AC4347 HAM 32 Metropolitan Borough of Hammersmith. ANNUAL REPORT of the Medical Officer of Health for the YEAR 1940. '2 Public Health Department, Town Hall, Hammersmith, W.6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Ladies and Gentlemen,—In accordance with the recommendations of the Ministry of Health, the Animal Report upon the Health of the Borough for the year 1940 is presented in an abridged form, as it was for the year 1939. It consists largely of a series of tables and statistics dealing with the vital services. Vital Statistics.—The birth rate (1G.3 per 1,000) is the Highest recorded for the past 14 years, and is higher than the rate for London (13.7) and for England and Wales (14.6). On the estimated population, i.e., 98,320, the corrected number of deaths of residents was equal to an annual rate of 17.9 per 1,000. An adjusting factor has been supplied by the Registrar-General, and this, when applied to the Hammersmith death rate gives a rate of 18.2 per 1,000 which is considerably higher than for past years, and is also higher than for London as a whole (17.8) and for England and Wales (14.3). The reason for the increase over previous years is the inclusion in the figure of deaths through enemy action. Both the birth rate and the death rate are based upon the Registrar-General's estimate of the population, namely, 98,320. This represents a reduction on the figure for the previous year of 24,480. The large scale evacuation of the child population and the absence from home of men and women serving with H.M. Forces are the main factors accounting for the decrease, supplemented by a movement of persons to areas less vulnerable than Hammersmith. The evacuation of children and the call-up for military service of a large number of men has caused a relative 3 increase in the proportion of women of child-bearing age. For this reason the birth rate cannot be properly compared with past years. Whilst the birth rate was higher than the previous twelve months the actual number of births was 229 less. The infantile mortality rate for the year was 51, an increase on last year's figure (43), but still considerably lower than for any previous year. The figure for the whole of London was 50, and for England and Wales 55. There were no deaths during the year from puerperal causes. This is the first time that it has been possible to record that no maternal deaths have occurred during the whole of the twelve months, and a high tribute must be paid to the various units comprised in the Maternity Services of the Borough (Ante-natal clinics, doctors, midwives and hospitals), which are now equal to any in the country. On the outbreak of war responsibility for the Civil Defence Casualty Services was placed upon the Public Health Department. First Aid Posts and Gas Cleansing Stations had to be set up—Stretcher Parties organised and trained—mortuaries established—arrangements made for the decontamination of foodstuffs and a hundred-and-one other jobs connected with the war effort had to be undertaken under extremely difficult conditions. Many of the staff were transferred to those other duties, and as a result the routine work of the department was disrupted. Nevertheless the essential health services were maintained. Early in 1940 no intensive air attacks had been made on London, and mothers started to drift back with their children from the evacuation areas. The infant welfare clinics and the ante-natal clinics which had been closed at the commencement of hostilities were re-opened, and by the end of the year more sessions were being held than in the years prior to the war. Attendances at these clinics were well maintained even during the latter part of the year when air raids were of nightly occurrence. In all 604 sessions were held at the Tnfant Welfare Centres, with an 4 average attendance of 40 and 354 sessions at ante-natal and post-natal clinics, with an average attendance of 11.5. During the year an additional Assistant Medical Officer for Maternity and Child Welfare services was appointed, making the total number then engaged three, and an additional appointment was made to the staff of health visitors, bringing the total number engaged to eight. As a result of the depletion of the staff of Sanitary Inspectors in the early days of the war, it was only possible for essential work such as investigations into cases of infectious diseases, complaints. &c., to be undertaken. All inspections under the Housing Act were suspended, and much of the routine work had to be left in abeyance. In the early part of the year under review some members of the staff who had been engaged on Civil Defence were recalled to their normal duties, and an endeavour was made to restart the ordinary machinery of the department. Inspections under the Housing Act in connection with reconditioning of houses and underground rooms were recommenced, and two temporary Sanitary Inspectors were appointed to assist with the work in place of some of the permanent Inspectors still engaged on Air Raid Precautions. When intensive raiding started towards the end of the year this work had to be discontinued once again. The verv heavy air raids during the last four months of the year caused large numbers to spend evenings and nights in public shelters or in their own private shelters, and this introduced a number of problems connected with hygiene of the shelters and comfort of the shelterers. At one time the nightly public shelter population reached the figure of 0.000. Despite the abnormal conditions the health of the population was good, and no outbreaks of infectious diseases were recorded. As in previous vears close attention was paid to the supervision of food supplies. Of 840 samples taken under 5 the food and Drugs Act only nine were reported to be adulterated. A considerable amount of work was occasioned by the, inspection of stocks of food-shops damaged by enemy action and in the examination of salvaged foodstuffs brought into the Borough. Although there was a scarcity of certain foods and other foods were strictly rationed no adverse effect on the health of the population was observed. Preparations containing essential vitamins were made available for mothers and children at the welfare centres to take the place of some of the foods which it was difficult to obtain. I should like to take the opportunity of expressing to the members of the Council my appreciation of the goodwill they have shown to me during the year, and my thanks to the staff for their loyalty and devotion to duty which has resulted in the services of the Department being maintained during the year under conditions which have at times placed a considerable strain upon all concerned. I am, Ladies and Gentlemen. Your obedient Servant. J. B. HOWELL, Medical Officer of Health. 