HAC 74 Metropolitan Borough of Hackney. REPORT ON THE Sanitary Condition OF THE METROPOLITAN BOROUGH OF HACKNEY FOR THE YEAR 1924, BY G. H. DART, M.D., M.R.C.P., Edin.i D.P.H., D.T.M. & H., Camb., Barrister.at.Law. Medical Officer of Health. . Administrative Maternity and Child Welfare..0fjjcer, Executive Tuberculosis Officer. London : Buck Bros. 4 Harding, Ltd., 6.7, West Avenue,. E..17 1925. INDEX. page I. General Statistics 18 II. Extracts from Vital Statistics of year 19 III. Notifiable Diseases during the year 31 IV. Causes of S.ickness 66 V. Summary of Nursing Arrangements, Hospitals, etc. 66 VI. Laboratory Work 79 VII. Sanitary Administration 81 VIII. Housing 134 Canal Boats Acts, Report of Inspector 113 Cancer 43 Cleansing of Persons Act, 1907 63 Constitutional Diseases 41 Cowhouses, Dairies and Milkshops 110 Disinfection 60 Food— Articles Surrendered to District Inspectors 86 Articles Purchased for Analysis 105 Prosecutions under Sale of Food and Drugs Acts 106 Public Health (Meat) Regulations, 1924 96 Registration of Purveyors of Milk 110 Report of Food Inspector 110 Housing— Public Health (London) Act, 1891 81 Housing Acts 13 Housing Conditions in the Borough 85 Legal Proceedings 86 Rent and Mortgage Interest (Restriction) Act, 1920.23 82 Verminous Premises 82 Work of Sanitary Inspectors (Table of Inspections) 114 Industrial Statistics— Factory and Workshop Act, 1901 85 Factories, Nuisances found 91 Factories, General Table of Inspections and Defects found 90 Workshops Inspected 90 Workshops, Analysis of Occupations 89 Home Workers 93 Outworkers 94 List of Industries 88 Infectious Diseases— Cerebro Spinal Meningitis 39 Cholera 38 Continued Fever 38 Diarrhoea 41 Diphtheria 35 Diphtheria Anti.toxin 36 Dysentery 40 Encephalitis Lethargica 39 Enteric Fever 37 Erysipelas 38 Influenza 40 Malaria 40 Measles and Gorman Measles 40 Ophthalmia Neonatorum 39 index Infectious Diseases (continued). page Plague 38 Pneumonia 39 Polio.Myelitis 39 Puerperal Fever 38 Scarlet Fever 35 Small.pox 33 Typhus Fever 38 Vaccination 34 Whooping Cough 41 Maternity and Child Welfare— Contributions to Maternity Hospitals 77 Convalescent Aid 77 Health Visiting 74 Infant Consultation and Ante.natal Clinics 75 Provision of Milk and Foods 78 Mortuary 29 Rats and Mice Destruction Act, 1919 83 River Lee 14 Sanitary Inspection—Table of Inspections 114 Shelter 63 Slaughterhouses 110 Tuberculosis— Advanced Cases 58 After Care 59 Discharged Soldiers and Sailors 50 Dispensary Districts : Population 51 Extra Nourishment 58 Health Visitors—Visits of 50 Notifications and Deaths 44 Open.air School 59 Public Health (Tuberculosis) Regulations, 1912 46 Summary of Notifications 47 Summary of Deaths, Number and Classification 53 Reports of Medical Officers 54. 56 Vital Statistics— Acreage of Borough 18 Births and Birth Rates 19. 20 Deaths and Death Rates 23 Deaths in Public Institutions 25 Density of Population 18 Infantile Mortality 24 Institutions outside the Borough receiving Sick from the Borough 26 Illegitimate Birth Rate 21 Marriage Rate 20 Notification of Births 21 Population 18 Registration of Births 22 Senile Mortality 25 Still Births 21 Tables of Causes of Deaths 126 Table (Comparative) of Rates for years 1915.24 30 ,, ,, „ year 1924—London Boroughs 17 5 PUBLIC HEALTH DEPARTMENT Publlo Health and Maternity and Child Welfare Committee!. Public Health Committee. Ex.officio—Councillor E. Farmer, j.p. (Mayor). Chairman—Councillor H. Layland. Vice.Chairman—Councillor T. Chapman, j.p., l.c.c. Councillor Barnes, J. G. Benwell, Mrs. L. C., j.p. Chapman, T., j.p., l.c.c. Dorley.Brown, G. W. Dunsford, A. E. Alderman Elliott, E. Councillor Jones, W. Keil, A. Layland, H. Councillor Leeson, J. S. Loweth, W. E. Lusher.Pentney, G. J, Palmer, J. M. Payne, A. W. Ridley, W. A. Rushbrooke, T., j.p., m.a., m.r.c.s., l.r.c.p. Smith, A. E. Tozer, O. W. Maternity and Child Welfare Committee. Consisting of Members of the Public Health Committee, and three persons being women and not Members of the Council. Chairman—Councillor G. J. lusher.Pentney. 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. 6 STAFF OF PUBLIC HEALTH DEPARTMENT. Sanitary Inspectors. R. H. Ellis. E. A. Hillier. R. H. Bew. E. S. Crook, also Canal Boats W. C. Vobe. Inspector. A. Sadler. J. E. Truslove. H. Booy. J. W. Hall. G. F. High. G. Fowler. R. J. Shippard. A. J. Bobbitt (for Cowhouses, Milk. C. F. Long. shops, Slaughterhouses, etc.) W. Goldsworthy. J. Nighy, House to House W. Peverett. VV. E. Galvin, Inspection. Miss Alice Teebay (for Workshops, Laundries. &c.). Miss Mabel Portlock (for Outworkers. Premises) Health Visitors. Mrs. A. Rhodes. Miss D. E. Vidal. Mrs. L. Harrison. Miss A. K. Roche. Miss M. Chitson. Miss M. K. Cockle. Mrs. L. E. Bartholomew. Miss S. E. Love. Miss G. M. Servante for Tuberculosis cases. Miss M. Clarke Medical Officers (Temporary Staff) Municipal Infant Welfare Centres. Elizabeth Wilks, m.d. Reginald Brown, m.r.c.s., l.r.c.p. Eva Morton, m.r.c.s., l.r.c.p. Dorothy B. Gere, m.r.c.s., l.r.c.p. Tuberculosis Dispensary Medical Officers (Metropolitan and City of London Hospitals.) L. Unwin Young, m.b. H. Tylford Howell, m.r.c.s. Public Analyst—Leo Taylor, f.i.c. Disinfecting Station and Shelter Caretakers. E. G. Hasler. Mrs. E. Hasler. Mortuary Keeper—s W. Boxei.l. Messenger—H. Storey. Clerical Staff. A. Higgins. P. A. Hitch. V. Weliiam. L. W. Harvey. H. C. Bowman. F. Whittaker H. R. Sandford. C. J. Haynes. 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 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1924 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 1924. A comparative table for the Borough showing the Death, Birth and Infantile Mortality Rates for the past ten years is set out on page 30. The birth.rate is 18.5 per 1,000 for Hackney, compared with 18.7 for the whole of the County of London. The death.rate for Hackney for the past year is 11.4, a slight increase on the previous year.s rate of 10.6, the rate for the County is also increased, being 12.1 as compared with 11.2 for the previous year. The death and infantile mortality rates for the past two years remain however the lowest ever recorded in Hackney. The infantile mortality of the Borough, measured by the number of deaths under 1 year of age per 1,000 births registered, was 60, as compared with 58, the figure for last year; the Borough average during the last 5 years 1919.1923 is 72, and the figure for all London during the past year is 69, as compared with 60 in 1923. The position of Hackney, as compared with the other Metropolitan Boroughs is very satisfactory—and appears to be improving—as is shown by the following table, which gives the death rates and infantile mortality rates in 1924. 8 Deaths per 1000 Population. Infantile Deaths per 1000 Births. Lewisham 10.4 Lewisham 47 Woolwich 11.0 Lambeth 50 Wandsworth 11.0 Hampstead 56 Fulham 11.1 Wandsworth 57 Stoke Newington 11.3 Stoke Newington 58 Hackney 11.4 Westminster 59 Greenwich 11.4 Hackney 60 Camberwell 11.1 Battersea 62 Hampstead 11.7 Chelsea 63 Battersea 11.7 Woolwich 65 Deptford 12.0 Islington 66 Westminster 12.1 Camberwell 70 Poplar 12.1 Southwark 71 Holborn 12.2 Poplar 72 Stepney 12.2 Hammersmith 72 Islington 12.3 Fulham 72 Hammersmith 12.4 Greenwich 73 Bethnal Green 12.4 St. Pancras 74 Lambeth 12.5 Stepney 74 St. Pancras 13.0 Kensington 75 Kensington 13.0 Finsbury 75 Paddington 13.1 Deptford 76 Chelsea 13.2 Bermondsey 78 St. Marylebone 13.6 St. Marylebone 78 Bermondsey 13.6 Paddington 78 Shoreditch 13.7 Bethnal Green 78 Finsbury 14.1 Holborn 81 Southwark 14.2 Shoreditch 87 The zymotic death-rate is 45 as compared with 34, the figure for 1923. The number of Scarlet Fever cases notified during 1924 was 528, as compared with 457 in 1923, and the number of Diphtheria cases notified in 1924 was 546, as compared with 528 during 1923. The deaths from Scarlet Fever numbered only 7, 2 more than the previous year, and the deaths from Diphtheria 34, being 5 more than those registered in 1923. 9 Maternity and Child Welfare. The Maternity and Child Welfare Committee have had under consideration a scheme for extending the work and particulars of the proposed extension were forwarded to the Ministry of Health on April 9th, 1924, but as the Ministry would not approve any scheme that involved building operations, a proposal to acquire No. 28, Lower Clapton Road as a Centre for the Maternity and Child Welfare work of the Borough was forwarded to the Ministry on July 23rd, 1924. The views of the Ministry having been ascertained in subsequent correspondence, it was possible on February 20th, 1925, to forward full financial particulars, plans, &c., to the Ministry for approval. The Ministry, in a letter dated May 29th, 1925, have intimated that a loan will be sanctioned for the purpose of meeting the cost of alterations to No. 28, Lower Clapton Road on receipt of an estimate based on tenders, and as this was the last matter remaining for approval, it should be possible to commence work immediately. The additional expenditure will not cause the total annual cost of the Maternity and Child Welfare service to amount to a penny rate. The measures approved include the provision of artificial light treatment, dental, ante-natal and child welfare clinics, clerical, and nursing assistance, but do not meet the full wishes of the Maternity and Child Welfare Committee as regards nursing assistance. The Committee wished to introduce a nursing scheme to supplement the work of the Centres and Health Visitors, and the very low figure of £400, an amount equal to that paid by the London County Council for the part.time services of two nurses at Lower Clapton Road School Clinic, was approved by the Committee. The Ministry, however, or the financial officers concerned, have reduced this amount to £150. In taking this action the Ministry rely principally on a Circular of August, 1918, M. & C. W. 4, a letter of the Ministry of May 31st, 10 1924, stating "At present the powers of Local Authorities do not extend to the general nursing of the sick, and the Ministry.s grant is only available in respect of nursing to the extent indicated in paragraph 19 of the Circular of the 9th August, 1918, (M. & C. W. 4) with the addition of nursing for cases of poliomyelitis. The Minister is of opinion that £150 per annum would represent a reasonable maximum expenditure by the Council for such nursing as they may provide under the Maternity and Child Welfare Regulations, and he sanctions an expenditure not exceeding that sum by the Council for the purpose." The conditions in which nursing assistance may be granted are specified in Circulars M. & C. W. 4 and 11, so that this help may be given to severe cases of Measles but not German Measles, Chickenpox, &c. Whooping Cough „ Acute Bronchitis, &c. Epidemic Diarrhoea „ Acute Gastritis, &c. Poliomyelitis „ Any other Paralytic conditions. Ophthalmia Neonatorum „ Diseases of Ear or Throat, &c. Under the Pneumonia Regulations help can be given to acute primary pneumonia, but other forms of pneumonia must not be assisted. Respiratory diseases, one of the most frequent sources of death and crippling, are practically excluded from the scope of Maternity and Child Welfare work unless associated with Measles or Whooping.cough. The Borough can supply a midwife and a nurse to a confinement case, but if the infant is injured at the confinement no assistance must be given on behalf of the Maternity and Child Welfare Committee. A child may receive treatment at a Centre for thread.worms, for instance, but the nurse must not attend at the home to supplement the medicinal treatment advised by the doctor. 11 It is difficult to reconcile this ruling with the Maternity and Child Welfare Act, which authorises any local authority, within the meaning of the Notification of Births Act, 1907, to make such arrangements as may be sanctioned by the Minister (with the exception of the establishment of a general domiciliary service by medical practitioners) for attending to the health of expectant and nursing. mothers and children who have not attained the age of five years and are not under the care of the school authorities. It is certainly very unfortunate that the work of the Centres and Health Visitors cannot be followed up where necessary by nursing assistance. An expenditure on nursing assistance of £150, amounting to less than the whole.time services of one nurse, is evidently inadequate in such a Borough as Hackney, with an average of 5,000 births a year, particularly when it is borne in mind that the new Centre will require the presence of a nurse at several of the clinics. It should be remembered that all the families assisted are in distressed circumstances and that, if the King.s Home for Nurses are unable to supply a nurse, these cases must undoubtedly be neglected. Tuberculosis. The Tuberculosis Death.rate shows a slight decrease, the mortality being 1.12 per 1,000 of the population, as compared with 113 for 1923, and there were 27 fewer primary notifications as compared with 1923. One of the outstanding features of the tuberculosis service is the extremely unsatisfactory conditions under which the treatment of advanced cases is carried out. These cases are permitted to remain at home to infect other members of the family, there being no adequate provision for the institutional treatment of advanced pulmonary tuberculosis and no means by which young children exposed to almost certain infection can be removed to safe surroundings. 12 During the past year 110 or 53 per cent, of the persons who died from pulmonary turberculosis were unable to secure a separate bedroom during the course of the treatment at home, although some of this number actually died in an institution, the total number of deaths occurring at home during the year being 99, or 48.3 per cent, of the total number, 205. In 40 of the cases who did not have even a bed to themselves, tubercle bacilli were known to be present in the sputum. During 1923 the number of deaths at home was 116, or 53.7 per cent, of the total number, 216, so that this year.s figures are slightly better than the previous year. Under these circumstances there is little to wonder at in the fact that this disease is still so prevalent. The Council has no power to arrange for the treatment of advanced cases, and has protested on several occasions against the inadequate accommodation provided for them. There were 134 deaths among dispensary patients, and 51 of these patients, or 38 per cent., were in the final stage of the disease on first attendance; 59 patients, or 44 per cent., were in the second stage. It also appears from an examination of the case papers that 90 of these cases, or 67 per cent., had been suffering from this disease for a period varying between three to twelve months before being referred to the dispensary. An attempt has been made during the past year to improve the notification of Tuberculosis and on page 48 will be found copies of a letter and circular sent to medical practitioners when it appeared that delay had occurred in notifying cases. The action of the Council in bringing to the notice of the Ministry of Health the danger that results from Tuberculous persons being engaged in the distribution of milk has resulted in the drafting of Regulations, which are not yet however approved by the Minister of Health. 13 Sanitary Inspection. The work of Sanitary Inspection has been carefully and con. scicntiously carried out throughout the year, a fact of the utmost importance in view of the overcrowding in Hackney and neighbouring Boroughs. If the Public Health (London) Act, 1891, could be amended so that the conditions described in the Ministry of Health "Manual on Unfit Houses," as being necessary could be enforced under the Nuisances sections of this Act, a great step forward would be made. Section 28 of the Housing and Town Planning, etc., Act, 1919, as amended by Section 10 of the Housing, etc., Act, 1923, does not give the local authorities power to improve housing to any appreciable extent unless they are prepared to meet the cost out of the rates. In order to avoid the difficulties arising, under the Housing and Town Planning Act the Council has carried out repairs after a Magistrate.s Order has been obtained under the Public Health (London) Act, 1891, the cost of the work being recovered under the powers contained in that Act. Although the work carried out by the Sanitary Inspectors is of the utmost value in maintaining housing property in a comparatively decent condition, and in checking the formation of slum areas, it is not possible to prevent overcrowding, so that the situation is becoming steadily more difficult in this respect. The extent to which the careful work of the sanitary inspectors and staff of the department has neutralised the ill.effects of over.crowding is not realised. Thus, no fewer than 120 premises have been cleared of rats, 658 rooms sprayed or otherwise cleared of vermin, 536 rooms cleansed, 22,194 articles disinfected, 1,320 adults and children cleansed from parasitic disease, by the staff of the Public Health Department. The work of sanitary inspection, however, can only be realised by carefully considering the tables of inspection of food premises, food seizure, drain testing, sampling, notices served, nuisances abated and other details of the work of the department set out in the body of this report. 14 The Council has on several occasions requested that the County Council should make by.laws in accordance with the provisions of Section 26 of the Housing and Town Planning Act, 1919, whereby the Council could secure more sanitary conditions as regards houses let in lodgings, and the Council has also pressed for powers to deal with disused drains, to prevent the institution of workshops and factories under unsuitable conditions, and to prevent the spread of infectious disease in insanitary offices and workshops. The Council has requested the Ministry of Health to grant additional powers for preventing ill.health through the adulteration and chemical contamination of food such as the undue use of boric acid and the use of copper salts or preservatives containing arsenic or lead. The Ministry of Health has also been informed that there is considerable evidence that particles of glass were sometimes present in jam sold in glass containers. All these matters are now receiving the attention of the Ministry. The River Lea remains in as offensive a condition as usual, and is the subject of the usual complaints. In February, 1923, the Council protested against yet another local authority—St. Albans Rural District—being permitted to discharge sewage effluent into the River, and received a reply from the Ministry of Health stating that "the proposed works will result in less, not more, pollution of the River Lea." The Ministry, however, considers that Leyton and Walthamstow sewage would be better discharged into a London County Council sewer than into the Lea, but the Borough Engineer and Surveyor and Sanitary Engineering Specialists consulted by the Council have stated that the scheme for dealing with Walthamstow and Leyton sewage will result in storm times in sewage flooding into houses in the Hackney Wick area, and in addition to this to further contamination of the Lea by London sewage released by storm overflows that it is proposed to construct under the scheme. 