HAM 35 3 Public Health Department, Town Hall, Hammersmith, W.6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Mr. Mayor, Ladies and Gentlemen,—I submit herewith a report upon the health of the Borough and the work of the Public Health Department during 1943. In accordance with instructions of the Ministry of Health the report is in abridged form and consists for the most part of a series of tables and statistics dealing with the vital services. Generally speaking the health of the Borough has remained satisfactory despite the continuance of war-time conditions. The death rate for the year was 14.1 as compared with 14.0 in the previous year and the birth rate 19.2 as compared with 17.8 in 1942. This birth rate is the highest recorded for the Borough since 1923. Compared with the previous year there were 69 less cases of infectious diseases reported, although the number of cases of scarlet fever notified increased from 282 to 410. Cases of diphtheria were 7 fewer at 53. No deaths were recorded from either of these diseases. Objectors to diphtheria immunisation would do well to ponder the following simple record of facts. In 1934 the number of cases of diphtheria notified was 549 and there were 25 deaths from the disease. In 1935 the immunisation scheme was started in the Borough. In 1939 104 cases were notified and four of the children died. In the year under review 53 cases were notified, none of which proved fatal. Cases of measles and whooping cough decreased by 64 and 150 respectively. 201 cases of tuberculosis were notified and 72 deaths from that disease occurred during 4 the year as compared with 200 and 104 during the preceding twelve months. The work of the Infant Welfare centres continued throughout the year on a peace-time basis and additional ante-natal clinics had to be started to cope with the large numbers of women attending. The total attendances at Infant Welfare clinics was 6,952 more than during the previous year and attendances at the ante-natal clinics increased by 1,416 over 1942. The Infant Mortality rate and the Maternal Mortality rate for the year were slightly lower at 58 and 1.6 respectively. The work of the sanitary inspectors was continued throughout the year under very difficult conditions. Scarcity of labour and materials was acute; nevertheless, on the whole, satisfactory results were obtained. I should like to record my appreciation of the support and co-operation I have received from the members of the staff of the department. In addition to their normal duties most of them have been called upon to undertake Civil Defence duties after hours and at week-ends. This they have done ungrudgingly. I should like also to express my thanks to the Chairman and Members of the Public Health Committee and the Maternity and Child Welfare Committee for their support and encouragement throughout the year. T am, Your Worship. Ladies and Gentlemen, Your obedient Servant, W. H. BRODIE, Medical Officer of Health. 5 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. General Statistics, 1943. Area 2,282.5 acres Population (1943) (estimated) 92,050 Population Census (1901) 112,239 (1911) 121,521 (1921) 130,295 (1931) 135,521 Natural increase, i.e., excess of births over deaths 468 Density of population 40.3 persons per acre Marriages registered 936 Rateable value (April, 1943) £l,221.085 Sum represented by a penny rate (April, 1943) £4,620 Vital Statistics. Births (legitimate) 1.599 Birth rate 19.2 ,, (illegitimate) 169 Rate per 1.000 (live and still births) 23 Stillbirths 42 Deaths (corrected) 1,300 Death rate 14.1 Deaths from puerperal causes Deaths. Rate per 1,000 total (live and still) births. Puerperal sepsis 2 1.10 Other puerperal causes 1 0.55 Total 3 1.65 6 Deaths of infants under one year of age per 1,000 births 58 ,, from cancer (all ages) '206 ,, ,, measles ,, 2 ,, whooping cough (all ages) 9 diarrhœa (under 2 years of age) 37 Cancer.—There were 206 deaths from Cancer, and of this number, 190 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 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 — 20 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 1941 181 M 96 — 1 2 45 48 F 85 — — 9 33 43 1942 204 M 111 — — 7 5 53 F 93 1 — 3 37 52 1943 206 M 85 1 — 4 29 51 F 121 — — 11 48 62 Statistics.—The following table gives the statistics of the Borough during 1943 and previous years:— Vital Statistics of Whole District during 1943 and Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths ltegistered in the District. Transferable Deaths Nett Deaths belonging to tlie 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. Number. Rate per 1.000 Nett Birth-. Number. Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1925 134500 2178 2351 17.5 1034 7.7 186 756 153 65 1604 11.9 1926 134400 2001 2188 16.3 1174 8.7 195 556 144 66 1535 11.4 1927 132800 1789 2076 15.6 1581 11.9 230 377 126 61 1728 13.0 1928 13G300 1938 2258 16.6 1449 10.6 222 326 156 69 1553 11.4 1929 136900 1869 2162 15.8 1757 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 133710 1795 1940 14.5 1465 10.9 294 513 129 66 1714 12.8 1933 131400 1682 1827 13.9 1500 11.1 340 530 119 65 1690 12.9 1931 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 10.9 441 639 116 60 1597 12.5 1937 l26500 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 17.0 370 401 76 51 1756 17.9 1941 84880 2480 1405 16.5 1315 15.4 351 364 52 41 1328 15.6 1942 89370 2735 1589 17.8 1270 14.2 356 338 94 59 1252 14.0 1943 92050 3941 1768 19.2 1278 13.9 365 387 102 58 1300 14.1 * B = Birth Rate Population Figure. D = Death ,, ,, ,, 7 8 Causes of, and Ages at, Death during the Year 1943. 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 — — — — — — 2 F — 1 — — 1 — 3. Scarlet Fever M — — — — — — — F — — — — — — — 4. Whooping Cough M 5 3 — — — — 8 F 1 1 5. Diphtheria M — — — — — — — F — — — — — — — 6. Tuberculosis of Respiratory System M — 1 — 18 19 5 43 F — — 1 13 2 1 17 7. Other forms of Tuberculosis M — 2 2 3 — — 7 F — — — 4 — 1 5 8. Syphilitic Diseases M 1 — — 8 3 12 F — — — — 2 2 4 9. Influenza M 1 — — 2 1 8 12 F — — — — 1 7 8 10. Measles M — — — — — — — F 2 — — — — — 2 11. Ac. Polio-myelitis and Polioencephalitis M — — — — — — — F — — — — — — — 12. Ac. Inf. Encephalitis M — — — — — — — F — — — — — — — 13. Cancer of Buc. Cav. and Oesoph. (M), Uterus (F) M — — — — 2 9 11 F — — — 2 4 4 10 14. Cancer of Stomach and Duodenum M — — — 2 5 6 13 F — — — 2 5 14 21 15. Cancer of Breast M — — — — — 1 1 F — — — 3 16 13 32 16. Cancer of all other sites M 1 — — 2 22 35 60 F — — — 4 28 31 58 17. Diabetes M — — — — — 1 1 F — — — 1 4 8 13 18. Intra-cranial Vascular Lesions M — 1 — — 15 25 41 F — — — — 18 44 62 19. Heart Disease M — — — 4 29 102 135 F — — — 7 21 126 154 20. Other Diseases of Circ. System M — — — — 6 15 21 F — — — — 6 22 28 21. Bronchitis M 2 — 1 3 21 37 64 F 1 — 1 2 6 25 35 22. Pneumonia M 7 1 — 2 11 25 46 F 6 2 — 6 11 21 46 23. Other Respiratory Diseases M — — — 3 5 7 15 F — — — — 1 4 5 24. Ulcer of Stomach or Duodenum M — — — 2 8 1 11 F — — — 1 — 1 2 25. Diarrhoea under 2 years M 21 1 — — — — 22 F 14 1 — — — — 15 26. Appendicitis M — 1 2 2 — 3 8 F — — — 2 — 1 3 27. Other Digestive Diseases M 1 2 — 2 7 5 17 F — — — 3 3 9 15 28. Nephritis M — — — 2 2 4 8 F — — — 1 1 7 9 29. Puerperal and Post-abortive Sepsis M — — — — — — 2 F — — — 2 — — 30. Other Maternal causes M — — — — — — — F — — — 1 — — 1 31. Premature Birth M 9 — — — — 9 F 8 — — — — — 8 32. Con. Mal. Birth Injuries Infant Dis. M 5 — — — — 5 F 9 — — — — — 9 33. Suicide M — — — 2 4 2 8 F — — — — — 34. Road Traffic Accidents M — — 2 2 1 1 6 F — — — 1 1 35. Other violent causes M — — 3 5 7 5 20 F 2 — 1 1 4 7 15 36. All other causes M 2 — 2 6 13 33 56 F 4 1 1 9 17 25 57 Totals of all causes M 55 12 12 62 186 333 660 F 47 5 4 64 146 374 640 102 17 16 126 332 707 1,300 9 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 1918 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† 1941 1405 52 41‡ 1942 1589 94 59 1943 1768 102 58 * Rate calculated on a birth figure supplied by the Registrar-General of 1,781. † Rate calculated on a birth figure supplied by the Registrar-General of 1,501. ‡ Rate calculated on a birth figure supplied by the Registrar-General of 1,253. 10 The following table shows the deaths of infants under one year of age and the cause:— INFANT MORTALITY, 1943. Infantile Mortality during the year 1943. 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 — — — — — — — 1 1 2 Scarlet Fever — — — — — — — — — — Whooping Cough — — — — — 1 2 2 1 6 Diphtheria and Croup — — — — — — — — — — Influenza — — — — — 1 — — — 1 Erysipelas — — — — — — — — — — Tuberculous Meningitis — — — — — — — — — — Abdominal Tuberculosis — — — — — — — — — — Other Tuberculous Diseases — — — — — — — — — — Meningitis (not T.B.) — — — — — — — — — — Laryngitis — — — — — — — — — — Bronchitis — — — — — 2 1 — — 3 Other Respiratory diseases — — — — — — — — — — Pneumonia (all forms) — — 1 1 2 1 5 4 1 13 infective Gastro-Enteritis — — 1 — 1 12 12 7 3 35 Other Digestive diseases — — — — — — — — — — Syphilis — — — — — — — — — — Rickets — — — — — — — — — — Suffocation, Overlying — — — — — — — — — — Injury at Birth and genital Malformations. 3 1 1 2 7 1 — — — 8 Atelectasis 5 1 — — 6 — — — — 6 Premature Births 14 — 2 1 17 — — — — 17 Otitis Media — — — — — — 1 1 — . 2 Violence — — — — — — — — — — Icterus Neonatorum 1 — — — 1 — — — — 1 Haemorrhage of the Newborn 1 — — — 1 — — — — 1 War Operations — — — — — — — — — — Other causes — — — — — 2 3 1 1 7 Totals 24 2 5 4 35 20 24 10 7 102 Nett Births in the Year: Legitimate, 1,599; Illegitimate, 169. Nett Deaths in the Year: Legitimate Infants, 92; Illegitimate Infants, 10. 