6 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. General Statistics, 1940. Area 2,282.5 acres Population (1940) (estimated) 98,320 Population Census (1901) 112,239 „ „ (1911) 121,521 „ „ (1921) 130,295 „ „ (1931) 135,521 Natural decrease, i.e., excess of deaths over births 156 Density of population 43.0 persons per acre Marriages registered 1,363 Rateable value (1940) 11,283,259 Sum represented by a penny rate, 1940 £5,051 Vital Statistics. Births (legitimate) 1,466 Birth rate 16.3 ,, (illegitimate) 134 Rate per 1,000 (live and still births) 33 Stillbirths 54 Deaths (corrected) 1,756 Death rate 17.9 Adjusted death rate 18.2 Deaths from puerperal causes Nil 7 Deaths of infants under one year of age per 1,000 births 51 ,, from cancer (all ages) 220 ,, ,, measles ,, 1 ,, ,, whooping cough (all ages) 0 ,, ,, diarrhoea (under 2 years of age) 8 Cancer.—There were 220 deaths from Cancer, and of this number, 205 occurred in persons over the age of 45 years. These deaths were equal to 2.2 per 1,000 of the population. The following table shows the number of deaths from Cancer under the various age groups during the past 10 years :— Year. Total Deaths. Sex. All Ages. 1— 2— 5— 15— 25— 35— 45— 55— 65— 75- 1931 229 M 104 - - - - 11 - 53 - 29 11 F 125 - 1 - - 12 - 48 - 32 32 1932 206 M 92 - - - 1 6 - 48 - 26 11 F 114 - - 1 2 9 - 54 - 27 21 1933 231 M 114 - - - 2 8 - 46 - 38 20 F 117 - - - 1 11 - 46 - 29 30 1934 235 M 112 - - - 1 9 - 46 - 31 25 F 123 - - 1 - 9 - 40 - 51 22 1935 216 M 117 - - - - 8 - 57 - 38 14 F 99 - - - - 7 - 45 - 26 21 1936 249 M 111 - - 1 2 5 - 48 - 42 13 F 138 - - - 3 14 53 38 30 1937 227 M 107 — — - - 11 - 41 - 37 18 F 120 - - - - 11 - 45 - 35 29 1938 234 M 123 - - - 2 6 21 45 28 21 F 111 - - - - 4 2 20 22 43 20 1939 227 M 104 - - - 2 - 6 10 34 35 17 F 123 - - - - 1 9 19 29 37 28 1940 220 M 111 1 - 7 51 52 F 109 - - 7 46 56 The average number of deaths for the ten years is 227. 8 Statistics.—The following table gives the statistics of the Borough during 1940 and previous years :— Vital Statistics of Whole District during 1940 and Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Number. Rate. of Non-residents registered in the District. of Residents not registered in the District Under 1 Year of Age. At all Ages. Number. Rate. N umber. Rate per 1,000 Nett Births. Number. Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1924 134200 2199 2399 17.9 1123 8.4 173 718 173 72 1668 12.4 1925 134500 2178 2351 17.5 1034 7.7 180 756 153 65 1604 11.9 1926 134400 2001 2188 16.3 1174 8.7 195 556 144 66 1535 11.4 1927 132800 17S9 2076 15.6 1581 11.9 230 377 126 61 1728 13.0 1928 136300 1938 2258 16.6 1449 10.6 222 326 156 69 1553 11.4 1929 136900 1869 2162 15.8 1767 12.8 222 340 133 62 1875 13.7 1930 136900 1962 2173 15.9 1387 10.1 219 436 140 64 1604 11.7 1931 135100 1954 2073 15.3 1567 11.6 288 373 140 68 1652 12.2 1932 133700 1795 1940 14.5 1465 109 294 543 129 66 1714 12.8 1933 131400 1682 1827 13.9 1500 11.4 340 530 119 65 1690 12.9 1934 129170 1551 1783 13.8 1359 10.5 346 655 137 77 1668 12.9 1935 128100 1774 1877 14.7 1347 10.5 406 583 131 70 1524 11.9 1936 127700 2266 1922 15.1 1399 10.9 141 639 116 60 1597 12. 5 1937 126500 2707 1913 15.1 1333 10.5 402 662 130 68 1593 12. 6 1938 125100 2840 1874 15.0 1340 10.7 450 522 117 62 1412 11.3 *1939 B122800 D116200 2214 1829 14.9 1311 11.2 362 442 77 43 1391 12.0 1940 98320 1733 1600 16.3 1725 17.5 370 401 76 51 1756 17.9 * B = Birth Rate Population Figure. D = Death „ „ „ 9 Causes of, and Ages at, Death during the Year 1940. Cause of Death. Sex. 0— 1— 5— 15— 45— 65— Total all Ages. 1. Typhoid and Paratyphoid Fevers M - - - - - - - F - - - - - - - 2. Cerebro-spinal Fever M - 1 - 1 - - 2 F 1 1 1 - 3 1 7 3. Scarlet Fever M - - - - - - - F - - - - - - - 4. Whooping Cough M - - - - - - - F - - - - - - - 5. Diphtheria M - 1 1 - - - 2 F 1 - - - - - 1 6. Tuberculosis of Respiratory System M - 1 - 31 35 9 76 F - - - 23 5 1 29 7. Other forms of Tuberculosis M 1 - 1 - 3 3 8 F - - - 3 1 1 5 8. Syphilitic Diseases M 1 - - 3 4 6 14 F - - - 2 3 4 9 9. Influenza M 3 - - - 3 - 9 F - - 1 2 2 2 7 10. Measles M - - - - - - 1 F - - - - - - - 11. Ac. Polio-myelitis and Polioencephalitis M - - - - - - - F - - 1 - - - 1 12. Ac. Inf. Encephalitis M - - - 1 - - 1 F - - - 1 - 1 2 13. Cancer of Buc. Cav. and Oesoph. (M). Uterns (F) M - - - 1 7 3 11 F - - - 5 11 7 23 14. Cancer of Stomach and Duodenum M - - - 1 6 6 13 F - - - - 5 7 12 15. Cancer of Breast M - - - - - - - F - - - 1 10 11 22 16. Cancer of all other sites M - 1 - 5 38 43 87 F - - - 1 20 31 52 17. Diabetes M - - - - - 3 3 F - - - 2 6 5 13 18. Intra-cranial Vascular Lesions M - - - - 18 29 47 F - - - - 20 39 59 19. Heart Disease M - - - 5 39 99 143 F - - - 5 29 145 179 20. Other Diseases of Cire. System M - - - - 10 18 28 F -, - - 1 8 24 33 21. Bronchitis M 4 - - 2 33 44 83 F 2 - - 2 9 52 65 22. Pneumonia M 17 - - 4 20 26 67 F 2 - - 2 8 37 49 23. Other Respiratory Diseases M - - - 1 6 7 14 F - - - - 2 7 9 24. Ulcer of Stomach or Duodenum M - - - 1 8 3 12 F - - - - 2 2 4 25. Diarrhoea under 2 years M 1 - - - - - 1 