15 It is difficult to do justice to the present conditions of the Lea, but the following is an attempt in the local press:— "HACKNEY.S PUTRID RIVER. The River Lea, described by satirists as . Hackney.s scent bottle,. is again exuding foul smells. It rarely does anything else at this time of year, when the blazing orb plays upon its putrid surface and increases the pungency of its odour. The only cause for wonder is that Hackney.s indignation has been bottled up so long. For as many years as most of us can remember the Lea has been a source of recurring complaint. Scarcely a summer goes by without the catalogue of protest being added to. But there has been no permanent redress—nothing but inquiries and analytical tests, the serving of abatement notices on offenders, sporadic prosecutions, and then more effluvia and another period of stagnation. When the Lea Conservancy Board was reconstituted in 1901 it was expected that a remedy would be found, but the optimists of that day would probably be the most confirmed pessimists of to.day were they to seek first.hand information or read extracts from letters received in recent years. One writer, referring to the section between the old sluice gates and Tottenham Lock, stated:- The filth on the surface here could be gathered with a spade, and eventually floats into that portion of the river in the jurisdiction of Hackney.. Another, speaking of conditions lower down, wrote that . gas bubbles and matter were rising to the surface, the latter boiling and seething until its . viciousness. had spent itself.. Owing to its urgency,. the Public Health Committee have instructed the Town Clerk to take steps. to have the matter raised in Parliament, with the object, first, of emphasising the advisability of promoting legislation to make the Lea Conservancy Board the Pollution Prevention Authority for the whole length of the river and its tributaries, and, secondly, of action being taken to induce the urban districts in Middlesex and the Middlesex County Council to cease discharging sewage into them. It might have a more convincing—and certainly a more moving—effect if the Lea matter could be brought under the noses, as well as the notice, of Members of Parliament ! The Conservancy Board have discovered that a 16 particular cause of pollution is the intercepting drain which discharges just below Tottenham Lock, and the Moselle Brook (obviously mis.named) and the Stonebridge Brook (which discharge at the Tottenham sewage works), and a notice has been served on the Middlesex Council to abate the latter pollution (consisting of surface water and crude sewage) within three months. These proceedings and revelations are highly interesting in view of Hackney.s grounds of opposition to the Walthamstow and Leyton sewage scheme, one of which aims at safeguarding the Lea against further contamination." A most interesting point, however, is that it is not Walthamstovv and Leyton that are at fault at the moment, but on the authority of the Lea Conservancy Board the areas causing the present pollution pour their effluent into the Intercepting Drain, which "brings down sewage effluents from Enfield, Edmonton, Finchley, Friern Barnet, Hornsey, East Barnet and Cheshunt." These authorities are evidently not assisting St. Albans Rural District in its work of lessening the pollution of the River Lea. 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 4.08 pence. This includes the expenditure required by the extension of the Maternity and Child Welfare Service. 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. 17 COMPARATIVE TABLE, YEAR 1924. Name of Borough. Population. Birth Rate. Zymotic Death Rate. Death Rate all causes. Infant Mortality. Battersea 171,000 18.4 0.7 11.7 62 Bermondsey 122,100 23.8 — 13.6 78 Bethnal Green 119,200 22.1 1.1 12 .4 78 Camberwell 273,700 18.8 0.7 11.4 70 Chelsea 64,580 14.4 0.8 13.2 63 Deptford 115,200 20.6 0.7 12 .0 76 Finsbury 77,180 21.5 1.27 14.1 75 Fulham 163,100 18.2 0.5 11.1 72 Greenwich 102,470 20.0 0.69 11.4 73 Hackney 226,900 18.5 0.45 11.4 60 Hammersmith 134,200 17.9 0.7 12.4 72 Hampstead 87,600 13.5 0.09 11.7 56 Holborn 43,250 13.3 0.57 12.2 81 Islington 337,400 19.8 0.66 12.3 66 Kensington 178,700 16.2 0.64 13.0 75 Lambeth 309,300 25.5 0.6 12.5 50 Lewisham 184,900 16.3 0.3 10.4 47 Paddington 146,400 17.1 0.9 13.1 78 Poplar 167,300 22.9 0.8 12.1 72 St. Marylebone 105,300 14.5 1.01 13.6 78 St. Pancras 214,300 18.8 1.0 13.0 74 Shoreditch 106,500 23.7 1.2 13.7 87 Southwark 187,714 22.5 1.5 14.2 71 Stepney 254,340 21.4 0.78 12.2 74 Stoke Newington 52,920 16.6 0.7 11.3 58 Wandsworth 338,200 14.57 0.47 11.0 57 Westminster 143,000 11.6 0.4 12.1 59 Woolwich 139,980 18.5 0.5 11.0 65 City of London 13,300 7.1 0.14 11.3 117 County of London 4,576,505 18.7 — 12.1 69 City of Belfast - 24.0 - 14.3 107 ,i „ Dublin — 25.5 — 15.8 113 .i i, Glasgow — 24.1 — 16.1 119 „ „ Edinburgh — 19.7 — 14.8 89 n „ Liverpool — 24.4 — 13.6 103 n „ Manchester — 19.9 - 13.9 100 b 18 1. GENERAL STATISTICS. Area (acres) 3,287 Population—Census, 1901 219,780 ,, —Census, 1911 222,674 ,, —Census, 1921 222,159 ,, —Estimated, 1924 226,900 Number of inhabited houses, 1924 34,917 Number of families or separate occupiers (1921) 56,020 Rateable Value £1,279,141 Sum represented by a penny rate £5,260 Population.—The population for the whole Borough gives a density of 69.0 persons per acre, varying from 53.2 persons per acre in the Northern Sub.district to 99.2 persons per acre in the South-western Sub-district. The following table gives the estimated population and density of population per acre for each o! the Registration Sub.districts in the Borough:— Table showing Estimated Population, Area and Density of the Registration Sub.Districts in Hackney at middle of 1924. North Central South. West South. East Total for Hackney Total for London Estimated population 57.452 53,641 58,177 57,630 226,900 4,576,505 Area in square acres 1,080 857 586 764 3,287 74,816 Density, persons per acre 53.2 62.5 99.2 75.4 69.0 61.0 19 Register of Rainfall during the year at Clapton Pond. Month. Total rainfall. No. of days on which rain fell. Heaviest fall. Remarks. January 2.78 14 0.56 — February 0.57 10 0.21 — March 053 7 0.13 — April 2.87 13 0.41 — May 2.78 19 0.49 13th & 18th Thunderstorm June 2.43 11 0.51 — July 4.24 14 1.17 — August 2.45 18 0.58 19th, 20th & 22nd Thunderstorm. September 2.51 17 0.54 — October 3.39 17 0.83 — November 2.57 12 0.65 — December 3.26 16 0.70 — Total 30 .38 168 2. EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Births— Total. M. F. Legitimate 4,096 2,130 2,084 Birth Rate 18.57 Illegitimate 118 Deaths 2,588 Death Rate 11.4 Number of women dying in, or in consequence of childbirth:— From sepsis 3 From other causes 10 Deaths of Infants under one year of age per 1,000 births:— Legitimate 57. Illegitimate 161. Total 60. Deaths from Measles (all ages) 27. ,, ,, Whooping Cough (all ages) 16. ,, ,, Diarrhoea (under 2 years of age) 15. 20 *Marriages and Marriage.rates.—During 1924 there were 2,024 marriages solemnised in the Borough of Hackney. The annual rate for persons married during this period is therefore 17.8 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, 1914.1924. Year. Borough of Hackney. London. Marriages. Marriage rate. 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 1922 2,212 19.6 18.3 1923 1,971 17.4 17.3 Average,1914—1923 2,236 20.1 20.4 1924 2,024 17.8 17.3 Births and Birth.rate.—The births registered in the Borough of Hackney during the year 1924 numbered 4,802, of which 2,419 were males and 2,383 females. The total shows a decrease of 263 compared with the number registered during 1923, 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., 884 births to be transferred to other districts and 296 to Hackney. After these necessary corrections have been made, the correct total of registered births amongst Hackney residents is 4,214. From this figure the birth . *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 1924. 21 rate for Hackney during 1924 has been calculated to be 18.5 per 1,000 of the population. The birth-rate for all London for the same period is 18.7 per 1,000 of the population. Notification of Births Act, 1907.— Under the provisions of this Act 4,861 notifications of births were received during 1924. This total includes notifications from medical practitioners, midwives, parents and others. It also includes still-births. The total is 59 more than the number registered by the Registrar of Births. Still-Births.— Amongst the births notified 144 were stillborn. This is equal to 3.0 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 StiU-born) received during the year 1924. Year 1924. Medical Practitioners Midwives. Parents and Others. Total. Live. Still. Live. Still. Live. Still. Live. Still M. F M. F. M. F. M. F M. F. M. F. M. F. M F Totals 395 389 9 14 1564 1534 45 50 434 401 16 10 2293 2324 70 74 Illegitimate Births and Birth-rate.— The total number of illegitimate births registered in the Borough during the year 1921 was 334, but of these, the Registrar-General states that 243 should be transferred to districts outside the Borough, as the mothers were not Hackney residents, and 27 births which took place in other districts, should be transferred to Hackney. These corrections having been made, there remain 118 illegitimate births amongst Hackney residents. This is equivalent to an illegitimate birth-rate of 28.0 per 1,000 births. 22 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 South- East Total No. of births 4.802 781 1,959 1,022 1,040 85,147 Rate per 1,000 living 21.1 13.6 36.5 17.5 18.0 18.7 No of illegitimate births 118 ... ... ... ... ... Rate per 1,000 births 28.0 ... ... ... ... ... 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 1,140 births occurring during this year at the Salvation Army Mothers' Hospital, which Institution is situate in the Central District. Of this number 741 births are transferable to districts outside Hackney. The following table shows the birth-rates for the Borough and its Sub-Districts during the years 1914-1924, inclusive:— Birth-rate for the Borough of Hackney and its Sub-Districts for the years 1914-1924 compared with that of London. Year Borough of Hackney North SubDistrict Central SubDistrict South-West SubDistrict South-East SubDistrict London 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 1922 23.4 15.8 37.7 18.3 22.5 21.0 1923 22.3 14.5 38.7 17.4 19.8 20.2 Average 1914-1923. 22.8 15.4 34.2 19.1 224 21.1 1924 21.1 13.6 36.5 17.5 180 18.7 * The Salvation Army's Mothers' Hospital was opened in 1913. 23 Deaths.— The deaths registered in the Borough during 1924 numbered 2,844; but of these 680 were deaths of non-residents who died inside the Borough. There were, however, 424 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 2,588. This is an increase of 182 upon the number of deaths occurring during 1923. The general death-rate from all causes for the year 1924 is 11.4 per 1,000 of the population. Amongst the Registration Sub-districts the death-rate was lowest in the North Sub-district (112 per l,000) the highest in the Central and South-east Sub-districts (ll.5 per 1,000). Subdistrict. Population (estimated). Total No. of Births. Uncorrected. * Birlh rate. Uncorrected . Total Deaths Cor'ted. Deathrate Deaths under 1 year. * Infant Mortality per 1.000 Births. Uncorrected. North 57,452 781 13.6 646 11.2 52 66 Central 53,641 1,959 36.5 617 11.5 58 30 South - west 58,177 1,022 17.5 662 11.3 79 77 South - east 57,630 1,040 18.0 663 11.5 65 62 All Hackney 226,900 4,802 211 2,588 11.4 254 53 * 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 30. 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. 1915 149 16.1 1920 12.7 12.4 1916 13.8 14.3 1921 11.5 12.4 1917 14.6 15.0 1922 12.7 13.4 1918 18.9 18.9 1923 10.6 11.2 1919 130 13.4 1924 11.4 12.1 24 Infantile Mortality.— The deaths under 1 year of age in the Borough during 1924 numbered 254. This is a decrease of 3 upon the number of infants' deaths recorded during 1923. The infant mortality rate for the year is 60 per 1,000 births. The causes of death are set out in the following table INFANT MORTALITY, 1924. 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 ... ... ... ... ... ... ... ... 1 1 Measles ... ... ... ... ... ... 1 1 3 5 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 2 ... 2 3 7 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... 2 ... 2 ... ... ... ... 2 Tuberculous Meningitis ... ... ... ... ... 1 2 ... 1 4 Other Tuberculous Diseases ... ... ... ... ... ... 1 ... 1 2 Meningitis (Not Tuberculous) ... ... ... ... ... 1 ... ... 1 2 Convulsions 1 1 1 ... 3 1 2 1 ... 7 Laryngitis ... ... ... ... ... ... ... ... 1 1 Bronchitis ... ... 1 1 2 4 2 ... 1 9 Pneumonia (all forms) ... ... 2 3 6 14 20 12 11 63 Diarrhoea ... ... ... 1 1 1 1 1 ... 4 Enteritis ... ... ... ... ... 2 5 3 1 11 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) 1 ... ... ... 1 ... ... ... ... 1 Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Defects 9 ... ... ... 9 3 ... ... ... 12 Premature Birth 43 8 4 3 58 6 ... ... ... 64 Atrophy, Debility and Marasmus 6 3 2 ... 11 5 1 ... ... 17 Other Causes 6 3 1 1 11 5 9 8 3 36 72 15 13 9 109 46 44 28 27 254 25 Senile Mortality.— The deaths which occurred in Hackney at 65 years of age and upwards during 1924 numbered 1,009 and of these 509 were between the ages of 65 and 75 years, 388 between 75 and 85 years, and 112 at 85 years and upwards. The annual mortality rate of persons at 65 years and upwards is 4-4 per 1,000 inhabitants. Deaths in Public Institutions.— There were 1,608 deaths in public institutions in the Borough during 1924; of these 680 were residents of other districts, and the remaining 928 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 1924:— Institutions within the Borough receiving persons both from and without the Borough. Brooke House, Upper Clapton Road 8 Eastern Fever Hospital, Homerton 209 French Hospital, Victoria Park Road 6 German Hospital, Dalston 145 Hackney Union Infirmary, Homerton 898 ,, Central Institution, Homerton 2 Metropolitan Hospital, Kingsland 169 Nursing Home, 46, Amhurst Park 2 ,, ,, 2, Amhurst Park 3 ,, ,, 7, Dunsmure Road 1 ,, ,, 7, Powell Road 2 ,, ,, 94, Cazenove Road 1 Carried forward 1,446 26 Brought forward 1,446 Nursing Home, 18 and 20, Southwold Road 6 ,, ,, 4, Navarino Road 3 ,, ,, 2, Queensdown Road 3 ,, ,, 262, Victoria Park Road 1 St. Joseph's Hospice, Mare Street 122 Salvation Army Nursing Home, 9, Amhurst Park 1 Salvation Army Maternity Hospital, Lower Clapton Road 21 ,, ,, Home, 183, Amhurst Road 3 ,, ,, ,, 259, Mare Street 2 1,608 Institutions Outside the Borough Receiving Sick and Infirm Persons Residing in the Borough. Banstead Mental Hospital 1 Bethnal Green Infirmary 4 Cancer Hospital 2 Cane Hill Mental Hospital 1 Central London Throat and Ear Hospital 1 Charing Cross Hospital ... 1 Children's Hospital, Gt. Ormond Street 10 City of London Maternity Hospital 8 Claybury Mental Hospital 17 Colindale Hospital 14 Colney Hatch Mental Hospita1 13 Darenth Industrial Colony, Dartford 1 Dartford Heath Mental Hospital 5 East London Hospital 2 Elizabeth Garrett Anderson Hospital 2 Grove Fever Hospital 2 Carried forward 84 27 Brought forward 84 Guy's Hospital 4 Hackney Branch Institution, Brentwood 1 Hanwell Mental Hospital 1 Homeopathic Hospital 2 Horton Mental Hospital 1 Hospital for Jewish Incurables, Tottenham 3 Hospital of St. John and St. Elizabeth 1 Hostel of God 2 Joyce Green Fever Hospital 2 Leavesden Mental Hospital 11 London Fever Hospital (T.B.) 3 London Hospital 44 London Jewish Hospital, Stepney 1 London Temperance Hospital 1 Long Grove Mental Hospital 4 Middlesex Hospital 7 Mildmay Memorial Hospital 1 Mildmay Mission Hospital 5 Ministry of Pensions Hospital, Orpington 3 Mothers' Home, Commercial Road 1 National Heart Hospital 1 National Hospital, Queen's Square .1 New End Hospital, Hampstead 1 North-Eastern Fever Hospital 9 North Middlesex Hospital, Edmonton 5 North-Western Fever Hospital 4 Park Fever Hospital 1 Peckham House 1 Poplar Hospital 1 Prince of Wales' General Hospital 7 Carried forward 213 28 Brought forward 213 Queen's Hospital for Children 45 Queen Mary's Hospital, Stratford 2 Royal Chest Hospital, City Road 2 Royal Northern Hospital 2 St. Bartholomew's Hospital 20 St. Columba's Hospital 3 St. George's Home, Chelsea 3 St. George's Hospital 2 St. Luke's Hospital 1 St. Mark's Hospital 1 St. Mary's Hospital 1 St. Peter's Hospital 1 St. Thomas's Hospital 4 Shoreditch Infirmary 5 South-Eastern Fever Hospital 2 South-Western Fever Hospital 1 Tooting Bee Mental Hospital 13 University College Hospital 2 Victoria Park Hospital 15 Westminster Hospital 1 Western Fever Hospital 1 Whipps Cross Hospital, Leyton 4 Miscellaneous 80 Total 424 29 MORTUARY, 1924. Number of bodies in Mortuary 246 (a) Infectious — 1. To await Inquests— (b) Non-Infectious 219 2. To await Burial 27 Number of Post Mortems 102 Inquests. Verdict. Sex. Male. Female. Natural Causes 61 31 Accidental Death 36 34 Suicide 25 13 Open Verdict 10 7 Manslaughter 1 ... Murder ... ... Misadventure 1 ... Totals 134 85 Table showing nature of Suicidal and Accidental Deaths in the Borough of Hackney during the year 1924. Nature of Suicide. No. Nature of Accidental Death. No. Hanging 6 Shock from Burns 9 Poisoning 17 Shock from Fall 23 Drowning 10 Suffocation 2 Jumping from window 1 Drowning 1 Shooting 1 Run over 22 Run over by train 3 Shock from Scalds 5 Poisoning 1 Others 7 38 70 30 TABLE I. Vital Statistics of Whole District during 1924 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. Jncorrec- 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 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 4,748 4,141 21.0 2.990 13.7 673 530 355 85 2.847 13.0 For Births, 225,774 1920 For Deaths 225,172 6,486 6,010 26.6 3,030 13.4 679 510 485 81 2,861 12.7 For Births, 225,542 1921 224,200 5,437 4,978 22.2 2,757 12.6 648 471 329 66 2,580 11.5 1922 225,400 5,270 4,743 21.0 3,098 13.7 678 459 344 72 2,879 12.1 1923 226,400 5,065 4,433 19.6 2.561 11.3 554 399 257 58 2,406 10.6 1924 226.900 4,802 4.214 18.5 2,844 12.5 680 424 254 60 2,588 11.4 31 TABLE II.- HACKNEY BOROUGH. Notifiable Diseases during the Year 1924 (Age groups of notifications). Diseases. Cases Notified 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 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and upwards. North. Central. South-East. South-West. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 546 5 40 41 60 49 169 84 36 48 10 3 1 118 185 156 87 522 Erysipelas 48 ... 1 ... ... 1 2 3 2 6 7 21 5 5 12 15 16 15 Scarlet Fever 528 3 23 39 42 82 196 75 26 33 8 1 ... 