11 1*2 Visits paid by Health Visitors are enumerated in detail below:— District. No. 1 No. 2 No. 3 No. 4 No. 5 No. 6 No. 7 No. 8 No. 9 No. 10 Total Visits. First visits 149 126 147 216 143 202 95 82 170 222 1,552 Subsequent Visits. Under 1 year 737 701 499 471 587 594 649 392 408 597 5,635 1-5 Years 734 514 450 311 755 791 450 759 641 405 5,810 Outs 581 228 490 717 508 646 451 355 395 593 4,964 Removals 53 43 106 30 70 117 18 15 16 79 547 Other Visits. Infant Deaths 7 7 5 8 6 16 — 5 8 7 69 Stillbirths 5 1 5 4 2 6 2 2 1 5 36 Ophthalmia Neonatorum 3 7 — — 5 2 3 1 1 6 28 Puerperal Fever 1 — — 2 2 1 1 — 2 6 1! Puerperal Pyrexia 1 2 — 1 1 3 — 1 2 11 Epidemic Diarrhœa 7 16 10 13 4 16 5 9 9 13 102 Encephalitis Lethargica — — — — — — — — — — Polio-Myelitis — — 1 — 1 — — — — — 2 Measles 6 — — — — 5 — 4 — — 15 Diphtheria — — — — — — — — — — Cerebro-Spinal Fever — — — — — — — — — — — Pneumonia — — — — — — — 2 — — 2 Chickenpox — — — — — — — — — — — Whooping Cough — — — — — — — — — — — Scabies — — — — — — — — — — — Child Life Protection 9 35 58 30 42 44 9 2 56 13 298 Diphtheria Immunisation 1 — — — — — — 7 10 7 25 Home Helps 6 8 — — — 25 2 6 15 17 79 Evacuation Scheme — — — — — — — — — — — Convalescent — — — — — 2 — — 1 — 3 Free Milk — — — — — — — — — — — Special 9 5 — 53 12 18 — — 2 10 109 Rest Centres — — — — — — — — — Tuberculosis 162 250 107 — 239 184 271 248 339 155 1,955 Adoption 1 2 32 — — 1 — — 1 — 37 Ante-natal. First Visits 78 130 23 72 82 67 63 59 99 25 698 Subsequent Visits 72 75 110 30 69 118 7 98 72 66 717 Total Visits 2,622 2,150 2,043 1,958 2,528 2,858 2,026 2,016 2,250 2,228 22,709 Attendances at Infant Welfare Centres 156 154 113 150 95 107 84 92 100 99 1,150 Attendances at Antenatal Clinics 69 56 51 75 84 120 59 61 68 101 744 Attendances at Tuberculosis Clinics 5 13 7 8 20 8 17 23 11 112 Attendances at Diphtheria Immunisation Clinics 59 49 — 1 3 4 — 3 4 5 128 Number of insanitary conditions reported 7 10 — 5 12 21 2 — 1 11 69 13 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 1 y r. Antenatal. Postnatal. Under 1 yr. Over 1 yr. 48, Glenthorne Rd. 106 326 12 — — 1,702 12 — — 156 — — 328 27 — — 4.990 2,025 Becklow Gardens 200 579 8 — — 3,104 21 — — 258 — — 563 126 — — 9,269 3,777 Milson Road 74 309 — — — 1,460 17 — — 156 — — 290 86 — — 4,351 2,103 Old Oak, West way 104 306 25 — — 1.94!) 20 — — 153 — — 239 46 — — 5,551 2,131 Latymer Road 52 131 — — — 799 2 — — 52 — 101 9 — — 1,249 50P College Park 53 — — 30 8 — — 764 112 Totals 1,364 1,651 45 1,551 302 9,014 72 26,174 10,957 Ante-natal Clinics, Number of Sessions held 536 Infant Consultations, ,, ,, ,, 828 1.364 The average attendance at Infant Welfare Centres = 45. During the year 205 cases received massage treatment, the total number of treatments being 1.816. Milk for Expectant Mothers and Children.—During the year the scheme bv which the Council provide free one pint of milk a day for all expectant mothers and children under five where the family income does not exceed 10s. Od. more than the scale of the Ministry of Food entitling them to free milk was continued. 33.488 quarts of liquid milk and 9,823 packets of dried milk were supplied under the scheme during the year. 14 Dinners.—Free dinners have been supplied by the Council to expectant mothers and children under five recommended by the Assistant Medical Officers through the Londoners' Meals Service at Communal Dining Centres in the Borough. During the year 4 adults were referred to the Centres and 370 dinners were supplied at a cost of £20 Os. lOd. MATERNAL DEATHS. The number of Maternal Deaths during the past nineteen 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 1926 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 1941 — — 1,600 — 1941 1 1 1,405 1.5* 1942 —† 3 1,589 1.9 1943 2 1 1,768 1.6 * Rate calculated on a (live and still) birth figure supplied by the Registrar-General of 1,289. †1 death from puerperal sepsis not counted as " Maternal death." 15 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. No. of Cases Removed to Hospital. Puerperal Fever 26 11 26 — 26 Puerperal Pyrexia 17 12 17 — 17 Ophthalmia Neonatorum 9 3 9 — 9 Epidemic Diarrhoea* 37 18 — — — Measles and German Measles (under 5) 425 402 425 21 126 Whooping Cough (under 5) 164 269 164 3 70 Poliomyelitis (under 5) — — — — — * 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 nine against three in the previous vear. 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. 6.1.43 — 1 Yes — — — — — 27.2.43 — 1 „ — — — — — 23.3.43 — 1 ,, — — — — — 31.3.43 — 1 ,, — — — 23.5.43 — 1 ,, — — — — — 27.5.43 — 1 ,, — — — — — 21.6.43 — 1 ,, — — — — — 20.7.43 — 1 ,, — — — — — 18.10.43 — 1 ,, — — — — — Totals 9 9 — — — — — 16 War-time Day Nurseries.—During the year two additional day nurseries were opened with accommodation for 140 children. The following particulars show the average daily attendances each month for each of the six nurseries now in operation:— 1943. Latimer Rd. Accoradn. 36. Brook Green. Accomdn. 83. West way. Accomdn. 50. Uxbridge Rd. Accomdn. 65. Balling Hd. Accomdn. 70. Australia Rd. Accomdn. 70. Mon. to Fri. % Sat. Mon. to Fri. Sat. Mon. to Fri. Sat. Mon. to Fri. Sat. Mon. to Fri. Sat. Mon. to Fri. Sat. Jan. 33 18 40 21 39 22 41 15 — — __ — Feb. 31 14 48 27 37 20 22 12 — — — — Mar. 28 12 42 23 35 17 37 17 — — — — April 32 12 54 32 36 17 46 22 — — — — May 33 15 70 40 47 23 54 30 — — — — June. 32 17 75 39 45 19 40 19 — — — — July 29 13 68 28 47 21 50 25 — — — — Aug. 30 17 72 35 48 26 49 28 — — — — Sept. 33 17 68 28 46 24 59 32 — — — — Oct. 36 21 71 32 47 28 59 31 .35 25 — — Nov. 29 18 53 23 39 24 50 30 38 22 — — Dec. 30 17 64 20 43 22 54 24 46 24 Opened in December. 