F 6 1 - - - - 7 26. Appendicitis M -' 1 1 1 3 1 7 F - - - - 1 - 1 27. Other Digestive Diseases M - 1 - 1 9 5 16 F - - - 2 5 13 20 28. Nephritis M - - - 4 3 9 16 F - - - 5 5 12 22 29. Puerperal and Post-abortive Sepsis M - - - - - - - F - - - - - - - 30. Other Maternal causes M - - - - - - - F - - - - - - - 31. Premature Birth M 11 - - - - - 11 F 5 - - - - - 5 32. Con. Mai. Birth Injuries Infant Dis. M 10 - - - 1 - 11 F 2 - - 1 1 1 5 33. Suicide M - - - 5 4 2 11 F - - - 1 2 - 3 34. Road Traffic Accidents M - 2 1 1 4 4 12 F - -• - - 1 2 3 35. Other violent causes M 2 5 11 50 40 27 135 F 2 3 7 50 35 38 135 36. All other causes M 4 - 1 5 24 32 66 F - 3 2 6 12 44 67 Totals all causes M 54 14 16 123 318 382 907 F 21 8 12 115 206 487 849 75 22 28 238 524 869 1,756 10 Death rate calculated on the estimated population of each Ward. Ward. Estimated Population. No. of Deaths. Death Rate. No. 1 River 12,381 214 17.3 No. 2 Brook Green 19,560 354 18.1 No. 3 The Grove 16,971 294 17.3 No. 4 St. Stephens 5,968 115 19.3 No. 5 Starch Green 16,993 , 291 17.1 No. 6 Wormholt 17,302 358 20.7 No. 7 College Park and Latimer 9,145 130 14.2 METROPOLITAN BOROUGHS. City and Boroughs. Estimated Population. Live Births Rate per 1,000 Population. Death Rate per 1,000 Population. Infant Mortality Rate per 1,000 Live Births. Crude. Adjusted West Districts. Kensington 123,860 13.5 18.3 17.4 58.0 Paddington 97,860 15.90 18.04 17.85 59.0 Fulham 106,630 15.70 18.70 18.10 45.0 Hammersmith 98,320 16.3 17.9 18.2 51.0 City of Westminster 85,920 9.7 17.4 17.5 44.6 Chelsea 38,700 11.0 22.0 17.8 40.0 North Districts. St. Marylebone 62,240 8.52 11.04 10.16 67.07 St. Pancras 133,600 11.64 16.30 - 56.0 Islington 224,110 17.18 18.48 18.11 47.0 Hackney 168,290 15.2 16.5 17.8 40.2 Hampstead 71,520 11.1 16.2 15.4 49.0 Stoke Newington 40,510 15.3 18.5 18.3 28.1 Central Districts. Holborn 23,470 9.29 21.60 21.38 67.63 Finsbury 40,090 14.3 23.1 23.4 68.0 City of London Not available East Districts. Stepney 136,030 15.7 20.0 22.0 43.1 Bethnal Green 66,620 15.1 20.1 21.7 49.5 Poplar 97,410 17.4 19.7 20.5 41.0 Shoreditch 57,900 16.04 23.09 23.55 69.0 South Districts. Battersea 108,380 16.57 18.38 17.46 41.24 Lambeth 210,650 15.52 - 19.72 47.0 Greenwich 74,280 15.76 17.18 17.52 56.0 Deptford Not available Woolwich 124,340 14.8 15.7 15.7 36.0 Southwark 101,900 17.3 24.1 23.6 49.0 Wandsworth 271,340 12.49 16.91 15.21 49.0 Lewisham Not available Bermondsey 71,590 17.2 21.7 23.4 35.0 Camberwell 173,750 15.34 19.13 18.36 48.0 11 MATERNITY AND CHILD WELFARE. The following table gives the number of births and deaths of infants and the rate per 1,000 births :— Year. Births. Deaths of Infants. Deaths of Infants per 1000 births. 1906 3112 430 138 1907 3029 362 117 1908 3204 383 120 1909 2995 360 120 1910 2906 329 99 1911 2929 434 146 1912 2880 259 90 1913 2951 314 103 1914 2935 276 94 1915 2708 277 102 1916 2605 222 85 1917 2278 251 110 1918 2014 210 104 1919 2296 228 99 1920 3312 219 66 1921 2779 245 88 1922 2758 196 71 1923 2701 173 64 1924 2399 173 72 1925 2351 153 65 1926 2188 144 66 1927 2076 126 61 1928 2258 156 69 1929 2162 133 62 1930 2173 140 64 1931 2073 140 68 1932 1940 129 66 1933 1827 119 65 1934 1783 137 77 1935 1877 131 70 1936 1922 116 60 1937 1913 130 68 1938 1874 117 62 1939 1829 77 43 1940 1600 76 51 12 The following table shows the deaths of infants under one year of age and the cause :— INFANT MORTALITY, 1940. Infantile Mortality during the year 1940. Nett deaths from stated causes at various ages under one year of age. CAUSES 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 1 year. Total Deaths under 1 year. Small-pox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - - - - - Scarlet Fever - - - - - - - - - - Whooping Cough - - - - - - - - - - Diphtheria and Croup - - - - - - - - 1 1 Influenza - - - - - - - - - - Erysipelas - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - - 1 — 1 Meningitis (not T.B.) - - - - - 1 — 1 — 2 Laryngitis - - - - - - - - - - Bronchitis 1 - - - 1 3 1 - - 5 Pneumonia (all forms) - 1 2 - 3 8 6 4 3 24 Infective Gastro Enteritis - - - - - 1 - 3 - 4 Syphilis - - 1 - 1 - - - - 1 Rickets - - - - - - - - - - Suffocation. Overlying - - - - - - - - - - Injury at Birth 9 - - - - - - - - 2 Atelectasis 2 - - - - - 1 - - 3 Congenital-Malformations 3 - - - 3 3 - - - 6 Premature Births 15 - 1 - 16 - - - - 16 Otitis Media - - - - - - 1 - - 1 Violence - - - - - - - - - - Icterus Neonatorum - - - - -- - - - - -- Haemorrhage of the Newtborn - - - - - - - - - - War Operations - - - - - - - 3 - 3 Other causes 2 - - - 2 1 2 - 2 7 Totals 25 1 4 — 30 17 11 12 6 76 Nett Births in the Year : Legitimate, 1,466; Illegitimate. 134. Nett Deaths in the Year of: Legitimate Infants, 68; Illegitimate Infants, 8. 13 The following Chart shows the Infantile Mortality rate for the years 1904-1940. 14 Visits paid by Health Visitors are enumerated in detail below:— District. No. 1 No. 2 No. 3 No. 4 No. 5 No. 6 No. 6a No. 7 Total Visits. First visits 171 176 220 183 185 150 64 112 1,261 Subsequent Visits. Under 1 year 451 404 536 435 424 975 174 703 4,102 1-5 Years 986 445 579 726 467 750 141 693 4,787 Outs 533 510 986 446 597 388 185 562 4,207 Removals 260 399 316 533 216 241 21 281 2,267 Other Visits. Infant Deaths 4 8 - 13 7 9 1 4 46 Stillbirths 4 4 10 9 4 6 2 3 42 Ophthalmia Neonatorum 2 3 8 3 1 17 Puerperal Fever 1 - 2 1 - - - - 4 Puerperal Pyrexia 2 2 5 3 3 4 - - 19 Epidemic Diarrhcea - 1 4 - - - - - 5 Encephalitis Lethargica 3 1 2 3 - 1 - - 10 Polio-Myelitis - - - - - - - - - Measles 2 1 17 - - 1 5 - 26 Diphtheria - - - - - - - - - Cerebro-spinal Fever - - - - - - - - - Pneumonia - - 2 - - - 1 - 3 Chickenpox - 1 10 - - 1 1 - 13 Whooping Cough - - - 2 - - - - 2 Scabies - 2 1 - - - - - 3 Child Life Protection - - - 1 1 - - - 2 Diphtheria Immunisation 2 16 32 40 4 - - 77 171 Home Helps 15 22 11 14 7 2 - 2 73 Evacuation Scheme 13 15 66 - - - - - 94 Convalescent - - - - - - - - - Free Milk - 1 6 - 2 - - - 9 Free Dinners - - - 6 - - - - 6 Adoption of Children - - 4 - - - - - 4 Factories, &c. - - - - - - - - - Special 1 5 - 67 - 12 143 - 228 Refugees 1 - - - - - - - 1 Rest Centres 23 32 28 - - 10 - - 93 Tuberculosis - 6 16 - - - - - 22 Ante-natal. First Visits 129 124 210 128 110 175 74 113 1,063 Subsequent Visits 92 56 105 71 14 80 28 25 471 Total Visits 2,695 2,234 3,176 2,684 2,042 2,805 840 2,575 19,051 Attendances at Infant Welfare Centres 47 78 44 98 90 84 209 64 714 Attendances at Antenatal Clinics 38 50 30 51 45 55 134 49 452 Schick Test Clinics - - 1 12 - - 2 2 17 Number of insanitary conditions reported 2 - 6 6 7 - - - 21 15 Schedule of Attendances at Infant Welfare Centres, and Ante-Natal Clinics. Address of Clinic. No. of Clinics New Cases. Total Attendances. Mothers. Children. Mothers. Children. Antenatal. Postnatal. Under 1 yr. Over lyr. Antenatal. Postnatal. Under 1 yr. Over 1yr. 48, Glenthorne Rd. 182 560 13 - - 1,967 17 - - 130 - - 345 56 - - 3,865 830 Beeklow Road 220 - - 365 124 - - 5,475 2,769 Milson Road 70 - - 146 49 - - 1,754 818 Old Oak Centre, 122 378 12 - - 1,635 42 - - Westway 135 - - 262 217 - - 4,541 2,068 Latymer Rd. Miss., 50 75 - - - 412 2 - - Bleehynden St. 49 - - 129 30 - - 1,313 599 Totals 958 1,013 25 1,247 476 4,014 61 16,948 7,084 Ante-natal Clinics 854 Infant Consultations 604 958 The average attendances for the Centres are as follows :— Municipal Infant Welfare Centres 40 Many children and mothers who attend the clinics in South Hammersmith have derived much benefit from the Massage and Remedial Exercise clinic held twice weekly at 48, Glenthorne Road. During the year 70 cases received massage treatment, the total number of treatments being 692. Milk (Mothers and Children) Orders, 1918-1919.— Under these Orders the Council has continued to supply milk to necessitous cases, each case being investigated, before a supply is granted. 12,382 lbs. of dried milk and 17,722 quarts of raw milk were distributed during the year. Cod Liver Oil.—The arrangement whereby mothers can obtain small quantities of cod liver oil for their children 16 was continued throughout the year. This is provided free to those mothers who are receiving free milk under the Maternity and Child Welfare Scheme. Those above the scale are supplied with small quantities at cost price. The Medical Officers of the Clinics report that many children have greatly benefited since this provision was made. Dinners.—Dinners have been supplied to expectant and nursing mothers and in exceptional cases to children since May, 1937, through the Invalid Kitchens of London and the Second Feathers Club from premises situate in Melina Road and Norland Gardens respectively. During the year 8 cases were referred to these centres by the Borough Council to whom 328 dinners were served at an approximate cost of £12 8s. 4d. Owing to lack of support, however, the premises in Melina Road were closed by the Invalid Kitchens of London in April, and the premises of the Second Feathers Club in Norland Gardens had to be closed late in the year owing to severe damage by enemy action. MATERNAL DEATHS. The number of Maternal Deaths during the past sixteen years is as follows :— Year. Number of Deaths. Number of live Births. Maternal Death Rate./###] Puerperal Sepsis. Other Accidents of Pregnancy. 1925 6 7 2,351 5.5 1026 3 4 2,188 3.2 1927 3 4 2,076 3.4 1928 5 5 2,258 4.4 1929 5 2 2,162 3.3 1930 4 5 2,173 4.1 1931 2 5 2,073 3.4 1932 3 4 1,940 3.6 1933 6 2 1,827 4.4 1934 4 5 1,783 5.0 1935 1 1 1,877 1.1 1936 1 2 1,922 1.6 1937 1 3 1,913 2.1 1938 - 2 1.874 1.1 1939 1 1 1,829 1.0 1940 - - 1,600 - 17 Infectious Diseases of Mothers and Children under Five Years of Age. Disease. No. of Cases Notified. Previous Year. No. of Cases Visited. No. of Cases Nursed. f Cases Removed to Hospital. Puerperal Fever 14 6 14 14 Puerperal Pyrexia 31 32 31 — 31 Ophthalmia Neonatorum 5 12 5 3 4 Epidemic Diarrhcea* 8 16 8 - - Measles and German Measles (under 5) 65 15 65 3 35 Whooping Cough (under 5) 15 445 15 - 5 Poliomyelitis (under 5) — 3 - - - * Summer Diarrhœa.—As this is not a notifiable disease the figures available are those of deaths which were registered as having been due to this cause. Ophthalmia Neonatorum.—The number of cases reported was five against twelve in the previous year. The analysis of the final reports received is as follows :— Cases. Vision unimpaired. Vision Impaired. Total Blindness. Removed from District. Still under Treatment. Deaths. Notified. Treated. At Home. In Hospital. 29.1.40 - 1 Yes - - - - - 29.2.40 1 - ,, - - - - - 22.3.40 - 1 ,, - - - - - 8.5.40 - 1 „ - - - - - 5.8.40 - 1 ,, - - - - - Totals 1 4 5 - - - - - 18 CHILD LIFE PROTECTION. Public Health (London) Act, 1936. At the end of the year there were 17 foster-children being cared for in the Borough, and 15 names on the list of foster-mothers. The Lady Sanitary Inspector is responsible for visiting the homes of all foster-children. During the year 36 foster-mothers were removed from the register for various reasons and 14 new foster-mothers were registered. Five applications for registration were not approved. A summary of the work carried out during the year under review follows :— FOSTER-MOTHERS. No. of Poster-Mothers on Register December 31st, 1940 ... 13 „ ,, Recommended for Registration ... 14 „ ,, removed from Register ... 36 (1) Removed from Borough 6 (2) Adopted Children - (3) Unsuitable - (4) 9 years of age 1 (5) Temporarily approved 3 (6) No further Foster-Children required 8 (7) Illness of Foster-Mothers - (8) Lack of accommodation - (9) Mother living at address - (10) Evacuated with Child 2 (11) Child evacuated 6 „ Applications for Registration received but not Recommended 5 FOSTER-CHILDREN. No. of Foster-Children on Register December 31st, 1940 ... 17 „ ,, received by Foster-Mothers ... 31 „ ,, moved from Foster-Mothers ... 