AC 4365 HAC 35 Metropolitan Borough of Hackney. REPORT on the Sanitary Condition of the metropolitan borough of hackney FOR THE YEAR 1922, by G. H. DART, M.D., M.R.C.P., Edin.; D.P.H., D.T.M. & H., Camb., Barrister-at-Law. Medical Officer of Health. Administrative Maternity and Child Welfare Officer, Executive Tuberculosis Officer. London Buck Bros. & Harding, Ltd., 6-7, West Avenue, E.17. 1923. index PAGE Canal Boats Acts, Report of Inspector 91 Cleansing of Persons Act, 1907 59 Constitutional Diseases 42 Cowhouses, Dairies and Milkshops 89 Disinfection 56 Food— Articles Surrendered to District Inspectors 74 Articles Purchased for Analysis 87 Prosecutions under Sale of Food and Drugs Acts 88 Registration of Purveyors of Milk 89 Report of Food Inspector 89 Housing— Public Health (London) Act, 1891 73 Housing Acts 79 Housing Scheme 16 Housing Conditions in the Borough 16 Legal Proceedings 74 Rent and Mortgage Interest (Restriction) Act, 1920 71 Verminous Premises 71 Work of Sanitary Inspectors (Table of Inspections) 92—103 Industrial Statistics— Factory and Workshop Act, 1901 79 Factories, Nuisances found 82 Factories, General Table of Inspections and Defects found 79 Workshops Inspected 81 Workshops, Analysis of Occupations 80 Home Workers 83 Outworkers 85 List of Industries 85 InfectiousDiseases— Cerebro Spinal Meningitis 38 Cholera 38 Continued Fever 37 Diarrhoea 40 Diphtheria 35 Diphtheria Anti-toxin 36 Dysentery 40 Encephalitis Lethargica 39 Enteric Fever 37 Erysipelas 38 Influenza 40 Malaria 40 Measles and German Measles 39 Ophthalmia Neonatorum 38 Plague 38 Pneumonia 39 Polio-Myelitis 38 Puerperal Fever 37 index PAGE Infectious Diseases (continued). Scarlet Fever 38 Small-pox and Vaccination 88, 34 Typhus Fever 37 Whooping Cough 40 Maternity and Child Welfare— General Organisation 9, 62 Contributions to Maternity Hospitals 69 Convalescent Aid 69 Health Visiting 66 Infant Consultation and Ante-natal Clinics 67 Provision of Milk and Foods 70 Mortuary 80 Rats and Mice Destruction Act, 1919 72 River Lee 18 Sanitary Inspection—Table of Inspections 92—108 Shelter 59 Slaughterhouses 89 Tuberculosis— Advanced Cases 55 After Care 56 Discharged Soldiers and Sailors 46 Dispensary Districts: Population 48 Extra Nourishment 54 Health Visitors—Visits of 46 Notifications and Deaths 43 Open-air School 55 Public Health (Tuberculosis) Regulations, 1912 44 Summary of Notifications 45 Summary of Deaths, Number and Classification 49 Reports of Medical Officers 50—52 Vital Statistics— Acreage of Borough 20 Births and Birth Rates 21 Deaths and Death Rates 24 Deaths in Public Institutions 27 Density of Population 20 Infantile Mortality 25 Institutions outside the Borough receiving Sick from the Borough 28 Illegitimate Birth Rate 22 Marriage Rate 21 Notification of Births 22 Population 20 Registration of Births 23 Senile Mortality 26 Still Births 22 Tables of Causes of Deaths 104—111 Table (Comparative) of Rates for years 1913-22 32 „ „ „ year 1922—London Boroughs 19 5 PUBLIC HEALTH DEPARTMENT Public Health and Maternity and Child Welfare Committees. Public Health Committee. Ex-officio—Councillor John Genese, j.p. (Mayor). Chairman—Councillor W. E. Loweth. Vice-Chairman—Councillor G. J. Lusher-Pentney. Councillor Benwell, Mrs. L. C., J.P. Councillor Lusher-Pentney, G. J. Beven, S. Bloomfield, B. H. Chapman, T., j.p., l.c.c. Chisham, J. Green, G. Jones, W. Layland, H. Loweth, W. E. Muirhead, Mrs. E. C., l.l.a. Palmer, J. M. Payne, A. W. Rushbrooke, T., j.p., m.a., m.r.c.s., l.r.c.p. Ridley, W. A. Sinclair, H. A. Smith, A. E. Alderman Thomas, M. J. T. 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 Mrs. E. C. Muirhead, l.l.a. Vice-Chairman— Councillor Mrs. L. C. Benwell, j.p. Members of the Committee—as set out above with the addition of Mrs. F. M. Ashdown, Mrs. J. M. Palmer, and Miss B. W. Payne. c STAFF OF PUBLIC HEALTH DEPARTMENT. Sanitary Inspector5. 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, etc.) J. Nighy, W. E. Galvin, House to House Inspection. Alice Teebay (for Workshops, Laundries, &c.). Mabel Portlock (for Outworkers' Premises). Health Visitors. Mrs. A. Rhodes. Mrs. L. Harrison. Miss M. Chitson. Mrs. L. E. Bartholomew. Miss D. F. Vidal. Miss A. K. Roche. Miss M. K. Cockle. Miss S. E. Love. Miss E. D. Mann. Miss G. M. Servante Miss M. Clarke for Tuberculosis cases. Medical Officers (Temporary Staff) Municipal Infant Welfare Centres. Elizabeth wilks, m.d. J. H. Porter, m.r.c.s., l.r.c.p. Tuberculosis Dispensary Medical Officers Hospitals.) L. Unwin Young, M.B. Reginald Brown, m.r.c.s., l.r.c.p. Dorothy B. Gere, m.r.c.s., l.r.c.p. (Metropolitan and City of London 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. A. Higgins. P. A. Hitch. L. W. Harvey. E Whittaker. V. Welham. H. C. Bowman. H. R. Sandford. D. SoRRELL. Medical Officer of Health. G. H. Dart, m.d.. m.r.c.p., Edin., d.p.h,, d.t.m & h. Camb. Barrister-at-Law. 7 Metropolitan Borough of Hackney. REPORT OF THE MEDICAL OFFICER OF FOR THE YEAR 1922. PUBLIC HEALTH DEPARTMENT, 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 1922. 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 Death, Birth and Infantile Mortality Rates for the past ten years is set out on page 32. The birth-rate is 21.0 per 1,000 for Hackney, the same figure as that for the whole of the County of London. The death-rate for Hackney for the past year is 12.7, and although this is an increase on the rate for the previous year, it appears from the Registrar General's returns that there has been a slight increase in all London Boroughs with the sole exception of Chelsea, and the rate for the whole County of London is, of 9 course, proportionately increased, the rate for the County being 13'4 as compared with 12 4 for the previous year. The 1921 death-rate of 11.5 and infant mortality rate of 66 were the lowest ever recorded in Hackney. The position of Hackney—6th in the comparative table of the 29 boroughs and cities—is still very satisfactory, the boroughs with the lower death rate being Hampstead, Lewisham, Wandsworth, Woolwich and Fulham. As regards the infantile mortality, to the Boroughs already mentioned, several others must be added as showing a more favourable return than Hackney, viz., Westminster, Green, wich, Holborn, Chelsea, Stoke Newington, Paddington and Battersea. The increased death-rate, as regards the younger age periods, is mainly due to a greater number of deaths from organic diseases of the heart, bronchitis, and broncho-pneumonia; cancer and tuberculosis, two very important factors in every deathrate, show a very slight decrease. Cancer is a disease affecting the later age periods and tuberculosis the prime of life, although there is considerable evidence that tuberculous infection is received in childhood. The infantile mortality rate for the Borough, measured by the number of deaths under 1 year of age per 1,000 births registered, was 72, as compared with 66, the figure for last year; the Borough average during the last 5 years 1917-1921 is 87, and the figure for all London during the past year is 74, as compared with 80 in 1921. There was an increase during the year in the number of deaths from Measles, Whooping Cough, Bronchitis and Pneumonia. The zymotic death-rate is .63 as compared with .7, the figure for 1921. The number of Scarlet Fever cases notified during 1922 was 674, as compared with 1,863 in 1921, and the number 9 of Diphtheria cases notified in 1922 was 732, as compared with 872 during 1921. The deaths from Scarlet Fever number only 10; 4 less than the previous year, and the deaths from Diphtheria 22, being 24 less than those registered in 1921. Deaths from Measles, however, number 45, 41 more than in 1921, and Whooping Cough 62, being 46 more than in 1921. Small Pox did not appear in Hackney during the year, although considerable anxiety was felt in this direction, and it was necessary to keep under observation thirty-six contacts to cases notified in other Boroughs. As always occurs during periods of anxiety due to Small Pox, a considerable number of cases of illness were suspected of being Small Pox, the majority of them being severe cases of Chicken Pox. The Disinfecting Station and Isolation Shelters were placed in a thorough state of repair during the past year at a cost of £939. The report on the condition of the Disinfecting Station and repairs required is on page 112. Maternity and Child Welfare. The institution of Maternity and Child Welfare Centres is probably one of the most important of the measures yet adopted for the prevention of infant mortality in the Borough, and to the work of these Centres must be attributed a considerable share in the very appreciable decline in infant mortality, which is measured by the number of deaths occurring among infants of under one year of age, that has undoubtedly taken place during recent years. The infantile mortality rate is considered to be the most sensitive index of sanitary conditions now possessed, as it reacts immediately to any epidemic condition and is always constantly high wherever there is an insanitary environment within or without the home. Therefore, as one would expect, the decline in the infantile mortality rate has not been uniform. 10 On pages 62 and 63 will be found tables giving infantile mortality rates since 1900, and the dates of adoption of special measures directed towards the prevention of infantile mortality. It must not be forgotten when examining these annual infantile mortality rates that the War period and subsequent unemployment and inadequacy of sanitary housing accommodation have introduced most important adverse conditions. It is estimated that for each infant death from preventible causes there are three infants who survive in a more or less damaged condition, and that there are not less than a million children of school age at the present time " in such physical condition that they are unable to derive reasonable benefit from the education that the State provides." There has very recently been an attempt to abolish the provision of infant foods at the Welfare Centres, and to refer the parents to the ordinary trade sources of supply. It is almost unanimously the opinion of medical practitioners in charge of Centres that one of the most beneficial activities of a Centre is the provision, as cheaply as possible, of pure and nourishing foods for infants. Dr. Wilks states that the people attending the Centres are poor, and could not afford the chemist's price for dried milk. "They would fall back on fresh milk, which they dilute more as money runs out at the end of the week, or on cheap patent foods, or barley water and sugar. The new milks at reduced prices are a boon to the neighbourhood. They have helped to kill the patent foods. It is the same with 'Marylebone Cream and Cod Liver Oil; these are used when inexpensive, and if people have to pay the chemist's price, they will not have them. We shall have more cases of rickets to contend with." But even more unsuitable foods than those mentioned are used for infants. In the Local Government Board Report on 11 Infant Mortality for the year 1913-14, it is pointed out that bread soaked in water and oatmeal gruel, and other most unsuitable diets are quite often adopted for infants: every medical practitioner who has had charge of a Centre can give many and various instances of this fact. Dr. Gere states that "with regard to dried milks, if these were not supplied at the Centres there is no guarantee that the mothers will get the particular kind ordered, or that they will get dried milk at all." Dr. Gere also points out that the use of dried milk has been practically introduced through the Centres, and that the reason for its present popularity is due to this fact. I have been informed by a colleague that in his Borough the sale of infant foods at cost and reduced prices was abolished, and there is no doubt that there is a tendency in some directions for this course to be adopted. It is, in my opinion, a very mistaken action that in all probability will not benefit the retailers who are behind the movement. Thus as regards the district where the supply of infant foods through the Centres has been discontinued, I am informed by a most important firm of manufacturers that even less dried milks, etc., have been sold by the chemists and other retailers since the adoption of this measure. Probably the persons who would most benefit by discontinuing the sales at the Centres in this Borough would be the vendors of skimmed milk. Medical practitioners have been appointed, the appointments being temporary, i.e., not on the permanent staff, to conduct the clinical work of the Consultation Centres, their duties having been arranged as regards the Welfare Centres as follows:— 1. Attend the Centre during the periods when Clinics are held. 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. 12 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 conditions 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. Particulars of the attendances at the Centres will be found on page 68. Memorandum 14M.C.W., of the Ministry of Health states that "the District served by a Centre should be as compact as possible, so that it may be within easy reach of all women wno should attend it. Not more than 30, or at most, 40 children can ordinarily be dealt with at one Session." Where the average attendance exceeds this limit, the Ministry are of opinion, according to this Circular, that the Centre should be opened on an additional day each week, or a Branch Centre should be opened. It is apparent that the Municipal Centres have to serve too many Health Visiting Districts, but an additional Centre could not be opened with the present staff and without the consent of the Ministry of Health. An Ante-Natal Clinic is also needed very greatly at Northwold Road Centre to relieve Overbury Street of some of the increasing work now being carried out by Dr. Wilks. The Ministry of Health, in the Circular already quoted, advises that dental treatment for nursing and expectant mothers should be included in the scope of a Centre whenever possible, as there is a reason to believe that carious and septic teeth exercise a specially deleterious effect on health during pregnancy and lactation. The Medical Officers of the Centres have repeatedly urged the necessity for the opening of a Dental Clinic. Proposals were put forward by the Committee for the establishment of a Dental Clinic at Eton Mission in co-operation with the London County Council 13 School Dental Clinic. The establishment of this Clinic would have cost £130, but the additional expenditure was not approved by the Ministry of Health. Midwifery assistance was provided during the year to 57 mothers confined in their homes, and Home Helps granted in three cases, in addition to in-patient hospital treatment to 265 confinement cases at the City of London Maternity Hospital and Mothers' Hospital, Clapton, under the Council's agreement with these institutions. The King's Home for Nurses has supplied nursing assistance to 135 necessitous cases of infectious disease under the agreement between the Association and the Council, and 1,879 visits were paid to those cases by the nurses. Tuberculosis. The Tuberculosis Death-rate shows a slight decrease, the mortality being 1.05 per 1,000 of the population, as compared with 117 for 1921, the number of deaths being fewer by 26 in 1922, and there were 62 less primary notifications as compared with 1921. One of the outstanding features of the tuberculosis service is the extremely unsatisfactory conditions under which the treatment of advanced cases is carried out. There is no adequate provision for the institutional treatment of advanced pulmonary tuberculosis. It should also be borne in mind that a large proportion of the cases who are tabulated among the deaths in institutions have in reality, during the greater part of the time that the disease was advanced, been under treatment at home, such cases frequently entering and leaving hospitals and infirmaries (see pages 49 and 55), while in an extremely infective condition. 