154 105 115 154 494 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 8 ... ... ... ... ... ... ... 3 1 3 1 ... 1 2 2 3 6 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 11 ... ... ... ... ... ... ... ... 10 1 ... ... 4 4 1 2 8 Cerebro-Spinal Meningitis 8 2 1 2 ... ... 1 ... ... 2 ... ... ... 2 2 1 3 8 Polio Myelitis 2 ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 2 2 Ophthalmia Neonatorum 25 25 ... ... ... ... ... ... ... ... ... ... ... 4 4 8 9 10 Pulmonary Tuberculosis 334 ... 1 ... ... ... 6 9 44 144 53 72 5 73 73 105 83 216 Other forms of Tuberculosis 115 1 3 8 9 8 29 19 10 8 5 14 1 29 24 30 32 57 Encephalitis Lethargica 34 ... ... 2 ... ... 2 7 2 8 6 5 2 12 6 9 7 23 Influenzal Pneumonia 9 ... ... ... ... ... ... ... ... 1 ... 5 3 2 3 2 2 1 Acute Primary Pneumonia 34 ... 2 1 1 1 2 2 1 7 7 7 3 2 7 16 9 21 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 1,702 36 71 93 113 141 408 199 124 268 100 129 20 406 427 460 409 1,383 32 Notifiable Diseases during the year 1924 (Age Groups of Deaths). Disease. Total cases notified. Cases admitted to Hospital. Age Groups of Deaths. Total deaths at all ages. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to IS 15 to 20 20 to 35 35 to 45 45 to 65 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 546 522 ... 2 3 7 5 15 1 ... 1 ... ... ... 34 Erysipelas 48 15 2 1 ... ... ... ... ... ... ... ... 1 1 5 Scarlet Fever 528 494 ... 1 2 1 1 2 ... ... ... ... ... ... 7 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 8 6 ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 11 8 ... ... ... ... ... ... ... ... ... ... ... ... 3 Cerebro-Spinal Meningitis 8 8 2 1 1 1 ... 1 ... ... ... ... ... ... 6 Polio Myelitis 2 2 ... ... ... 1 ... ... ... ... ... ... ... ... 1 Ophthalmia Neonatorum 25 10 ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica 34 23 ... ... ... ... ... 1 ... 2 2 3 2 1 11 Influenzal Pneumonia 9 1 ... ... ... 1 ... ... ... ... ... 1 5 ... 7 Acute Primary Pneumonia 34 21 ... ... ... ... 1 ... ... 1 ... 2 6 ... 10 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 3 Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 1253 1110 4 5 6 11 7 19 1 3 7 7 14 3 87 For age groups of notifications (including Tuberculotis) see previous page. 33 Notifiable Diseases during the year 1924 (Deaths in Hospitals). Disease. No. of Deaths in Hospitals. Total Deaths. Diphtheria 32 34 Erysipelas 5 5 Scarlet Fever 7 7 Puerperal Fever 3 3 Cerebro-Spinal Meningitis 6 6 Polio Myelitis 1 1 Encephalitis Lethargica 10 11 Influenzal Pneumonia 6 7 Acute Primary Pneumonia 3 10 Dysentery 3 3 76 87 INFECTIOUS DISEASE. During 1924 there were 1,253 cases of acute infectious disease compulsorily notified in the Borough, as set out in Table II. This total shows an increase of 84 upon those notified during 1923. The attack-rate in respect of the acute notifiable infectious diseases for the year is 5 5 per 1,000 inhabitants. In addition there were 334 notifications received of pulmonary tuberculosis and 115 notifications of other forms of tuberculosis. The deaths from the chief zymotic diseases numbered 102. This is equivalent to a zymotic death-rate of 0.45 per 1,000 living in the Borough, as compared with a zymotic death-rate of 0 34 during the previous year. III. NOTIFIABLE DISEASES DURING THE YEAR. Small-Pox.— There were no notifications of small-pox in the Borough during 1924. C 34 Summary of Proceedings under the Vaccination Acts, 1867 to 1898, during the year 1924. 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 800 531 37 — - 227 2 31 4 218 Central 1,948 517 32 - - 716 3 369 83 293 South-East 1,048 370 15 - - 493 — 30 34 330 South-West 1,017 465 34 - - 424 2 36 4 349 Total 4,813 1,883 118 — — 1,860 7 466 125 1,190 35 Scarlet Fever or Scarlatina.— The number of cases of scarlet fever notified during 1924 was 528. This is an increase of 71 cases upon the number of genuine cases notified during 1923. The attack rate for scarlet fever was 2.32 per 1,000 persons living, and for England and Wales 2T6. The number of cases removed to hospital during the year was 494. This is equal to 93 per cent, of the total notified. The following table shows the distribution of scarlet fever in the respective Sub-districts of the Borough:— Sub-Districts. North. Central. South-west. South-east. Number of cases of Scarlet Fever 154 105 154 115 Attack-rate per 1,000 living 2.8 1.9 2.6 1.9 It will be seen from the above that scarlet fever was most prevalent in the North and South-West Sub-districts. The deaths from scarlet fever during 1924 numbered 7, which is equal to a case mortality of T3 per cent, attacked, and a scarlet fever death-rate of 0.03 per 1,000 inhabitants. The mortality rate for London from scarlet fever during the same year was 0.03 per 1,000 inhabitants. Diphtheria and Membranous Croup.— There were 546 cases of diphtheria and membranous croup notified during the year. This is an increase of 18 upon the number of genuine cases notified during 1923. The attack rate of diphtheria was 2 4 per 1,000 inhabitants, compared with 1.07 for England and Wales. 36 There were 522 cases removed to hospital during the year. This is equal to 95 per cent, of the cases notified. The following table shows the distribution of diphtheria in the respective Sub-districts of the Borough:— Sub-Districts. North. Central. South-west. South-east. Number of cases of Diphtheria and Membranous Croup 118 185 87 156 Attack-rate per 1,000 living 2.0 3.4 1.5 2.7 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 34. This mortality is equal to a death-rate of 6 2 per cent, attacked and 0.15 per 1,000 inhabitants, as compared with a death-rate of 5.4 per cent, attacked, and 0.12 per 1,000 inhabitants for the previous year. The death-rate from diphtheria for London during the same period is 0.12 per 1,000 inhabitants. During the year 922 swabbings from throats of persons suspected to be suffering from diphtheria were bacteriologically examined, of which 103 gave positive results, 804 negative results, and 15 were returned as doubtful. Diphtheria Anti-toxin.— In accordance with the Anti-toxin Order of 1910, a supply of diphtheria anti-toxin was provided 37 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 108 bottles of anti-toxin of 8,000 units each, one of 2,000 units, and two of 500 units were supplied to medical practitioners, most of which was used for prophylactic purposes. The following table shows the number of attacked persons under 15 years of age not known to have had a previous attack of Scarlet Fever and Diphtheria as they are housed, as follows:— Disease. Cases removed to Hospital Cases nursed at Home Less than 1 person per room 1 to 2 persons per room More than 2 persons per room Less than 1 person per room 1 to 2 persons per room More than 2 persons per room Scarlet Fever 33 323 80 9 14 1 Diphtheria 37 294 102 10 5 - It is not possible to show the attack rates per 1,000 persons under 15 years of age, as the records do not give the information as to the housing conditions of the population coming within this age period. Typhoid or Enteric Fever.— During the year under consideration, 8 cases of entcric fever were notified. This shows a decrease of 9 on the number of genuine cases notified during 1923. The attack rate was 0 03 per 1,000 inhabitants, compared with 0*11 for England and Wales. Six of the cases were removed to hospital. 38 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 1 2 3 2 There were no deaths from enteric fever in the Borough last year. The mortality from enteric fever for the same period in London was '01 per 1,000 inhabitants. During the year 39 specimens of blood from persons suspected to be suffering from enteric fever were submitted to Widal's test. All gave a negative reaction. 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 11 cases of puerperal fever notified during 1924; 8 cases were removed to hospital. The deaths from puerperal fever and septicaemia numbered 3. The attack-rate for the year was 2 6 per 1,000 births, and the deathrate 0.7 per 1,000 births. 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 48 cases of Erysipelas notified during 1924. This is equal to an attack-rate of 0 21 per 1,000 inhabitants, compared with 0 33 for England and Wales. Of the 48 cases notified, 15 were removed to hospital. 39 There were 5 deaths certified to be due to erysipelas. 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 5 12 16 15 Rate per 1,000 living .08 .22 .27 .26 Cerebro-spinal Meningitis.— During 1924 there were 8 cases of this disease notified in the Borough, all were removed to hospital. Six deaths occurred. Polio-myelitis.— There were 2 cases of polio-myelitis notified in the Borough during the year. One death occurred. Ophthalmia Neonatorum.— There were :— Notified Cases Vision Unimpaired Vision Impaired Tota! Deaths Blindness Treated At Home In Hospital 25 15 10 25 — - Encephalitis Leihargica.— The Public Health (Acute Encephalitis Lethargica and Acute Polio Encephalitis) Regulations, 1918, came into operation on 1st January, 1919. During the year 1924 34 cases were notified, 11 being fatal. Twenty-three patients were removed to hospital. Influenzal Pneumonia and Pneumonia.— There were 9 cases of influenzal pneumonia and 34 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 Is. 3d. per visit. During the year 51 cases were nursed 40 and 1,010 visits were paid to those cases. Influenza, unless complicated by pneumonia, is not notifiable. Malaria.— There were no notifications of Malaria in the Borough during the year. Dysentery.— There were no notifications of Dysentery in the Borough during the year. Three deaths, however, occurred. 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 1924. NON-NOTIFIABLE. Measles and German Measles.— The Public Health (Measles and German Measles) Regulations, 1915, were withdrawn by Order in Council on 31st December, 1919. Twenty-seven deaths were recorded from this disease. The annual mortality is therefore 11 per 1,000 inhabitants, compared with London .29 per 1,000 inhabitants. Information of 1,540 cases of measles and 152 cases of German 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. Influenza.— During 1924 there were 76 deaths in the Borough. This is an increase of 27 on the deaths from this cause registered during 1923. The annual mortality rate from influenza is 0.33 per 1,000 inhabitants. 41 Diarrhoea.— There was an increase in the number of deaths due to diarrhoeal disease in the Borough during 1924. The total number of deaths from this cause was 18, and of these 15 were under 1 year of age. The annual mortality rate for diarrhoea and enteritis during the year is 0 08 per 1,000 inhabitants. Whooping Cough.— The deaths from this cause during the year numbered 16. This is an increase of 2 upon the number registered during 1923. All of the deaths occurred in children under five years of age. The mortality for Hackney is equal to 07 per 1,000 inhabitants, and that for all London, 11 per 1,000 inhabitants. The King's Home for Nurses attended to 11 cases and paid 334 visits. Information was received from the head masters and head mistresses of elementary schools in Hackney of 523 cases of whooping cough occurring among their scholars during the year. CONSTITUTIONAL DISEASES. For Table of Deaths see pages 126 to 133. Cancer.— There were 310 deaths during 1924 due to the different varieties of malignant disease. This is an increase of 7 on the number registered during 1923. The annual mortality rate from malignant disease for last year is therefore 136 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 87 66 81 76 Mortality-rate per 1,000 inhabitants 1.5 1.2 1.3 1.3 42 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 1924:— London. | Borough of Hackney. Years. 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Deaths from Cancer. 276 245 230 236 274 246 289 285 303 310 Death-rate per 1,000. 126 1.16 1.17 1.07 1.26 1.09 1.28 1.26 1.33 1.36 Death-rate per 1,000. 1.16 1.18 1.25 1.26 1.20 1.20 1.31 1.30 1.35 1.40 43 CANCER— 1924. Analysis of the Deaths from Cancer, Malignant Tumour, Sarcoma and other forms. Under 1 1-2 2-5 5-15 15-25 25-35 35-45 45-55 55-65 65-75 75-85 85 Total. Brain or Meninges ... ... 1 ... ... ... ... ... ... ... ... ... 1 Mouth and Annexa ... ... ... ... ... ... ... 1 8 6 1 ... 16 Oesophagus ... ... ... ... ... ... ... 1 8 5 2 ... 16 Stomach ... ... ... ... ... ... 2 7 12 20 12 1 54 Pancreas ... ... ... ... ... ... ... 2 3 3 2 ... 10 Intestine (large or small) ... ... ... ... ... ... 4 4 9 18 3 ... 38 Rectum ... ... ... ... ... 1 3 5 4 8 5 1 27 Liver ... ... ... ... ... ... ... 1 6 7 3 2 19 Larynx ... ... ... ... ... ... ... 5 3 4 2 ... 14 Lung ... ... 1 ... ... 1 3 2 3 1 2 ... 13 Bladder ... ... ... ... ... ... ... ... 3 4 1 ... 8 Breast ... ... ... ... ... ... 4 5 14 7 4 1 35 Uterus and appendages ... ... ... ... ... 1 2 11 5 4 1 1 25 Bones and Joints ... ... ... ... 1 1 ... ... ... ... ... ... 2 Other and ill-defined situations ... ... 1 ... ... 5 4 4 7 7 3 1 32 ... ... 3 ... 1 9 22 48 85 94 41 7 310 44 Alcoholism. Alcoholism.— During the year under consideration there was one death from alcoholic poisoning; and 10 deaths registered as due to cirrhosis of the liver, a condition regarded, as a rule, to be due to excessive indulgence in alcohol, extending over lengthy periods. TUBERCULOSIS. Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0 ... ... ... 1 ... ... 4 2 1 ... 1 16 12 ... ... 12 10 5 3 3 14 15 ... ... ... 3 10 3 6 6 14 ... 5 ... 2 15 20 24 4 6 5 10 3 ... 20 21 30 3 2 20 14 2 1 25 47 46 n 1 20 26 ... ... 35 29 24 2 3 26 17 2 ... 45 38 15 7 3 31 11 2 1 55 11 8 ... 4 9 10 ... ... 65 and upwards 4 1 ... 1 2 1 2 1 Totals 176 158 54 62 113 94 27 20 During 1924, 449 primary notifications of tuberculosis were received, details of which are given on page 47 of this Report. Bacteriological examination of sputa from 506 cases was made by the Council's Bacteriologist during the same period. In 68 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 1924, was 254, a decrease of 2 upon the deaths during 1923. These deaths are classified as follows: — 45 Pulmonary Tuberculosis 207 General tuberculosis 3 Tuberculous meningitis 26 Tuberculous peritonitis 7 Lupus - Tabes mesenterica — Tubercle of other organs 11 254 This number of deaths gives an annual mortality of 112 per 1,000 inhabitants. In the following table the yearly deaths from tuberculous diseases in the Borough for the last 26 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. ent. 1898-1900 483 — 1901-1903 452 64 1904-1906 417 137 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 1922-1924 249 48.2 There were 41 deaths where a notification had not been received under the Regulations. The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is therefore as 1 is to 6. 25 deaths occurred in hospitals, 6 in the Hackney Infirmary, 2 in mental hospitals, 2 certified on inquest, and in 7 cases the deaths were certified by local practitioners. In 12 cases post mortems were performed to ascertain the cause of death. 46 Enquiries were made in all these cases, with the exception of deaths in Mental Hospitals, to ascertain, if possible, the extent of treatment prior to death. It was found that in 11 cases the patient had only attended a local doctor or had been admitted to hospital from 1 to 7 days before death, and in 12 others for a period under 3 months. Endeavours were made for the contacts to attend the Dispensary for examination. It will be seen from the preceding table 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 1924, being equal to 48 2 per cent. 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 43 62 70 79 Mortality rate per 1,000 inhabitants .78 11 1.2 1.3 Public Health (Tuberculosis) Regulations, 1912. Under these Regulations 1,160 notifications of tuberculosis were received during the year, of which 941 were pulmonary and 219 non-pulmonary. 47 Summary of Notifications during the period from 30th December, 1923. to 3rd January, 1925. Age Periods. Notifications on Form A. and Primary Notifications. Total 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 Pulmonary Males ... ... 3 3 20 21 47 29 38 11 4 176 206 „ Females ... 1 3 6 24 30 46 24 15 8 1 158 200 Non-Pulmonary Males ... 16 14 6 4 3 2 2 7 ... ... 54 57 „ „ Females 1 12 15 13 6 2 1 3 3 4 1 61 66 Number of Notifications on Form B. Number of Notifications on Form C. Age Periods. 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 ... ... ... ... ... 28 137 „ Females ... ... ... ... ... 48 101 Non-Pulmonary Males ... ... ... ... ... ... 33 „ n Females ... 1 ... 1 1 1 27 48 Copies of Letters and Circulars forwarded to Medical Practitioners regarding cases where delay had occurred in notifying cases under the Regulations. I find from my returns of deaths that the above-named was certified by you to have died on the from but I have not received a notification as required by the Public Health (Tuberculosis) Regulations, 1912. Article V. of the Regulations requires that "every medical practitioner shall within 48 hours after becoming aware that such person is suffering from tuberculosis, make and sign a notification of the case in Form A'., and shall transmit the notification to the Medical Officer of Health for the district within which the place of residence of the person is situate at the date of notification." I am forwarding, for your information, an extract from Circular 549 of the Ministry of Health with reference to the Public Health (Tuberculosis) Regulations, 1912 and 1921. The Ministry of Health are paying increasing attention to the question of notification of Tuberculosis, and I should be glad if you would co-operate with me in this respect as fully as possible. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912 and 1921. Circular 549— Ministry of Health— 22nd December, 1924. " Notifications under the Regulations"— Paragraph 5 :— " The Minister desires to take this opportunity of impressing upon Local Authorities the responsibility which attaches to them for seeing that the requirements of the Regulations are fully observed in their Districts, and I am to state that where (as in the 49 case of a death certified as due to tuberculosis of a person who had not previously been notified under the Regulations) there is ' prima facie ' evidence of neglect to notify on the part of the medical attendant, immediate steps should be taken by the Local Authority to obtain an explanation from the medical attendant as to the circumstances under which formal notification under the Regulations was not made. If the explanation is not satisfactory, it should be borne in mind that the Local Authority have power to institute proceedings for the recovery of a penalty under Section 1 (3) of the Public Health Act, 1896, in cases of wilful neglect or refusal to carry out the Regulations; and it appears to the Minister that it may even be desirable to proceed to a prosecution in one or two cases of the kind where the circumstances warrant such action in order to secure the objects of the Regulations." I have received information that a sample of sputum in respect of the above named patient has been found to contain tubercle bacilli, but I do not appear to have received a notification as required by the Public Health (Tuberculosis) Regulations, 1912. Article V. of the Regulations requires that " every medical practitioner shall within 48 hours after becoming aware that such person is suffering from tuberculosis, make and sign a notification of the case in Form A, and shall transmit the notification to the Medical Officer of Health for the district within which the place of residence of the person is situate at the date of notification." I am forwarding, for your information, an extract from Circular 549 of the Ministry of Health with reference to the Public Health (Tuberculosis) Regulations, 1912 and 1921. The Ministry of Health are paying increasing attention to the question of notification of Tuberculosis, and I should be glad if you would co-operate with me in this respect as fully as possible. D 50 Visits paid by Tuberculosis Visitors. New Cases. Contacts Sailors and Soldiers Other Persons. Total. Insured. Noninsured. Miss Servante 167 160 442 1641 2410 1272 1138 Miss Clarke 301 229 387 1287 2204 1092 1112 468 389 829 2928 4614 2364 2250 The Staff of the King's Home for Nurses paid 2,682 visits to 54 cases. Discharged Tuberculous Sailors and Soldiers. Arrangements were made at the commencement of 1919 with the Ministry of Pensions for the home visiting and after-care of discharged sailors and soldiers 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 375, and the total number of visits of this kind made was 829. 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 five. 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. The Scheme for carrying out Dispensary Treatment and After-care was thrust ready-made upon the Borough Council, so 51 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. 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 Case 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 1924 a total estimated population of 399,020 with 451 deaths from tuberculosis and with 785 primary cases of tuberculosis notified during that year alone. DISPENSARY DISTRICTS. Estimated Population in Electoral wards. Metropolitan Hospital Area— Stamford Hill 33,448 West Hackney 19,386 Kingsland 23,500 Downs 17,407 93,741 Estimated population (1924)— Borough of Stoke Newington 52,920 146,661 52 Brought forward 146,66] Victoria Park Hospital Area— Clapton Park 43,380 Homerton 37,932 South Hackney 23,509 Hackney 28,338 133,159 Estimated population (1924)— Borough of Bethnal Green 1119,200 252,359 399,020 Estimated population (1924) Hackney 226,900 DISPENSARY DEATHS. Condition of Patient on First Attendance. Pulmonary Tuberculosis 1st Stage. 2nd Stage. 3rd Stage. Number 24 59 51 Percentage 18% 44% 38% Duration of illness before attending Dispensary Under 1 month 6 1 to 3 months 24 3 to 6 months 17 6 to 9 months 19 9 to 12 months 5 Over 12 months 49 Period indefinite 14 53 ALL DEATHS FROM TUBERCULOSIS. Interval elapsing between Notification and Death. 1922. 1923. 1924. Pul. Non-pul. Pul. Non-pul Pul. Non-pul. 1. Number of Deaths from Tuberculosis 202 36 216 40 207 47 2. Number of cases only notified at death 11 4 15 3 3 6 3. Do. notified within a month of death 20 1 16 2 19 6 4. Do. do. 3 months of death 25 1 19 1 22 1 5. Do. do. 6 months of death 24 1 9 1 20 1 6. Number of deaths in cases not notified under Tuberculosis Regulations 24 20 26 18 16 25 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. During 1924, 449 primary cases were notified, and the contacts to these cases number in all 1,234 persons, and of these 583 contacts were examined, making the number examined slightly over 47 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 1924, 254 deaths were registered—207 pulmonary and 47 non-pulmonary; but of these 16 pulmonary and 25 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. 54 Of the pulmonary deaths, there were 584 contacts, of which 376 were examined, representing 64 per cent, examined; and of the non-pulmonary deaths there were 132 contacts, of which 59 were examined, representing 44 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 348 Females' 363 Total 711 2.— The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 88 42 Local Practitioners Primary 186 198 61 Contact 12 5 War Pensions Committee 10 4 Contact cases (Tuberculosis Visitors) 364 11 London County Council 14 6 Victoria Park Hospital 15 15 Other sources 22 15 55 3.— The Diagnosis of the New Cases. Diagnosis. Insured. Uninsured. Total. Males. Females. Children under 16. Males. Females. Pulmonary Tuberculosis 58 28 3 12 23 124 Non-pulmonary Tuberculosis 2 7 17 2 7 35 Non-tuberculous 104 70 229 17 93 513 Doubtful 15 6 11 3 4 39 Totals 179 111 260 84 127 711 4.— The Diagnosis of Contact Cases. Pulmonary tuberculosis 9 Non-pulmonary tuberculosis 7 Non-tuberculous 346 Doubtful 14 Total 376 5.— Sputum Examinations of Insured and Uninsured Patients. Tubercle Bacilli present 166 Tubercle Bacilli absent 588 Total 754 56 6.— Other Figures. Insured. Uninsured. Total number of attendances 1841 3764 Systematic examinations at the above 2548 Number of letters written 1685 Number of visits to patients at their homes 176 Number of patients sent to hospital or sanatorium 83 26 Number of patients referred to:— X-ray Department 74 Dental Department 44 Other Departments 31 METROPOLITAN HOSPITAL TUBERCULOSIS DISPENSARY. (Dr. Young.) HACKNEY CASES TREATED. 1.—The Totals of New Cases. Males 182 Females 207 Total 389 2.— The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 60 37 Local Practitioners 93 45 War Pensions Committee 2 1 Contact cases (Tuberculosis Visitors) 201 4 Ministry of Pensions 5 1 London County Council 2 — Metropolitan Hospital 11 11 Other Hospitals 10 8 Other sources 5 5 57 3.— The Diagnosis of the New Cases. Diagnosis. Insured. Uninsured. Total. Males. Females. Children under 16. Males. Females. Pulmonary Tuberculosis 35 24 1 12 19 91 Non-pulmonary Tuberculosis 1 4 14 — 2 21 Non-tuberculous 41 34 128 14 47 264 Doubtful 3 1 5 — 4 13 Totals 80 63 148 26 72 389 4.— The Diagnosis of Contact Cases. Pulmonary tuberculosis 2 Non-pulmonary tuberculosis 2 Non-tuberculous 195 Doubtful 2 Total 201 6.— Sputum Examinations of Insured and Uninsured Patients. Tubercle Bacilli present 157 Tubercle Bacilli absent 260 417 58 6.— Other Figures. Insured. Uninsured. Total number of attendances 1449 1377 Systematic examinations at the above 420 360 Number of letters written 715 284 Number of visits to patients at their homes 60 61 Number of patients recommended for hospital or sanatorium 53 29 Number of patients referred to :— X-ray Department 22 18 Other Departments 20 72 Extra Nourishment. The Scheme came into operation on 6th June, 1921, and during the year 151 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 £416 5s. 9d. Advanced Cases. 59 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 99 9 108 At Hackney Infirmary 56 6 62 At other Institutions 52 32 84 207 47 254 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 average number on the roll for the year is 87, with an average attendance of 74. Dr. Howell, Tuberculosis Officer to the City of London Hospital Tuberculosis Dispensary is responsible for the medical care of the children, and visits the School once weekly. After-Care.— Every effort has been made by the Care Committee to carry out every duty possible under existing circumstances. 60 DISINFECTION. (a) Rooms.— During 1924 there were 2,117 rooms fumigated and 536 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 1924. Month Rooms Fumigated. Rooms Cleansed. January 165 41 February 232 33 March 209 42 April 190 39 May 182 46 June 175 32 July 139 36 August 120 34 September 153 36 October 176 74 November 166 58 December 210 65 Total 2,117 536 (b) Articles of Clothing, Furniture, etc.— The number of articles under this head disinfected during last year was 22,194. This is an increase of 7,664 upon the number disinfected during 1923. A table is here given showing details of the articles disinfected each month. 61 Articles Disinfected, 1924. Description of Articles. January. February. March. April. May. June. July. August. September. October. November. December. Totals. House linen and furniture 1,156 1,156 1,042 1,077 961 969 1,154 1,451 1,788 2,856 2,546 2,939 19,075 Men's clothing 5 4 3 6 4 ... 17 24 25 49 87 65 289 Women's clothing 14 16 18 4 12 9 20 62 93 240 234 227 349 Children's clothing ... ... ... ... ... ... 1 15 11 44 38 19 128 Other articles 327 93 89 74 99 97 103 16 32 150 202 471 1,753 Total 1,482 1,269 1,152 1,161 1,076 1,075 1,295 1,568 1,949 3,339 3,107 3,721 22,194 62 In addition to these there were 284 articles destroyed on request from the owners. These are .set out in the following; table:— Articles Destroyed. Beds 62 Bolsters 11 Mattresses 46 Pillows 51 Sundry Articles 114 Total 284 (c) Public Library Books.—During the past year 457 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 burning sulphur. Books Disinfected. Month. Number. January 31 February 50 March 45 April 50 May 58 June 37 July 39 August 11 September 24 October 55 November 29 December 28 457 63 Isolation Shelter. During the year there were 131 persons admitted to the Shelter whilst their homes were being disinfected. This total consisted of 29 men, 36 women and 66 children. The cost of maintenance of these persons admitted was £9. 6s. 2d. 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, The total number of baths given during the year was 4,061 (143 to adults and 3,918 to children). This total shows a decrease of 590 upon the number given during 1923. Of the 4,061 baths given, 1,031 were sulphur baths for scabies, and 3,030 for pediculi. The great majority of those persons presenting themselves for baths were children from the elementary schools in the Borough. The children received 3,918 baths, a decrease of 430 upon the number given during 1923. The following are the Schools from which children were sent to the Cleansing Station, with the number of baths given :— Number Cleansed. Schools. Hot Baths. Sulphur Baths. Benthal Road 102 14 Berger Road 204 27 Berkshire Road — 45 Church Street — 10 Craven Park 75 — Dalston Central 6 12 Daubeney Road 445 16 Detmold Road 200 18 Enfield Road — 44 Carried forward 1,032 186 64  Hot Baths. Sulphur Baths. Brought forward 1,032 186 Gainsborough Road — 10 Gayhurst Road 45 2 Glyn Road 114 35 Hackney Parochial 107 15 High Street 2 22 Homerton Row 229 55 Lady Holies 2 — Lamb Lane 10 7 Lauriston Road 1 1 Mandeville Street 253 — Millfields Road 35 20 Morning Lane 163 10 Newington Green — 34 North Hackney Central 4 — North wold Road 158 — Orchard Street 97 33 Percy Road 48 — Princess May Road — 58 Queen's Road 43 4 Rams 3 — Rushmore Road 132 — St. Joseph's 46 21 St. Jude's 1 — St. Matthias — 2 St. Michael's 33 — St. Scholastica's 7 60 Sidney Road 187 19 Sigdon Road 154 177 South Hackney Central 3 — Tottenham Road — 42 Wilton Road 69 — Wordsworth Road 2 79 Other young children 5 41 Total 2,985 933 65 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 7 5 6 1 2 3 3 ... 2 ... 29 Women 2 1 1 1 3 2 3 ... 3 ... ... ... 16 Children 168 212 301 217 265 297 256 40 395 332 328 174 2985 [ Receiving Sulphur Baths. Men 3 9 7 3 4 ... ... 3 1 5 12 13 60 Women 10 5 ... 3 2 ... ... ... ... 3 7 8 38 Children 91 103 96 67 137 54 68 13 115 110 26 53 933 116 IV—CAUSES OF SICKNESS. The special causes of sickness and invalidity are those resulting from miserable environment and adulterated and dirty food. The insufficiency of present methods for preventing infectious disease, in particular non-notifiable diseases in infancy and childhood, naturally results in enfeebled constitutions unable at any time to combat any additional stress. The high number of deaths from cancer, heart diseases, bronchitis, and the pneumonias is evidence of this, and it is worthy of note that there were 27 cases of suicide among Hackney residents during the year. V.—SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS, AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. Professional Nursing in the Home— (a) General.—This is carried out in the Borough by the King's Home for Nurses who employ a staff, including the Superintendent, of 12 trained nurses who attend at the houses of the sick, at such times as are necessary, to carry out skilled nursing. (b) For Infectious Diseases.—Arrangements made between the King's Home and the Borough Council for nursing selected cases of infectious disease, the agreed working being as follows :— 1. Nursing assistance is granted under the Maternity and Child Welfare scheme in cases of Ophthalmia Neonatorum, Puerperal Fever, Measles and German Measles, Whooping Cough, Epidemic Diarrhoea and Polio-Myelitis. One half of the money expended under this head is returned by the Ministry of Health. Except as regards Ophthalmia Neonatorum and Puerperal Fever no attempt is made to grant routine nursing assistance to any but emergency cases; by emergency I mean that only where representation is made by a member of my staff or by medical 67 practitioners that nursing is an urgent necessity is this assistance granted; the scheme does not permit the granting of routine nursing assistance. Of these diseases Ophthalmia Neonatorum, Puerperal Fever and Polio-Myelitis only are notifiable in this Borough. 2. Nursing assistance is granted under the various regulations, etc., to cases of Tuberculosis, Pneumonia, Dysentery, etc., and here again nursing assistance is only granted to those most urgently requiring this assistance. 3. The agreed amount to be paid to the nursing association is 1s. 3d. per visit. 4. A return is rendered by the Superintendent of the King's Home for Nurses, giving the details of the cases nursed as regards name, age, sex, address, disease, number of visits made and amounts, if any, of contributions given to the Home by those in charge of the patients nursed. 5. Where the patients or their relatives are able to make a contribution to the nursing association, the amount so contributed is deducted from the amount payable by this Council to the nursing association. C. The amount estimated, which will probably be expended during the current year, under the Maternity and Child Welfare heading is £100, and under the general nursing heading £175, making in all a total of £275 for nursing assistance. For information as to visits paid see page Midwives— There are no whole-time midwives employed by the Council. The fees of midwives attending the confinements of necessitous persons are paid as regards cases approved by the Maternity and Child Welfare Committee. There are 40 midwives practising in the Borough. 68 Clinics and Treatment Centres.— (a) Infant Welfare Centres. Name and Situation. Nature of Accommodation. By whom provided. Wesleyan Church Schools, One weekly clinic Borough Council. Mayfield Road, Dalston (Doctor) Weekly weighing (Health Visitors) Grove Mission, Brooksby's Walk, Homerlon One clinic weekly Borough Council. (Doctor) All Souls' Schoolroom, Overbury St., Clapton Park Two clinics weekly Borough Council. (Doctor) St. Michael's Hall, Nor.thwold Road, Upper Clapton. One clinic weekly Borough Council. (Doctor] Hackney Mothers' and Babies' Welfare, Mission House, 41, Hackney Grove (Voluntary Centre) One clinic weekly Hackney Mothers' and Babies' Welfare, subsidised by Borough Council (Doctor) One weekly "weighing" (Health Visitors) St. Martin's Mission, Ada Street (Voluntary Centre) One weekly "weighing" (Health Visitors) Eton Mission, Gainsborough Road, Hackney Wick (Voluntary Centre) One weekly clinic Eton College, subsidised by Borough Council. (Doctor) (b) Ante-Natal Clinics. Grove Mission, Brooksby's Walk, Homerton One fortnightly clinic Borough Council. (Doctor) All Souls' Schoolrooms, Overbury Street One weekly clinic Borough Council. (Doctor) Eton Mission, Gainsborough Road, Hackney Wick (Voluntary Centre) One fortnightly clinic Eton College, subsidised by Borough Council (Doctor) (c) Tuberculosis. Metropolitan Hospital, Kingsland Road Victoria Park Hospital, Bonner Road, E.2. Tuberculosis Dispensary Borough Council. Tuberculosis Dispensary Borough Council. (d) School Clinics. Cleansing Station, Millfields Road, E.5. Inspection and Treatment of skin conditions Premises by Borough Council, Staff by London County Council. Treatment Centre, Lower Clapton Road Minor ailments London County Council Orthopaedic Clinic, Dalston Lane Massage and remedial treatment British Red Cross 69 (e) Venereal Diseases. Name and Situation. Nature of Accommodation. By whom provided. Metropolitan Hospital, Kingsland Road, E.8 Treatment Clinic London County Council Hospitals provided or subsidised by the Local Authority or by the London County Council.— Name and Situation. By whom provided. (l) Tuberculosis St. Joseph's Hospice for the Dying (33 beds for Tuberculosis), Cambridge Lodge, Mare Street This is a Religious Institution, but beds are obtainable by Local Authorities. In London residential treatment of tuberculosis is provided by the London County Council. (2) Maternity Salvation Army Mothers Hospital, Lower Clapton Road, and (see below) City of London Lying-in Hospital, City Road Agreement with these two Institutions to pay sum of one guinea in respect of each necessitous case admitted from the Borough. A necessitous case is defined on page 77. (3) Children Agreement with the Invalid Children's Aid Association whereby this Association arranges convalescent aid under the Maternity and Child Welfare Scheme. There is no Hospital for Children in the Borough. (4) Fever Eastern Fever Hospital, The Grove, Homerton This Hospital is the property of the Metropolitan Asylums Board. (5) Other Hospitals Metropolitan Hospital, Kingsland Road A General Hospital supported by voluntary contributions. It has accommodation for in- and out-patients. German Hospital, Ritson Road, Dalston Ditto. Hackney Infirmary, High Street, Homerton Maintained by the Hackney Board of Guardians. Mission of Help to the Suffering Poor, Upper Clapton Assistance to aged and infirm. Medical and dental treatment in hospital. Institutional Provision for Unmarried mothers, illegitimate infants and homeless children.— The following institutions are subsidised by the Ministry of Health, but not by the Borough Council, with the exception of 70 the Salvation Army Mothers' Hospital, Clapton, and afford, in most instances, accommodation for both married and unmarried mothers. Name and Situation. Nature of Accommodation. By whom provided. Brent House, 27, Devonshire Road Home for 30 mothers and 18 babies Salvation Army. Cotland, 9, Amhurst Park Home for 33 mothers and 23 babies Salvation Army. Lome House I., 16, Rectory Road Home for 12 mothers and 8 babies Salvation Army. Lorne House II., 4 Clapton Common Home for 20 mothers and 14 babies Salvation Army. Mothers' Hospital, 153, Lower Clapton Road Maternity Hospital for 80 mothers Salvation Army. St. Mary's, 153, Stamford Hill Home for 24 mothers and 15 babies Church of England. Maternity Refuge, 6, Pembury Road Preventive and Rescue Aid—16 mothers and babies Church of England. Sapsworth House, 122, Lower Clapton Road Home for mothers and babies Salvation Army. Rescue Home, 181/183, Amhurst Road Home for 32 mothers and 18 babies Salvation Army. Ambulance Facilities.