42 (1) To Foster-Mothers 5 (2) To Parents or Guardians 14 (3) To Institutions 7 (4) Adopted 2 (5) Children removed from Borough with FosterMother 8 (6) Foster-Children who have reached the age of 9 years during the Year 2 (7) Evacuated 4 VISITS. No. of visits to new Foster-Mothers 19 „ Registered Foster-Mothers 302 Verification Visits 3 Special Visits 6 Outs 165 Total Visits 495 19 Sanitary Circumstances of the Borough. Inspections.—The following table shows the number of visits made in each district under the various inspection heads:— NUMBER OF INSPECTIONS MADE DURING 1940. Cause of Inspection. Inspectors. C. W. Southerby T. W. Glew W. A. Collins H. W. l'otter S. R. Daly J. Broadhead A. Hayes E. J. Nether J. C. Hopkins \V.Goddcn Miss E. M. Cross Total Infectious Diseas 4 21 79 69 35 22 96 27 - 5 646 1,004 Complaints 295 306 556 584 329 268 245 225 1 7 78 2,894 House to House - - - - - 6 - 17 - - - 23 Housing Acts 327 164 273 320 260 150 231 198 - - 1 1,924 Shops Act, 1934 - 52 102 7 53 8 12 8 - - - 242 Food (other than Restaurants and Eating Houses) Restaurants and Eating 20 294 203 62 18 25 65 91 1,344 1,963 - 4,085 Houses 1 8 46 6 - - 2 8 161 120 - 352 Markets 6 100 20 249 14 138 10 53 228 382 - 1,200 Slaughterhouses - - - - - - - - - 3 - 3 Bakehouses - 7 13 10 - 2 6 - 25 79 - 142 Milk Vendors 1 1 3 1 1 - 5 27 50 175 - 264 Ice Cream Vendors - - - - - - 1 - - 6 - 7 Factories (Mechanical) - 47 44 3 10 6 12 47 10 - 126 305 Factories (Non-mechanical) 6 4 41 3 - - 1 - - - 203 258 Outworkers 2 - 9 9 - - - - - - 222 242 Public Urinals 5 2 49 9 - - 33 5 - - - 103 Smoke Observations 1 2 5 10 - - - - - - 32 50 Drainage 129 135 234 112 79 50 78 165 - - - 1.282 Miscellaneous 3S 62 159 190 131 371 1,189 240 - 273 448 3,101 Re-visits 704 928 1.694 1,187 1.100 1,007 987 1,546 - - 82 9.235 Child Life Protection - - - - - - - - - - 495 495 Common Lodging Houses - - - 4 2 - - - - - - 6 Pharmacy and Poisons Act 8 - 10 33 17 - 10 10 - - - 88 Cancer - - - - - - - - - - 48 48 Rest Centres - - - - - - - - - - 35 35 Refugee Billets - 63 201 203 1,112 215 1.094 1,373 - - 273 4,534 Air Raid Shelters - 271 31 38 - 140 48 2 152 - - 688 Fire Watchers' Order - 155 86 72 - 42 - - - - - 355 Total 1.547 2,622 3,858 3,481 3,161 2,456 4,125 4,042 1,971 3.013 2,689 32.965 20 Notices.—The following table shows the number of Preliminary Notices served and complied with during the year:- Notices Served. Notices complied with. Infectious Diseases 18 16 Complaints 1,494 1,399 House to House - 22 Housing Act 27 48 Food (other than Restaurants) 6 5 Restaurants, &c. 2 1 Bakehouses 6 5 Milk Vendors - - Factories (Mechanical) 6 4 Factories (Non-Mechanical) 14 12 Outworkers 2 2 Public Urinals 2 - Smoke Observations - - Drainage 17 29 Miscellaneous 27 6 Re-visits 514 663 Common Lodging Houses ... 4 12 Child Life Protection 1 1 Shops Act. 1934 23 3 Women's Hostels - - Poultry, Slaughterhouse - - Total 2,163 2,228 During the year 603 Statutory Notices were served and 497 complied with. SUMMONSES—YEAR 1940. The following table shows the number of proceedings instituted during the year:— Public Health (London) Act, 1986 45 Food and Drugs (Adulteration) Act, 1928 1 London County Council (General Powers) Act, 1987 2 Housing Act, 1986 12 London County Council Drainage Bye-laws 3 Food and Drugs Act, 1938 5 21 1.—INSPECTION OF FACTORIES. Premises Number of Inspections. Written Notices. Occupiers Prosecuted. Factories (with Mechanical Power) 305 6 - Factories (without Mechanical Power) 258 14 - Other Premises - - - Total 563 20 - 2.—DEFECTS FOUND IN FACTORIES, Etc. Particulars Number of Defects Number of Prosecutions Found Remedied Referred to H.M. Inspector Want of Cleanliness 4 4 - - Unreasonable Temperatures 3 3 - - Inadequate Ventilation - - - - Overcrowding - - - - Ineffective Drainage of Floors - - - - Sanitary Conveniences insufficient - - - - unsuitable or defective 11 7 - - not separate for sexes - - - - Offences under the Factory and Workshops Act Illegal occupation of underground bakehouse - - - - Other Offences (excluding offences relating to out-work which are included in Part 3 of this report) - - - - Total 18 14 - - 22 3.—OTHER MATTERS RELATING TO FACTORIES. Class. Number. Matters notified to H.M. Inspector of Factories— Failure to affix Abstract of the Factory Act 1937 (Sec. 2) - Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory Act, 1937 'Notified by H.M. Inspector - Reports of action taken sent to H.M. Inspector - Other - Underground bakehouses (Sec. 54)— - Certificates granted during year - In use at the end of the year 18 NEWLY ERECTED HOUSES AND FLATS— WATER SUPPLY. Number of certificates granted during the year 801 INCREASE OF RENT AND MORTGAGE RESTRICTIONS ACT, 1920 33. During the year 42 applications were received for certificates under the above Act, and in 39 cases certificates were granted. EXHUMATION AND RE-INTERMENT OF BODIES. During the year three Licences were granted by the Secretary of State for the exhumation and removal of bodies from graves in St. Mary's Catholic Cemetery, Harrow Road. 23 PUBLIC MORTUARY, AND CIVILIAN WAR DEATHS MORTUARY. Eight hundred and fifty-eight bodies were admitted to the Public Mortuary and Civilian War Deaths Mortuary during the year Hammersmith Public Mortuary :— Admitted by order of Coroner 279 Admitted by order of Police 8 Admitted on application of undertakers for accommodation 48 War operations 72 407 Civilian War Deaths Mortuary :— War operations 171 171 Bodies admitted from other Boroughs :— Fulham 93 Chelsea 187 280 No. of P.-M. examinations conducted :— Hammersmith cases 281 Fulham cases 80 Chelsea cases 165 Total P.-Ms. - 532 No. of Inquests held :— Hammersmith cases 103 Fulham cases 41 Chelsea cases 104 Total Inquests held - 248 24 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Infectious Diseases.