14 Thus the fact that only 74 deaths, or 36.6 per cent. occurred at home out of a total of 202, is entirely misleading in that the remaining number of cases under treatment in institutions at the time of death by no means represents cases rendered harmless by removal to an institution. A fact that conveys a more accurate idea of the conditions existing that help to spread infection is that out of the total number of deaths from pulmonary tuberculosis 138 or 68.3 per cent. were unable to secure a separate bedroom during the course of treatment at home. These figures are, however, a considerable improvement on last year, and it is due mainly to the personal exertions of the Tuberculosis Visitors that there has been improvement in this respect. All the cases under treatment at the dispensaries, or at one time under treatment at the dispensaries, had a sputum examination carried out, and it is therefore known that as regards 64 of the cases who did not have even a bed to themselves, tubercle bacilli were present in the sputum. Here again the Tuberculosis Visitors have spared no pains, however adverse the conditions, to prevent the spread of infection. A further point of great interest and importance is the stage of the disease at the first attendance of the patients who came under dispensary treatment and died during the year. There were 113 deaths among dispensary patients and 57 of these patients or 50.4 per cent. were in the final stage of the disease on first attendance, 47 patients or 41.6 per cent. were in the second stage. It also appears from an examination of the case papers, that 36 of these cases or 31.8 per cent. had been suffering from this disease for a period varying between three to twelve months, but a great many had evidently been ill for a far longer period, suffering evidently from tuberculosis of the lungs as shown by the fact of the history of such conditions as pleurisy and haemorrhage, etc., manifestations which were in all probability 15 in every case tuberculous but which the patients did not realise were connected with the final onset; however, no fewer than 56 of the total number of cases, or 49'5 per cent. had known for a longer period than one year before attending the dispensary that they were suffering from Consumption. The scheme for granting extra nourishment to necessitous tuberculous patients under Circular 194 of the Ministry of Health has worked very satisfactorily during the past year. Extra nourishment was granted to 138 patients during the year. Assistance under this scheme is limited by the Ministry of Health to early or Sanatorium cases; all others must be referred to the Guardians. Sanitary Inspection. The Public Health Committee adopted on April 27th, 1922, a resolution that applicants for Registration as Purveyors of Miik should be required to give an undertaking to comply with certain conditions (see Page 121), and it was also made a condition of registration that milk shall not be sold from a private house unless structural alterations are made whereby the milk can be stored and sold without being placed in or brought through rooms used for living purposes. The work of Sanitary Inspection has been carefully and conscientiously carried out throughout the year, a fact of the utmost importance in view of the adverse housing conditions of the Borough. The Ministry of Health in their " Manual on Unfit Houses," has suggested that :— A fit house should be :— (1) free from serious dampness ; (2) satisfactorily lighted and ventilated ; (3) properly drained and provided with adequate sanitary conveniences* and with a sink and suitable arrangements for disposing of slop water. (4) in good general repair, and should have (5) a satisfactory water supply ; 16 (6) adequate washing accommodation; (7) adequate facilities for preparing and cooking food, and (8) a well ventilated store for food. The Manual was, however, published in 1919, the year also of the Housing and Town Planning Act, under which all these things were to be brought about, but which has apparently placed in considerable difficulties every local authority that has attempted to use its provisions in other than very carefully selected cases. It is difficult in Hackney to enforce the carrying out of even minor repairs in view of the age of a great deal of the property and the fact that it is not considered a business proposition to place old property of this description in decent condition, and as an example of this I may instance Nos. 1-7, Dockway, where notice to carry out repairs that necessitated the spending of under £70 for the whole property was met by the threat that the property would be closed. A Summons was heard on July 31st, on August 1st the Magistrate viewed the property, and on August 10th the case again came before the Court, the Magistrate refused to make a Closing Order and no further opposition was experienced in enforcing the necessary repairs. But this difficulty is constantly recurring. On January 5th a deputation from the Borough Council was received at the Ministry of Health and urged the seriousness o." the housing question in Hackney upon the Ministry. There had been up to that date 2,224 applicants for houses. The list was closed on March 31st, although letters, some of them most pitiable, are still received. The total number of tenants that can be accommodated under the Council's scheme is 179. Of the applications placed by the Committee on the special list as urgent 58 were from families living in one room, and 51 of these were from families containing two or more children. The Committee necessarily took all circumstances into consideration in arriving at a decision as to special necessity, the 17 two other most important, apart from the number of children, being the condition of the property and the presence of illness such as Tuberculosis in the family. The question may well be asked how it is that the death-rate and infantile mortality rate should remain so comparatively satisfactory in view of the fact that more than i22,000 families in Hackney inhabit dwellings originally built for one family, that is, not structurally separate, and that a large proportion of these families are living in one or two rooms in dwellings constantly in need of repair. There are many conditions helping to counteract the deplorable state of much of the housing in the Borough. Hackney is fortunate in its open spaces. Much of the housing property built for single families and now housing several tenants have gardens attached. Property like Nisbet Street, well known to the Public Health Committee, and Middlesex Wharf where more than 100 persons are living in houses condemned as unfit for human habitation, have plenty of open space surrounding where young children can enjoy healthy exercise in the fresh air. The numerous agencies working towards the relief of suffering and the amelioration of conditions of life, such as the Hospitals, the Guardians, the Voluntary Associations and the Charitable agencies, although many of them help with small matters in themselves possibly, yet accomplish in the aggregate a very great deal, and it should be remembered that the forces tending to improve the public health are interacting; for instance, the Welfare Centres by improving the stamina of the infant life of the Borough are helping to reduce the Tuberculosis death-rate, and the special measures directed against Tuberculosis help to prevent infantile death and crippling. The work of the Sanitary Inspectors and Health Visitors in ameliorating the conditions arising from the housing shortage cannot be over-estimated. If these services were inefficient, choked and broken drains, leaky roofs, minor sanitary defects B 18 accumulating, adulteration and the sale of unsound food remaining unchecked, immediate disinfection and other measures against infectious disease ceasing, and all the manifold activities of the Public Health Department not being promptly carried out, the full effects of the housing difficulty would then be experienced. The extent to which the careful work of the sanitary inspectors and staff of the department neutralise the ill-effects of overcrowding is not realised. It is true that the sanitary service is still very far from the goal to which it is striving; that is, good housing, pure food, healthy working conditions, the prevention of infectious disease and of the illnesses that arise from ignorance of the laws of nature, but no steps that it was possible under existing conditions for the staff of the Public Health Department to take during the past year have been neglected. The entire cost of the Public Health service in the Borough, including all staff and the maintenance of the Tuberculosis Dispensaries, the Welfare Centres, the Disinfecting Station, Isolation Shelters and Mortuary, and all forms of assistance under the Tuberculosis and Maternity and Child Welfare Schemes is estimated during the coming financial year to amount to a rate of 3.9 pence. The River Lee has remained in the usual offensive condition throughout the summer. In conclusion, I have to thank the Public Health and Maternity and Child Welfare Committees for their support and kind consideration, and I wish to express my appreciation of the manner in which my staff have performed their duties. I am, Yours obediently, G. H. DART Medical Officer of Health 19 COMPARATIVE TABLE, YEAR 1922. Name of Borough. Population. Birth Rate. Zymotic Death Rate. Death Rate all causes. Infant Mortality Battersea 169,200 21.6 1.13 13.1 69 Bermcndsey 120,500 27.0 — 17.0 101 Bethnal Green 118,400 25.2 — 15.3 90 Camberwell 269,600 21.5 — 13.4 78 Chelsea 63,920 16.1 0.78 13.3 66 Deptford 114,100 23.1 1.38 13.8 74 Finsbury 76,840 25.2 1.29 16.3 82 Fulham 159400 20.3 — 12.0 68 Greenwich 101,930 21.0 0.86 12.9 56 Hackney 225,400 21.0 0.63 12.7 72 Hammersmith 134,400 20.5 1.17 12.9 71 Hampstead 86,920 14.8 0.49 11.1 56 Holborn 42,850 16.9 0.3 13.2 66 Islington 333,900 22.4 1.05 13.8 77 Kensington 179,100 17.6 0.97 13.6 82 Lambeth 305,700 20.8 — 13.7 77 Lewisham 176,600 18.1 0.52 11.1 54 Paddington 145,300 18.7 0.68 12.9 69 Poplar 165,700 26.6 1.58 14.3 79 St. Marylebone 105,200 15.9 0.88 13.7 68 St. Pancras 212,500 21.5 1.19 14.6 74 Shoreditch 105,800 27.9 1.7 16.3 102 Southwark 187,220 24.4 2.2 15.5 79 Stepney 252,000 22.9 — 13.9 80 Stoke Newington 52,620 17.8 — 12.9 67 Wandsworth 331,500 16.6 — 11.2 61 Westminster 139,389 13.4 0.4 12.9 54 Woolwich 138,254 21.3 0.69 11.6 62 City of London 13,527 10.9 — 13.9 81 County of London 4,514,405 21.0 — 13.4 74 City of Belfast — — — 14.8 94 „ „ Dublin — — — 17.0 116 „ „ Glasgow — — — 17.2 120 „ „ Edinburgh — — — 15.2 91 „ „ Liverpool — — — 14.6 96 „ „ Manchester — — — 14.2 96 20 VITAL AND OTHER STATISTICS. Population and Density. Area =3,287 acres. Population—Census, 1901= 219,780 ,, —Census, 1911= 222,674 —Census, 1921 = 222,159 The population of the Borough at the middle of the year 1922 is estimated by the Registrar-General to number: 025,400. This gives a density of population for the whole Borough of 68.5 persons per acre, varying from 52.8 persons per acre in the Northern Sub-district to 98.6 persons per acre in the Southwestern 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 1922. North Central Southwest SouthEast Total for Hackney Total for London Estimated population 57,067 53,299 57,788 57,246 225,400 4,540,740 Area in square acres 1,080 857 586 764 3,287 74,816 Density, persons per acre 52.8 62.1 98.6 74.9 68.5 60.6 *Marriages and Marriage-rates.—During 1922 there were 2,212 marriages solemnised in the Borough of Hackney. The *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 1922. 21 annual rate for persons married during this period is therefore 19.6 per 1,000 of the population. The following table gives the number of marriages and marriage-rates for the Borough of Hackney and London during the years, 1912-1922:— Year. Borough of Hackney. London. Marriages. Marriage rate. Marriage rate. 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 18.0 18.5 1918 2,011 18.3 21.0 1919 2,571 22.8 23.0 1920 2.380 21.1 21.7 1921 2,358 21.0 19.6 Average, 1912—1921 2,208 19.9 20.3 1922 2,212 19.6 18.3 Births and Birth-rate.—The births registered in the Borough of Hackney during the year 1922 numbered 5,270, of which 2,713 were males and 2,557 females. The total shows a decrease of 167 compared with the number registered during 1921, 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., 809 births to be transferred to other districts and 282 to Hackney. After these necessary corrections have been made, the correct total of registered births amongst Hackney residents is 4,743. From this figure the birthrate for Hackney during 1922 has been calculated to be 21.0 per 1,000 of the population. The birth-rate for all London for the same period is 21.0 per 1,000 of the population. 22 Notification of Births Act, 1907.—Under the provisions of this Act 6,472 notifications of births were received during 1922. This total includes notifications from medical practitioners, midwives, parents and others. It also includes still-births. The total is 202 more than the number registered by the Registrar of Births. Still-Births.—Amongst the births notified 149 were stillborn. This is equal to 2.7 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 1922. Year 1992. Medical Practitioners Midwives. Parents and Others. Total, Lire. Still. Live. Still. Live. Still. Live. Still. M. F M. F. M. F. VI . F. M. F. M. F. M. F. M. F. Totals 488 445 21 14 1,742 1,653 45 51 521 474 12 6 2,751 2.572 78 71 Illegitimate Births and Birth-rate.—The total number of illegitimate births registered in the Borough during the year 1922 was 394, but of these, the Registrar-General states that 279 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 139 illegitimate births amongst Hackney residents. This is equivalent to an illegitimate birth-rate of 29.3 per 1,000 births. 23 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 5,270 906 2.011 1,061 1.292 94,792 Rate per 1,000 living 23.4 15.8 37.7 18.3 22.5 21.0 No of illegitimate births 139 ... ... ... ... ... Rate per 1,000 births 29.3 ... ... ... ... ... It will be noticed that the birth-rate is abnormally high in the Central District compared with other Registration Subdistricts. This is accounted for by reason of 1,084 births occurring during the year at the Salvation Army Mothers' Hospital, which Institution is situate in the Central District. Of this number 709 births are transferable to districts outside Hackney. The following table shows the birth-rates for the Borough and its Sub-districts during the years 1912-1922 inclusive:— Birth-rate for the Borough, of Hackney and its Sub-Districts for the years 1912-1922 compared with that of London. Year Borough of Hackney North SubDistrict Central SubDistrict South-West SubDistrict South-East SubDistrict London 1912 2.3 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 23.0 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 21.0 13.2 33.9 16.5 20.6 18.3 1920 28.7 20.6 41.3 23.6 29.5 26.5 1921 24.2 16.7 36.9 19.5 23.6 22.3 Average 1912-1921. 23.2 16.1 31.6 21.4 23.4 21.9 1922 234 158 377 183 22.5 21.0 *The Salvation Army's Mothers' Hospital was opened in 1913. 24 Deaths.—The deaths registered in the Borough during 1922 numbered 3,098; but of these 678 were deaths of non-residents who died inside the Borough. There were, however, 459 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 2,879. This is an increase of 299 upon the number of deaths occurring during 19214. The general death-rate from all causes for the year 1922 is 12.7 per 1,000 of the population=. Amongst the Registration Sub-districts the death-rate was lowest in the Central Sub-district (11.9 per 1,000), the highest in the South-east and South-west Sub-districts (13.1 per 1,000). Subdistrict. Population (estimated). Total No. of Births. Uncorrected. * Birth rate. Uncorrected. Total Deaths Cor 'ted. Deathrate. Deaths under I year * Infant Mortality per 1,000 Births Uncorrected. 55 North 57,067 906 158 728 12.7 50 Central 53,299 2,011 377 636 11.9 89 44 South-west 57,788 1,061 18'3 762 13.1 90 84 South-east 57,246 1,292 225 753 13.1 115 89 All Hackney 225,400 5,270 234 2,873 12.7 344 65 *The uncorrected figure counts in all births and Infant deaths relating to the whole Borough; but some of these having occurred in Institutions, etc., are referred to other districts. For corrected figure see page 32. 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. 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 1916 13.8 143 1921 11.5 12.4 1917 14.6 15.0 1922 12.7 13.4 25 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-rate of infants under 1 year of age for the year 1922:— Boroughs. Death rate from all causes per 1,000 living. Deaths under 1 year tc 1,000 births. Hampstead 11.1 56 Lewisham 11.1 54 Wandsworth 11.2 61 Woolwich 11.6 62 Fulham 12.0 68 HACKNEY 12.7 72 City of Westminster 12.9 54 Hammersmith 12.9 71 Greenwich 12.9 56 Stoke Newington 12.9 67 Paddington 12.9 69 Battersea 13.1 69 Holborn 13.2 66 Chelsea 13.3 66 Camberwell 13.4 78 Kensington 13.6 82 St. Marylebone 13.7 68 Lambeth 13.7 77 Deptford 13.8 74 Islington 13.8 77 Stepney 13.9 80 City of London 13.9 81 Poplar 14.3 79 St. Pancras 14.6 74 Bethnal Green 15.3 90 Southwark 15.5 79 Finsbury 16.3 82 Shoreditch 16.3 102 Bermondsey 17.0 101 Infantile Mortality.