— (а) For infectious cases.—Provided by the Metropolitan Asylums Board. Ambulance Station : Eastern Hospital, Homerton Grove. (б) For non-infectious and accident cases.—The Council has repeatedly urged the establishment in Hackney of an ambulance station by the London County Council. MATERNITY AND CHILD WELFARE. The original scheme for extension of this service was altered, in accordance with the wishes of the Ministry of Health, by the substitution of No. 28, Lower Clapton Road, as a Maternity and Child Welfare Centre in place of the smaller treatment centre that it was proposed to erect at Millfields Road, and by proposing the 71 installation of the extra clinics at No. 28, Lower Clapton Road, instead of at premises rented for that purpose. The estimate of the cost of alterations, provisionally accepted by the Ministry at £750, still requires the formal approval of the Ministry. Particulars of the extension are as follows :— (1) An increased contribution of £50 per annum to the King's Home for Nurses, for nursing assistance. (2) The appointment of an additional Fifth Class Clerk, and the promotion of Mr. H. C. Bowman from Class 4 to Class 2; the additional salary required amounting to £180 per annum. (3) The appointment of four additional Health Visitors, the total additional salaries amounting to £980 per annum. (4) (a) The transfer from the Electricity Department to this Department of No. 28, Lower Clapton Road, at the sum of £1,771, the annual loan charge on this amount (30 years at 4f per cent.) being £111. (b) The provision of equipment at an estimated cost of £416. (c) An estimated expenditure upon rates and taxes at the rate of £70 per annum. (5) The appointment of a Resident Caretaker at a salary (including value of emoluments) of £234. 10s. Od. per annum. (6) The provision of two Welfare, two Ante-Natal, one Dental, and one Light Treatment Clinic, at an expenditure of £680 per annum. (7) Alteration of the premises by the Borough Engineer and Surveyor, at an estimated cost of £750. 72 73 1. Primary Visits. 2. Total Visits. VISITS OF HEALTH VISITORS 1924. 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 Temporary Visitors. Eton Mission (voluntary) Hackney Grove (voluntary) Totals. 1 2 1 2 1 2 1 2 l 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 Infants (Leg.) under 1 year of age 194 681 312 889 340 671 331 1010 290 551 259 676 60 187 142 596 291 1128 883 1919 304 1200 426 1178 3832 10686 „ (Illeg.) „ „ 1 2 3 12 4 4 4 4 4 4 ... ... ... ... 1 1 5 9 12 14 5 34 2 17 41 101 Children 1-5 years of age 3 1156 24 1118 33 1218 ... 659 ... 610 ... 910 ... 191 ... 742 ... 813 ... 2401 ... 1311 ... 1510 60 12639 Total visits to Infants & Children 198 1839 339 2019 377 1893 335 1673 294 1165 259 1586 60 378 143 1339 296 1950 895 4334 309 2545 428 2705 3933 23426 Still Births 4 4 11 11 7 8 11 11 6 6 ... ... 3 3 7 7 4 8 24 25 9 9 11 11 97 103 Death Enquiries 12 12 15 15 16 18 28 28 16 15 ... ... 1 1 9 9 14 17 76 97 12 12 23 23 222 248 Ophthalmia Neonatorum 2 7 1 1 1 5 2 2 3 3 3 3 1 1 1 1 2 6 15 17 3 24 2 14 36 84 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 1 Expectant Mothers 60 77 32 49 33 43 35 35 7 1 84 84 37 37 65 65 52 74 99 106 130 234 19 40 653 851 Other Visits (outs, removals, etc.) Measles and German Measles— ... 224 ... 168 ... 23 ... 376 ... 220 ... 109 ... ... ... 151 ... 16 ... 424 ... 1398 ... 377 ... 3486 Infants 1 1 4 6 6 6 20 20 ... ... 1 1 2 2 4 4 2 3 3 3 30 30 ... ... 73 76 Children 12 12 14 20 65 65 7 7 ... ... 3 3 4 4 1 1 9 10 7 7 53 55 ... ... 175 184 Whooping Cough ... Infants 5 6 3 5 3 3 3 3 8 I ... ... 2 2 15 15 6 15 4 6 15 34 10 10 74 107 Children 6 13 3 6 18 18 2 2 19 19 ... 21 21 15 18 22 22 20 26 12 12 138 157 Epidemic Diarrhoea Infants 1 3 ... ... ... ... ... ... 1 1 2 2 ... ... ... ... 7 11 ... ... 6 17 2 2 19 36 Children ... ... ... ... ... ... ... ... ... ... 5 5 ... ... 6 6 3 3 ... ... 3 4 2 4 19 22 Polio-Myelitis Infants ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Children ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 6 18 ... 7 19 Total Visits paid during the year 301 2198 422 2300 526 2082 443 2157 325 1426 376 1812 Ill 429 272 1619 410 2131 1146 5042 596 44C6 509 3198 5447 28800 No. of Clinics attended Morning ... 5 33 41 3 40 10 15 6 90 ... ... 243 Afternoon 107 109 61 51 127 104 22 76 113 249 100 153 1272 74 DESCRIPTION OF THE WORK DURING THE PAST YEAR. The work carried our during 1924 can be conveniently reported under the following descriptive titles:— 1. Health Visiting; 2. Consultation and Ante-natal Clinics; 3. Provision of Hospital Treatment, Convalescent Home Treatment, Midwifery Assistance, Home Helps; 4. Nursing assistance; 5. Provision of milk and other foods to necessitous mothers and children. 1 .—HEALTH VISITING. The preceding table (pages 72 and 73) gives details of the visits made by the Health Visitors during the year. Conditions Found by the Visitors. No. of Infants visited. Method of Feeding. Separate cot provided for Infant. Use of Comforter. Home conditions. Secondary visits. Breast Artificial. Mixed. Yes. No. Yes. No. Satisfac tory. Unsatis factory. 3873 3316 381 176 2681 1192 1658 2215 3499 374 19553 75 2 —INFANT CONSULTATION AND ANTE-NATAL CLINICS. 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. 76 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 atten. dances of children over 1 year. 1 Overbury Street I Morning 52 256 2,793 3,116 1,722 1,394 ' Afternoon 52 204 2,860 2,997 1,683 1,311 2. Brooksby's Walk 51 452 3,694 4,146 3,133 1.013 3. May field Road Monday 48 44 1,091 1,135 686 449 Friday 50 460 3,795 4,255 3,024 1.231 4. Northwold Road 52 438 5,547 5,985 3,816 2.169 5."Hackney Mothers' and Babies', Hackney Grove 101 185 2,637 2,822 J 2,315 1,082 Do. Ada Street ... 52 59 516 575 6."Eton Mission' Wednesday 50 209 4,793 5,002 3,520 1,482 Friday 50 Totals 558 2,307 27,726 30,033 19,899 10,134 *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 £250 from the Council, and the Eton Mission Centre £100. Ante-Natal Welfare Centres. Centre. No. of times Centre opened No. of expectant mothers attending No. of repeated attendances at Centre Total attendances 1 Overbury Street 51 520 823 1,343 2 Brooksby's Walk 27 164 132 296 3 *Eton Mission 26 96 100 196 Totals 104 780 1,055 1,835 *Voluntary Centre. 77 3.—HOSPITAL, CONVALESCENT 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 1923. Necessitous Cases. Cases. Cost. Salvation Army Mothers' Hospital 156 £163 16 0 City of London Lying-in Hospital 113 118 13 0 269 £282 9 0 (2) 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 Council's 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 43. Seven other cases were referred to the United Services Fund. (3) Provision of Midwives.—During the year the fees of midwives in attendance on 30 mothers confined in their homes were paid by the Council and in 1 case a Home Help was provided. 78 4.—NURSING ASSISTANCE. As already stated, only a fraction of the cases have been dealt with. No. of cases nursed. No. of visits paid. Pneumonia 37 592 Whooping Cough 11 334 Measles 55 902 Diarrhoea 2 26 Ophthalmia Neonatorum 7 107 Post Confinement, etc. 61 907 Totals 173 2,868 5.—PROVISION OF MILK AND OTHER FOODS TO NECESSITOUS MOTHERS AND CHILDREN. In each 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 £1,663 1s. 8d. The applications dealt with for milk numbered 3,120, and those for milk food amounted to 877. Dried Milk, Foods, Medicines, etc. (a) Supplied free of charge to necessitous mothers :— £ s. d. Glaxo 56 18 6 Cow and Gate 218 5 0 Virol 17 17 0 Marylebone Cream 15 8 6 Cod Liver Oil and Malt 34 9 6 Sundries 18 5 1 £361 3 7 79 (b) Supplied at cost price :— £ s. d. Glaxo 346 8 6 Cow and Gate 1,455 7 6 Virol 103 5 0 Lactagol 8 6 3 Marylebone Cream 98 17 2 Petroleum Emulsion 46 7 0 Syrup Ferri 14 1 9 Cod Liver Oil and Malt 64 15 1 Sundries 116 2 7 £2,253 10 10 VI.—LABORATORY WORK. Arrangements have been made with the Camberwell Research Laboratories and the Royal Institute of Public Health for bacteriological examinations at the following charges:— Camberwell Research Laboratories. Diphtheria swabs 3s. Od., sputa 3s. Od., blood of suspected Enteric Fever cases 3s. 6d. plus charges for telephone and telegraph, the Laboratories providing outfit. Royal Institute of Public Health. Diphtheria swabs, sputa and blood 3s. Od. plus telephone and telegraph charges. Council charged for outfits. Special Examinations 1 to 2 guineas. Full details of bacteriological examinations during the year will be found under the heading of Infectious Diseases. Diphtheria Antitoxin. Arrangements have been in force for some time past in this Borough for supplying Diphtheria Antitoxin to medical practitioners on request. 80 Antitoxin can be obtained at any time by a medical practitioner on applying to this department during office hours, and after office hours to the resident hall porter. It has been my experience that not only is the mortality increased by delay in injecting antitoxin, but that paralytic and other complications are far more likely to occur. The medical practitioners in the Borough have been circularised on this matter, and a copy of the following memorandum is issued with each dose of antitoxin :— " The Ministry of Health suggest that Medical Officers of Health should arrange to send out with each phial of antitoxin a slip stating that the whole of the contents of each phial of 8,000 units of antitoxin should be regarded as ordinarily constituting a single dose for a patient of any age. The Ministry state that 'Experience has shown that for the purposes of treatment it is seldom safe practice to rely on any dose which is less than 8,000 units, whatever the age of the patient may be. The magnitude of the initial dose and the occasions on which subsequent doses are given must be determined by close observation of the case, and it is impossible to lay down a stereotyped procedure. As an indication it may be stated, especially from the experience of Metropolitan Asylums Board Hospitals, that when in a case seen early in the attack an initial dose of 8,000 units (116,000 or more if the case is severe), is followed by definite improvement at the end of about 12 hours, further administration of antitoxin is unnecessary. On the other hand, if at the end of about 12 hours (or sooner in urgent cases), there is no evidence of improvement, or it is clear that the disease is advancing, a second dose of similar magnitude should be given, followed by a further dose if no distinct improvement occurs. 81 Larger initial doses, e.g., from 16,000 to 30,000 units, are specially required when for any reason the administration of antitoxin has been delayed until the third or fourth day from the onset. The need for further administration will be determined by the progress of the disease, on the lines just indicated.' " In 1920, when the Asylums Board were pressed for accommodation during the last quarter of the year, medical practitioners were advised to administer the maximum dose of antitoxin, but even in that year only 82 bottles of antitoxin of 2,000 units each were requisitioned. The number of applications for antitoxin last year increased, 108 bottles of antitoxin of 8,000 units each being supplied to medical practitioners, as compared with 56 the previous year. The maximum number of applications in 1922 numbering 129. VII.—SANITARY ADMINISTRA TION. HOUSINC AND WORK OF SANITARY INSPECTION, Public Health (London) Act, 1891. Year. Intimation Notices. Statutory Notices. Legal 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 1923 6,553 1,376 42 1924 6,241 1,608 57 82 Rent and Mortgage Interest (Restriction) Acts 1920 and 1923. The number of certificates granted under the Increase of Rent and Mortgage Interest (Restriction) Acts during the year was 11. In 10 cases the work required on the notice was carried out without action being taken. In 2 cases certificates were applied for but were not granted, the application in one instance being withdrawn, and in the other case it was found that the tenant was liable for repairs. Under Section 5 of the Rent and Mortgage Interest (Restriction) Act, 1923, it is not now necessary for the tenant to take proceedings at the County Court, but a copy of the certificate must be served on the landlord, who may, if the work is completed satisfactorily, obtain a certificate to this effect from the Sanitary Authority on payment of one shilling. London County Council (General Powers) Act, 1904. During the year attention was drawn by the Medical Officer (Education) of the London County Council to 111 homes in the Borough from which children were attending school in a verminous condition, asking that steps be taken to deal with them under the above Act. These homes were inspected, with the following results.:— No. of Homes Inspected. No. of Homes where Rooms alone were found Verminous. No. of Homes where Bedding or Clothes and Rooms were found Verminous. No. of Homts not Verminous. 1ll 27 26 . 58 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 present. 83 In addition to the cleansing of verminous rooms or premises by owners and tenants after service of notice by the Sanitary Inspectors, 658 rooms were discovered to be verminous where neither tenant nor owner could be shown to be directly responsible. These rooms were cleansed of vermin by the staff of the Public Health Department. Rats and Mice Destruction Act, 1919. Approximately 320 complaints were received during the year of premises being infested with rats. These complaints were effectually dealt with in most cases by the repair or reconstruction of defective sewers, drains and sanitary fittings, under the supervision of the Sanitary Inspectors. In 54 cases it was necessary to serve notices under the Act upon the occupiers of the land or premises. Nine premises were cleared under the agreement with Messrs. Howard & Son, (Ratcatchers), under the supervision of the Council's Sanitary Staff. In 142 cases poison baits have been provided and laid down under the supervision of the Sanitary Inspectors. By this means 120 premises have been effectively cleared of rats and 22 premises were under observation and treatment at the end of the year. This method has proved to be very successful and has resulted in the extermination of a very large number of rats without any complaints of smells after the rats have been poisoned. SANITARY INSPECTION. Public Health (London) Act, 1891. (a) Complaints of Nuisances.—During the year 1924 there were 4,748 complaints of nuisances made to the Public Health Department and investigated by the Sanitary Inspectors of the Borough. Defects or nuisances were discovered in 3,802 of the complaints. Notices for the remedy or abatement of these were served upon the owner or person responsible under the above Act. 84 Drainage. Plans for reconstruction of drains under notice and supervision of the Sanitary Inspectors at 106 premises were reported to the Public Health Committee during the year. Smoke Nuisance. In addition to 235 observations of chimneys of large works in the Borough made by the Sanitary Inspectors, 746 observations were made by an Assistant detailed for that purpose. 33 notices were served on the persons responsible for the issue of black smoke in contravention of the Public Health (London) Act, 1891. Dangerous Structures. Complaints of alleged dangerous structures at 230 premises were forwarded to the London County Council during the year. Water Fittings. Complaints of defective water fittings at 120 premises were forwarded to the Metropolitan Water Board during the year. Dust Receptacles. During the year 719 complaints were received from the Borough Engineer and Surveyor, of houses without dust bins, or with defective dust bins. These complaints were dealt with by the service of 532 informal notices and 105 statutory notices. Food Premises. 1,142 visits were made during the year by the Food Inspector and the District Sanitary Inspectors to places (other than milk premises and slaughterhouses) where food is sold or prepared for sale. In 36 cases notices had to be served to have defects that were found to exist at time of visit remedied. 85 (b) Infectious Diseases.—The occupied dwellings inspected during the year after infectious disease numbered 1,142. This is an increase of 57 upon the number inspected during 1923. Any nuisances or sanitary defects found were dealt with under the provisions of the above Act. (c) Inspections.—The number of inspections, other than those arising on complaint, made by the Inspectors during the year was 1,295. 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 1924 was 6,241. The number of statutory notices served was 1,608; and summonses were issued in 57 cases. 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 965. Factory and Workshop Act, 1901. Factories.—During the year, 242 inspections were made of factories and 2,230 of workshops by the officers of the Public Health Department. In 128 of these premises the sanitary accommodation was defective, unsuitable or insufficient, or not separate for the sexes. Nuisance. i Found. Abated by Workshop Inspector. Abated by District Inspector. Outstanding. Unsuitable or defective w.c.'s 114 89 6 22 Insufficient w.c.'s 3 3 1 — Not separate to sexes 11 11 — 3 Other defects 352 213 98 41 86 (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 8 cwts. ; Meat 4 cwts. 2 qrs. 20 lbs. ; Fruit 2 cwts. 20 lbs. Prosecutions under the Public Health (London) Act, 1891, during the year 1924. Inspector. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. £ s. d. C. F. L. 5, Queens Gate Villas Roof defective Withdrawn (Work done) 1 1 0 A. J. B. Lawrence Bidgs., (Fur Skin Dressing Fac.) Refuse receptacles not provided Defendant ordered to pay 2 2 0 A. J. B. do do. Walls and ceilings not lime washed do. do. 3 3 0 H. B. 61, Buckingham Rd. Dust bin defective do. do. 1 1 0 G. F. 125, Osbaldeston Rd. Roof defective Withdrawn (work done) 1 1 0 W. C. V. 3, Clarence Terrace Roots and paving defective do. do. 1 11 0 E. A. H. 19, Gainsborough Sq. Roofs, rain water gutters, etc., defective do. do. 1 3 0 H. B. 16, Middleton Road Gutter and rain water pipe, etc., defective do. do. 1 11 0 W. C. V. 5, Hindrey Place Smoke nuisance do. do. 1 11 0 W. C. V. do. do. Dust receptacle not maintained in proper state of repair Withdrawn (Dust bin supplied) 1 11 0 C. F. L. 9, Minson Road First floor front room flue smoky Withdrawn (work done) 0 13 0 W. P. 48, Brunswick Street Roof, yard paving, etc., defective do. do. 1 11 0 W. P. 50, do do. Rain water pipe and copper defective do. do. W. C. V. 44, Hindrey Place General insanitary condition Order to abate in 14 days 0 4 0 R. H. B. 79, High Street, Stoke Newington Drains defective Order to abate in 21 days 1 1 0 A. S. 7. Blurton Road Roof defective Withdrawn (work done) 1 1 0 A. S. 84. do. do. do. do. do. do. 1 1 0 G. F. 39, Durley Road Eaves gutters defective Order to abate in 7 days 1 1 0 G. F. H. 44, Malvern Road General insanitary Order to abate in 1 1 0 condition 21 days 0 E. S. C. 4, Thistlewaite Road do. do. Order to abate in 14 days 1 1 0 W. C. V. 10, Charnock Road Drain, soil pipe and rain water pipe defective Order to abate in 21 days 1 1 0 A. S. 27, Mayola Road Drains defective Withdrawn (work done) 1 1 0 87 Inspector. Address. Complaint. Magistrate's Decision. Fine. Costs. £ s. £ s. d. H.B. 14, Middleton Road No water supply to W.C. Eaves gutters and dust bin def. do. do. 1 11 6 H.B. 2, Lenthall Road Roof of Workshop defective Order to abate in 28 days 1 1 0 H.B. 24, De Beauvoir Cres. General insanitary condition do. do. 1 1 0 H.B. 26, do. do. do. do. do. do. 1 1 0 H.B. 28, do. do. do. do. do. do. 1 1 0 H.B. 30, do. do. do. do. do. do. 1 1 0 H.B. 32, do. do. do. do. do. do. 1 1 0 H.B. 34, De Beauvoir Cres. General insanitary condition Order to abate in 28 days 1 1 0 E.S.C. 4, Thisdewaite Road Non-compliance with Magistrate's order Fined 2 2 2 0 G.F.H. 44, Malvern Road do. do. do. 5 0 2 0 G.F. 50, Cranwich Road Forecourt drain defective Order to abate in 7 days 1 1 0 G.F. 203, Northwold Road Roof defective Order to abate in 14 days 1 11 6 H.B. 30, De Beauvoir Cres. Non-compliance with Magistrate's order Withdrawn (work done) 1 11 6 H.B. 38, Richmond Road Roof and wall defective Withdrawn (work done) 1 1 0 H.B. 40, do. do. Roof defective do. do. 1 1 0 H.B. 42, do. do. Yard paving defective do. do. 1 1 0 No door to washhouse C.F.L. 128, Victoria Pk. Rd. Roof defective do. do. 1 0 J.N. 121, Bentham Road Rooms dirty do. do. 2 0 J.N. 123, do. do. do. J. N. 125, do. do. do. R. J. S. 17, Shore Road Rooms dirty, roof defective Order to abate in 21 days 1 1 0 J. W. H. 91, Norfolk Road do. do. Withdrawn (work done) 1 11 6 A.T. 260, Dalston Lane Rooms dirty do. do. 1 1 0 w. c. V. 17, Hindrey Place Roof defective Adjourned sine die 2 0 W. E. G. 38, Andrews Road General insanitary condition Order to abate in 14 days 1 1 0 W. E. G. 29, do. do. do. do. do. do. 1 1 0 R. J. S. 15, King Edward Rd. do. do. Order to abate in 28 days 1 0 H. B. 104, Haggerston Rd. do. do. Order to abate in 14 days 1 1 0 H. B. 110, do. do. do. do. do. do. 1 1 0 H. B. 451, Kingsland Road Roof defective Order to abate in 7 days 1 1 0 J- E. T. 48, Trehurst Street Rain water pipe and eaves gutter def. Order to abate in 7 days 1 1 0 A. T. 2, Conrad Street W.C. without flush of water Withdrawn (work done) 10 6 A. S 157, Mandeville Street Roof defective, room dirty do. do. 1 1 0 H. B. 176, Southgate Road Roofs defective Order to abate in 21 days 1 1 0 H. B. 17, Tottenham Road Roof, eaves, gutter and yard paving defective Withdrawn (work done) 1 1 0 £7 2 £66 1 88 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. f Workshops.—The number of workshops registered in Hackney at the end of 1924, was 752, a decrease of 122 on the number registered at the end of 1923. Of this total, 603 were workshops in which females were employed. Of these latter, 392 were workshops in which articles of wearing apparel were manufactured, altered or prepared for sale, etc., 182 in which other articles were manufactured, etc., and 29 were domestic workshops. Amongst the workshops in which wearing apparel is manufactured, there were 237 in which females alone and 155 in which both males and females were employed. In workshops of other occupations, there were 98 in which females alone, and 84 in which both males and females were employed. Of the domestic workshops, females alone were employed in 16, and both males and females in 13. 89 During the year notices and complaints were received from H.M. Inspectors of Factories, as follows:— Complaints—Factories 8 Complaints—Workshops 20 Notices—Workshops 98 Analysis of Occupations Carried on in the Registered Workshops of Hackney. (a) Wearing Apparel. No. of Occupations. Workshops. Artificial Flower Makers 7 Baby Linen 1 Blouses 23 Boot&Shoe Manufacturers 88 Boot Machinists 12 Children's Costumes 6 Clothing 3 Corsets 7 Dressmakers 52 Dressing & Tea Gowns 7 Fancy Bows on Shoes 4 Furriers 60 Hats 3 No. of Occupations. Workshops. Infants' Millinery 3 Mantles 32 Millinery 28 Needlework 4 Shirts 2 Tailoring 96 Ties 18 Trimmings 10 Underclothing 8 Vests 4 Waterproofs 2 480 (b) Other Occupations. Bakers 26 Baskets 4 Box Makers 11 Brush Makers 6 Cabinet Makers 39 Confectionery 8 Cycle Makers 3 Leather Goods 28 Laundries 15 Pianoforte Makers 14 Picture Frames 3 Rag Sorting 3 Rubber Goods 2 Toy Makers 9 Trunk & Bag Makers 4 Umbrella Makers 2 Upholsterers 7 Upholsterers' Trimmings 1 Miscellaneous 87 272 90 During 1924, Miss Tebay, the Workshops Inspector, made 2,253 inspections and re-inspections of factories and workshops where females are employed. In connection with these inspections, 216 intimation and 43 statutory notices were served and 2 summonses issued 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) 242 47 - Workshops (Including Workshop Laundries) 2,199 338 2 Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 31 5 - Total 2,472 390 2 91 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H.M. Inspector Nuisances under the Public Health Acts—* Want of cleanliness 219 194 ... 1 Want of ventilation 13 9 ... ... Overcrowding 7 10 ... ... Want of drainage of floors ... ... ... ... Other nuisances 93 78 ... ... Sanitary accommodation— Insufficient 3 4 ... ... Unsuitable or defective 114 95 ... 1 Not separate for sexes 11 11 ... ... Offences under the Factory and Workshops Acts :— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Other offences 20 20 ... ... (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921). Total 480 421 2 *Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 92 4.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and shop Act, 1901, (S. 133) 35 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act, 1901, Notified by H.M. Inspector 28 Reports (of action taken) sent to H.M. Inspector 30 (S. 5.) Other - Underground Bakehouses (S. 101):— In use at the end of the year 51 3.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Total number of Workshops on Register 752 93 5.—HOME WORK. Nature of Work. Outworkers' Lists, Section 107. Outwork in Unwholesome Premises, Section 108 Outwork tm Infected Premises. SiCTIONS 109, 110. List receiver from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders Made (Section 110). Prosecutions (Sections 109, 110) Twice in the year. Once in the year. Failing to keep or permit inspection of Lists. Falling to send Lists. Lists. Outworkers. Tists. Outworkers. Contractors Workmen. Contractors Workmen. Wearing Apparel— (1) Making, &c 274 88 2443 28 1 97 289 ... ... ... ... ... ... ... ... (2) Cleaning and Washing 2 1 2 ... ... ... 5 ... ... ... ... ... ... ... Lace, Lace Curtains and Nets 4 ... 24 ... ... ... 3 ... ... ... ... ... ... ... ... Furniture and Upholstery 12 ... 81 1 ... ... 11 ... ... ... ... ... ... ... ... Fur Pulling 10 ... 14 2 ... 2 19 ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial Flowers 8 ... 37 ... ... ... 13 ... ... ... ... ... ... ... ... Racquet and Tennis Balls ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... Paper, &c., Boxes, Paper Bags 28 ... 297 1 ... 30 23 ... ... ... ... ... ... ... ... Brush Making 20 ... 363 1 ... 1 17 ... ... ... ... ... ... ... ... Stuffed Toys 4 ... 7 1 ... 17 5 ... ... ... ... ... ... ... ... Basket Making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cosaques, Christmas crackers, Christmas stockings, 2 ... 8 2 ... 5 8 ... ... ... ... ... ... ... ... Totals 364 97 3276 38 2 152 395 ... ... ... ... ... ... ... ... 94 Outworkers.—The number of outworkers on the register at the end of 1924 was 2,481, against 2,492 at the end of 1923. There were thus 11 outworkers removed from the register during the past year. The following analysis shows the trades followed by these outworkers :— Trade. NO of Outworkers. Trade. NO of Outworkers. Artificial Florist 67 Fur Trade 76 Baby Linen 22 Gaiters 9 Belts and Bags 17 Hats 4 Blouses 145 Hosiery 4 Boots and Shoes 529 Lace Goods 19 Boxes and Paper Bags 191 Leather Goods 6 Braces 3 Mantles and Costumes 225 Brushes 188 Millinery 89 Children's Costumes 19 Pyjamas and Shirts 62 Children's Millinery 48 Shoe Bows 46 Christmas Crackers, etc. 35 Skirts 6 Clothiers & Outfitters 82 Tailoring 137 Collars and Bibs 14 Tennis Ball Covering 5 Confectionery Packing 7 Ties and Neckwear 130 Corsets 1 Trimmings 65 Dolls and Toys 16 Umbrellas 14 Dressing Gowns 18 Underclothing 52 Dress Making 26 Upholsterers' Trimmings 21 Embroidery 8 Miscellaneous 39 Fancy Goods 19 Feather Trade 17 2,481 2,470 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 95 outworkers sent in by employers in this Borough, addresses of 1,680 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 1924, Miss Portlock, the Inspector appointed for the inspection of Outworkers' premises, made 1,228 inspections and 983 re-inspections. She also made 320 visits, without inspections, the outworkers having left the premises (84), or having given up home work (110), or being out at the time of visit (89), or owing to a wrong address being given (19), or the premises being workshops (8), or the outworkers having died (10). Miss Portlock also discovered 2 new workshops and handed in their addresses for registration. During her visits of inspection she found 336 premises with sanitary defects. For the abatement of these she served 226 intimation, and 32 final notices. Of the 1,228 premises inspected, in only 6 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 81 „ ,, and living room 65 „ „ kitchen 401 ,, and kitchen 618 ,, ,, bedroom 49 „ „ parlour 2 „ „ scullery 5 ,, ,, bath room 1 ,, provided separately 6 1.228 96 FOOD. A very welcome step has been taken by the Ministry of Health in issuing the Public Health (Meat) Regulations, 1924, but it is necessary again to point out that local authorities can only endeavour, very inadequately, to protect the public against contamination of two articles of food—meat and milk. The Bye-laws and other legal powers relating to food are directed to securing ordinary sanitation of the premises; food obviously dangerous to the public can be seized, but there are practically no powers to prevent the preparation of food in such a manner that it is really dangerous to the pubilc health, while after treatment, appearing sound to ordinary inspection, if inspection should come that way. The following notices are used to bring to the attention of the tenants of food premises, stalls, shops, etc., the sanitary requirements relating to their premises :— NOTICE IS HEREBY GIVEN that the above Regulations have been made by the Minister of Health. STALLS, SHOPS, STORES, etc.—GENERAL. 1. "Meat" means the flesh of cattle, swine, sheep, or goats, including bacon and ham and edible offal and fat, which is sold or intended for sale for human consumption, and " animal " means any animal from which meat is derived. 2. " Inspector " means the Medical Officer of Health or any other Officer of a Local Authority, having under the Acts relating to Public Health or any Local Act, power to inspect and examine meat intended for the food of man, and who for the purpose of ascertaining whether these Regulations are being observed are empowered at all reasonable times to enter and inspect any slaughter-house, room, or other place and any stall or vehicle to which these Regulations apply. 97 3. Stall includes any stall, barrow or vehicle from which meat is offered for sale in a street or other open space or in any market place. 4. "Room" includes a shop, cellar, passage or other space forming the whole or part of a building other than a slaughterhouse. 5. A person shall, if so required, give to any officer of a Local Authority acting in the execution of these Regulations, all reasonable assistance in his power, and shall, in relation to anything within his knowledge, furnish any such officer with all information he may reasonably require for the purposes of the Regulations. 6. No person who is for the time being suffering from an infectious disease shall take part in the slaughtering of animals intended for human consumption or the handling of meat. PART IV.—STALLS. 19. A person selling meat or exposing or offering meat for sale from any stall— (a) shall keep his name and address legibly painted or inscribed on such stall in some conspicuous position ; (b) shall cause such stall (if not placed in an enclosed and covered market place) to be suitably covered over and to be screened at the sides and back thereof in such a manner as to prevent mud, filth or other contaminating substance being splashed or blown from the ground upon any meat on the stall; (c) shall cause every counter, slab, vessel or other article on or in which meat is placed for sale and all knives and other implements used in connection with the meat to be thoroughly cleansed after use and to be kept at all times in a cleanly condition ; (d) shall take all such steps as may be reasonably necessary to guard against the contamination of the meat by flies; G 98 (e) shall not place or cause to be placed any meat on, or within eighteen inches of the ground or floor, unless the meat is placed in a closed cupboard or other adequately protected space not less than nine inches from the ground or floor ; (/) shall cause all trimmings, refuse and rubbish to be placed in properly covered receptacles kept for the purpose apart from any meat intended for sale. PART V.—SHOPS, STORES, Etc. 20.-—(1). The occupier of any room in which meat is sold or exposed for sale or deposited for the purpose of sale or of preparation for sale or with a view to future sale, and any person who knowingly lets any room or suffers any room to be occupied for such purpose shall cause the following provisions to be complied with :— (a) No urinal, water-closet, earth-closet, privy, ashpit or other like sanitary convenience shall be within such room or shall communicate directly therewith, or shall be otherwise so placed that offensive odours therefrom can penetrate to such room; (b) No cistern for supplying water to such room shall be in direct communication with or directly discharge into any such sanitary convenience; (c) No drain or pipe for carrying off faecal or sewage matter shall have any inlet or opening within such room unless it is efficiently trapped ; (d) No such room shall be used as a sleeping place, and, so far as may be reasonably necessary to prevent risk of the infection or contamination of any such meat as aforesaid, no sleeping place shall communicate directly with such room ; (e) Except in the case of a room used as a cold store, adequate means of ventilation shall be provided. 99 2. The occupier of any such room shall not cause or suffer any refuse or filth whether solid or liquid to be deposited or to accumulate therein except so far as may be reasonably necessary for the proper carrying on of the trade or business. 3. Such occupier shall cause the walls and ceiling of such room to be whitewashed, cleansed or purified as often as may be necessary to keep them in a proper state. 4. Such occupier and every other person engaged in such room shall observe due cleanliness in regard to such room and all articles, apparatus and utensils therein. 5. The occupier of any such room— (a) shall take all such steps as may be reasonably necessary to guard against the contamination of the meat therein by flies and shall cause the meat to be so placed as to prevent mud, filth or other contaminating substance being splashed or blown thereon ; (b) shall not permit any gut-scraping, tripe-cleaning or household washing to be carried on therein ; (c) shall cause every counter, slab, vessel or other article on or in which meat is placed for sale and all knives and other implements used in connection with the meat to be thoroughly cleansed after use and to be kept at all times in a cleanly condition ; (d) shall cause all trimmings, refuse and rubbish to be placed in properly covered receptacles kept for the purpose apart from any meat intended for sale. FART VI.—TRANSPORT AND HANDLING. 21.—1. Every person who conveys or causes to be conveyed any meat in a vehicle— (a) shall cause to be kept clean the inside and covering of the vehicle, the receptacles in which the meat is placed, and 100 such parts of any slings or other implements or apparatus used for loading or unloading as come into contact with the meat or its covering; and (b) if the vehicle is open at the top, back, or sides or if any other commodity is being conveyed therein, shall cause the meat to be adequately protected by means of a clean cloth or other suitable material; (c) shall not permit any live animal to be conveyed in the vehicle at the same time as meat. 2. A person engaged in the handling or transport of meat— (a) shall not permit any part of the meat to come into contact with the ground ; and (b) shall take such other precautions as are reasonably necessary to prevent the exposure of the meat to contamination. 3. Every person who employs a person to carry meat in or about a market or other place in which meat is sold by wholesale or in or about any place wholly or mainly used for the storage of meat before it is distributed to retailers, shall cause such person while so occupied to wear, and every person while so occupied shall wear, a clean and washable head covering and overall. 4. This Article shall not apply to any meat which is packed in hampers or other strongly constructed and impervious cases or is adequately wrapped in jute or some other stout fabric. NOTE.—The Public Health Act, 1896, provides by subsection (3) of Section 1, that if any person wilfully neglects or refuses to obey or carry out, or obstructs the execution of any regulations made under any of the enactments mentioned in that Act, he shall be liable to a penalty not exceeding £100, and, in the case of a continuing offence, to a further penalty not exceeding £50 for every clay during which the offence continues. 