17 CHILD LIFE PROTECTION. Public Health (London) Act, 1936. At the end of the year there were 30 foster-children being cared for in the Borough, and 30 names on the list of foster-mothers. The Health Visitors are responsible for visiting the homes of all foster-children in their various districts. During the year 21 foster-mothers were removed from the register for various reasons and 25 new foster-mothers were registered. A summary of the work carried out during the year under review follows:— FOSTER-MOTHERS. No. of Foster-Mothers on Register December 31st, 1943 30 „ Recommended for Registration 25 „ removed from Register 21 (1) Removed from Borough 1 (2) Adopted Children — (3) Unsuitable 2 (4) 9 years of age — (5) Temporarily approved — (6) No further Foster-Children required 14 (7) Illness of Foster-Mothers 4 (8) Lack of accommodation — (9) Mother living at address — (10) Evacuated with Child — (11) Child evacuated — ,, Applications for Registration received but not Recommended — FOSTER-CHILDREN. No. of Foster-Children on Register December 31st, 1943 30 ,, „ received by Foster-Mothers 34 ,, „ moved from Foster-Mothers 33 (1) To Foster-Mothers 3 (2) To Parents or Guardians 22 (3) To Institutions 3 (4) Adopted 2 (5) Children removed from Borough with Foster- Mother — (6) Foster-Children who have reached the age of 9 years during the Year — (7) Evacuated to Residential Nursery 3 (8) No payment now received — VISITS. No. of visits to Registered Foster-Mothers 298 18 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 1943. Cause of Inspection Inspectors W. A. Collins P. T. Bayes 1 E. J. Nether F. Q. Barry J. R. Bailey J. E. Broadhead J. C. Hopkins G. W Herrick W. Eigby W. J. Godden Miss E. M Cross Total Infectious Disease 75 108 103 109 86 104 140 124 1 — 2,140 2,990 Complaints 491 781 693 756 810 674 S09 723 — 27 71 5,835 House to House — — — — — — — — Housing Act 18 20 64 30 29 24 3 4 34 — — 226 Food 127 161 277 317 89 100 166 153 — 523 — 1,983 Restaurants 21 103 86 39 6 29 63 63 — — — 410 Markets 10 12 98 34 10 116 44 273 — — 599 Bakehouses 8 25 38 26 6 18 10 4 — — — 135 Milk Vendors 23 2 5 7 3 3 5 9 8 — — 567 Ice Cream Vendors — — — — — — — 502 — 2 Factories (Mechanical) 32 39 29 53 15 35 58 326 7 2 14 605 Factories (Non-mechanical) 7 11 9 — 1 31 40 — — 10 109 Outworkers 2 1 9 — 2 — 22 2 — — 73 111 Public Urinals 34 97 47 23 90 48 14 86 — — — 439 Drainage 103 260 272 394 178 286 272 293 — — — 2,061 Miscellaneous 200 521 806 335 226 559 489 307 448 2 82 4,267 Re-visits 764 1,424 1,698 1,672 1,339 1,799 1,051 1.364 — 294 84 11,195 Shops Act 13 20 6 1 20 45 44 13 — — — 162 Pharmacy and Medicines 7 22 17 19 9 15 18 15 — — 122 War Damage 21 — 22 116 27 21 1 13 — — — 221 A.R.P. Shelters 6 15 32 29 33 28 7 30 1 — — 181 Food Poisoning — — — — — — 2 — — — — 2 Requisitioning of^Houses 181 234 81 154 131 44 — — — 825 Smoke Observations — 8 — — 21 7 13 — — — — 49 Total 1,962 3,630 4489 4,194 3,081 4,065 3,393 3.886 501 1,421 2,474 30,096 * Joined H.M. Forces on 8.11.43. 19 Notices.—The following table shows the number of Preliminary Notices served and complied with during the year:— Notices Served. Notices complied with. Infectious Diseases 68 42 Complaints 1,799 1,463 Housing Act 1 4 Food (other than Restaurants) 21 18 Restaurants, &c. 18 20 Bakehouses 5 5 Milk Vendors 10 — Factories (Mechanical) 20 18 Factories (Non-Mechanical) 3 3 Public Urinals 8 6 Drainage 38 10 Miscellaneous 92 36 Re-visits 365 433 Shops Act, 1934 4 11 War Damage 8 17 A.R.P. Shelters 2 1 Requisitioning of Houses 1 1 Smoke Observations 5 — Total 2,468 2,088 During the year 783 Statutory Notices were served and 668 complied with. SUMMONSES—YEAR 1943. The following table shows the number of proceedings instituted during the year:— Public Health (London) Act, 1936 66 Housing Act, 1936 2 Pood and Drugs Act. 1938 6 L.C.C. Lodging House Byelaws 6 L.C.C. Drainage Byelaws 3 Milk and Dairies (Consolidation) Act. 1915, and Milk and Dairies Order, 1926 2 Rats and Mice (Destruction) Act, 1919 1 20 1 .—inspection of factories. Premises Number of Inspections. Written Notices. Occupiers Prosecuted. Factories (with Mechanical Power) 598 20 — Factories (without Mechanical Power) 109 3 — Other Premises — — — Total 707 23 — 2.