—The deaths under 1 year of age in the Borough during 1922 numbered 344. This is an increase of 15 upon the number of infants' deaths recorded during 1921. The infant mortality rate for the year is 72 per 1,000 births. 23 The causes of death are set out in the following table:— INFANT MORTALITY, 1922. 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 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 1 7 9 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... 1 ... 1 5 6 6 11 29 Diphtheria and Croup ... ... ... ... ... ... ... ... 1 1 Erysipelas ... ... ... ... ... ... ... 1 ... 1 Tuberculous Meningitis ... ... ... ... ... ... 3 ... 1 4 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 ... 1 ... 2 Meningitis (Not Tuberculous) ... ... ... ... ... ... ... 2 ... 2 Convulsions 2 ... ... ... 2 ... ... 3 ... 5 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 7 2 3 4 16 Pneumonia (all forms) 1 3 ... ... 8 14 16 23 21 82 Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis 1 ... 1 2 4 6 11 5 3 29 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) ... ... ... ... ... ... 1 ... ... 1 Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 7 1 ... ... 8 ... ... ... ... 8 Congenital Malformation 10 4 4 ... 18 3 4 2 ... 27 Premature Birth 54 1 3 3 61 5 ... ... ... 66 Atrophy, Debility and Marasmus 7 4 ... 1 12 3 1 1 ... 17 Other Causes 5 3 1 ... 9 11 11 8 4 43 89 16 10 10 125 55 56 56 52 344 Senile Mortality.—The deaths which occurred in Hackney at 65 years of age and upwards during 1922 numbered 1,078 and of these 543 were between the ages of 65 and 75 years, 426 between 75 and 85 years, and 109 at 85 years and upwards. The annual mortality rate of persons at 65 years and upwards is 4.7 per 1,000 inhabitants. 27 Deaths in Public Institutions.—There were 1,556 deaths in public institutions in the Borough during 1922; of these 678 were residents of other districts, and the remaining 878 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 1922:— Institutions within the Borough receiving persons both from and without the Borough. Brooke House, Upper Clapton Road 7 Eastern Fever Hospital, Homerton 172 French Hospital, Victoria Park Road 4 German Hospital, Dalston 144 Hackney Union Infirmary, Homerton 881 „ Central Institution, Homerton 3 Metropolitan Hospital, Kingsland 213 Nursing Home, 46, Amhurst Park 6 „ „ 12, Amhurst Park 4 „ „ 122, King Edward Road 1 „ „ 117, Mount Pleasant Lane 5 „ „ 8, Springfield 1 „ „ 94, Cazenove Road 1 „ „ 153, Stamford Hill 2 „ „ 18 and 20, Southwold Road 5 „ „ 157, Richmond Road 1 „ „ 2, Queensdown Road 5 St. Joseph's Hospice, Mare Street 72 Salvation Army Nursing Home, 9, Amhurst Park 1 Salvation Army Maternity Hospital, Lower Clapton Road 21 „ Home, Rookwood Road 1 „ „ 122, Lower Clapton Road 3 „ „ 259, Mare Street 2 „ „ 16, Rectory Road 1 1,556 28 Institutions outside the Borough Receiving Sick and Infirm Persons in the Borough. Bancroft Lodge, Mile End 1 Banstead Mental Hospital 1 Bethnal Green Infirmary 5 Brook Hospital 1 Brompton Hospital 1 Cancer Hospital 3 Cane Hill Mental Hospital 1 Charing Cross Hospital 2 Children's Hospital, Great Ormond Street 5 City of London Maternity Hospital 5 Clare Hall Sanatorium, South Mimms 1 Claybury Mental Hospital 29 Colindale Hospital 10 Colney Hatch Mental Hospital 16 Darenth Industrial Colony 1 Dartford Heath Mental Hospital 2 Downs Sanatorium 1 East London Hospital 3 Elizabeth Garrett Anderson Hospital 1 Evelina Hospital 1 Guy's Hospital 7 Hackney Institute, Brentwood 2 Hampstead General Hospital 1 Hanwell Mental Hospital 3 Home Hospital for Women, Stoke Newington 1 Home and Hospital for Jewish Incurables, Tottenham 3 Horton Mental Hospital 2 Italian Hospital 1 Jubilee Hospital, Woodford 1 King's College Hospital 1 Carried forward 112 29 Brought forward 112 Lambeth Hospital 1 Leavesden Mental Hospital 12 London Hospital 49 London Temperance Hospital 1 Long Grove Mental Hospital 5 Manor Institution, Epsom l Middlesex Hospital 3 Mildmay Memorial Hospital 2 Mildmay Mission Hospital 1 Ministry of Pensions Hospital, Brixton 2 Ministry of Pensions Hospital, Richmond 1 Mothers' Home, Commercial Road 1 Mount Vernon Hospital 2 National Hospital, Queen's Square 3 National Heart Hospital 1 Northern Hospital, Winchmore Hill 1 North Eastern Fever Hospital 9 North Middlesex Hospital 1 Park Hospital 3 Peckham House 2 Prince of Wales' General Hospital 8 Queen's Hospital for Children 53 Queen Mary's Hospital, Carshalton 4 Royal Chest Hospital, City Road 3 Royal Hospital for Incurables 1 Royal Ear Hospital 1 Royal Free Hospital 5 Royal Northern Hospital 4 St. Bartholomew's Hospital 23 St. Columba's Hospital 6 St. George's Home 1 Carried forward 322 30 Brought forward 322 St. Luke's House, Kensington 3 St. Mary's Hospital l St. Peter's Hospital 1 St. Thomas's Hospital 3 Shoreditch Infirmary . 4 South Eastern Fever Hospital 3 South London Hospital 1 Tooting Bee Mental Hospital 13 Tuberculosis Hospital, Isleworth 1 University College Hospital 5 Victoria Park Chest Hospital 19 West Ham Union Hospital 2 Westminster Hospital 2 Miscellaneous Institutions 79 Total 459 MORTUARY, 1922. Number of bodies in Mortuary 284 1. To await Inquests— (a) Infectious - (b) Non-Infectious 276 2. To await Burial 8 Number of Post Mortems 139 Inquests. Verdict. Sex. Male. Female. Natural Causes 83 65 Accidental Death 45 28 Suicide 28 8 Open Verdict 7 6 Manslaughter — — Murder — 1 Misadventure 3 2 Totals 166 110 31 Table showing nature of above Suicidal and Accidental Deaths in the Borough of Hackney during the year 1922. Nature of Suicide. No. Nature of Accidental Death. No. Hanging 3 Shock from Burns 4 Poisoning 19 Shock from Fall 22 Cut Throat 2 Suffocation 4 Shooting — Drowning 3 Drowning 5 Run over 11 Run over by train 2 Fracture of Skull 19 Jumping from window 4 Fracture of Ribs 1 Stabbing 1 Fracture of spine 1 Shock from Scalds 5 Poisoning 1 Others 2 36 73 34 TABLE I.—HACKNEY BOROUGH. Vital Statistics of Whole District during 1922 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. ted Number. Nett Number. Rate. of Nonresidents registered in the District. of residents not registered in the District. Under 1 Year of Age At all Ages. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13' 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 2,853 14.6 1918 For Deaths 195.804 3,828 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 j4,748 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 2,861 127 For Births, 225.542 1921 224,200 5.437 1 4,978 222 2.757 12.6 648 471 329 66 2580 11.5 33 SPECIFIC INFECTIOUS DISEASE. During 1922 there were 1,583 cases of acute infectious disease compulsorily notified in the Borough, as set out in Table II.; of these 4 were found subsequently not to be suffering from any notifiable infectious disease, thus reducing the number of genuine cases to 1,579. This total shows a decrease of 1,381 upon those notified during 1921. The attack-rate in respect of the acute notifiable infectious diseases for the year is 61 per 1,000 inhabitants. In addition there were 319 notifications received of pulmonary tuberculosis and 85 notifications of other forms of tuberculosis. The deaths from the chief zymotic diseases numbered 144. This is equivalent to a zymotic death-rate of 0.63 per 1,000 living in the Borough, as compared with a zymotic death-rate of 0.7 during the previous year NOTIFIABLE INFECTIOUS DISEASES. Small-pox.—There was not any notification of small-pox in the Borough during 1922. Scarlet Fever or Scarlatina.—The number of cases of scarlet fever notified during 1922 was 674. This is a decrease of 1,189 cases upon the number of genuine cases notified during 1921. The prevalence of the disease each week throughout the year is shown on the chart. The attack rate for scarlet fever was 2"9 per 1,000 persons living, and for England and Wales 2.85. The number of cases removed to hospital during the year was 637. This is equal to 94 per cent. of the total notified. C 34 'Summary of Proceedings under the Vaccination Acts, 1867 to 1898, during the year 1922. 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 900 581 37 — — 299 2 38 17 229 Central 2,042 727 17 — — 861 2 397 68 309 South-East 1,276 546 13 — — 622 1 27 29 396 South-West 1,053 509 19 — — 506 — 8 17 402 Total 5,271 2,363 86 — — 2,288 5 470 131 1,336 Chart showing the Number of Cases of SCARLET FEVER and DIPHTHERIA weekly during 1922. NOTES:-Scarlet Fever Diphtheria 35 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 121 190 197 166 Attack-rate per 1,000 living 21 3.5 3.4 2.9 It will be seen from the above that scarlet fever was most prevalent in the Central Sub-district. The deaths from scarlet fever during 1922 numbered 10, which is equal to a case mortality of 1.4 per cent. attacked, and a scarlet fever death-rate of 0.044 per 1,000 inhabitants. The mortality rate for London from scarlet fever during the same year was 0.07 per 1,000 inhabitants. Diphtheria and. Membranous Croup—There were 736 cases of diphtheria and membranous croup notified during the year; and of these 4 cases of diphtheria were found subsequently not to be suffering from this disease, thus the total of genuine cases of diphtheria was reduced to 732. This is a decrease of 140 upon the number of genuine cases notified during 1921. The incidence of the disease can be seen by reference to the chart. The attack rate of diphtheria was 3.2 per 1,000 inhabitants, compared with 1.37 for England and Wales. There were 675 cases removed to hospital during the year. This is equal to 92 per cent. of the cases notified. 36 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 174 191 172 195 Attack-rate per 1,000 living 3.0 3.5 3.0 3.4 From the above it will be seen that diphtheria was most acute in the Central Sub-district. The deaths from diphtheria and membranous croup during the year numbered 22. This mortality is equal to a death-rate of 3'0 per cent. attacked and 0.09 per 1,000 inhabitants, as compared with a death-rate of 5.3 per cent. attacked, and 0'20 per 1,000 inhabitants for the previous year. The death-rate from diphtheria for London during the same period is 0"25 per 1,000 inhabitants. During the year 823 swabbings from throats of persons suspected to be suffering from diphtheria were bacteriological!)' examined, of which 257 gave positive results, 547 negative results, and 19 were returned as doubtful. Diphtheria Anti-toxin.—In accordance with the Anti-toxia 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 129 bottles of anti-toxin of 500, 2,000 and 8,000 units each respectively were supplied to medical practitioners, most of which was used for prophylactic purposes. 97 Typhoid or Enteric Fever.—During the year under consideration, 4 cases of enteric fever were notified. This shows a decrease of 3 on the number of genuine cases notified during 1921. The attack rate was 0 01 per 1,000 inhabitants, compared with 0 06 for England and Wales- All the cases notified were removed to hospital. 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 2 1 1 0 The deaths from enteric fever in the Borough last year numbered 1. During 1922 specimens of blood from 12 persons suspected to be suffering from enteric fever were submitted to Widal's test. All these gave 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 10 cases of puerperal fever notified during 1922; all the cases were removed to hospital. The deaths from puerperal fever and septicaemia numbered 1. The attack-rate for the year was 2.1 per 1,000 births, and the deathrate 0.2 per 1,000 births. 38 Plague.—There were no notifications of plague in the Borough during the year. Cholera.—There were no notifications of Cholera in the Borough during the year. Erysipelas.—There were 64 cases of Erysipelas notified during 1922. This is equal to an attack-rate of 0.28 per 1,000 inhabitants, compared with 0.35 for England and Wales. Of the 64 cases notified, 14 were removed to hospital. The deaths from erysipelas numbered 4. This gives a mortality-rate of 6.2 per cent. attacked, and of .01 per 1,000 inhabitants. 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 15 16 16 17 Rate per 1,000 living .26 .30 .27 .29 Cerebrospinal Meningitis.—During 1922 there were 4 cases of this disease notified in the Borough. These were removed to hospital. Polio-myelitis.—There was 1 case of Polio-myelitis notified in the Borough during the year. Ophthalmia Neonatorum.—There were 30 cases of this disease notified during the year. Five of these were removed to hospital. All the cases recovered without any impairment of sight. 39 Measles and German Measles.—The Public Health (Measles and German Measles) Regulations, 1915, were withdrawn by Order in Council on 31st December, 1919. Forty-five deaths were recorded from this disease. The annual mortality is therefore .2 per 1,000 inhabitants, compared with London .35 per 1,000 inhabitants. Information of 1882 cases of measles was received from headmasters of elementary schools in the Borough. A few cases were discovered by the Health Visitors, and parents advised (in the event of no medical man being in attendance) to obtain proper treatment for the cases. When the nursing was considered inadequate a nurse was provided at the expense of the Council through the King's Home for Nurses. Encephalitis Lethargica.—The Public Health (Acute Encephlitis Lethargica and Acute Polio Encephalitis) Regulations, 1918, came into operation on 1st January, 1919. During the year 1922 4 cases were notified, 1 case fatal; cause of death on Coroner's inquest returned as Acute Encephalitis due to result of fall. Three patients were removed to hospital. All necessary particulars were supplied by the medical practitioners in attendance. Influenzal Pneumonia and Pneumonia.—There were 17 cases of influenzal pneumonia and 33 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 77 cases were nursed and 1,137 visits paid to those cases. Influenza, unless complicated by pneumonia, is not notifiable. 40 Malaria.—The total number of cases of Malaria certified was 5, all of which, it was ascertained upon enquiry, had been contracted out of England. Dysentery.—There was 1 case of dysentery certified, this being contracted abroad; 3 deaths were registered. London (Notification of Glanders Order) 1907. No notification of glanders in animals in the Borough was received from the Veterinary Inspectors of the London County Council during 1922. NON-NOTIFIABLE INFECTIOUS DISEASES. Influenza.—During 1922 there were 113 deaths in the Borough. This is a increase of 81 on the deaths from this cause registered during 1921. The annual mortality rate from influenza is 0 5 per 1,000 inhabitants. Diarrhoea.—There was a decline in the number of deaths due to diarrhœal disease in the Borough during 1922. The total number of deaths from this cause was 4, and of these 3 were under 1 year of age. The annual mortality rate for diarrhoea and enteritis during the year is 0.01 per 1,000 inhabitants. Whooping Cough.—The deaths from this cause during the year numbered 62. This is an increase of 46 upon the number registered during 1921. Sixty-one of the deaths occurred in children under five years of age. The mortality for Hackney is equal to .27 per 1,000 inhabitants, and that for all London, S5 per 1,000 inhabitants. The King's Home for Nurses attended to 8 of the cases and paid 66 visits. Information was received from the head masters and head mistresses of elementary schools in Hackney of 723 cases of whooping cough occurring among their scholars during the year. 41 TABLE II.—HACKNEY BOROUGH. Cases of Infectious Disease notified during the year 1922. Notifiable Diseases. Cases Notified in whole District. 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 ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 732 14 197 347 103 58 13 ... 174 191 195 172 675 Erysipelas 64 ... 1 5 10 13 26 9 15 16 17 16 14 Scarlet Fever 674 6 178 368 85 36 1 ... 121 190 166 197 637 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 4 ... 1 ... 1 2 ... ... 2 1 ... 1 4 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 10 ... ... 1 1 8 ... ... 5 1 1 3 10 Cerebro-Spinal Meningitis 4 1 1 1 1 ... ... ... ... 1 2 1 4 Polio Myelitis 1 ... 