—There were, omitting tuberculosis, 461 cases reported as due to notifiable infectious diseases in the Borough, against 880 in the previous year. There were also reported 64 cases of infectious diseases that were not notifiable, against 576 in the previous year: 15 of these were *Measles, 3 *Whooping Cough and 46 Chickenpox. The number of cases of Tuberculosis notified was 167 against 198 in the previous year. *Totals (incl. notifiable cases—Measles 172 and Whooping Cough 18) noted in Department. BACTERIOLOGY The following bacteriological examinations were made on behalf of the Council:— Material from cases of suspected Diphtheria— Positive results 7 Negative results 276 Sputa from cases of suspected Tuberculosis— Tubercle bacillus found 18 Tubercle bacillus not found 234 Blood from cases of suspected Fever— Widal or Typhoid reaction obtained Nil Widal or Typhoid reaction not obtained Nil Faeces 3 Other 1 Grand Total 539 25 Cases of Infectious Disease notified during the year 1940. Notifiable Disease Number of Cases Notified. Wards. Total Removed to Hospital. At all Ages. Under 1 1— 2— 3- Age Periods. 1 2 3 4 5 6 7 4- 5— 10— 15— 20- 35— 45— 65- Smallpox - - - - - - - - - - - - - - - - - - - - - Cholera, Plague - - - - - - - - - - - - - - - - - - - - - Diphtheria (including Membranous Croup) 43 - 1 6 3 12 11 - 4 5 1 - - 4 9 3 1 8 16 2 43 Erysipelas 26 2 - - - - - - 2 4 1 10 7 2 4 4 2 7 5 21 Scarlet Fever 71 - 4 6 8 4 23 8 8 9 1 - - 4 6 8 1 12 31 9 68 Typhus Fever - - - - - - - - - - - - - - - - - - - - - Enteric Fever 9 1 - 1 - 1 1 - 1 3 - 1 - - 1 - - - 7 1 9 Relapsing Fever, Continued Fever - - - - - - - - - - - - - - - - - - - - - Puerperal Fever 14 - - - - - - - 1 9 4 - - 1 2 2 1 2 5 1 14 Puerperal Pyrexia 31 - - - - - - - - 25 6 - - 2 5 5 3 7 7 2 31 Cerebro-spinal Meningitis 33 5 1 1 3 1 - 1 4 10 - 6 1 3 3 8 5 4 8 2 32 Polio-myelitis 1 - - - - - 1 - - - - - - - - - - 1 - - 1 Encephalitis Lethargica - - - - - - - - - - - - - - - - - - - - - Ophthalmia Neonatorum 5 5 - - - - - - - - - - - - 1 - - 3 1 - 4 Anthrax - - - - - - - - - - - - - - - - - - - - - Pneumonia 48 - 3 1 3 - 1 - 2 11 7 15 5 9 7 5 2 8 11 6 20 Malaria 1 - - - - - - - - 1 - - - - 1 - - - - - 1 Dysentery 9 1 - - - - - - - - - - - - - - - - - - 2 Food Poisoning 5 - 1 2 - - - - - 1 1 - - - 2 - — 1 2 — 4 Measles 157 14 23 11 8 7 21 8 21 35 6 2 1 12 27 37 7 26 43 5 84 Whooping Cough 15 2 3 3 2 2 3 — — — — — — 2 3 2 1 — 7 — 8 Totals 461 30 36 31 27 27 61 17 43 114 27 34 14 40 71 74 24 74 145 33 342 26 Deaths from the Seven Principal Zymotic Diseases.— The total number of deaths of residents registered from the seven principal zymotic diseases was 48 against 24 in the previous year. The deaths of residents from these diseases were equal to 27 per 1,000 of the total deaths of residents registered and were at the rate of 0.3 deaths per 1,000 persons living. The following table shows the deaths of residents registered from the seven principal zymotic diseases which occurred in the ten years, 1931 to 1940 :— Year. Smallpox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Enteric Fever. Diarrhoea and Cholera. Total. 1931 0 0 2 6 7 0 23 38 1932 0 29 4 8 6 1 26 74 1933 0 3 4 *4 5 1 27 54 1934 0 25 4 25 19 0 27 100 1935 0 0 3 12 7 1 28 49 1936 0 15 3 5 7 2 25 57 1937 0 0 1 12 9 2 29 53 1938 0 5 0 5 4 0 36 62 1939 1940 0 0 0 1 0 0 4 3 3 0 0 0 17 44 24 48 Average last 10 yrs. 0 8 2 9 7 1 28 56 Notifiable Diseases (other than Tuberculosis) during the Year 1940. DISEASE. Total cases notified. Cases admitted to Hospital. Total deaths. Diphtheria 43 43 3 Erysipelas 26 21 — Scarlet Fever 71 68 — Enteric Fever 9 9 — Puerperal Fever 14 14 _ Puerperal Pyrexia 31 31 - Cerebro-Spinal Meningitis 33 32 9 Encephalitis Lethargica — — 1 Ophthalmia Neonatorum 5 4 — Pneumonia 48 20 116 Dysentery 2 2 — Poliomyelitis 1 1 1 Malaria 1 1 — Food Poisoning 5 4 — *Measles 157 84 1 *Whooping Cough 15 8 0 Totals 461 342 131 *This is not total brought to notice of Department. 27 DIPHTHERIA IMMUNISATION. During 1940 the number of children who were immunised decreased considerably, but this was mainly due to the fact that during the early part of the year, owing to war conditions and the evacuation of children from the Borough, Immunisation Clinics were not held. Towards the end of November, however, a big drive was commenced to immunise all children remaining in the Borough. Letters were sent to parents of 250 children sleeping in air raid shelters, and the School Medical Officers of the London County Council used propaganda to persuade the parents of children still in Hammersmith Schools to have them immunised. From the following table it can be seen that before the end of 1940 111 children had received their first immunising inoculation. It is satisfactory to note that the number of children who are being immunised at the Council's Welfare Centres is steadily increasing, and although the percentage of PostSchick Tests made is low, this is entirely due to the large number of children who were evacuated. The following are the particulars of the work carried out under the immunisation scheme during the year:— Number of children immunised at the Council's Welfare Centres 106 Number of children immunised privately or in hospitals, &c. 104 Number of children who attended for first inoculation at the Council's Welfare Centres 104 Number of children who received first inoculation privately 7 Number of attendances at Welfare Centres 459 Number of Pre-Schick Tests—positive result 8 Number of Pre-Schick Tests—negative result 8 Number of Post-Schick Tests—positive result 2 Number of Post-Schick Tests—negative result 60 Fees paid to Medical Practitioners :— 1 at l1s. 6d £0-11 6 7 at 7s. 6d 2 12 6 77 at 5s. Od. 19 5 0 8 at 2s. 6d 0 7 6 £22 16 6 28 The Chart hereunder shows the number of cases of Diphtheria notified week by week during the year. 29 The Chart hereunder shows the number of cases of Scarlet Fever notified week by week during the year. TABULAR STATEMENT—ZYMOTIC DISEASES. The following table shows the number of cases that were reported as due to the undermentioned diseases during the years 1931 to 1940. Year. Smallpox. Scarlet Fever. Diphtheria or Diphtheritic Croup. Typhus Fever. Enteric Fever. Simple Continued Fever. Relapsing Fever. Puerperal Fever. Puerperal Pyrexia, d Cholera. Erysipelas. Plague. Chickenpox. a Measles, b Whooping Cough, b Cerebro-Spinal Fever. Anthrax. Glanders. Hydrophobia. Ophthalmia Neonatorum. Acute Polio-Myelitis. Encephalitis Lethargica. Pneumonia, e Malaria, c Dysentery, c Trench Fever, e Food Poisoning. / Total. 