—defects found in factories, eTC. Particulars Number of Defects Number of Prosecutions Found Remedied Referred to H.M. Inspector Want of Cleanliness 6 9 — — Unreasonable Temperatures — — — — Inadequate Ventilation 1 1 — — Overcrowding — — — — Ineffective Drainage of Floors — — — — Sanitary Conveniences insufficient 4 5 — — unsuitable or defective 9 8 — — not separate for sexes 1 — — — 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) 2 — — — Total 23 23 — — 21 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 2 Underground bakehouses (Sec. 54)— Certificates granted during year — In use at the end of the year 16 RATS AND MICE DESTRUCTION. The Infestation Order, 1943, dated 6th May, 1943, was made by the Minister of Food under the Defence General Regulations, 1939. On the llth June the Minister issued a direction to the Council to submit to him a report on the extent to which the Borough was infested by rats and mice. The Borough was surveyed by the Sanitary Inspectors and reports submitted to the Minister during August. On the '29th October the Minister further directed the Council to proceed on and from the 6th December with the treatment of the Council's sewers. This was carried out- by the Borough Engineer and Surveyor and the Medical Officer of Health working in co-operation. Civil Defence personnel from the Light Rescue Service assisted in the work. As a result of this treatment it is estimated that 21.000 rats were destroyed in the Council's sewers. On the 9th November the Minister further directed the Council to proceed with all necessary action for the remedying of all infestations by rats and mice within the Borough. The Council's Rodent Officer resigned during the year. Operatives have been engaged and one of the Council's Sanitary Inspectors has been placed in charge of operations. 22 The following is a brief summary of the work carried out during the year in connection with rat and mice destruction :— No. of houses inspected 703 No. of food premises inspected 886 No. of stores inspected 276 No. of factories inspected 188 Total No. of premises inspected. 2,053 No. of premises found to be rat infested 1.585 NEWLY ERECTED HOUSES AND FLATSWATER SUPPLY. Number of certificates granted during the year Nil INCREASE OF RENT AND MORTGAGE RESTRICTIONS ACT, 1920/38. During the year 6 applications were received for certificates under the above Act, and in 5 cases certificates were granted. CERTIFICATES OF ESSENTIALITY. In October the Ministry of Health issued Circular 2871, which dealt with the general scheme for the repair of houses and provided for the issue of certificates of essentiality by the local authority to serve for evidence in procuring building licences from the Ministry of Works and for the contractor to present to the Ministry of Labour as protection of the labour engaged on the work against transfer. The circular aims at securing the maximum improvement in housing conditions and defines the work which comes within the scheme. The Borough Engineer and Surveyor and the Medical Officer of Health report jointly upon all applications and make recommendations as to the issuing of certificates to the Town Clerk. EXHUMATION AND RE-INTERMENT OF BODIES. During the year one Licence was 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. Six hundred and four bodies were admitted to the Public Mortuary and Civilian War Deaths Mortuary during the year:— Hammersmith Public Mortuary :— Admitted by order of Coroner 287 Admitted by order of Police 26 Admitted 011 application of undertakers for accommodation 51 Admitted by order of Medical Officers of Institutions War operations 2 — 816 \ Civilian War Deaths Mortuary :— War operations — — — Bodies admitted from other Boroughs :— Fulham 97 Chelsea 191 — 288 No. of P.-M. examinations conducted :— Hammersmith cases 246 Fulham cases 108 Chelsea cases 193 Total P.-M.s — 542 No. of Inquests held :— Hamm'ersmith cases 64 Kensington cases 95 Fulham cases 51 I'addington cases 48 Chelsea cases 56 St. Marylebone cases 24 Total Inquests held — 388 24 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Infectious Diseases.—There were, omitting tuberculosis. 2,233 cases reported as due to notifiable infectious diseases in the Borough, against 1,658 in the previous year. There were also reported 876 cases of infectious diseases that were not notified, against 556 in the previous year; 252 of these were *Measles, 100 *Whooping Cough, 30 *Scabies and 494 Chickenpox. The number of cases of Tuberculosis notified was 201 against 200 in the previous year. *Totals (notified cases and cases reported from other sources)—Measles 973. Scabies 674 and Whooping Cough 308. BACTERIOLOGY. The following bacteriological examinations were made on behalf of the Council:— Material from cases of suspected Diphtheria— Positive results 7 Negative results 631 Sputa from cases of suspected Tuberculosis— Tubercle bacillus found 104 Tubercle bacillus not found 302 Blood from cases of suspected Fever— Widal or Typhoid reaction not obtained 4 Faeces 2 Other 1 Grand Total 1,111 25 Cases of Infectious Disease notified during the year 1943. Notifiable Disease Number of Cases Notified. Wards. Total Removed to Hospital. At all Ages Age Periods. Under 1 1— 2— 3— 4— 5— 10— 15— 20— 35— 45— 65— l 2 3 4 5 6 7 Smallpox — — — — — — — — — — — — — — — — — Cholera, Plague — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 53 8 4 6 — 10 3 2 16 3 1 — 3 13 11 5 9 11 1 53 Erysipelas 25 — — 1 — — — — 1 7 4 6 6 1 6 5 1 3 6 3 13 Scarlet Fever 410 4 19 34 40 52 203 34 7 14 2 1 — 40 39 78 45 65 101 42 347 Typhus Fever — — — — — — — — — — — — — — — — — —■ — — — Enteric Fever — — — — — — — — — — — — — — — — Relapsing Fever, Continued Fever — — — — — — — — — — — — — — — — — — — Puerperal Fever 26 — — — — — — — — 21 5 — — 3 8 — 4 5 5 1 26 Puerperal Pyrexia 17 — — — — — — — — 16 1 — — — 1 5 1 2 5 3 17 Cerebro-Spinal Meningitis. 