1 ... ... ... ... ... ... ... ... 1 ... Ophthalmia Neonatorum 30 30 ... ... ... ... ... ... ... 5 16 9 5 Pulmonary Tuberculosis 319 ... 2 14 83 154 57 9 58 68 90 103 192 Other Forms of Tuberculosis 85 2 7 40 21 12 2 1 27 14 27 17 39 Encephalitis Lethargica 4 ... ... 1 1 ... 2 ... 1 ... 2 1 3 Influenzal Pneumonia 17 1 ... 2 2 3 5 4 2 2 7 6 4 Pneumonia 33 1 3 8 ... 7 10 4 1 7 20 5 6 Malaria 5 ... ... ... 2 2 1 1 ... 1 3 2 Dysentery 1 ... ... ... ... ... 1 1 ... ... ... 1 Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... Totals 1,983 55 391 787 310 295 117 28 408 496 544 535 1.596 42 CONSTITUTIONAL DISEASES. For table of Deaths, see pages 104 and 111. Cancer.—There were 285 deaths during 1922 due to the different varieties of malignant disease. This is a decrease of 4 on the number registered during 1921. The annual mortality rate from malignant disease for last year is therefore 1.26 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 94 59 65 67 Mortality-rate per 1,000 inhabitants 1.6 1.1 1.1 1.1 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 1922:— London. Years. 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 Deaths from Cancer. 250 256 276 245 230 236 274 246 289 285 Death-rate per 1,000. 111 114 126 116 117 107 126 109 128 126 Death-rate per 1,000. 110 113 116 13.3 125 126 120 120 131 130 Alcoholism. Alcoholism.—During the year under consideration there were no deaths from alcoholic poisoning; there were, however, 9 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. 43 TUBERCULOSIS. During 1922, 404 primary notifications of tuberculosis were received, details of which are given on page 45 of this Report. Bacteriological examination of sputa from 350 cases was made by the Council's Bacteriologist during the same period. In 59 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 1922, was 238, a decrease of 26 upon the deaths during 1921. These deaths are classified as follows:— Pulmonary tuberculosis 202 General tuberculosis 8 Tuberculous meningitis 14 Tuberculous peritonitis 2 Tabes mesenterica 1 Tubercle of other organs 11 238 This number of deaths gives an annual mortality of 1.05 per 1,000 inhabitants. In the following table the yearly deaths from tuberculous disease in the Borough for the last 24 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 1919-1921 261 45.9 1922 238 50.7 44 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 the year 1922, being equal to 50.7. There is good reason to believe that the Borough Council's Tuberculosis Scheme is doing valuable work, although much might be done in the direction of improving the present scheme. 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 44 56 70 68 Mortality rate per 1,000 inhabitants .77 1.0 1.2 1.2 Public Health (Tuberculosis) Regulations, 1912. Under these Regulations 1,138 notifications of tuberculosis were received during the year, of which 957 were pulmonary and 181 non-pulmonary notifications. 45 Summary of Notification during the Period from 1st January, 1922, to 30th December, 1922. 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 Notifications. Primary Total Pulmonary Males ... 1 1 5 11 23 43 42 30 8 7 171 206 „ Females ... 1 2 6 21 28 40 29 14 5 2 148 166 Non-Pulmonary Males 2 4 9 9 5 4 2 ... 2 ... ... 37 38 „ „ Females ... 3 6 11 7 5 7 3 ... ... 1 43 45 Age Periods. Number of 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 ... ... ... ... ... 33 190 „ Females ... ... ... ... ... 43 89 Non-Pulmonary Males ... 2 1 3 4 1 30 „ „ Females ... 1 1 2 2 1 27 46 Visits paid by Tuberculosis Visitors. New Cases. Contacts Sailors and Soldiers Other Persons. Total. Insured. Noninsured Miss Servante 191 192 525 1,735 2,643 1,501 1,142 Miss Clarke 243 147 466 1,454 2,310 1.112 1,198 434 339 991 3,189 4,953 2,613 2,340 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 383, and the total number of visits of this kind made was 991. 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. 47 The expenditure on the dispensary scheme, after deducting the payment made by the Ministry of Pensions in respect of the treatment of ex-service men or any other contribution, being- made as follows:— (a) 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 have been transferred to the London County Council both in respect to the dispensaries and the provision of sanatorium treatment, so that the London County Council are 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. The Scheme for carrying out Dispensary Treatment and After-care was thrust ready-made upon the Borough Council, so that the following authorities are now interested in the Dispensary treatment of Tuberculosis in Hackney:— Hackney Borough. Council, Stoke Newington Borough Council, Bethnal Green Borough Council, Ministry of Health, London County Council, Metropolitan Hospital Management Committee, Victoria Park Hospital Management Committee. 48 A Tuberculosis Officer in addition to the primary duty of diagnosis and treatment of tuberculosis, is required to attend meetings of the Advisory Committees, Care Committees and Ca,se Committees, and prepare tables of statistics for the information of the Committees. He is also expected, according to Circular 149, to visit at least once, the home of each dispensary patient; and should also visit for the purpose of examining contacts, and for consultation and reporting purposes as often as may be required. The three Tuberculosis Officers appointed at the two Dispensaries are required to carry out the treatment of Tuberculosis in three Metropolitan Boroughs containing in 1922 a total estimated population of 396,420, with 504 deaths from tuberculosis and with 778 primary cases of tuberculosis notified during that year alone. DISPENSARY DISTRICTS. Estimated Population in Electoral Wards. Metropolitan Hospital Area— Stamford Hill 33,211 93,110 145,730 West Hackney 19,261 Kingsland 23,342 Downs 17,296 Estimated population (1922)— Borough of Stoke Newington 52,620 Victoria Park Hospital Area— Clapton Park 43,098 132,290 250,690 Homerton 37,692 South Hackney 23,351 Hackney 28,149 Estimated population (1922)— Borough of Bethnal Green 118,400 396,420 Estimated population (1922) Hackney 225,400 49 DISPENSARY DEATHS. Condition of Patient on First Attendance. Pulmonary Tuberculosis lit Stage. 2nd Stage. 3rd Stage. Number 9 47 57 Percentage 7.96% 41.60% 50.44% Duration of illness before attending Dispensary Under 1 month 3 1 to 3 months 10 3 to 6 months 16 6 to 9 months 6 9 to 12 months 4 Over 12 months 56 Period indefinite 18 ALL DEATHS FROM TUBERCULOSIS. Interval elapsing between Notification and Death. 1920. 1921. 1922. Pul. Non-pul Pul. Non-pul Pul. Non-pul. 1. Number of Deaths from Tuberculosis 190 59 213 51 202 36 2. Number of cases only notified at death 6 16 10 10 11 4 3. Do. notified within a month of death 17 1 17 ... 20 1 4. Do. do. 3 months of death 14 4 23 ... 25 1 5. Do. do. 6 months of death 23 1 27 1 24 1 6. Number of deaths not notified under Tuberculosis Regulations 7 11 23 25 24 20 It has been stated that too little attention is paid to the examination of contacts, but every endeavour has been made during the past year to examine the contacts to every notified case. 50 During 1922, 404 primary cases were notified, and the contacts to these cases number in all 893 persons, and of these 569 contacts were examined, making the number examined slightly over 63 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. Some of these contacts were examined privately and not at the Dispensary. During the year 1922, 238 deaths were registered—202 pulmonary and 36 non-pulmonary; but of these 24 pulmonary and 20 non-pulmonary were not originally notified under the regulations. Enquiries as to contacts, however, were made in all cases, with the exception of deaths occurring in Mental Hospitals, Of the pulmonary deaths, there were 507 contacts, of w hich 282 were examined, representing 55 per cent. examined; and of the non-pulmonary deaths there were 76 contacts, of which 23 were examined, representing 30 per cent. examined. 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 in charge of the dispensaries. CITY OF LONDON HOSPITAL TUBERCULOSIS DISPENSARY. (Dr. Howell.) HACKNEY CASES TREATED. 1.—The Totals of New Cases. Males 295 Females 345 Total 640 51 2.—The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 102 55 Local Practitioners Primary 98 107 143 50 Contact 9 7 London War Pensions Committee 31 11 Contact cases 354 6 London County Council 15 9 Victoria Park Hospital 19 19 Other sources 12 5 3.—The Diagnosis of the New Cases. Diagnosis. Insured. Uninsured. Total. Males. Females. Children under 16. Males. Females. Pulmonary Tuberculosis 47 26 1 16 30 120 Non-pulmonary Tuberculosis 3 3 17 4 8 35 Non-tuberculous 66 52 239 20 85 462 Doubtful 11 1 2 1 8 23 Totals 127 82 259 41 131 640 4.—The Diagnosis of Contact Cases. Pulmonary tuberculosis 11 Non-pulmonary tuberculosis 2 Non-tuberculous 344 Doubtful 6 Total 363 52 5.—Sputum Examinations of Insured and Uninsured Patients. Insured. Uninsured. Total. Tubercle Bacilli present 119 37 156 Tubercle Bacilli absent 409 143 552 6.—Other Figures. Insured. Uninsured. Total number of attendances 2,454 3,298 Systematic examinations at the above 1,345 1,246 Number of letters written 1,894 Number of visits to patients at their homes 126 Number of patients sent to hospital or sanatorium 88 30 Number of patients referred to:— X-ray Department 35 5 Other Departments 32 53 METROPOLITAN HOSPITAL TUBERCULOSIS DISPENSARY. (Dr. Young.) HACKNEY CASES TREATED. 1.—The Totals of New Cases. Males 182 Females 165 Total 349 53 2.—The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 56 26 Local Practitioners 58 23 London War Pensions Committee 7 7 Contact cases 192 10 Ministry of Pensions 15 4 London County Council 5 2 Metropolitan Hospital 5 4 Other Hospitals 4 3 Other sources 7 5 3.—The Diagnosis of the New Cases. Diagnosis. Insured. Uninsured. Total. Males. Females. Children under 16. Males. Females. Pulmonary Tuberculosis 30 11 5 14 11 71 Non-pulmonary Tuberculosis . 1 ... 10 1 1 13 Non-tuberculous 56 28 117 6 46 253 Doubtful 2 1 8 1 ... 12 Totals 89 40 140 22 58 349 4.—The Diagnosis of Contact Cases. Pulmonary tuberculosis 6 Non-pulmonary tuberculosis 5 Non-tuberculous 179 Doubtful 3 Total 192 54 5.—Sputum Examinations of Insured and Uninsured Patients. Insured. Uninsured. Total. Tubercle Bacilli present 86 46 132 Tubercle Bacilli absent 74 166 240 6.—Other Figures. Insured. Uninsured. Total number of attendances 1,373 1,546 Systematic examinations at the above 331 321 Number of letters written 777 298 Number of visits to patients at their homes 16 18 Number of patients recommended for hospital or sanatorium 43 18 Number of patients referred to:— X-ray Department 32 20 Other Departments 13 24 Extra Nourishment. The Scheme came into operation on 6th June, 1921, and during the year, 138 cases have received assistance. The length of time each patient has been in receipt of nourishment has varied from a few days to several weeks. Those cases who received this assistance for a few days only ceased to receive it on account of their removal to Sanatorium. The Tuberculosis Officers have entire freedom under Circular 194 as to the granting of Extra Nourishment, provided the cases come within the "necessity" limit of the Council, are early or sanatorium cases and that the number of cases in receipt of this assistance is not so large as to cause the approved expenditure to be exceeded. The total cost for the year is £368 8s. 8d. 55 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. Pulmonary Tuberculosis. Other forms of Tuberculosis. Totals. At Patients' Homes 74 11 85 At Hackney Infirmary 64 7 71 At other Institutions 64 18 82 202 36 238 It should be remembered that the deaths which occur in institutions cannot be considered to represent the 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: "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 87. Dr. Howell, Tuberculosis Officer to the City of London Hospital Tuberculosis Dispensary is responsible Tor the medical care of the children, and visits the School once weekly. 56 After Care.—Every effort has been made by the Care Committee to carry out every duty possible under existing circumstances. DISINFECTION. (a) Rooms.—During 1922 there were 1,902 rooms fumigated and 578 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 1922. Month. Rooms fumigated. Rooms cleansed. January 190 80 February 154 50 March 178 46 April 141 45 May 186 34 June 111 50 July 147 44 August 126 39 September 125 50 October 163 49 November 202 49 December 179 42 Total 1902 578 (b) Articles of Clothing, Furniture, etc.—The number of articles under this head disinfected during last year was 12,711. This is a decrease of 8,216 upon the number disinfected during 1921. A table is here given showing details of the articles disinfected each month. 57 Articles Disinfected, 1922. Description of Articles. January. February. March. April. May. June. July. August. September. October. November. December. Totals. House linen and furniture 1,217 871 1,064 1,038 971 614 826 638 805 854 1,213 1,003 11.114 Men's clothing 7 5 14 ... 3 ... ... 6 39 ... 6 ... 80 Women's clothing 19 4 4 2 1 1 8 3 3 2 2 6 55 Children's clothing ... 2 1 1 ... ... ... ... 3 ... ... ... 7 Other articles 89 170 118 170 87 51 154 99 103 150 117 147 1,455 Total 1,332 1,052 1,201 1,211 1.062 666 988 746 953 1,006 1,338 1,156 12,711 58 Articles Disinfected, 1922. In addition to these there were 186 articles destroyed on request from the owners. These are set out in the following table:— Articles Destroyed. Beds 56 Bolsters 7 Mattresses 39 Pillows 35 Sundry Articles 49 Total 186 (c) Public Library Books.—During the past year 442 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 44 February 16 March 44 April 31 May 44 June 18 July 28 August 41 September 47 October 40 November 45 December 44 442 59 Isolation Shelter. During' the year there were 75 persons admitted to the Shelter whilst their homes were being disinfected. This total consisted of 20 men, 20 women and 35 children. The cost of maintenance of these persons admitted was £5 18s. 0d. 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, except as stated below, during last year, The total number of baths given during that period was 3,533 (210 to adults and 3,323 to children). This total shows a decrease of 1,350 upon the number given during 1921. Of the 3,533 baths given, 1,754 were sulphur baths for scabies, and 1,779 for pediculi. The great majority of those persons presenting themselves for baths were children from the elementary schools in the Borough. The children received 3,323 baths, a decrease of 1,077 upon the number given during 1921. As already mentioned, the Station was closed for three months during the year—June to August—for extensive alterations to the building and instalment of new plant. The following are the Schools from which children were sent to the Cleansing Station, with the number of baths given:— Schools. Number Hot Baths. Cleansed. Sulphur Baths. Benthal Road 130 10 Berger Road 123 39 Church Street — 104 College Lane — 43 Craven Park 49 14 Daubeney Road 158 88 Detmold Road 136 161 Eleanor Road — 49 Enfield Road — 4 Carried forward 596 512 60 Brought forward 596 512 Gainsborough Road — 19 Gayhurst Road 32 35 Glyn Road 64 4 Hackney Parochial 37 33 High Street 1 18 Homerton Row 152 7 Lamb Lane 7 3 Mandeville Street 249 23 Millfields Road 22 — Morning Lane 100 16 Newington Green — 53 North wold Road 94 — Orchard Street 73 48 Percy Road 23 — Princess May Road — 14 Queen's Road 14 — Rams 3 — Rushmore Road 69 139 St. John the Baptist 1 19 St. Joseph's 18 — St. Jude's — 1 St. Matthias 1 9 St. Michael's 7 — St. Soholastica's 2 — Shacklewell 1 18 Sidney Road 94 102 Sigdon Road 45 312 Tottenham Road — 42 Wilton Road 44 17 Wordsworth Road — 22 Other young children 5 103 1,754 1,569 61 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 2 4 1 1 ... ... ... 2 3 1 3 4 21 Women ... ... 2 ... ... ... ... ... 1 ... 1 ... 4 Children 43 163 170 111 200 ... ... ... 335 351 221 160 1754 Receiving Sulphur Baths. Men 29 4 19 14 6 ... ... 7 12 3 14 3 114 Women 13 ... 6 3 14 ... ... 7 16 ... 6 4 74 Children 204 244 239 237 212 ... ... 1 91 137 107 97 1569 62 MATERNITY AND CHILD WELFARE. Dates of Adoption of Special Measures directed towards the Prevention of Infantile Mortality. 1906. Conference on Infant Mortality held in London under the presidency of the President of the Local Government Board. The Conference recommended the appointment of women to give instruction in the care and feeding of infants. 