101 FOOD PREMISES. NOTICE IS HEREBY GIVEN that Part II of the London County Council (General Powers) Act, 1908, provides as follows :— From and after the passing of this Act the following provisions shall apply to any room shop or other part of a building within the county in which ANY ARTICLE whether SOLID OR LIQUID intended or adapted for the food of man is sold or exposed for sale or deposited for the purpose of sale or of preparation for sale or with a view to further sale : (a) No urinal water-closet earth-closet privy ashpit or other like sanitary convenience shall be within such room shop or other part of a building or shall communicate therewith except through the open air or through an intervening ventilated space; (b) No cistern for supplying water to such room shop or other part of a building shall be in direct communication with and directly discharge into any such sanitary convenience; (c) No drain or pipe for carrying off faecal or sewage matter shall have any inlet or opening within such room shop or other part of a building; (d) No such room shop or other part of a building shall be used as a sleeping place and so far as may be reasonably necessary to prevent risk of the infection or contamination of any such article as aforesaid no sleeping place shall adjoin such room shop or other part of a building and communicate therewith except through the open air or through an intervening ventilated space; (e) Refuse or filth whether solid or liquid shall not be deposited or allowed to accumulate in any such room shop or other part of a building except so far as may be reasonably necessary for the proper carrying on of trade or business ; 102 (f) DUE CLEANLINESS shall be observed in regard to such room shop or other part of a building and all articles apparatus and utensils therein and shall be observed by persons engaged in such room shop or other part of a building. If any person occupies or lets or knowingly suffers to be occupied any such room shop or other part of a building wherein any of the conditions prohibited by this section exist or does or knowingly permits any act or thing therein in contravention of this section he shall be liable on summary conviction to a fine not exceeding for the first offence twenty shillings and for every subsquent offence five pounds and in either case to a daily penalty not exceeding twenty shillings. As regards the milk supply it is suggested that all milk should be partially cooked or sterilised in order to kill disease germs, milk containing cooked disease germs instead of clean milk being the highest attainable ideal, and the percentage of Tuberculous milk detected in the London supply varying from 3 to 10 percent. of samples, and it is still a remarkable fact that the powers of the Public Health authorities in preventing infection by tuberculous persons remain purely persuasive, being circumscribed by Article XVI. of the Public Health (Tuberculosis) Regulations, 1912, which is as follows :— ' Exception and application of Enactments. Article XVI.—Nothing in these Regulations shall have effect so as to apply, or so as to authorise or require a Medical Officer of Health or a Local Authority, or any other person or authority, directly or indirectly, to put in force with respect to any person in relation to whom a notification in pursuance of these Regulations has been transmitted to a Medical Officer of Health any enactment which renders the person, or any one in charge of the person, or any 103 other person, liable to a penalty, or subjects the person to any restriction, prohibition or disability affecting himself, or his employment, occupation or means of livelihood, on the ground of his suffering from Tuberculosis.' The attention of the Ministry of Health was drawn to this danger, and a Draft, dated October 17th, 1924, of the Public Health (Prevention of Tuberculosis) Regulations, 1924, giving additional powers to local authorities in this direction is receiving the consideration of the Ministry of Health. Local authorities still require powers as regards Contamination of food during preparation for sale, Addition of preservatives, Adulteration, safely carried out owing to the absence of recognized standards. 104  District Numbers. s. 1 2 3 4 5 6 7 8 9 10 11 12 . 13 14 Food Premises Regulated by Bye-Laws— Ice Cream Premises 14 7 23 20 18 12 20 30 9 22 7 11 15 40 248 Fried Fish Premises — 2 3 6 8 1 5 5 4 7 7 1 3 9 61 Slaughterers of Poultry — 1 — — — — — — — — — — — 2 3 Slaughter Houses (Cattle) 1 3 1 — 2 1 — 1 — 2 — 1 1 4 17 Cowhouses 1 — — — 3 — — 2 — — — — — 2 8 Purveyors of Milk— 13 10 8 23 39 15 27 37 21 25 27 11 32 30 318 Other Food Premises— Coffee Houses, etc. 5 6 8 10 21 4 21 12 8 27 9 8 4 29 172 Bakehouses (above ground) 7 6 1 3 5 1 4 1 5 11 7 — 1 2 54 (underground) 1 4 4 5 5 4 4 7 2 2 — 2 1 10 51 105 Sale of Food and Drugs Acts, 1875-1907. Samples purchased during 1924. Articles Purchased. Number purchased Number Adulterated. Number where Proceedings taken. Milk 649 13 5 Do. (separated) 1 — — Do. (sterilized) 45 — — Do. (pasteurised) 1 1 — Do. (condensed) 6 — — Do. (scalded) 2 — — Coffee 19 — — Cocoa 15 — — Lard 12 — — Margarine 45 — — Olive Oil 12 — — Custard Powder 6 — — Baking Powder 4 — — Butter 43 2 1 Jam 12 — — Dripping 6 3 — Camphorated Oil 6 — — Fruit Cordial 1 — — Sausage 6 1 — Cream 5 2 — Do. (preserved) 1 — — Minced Meat 3 1 — Totals 900 23 6 106 Prosecutions under the Sale of Food and Drugs Acts, during the Year 1924. No. of Sample Inspector Article Adulteration or Offence Result of Legal Proceedings Fine Costs £ s d f s. d. 3E A. J. B. Margarine . Exposed for sale Fined 10 0 2 2 0 7S J. E. T. Milk 6.7% fat abstracted Dismissed (warranty proved) 14N W.G. „ 4 .12% added water Ordered to pay 2 2 0 16N W.G. „ 2.59% added water Dismissed 25 H R. J. S. „ 3.3% fat abstracted Withdrawn (warranty produced) 44V R. H. B „ 5 06% added water do. do. 10 0 4 4 0 Public Health (Milk and Cream) Regulations, 1912 and 1917. Report for the Year 1924. 1. Milk; and Cream not sold as Preserved Cream. (a) Number of Samples examined for the presence of a Preservative. (b) Number in which Preservative was reported to he present, and Percentage of Preservative found in each Sample. Milk 649 Nil. Cream 5 .26% Boric Acid. .3% Boric Acid. 107 Nature of preservative in each case in column (b) and action taken under the Regulations in regard to it. The statements of the respective Vendors were accepted by the Public Health Committee. 2. Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the label as to preservatives were correct. (i) Correct statements made 1 (ii) Statements incorrect nil 1 (iii) Percentage of preservative found in each sample .2% Percentage stated on Statutory label .4% (b) Determinations made of milk fat in cream sold as served cream. (i) Above 35 percent. 1 (ii) Below 35 per cent. nil 1 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V (1) and the proviso in Article V (2) of the Regulations have not been observed Nil. (d) Particulars of each case in which the Regulations have not been complied with, and action taken Nil. 108 3. Thickening substances.—Any evidence of their addition to cream or to preserved cream. Action taken where found. Nil. 4. Other observations, if any. Nil. Milk (Special Designations Order), 1923. The special designations under which milk may be sold or offered or exposed for sale in pursuance of this Order are the following:—"Certified," "Grade A. (Tuberculin tested)," "Grade A. (Pasteurised)," and "Pasteurised," and the Borough Council is authorised to grant licenses to any person other than a producer to sell such graded milk. The licenses are valid for a period ending on the 31st December of the year in which it is granted. Applications were received during the year from the undermentioned dealers, all of whom satisfied the Local Authority that their arrangements for the storage, treatment and distribution of the milk complied with the conditions required: Welford & Co., 83, Upper Clapton Road. "Certified." A. Stapleton & Sons, Brookland Farm, Northwold Road "Grade A. (Tuberculin tested)." do. do. do. "Pasteurised." A. Stapleton & Sons, 124, Dalston Lane "Grade A. (Tuberculin tested)." Manor Farm Dairy, Ltd., 164, Stamford Hill "Pasteurised." do. do. do. "Certified." A. B. Mansfield & Sons, 2, Maury Road "Certified." J. Akam & Sons, 53, Kynaston Road. "Pasteurised." 109 In accordance with the Order the following samples were taken and submitted to bacteriological examination:— Date. Producer. Dealer. Bacteriologist's report. 9 Feb. Wilkin & Son, Ltd., Gatehouse Dairy, Tiptree, Essex. Welford & Co., 83, Upper Clapton Road. Conforms to the requirements for Certified milk. 1 April Brig.-General Aldercrow, Park Farm, Culverthorpe, Grantham. do. do. do. do. do. 30 June do. do. do. do. Does not conform to the standard required for Certified milk. The sample contains more than 30,000 organisms per c.c. 16 July do. do. do. do. Does not conform to the standard required for certified milk. The sample contains more than 30,000 organisms per c.c. 6 Aug. do. do. do. do. Does not conform to the standard required for certified milk, as Bacillus Coli are present. 27 Aug. do. do. do. do. Conforms to the requirements for certified milk. 25 Sept. do. do. do. do. do. 3 Nov. do. do. do. do. Does not conform to the standard required for certified milk, as Bacillus Coli are present. 1 April Lord Rayleigh, Witham, Essex A. B. Mansfield, 2, Maury Road. Conforms to the requirements for certified milk. 17 July do. do. do. do. Does not conform to the standard required for certified milk, as Bacillus Coli are present. 28 Aug. do. do. do. do. Conforms to the requirements for certified milk. 26 Sept. do. do. do. do. do. do. do. 16 Dec. Brig.-General Aldercrow, Grantham. Welford & Co., 83, Upper Clapton Road. do. do. do. 110 Report of the Food Inspector for the Year 1924. (Mr. A. J. Bobbitt). Dairies and Milkshops.—1,629 visits were made to these during the year. 67 new Milksellers have been registered. 5 applications for registration were refused by the Public Health Committee on the grounds of unsuitability of premises or the applicants. The total number of persons registered is now 361. No notices have been served for repairs or limewashing; these, where required, have been carried out on verbal instructions only. Cow-Houses.—These now number 8, one dairyman not having applied for a renewal of his licence. 104 inspections were made during the year, and on each visit I found that the premises were being kept in accordance with the regulations. Offensive Trades.—The only offensive business now carried on in the Borough is that of fur-skin dressing, and 13 of such are actively engaged. 50 visits were made to these, and it was necessary to issue 2 summonses against one firm for failing to carry out the periodical limewashing and the provision of suitable refuse receptacles, when costs amounting to £5 5s. Od. were imposed. In all other respects I found the regulations were being observed. Slaughterhouses and Meat Inspection.—The licensed slaughterhouses now number 17, a reduction of 2 since last year. 111 The renewal of one licence was not applied for as the premises had been demolished, and one was refused by the L.C.C. Licensing Committee in consequence of non-use. Four of the slaughterhouses have been little used during the year owing to various causes. The new By-law making the use of a stunning instrument compulsory previous to bleeding came into force in March, and although not liked at first by the butchers, is now universally used on all animals. 286 visits were made during the usual slaughtering times, when I have examined the carcases and organs of 71 oxen and heifers, 10 calves, 1,232 sheep and lambs, and 46 pigs. No serious case of disease has been met with, and Tuberculosis has been entirely absent. The following I found diseased and had destroyed Livers of 7 oxen and 26 sheep affected with Distomatosis. Livers of 1 ox and 5 sheep affected with Abscess. Livers and lungs of 9 sheep affected with Parasitic Cysts. Lungs of 1 ox affected with Parasitic Cysts. The new by-laws regulating the slaughter of poultry are now in force: these would have affected 8 of the Jewish butchers only, but 5 of these have given up killing fowls, 2 have adapted their premises to meet the requirements of the by-laws, and one is being dealt with. Wholesale Meat Factories.—These number 3, and one blackpudding maker. 37 visits were made to these, and on each occasion I found the premises kept in a cleanly condition, and the carcases and meat of various kinds sound and free from disease. 112 Sale of Food and Drugs Acts.—54 samples were purchased for analysis. Miscellaneous Inspections and Unsound Food.—377 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. The storage premises have been regularly inspected, and limewhiting, etc., carried out when required. The number of meat stalls on the register is now 28. Meat Marking.—Observation has been kept on the butchers' shops and stalls for the enforcement of the labelling of Imported Meat. The butchers are ever ready to, and do label home-killed meat, but they seem to have an objection to placing labels on imported meat, but they have gradually come into line, and there are now few evasions of the order. The following foodstuffs have been condemned and destroyed :— 201 Rabbits. 3 Boxes of Plaice. 197 Turkeys. 6 „ Skate. 62 lbs. of Pork Trimmings. 1 Box of Cat Fish. 1,009 Tins of Sardines. 4 Boxes of Sprats. 200 Tins of Salmon and 3 Trunks of Haddock. Pilchards. 5 Stones of Lemon Soles. 6 Tins of Corned Beef. 12 lbs. of Grapes. 1 ton 3 cwt. 1 qr. 16 lbs. of 85 Bananas. Bacon. 8 Railway Trucks of Cabbages Total Weight of all Foodstuffs destroyed:— Meat and Bacon 1 ton 9 cwt. 3 qrs. 10 lbs. Fish 19 cwt. 2 qrs. 26 lbs. Fruit and Vegetables 1 ton 12cwt. 0 qrs. 24lbs 113 Report of Canal Boats Inspector for the Year 1924. (Mr. E. S. Crook). Number of visits to waterways 43 „ boats inspected 27 „ „ not registered Nil „ „ conforming to Acts 27 „ „ infringing the Acts Nil „ certificates examined 27 „ persons for which boats were registered— Adults 97 Children Nil „ persons living on boats so registered— Men 54 Women Nil Children Nil „ Notices issued Nil „ „ complied with — l.egal Proceedings taken Nil 114 INSPECTIONS BY SANITARY INSPECTORS, 1924 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. to 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 113 213 337 217 436 306 395 408 154 415 295 249 224 373 181 176 226 ... 31 ... 4748 No. of premises in which defects were discovered 96 162 263 185 320 235 334 352 110 313 271 220 190 275 150 129 175 ... 22 ... 3802 Builder's Notices— No. of premises inspected ... 40 21 11 ... 22 36 12 39 18 11 29 16 28 14 ... 1 ... ... ... 298 House to House— No. of premises inspected ... ... 63 ... ... 35 61 ... 23 5 2 ... 95 46 34 600 331 ... ... ... 1295 No. of premises in which defects were discovered ... ... 34 ... ... 28 46 ... 17 1 2 ... 73 39 21 444 252 ... ... ... 957 Infectious Disease— No. of premises inspected 31 89 59 67 83 57 69 64 80 63 48 76 117 121 56 49 13 ... ... ... 1142 No. of premises in which de fects were discovered 8 47 19 31 36 26 23 34 30 36 23 45 62 60 23 18 9 ... ... ... 530 No. of re-inspections. (All forms of inspection) 809 2106 2055 2035 1428 2192 2394 2063 2277 2165 2520 1627 2154 1907 1975 2859 2856 ... 819 983 37224 No. of premises in which de fects were discovered. (A1l forms of inspection.) 116 241 327 257 358 333 407 424 237 450 350 338 348 491 262 591 407 ... 262 336 6535 No. of premises in which de fects were abated. (A1l forms of inspection.) 75 196 337 296 339 344 375 407 242 337 322 287 357 497 272 366 268 ... 252 312 5881 Total number of Intimation notices served 116 262 327 279 368 331 403 390 236 411 359 291 363 497 250 532 384 ... 216 226 6241 Total number of Final Notices served 23 62 12 2 39 5 44 3 ... 12 13 42 4 68 49 ... ... ... 33 32 443 Total number of Statutory Not ires served 5 35 121 73 115 56 51 118 47 83 74 62 102 67 30 21 61 ... 15 ... 1136 Notices served for infringe ments of Bye-Laws ... 23 ... 26 ... 8 22 19 2 68 9 62 6 44 33 4 ... ... 28 ... 354 Notices served for Infringe ments of L.C-C. General Towers Acts, Public Health Acts, etc. ... ... 23 12 ... ... ... 2 1 15 1 3 1 23 ... 4 37 ... ... ... 118 115 116 117 INSPECTIONS BY SANITARY INSPECTORS, 1924 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. Goldsworth No. 9 District. Mr. Peverett, No. 10 District Mr. Hillier, No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove No. 18 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 Notices served under Rats & Mice Destruction Act, 1919 1 ... 3 10 ... ... ... 7 ... 3 16 7 7 ... ... ... ... ... ... ... 64 Inspections for Certificates under Increase of Rent, Mortgage Interest (Restrictions) Act, 1920-3 . 2 3 1 2 ... ... ... 1 ... ... ... 1 ... 3 ... ... ... ... ... ... 13 Proceedings before Magistrate under Public Health (London) Act, &c. . ... 1 6 4 19 2 2 3 ... 2 1 2 1 1 4 3 2 2 2 ... 57 Attendances at Police Court ... 4 8 5 18 13 3 12 5 4 2 9 5 4 5 3 12 5 ... ... 117 Miscellaneous Inspections— Mews and stables 1 16 5 2 51 2 1 ... 4 17 2 9 6 ... 4 ... ... ... ... ... 120 Urinals ... 15 16 3 ... 24 7 14 13 13 6 ... ... 8 4 ... ... ... ... ... 123 Canal boats ... ... ... ... ... ... ... ... ... ... ... 27 ... ... ... ... ... ... ... ... 27 Visits to waterways ... ... ... ... ... ... ... ... ... ... ... 43 ... ... ... ... ... ... ... ... 43 Animals improperly kept 1 ... 2 ... ... ... ... 3 1 1 ... 2 5 ... 3 ... 7 ... ... ... 25 Offensive trades ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... 50 ... ... 50 New buildings (water certificates) 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 Floodings ... ... ... ... ... ... ... ... ... 3 ... 35 ... ... ... ... ... ... ... ... 38 Special inspections 1 147 423 194 119 53 57 247 69 128 178 138 69 101 71 69 73 377 ... ... 2514 Drains relaid 2 22 25 22 57 27 46 13 20 10 21 21 18 19 53 10 5 ... ... ... 391 do. repaired. 6 28 34 37 63 23 79 19 8 54 36 49 7 32 34 ... 29 ... ... ... 548 Drains and Sanitary Fittings tested and examined 35 159 223 113 114 275 70 104 45 176 72 180 104 338 137 196 400 ... ... ... 2741 Places where Food Prepared for Sale (Restaurants, Coffee Shops), etc. No. of inspections 4 10 8 10 15 6 11 11 1 27 16 12 1 10 3 ... ... 37 ... ... 182 No. of Notices 2 2 2 6 ... 3 ... 3 ... 7 5 ... ... 5 1 ... ... ... ... ... 36 118 119 INSPECTIONS BY SANITARY INSPECTORS,1924 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 Districi. Mr. .Long, No. 8 District. Mr. Goldsworthy No. 9 District. Mr. Peverett. No. lO District. Mr. Hillier. No. 11 District. Mr. Crook, No. 12 District. Mr. Truslove No. 18 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 Ice Cream Premises No. of inspections 19 7 23 20 20 12 20 30 9 22 7 20 15 38 ... ... ... ... ... ... 262 No. of Notices 3 ... ... 3 ... ... ... 16 ... 8 1 ... 3 8 ... ... ... ... ... ... 42 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tenement Houses— No. provided with additional water supply ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Overcrowding— No. of houses overcrowded ... 2 ... ... ... 4 4 5 ... 21 4 3 6 ... 6 ... 5 ... ... ... 60 No. remedied ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... 1 ... 1 ... ... ... 5 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Verminous Premises— Verminous Premises Cleansed 2 5 50 26 14 25 58 44 17 71 51 10 27 47 3 35 33 ... ... ... 518 Inspections after complaint by London County Council 2 2 1 5 5 4 35 6 ... 8 4 1 5 12 ... ... 3 ... ... ... 93 Verminous conditions found after complaint by L.C.C. ... ... 1 4 ... 3 13 4 ... 7 4 1 5 5 1 ... 1 ... ... ... 49 Bakehouses— No of inspections 8 21 10 16 21 12 47 21 15 31 14 8 4 24 6 ... ... ... ... ... 258 No. of Notices 4 4 1 13 ... 1 ... 3 4 6 12 3 ... 