12 2 — 2 — — 3 1 — 2 1 1 — 1 2 2 1 — 5 1 11 Polio-myelitis 1 — — — — — — 1 — — — — — — — — 1 — — I Encephalitis Lethargica — — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 9 8 — — — — 1 — — — — 2 2 — 1 2 1 1 9 Anthrax — — — — — — — — — — — — — — — — — — — — Pneumonia 59 7 2 2 1 — 1 3 2 7 9 15 10 7 6 20 1 8 10 7 8 Malaria 4 — — — — —- — — — — — 3 1 — — 1 1 1 — 1 4 Dysentery 39 7 10 2 1 2 8 2 3 3 — — 1 2 14 7 1 3 10 2 37 Food Poisoning 5 — — — — — — — 2 — 2 — 1 — 1 — — — o 2 I Measles 721 39 105 85 95 93 257 19 7 18 2 1 — 53 114 139 48 142 165 60 180 Whooping Cough 208 33 49 28 26 28 40 2 — 1 — 1 — 16 20 35 17 56 55 9 83 Scabies 644 26 23 27 17 19 85 83 73 161 64 54 12 57 99 95 38 131 176 48 2 Totals 2,233 126 216 185 186 194 607 148 98 266 93 83 31 185 325 398 164 428 552 181 792 26 Deaths from the Seven Principal Zymotic Diseases.— The total number of deaths of residents registered from the seven principal zymotic diseases was 80 against 49 in the previous year. The deaths of residents from these diseases were equal to 61 per 1.000 of the total deaths of residents registered and were at the rate of 0.8 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, 1934 to 1943 :— Year. Smallpox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Enteric Fever. Diarrhoea. Total. 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 0 0 0 4 3 0 17 24 1940 0 1 0 3 0 0 44 43 1941 0 0 0 5 5 1 40 51 1942 0 0 0 1 8 0 40 49 1943 0 2 0 0 9 0 37 48 Averag last 10 yrs 0 5 1 7 7 1 32 53 Notifiable Diseases (other than Tuberculosis) during the Year 1943. DISEASE. Total cases notified. Cases admitted to Hospital. Total deaths. Diphtheria 53 53 — Erysipelas 25 13 — Scarlet Fever 410 347 — Enteric Fever — — — Puerperal Fever 26 26 2 Puerperal Pyrexia 17 17 Cerebro-Spinal Meningitis 12 11 2 Encephalitis Lethargica — — — Ophthalmia Neonatorum 9 9 — Pneumonia (Acute Primary and Influenzal) 59 8 f92 Dysentery 39 37 — Poliomyelitis 1 1 — Malaria 4 4 — Food Poisoning 5 1 — Measles 721 180 2 Whooping Cough 208 83 9 Scabies 644 2 — Totals 2,233 792 107 *This is not total brought to notice of Department. |Deaths from all forms of Pneumonia. 27 DIPHTHERIA IMMUNISATION. The immunisation of children at the Borough Welfare Centres and at the schools by L.C.C. doctors continued during 1948. At the 81st December it was estimated that 62.9 per cent. of the children under five in the Borough and 74.1 per cent. of those between 5-15 years had been immunised. 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 941 Number of children immunised at schools by L.C.C. 705 Number of children immunised by local medical practitioners 80 Number of Schick Tests—positive result 10 Number of Schick Tests—negative result 884 Fees paid to Medical Practitionerss £16 16s, 6d. 28 The Chart hereunder shows the number of cases of Scarlet Fever notified week by week during the year. 29 The Chart hereunder shows the number of cases of Diphtheria notified week by week during the year. 30 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 37 Mattresses 364 Pillows 1,059 Bolsters 46 Blankets 3,079 Sheets 1,029 Quilts 515 Articles of Clothing 2,747 Sundries 41 Carpets 1 Curtains 4 Total 8.922 Rooms (Infectious Disease, &e.) 854 Verminous Rooms 96 950 31 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. Figures showing the numbers dealt with during the year are as under :— School Children- Hammersmith. Scabies 2,759 Verminous 1,431 Impetigo 17 School Children Non-Hammersmith. Nil. Children under Five Years—Hammersmith. Scabies 663 V erminous 64 Children under Five Years—Non-Hammersmith. Nil. Adults—Hammersmith. Scabies 2,269 Verminous 145 Impetigo 9 Adults Non-Hammersmith. Nil. Common Lodging-houses. Scabies 15 Verminous 93 VACCINATION. The duties under the Vaccination Acts and the Vaccination Order were carried out by the Public Health Department. The Return for 1942 shows that 1.893 Infants were vaccinated, this being 75.18 per cent. of the Births compared with 71.6 per cent. in 1941. No proceedings under the Vaccination Acts were instituted. 32 VACCINATION RETURNS. RETURN FOR 1942. Registration Sub-Districts comprised in the Vaccination Officers' District ft umber of Births returned in the " Birth List Sheets " as registered from 1st January to 31st Dec., 1942 Number of these Births duly entered by 31st January, 1944, in Columns I, II, IV and V of the "Vaccination Register" (Birth List Sheets), viz. : Number of these Births which on 31st January, 1944, remained unentered in the "Vaccination Register" on account (as shown by Report Book) of Number of these Births remaining on 31st January, 1944, neither duly entered in the "Vaccination Register" (columns 3, 4, 5, 6 and 7 of this Return) nor temporarily accounted for in the "Re port 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 1943 Number of statutory 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 1943 Col. 1 Successfully Vaccinated