2 1 ... ... 10 Nervous System, other Diseases ... 2 1 ... 1 1 1 ... 3 3 1 ... 13 Disease of Organs of Sense. Otitis, Mastoid Dis. ... ... ... 3 2 1 3 ... ... ... ... ... 5 Epistaxis, Nose Dis. ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia, Eye Dis. ... ... ... ... ... ... ... ... ... ... ... ... ... ... Accidents 2 2 5 8 1 4 3 7 10 8 12 1 63 Violence Suicide ... ... ... ... ... 4 3 8 6 7 ... ... 28 Drowned ... 1 ... ... 1 4 ... 2 8 2 1 ... ... 19 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... Disease of Heart. Valve Dis., Endocarditis ... ... ... 4 9 21 11 14 32 44 27 6 168 Pericarditis ... ... ... 2 1 ... ... ... ... 1 ... ... ... 109 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 05 to 75 75 to 85. 85 and upwards. All Ages. Hypertrophy of Heart... ... ... ... ... ... ... ... ... ... ... ... ... ... Angina Pectoris ... ... ... ... ... ... 2 1 2 1 3 ... 9 Dilatation of Heart ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Fatty Degeneration of Heart ... ... ... 1 ... 1 ... 7 8 7 8 3 35 Syncope Heart Dis. (not specified) 1 ... ... 1 2 3 3 11 13 15 13 2 64 Disease of Blood Vessels. Cerebral Haemorrhage, Emb., Throm. 1 ... ... ... ... 1 4 11 29 36 47 4 133 Apoplexy, Hemiplegia...... ... ... ... ... ... ... 2 1 3 7 7 20 Aneurysm ... ... ... ... ... ... 1 1 5 1 ... ... 8 Senile Gangrene ... ... ... ... ... ... ... 1 1 2 1 ... 5 Embolism, Thrombosis (not Cerebral) ... ... ... ... ... ... ... ... .... ... ... ... ... Phlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... Varicose Veins ... ... ... ... ... ... ... ... ... ... 1 ... 1 Blood Vessels, other Diseases ... ... 1 2 2 ... ... 1 7 4 3 ... 20 Arterio Sclerosis ... ... ... ... ... ... ... 1 13 14 24 13 65 Disease of Respiratory Organs. Laryngitis 1 ... 1 ... ... ... ... ... ... ... ... ... 2 Membranous Laryngitis (not Diphtheritic) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup (not Spasmod. or Membr.) ... ... ... ... ... ... ... ... ... ... ... ... ... Urynx. other Dis. (not specified) ... ... ... ... ... ... ... ... ... ... ... ... ... 110 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. | All Ages. Bronchitis 41 3 3 ... ... 2 9 18 28 56 57 21 238 Lobar (Croupous) Pneumonia... 2 ... ... 2 5 4 8 8 11 4 3 ... 47 Broncho, Catarrhal, Lobular Pneumonia 74 23 14 6 1 5 1 7 9 11 5 1 157 Pneumonia 9 2 8 8 5 4 6 6 13 9 2 ... 72 Emphysema, Asthma ... ... ... ... ... ... ... 3 5 10 11 2 2 33 Pleurisy ... ... ... ... ... 1 2 2 2 ... ... ... 7 Fibroid Dis. of Lung ... ... ... ... ... ... ... 3 3 1 1 ... ... 8 Respiratory Dis.,other... 1 ... ... 1 ... ... ... 1 3 ... 1 ... 7 Disease of Digestive System. Tonsilitis, Quinsey ... ... 3 ... 2 ... 1 ... ... ... ... ... 8 Mouth, Pharynx, Dis. (not specific) ... ... 1 ... ... ... ... ... ... ... ... ... 1 Gastric Ulcer ... ... ... ... ... 2 3 2 5 5 ... ... 17 Gastric Catarrh or Gastritis 3 ... ... ... 1 ... ... 2 2 1 1 ... 10 Stomach, other Dis. (not Malig.) ... ... ... ... ... ... ... ... ...1 ... 1 Enteritis (not Epidemic) ... ... 1 ... ... 1 ... ... ... ... ... ... 1 Gastro-Enteritis 5 ... ... ... ... ... ... ... ... ... ... ... 5 Appendicitis, Perityphilitis ... ... 2 5 4 1 1 ... 4 ... ... ... 17 Hernia 16 ... ... ... ... ... 2 ... 1 4 3 ... 