1907. Notification of Births Act passed requiring notification of births within 36 hours. Local authorities adopting the Act were given power to make arrangements for giving advice and instruction on infant hygiene, etc. (The Hackney Infant Life Protection Society formed.) 1908. Medical Officer of Health reported on Infant Mortality of the Borough, and recommended the appointment of a Health Visitor. 1909. Health Visitors (London) Order issued by the Local Government Board. Notification of Births Act extended to Hackney by order of the Local Government Board of Oct. 18th, 1909. 1910. Voluntary workers carried on work under the Notification of Births Act. In October of the same year a Health Visitor was appointed by the Council. 1911. A Weighing Centre was opened for a short time in the Town Hall. 1912. During this year the Infant Welfare work was for a time discontinued owing to the resignation of a Health Visitor whose place was not filled. 1913. A Health Visitor appointed. Weekly weighing meetings. 1914. No change in Hackney other than the opening of a Voluntary Welfare Centre. Many Municipal Centres opened in London during this year. 1915. No change. 1916. The Medical Officer of Health reported on Maternity and Child Welfare recommending the appointment of four Health Visitors and the opening of two Infant Centres. An Inspector of the Local Government Board attended the Public Health Committee when the report was discussed. 63 1917. Overbury Street, Brooksby's Walk, and Mayfield Road Infant Welfare Clinics opened. 1918. An Ante-natal Clinic established at Overbury Street and at Brooksby's Walk. Arrangements made for the supply of milk under the Milk Orders. Maternity and Child Welfare Committee appointed two additional Health Visitors. 1919. Midwifery agreements with Mothers' Hospital, Clapton, and City of London Maternity Hospital. Scale of assistance for granting milk adopted. 1920. Three add.tional Health Visitors appointed, making a total of nine now in the service of the Council. Milk not given from Centres, all applications dealt with through the Public Health Department. 1921. Arrangements for providing the services of Midwives to necessitous persons: extension of agreement with Mothers' Hospital, Clapton. An additional Welfare Centre was opened in February by the Council, at Northwold Road, Clapton, and the Hackney Grove Voluntary Infant Welfare Association opened in October an additional Centre for the Hackney Grove District, so that there are now seven Centres operating in Hackney; four Municipal and three Voluntary. The work of the Eton Mission Welfare Centre was also increased in scope by the institution of an Ante-natal Clinic, and an additional grant of £50 per annum by the Council was sanctioned by the Ministry to date from March 31st. At Overbury Street Centre a weekly instead of a fortnightly, Ante-natal Clinic, and an additional Child Welfare Clinic were put into operation. The Infant Mortality in Hackney during the years 1900 to 1921 has been as follows:— 1900 158 1901 135 1902 121 1903 127 1904 155 1905 140 1906 123 1907 116 1908 123 1909 113 1910 104 1911 120 1912 79 1913 99 1914 85 1915 107 1916 84 1917 92 1918 111 1919 85 1920 81 1921 66 64 Extension of the work in the following directions is urgently necessary— Centres.—Reports from the Centres show that the work carried out is meeting a great need, but that the Centres are inadequate for the work required. There are too few Centres, which results in overcrowding, and at Northwold Road Infant Welfare Centre there is particular need for an additional Clinic, and for an Ante-natal Clinic at the same Centre. Infectious Disease.—No attempt can be made under present conditions to control non-notifiable infectious disease, such as Measles, Whooping Cough and Epidemic Diarrhoea, which are responsible for so great an infant mortality. The school authorities forwarded notifications during the year of 1,882 children absent from school on account of Measles, and 723 children absent on account of Whooping Cough. It is practically impossible to attempt the routine visiting of these cases. Only urgent cases brought tp notice can be dealt with. The King's Home for Nurses renders the greatest assistance in regard to these urgent cases, but if one compares the number assisted in this way with the number reported from schools (and school age is much less dangerous than infancy as regards Measles), it is evident that this disease alone requires further measures to bring about any degree of control. The Health Visiting Staff is barely able to carry out the duties as regards notification of births and Centre work, and any additional duties would mean the relinquishing of work now being performed. During the past year 45 deaths occurred from Measles, but the deaths convey only a slight indication of the amount of damage caused by Measles treated under unfavourable conditions. 65 Nursing Assistance.—As already stated, only a fraction of the cases are dealt with. No. of cases nursed. No. of visits paid. Pneumonia 77 1,137 Whooping Cough 8 66 Measles 16 197 Tuberculosis 3 44 Ophthalmia Neonatorum 8 145 Others 23 290 Totals 135 1,879 Dental Clinic.—The Medical Officers of the Centres have repeatedly urged the necessity for the installation of a Dental Clinic. Proposals were put forward by the Committee for the establishment of a Dental Clinic at Eton Mission in co-operation with the London County Council School Dental Clinic. The establishment of this Clinic would have cost £130, but the additional expenditure was not approved by the Ministry of Health. DESCRIPTION OF THE WORK DURING THE PAST YEAR. The work carried out during 1922 can be conveniently reported under the following descriptive titles:— 1. Health Visiting; 2. Consultation and Ante-natal Clinics; 3. Provision of Midwifery Assistance and Convalescent Home treatment; 4. Provision of milk and other foods to necessitous mothers and children. E 66 I.—HEALTH VISITING. The following table gives details of the visits made by the Council's Health Visitors during the year:— Miss M. Chitson Mrs. A. Rhodes Miss D, F. Vidal Mrs. L. E. Bartholomew Miss S. Love Miss A. Roche Miss E. D. Mann. Mrs. L. Harrison Miss M. Cockle Totals. Number of visits to infants under 1 year of age (first visits) 416 364 451 306 368 384 277 269 459 3,294 Secondary visits to infants under 1 year of age 967 632 457 456 482 623 126 337 639 4,719 Number of visits to children 1-5 years of age 592 478 533 395 225 468 155 362 774 3,982 Total number of infants and children visited 1,975 1,474 1,441 1,157 1,075 1,475 558 968 1,872 11,995 Number of visits to Measles cases — 10 30 — — 7 — 4 2 53 Number of visits to Pneumonia cases 16 4 6 4 1 4 1 1 14 51 Number of visits to Ophthalmia Neonatorum cases 20 3 1 3 2 12 3 8 29 81 Number of visits to expectant mothers 59 38 73 25 19 78 24 68 89 473 Number of special visits 115 52 22 37 56 98 10 163 32 585 Number of fruitless visits (outs, removals, etc.) 340 168 140 402 248 175 128 39 201 1,841 Total number of visits paid during the year 2,525 1,749 1,713 1,628 1,401 1,849 724 1.251 2,239 15,079 Total number of Clinics at- tented during the year. 137 120 140 58 126 105 61 85 963 67 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. satis- tory. 3294 2778 302 214 2213 1081 1255 2039 3086 208 8701 2.-INFANT CONSULTATION AND ANTE-N ATALCUN1CS. Part-time (temporary, i.e., not on the permanent staff) Medical Officers have been appointed to conduct the work of the consultation 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. 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 attendant of children over 1 yet 1. Overbury Street 1 Morning 51 160 1,795 1,955 1,266 68) 1 Afternoon 51 320 3,590 3,910 2,534 1,376 2. Brooksbv's Walk 51 509 3,623 4,132 3,196 936 3. Mayfield Road Monday 43 34 922 956 586 371 Friday 50 498 3,733 4,231 2,848 1,383 4. Northwold Road 51 476 4,562 5,038 2,347 2,691 5.*Hackney Mothers' and Babies', Hackney Grove 102 316 2,685 3,001 ! 2,690 1,04! Do. Ada Street 52 97 640 737 6.*Eton Mission, Gainsborough Road 99 251 2,006 2,257 1,801 456 Totals 550 2,661 23,556 26,217 17,268 8,949 *These are Voluntary Centres and are co-ordinated with the Infant Welfare work in the Borough. The Hackney Mothers' and Babies' Welfare Centre receives an annual grant of £200 from the Council and the Eton Mission Centre £100. Ante-Natal Welfare Centres. Overbury Street. Brooksby's Walk. Eton Mission. Number of times Centre opened 51 26 26 Number of expectant mothers attending 412 220 98 Number of repeated attendances at Centre 621 176 88 Total attendances 1,033 396 186 Number of visits to expectant mothers at their homes by the Health Visitors Number of cases 69 55 105 Number of visits 78 59 251 69 3.—HOSPITAL AND MIDWIFERY ASSISTANCE. (1) Maternity Hospitals.—The Council pays 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 pay for the treatment received, an amount equal to one-half the average cost per patient of the maintenance and administration charges for the year ended December 31st, 1920. Necessitous Cases. Cases. Cost. Salvation Army Mothers' Hospital 145 £152 5 0 City of London Lying-in Hospital 120 126 0 0 265 278 e 0 (2) Provision of Midwives.—During the year the fees of midwives in attendance on 57 mothers confined in their homes were paid by the Council and in 3 cases Home Helps were provided. (3) Agreement for the Provision of Convalescent Home Treatment. An agreement has been entered into, with the sanction of the Ministry of Health, with the Invalid Children's Aid Association, whereby the Association arranges, on behalf of the Maternity and Child Welfare Committee, convalescent aid under the Councils Maternity and Child Welfare scheme. The Maternity and Child Welfare Committee, under this arrangement, is not required to meet any cost other than that the parent is unable to contribute towards the actual cost of the treatment provided at the Convalescent Home. The number of cases assisted during the year was five. 70 4.—PROVISION OF MILK AND OTHER FOODS TO NECESSITOUS MOTHERS AND CHILDREN. In every case dealt with, every form of assistance was taken into account, including, of course, that given by the Guardians. Milk supplied free of cost to necessitous cases involved the Council in an expenditure of £ 1,777 12s. Id. (a) Supplied free of charge to necessitous mothers :— £ s. d. Glaxo 148 8 2 Cow and Gate 41 6 9 Virol 23 5 0 Marylebone Cream 7 17 3 Cod Liver Oil and Malt 18 0 1 Sundries 19 7 3 £258 4 6 Dried Milk, Foods, Medicines, etc. (b) Supplied at cost price— £ s. d. Glaxo 1,438 19 8 Cow and Gate 605 17 10 Virol 146 18 0 Lactagol 18 13 9 Marylebone Cream 52 10 0 Petroleum Emulsion 37 0 1 Syrup Ferri 12 11 6 Malt 0 15 11 Cod Liver Oil and Malt 30 3 10 Sundries 75 11 6 £-2,419 2 1 71 Housing and work of sanitary inspection. Public Health (London) Act, 1891. Year. Intimation Statutory Legal Notices. Notices. Proceedings. 1913 4,852 223 4 1914 3,980 280 13 1918 2,466 258 24 1919 4,780 405 60 1920 6,781 982 116 1921 8,032 1,701 117 1922 6,713 1,207 95 Rent and Mortgage Interest (Restriction) Act, 1920. The number of certificates granted under the Increase of Rent and Mortgage Interest (Restriction) Act, 1920, during the year was 31. In order to obtain any relief under the Sanitary Certificate Section action must be taken by the tenant at the County Court, and there is on this account no eagerness to take advantage of the Section. In 24 cases the work required on the notice was carried out without action being taken. In 4 cases action was taken and the work carried out. In 3 cases action was taken and the increase of rent remains suspended, the work not yet being carried out. London County Council (General Powers) Act, 1904. During the year attention was drawn by the Medical Officer (Education) of the London County Council to 151 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:— 72 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 151 10 14 127 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. In addition, 58 houses were discovered to be verminous under conditions where neither tenant nor owner could be shown to be directly responsible. The rooms in these houses, numbering 95, were cleared of vermin by the Public Health Department. Rats and Mice Destruction Act, 1919. The agreement entered into between the Council and Messrs, Howard and Sons, has worked most satisfactorily throughout the year, the scale of fees payable in those cases where the persons responsible for the destruction of rats desire the work to be done by Messrs. Howard under the supervision of the Council's Sanitary Staff is as follows:— £ 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 „ 73 During the year the following premises have been cleared of rats:— 1 Factory, (Business Premises). 27 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. SAN IT A R Y ■ INSPECTION. Public Health (London) Act, 1891. (a) Complaints of Nuisances.—During the year 1922 there were 4,421 complaints of nuisances made to the Public Health Department and investigated by the Sanitary Inspectors of the Borough. Defects or nuisances were discovered in 3,730 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 Diseases.—The occupied dwellings inspected during the year after infectious disease numbered 1,473. This is a decrease of 1,381 upon the number inspected during 1921. Any nuisances or sanitary defects found were dealt with under the provisions of the above Act. 74 (c) General Inspections.—The number of other inspections made by the Inspectors during the year was 1,769. 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 1922 was 6,713. The number of statutory notices served was 1,207 ; and summonses were issued in 95 cases. (d) 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, 4 cwt.; Meat, i cwt. ; tinned foods, 3 tons, 2 cwts. 1 qr. 21 lbs. ; fruit, 14 lbs. Prosecutions under the Public Health (I^ondon) Act, 1891, during the year 1922. Address. Complaint. Magistrate's Decision. Fine. Costs Lea Valley Laundry Smoke nuisance Order to abate in 28 days. £ s. d. £ s. — 5 5 162, Dalston Lane Rooms dirty; roof, gutter, and yard paving defective ,, ,, — 1 5 14, Sylvester Road ... W. C. defective Order to abate forthwith. — 1 5 24, Wick Road Sink waste pipe defective Withdrawn (Work done.) — 1 3 1, Digby Road W.C. pan and cover to inspection chamber defective ,, ,, — 1 3 69, Paragon Road Insufficient ventilation in kitchen ,, ,, — 1 3 Carried forward — 12 5 75 Address. Complaint. Magistrate's Decision. Fine. Costs. brought forward £ s. d. £ s. d. — 12 5 0 41, Hindrey Place Roof defective Withdrawn (Work done.) — 1 3 0 151, Sandringham Rd. Roof and W.C. defective Order to abate in 7 days. ■— 1 11 6 10, Durrington Road Rooms dirty; stove defective Withdrawn (Work done.) — 0 15 0 16 " " Roof defective " " — 0 15 0 20, " " Rooms dirty ; sashes defective " " — 0 15 0 22, Percy Terrace Kitchen stove defective " " — 1 3 0 21, Wallis Road No water supply Order to abate in 14 days — Stall—Ridley Road 16 tins of condensed milk unfit for food Dismissed — Green Dragon P.H. Well Street Urinal so constructed as to be a nuisance Withdrawn on payment of — 1 1 0 23, Downs Park Road Roof defective ; room dirty Withdrawn (Work done.) 1 3 0 29, Amhurst Road Non-compliance with Magistrate's Order Fined S 0 0 2 2 0 28, Nisbet Street Eaves gutters, flooring, &c., defective Order to abate in 21 days — 2 2 0 32," " General insanitary condition " " — 2 2 0 53, " " " " " " " — 2 2 0 58, Brunswick Street Eaves gutters, sashes, &c., defective Withdrawn (Work done.) — 1 3 0 182, Well Street Ceiling defective and dangerous Order to abate in 14 days — 1 1 0 " " Non-compliance with Magistrate's Order Fined 1 0 0 1 1 0 299, Kingsland Road General insanitary condition Order to abate in 28 days — 1 1 0 12, Sylvester Road " "" Order to abate in 14 days — 1 11 6 146, Chatsworth Rd. Defective drains Order to abate in 21 days — 1 1 0 148, " " " " " " — 1 1 0 191, North wold Road Roof defective Order to abate in 7 days — 1 1 0 27, Gransden Avenue Rooms dirty, roofs defective Order to abate in 7 days — 1 1 0 23, " " Rooms dirty Withdrawn (Work done.) — 1 11 6 23, Warburton Road Roof defective Order to abate in 7 days. — 1 1 0 Carried forward 6 0 0 41 13 6 76 Address. Complaint. Magistrate's Decision. Fine. Cost. Brought forward £ s. d. £ s. 6 0 0 41 13 205, White Cross St. Condensed milk sold to local dealer unfit for food Fined 5 0 0 5 5 24, Detmold Road Drain defective Order to abate in 14 days — 1 1 31, Bower Road Rooms dirty, flooring defective Withdrawn (Work done.) — 0 2 47, Nisbet Street General insanitary condition " " " — 0 10 49, " " " " " " " " — 0 10 55, " " " " " Order to abate in 21 days — 2 2 38, Hertford Road Paving of Roadway defective Withdrawn — 1 1 " " No separate Urinal accommodation for " " " — – " " men No separate W.C. accommodation for " " " — 1 1 299, Kingsland Road women Non-compliance wilh Magistrate's Order " " " — 3 3 37, Nisbet Street General In>anitary condition Order to abate in 21 days 0 10 39. " " " " " " " " — 0 10 41. " " " " " " " " — 0 10 45. " " " " " " " " — 0 10 12, Sylvester Road Von-compliance with Magistrate's Order Withdrawn (Work done.) — 2 2 " " " Flooring defective " " — – 191, North wold Road Non-compliance with Magistrate's Order " " — 1 1 110, Chatsworth Road General insanitary condition " " — 1 1 69, North Street " " " " " — 1 11 60, Holly Street " " " " " — 1 222, Dalston Lane " " " Order to abate in 14 days — 1 11 21, Hartwell Street " " " Order to abate in 28 days — 1 11 4, Ridley Road " " " Order to abate in 21 days — 1 1 " " Defective dust-bin " " — –- Carried forward 11 0 0 69 12 77 Address. Complaint. Magistrate's Decision. Fine. Costs. Brought forward £ s. d. £ s. c . 