Col. II Col IV. Number in respect of whom Certificates of Conscientious Objection have been received Col. V Dead, Un vaccinated 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 270 132 1 — 66 15 1 6 19 30 145 88 2. Hammersmith Hospital 1,486 910 6 — 208 77 2 82 108 93 924 246 3. South Hammersmith 178 80 2 — 36 16 — 1 12 31 86 34 4. Queen Charlotte's Hospital 1,340 771 9 — 156 52 — 177 167 8 920 197 3.274 1,893 18 — 466 160 3 266 306 162 2,075 565 33 Table showing Work of Vaccination Officer from 1st January to 31st December, 1943. No. of Vaccination 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 " " Notices Served. No. of Children Died Unvaccinated. No. of Cases Removed and not Traced. Nos. entered on "U" Lists to Public Vaccinators. District No. 1. District No. 2. District No. 3. District No. 4. District No. 5. Other Doctors. District No. 1. District No. 2 District No. 3. District No. 4. District No. 5. Total North 45 16 48 3 33 — 145 88 5 — 18 210 44 10 5 84 23 51 — 158 South 23 42 2 — 19 1 86 34 14 — 3 156 45 7 5 84 55 1 1 141 Hammersmith Hospital 185 116 146 9 468 3 924 246 20 — 617 684 122 74 39 268 134 152 14 568 Queen Charlotte's Hospital 41 12 8 — 859 2 920 197 9 — 1625 112 26 36 37 73 17 13 1 104 Removed Inwards 31 30 22 — 27 1 110 7 12 184 — 67 37 4 36 39 43 27 4 113 Total 325 216 226 12 406 7 2185 572 60 184 2263 1229 274 131 122 548 272 244 20 1084 Total number of births registered during 1943 — 3.941. 34 TUBERCULOSIS. Tuberculosis.—Two hundred and one cases of Tuberculosis were reported during the year, one hundred and seventy-seven of which were Pulmonary and twenty-four being other forms of Tuberculosis, against two hundred cases in the previous year. PART 1. Summary of Notifications during the period from the 1st January, 1943, to the 31st December, 1943. 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 ages Pulmonary Males — 1 4 2 9 14 16 18 16 22 7 109 Pulmonary Females — 2 — 1 15 18 21 5 4 2 — 68 Non-Pulmonary Males — - — — — 1 — 2 1 — — . 4 Non-Pulmonary Females — 1 4 - - 6 5 — 2 1 1 20 PART II. Supplemental Return. New cases of Tuberculosis coming to the knowledge of 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 — — — 3 7 9 3 6 2 31 Pulmonary Females — - — 1 3 6 17 4 2 - - 33 Non-Pulmonary Males — 3 3 — 1 1 1 1 — 1 — 11 Non-Pulmonary Females — 1 - 1 — 1 3 — — — — 6 35 The following table has been prepared, giving particulars of new cases of tuberculosis and of deaths from tuberculosis during 1943 :— Age Periods New Cases. Deaths. Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0- — 1 2 — 15- 26 42 3 7 18 13 3 4 25- 23 38 1 8 35- 27 9 3 — 45- 19 6 1 2 19 2 — — 55- 28 2 1 1 65 and on 9 — — 1 5 1 — 1 Total 140 101 15 26 43 17 7 5 The ratio of non-notified tuberculosis deaths to the total tuberculosis deaths is 1 to 3. The following table indicates the number of cases and deaths from Tuberculosis:- Year. No. of Cases notified. No. of Deaths. No. of Cases on Dispensary Register. No. of Cases on Register of Notifications. Pulmonary. NonPulmonary. Total. 1924 200 56 256 170 — 1,426 1925 221 45 266 138 — 1,280 1926 210 68 278 142 824 1,302 1927 226 53 279 182 686 1.289 1928 205 56 261 135 744 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 1941 160 39 199 103 812 828 1942 169 31 200 104 935 963 1943 177 24 201 72 1,044 36 Sixty deatlis from Pulmonary Tuberculosis were registered, against ninety-one in the previous year, representing a death-rate of 0.65 per 1,000 compared with 1.0 in 1942 and 1.0 in 1941. Figures for the years 1927-43, showing the interval between notification and death of tuberculous persons are as under:— 1927. 1928. 1929. 1930. 1931 1932. 1933 1934 1935. 1936. 1937. 1938 1939. 1940. 1941. 1942. 1943  1. Total number of deaths from Tuberculosis in the Borough 181 135 149 153 127 156 150 124 119 116 106 87 107 118 103 104 7 2. The number of cases notified at death _ 7 3 7 2 6 13 5 11 6 8 8 5 9 10 22 1 3. The number of cases notified within one month of death (excluding above) 25 17 32 18 10 21 17 21 11 20 16 13 12 11 13 16 10 4. The number of cases notified within three months of death (excluding above). 23 13 18 21 14 17 17 9 8 7 11 6 3 10 10 8 ??? 5. The number of cases notified within six months of death (excluding above) 18 9 8 9 14 15 16 11 11 7 8 5 5 11 6 3 3 Average number of cases notified tor the 10years 1924-1933 (inclusive) = 255. Average number of cases notified for the 10 years 1984-1943 (inclusive) = 194. Average number of deaths for the 10 years 1924-1933 (inclusive) = 150. Average number of deaths for the 10 years 1984-1943 (inclusive) = 107. 37 TUBERCULOSIS DISPENSARY.