1931 21 280 228 0 1 0 0 5 30 0 48 0 707 178 264 9 0 0 0 13 0 2 141 0 2 0 0 1957 1932 49 594 192 0 4 0 0 2 29 0 51 0 405 1588 330 8 0 0 0 19 1 1 178 0 1 0 2 3405 1933 0 895 241 0 8 0 0 9 33 0 97 0 333 299 319 6 0 0 0 10 4 1 179 0 3 0 8 2445 1934 0 609 519 0 1 0 0 2 22 0 79 0 422 1334 272 6 0 0 0 11 1 1 154 0 0 0 4 3467 1935 0 349 333 0 5 0 0 2 19 0 50 0 435 45 312 2 0 0 0 11 2 2 88 0 14 0 9 1678 1931 0 335 130 0 13 0 0 9 21 0 38 0 293 1372 234 6 0 0 0 4 2 0 83 0 14 0 1 2557 1937 0 332 179 0 1 0 0 9 37 0 51 0 353 81 314 5 0 0 0 14 2 0 89 2 26 0 2 1495 1938 0 291 189 0 2 0 0 11 16 0 54 0 429 1859 166 8 0 0 0 7 5 1 115 0 23 0 5 3181 1939 0 125 104 0 I 0 0 6 32 0 33 0 188 33 736 4 0 0 0 12 4 0 96 0 29 0 3 1406 1940 0 71 43 0 9 0 0 14 31 0 26 0 46 172 18 33 0 0 0 5 1 0 48 1 2 0 5 525 A verage for 10 years 7 388 219 0 4 0 0 Li 7 27 0 53 0 361 696 296 9 0 0 0 11 2 1 117 0 11 0 4 2211 a Not Notifiable. b Notifiable from 1st October, 1938. c Notifiable from 1st March, 1919. d Notifiable from 1st October. 1926. e Notifiable from 1st March, 1919, to 31/12/1927. f Notifiable from 12th July, 1932. 30 31 DISINFECTION. The following table shows the amount of disinfection carried out by your Council during the year; all bedding and articles of clothing, &c., being removed to the Council's Disinfecting Station. Beds 129 Mattresses 391 Pillows 1,856 Bolsters 392 Blankets. 2,578 Sheets 848 Quilts 585 Articles of Clothing 2,684 Sundries 578 Carpets 5 Curtains 29 Total 10,075 Rooms (Infectious Disease, &c.) 459 Verminous Rooms 34 A.R.P. Visits for Disinfection 19 512 32 CLEANSING OF VERMINOUS PERSONS. The Medicinal Baths in Scotts Road, Shepherd's Bush, provide for the treatment of cases of Scabies, Impetigo and the cleansing of verminous persons, &c. I append figures showing the numbers dealt with during the year. School Children—Hammersmith. Scabies 543† Verminous 1,277* Impetigo 116 Minor Ailments 18 School Children—Non-Hammersmith. Nil. Children under Five Years—Hammersmith. Scabies 187 Verminous 23 Impetigo 5 Children under Five Years—Non-Hammersmith. Scabies 4 Adults—Hammersmith. Scabies 465 Verminous 205 Impetigo 2 Other Conditions 1 Adults—Non-Hammersmith. Scabies 2 Common Lodging-houses. Scabies 80 Verminous 6 Gibraltar Refugees. Verminous Children under 5 years 5 Verminous Adults 1 †ncludes 1 Belgian refugee and 88 evacuees. ♦Includes 16 evacuees. VACCINATION. The duties under the Vaccination Acts and the Vaccination Order were carried out by the Public Health Department. The Return for 1939 shows that 1,063 Infants were vaccinated, this being 61.3 per cent, of the Births and compared with 66.2 per cent, in 1938. No proceedings under the Vaccination Acts were instituted. VACCINATION RETURNS. RETURN FOR 1939. Registration Sub-Districts comprised in the Vaccination Officers' District Number of Births returned in the " Birth List Sheets " as registered from 1st January to 31st Deo., 1939 Number of these Births duly entered by 31st January, 1941, in Columns I, II, IV and V of the " Vaccination Register " (Birth List Sheets), viz. : Number of these Births which on 31st January, 1941, remained unentered in the " Vaccination Register " on account (as shown by Report Book) of Number of these Births remaining on 31st January, 1941, neither duly entered in the "Vaccination Register" (columns 3, 4, 5, 6 and 7 of this Return) nor temporarily accounted for in the "Report Book" (columns 8, 9 and 10 of this Return Number of Certificates of Successful Primary Vaccination of children under 14 years received during the calendar year 1940 Number of s tatutory Declarations of Conscientious Objection actually received by the Vaccination Officer irrespective of the dates of birth of the children to which they relate during the calendar year 1940 Col. 1 Successfully Vaccinated Col. II Col IV. Number in respect of whom Certificates of Conscientious Objection have been received Col. V Dead, l'n vacina ted Postpone ment by Medical Certificate Removal to Districts, the Vaccination Officer of which has been duly apprised Removal to Places unknown or which cannot be reached; and Cases not having been found Insusceptible of Vaccination Had SmallPox 1 2 3 4 5 6 7 8 9 10 11 12 13 1. North Hammersmith. 351 149 — - 102 12 5 15 60 8 792 386 2. Hammersmith Hospital 1,707 789 — — 364 59 5 344 40 106 3. South Hammersmith 111 47 — 24 1 — 6 26 7 4. Queen Charlotte's Hospital 45 18 - - 13 2 - 12 - - 5. Removed into Borough 126 60 1 - 12 3 8 - 44 6 2,340 1,063 1 — 515 77 18 377 170 12 792 386 38 00 tffc. Table showing Work of Vaccination Officer from 1st January to 31st December, 1940. No. of Vaccinal ion Certificates received from— No. of Insusceptibility Certificates. Total No. of Certificates. No. of Declarations of Conscientious Objection. No. of Postponement Certificates. No. of Cases Removed Inwards. No. of Cases Removed Outwards. No. of " q " Notices Sent. No. of " K " Notices Served. No. of Children Died Unvaccinated. No. of Cases Removed and not Traced. Nos. entered on 'H " Lists to Public Vaccinators. District No. 1. District No. 2. District No. 3. District No. 4. District No. 5. Other Doctors. | District No. 1. 1 District No. 2 District No. 3. District No. 4. District No. 5. Total North 34 16 45 2 23 — 120 95 13 — 27 224 25 9 10 98 29 79 8 214 South 41 38 — — 20 — 99 52 6 — 9 153 19 7 4 68 71 1 — 140 Hammersmith Hospital 132 103 80 4 152 3 474 223 22 — 232 644 63 28 105 233 163 119 3 518 Queen Charlotte's Hospital — — 20 — 4 _ 24 3 — — 186 — — — — — — — — — Removed Inwards 38 29 — - 10 1 78 13 11 121 78 28 — 98 65 51 28 2 146 Total 245 186 145 6 209 4 795 380 52 121 454 1099 135 44 217 464 314 227 13 1018 Total number of births registered during 1940 -1.733. 