11 0 0 69 12 0 17a, Gransden Avenue General insanitary condition Order to abate in 14 days — 1 1 0 Mount Pleasant Mansions Sufficient number of dust-bins not maintained in repair Fined 4 0 0 1 11 6 29, Gransden Avenue Drains defective Order to abate in 28 days 0 8 6 31, " " " " " " 0 8 6 33, " " " " " " — 0 8 6 35, " " " " " " — 0 8 6 37, " " " " " " — 0 8 6 4, Ribstone Street General Insanitary condition Order to abate in 14 days — 1 1 0 16, " " " " " " ■— 1 1 0 8, " " " " " " — 1 1 0 4, Morning Lane Dust bin defective Fined 1 0 0 1 1 0 8, „ „ No dust bin " 1 0 0 1 4 0 08, Haggerston Road General insanitary condition Withdrawn (Work done.) — 1 3 0 75, Kingsland Road " " Dismissed on payment of 1 11 6 477, " " " " " " — 1 11 6 479, " " " " " " — 1 11 6 89, Northwold Road Defective drains Order to abate in 42 days — 0 10 6 191, " " " " " " — 0 10 6 193, " " " " " " — 0 10 6 195, " " " " " " — 0 10 6 197, " " " " " " — 0 10 6 199, " " " " " " — 0 10 6 201, " " " " " " — 0 10 6 203, " " " " " " — 0 10 6 205, " " " " " " — 0 10 6 " " Carried forward 17 0 0 90 4 0 78 Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. d. £ s. Brought forward 17 0 0 90 17a, Gransden Avenue Non-compliance with Magistrate's Order Fined. 3 0 0 1 28, Pedro Street Rooms dirty; no grating to vent-pipe Withdrawn (Work done.) .— 1 38, Lauriston Road Roof and floor defective " " — 0 15 46, „ „ Sink waste pipe defective " " — 0 IS 20, Tilia Road Rooms dirty ; flooring defective Order to abate in 14 days. — 1 5, Hindrey Place Roof defective ; W.C. choked Fined. 3 0 0 2 3, " " Windows and floor defective Withdrawn (Work done.) 1 13 29, Gransden Avenue Non-complance with Magistrate's Order Fined. 1 0 0 1 31, " " " " " " 1 0 0 1 33, " " " " " " 1 0 0 1 35, " " " " " " 1 0 0 I 37, " " " " " " 1 0 0 1 3, " " Defective drains Order to abate in 21 days — 1 5, " " " " " " — 1 13, Norfolk Road soof and gutter defective Dismissed (Work dour) — 1 £28 0 0 £107 Prosecutions under Cowsheds and Milkshops Orders, 1885-6, during the year 1922. 91a, De Beauvoir Rd. Unregistered purveyor of milk Withdrawn £ s. d. £ s, d. — " " Fail to employ means for preserving purity of milk Order to pay 1 1 " " " " Withdrawn — " " Unregistered purveyor of milk \ Pined. 1 0 0 1 1 £1 0 0 £2 21 79 Housing and Town Planning Regulations. A systematic inspection is being' made and an accurate card indexed record compiled of the housing- conditions of the Borough. The number of houses inspected under these regulations during the year was 1437. Factory and Workshop Act, 1901. Factories.—During the year, 120 factories were inspected by the officers of the Public Health Department. In 17 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 13 11 — 4 Insufficient w.c.s 3 2 — 1 Not separate to sexes 1 1 — — List of Industries in the Borough of Hackney. The chief staple industries are the manufacture of boots, shoes, cabinets 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., upholstery and furniture generally; lead pencils, brushes, boxes, artificial flowers, toys, leather goods, gas 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; also there are several furriers, and a number of laundries. 80 Workshops.—The number of workshops registered in Hackney at the end of 1922, was 881, a decrease of 140 on the number registered at the end of 1921. Of this total, 662 were workshops in which females wiere employed. Of these latter, 430 were workshops in which articles of wearing apparel were manufactured, altered or prepared for sale, etc., 202 in which other articles were manufactured, etc., and 30 were domestic workshops. Amongst the workshops in which wearing apparel is manufactured, there were 268 in which females alone and 162 in which both males and females were employed. In workshops of other occupations, there were 110 in which females alone, and 92 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 15 Complaints—Workshops— 16 Notices—Workshops 54 Analysis of Occupations Carried on in the Registered Workshops of Hackney. (a) Wearing Apparel. No. of Occupations. Workshops. Artificial Flower Makers 5 Baby Linen 4 Blouses 39 Boot and Shoe Manufacturers 97 Boot Machinists 19 No. o( Occupations. Workshops. Children's Costumes Clothing Collars Dressmakers Dressing and Tea Gowns Fancy Bows on Shoes 81 Furriers 64 Hats 3 Infants' Millinery 4 Mantles 38 Millinery 28 Shirts 3 Stays 7 Tailoring 90 Ties 23 Trimmings Underclothing 11 Vests 4 Waterproofs 3 547 (b) Other Occupations. Bakers and Confectioners 35 Baskets 5 Box Makers 14 Brush Makers 8 Cabinet Makers 60 Doll Manufacturers and Dressers 5 Fancy Leather Goods 26 Laundries 30 Pianoforte Makers 13 Rag sorting 4 Rubber Goods 2 Toy Makers 1'2 Trunk and Bag Makers 11 Umbrella Makers 2 Upholsterers 10 Upho'sterers' Trimmings 2 Miscellaneous 95 334 During 1922, Miss Teebay, the Workshops Inspector, made 1,877 inspections and re-inspections of factories and workshops where females are employed. In connection with these inspections, 267 intimation and 32 statutory notices were served for the abatement of the nuisances found. 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. Prosecutions. Factories (Including Factory Laundries) 120 35 – Workshops (Including Workshop Laundries) 2,087 402 – Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 2 1 – Total 2,209 438 – 82 2.—DEFECTS FOUND. Particulars. Number of Defects. Numbtr of Prosecutions. Found. Remedied. Referred to H.M. Inspector Nuisances under the Public Health Acts—* Want of cleanliness 190 218 ... ... Want of ventilation 20 28 ... ... Overcrowding 17 18 ... ... Want of drainage of floors ... ... ... ... Other nuisances 81 94 ... Sanitary accommodation— Insufficient 6 5 ... ... Unsuitable or defective 118 105 ... ... Not separate for sexes 11 12 ... ... Offences under the Factory and Workshops Acts :— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 29 29 ... ... Other offences ... ... ... ... (Excluding offences relating to outwork which are included in Part 3 of this Report.) ... ... ... ... Total 472 509 ... ... •Including those specified in sections 2, 3, 7 and 8, of the Factor; Workshops Act, 1901, as remediable under the Public Health Acts. 83 home work. Nature of Work. Outworkers' Lists, Section 107. Outwork in Unwholesome Premises, Section 108 Outwork in Infected Premises Sections 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders Made (Section 110). Prosecution^ (Sections 109. 110) Twice in the year. Once in tbe year. Failing to keep or permit inspection of Lists. Failing to send Lists. Lists. Outworkers. Lists. Outworkers. Contractors Workmen. Contractors Workmen. Wearing Apparel— (1) Making, &c. 272 110 2409 25 1 136 242 ... ... 1 ... ... ... ... ... (2) Cleaning and Washing 4 3 5 ... ... ... 2 ... ... ... ... ... ... ... ... I.ace, Lace Curtains and Nets ft ... 18 ... ... ... 3 ... ... ... ... ... ... ... ... Furniture and Upholstery 12 6 120 ... ... ... 5 ... ... ... ... ... ... ... ... Fur Pulling 8 ... 11 2 ... 3 15 ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers 8 ... 75 1 ... 8 11 ... ... ... ... ... ... ... ... Racquet and Tennis Balls ... 7 ... 6 1 ... 3 2 ... ... ... ... ... ... ... ... Paper, &c„ Boxes, Paper Bags 28 ... 299 2 ... 10 18 ... ... ... ... ... ... ... ... Brush Making 22 ... 446 1 ... 1 16 ... ... ... ... ... ... ... ... Stuffed Toys 4 ... 34 ... ... ... 4 ... ... ... ... ... ... ... ... Basket Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cosaques, Christmas crackers, Christmas stockings, &c. ... ... ... 1 ... 7 3 ... ... ... ... ... ... ... ... Totals 366 119 3423 33 1 168 321 ... ... 1 ... ... ... ... ... 84 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number See pages 80 and 81. Total number of Workshops on Register ... 881 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories :— 14 Failure to affix Abstract of the Factory and Workshops Acts, 1901, (S. 133). ... Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshops Acts, 1901, (S. 5.) Notified by HM.. Inspector 33 Reports (of action taken) sent to H.M. Inspector 82 Other Underground Bakehouses (S. 101) :— In use at the end of the year 51 85 Outworkers.—The number of outworkers on the register at the end of 1922 was 2,601, against 2,360 at the end of 1921. There were thus 241 outworkers added to 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 81 Fur Trade 76 Baby Linen 34 Hats 4 Belts and Bags 18 Hosiery 4 Blouses 158 Lace Goods li2 Boots and Shoes 574 Leather Goods 6 Boxes 215 Mantles and Costumes 229 Braces 7 Millinery 105 Brushes 213 Paper Bags 5 Children's Costumes 21 Pyjamas and Shirts 31 Children's Millinery 29 Shoe Bows 51 Christmas Crackers, etc 12 Tailoring 147 Clothiers and Outfitters 92 Tennis Ball Covering 13 Collars and Bibs 13 Ties and Neckwear 154 Confectionery Packing 3 Trimmings 74 Corsets 2 Umbrellas 15 Dolls and Toys 21 LTnderclothing 70 Dressing Gowns 20 Upholsterers' Trimmings 23 Dress Making 15 Miscellaneous 23 Embroidery 8 Fancy Goods 13 2,601 Feather Trade 10 2,463 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 86 our workers sent in by employers in this Borough, addresses of 1,732 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 1922, Miss Portlock, the Inspector appointed for the inspection of Outworkers' premises, made 1,362 inspections and 1,294 re-inspections. She also made 259 visits, without inspections, the outworkers having left the premises {41), or having given up home work (51), or being out at the time of visit (129), or owing to a wrong address being given (31), or the premises being workshops (4), or the outworkers having died (3). Miss Portlock also discovered 2 new workshops and handed in their addresses for registration. During her visits of inspection she found 415 premises with sanitary defects. For the abatement of these she served 281 intimation, 42 final, and 2 statutory notices. Of the 1,362 premises inspected, in only 1 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 78 ,, ,, and living room 93 ,, ,, ,, kitchen 146 ,, and kitchen 939 ,, ,, bedroom 81 ,, ,, parlour 8 ,, ,, scullery 14 ,, ,, bath room 2 ,, provided separately 1 1,362 87 Sale oj Food and Drugs Acts, 1875-1907. Samples purchased during 1922. Articles Purchased. Number purchased Number Adulterated Number where Proceedings taken Milk 613 19 10 Do. (separated) 1 — — Margarine 43 — — Cocoa 12 — — Lard 12 — — Coffee 19 1 — Pepper 6 — — Mustard 6 — Olive Oil 9 — — Custard Powder 6 — — Baking Powder 6 — — Dripping 18 3 — Butter 64 5 4 Vinegar (Malt) 24 4 — Vinegar 3 1 — „ (wood) 1 — — Cornflour 6 — — Arrowroot 12 — — Cream (preserved) 4 — — Cream 10 4 — Camphorated Oil 22 2 1 Paregoric 7 — — Totals 904 39 15 88 Prosecutions under the Sale of Food and Drugs Acts during the year 1922. No. of Sample Article Adulteration or Offence Result of Legal Proceedings Fine Costs £ s. d. £ s. A 1 W Milk 12-94% added water Dismissed on payment of 15 15 0 10S Camphorated Oil 10-35% deficient in camphor Dismissed under Probation of Offender's Acl 5 5 0 12N Milk 10% fat abstracted Dismissed (Defendant proved that milk sold as it came from the cow) + 15R " 6-6% fat abstracted Fined 2 0 0 2 2 0 16T " 6-7% fat abstracted Withdrawn (warranty proved) 13T " 10-36% added water Fined 2 0 0 2 ! 0 22P " 26-7% fat abstracted Discharged under Probation of Offender's Act 1 1 0 30 M Butter Wholly foreign fat Fined 2 0 0 1 1 0 30M Margarine Exposed for sale unlabelled Fined 5 0 0 1 1 0 37J Butter 57% foreign fat Fined 15 0 0 3 3 0 38J " 47% foreign fat Fined 15 0 0 3 3 1 39J " 51 % foreign fat Fined 15 0 0 3 3 0 29 K Milk 18% fat abstracted Dismissed (Warranty proved) 47Y " 13-3% fat abstracted Dismissed under Probation of Offender's Act 2 2 0 52W " 3-12% added water Ordered to pay 1 1 0 56J " 12-7% fat abstracted Ordered to pay 3 3 0 £ 56 0 0 44 2 0 89 Report of the Food Inspector for the Year 1922 (Mr. A. J. Bobbit). Milkshops and Dairies.—1,495 inspections were made during the year; 4 notices have been served for repairs and limewashing, all of which have been complied with ; 6 vendors have been warned for having dirty or unwashed measures in use, all first offenders; 64 new milk sellers have been registered ; 3 applications for registration have been refused on account of the unsuitability of the premises; 2 milk sellers were prosecuted for using insanitary premises and not being registered, and a conviction obtained in each case. Cow-Houses.—113 inspections were made during the year to the 9 licensed sheds and1 on each visit I found that the premises were being kept in accordance with the bye-laws. Slaughterhouses and Meat Inspections.—287 visits were made to these during the usual slaughtering times when I have examined the carcases and organs of 118 oxen and heifers, 2,145 sheep and lambs, 11 calves, and 27 pigs. One case of Tuberculosis was discovered in an Ox, but the disease was confined to the lungs only. The continued high price of home bred stock has again been the cause of a decrease in the number of animals slaughtered for human food in the Borough, and 3 of the slaughterhouses have not been continuously used. The following I found diseased and had destroyed :— Livers of 5 oxen and 15 sheep affected with Distomatosis. Livers of 3 oxen and 10 sheep affected with Abscess. Livers and lungs of 8 sheep affected with Parasitic Cysts. Heart and lungs of an ox affected with Tuberculosis. Parts of 3 hindquarters of oxen affected with extensive bruises. Hindquarters of an ewe affected with Inflammatory condition. 90 Wholsesale Preserved Provision Factories.—43 visits were made to these and with one exception I found the premises kept in a cleanly condition and the meat of various kinds sound and free from disease. Sale of Food and Drugs Acts.—45 samples were purchased for analysis. Miscellaneous Inspections and Unsound Food.—494 visits and inspections have been made on complaint and in connection with the sale of food, the market thoroughfares have been frequently visited and the goods on the costers' stalls inspected. One prosecution has been taken during the year for exposing unsound condensed milk for sale, resulting in a fine of £5 and£5 5s. Od. costs. The premises used for storage by the street butchers have been regularly inspected and cleansing and limewashing done when required. The following foodstuffs have been condemned and destroyed :— 5 boxes of Skate. 4 ,, Herrings. 1 box of Plaice. 1 case of Haddocks. I box of Haddocks. 24 stone of Haddocks. 8 ,, Roker. 7 ,, Dogfish. 60 English Rabbits. 5cwt. 2qrs. lib. of Pork Trimmings. Parts of 11 Australian Lambs affected with Mould. 1 barrel of Grapes. 31 boxes of Pears. 21 boxes of Apples. 160 tins of Tomatoes. 16 boxes of Tomatoes. 480 tins of Salmon. 5,000 tins of Sardines 9cwt. 251bs. of Bacon. 