—The work of the Tuberculosis Dispensary was continued at the Hammersmith Hospital under the arrangement made with the London County Council and the British Post-Graduate Medical School. Under this arrangement the Dispensary is housed in a suite of rooms at the Hospital, the British Post-Graduate Medical School provides the Medical Staff and the Borough Council the nursing and clerical staff. Five sessions, at which patients are seen by appointment, are held each week. The work carried out at the Dispensary during the year shows a considerable increase as compared with pre-war years. The number of cases notified during the year was 201. Total attendances numbered 3,924 and 3,528 jahyscial examinations were made. In 19.38, when the number of cases notified was 192, the number of attendances at the Dispensary was 2,799 and examinations 1,806. The number of X-ray examinations made during 1943 was 1,724 against 275 in 1938 and the number of A.P. refills given in the same periods was 1,439 and 311. New Patients.—During the year 1.000 persons attended for examination for the first time, 468 males and 532 females. Of these 219 were under the age of fifteen and 781 were adults. Of the total 308 were referred to the clinic by local practitioners for the purpose of consultation and 106 by the National Service Medical Boards. Three hundred and thirty-four were "contacts" of persons suffering from tuberculosis. Of the "contacts" examined 12 were definitely cases of tuberculosis, whilst 322 were non-tuberculosis. Total Attendances and Examinations.—The total attendances of persons for the purpose of examination, observation or treatment, numbered 3,924, and physical examinations were carried out in 3,528 instances, i.e., in 90 per cent. of the total attendances. 38 Home Visitation.—The Tuberculosis Officer made 13 visits to homes of patients for the purpose of examination and investigation of the home conditions. The Health Visitors visit cases of tuberculosis on notification, and thereafter as far as possible at intervals of six months or less, as may appear advisable. During the year 2,323 such visits were made. During the year 39 definite cases were transferred from other areas into the Borough and 09 moved out or were lost sight of. Eleven were written off the register as being cured. Mass Radiography. -As part of a campaign for the early detection of symptomless tuberculosis arrangements were made by the Government for the use of miniature mass-radiographv units. One such unit was allocated to the London County Council and commenced work during the year at St. Luke's Hospital. Chelsea. A number of the large industrial undertakings in the Borough were invited to allow their employees to undergo examination by the unit, transport to and from Chelsea being provided by the Borough Council. The managements of a large number of the firms proved most cooperative and in all 2,444 men and women submitted themselves to examination. The following particulars give the results of the examinations :— Total examined. Referred for large films. Did not attend. No abnormality. Calcd. and other lesions N.F.A. Referred to General Practitioners. Probably T.B. Probably NonT.B. Cardio. Vase. 2,444 102 4 29 40 20 1 8 39 Tuberculosis Allowances.—The Government scheme for the payment of allowances to persons suffering from pulmonary tuberculosis who have to give up remunerative employment to undergo treatment came into force on 30th June, 1943. The allowances cover payments to patients for their own maintenance and that of their dependants, discretionary allowances in certain cases towards meeting special liabilities and allowances of pocket money, &c., to persons with no dependants whilst undergoing treatment in an institution. The assessments of the allowances to be paid are made by the London County Council, but all inquiries are made and administrative work carried out by the Dispensary staff. An Assessment Officer attends once weekly at the Dispensary to assess all new cases and to review old ones when any change in financial circumstances has occurred. Payments are made bv the Borough Treasurer's Department. The machinery has worked well and the co-operation of all concerned has resulted in the smooth working of the scheme. During the six months the scheme was in operation 129 cases were considered—113 patients were granted allowances and l6 cases were found to be ineligible. 99 maintenance allowances, 12 discretionary payments and 14 special payments were made. The total money paid to patients during the six months amounted to £1,935. FOOD SUPPLIES Unsound Food. One seizure of unsound food was made during the year :— 1 lb. 6 ozs. of mushrooms. A summons was issued and a penalty of £2 was imposed. 40 A quantity of unsound food was voluntarily surrendered during the year of which a large proportion was salvaged for use as animal and chicken food or recovery of fats for trade purposes other than for human consumption. FOOD AND DRUGS ACT, 1938. 800 samples of various food and drugs were submitted to the Public Analyst during the year by the Council's Sampling Officer for analysis; 2 were found to be inferior and 10 were adulterated. Legal proceedings were taken in respect of 7 of the adulterated samples, and penalties and costs amounting to L'18 2s. Od. were imposed. PHOSPHATASE TEST. 36 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 the pasteurising process had been properly carried out in each case. Metchim & Son, Ltd, Westminster, S.W. I.