2 3 ... ... ... ... ... 56 No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pood Adulteration— Samples collected for analysis ... 54 54 54 54 54 54 48 53 51 53 48 53 54 54 60 48 54 ... ... 900 Proceedings taken before Magistrate ... 1 ... ... ... ... 1 ... 2 ... ... ... 1 ... ... ... ... 1 ... ... 6 120 121 INSPECTIONS BY SANITARY INSPECTORS, 1924 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. . Factories and Workshops— No. of inspections (other than laundries) ... ... ... 1 25 14 15 14 ... 17 2 8 2 9 3 ... ... 1235 ... ... 1340 No. of Inspections (laundries) ... ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... ... 35 ... ... 35 No. of inspections (other workplaces) ... ... ... ... ... 1 ... ... ... 7 ... ... ... ... ... ... ... ... ... ... 8 No. of premises in which defects were discovered ... ... ... ... ... 2 7 6 ... 11 1 1 2 8 1 ... ... ... 252 ... 301 No. of premises in which defects were abated ... ... ... ... ... 1 11 6 ... 10 1 3 2 7 ... ... ... ... 262 ... 293 Smoke Nuisances— No. of observations ... ... 55 2 ... ... 57 1 1 7 6 77 22 4 3 ... ... ... ... ... 235 No. of Intimation Notices served ... ... 3 2 ... ... 6 1 ... 5 2 6 1 4 ... ... ... ... ... ... 30 No. of Statutory Notices served ... ... 1 ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Outworkers' Premises— No. of premises inspected ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 1548 1550 No. of premises in which defects were discovered ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 336 337 No. of premises in which defects were abated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 312 312 Dairies, Cowsheds and Milkshops Order— No. of cowsheds inspected ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... •• ... 104 ... ... 104 No. of dairies inspected ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1629 ... ... 1630 No. of dirty utensils discovered ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... No. of premises where infringements of By-laws discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of new registrations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 60 ... ... 60 122 123 INSPECTIONS BY SANITARY INSPECTORS, 1924 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. lO 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 Slaughter-houses. No. of inspections ... ... ... ... ... ... ... ... ... l ... ... ... ... ... ... ... 286 ... ... 287 No. of premises where infringements of by-laws discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Condemned as Unfit for Human Food— lbs cwt t.c.q.lbs. t. c.q.lbs. t.c.q.lbs. Fish ... ... ... ... ... ... ... ... 14 5 ... ... ... ... ... 0.2.0.14 ... 0.19.2.26 ... ... 1.6.3.26 Fruit and Vegetables ... ... ... ... ... ... ... ... 20 2 ... ... ... ... ... ... ... 12.0.24 ... ... 1.14.1.16 Meat (specially state number of carcases or parts of condemned for tuberculosis) ... ... ... ... ... ... ... ... 20 1 ... ... ... tc..q.lbs 0.3.2.0. ... ... ... 9.3.10 ... ... 1.14.2.2 Tinned foods ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other articles ... ... ... ... 1 ... ... ... ... qrs. 2 ... ... ... ... ... ... ... ... ... ... 0.0.2.0. Housing. Town Planning, ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... f.tc. Act. 1909— No. of premises inspected ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of premises in which defects were discovered ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of premises in which defects were abated ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Underground Rooms— Illegal occupation dealt with ... ... ... ... ... ... ... ... ... ... ... l ... ... ... ... — ... ... 1 No. of rooms closed ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Houses Let in. Lodgings— No. of inspections ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of Notices ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 124 inspections by sanitary inspectors, 1924 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. lO District.1 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 Insanitary Houses Closed— No. closed under Public Health (London) Act, 1891 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. closed under Housing of Working Classes Act, 1890 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fish Shops— No. of Inspections ... ... ... 21 ... 11 ... ... ... 11 3 ... ... ... ... ... ... ... ... 46 No. of Notices served ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... ... ... ... 3 Bakehouses— No. on Register at end of 1923 8 10 5 8 11 5 8 8 7 13 7 2 2 12 ... ... ... ... ... ... 106 No. on Register at end of 1924 8 10 5 8 10 5 8 8 7 13 7 2 2 12 ... ... ... ... ... ... 105 No. above ground 7 6 1 3 5 1 4 1 5 11 7 ... 1 2 ... ... ... ... ... ... 54 No. underground 1 4 4 5 5 4 4 7 2 2 ... 2 1 10 ... ... ... ... ... ... 51 Houses Let in Lodgings— No. on Register at end of 1923 ... ... ... ... ... ... 237 ... ... ... 236 ... ... ... ... ... ... ... ... ... 473 No. on Register at end of 1924 ... ... ... ... ... ... 237 ... ... ... 236 ... ... ... ... ... ... ... ... ... 473 Ice Cream Premises— No. on Register at end of 1923 13 6 20 26 18 12 19 26 8 18 6 11 9 28 ... ... ... ... ... ... 220 No. on Register at end of 1924 14 7 23 20 18 12 20 30 9 22 7 11 15 40 ... ... ... ... ... ... 248 Places Where Food Prepared for Sale— No. on Register at end of 1923 5 6 9 12 12 4 21 12 8 26 9 8 1 30 ... ... ... ... ... ... 163 No. on Register at end of 1924 5 6 8 10 21 4 21 12 8 27 9 8 4 29 ... ... ... ... ... ... 172 125 126 TABLE OF DEATHS. Of Inhabitants of the Borough of Hackney during the year 1924. 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 1 ... 1 ... ... ... ... ... ... ... ... ... 2 Measles (Morbilli) 5 15 6 1 ... ... ... ... ... ... ... ... 27 Epidemic Rose Rash, German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... 1 4 2 ... ... ... ... ... ... ... ... 7 Influenza 5 ... 2 ... 1 3 7 12 13 17 13 3 76 Whooping Cough 7 6 3 ... ... ... ... ... ... ... ... ... 16 Diphtheria, Membranous Croup ... 2 15 16 1 ... ... ... ... ... ... ... 34 Cerebro Spinal Fever 2 1 2 1 ... ... ... ... ... ... ... ... 6 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Diarrhoea, Epidemic (or Zym.) Enteritis 4 ... ... ... ... ... ... ... ... ... ... ... 4 Diarrhoea, Choleraic Diarrhœa ... ... ... ... ... ... ... ... ... ... ... 1 1 Dysentery ... ... ... ... ... 1 1 ... ... ... 1 ... 3 Malarial Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax Splenic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Tetanus ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis 1 ... ... ... ... ... ... ... ... 1 ... ... 2 Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... ... ... 1 3 1 3 2 ... 1 ... ... 11 Puerperal Septicaemia, Sapraemia Fever ... ... ... ... 1 2 ... ... ... ... ... ... 3 127 TABLE OF DEATHS—continued. AGES Under 1 year. I to 2. 2 to 5. 5 to 15. IS 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. Infective Endocarditis ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 1 ... ... ... ... ... ... 1 ... 1 ... 5 Septicaemia (not Puerperal) ... ... ... 1 ... 2 ... ... ... ... ... ... 3 Pyaemia (not Puerperal) ... ... ... ... 1 ... ... ... ... ... ... 1 Phlegmon, Carbuncle (not Anthrax) ... ... ... ... ... ... ... ... ... ... 1 ... 1 Other Septic Diseases 1 ... ... ... ... ... 3 ... ... 1 ... ... 5 Tuberculous Phthisis (Pulm. Tuberculosis). ... ... ... 5 49 46 43 42 19 3 ... ... 207 Tuberculous Meningitis 4 6 9 4 2 ... 1 ... ... ... ... ... 26 Tuberculous Peritonitis ... 2 2 1 2 ... ... ... ... ... ... ... 7 Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... Lupus ... ... ... ... ... ... ... ... ... ... ... ... ... Tubercle of other Organs ... 1 1 ... 2 ... 1 3 ... 3 ... ... 11 General Tuberculosis 2 1 ... ... ... ... ... ... ... ... ... ... 3 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism, Delirium Tremens ... ... ... ... ... ... ... 1 ... ... ... ... 1 Ptomaine Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatic Fever, Acute Rheumatism ... ... ... ... 1 ... 1 ... 1 1 ... ... 4 Rheumatism of Heart ... ... ... 3 ... ... ... ... ... ... ... ... 3 Chronic Rhcumaris ... ... ... ... 2 1 ... ... 1 1 ... ... 5 Rheumatic Arthritis, Rheumatic Gout ... ... ... ... ... ... ... 1 3 4 2 ... 10 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... Carcinoma ... ... ... ... ... 3 17 40 73 83 30 4 250 Sarcoma ... ... 3 ... 1 3 1 3 5 3 3 ... 22 128 TABLE OF DEATHS—continued. AGES Under 1 year. 1 to 2. 2 to 5. 5 to 15 16 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 ... ... ... ... ... 3 4 5 7 8 8 • 3 38 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... Haemophilia, Hemorrhagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... Anaemia, Leucocythæmia ... ... ... ... ... 1 1 1 2 1 ... ... 6 Diabetes Mellitus ... ... ... ... ... 1 1 1 6 5 ... 1 15 Premature Birth 64 1 ... ... ... ... ... ... ... ... ... ... 65 Congenital Defects 12 1 ... ... ... ... 1 ... ... ... ... ... 14 Injury at Birth 1 ... ... ... ... ... ... ... ... ... ... ... 1 Atelectasis 4 ... ... ... ... ... ... ... ... ... ... ... 4 Want of Breast Milk ... ... ... ... ... ... ... ... ... ... ... ... ... Teething 2 ... ... ... ... ... ... ... ... ... ... ... 2 Suffocation-Overlaying 1 ... ... ... ... ... ... ... ... ... ... ... 1 Diseases of Nervous System Meningitis, Inflammation of Brain 2 5 1 1 1 ... 1 1 ... ... ... ... 12 Softening of Brain ... ... ... ... ... ... ... ... 1 2 1 ... 4 General Paralysis of Insane ... ... ... ... ... ... 2 5 2 ... ... ... 9 Insanity (not Puerperal) ... ... ... ... ... ... 1 1 ... ... ... ... 2 Chorea ... ... ... 1 ... ... ... ... ... ... ... ... 1 Epilepsy ... ... 1 ... 2 1 ... 1 ... 1 ... ... 6 Convulsions 7 ... ... 1 ... ... ... ... ... ... ... ... 8 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy ... ... ... ... ... ... ... ... 1 2 1 ... 4 129 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 65. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. All ages. Poliomyelitis ... ... 1 ... ... ... ... ... ... ... ... ... 1 Paraplegia and Disease of Cord ... ... ... ... ... ... ... ... 1 ... ... ... 1 Neuritis, Periph, PolyNeuritis ... ... ... ... ... ... ... 1 ... ... ... 1 2 Brain Tumour (not specific) ... ... ... 1 1 5 2 ... 3 ... ... ... 12 Nervous System, other Diseases 4 ... 1 1 1 1 3 ... 5 8 2 ... 26 Diseases of Organs of Sense. Otitis, Mastoid Dis. 1 ... ... 2 3 1 1 ... 1 ... ... 9 Epistaxis, Nose Dis. ... ... ... 1 ... ... ... ... ... ... ... ... 1 Ophthalmia, Eye Dis. ... ... ... ... ... ... ... ... ... ... ... ... ... Accidents ... 4 3 2 9 8 6 10 7 5 5 3 62 Violence Suicide ... ... ... ... 4 2 3 8 6 4 ... ... 27 Drowned ... ... ... ... 1 ... 3 2 ... ... ... ... 6 Murder ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Heart. Valve Dis., Endocarditis ... ... 2 1 5 7 8 33 25 27 18 3 129 Pericarditis ... ... ... ... ... ... ... 1 ... ... ... ... 1 Hypertrophy of Heart ... ... ... ... ... ... ... ... ... ... ... ... ... Angina Pectoris ... ... ... ... ... ... ... 4 5 3 1 1 14 Dilatation of Heart ... ... ... ... ... ... 2 5 14 24 31 9 85 Fatty Degeneration of Heart ... ... ... ... ... ... 1 1 7 5 3 1 18 Syncope Heart Dis. (not specified) ... ... ... 2 ... 2 4 7 10 12 15 4 57 130 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 Blood Vessels. Cerebral Haemorrhage Emb., Throm. ... ... ... 1 1 2 2 14 25 53 35 6 139 Apoplexy, Hemiplegia ... ... ... ... ... ... 2 2 4 8 4 ... 20 Aneurysm ... ... ... ... ... ... ... ... 2 2 ... ... 4 Senile Gangrene ... ... ... ... ... ... ... ... ... 2 2 1 5 Embolism, Thrombosis (not Cerebral) ... ... ... ... ... ... ... 2 ... ... ... ... 2 Phlebitis ... ... ... ... ... ... ... ... 1 1 ... ... 2 Blood Vessels, other diseases 1 ... ... ... ... ... ... 3 3 6 1 1 15 Arterio Sclerosis ... ... ... ... ... ... ... 2 8 41 45 18 114 Diseases of Respiratory Organs. Laryngitis 1 ... ... ... ... ... ... ... ... ... ... ... 1 Bronchitis 9 1 ... ... ... 1 11 20 33 62 63 16 216 Lobar (Croupous) Pneumonia 2 2 3 ... 2 2 5 10 12 9 4 1 52 Broncho, Catarrhal, Lobular Pneumonia 55 28 13 3 ... 3 1 1 8 13 5 4 134 Pneumonia 6 4 2 3 1 1 8 4 6 7 3 ... 45 Emphysema, Asthma ... ... ... ... ... ... 2 9 8 12 4 ... 35 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... Fibroid Dis. of Lung ... ... ... ... ... ... ... ... ... 1 ... ... 1 Respiratory Dis., other 2 1 ... ... 1 2 2 1 2 2 ... ... 13 Diseases of Digestive System. Tonsilitis, Quinsey ... ... ... ... ... ... ... ... ... ... ... ... ... Mouth, Pharynx, Dis. (not specific) ... ... ... ... ... ... ... ... ... ... ... ... ... Gastric Ulcer ... ... ... ... 1 ... 2 4 4 5 3 1 20 131 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 ... ... ... ... ... ... ... ... ... ... ... ... ... Stomach, other Dis. (not Malig.) ... ... ... ... ... ... 2 1 ... ... ... ... 3 Enteritis (not Epidemic) ... 1 ... ... ... ... ... ... ... ... ... ... 1 Gastro-Enteritis 11 ... 1 ... ... ... ... ... ... ... 2 ... 14 Appendicitis, Perityphilitis ... ... 2 5 3 2 1 2 ... ... ... ... 16 Hernia ... ... ... ... ... ... ... 1 ... 1 2 ... 4 Intestinal Obstruction 1 1 2 ... ... ... 2 1 3 3 1 1 15 Other Dis. of Intestines 8 ... ... ... 1 ... ... 1 ... 3 ... ... 13 Peritonitis (not puerperal) ... ... 1 1... 3 ... 1 3 2 ... ... 11 Cirrhosis of Liver ... ... ... ... ... ... 3 1 4 2 ... ... 10 Liver and Gall Bladder, other Diseases ... ... ... ... 1 1 1 2 ... ... 1 ... 6 Digest. Syst., other Diseases ... ... ... ... ... ... ... 1 2 1 1 ... 5 Lymph Diseases. Spleen Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Lymph System, other Diseases 2 ... ... 1 1 ... 1 1 ... ... ... ... 6 Thyroid Body Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Supra Renal Capsules Disease ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Urin. Syst. Nephritis, Acute ... ... ... 2 3 6 5 12 26 19 12 3 88 Chronic Bright's Dis. Albuminura ... ... ... ... ... ... 1 ... 2 ... ... ... 3 Calculus (not Biliary) ... ... ... ... ... ... ... ... ... ... ... ... ... Bladder and Prostate Disease ... ... ... ... ... ... ... 1 1 6 4 1 13 Urin. Syst., other Dis. ... ... ... ... 1 3 2 1 1 3 ... 1 12 132 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 or Gener. Syst. Ovarian Tumour (not Malig.) ... ... ... ... ... ... ... ... ... ... ... ... ... Other Dis. of Ovary ... ... ... ... ... ... ... ... ... 1 ... ... 2 Uterinal Tumour (not Malig.) ... ... ... ... ... ... ... ... ... ... ... ... ... Other Dis. of Uterus and Vagina ... ... ... ... ... 1 1 1 ... ... ... ... 3 Accidents Childbirth. Abortion, Miscarriage ... ... ... ... ... ... ... 1 ... ... ... ... 1 Puerperal Mania ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions ... ... ... ... ... ... 1 ... ... ... ... ... 1 Placenta Prævia, Flooding ... ... ... ... ... 1 1 ... ... ... ... ... 2 Other Accid. of Preg. and Childbirth ... ... ... ... 1 2 2 1 ... ... ... ... 6 Joint Diseases. Caries, Necrosis ... ... ... ... ... ... 1 ... ... 1 ... ... 2 Arthritis, Periostitis ... ... ... ... ... ... ... ... ... 1 1 ... 2 Other Dis. of Locom. Syst. ... ... ... 3 ... ... ... ... ... 1 ... ... 4 Skin Diseases. Ulcer, Bedsore ... ... ... ... ... ... ... ... ... ... ... ... ... Eczema ... ... ... ... ... ... ... ... ... ... ... ... ... Pemphigus ... ... ... ... ... ... ... ... ... ... ... ... ... Skin Disease, other 3 1 ... ... ... ... 1 ... ... 1 1 ... 7 Ill-Defined Causes. Atrophy, Debility, Marasmus 17 ... ... ... ... ... ... ... ... ... ... ... 17 Old Age ... ... ... ... ... ... ... ... ... 13 58 24 96 Dropsy, Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... ... 1 ... ... ... ... ... ... 3 Abscess ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause unascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... Other Ill-defined Causes 3 ... ... ... ... ... ... ... 1 1 ... ... 5 Causes not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 254 86 81 67 106 128 183 293 381 509 388 112 2588 133 TABLE III. Causes of, and Age at, Death during the year 1924. 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 ... ... ... ... ... ... ... ... ... 4 Small-Pox ... ... ... ... ... ... ... ... ... ... Measles 27 5 15 6 1 ... ... ... ... 84 Scarlet Fever 7 ... 1 4 2 ... ... ... ... 13 Whooping Cough 16 7 6 3 ... ... ... ... ... 18 Diphtheria and Croup 34 ... 2 15 16 1 ... ... ... 69 Influenza 76 5 ... 2 ... 1 10 25 33 6 Erysipelas 5 2 1 ... ... ... ... 1 1 ... Dysentery 3 ... ... ... ... ... 2 ... 1 1 Phthisis (Pulmonary Tuberculosis) 207 ... ... ... 5 49 59 61 3 141 Tuberculous Meningitis 26 4 6 9 4 2 1 ... ... 14 Other Tuberculous Diseases 21 2 4 3 1 4 1 3 3 12 Cancer, Malignant Disease 310 ... ... 3 ... 1 31 133 142 208 Rheumatic Fever 4 ... ... ... ... 1 1 1 1 ... Meningitis 12 2 5 1 1 1 1 1 ... 10 Organic Heart Disease 304 1 ... 2 3 5 24 112 157 138 Bronchitis 216 9 1 ... ... ... 12 53 141 51 Pneumonia (all forms) 231 63 34 18 6 3 20 41 46 145 Other Diseases of Respiratory Organs 50 3 1 ... ... 1 6 20 19 30 Diarrhœa and Enteritis 18 15 ... 1 ... ... ... ... 2 9 Appendicitis and Typhlitis 16 ... ... 2 5 3 3 3 ... 21 Cirrhosis of Liver 10 ... ... ... ... ... 3 5 2 5 Alcoholism 1 ... ... ... ... ... ... 1 ... ... Nephritis & Brights' Disease 91 ... ... ... 2 3 12 40 34 78 Puerperal Fever 3 ... ... ... ... 1 2 ... ... 5 Other Accidents and Diseases of Pregnancy and Parturition 10 ... ... ... ... 1 7 2 ... 12 Congenital Debility and Malformation, including Premature Birth 79 76 2 ... ... ... 1 ... ... 31 Violent Deaths, excluding Suicide 68 ... 4 3 2 10 17 19 13 63 Suicide 27 ... ... ... ... 4 5 14 4 10 Other defined Diseases 711 57 4 9 19 15 63 138 406 430 Diseases ill-defined or unknown 5 3 ... ... ... ... ... 1 1 ... 2588 254 86 81 67 106 311 674 1009 1608 Sub-entries (included in above figures)— Cerebro-Spinal Meningitis, 6 2 1 2 1 ... ... ... ... 3 Polio Myelitis 1 ... ... 1 ... ... ... ... ... ... Encephalitis Lethargica 11 ... ... ... 1 3 4 2 1 5 134 VIII.—HOUSING. 1.—GENERAL. Number of Houses erected during the year:— (a) Total 79 (b) With State assistance under the Housing Acts, 1919 or 1923:— (i) By the Local Authority 4 (ii) By other bodies or persons 75 flats. 2— UNFIT DWELLING-HOUSES. 1.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 9,033 (2) Number of dwelling-houses which were spected and recorded under the Housing (Inspection of District) Regulations, 1910 1,295 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (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 5,924 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 4,316 135 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 — (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 6,241 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 5,881 (b) by Local Authority in fault of owners -6 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 — 136 (2) Number of dwelling-houses in respect of which Closing Orders were made — (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit — (4) Number of dwelling-houses in respect of which demolition orders were made — (5) Number of dwelling-houses demolished in pursuance of Demolition Orders—