15 Turkeys. Total Weight of all Foodstuffs Condemned :— Meat and Bacon 19cwt. 3qrs. 041bs. Fish 12cwt. Oqrs. 141bs. Fruit 11cwt. Oqrs. 201bs. Provisions 1ton 2cwt. 1qr. 271bs. 91 Report of Canal Boats Inspector for the Year 1922. (Mr. E. S. Crook). Number of visits to waterways 40 ,, boats inspected 15 ,, ,, not registered 1 ,, ,, conforming to Acts 14 ,, ,, infringing Acts Nil „ certificates examined 14 ,, persons for which boats were registered— Adults 48 Children Nil ,, persons living on boats so registered— Men 29 Women Nil Children Nil The boats inspected were found to be in good condition, and there were no infringements of the Acts. The boat not registered was a ship registered under the Merchant Shipping Acts. The reason for the small number of boats inspected is as follows:—There are no locks in Hackney and the opportunities of inspecting boats usually arise between Essex Wharf and Strong's Bridge, where the bargees pull up for relay of horses or for refreshment. Since July, however, the navigation of the River Lee above Enfield Lock has been closed, consequently boats that usually started from Ware and Hertford have had to start from Enfield, and the journey to Hackney being so short, they have not stopped for rest or relay, but have gone right through. 92 93 INSPECTIONS BY SANITARY INSPECTORS, 1922. 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. Golds worthy No. 9 District. - Mr. Pererettt, 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. Nighy, • Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Inspections. On Complaint— No. of premises inspected 166 222 321 295 375 347 404 405 198 356 814 267 195 850 28 57 107 ... 16 4424 No. of premises in which defects were discovered 141 164 264 246 312 292 360 331 179 309 291 238 167 278 21 46 81 ... 10 3780 Builder's Notices— No. of premises inspected 3 56 21 10 ... 14 39 25 25 19 2 26 9 29 3 30 ... 311 House to House— No. of premises inspected ... ... 31 ... ... ... 48 ... ... 59 5 8 134 48 293 744 400 ... 1770 No. of premises in which defects were discovered ... ... 21 ... ... ... 46 ... ... 56 6 6 121 34 264 538 293 ... 1384 Infectious Disease— No. of premises inspected 75 94 60 139 170 85 125 93 77 81 64 101 133 125 9 28 14 ... 1473 No. of premises in which defects were discovered 30 40 15 49 72 33 44 37 40 27 19 57 76 65 4 12 6 ... 626 No. of re-inspections. (All forms of inspection) 899 1729 2193 2036 1460 2226 1994 1830 1776 2315 2407 1850 2205 1870 2898 2320 2378 ... 806 1294 36486 No. of premises in which defects were discovered. (All forms of inspection.) 162 216 314 320 384 339 472 444 261 412 351 386 378 450 332 598 394 ... 277 415 6905 No. of premises in which defects were abated. (All forms of inspection.) 150 226 296 337 377 335 297 447 260 387 286 301 388 467 339 523 242 ... 298 391 6347 Total number of Intimation notices served 159 240 314 328 359 334 465 402 258 386 851 316 414 463 359 638 379 ... 267 281 6713 Total number of Final Notices served 27 64 27 8 33 4 61 9 ... 44 46 62 39 28 ... 39 42 533 Total number of Statutory Notices served 3 54 86 31 68 50 48 126 43 113 27 36 146 56 77 143 66 ... 32 2 1207 Notices served for infringements of Bye-Laws 1 o 11 29 14 17 1 62 10 11 14 5 6 3 4 ... 14 1 205 Notices served for Infringements of jL.C.C. General Powers Acts, Public Health Acts, etc. ... 1 1 1 ... ... ... 2 ... ... 1 8 ... 2 ... ... 8 1 ... ... 34 94 95 INSPECTIONS BY SANITARY INSPECTORS, 1922. 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. Hlitter, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove No. 13 District. Mr. Hall, Mo. 14 District. Mr. Fowler, 1 Special. Mr. Nighy, Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL Notices served under Rats & Mice Destruction Act, 1919 2 ... 6 ... ... ... ... 21 ... ... ... 5 1 4 ... ... ... ... ... ... 39 Inspections for Certificates under Increase of Rent, Mortgage Interest (Restrictions) Act, 1920 5 5 4 3 2 ... ... 4 ... 1 ... 1 ... 5 2 ... ... ... ... ... 32 Proceedings before Magistrate under Public Health (London) Act ... ... 4 3 10 5 12 5 ... 1 3 2 1 8 4 14 17 2 ... ... 95 Attendances at Police Court ... 15 12 3 18 7 17 11 ... 14 8 10 ... 22 13 30 18 16 ... ... 214 Factories and Workshops— No. of inspections (other than laundries) 8 1 2 2 13 16 8 8 1 13 ... 8 6 ... 14 ... 1 ... 1056 ... 1157 No. of Inspections (laundries) ... ... 1 ... ... ... ... ... 1 ... ... 2 ... ... 1 ... ... ... 15 ... 20 No. of inspections (other workplaces) 1 ... 8 ... ... ... ... ... ... 7 ... ... ... 6 ... ... ... ... ... ... 22 No. of premises in which defects were discovered 2 ... ... 2 2 2 2 3 1 6 ... 9 4 6 11 ... 1 ... 277 ... 328 No. of premises in which defects were abated 2 ... ... 2 2 ... 2 3 ... ... ... 6 4 5 2 ... 1 ... 298 ... 327 Bakehouses— No. of inspections 8 27 13 16 17 10 19 16 , 4 34 15 5 4 23 ... ... ... ... ... ... 211 No. of Notices 5 6 2 6 ... ... 1 5 ... 3 7 1 ... 3 ... ... ... ... ... ... 89 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Food Adulteration— Samples collected for analysis 30 48 48 48 54 59 54 54 48 55 54 48 54 42 54 54 53 51 ... ... 908 Proceedings taken before Magistrate ... ... 1 1 2 ... ... 1 1 1 ... 2 1 ... 1 2 ... ... ... ... 16 96 97 INSPECTIONS BY SANITARY INSPECTORS, 1922. 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. Prvertt No. 10 District. Mr. Hiller No. 11 District.. Mr. Crook, No. 12 District. Mr. Truslove No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Nighy, Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Houses Let in Lodgings— No. of inspections ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of Notices ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1621 1621 No. of premises in which defects were discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 415 415 No. of premises in which defects were abated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 391 391 Verminous Premises Cleansed— On notice from London County Council ... ... ... 23 ... 6 64 2 ... 1 3 ... ... 10 ... ... 1 ... ... ... 113 On complaint ... ... 48 1 15 14 18 63 13 64 19 22 ... 3 ... 1 2 ... ... ... 283 Underground Rooms— Illegal occupation dealt with ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of rooms closed ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Places where Food Prepared for Sale (Restaurants, Coffee Shops), etc. No. of inspections 5 6 5 8 12 5 18 6 7 11 10 8 1 17 1 ... ... 43 ... ... 163 No. of Notices 3 ... 1 5 ... ... ... 2 4 3 1 ... ... 13 1 ... ... ... ... ... 33 Ice Cream Premises-No. of inspections 12 5 20 20 22 10 17 19 5 9 6 12 9 20 ... ... ... ... ... ... 186 No. of Notices 2 ... ... 1 1 ... 1 7 ... ... 1 ... 6 4 ... ... ... ... ... ... 23 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 98 99 INSPECTIONS BY SANITARY INSPECTORS, 1922. ] 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. Nighy. Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Tenement Houses— No. provided with additional water supply ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Overcrowding— No. of houses overcrowded ... 1 ... ... ... ... 4 7 ... ... 4 ... ... 2 4 ... 2 ... ... ... 24 No. remedied ... ... ... ... ... ... 2 4 ... ... 1 ... ... 1 ... ... ... ... ... ... 8 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dairies, Cowsheds and Milkshops Order— No. of cowsheds inspected ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 113 ... ... 113 No. of dairies inspected ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1495 ... ... 1495 No. of dirty utensils discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of premises where infringements of By-laws discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 No. of new registrations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 64 ... ... 64 Slaughter-houses. No. of inspections ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 287 ... ... 287 No. of premises where infringements of by-laws discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Miscellaneous Inspections— Mews and stables ... 3 6 1 ... ... 1 ... 3 8 5 1 ... ... ... ... ... ... ... ... 28 Urinals ... 8 18 3 16 27 ... 13 ... 17 5 ... ... 2 ... ... ... ... ... ... 109 Canal boats ... ... ... ... ... ... ... ... ... ... ... 15 ... ... ... ... ... ... ... ... 15 Visits to waterways ... ... ... ... ... ... ... ... ... ... ... 40 ... ... ... ... ... ... ... ... 40 Animals improperly kept ... ... 4 1 ... ... 2 4 ... 10 ... 2 6 1 ... ... 2 ... ... 44 76 Offensive trades ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 100 101 INSPECTIONS BY SANITARY INSPECTORS, 1922. 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. Golds worthy No. 9 District.. Mr. Peverett, No. 10 District. Mr. H illier, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Nighy, Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. Miscellaneous Inspections. continued. New buildings (water certificates) 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Floodings ... ... ... ... ... ... ... 1 ... ... l ... ... ... ... ... ... ... ... ... 2 Special inspections 7 184 248 62 101 17 21 368 70 113 99 151 76 86 45 ... 135 494 ... ... 2283 Drains relaid or repaired 18 2 37 28 41 31 76 61 17 24 41 69 16 51 43 6 32 ... ... ... 593 Drains and Sanitary Fittings tested and examined 80 75 234 187 73 245 91 202 32 148 66 261 99 307 285 61 455 ... ... ... 2901 Condemned as Unfit for Human Food— Fish ... ... ... ... ... ... ... ... ... ½ cwt ... ... ... ... ... ... ... t c q 1DS ... t c q 1bs 0 12 0 14 0 12 2 14 Fruit and Vegetables ... ... ... ... ... ... ... ... 14 lbs ... ... ... ... ... ... ... 11 0 20 ... ... 11 1 6 Meat (specially state number of carcases or parts of con demned for tuberculosis) ... ... ... ... ... ... ... ... ... ½cwt ... ... ... ... ... ... ... 19 3 24 ... ... 1 0 1 24 Tinned foods ... ... ... ... ... ... ... ... ... t C fl 321 ... ... ... ... ... ... ... ... ... ... 3 2 1 21 Other articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... t c q lbs ... ... 1 2 n 1 27 l 2 1 27 Smoke Nuisances— No. of observations ... 2 16 2 ... ... 53 ... ... 4 ... 40 ... ... ... ... ... ... ... ... 117 No. of Intimation Notices served ... ... 4 2 ... ... 6 ... ... 4 ... 4 ... ... ... ... ... ... ... ... 20 No. of Statutory Notices served ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 102 103 INSPECTIONS BY SANITARY INSPECTORS, 1922. 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. 1 No.. Peverrtt. No 10District. Mr. Hillier. No. 11 District . Mr. Crook, No. 12 District. Mr. Truslove No. 13 District. Mr. Hall, No. 14 District. Mr. Fowler, Special. Mr. Nighy. Special. Mr. Galvin, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. TOTAL. General Information— Bakehouses— No. on Register at end of 1921 8 10 6 8 11 6 8 8 7 13 7 2 2 12 ... ... ... ... ... ... 107 Do. do. 1922 8 10 5 8 11 5 8 8 7 13 7 2 2 12 ... ... ... ... ... ... 106 No. above ground 7 6 1 3 6 1 4 1 5 11 7 l 2 ... ... ... ... ... ... 55 No. underground 1 4 4 5 5 4 4 7 2 2 ... 2 l 10 ... ... ... ... ... ... 51 Houses Let in Lodgings— No. on Register at end 1921 ... ... ... ... ... ... 237 ... ... ... 226 ... ... ... ... ... ... ... ... ... 463 Do. do. 1922 ... ... ... ... ... 233 ... ... ... 226 ... ... ... ... ... ... ... ... ... 459 Ice Cream Premises— No. on Register at end 1921 15 8 15 11 10 5 15 18 5 13 4 18 6 15 ... ... ••• ... ... ... 153 Do. do. 1922 13 7 20 20 18 10 17 19 5 9 6 12 9 21 ... ... ... ... ... ... 186 Places where Food Prepared for Sale— No. on Register at end 1921 5 6 4 11 14 3 8 6 6 20 14 7 1 18 ... ... ... ... ... ... 123 Do. do. 1922 5 6 5 8 12 4 18 6 7 11 9 8 1 29 ... ... ... ... ... ... 129 104 TABLE OF DEATHS. Of Inhabitants of the Hackney District between 1st Jan. and 31st Dec., 1922. 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. Small pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... Not ... ... ... ... ... ... ... ... ... ... ... ... ... Doubtful ... ... ... ... ... ... ... ... ... ... ... ... ... Cowpox, Effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles (Morbilli) 9 20 12 4 ... ... ... ... ... ... ... ... 45 Epidemic Rose Rash, German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... 1 3 2 2 1 1 ... ... ... ... ... 10 Influenza 7 3 5 3 3 10 9 9 22 29 13 ... ...113 Whooping Cough 29 19 13 1 ... ... ... ... ... ... ... ... 62 Diphtheria, Membranous Croup 1 4 9 8 ... ... ... ... ... ... ... ... 22 Cerebro Spinal Fever 3 ... 1 ... ... ... ... ... ... ... ... ... 4 Enteric Fever ... ... ... 1 ... ... ... ... ... ... ... ... 1 Epidemic Diarrhœa, Epidemic (or Zym.) Enteritis 3 ... ... ... ... ... ... ... 1 ... ... ... 4 Diarrhoea, Choleraic Diarrhœa ... ... ... ... ... ... ... ... 1 ... ... ... 1 Dysentery ... ... ... ... ... 1 ... 1 1 ... ... ... 3 Anthrax Splenic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Tetanus 1 ... ... ... ... ... ... ... 1 ... ... ... 2 Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Septicaemia, Sapræmia Fever ... ... ... ... ... 1 ... ... ... ... ... ... 1 105 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. 1 65 to 75. | 75 to 85. 85 and upwards. 1 All ages. | Infective Endocarditis ... ... ... ... 4 1 ... 1 ... ... ... ... 6 Erysipelas 1 ... ... ... 1 ... 1 ... 1 ... ... ... 4 Septicaemia (not Puerperal) ... ... ... ... 2 ... ... 1 ... ... ... ... 3 Pyaemia (not Puerperal) ... ... ... ... ... ... ... ... ... ... ... ... ... Phlegmon, Carbuncle (not Anthrax) ... ... ... ... ... ... 1 ... ... 1 ... ... 2 Other Septic Diseases 1 ... 1 ... 2 ... 3 ... 1 2 1 ... 11 Tuberculous Phthisis (Pulm. Tuberculosis). ... ... 2 3 40 47 45 31 21 11 1 1 202 Tuberculous Meningitis 4 1 2 5 ... ... 2 ... ... ... ... ... 14 Tuberculous Peritonitis ... ... 1 ... 1 ... ... ... ... ... ... ... 2 Tabes Mesenterica ... ... ... 1 ... ... ... ... ... ... ... ... 1 Tubercle of other Organs 2 ... ... 1 4 3 1 ... ... ... ... ... 11 General Tuberculosis ... 2 ... 3 1 1 ... ... 1 ... ... ... 8 Alcoholism, Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... ... Ptomaine Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatic Fever, Acute Rheumatism ... ... ... 1 1 1 ... ... ... ... ... ... 3 Rheumatism of Heart ... ... ... 2 1 2 ... ... ... ... ... ... 5 Chronic Rheumatism ... ... ... 2 1 2 1 2 ... 3 1 ... 12 Rheumatic Arthritis, Rheumatic Gout ... ... ... 1 ... ... ... 1 ... 4 5 ... 11 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... Carcinoma ... ... ... ... ... 3 21 31 55 64 24 1 199 Sarcoma ... ... ... 1 1 2 2 3 7 2 2 ... 20 106 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.  Malignant Diseases Cancer ... ... ... ... ... 1 5 13 19 18 8 2 66 Rickets ... 1 ... ... ... ... ... ... ... ... ... ... 1 Haemophilia, Haemor rhagic Diathesis ... ... ... 1 ... ... ... ... ... ... ... ... 1 Anaemia, Leucocythaemia 1 ... ... ... ... 1 1 4 2 3 1 ... 13 Diabetes Mellitus ... ... ... 1 2 ... 4 3 6 9 1 ... 26 Premature Birth 66 ... ... ... ... ... ... ... ... ... ... ... 66 Congenital Defects 27 1 ... ... 1 ... ... ... ... ... ... ... 29 Injury at Birth 2 ... ... ... ... ... ... ... ... ... ... ... 2 Atelectasis 8 ... ... ... ... ... ... ... ... ... ... ... 8 Want of Breast Milk ... ... ... ... ... ... ... ... ... ... ... ... ... Teething ... 2 ... ... ... ... ... ... ... ... ... ... 2 Suffocation-Overlaying 1 ... ... ... ... ... ... ... ... ... ... ... 1 Diseases of Nervous System. Meningitis, Inflammation of Brain 2 2 2 5 ... ... 1 ... 1 ... ... ... 13 Softening of Brain ... ... ... ... ... ... 1 ... 1 2 1 ... 5 General Paralysis of Insane ... ... ... ... ... 2 3 4 3 ... ... ... 12 Insanity (not Puerperal ... ... ... ... ... 1 ... 1 1 ... ... ... 3 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... Epilepsy ... ... ... ... 1 ... 2 ... ... ... 1 ... 4 Convulsions 5 ... ... ... ... ... ... ... ... ... ... ... 5 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy ... ... ... ... ... ... ... ... ... 2 ... ... 2 107 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. Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Paraplegia and Disease of Cord ... ... ... ... ... ... 1 ... ... 2 ... ... 3 Neuritis, Periph, Poly- Neuritis ... ... ... ... ... 1 1 ... ... 1 ... ... 3 Brain Tumour (not specific) ... ... ... 3 ... 1 1 1 1 1 ... ... 8 Nervous System, other Diseases 4 ... ... 1 3 1 3 2 1 1 4 ... 20 Diseases of Organs of Sense. Otitis, Mastoid Dis. ... ... ... 4 ... 1 3 1 1 ... ... ... 10 Epistaxis, Nose Dis. ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia, Eye Dis.. ... ... ... ... ... ... ... ... ... ... ... ... ... Accidents 1 2 3 8 4 1 4 5 3 8 4 ... 43 Violence Suicide ... ... ... ... 1 3 7 8 9 ... 2 ... 30 Drowned 1 ... ... 2 ... ... 1 2 ... ... ... ... 6 Murder ... ... ... ... 1 ... ... ... ... ... ... ... 1 Diseases of Heart. Valve Dis., Endocarditis ... ... ... 5 7 10 19 21 46 54 53 8 223 Pericarditis ... ... ... 1 ... ... ... ... 1 ... ... ... 2 Hypertrophy of Heart ... ... ... ... ... ... ... ... ... 1 ... ... 1 Angina Pectoris ... ... ... ... ... 1 ... 2 7 2 ... ... 12 Dilatation of Heart ... ... ... ... 1 ... ... ... 2 1 ... ... 4 Fatty Degeneration of Heart ... ... ... ... ... ... 1 ... 8 13 6 ... 28 Syncope Heart Dis. (not specified) ... ... ... 1 2 4 7 8 8 24 13 4 71 108 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5. 