10 Intestinal Obstruction... ... ... ... ... ... 1 ... 2 3 1 1 ... 1 Other Dis. of Intestines 16 1 ... ... 1 ... 1 2 2 ... ... ... 20 Peritonitis (not Puerperal) 1 ... 1 1 1 1 ... 2 ... 1 ... ... 23 Ill TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All Ages. Cirrhosis of Liver ... ... ... ... ... ... 1 2 2 2 1 ... 8 Liver and Gall Bladder, other Diseases ... ... ... ... ... 1 ... 2 1 1 2 ... 1 Digest. Syst., other Diseases 2 ... ... 1 ... ... 2 1 1 1 ... ... 8 Lymph Disease. Spleen Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Lymph System, other Diseases 1 ... ... 2 ... ... ... ... ... ... ... ... 3 Thyroid Body Disease... ... ... ... ... ... ... ... ... ... ... ... ... ... Sopra Renal Capsules Disease ... ... ... ... ... ... ... ... ... ... ... ... DISEASE OF URIN. SYST. Nephritis, Acute ... ... ... 2 1 5 9 12 27 21 7 1 85 Thronic Bright's Dis., Albuminura ... ... ... ... ... 1 1 ... 2 3 ... ... 7 Calculus (not Biliary) ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 Bladder and Prostate Dis. ... ... ... ... ... ... ... ... 1 3 8 1 13 Urin. Syst., other Dis. ... ... ... ... ... 1 ... 1 3 3 3 1 ... 12 Disease of Gener. Syst. Ovarian Tumour (not Malig) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Dis. of Ovary ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Uterinal Tumour (not Malig.) ... ... ... ... ... ... ... 1 ... ... ... ... 1 Other Dis. of Uterus and Vagina ... ... ... ... ... ... ... ... ... ... ... ... ... ... 112 TABLE OF DEATHS— continued. AGES Under 1 year. 1 to 2. 2 to 5 5 to 15. 15 to 25. 25 to 35 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upward?. All Ages. Disorders of Menstruation ... ... ... ... ... ... ... ... ... ... ... ... ... ... Gener. and Mam. Orgs., other Dis ... ... ... ... ... ... ... ... ... ... ... ... ... Accidents Childbirth. Abortion, Miscarriage... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Puerperal Mania ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions... ... ... ... ... ... ... ... ... ...... ... ... ... ... Placenta Praevia, Flooding ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accid. of Preg. and Childbirth ... ... ... ... ... 3 1 ... ... ... ... ... ... Joint Disease. Caries, Necrosis... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthritis, Periostitis ... ... ... ... ... ... 1. ... ... ... ... ... ... 1 Other Dis. of Locom. Syst. ... ... ... ... ... ... ... ... ... ... ... ... ... ... Skin Disease. Ulcer, Bedsore ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Eczema ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pemphigus 2 ... ... ... ... ... ... ... ... ... ... ... ... Skin Disease, other ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-Defined Causes. Atrophy, Debility, Marasmus 37 1 ... ... ... ... ... ... ... ... ... ... 38 Old Age ... ... ... ... ... ... ... ... 2 21 74 33 130 Dropsy, Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... 1 ... 2 2 1 Abscess ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death ... (cause unascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... Other Ill-defined Causes ... ... ... 1 ... ... 1 1 1 1 2 ... 1 Causes not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 485 102 125 116 118 165 200 2P6 398 407 363 96 2,861