35 TUBERCULOSIS. Tuberculosis.—One hundred and sixty-seven cases of Tuberculosis were reported during the year, one hundred and forty-three of which were Pulmonary and twenty-four being other forms of Tuberculosis, against one hundred and ninety-eight cases in the previous year. PART 1. Summary of Notifications during the period from the 1st January, 1940, to the 31st December, 1940. Age Periods Formal Notifications Number of Primary Notifications of new cases of Tuberculosis 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total (all pages) Pulmonary Males — — 1 — 9 14 20 12 15 8 2 81 Pulmonary Females — — — 14 20 14 4 7 2 1 62 Non-Pulmonary Males — 1 — — 1 1 4 — 1 2 1 11 Non-Pulmonary Females — 1 2 1 1 3 3 2 1 — — 13 PART 11. Supplemental Return. New cases of Tuberculosis coming to the knowledge ol' the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification. Age Periods 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total Pulmonary Males 1 1 1 1 — 5 8 6 7 4 2 36 Pulmonary Females — — — 1 — 4 8 2 3 1 1 20 Non-Pulmonary Males — 1 2 1 — — — 2 3 — — 9 Non-Pulmonary Females — — — 1 3 1 2 1 — — — 8 36 The following table has been prepared, giving particulars of new cases of tuberculosis and of deaths from tuberculosis during 1940 :— Age Periods New Cases. Deaths. Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0- 1 - - - - - 1 — 1- ] —' 1 1 — — — 5- 3 1 3 3 - - 1 - 15- 28 38 >> 8 31 23 — 3 25- 28 22 4 5 35- 18 0 3 45- 22 10 4 1 35 5 3 1 55- 12 3 2 — 65 and on 4 2 1 — 9 1 3 1 Total 82 20 21 70 29 8 5 The ratio ot non-notihed tuberculosis deaths to the total tuberculosis deaths is 1 to 7. The following table indicates the reduction in the number of cases and deaths from Tuberculosis and the efforts made throughout the country are clearly reflected thereby:— Year. No. of Cases notified. No. of Cases on Dispensary Register. No. of Cases on Register of Notifications. Pulmonary. NonPulmonarv. Total. No. of Deaths. 1921 260 51 311 173 - - 1922 246 49 295 162 — — 1923 211 63 274 145 — — 1924 200 56 256 170 — 1,426 1925 220 45 265 138 — 1,280 1926 210 68 278 142 824 1,302 1927 226 53 279 182 686 1,289 1928 205 56 261 136 744 1,308 1929 217 63 280 149 818 1,334 1930 196 54 250 153 803 1,293 1931 183 56 239 127 905 1,198 1932 183 45 228 156 763 1,128 1933 185 31 216 150 749 1,056 1934 184 31 215 124 715 1,070 1935 170 31 201 119 759 1,059 1936 156 40 196 116 805 1,063 1937 141 33 174 106 834 1,068 1938 155 37 192 87 824 859 1939 165 33 198 107 887 889 1940 143 24 167 118 791 813 37 One hundred and five deaths from Pulmonary Tuberculosis were registered, against ninety-eight in the previous year, representing a deatli-rate of 1.1 per 1.000 compared with 0.8 in 1939. I append figures for the years 1925-40, showing the interval between notification and death of tuberculous persons. 1925. 1926. 1927. 1928. 1929. 1930. 1931. 1932. 1933. 1934. 1935. 1930. 1937. L938. 1939. L940. 1. Total number of deaths from Tuberculosis in the Borough 138 142 181 135 149 153 127 150 150 124 119 110 100 87 107 118 2. The number of cases notified at death 13 8 - 7 3 7 2 0 13 5 11 0 8 8 5 9 3. The number of cases notified within one month of death (e x c 1 u ding above) 18 30 25 17 32 18 10 21 17 21 11 20 10 13 12 11 4. The number of cases notified within three m o n t h s o f death (excluding above) 13 20 23 13 18 21 14 17 17 9 8 7 11 6 3 10 5. The number of cases notified within six months of death (excluding above) 18 12 18 9 8 9 14 15 10 11 11 7 8 5 5 11 Average number of cases notified for the 10 years 1921-1930 (inclusive) = 275. Average number of cases notified for the 10 years 1981-1940 (inclusive) = 203. Average number of deaths for the 10 years 1921-1980 (inclusive) = 155. Average number of deaths for the 10 years 1981-1940 (inclusive) = 121. 38 FOOD SUPPLIES. Unsound Food. No seizure of unsound food was made during the year. The following is a list of unsound food voluntarily surrendered during the year:— Beef and Beef Offal, 12 cwt. 1 qtr. 11 lb. Pork and Pork Offal, 3 tons 5 cwt. 1 qtr. 14 lb. Sheep, Lamb and Offal, 2 cwt. 3 qtr.-). Fish, 3 cwt. 3 qtrs. 14 lb. Bacon, 4 cwt. 27 lb. Tinned Ham, 1 cwt. 1 qtr. 8 lb. Mushrooms, 15J lb. Apples, 3 cwt. 3 qtrs. 14 lb. Eggs, 120. Milk, 75 gallons. Tinned Fruit, Fish and Vegetables, 76 tins. Blackcurrant Pulp, 4 tons 12 cwt. Dates, 1 ton 1 qtr. 14 lb. Sultanas, 12 cwt. 3 qtrs. 12 lb. Dried Egg Yolk. 14 cwt. 2 qtrs. 4 lb. Danish Cheeses, 15. In addition the stocks of 48 foodshops in the Borough damaged as a result of enemy action were inspected and foodstuffs found to be contaminated by splintered glass, fire and water included the following:—meat, butter, margarine, lard, flour, cereals, pickles, sauce, bread, pastries, biscuits, cooked meat, bacon, sugar, tea, coffee, cocoa, sweetmeats, fish, tinned foods, fruit and vegetables. A large proportion of the foodstuffs unfit for human consumption were salvaged for use as animal and chicken food. Sugar, butter, margarine and flour were sold to firms approved by the Ministry of Food for refining and processing. FOOD AND DRUGS (ADULTERATION) ACT, 1928. 840 samples of various foods and drugs were submitted to the Public Analyst during the year by the Council's Sampling Officers for analysis; 64 were found to be inferior and 9 were adulterated. Legal proceedings were taken in respect of 1 of the adulterated samples, and penalties and costs amounting to 1 10s. 6d. were imposed. PHOSPHATASE TEST. 20 samples of milk sold under the special designation "Pasteurised" were submitted to the phosphatase test during the year. The results of these examinations showed that in 16 cases the pasteurising process had been properly carried out and that 4 samples had been incorrectly pasteurised or had become admixed with raw milk.