5 to 15. 15 to 25. 25 to 85. 35 to 46. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All ages. Diseases of Blood Vessels. Cerebral Haemorrhage Emb., Throm. 2 ... ... ... 1 1 1 16 38 49 52 8 168 Apoplexy, Hemiplegia ... ... ... ... ... ... 1 2 6 5 5 2 21 Aneurism ... ... ... ... ... ... 1 4 4 2 ... ... 11 Senile Gangrene ... ... ... ... ... ... ... ... ... 1 1 1 3 Embolism. Thrombosis (not Cerebral) ... ... ... ... ... ... ... 1 ... ... ... ... 1 Phlebitis ... ... ... ... ... ... ... ... 1 ... ... ... 1 Blood Vessels, other diseases ... ... ... ... ... ... ... 1 4 5 3 3 16 Arterio Sclerosis ... ... ... ... ... ... ... 1 14 28 34 13 90 Diseases of Respiratory Organs. Laryngitis ... ... ... 1 ... ... ... ... ... ... ... ... 1 Bronchitis 16 3 1 2 ... 1 6 15 41 70 67 14 236 Lobar (Croupous) Pneumonia ... 2 ... 2 2 6 9 9 9 6 5 ... 50 Broncho, Catarrhal, Lobular Pneumonia 71 43 21 4 3 4 3 3 14 13 12 4 195 Pneumonia 11 5 5 3 2 8 6 3 12 12 7 2 76 Emphysema, Asthma ... ... ... ... ... 3 3 7 7 4 4 ... 28 Pleurisy ... 1 ... ... ... 1 2 5 1 3 ... ... 13 Fibroid Dis. of Lung. ... ... ... ... ... ... ... 1 ... 1 ... ... 2 Respiratory Dis., other 2 1 ... ... 1 ... 1 2 2 1 1 1 12 Diseases of Digestive System. Tonsilitis, Quinsey ... ... ... ... 2 ... ... ... ... 1 ... ... 3 Mouth, Pharynx, Dis. (not specific) ... ... ... ... ... ... ... ... ... ... ... ... ... Gastric Ulcer ... ... ... ... ... 1 3 5 5 3 2 ... 19 109 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. 65 to 75. 75 to 85. 85 and upwards. All ages. Gastric Catarrh or Gastritis ... ... ... ... ... ... 1 ... ... 2 1 ... 4 Stomach, other Dis. (not Malig.) ... ... ... ... ... ... ... ... 1 ... 1 ... 2 Enteritis (not Epidemic) 7 ... ... ... ... ... ... 1 ... ... ... ... 8 Gastro-Enteritis 19 2 ... ... ... ... ... ... ... ... ... ... 21 Appendicitis, Perityphilitis ... ... ... 5 2 2 2 2 4 2 ... ... 19 Hernia ... ... ... ... ... 1 ... 1 2 1 ... ... 5 Intestinal Obstruction 1 ... ... ... ... 2 ... 1 2 4 ... ... 11 Other Dis. of Intestines 15 3 1 1 ... 1 1 3 2 1 4 ... 32 Peritonitis (not puerperal) ... 1 2 ... ... ... 1 1 ... ... ... ... 5 Cirrhosis of Liver ... ... ... ... ... 1 ... 4 1 3 ... ... 9 Liver and Gall Bladder, other Diseases ... ... ... ... ... ... ... ... ... 3 2 ... 5 Digest. Syst., other Diseases ... ... ... ... ... ... ... 2 ... ... ... ... 2 Lymph Diseases. Spleen Disease ... ... ... ... ... ... ... 2 ... ... ... ... 2 Lymph System, other Diseases ... ... ... 1 ... ... ... ... ... 1 ... ... 2 Thyroid Body Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Supra Renal Capsules Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Urin. Syst. Nephritis, Acute ... ... ... 3 2 7 4 10 19 27 10 ... 82 Chronic Bright's Dis. Albuminura ... ... ... ... ... ... ... ... 3 2 1 ... 6 Calculus (not Biliary) ... ... ... ... ... 1 1 ... ... 1 1 ... 4 Bladder and Prostate Disease ... ... ... ... ... ... ... 1 6 9 5 ... 21 Urin. Syst., other Dis. 1 ... ... ... 1 ... ... 2 ... 2 ... ... 6 110 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. Diseases of Gener. Syst. Ovarian Tumour (not Malig.) ... ... ... ... ... ... ... ... ... ... ... ... ... Other Dis. of Ovary ... ... ... ... ... 1 ... ... ... ... 1 ... 2 Uterinal Tumour (not Malig.) ... ... ... ... ... ... ... 1 ... ... ... ... 1 Other Dis. of Uterus and Vagina ... ... ... ... ... 1 ... ... ... ... ... ... 1 Accidents Childbirth Abortion. Miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Mania ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... Placenta Praevia, Flooding ... ... ... ... ... 1 ... ... ... ... ... ... 1 Other Accid. of Preg. and Childbirth ... ... ... ... 1 1 3 ... ... ... ... ... 5 Joint Diseases. Caries, Necrosis ... ... ... ... ... 1 ... ... ... ... ... ... 1 Arthritis, Periostitis ... ... ... ... ... ... ... ... 1 ... ... ... 1 Other Dis. of Locom. Syst ... ... ... 3 1 ... ... ... ... ... ... ... 4 Skin Diseases. Eczema ... ... ... ... ... ... ... ... ... ... ... ... ... Pemphigus ... ... ... ... ... ... ... ... ... ... ... ... ... Skin Disease, other 1 ... ... ... ... ... ... ... ... ... ... ... 1 Ill.Defined Causes. Atrophy Debility, Marasmus 17 ... ... ... ... ... ... ... ... ... ... ... 17 Old Age ... ... ... ... ... ... ... ... 2 21 67 44 134 Dropsy, Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... Toumour ... ... ... ... ... ... 2 2 1 1 ... ... 6 Abscess ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death cause nascertained ... ... ... ... ... ... ... ... ... ... ... ... ... Other Ill-defined Causes 2 1 ... ... 1 2 ... ... 1 ... ... ... 7 Causes not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 344 120 84 96 106 150 203 263 435 543 426 109 2,79 111 TABLE III. Causes of, and Ages at, Death during the year 1922. 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 ... ... ... ... 1 Small-Pox ... ... ... ... ... ... ... ... ... ... Measles 45 9 20 12 4 ... ... ... ... 21 Scarlet Fever 10 ... 1 3 2 2 2 ... ... 21 Whooping Cough 62 29 19 13 1 ... ... ... ... 24 Diphtheria and Croup 22 1 4 9 8 ... ... ... ... 104 Influenza 113 7 3 5 3 3 19 31 42 25 Erysipelas 4 1 ... ... ... 1 1 1 ... 3 Dysentery 3 ... ... ... ... ... 1 2 ... ... Pithisis (Pulmonary Tuberculosis) 202 ... ... 2 3 40 92 52 13 126 Tuberculous Meningitis 14 4 1 2 5 ... 2 ... ... 11 Other Tuberculous Diseases 22 2 2 1 5 6 5 1 ... 18 Cancer, Malignant Disease 285 ... ... ... 1 1 34 128 121 167 Rheumatic Fever 3 ... ... ... 1 1 1 ... ... 3 Meningitis 13 2 2 2 5 ... 1 1 ... 8 Organic Heart Disease 341 ... ... ... 7 10 42 103 179 162 Bonchitis 236 16 3 1 2 ... 7 56 151 59 Pneumonia (all forms) 321 82 50 26 9 7 36 50 61 169 Other Diseases of Respiratory Organs 56 2 2 ... 1 1 10 25 15 19 Diarrhœa and Enteritis 4 3 ... ... ... ... ... 1 ... 16 Appendicitis and Typhlitis 19 ... ... ... 5 ... 4 6 2 22 Cirrhosis of Liver 9 ... ... ... ... ... 1 5 3 5 Alcoholism ... ... ... ... ... ... ... ... ... ... Nephritis & Bright's Disease 88 ... ... ... 3 2 11 32 40 67 Puerperal Fever 1 ... ... ... ... ... 1 ... ... 4 Other Accidents and Disceases of Pregnancy and Parturition 6 ... ... ... ... 1 5 ... ... 9 Congenital Debility and Malformation, including Premature Birth 95 93 1 ... ... 1 ... ... ... 41 Violent Deaths, excluding Suicide 50 2 2 3 10 5 6 10 12 55 Suicide 30 ... ... ... ... 1 10 17 2 12 Other defined Diseases 817 89 9 5 20 21 60 176 437 384 Diseases ill-defined or unknown 7 2 3 ... ... 4 2 1 ... ... 2879 344 120 84 96 106 353 698 1078 1556 Sub-entries (included in above figures)— • Cerebro-Spinal Meningitis, 4 3 ... 1 ... ... ... ... ... 5 Polio Myelitis ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... 112 APPENDICES. Public Health Department, Town Hall, Hackney, E.8. 16th November, 1921. To the Chairman and Members of the Public Health Committee. REPORT ON DISINFECTING STATION. Present Condition of Disinfecting Station and Statement of Alterations and Repairs required to the Building, Fittings and Apparatus. Boiler Room. There is a settlement of the foundations of the boiler room which may become serious. This appears to be due to the steam pipes (which originally carried the used steam back to the boiler) having been cut off and allowed to discharge the waste water and steam into two sump holes. These have no drainage. The water has consequently been soaking away into the ground (which is soft and wet) below the foundations. Disinfectors. No. 3 Disinfector has moved, and the brick arch over is defective : the machine will have to be re-set. The lagging or asbestos covering of both disinfecting chambers is defective. The insides require cleansing of rust and repainting. The cages and fittings require re-galvanising. Two handles are broken. The supports to the super-heaters are defective. 113 The exhaust pipes from these two chambers discharge by one pipe into the boiler furnace. This results in offensive steam and odours in the boiler room and damps the furnace fire down, making it difficult to get up steam. Boiler. The brickwork of the boiler shaft is defective, and has resulted in a wood trimmer joist in the roof being burnt out. The connection between the iron and brick flue is defective, and the present iron flue is so constructed as .to baffle the draught of the furnace. The lagging or asbestos covering of the boiler is defective. The boiler base or foundation is eaten away with rust and is becoming dangerous. The boiler blow-off pipe is improperly terminated in front of the building, and when in use is dangerous. Laundry. The open channels, used to drain the laundry floor and apparatus are in a defective and insanitary condition. Many of the channels are defective, allowing the waste water to soak into the ground and through the external wall. Hot Water Tank. The lagging of the under side of the tank is loose and dangerous. Insufficient W.C. accommodation. There is only one W.C. in use for the boiler attendant and the four van attendants, and adults and children of both sexes who attend for baths and treatment owing to verminous and scabious condition. 114 Coal Storage. Storage for coal is provided in stable at rear of building. The coal has to be shot on path. (This results in continual choking of drains.) It is then shovelled into the stable and has to be brought round in a barrow to the boiler room as required. Main Gates. These gates are in a bad state of repair and the hanging stone in one pier requires re-setting. General Repairs. There are several sashes that want repairing, re-hanging and te-glazing. The sashes and blinds of the flats require repairing. Lead work over doors of boiler and disinfecting rooms defective. Clearing eye and fresh air inlet of drains defective. One flat used by nurses is without electric light. Additions or alterations are required to lighting in boiler and cleansing rooms. SUGGESTIONS AS TO WORK REQUIRED. Boiler Room. Removal of No. 3 Disinfector, breaking up of concrete, removal of wet and loose earth and providing new concrete base as found to be required. Breaking up of concrete and removal of loose earth on lelt hand side of No. 2 Disinfector and providing new concrete as fount to be required. Breaking up of concrete as required and the provision of as iron girder raft to carry weight of both disinfectors and boiler. 115 Making good floors, brickwork and sump holes and refixing No. 3 Dlsinfector. Providing a 4-inch drain and gullies to take drainage of sump holes. The drain to discharge into an outside gully. (See sketch). Disinjectors. The stripping and re-lagging of both disinfectors; re-painting, re-galvanising of cages and fittings ; repairs to handles and bolts as required; re-fixing supports to super-heaters. The exhaust pipes should be taken outside the building and discharged into a drain running into a condensing chamber with an overflow into a new gully connected to drain. (See sketch.) Boiler. Repair of brickwork of shaft and renewal of burnt-out trimmer joist. A new cast iron flue with bends (in place of existing iron flue) properly connected to brick shaft. The provision of a cowl to top of shaft. Stripping and re-lagging of boiler. A new iron rim or foundation plate rivetted to base of boiler. Foot plate to be cut in flush with floor. Boiler blow-off to be discharged into a drain discharging over the water in condensing chamber. The condensing chamber to have a 4-inch vent carried above eaves of roof. (See sketch.) Laundry. Provision of waste pipes to sinks and fittings in place of existing open channels and a gully to receive floor drainage; repairs to brickwork as required. (See sketch.) Re-lagging and support to base of hot water cistern. 110 W.C. Accommodation. A new W.C. apartment for use of staff to be built at side of existing W.C. apartment. (See sketch.) Coal Storage. Conversion of workshop which adjoins boiler room into a coal store by making- an opening in partition wall with iron shutter, and replacing lower sashes with wooden shutter for coal delivery. Repairs to floor as required. Main Gates. Properly repairing doors and fittings and repairing of hanging stone. General Repairs. Repairing, re-hanging and glazing of defective sashes; repairing and renewal of blinds where required. Dressing down and fixing of leadwork over doors of boiler room ; reinstatement of electric light in flat used by nurses ; alterations as required in cleaning the boiler room ; new cover to clearing eye of drain, and new fresh air inlet valve. G. H. DART, Medical Officer of Health. 117 HOUSINC CONDITIONS. Statistics—Year ended 31 st December, 1922, 1.—GENERAL. (1) Estimated population 225,400 (2) General death-rate 12.7 (3) Death-rate from Tuberculosis 1.05 (4) Infantile mortality 72 (5) Number of dwelling-houses of all classes 34,749 (6) Number of working-class dwelling- houses—Rateable value of £20 or under, approximately 14,032 (7) Number of new working-class houses erected and occupied 80 2.—UNFIT DWELLING-HOUSES. 1.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 7,666 (2) Number of dwelling-houses which were spected and recorded under the Housing (Inspection of District) Regulations, 1910 1,437 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as tr: be unfit for human habitation - 118 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 89 2.—Remedy of Defects without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers ... No record. 3.—Action under Statutory Powers. A.—Proceedings under section 28 of the Housing, Town Planning, etc., Act, 1919. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit— (a) by owners - (b) by Local Authority in default of owners - (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close - B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 6,713 119 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 6,3-47 (b) by Local Authority in default of owners - C.—Proceedings under sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders Nil. (2) Number of dwelling-houses in respect of which Closing Orders were made Nil. (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling - houses having been rendered fit (Closing Orders made in 1918) Nil. (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil. (5) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil. 3.—UNHEALTHY AREAS. Areas represented to the Local Authority with a view to Improvement Schemes under (a), Part I., or (b), Part II., of the Act of 1890:- 120 (1) Name of Area (2) Acreage (3) Number of working-class houses in area (4) Number of working-class persons to be displaced Nil 4.—Number of houses not complying with the building bye-laws erected with consent of Local Authority under section 25 of the Housing, Town Planning, etc., Act, 1919 Nil. 5.—Staff engaged on housing work with, briefly, the duties of each officer Nil. (No officers are exclusively engaged or housing work.) 121 METROPOLITAN BOROUCH OF HACKNEY. Public Health Department, Town Hall, Hackney, E.8. The Dairies, Cowsheds and Milkshops Orders, 1885 and 1886. London County Council (General Powers) Act, 1908, s.5. The Public Health Committee have decided that the following conditions must be complied with by applicants for registration under the above Orders:- (1) The lighting and ventilation must be maintained in a satisfactory condition. (2) No room which is used as a sleeping room must communicate directly with the room or shop in which the milk is sold or stored. (3) The premises must be so constructed that every part of the interior is capable of being maintained in a satisfactory state of cleanliness. (4) There must be no inlet to any drain in the room or place in which milk is sold or stored. (5) Milk must be stored in suitable receptacles with close fitting covers of suitable material. (6) Efficient means of cleansing the milk vessels, either bv steam or hot water must be available. (7) A plentiful supply of water must be provided, and where a storage cistern is necessary such cistern must be properly covered and ventilated and so placed as to be readily accessible. (8) No premises will be registered where it is possible that milk may be stored in close proximity to any article capable of contaminating such milk, as for instance, paraffin, coal, vegetables, vinegar and pickles (except when stored in unopened bottles), fish, &c., and no such articles must be sold from the premises. (9) No premises will be registered if there is a manure or other offensive accumulation in close proximity. (10) Efficient means for the storage and removal of refuse must be provided. I agree to comply with the above conditions. Signed Address W itness Date