HOL 38 METROPOLITAN BOROUGH OF HOLBORN. Abridged Report of the Medical Officer of Health for the Year 1940. POPULATION "Registrar General's estimated Population" mid-1940 23,470. LIVE BIRTHS Total M. F. Birth rate per 1000 Estimated Population 9. 29 Legitimate 184 92 92 Illegitimate 34 23 11 STILLBIRTHS 10 4 6 total (live and still) births Rate per 1,000 43. 86 DEATHS 504 21.47 Death Rate adjusted by area comparability factor 21.26 DEATHS FROM PUERPERAL CAUSES Deaths Rate per 1000, total live and still births. Puerperal Sepsis 0 Other Puerperal Causes 0 0 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE All infants per 1,000 live births 64.22 Legitimate infants per 1,000 live legitimate births 54.35 Illegitimate infants per 1,000 live illegitimate births 117.65 NOTIFICATION OF BIRTHS The total number of notified births, including stillbirths, occurring in the Borough were 59. Of this number 4 were notified by Medical Practitioners, 49 by Midwives and 6 by other persons. CLASSIFICATION 0F DEATHS The causes of deaths (504) were as follows:- Cerebro-spinal fever 1. Tuberculosis of respiratory pystera 21. Other forms of tuberculosis Syphilitic diseases 5. Influenza 2. Measles 1. Cancer of Buccal cavity and oesophagus (M) uterus (F) 8. Cancer of stomach and duodenum 7. Cancer of breast 3. Cancer of all other sites 27. Diabetes 2. Intracranial vaeuclar disease 24. Heart disease 104. Other diseases of circulatory system 11. Bronchitis 41. -1- Pneumonia 41. Other respiratory diseases 6. Ulcer of stomach or duodenum.6. Diarrhoea, under two years of age 5. Appendicitis 4. Other digestive diseases l6. Nephritis 4. Premature birth 1. Congenital malformations, birth injury, infantile disease 6. Suicide 8. Road traffic accidents 6. Other violent causes 103. All other causes 38. INFANT MORTALITY There were 14 deaths of Infants (4 of which were illegitimate under one year of age. The causes of deaths were as follows:Bronchitls 1. Pneumonia 4. Diarrhoea 4. Premature birth 1. Congenital malformation, birth injury, infantile disease 4. PROVISION OF HEALTH- SERVICES IN BOROUGH BACTERIOLOGICAL EXAMINATIONS. The total number of Bacteriological and other examinations carried out was 81. Included in this number were 63 for the Diphtheria Bacillus, 17 for the tubercle baccilue and 1 in a case of Enteric Fever. NURSING IN THE HOME The arrangement with the Metropolitan District Nursing Association to undertake the nursing of necessitous cases of Measles, Whooping Cough, Ophthalmia Neonatorum, Epidemic Diarrhoea, Pnuemonla, Encephalitis Lethargica, Tuberculosis, Maternity (including complications after confinement) Puerperal Fever and Puerperal Pyrexia was continued throughout the year. The total number of visits was 576 (20 cases). MATERNITY AND CHILD WELFARE CENTRES The Maternity and Child Welfare Centres in the Borough are maintained at 10 John Street and Short's Gardens. Four infant clinics and two ante-natal clinics were held weekly throughout the year. The total number of attendances at the clinics by mothers and children war 6775. There were 442 attendances by mothers at the ante-natal and post-natal clinics. BATHS. The baths provided free of charge at the John Street Centre for expectant and nursing mothers were used 719 times during the year. PHYSICAL CULTURE CLASSES FOR MOTHERS These classes which are held every Thursday at John Street -2- PHYSICAL CULTURE CLASSES FOR MOTHERS. (CONTD) Clinic were continued throughout the year under the direction of a fully qualified instructress (Miss N.Fnirgrleve) appointed on the recommendation of the Central Council for Recreative Physical Training. INSTRUCTION IN MOTHERCRAFT AND HYGIENE 38 lbs. White Vest Wool and 278 hanks of Welsh wool of a special quality were sold at opet price to the value of £29. 16s. lOd. Maternity Outfits are on sale at the Centre at cost price. No outfits were sold during the year. DENTAL TREATMENT A Dental Clinic is maintained at 10 John Street for the provision of dental treatment for nursing and expectant mothers and children under five years of age. 55 mothers and 43 children attended for treatment. HOME HELPS 17 cases were attended by the Home Helps. The applicants contributed £10. 4s. 0d. towards the cost. CONVALESCENT HOMES 3 mothers and 8 children were sent away to Convalescent Homes. INFANT LIFE PROTECTION There were no foster mothers on the Register in 1940. SUPPLY OF MILK FOR MOTHERS AND CHILDREN During the year 2,971 gallons of liquid milk and 2,024 lbs. of dried milk was supplied to expectant and nursing mothers and children- under five years of age. The coming into operation in July 1940 of the National Milk Scheme which provides for the supply of liquid milk free or at 2d. per pint according to income to all expectant and nursing mothers and to children under 5 years, and for the supply of dried milk to infants under 12 months considerably modified the Council's scheme for the supply of liquid or dried milk. - 3 - PRE-SCHOOL CHILDREN. Owing to the War, a number of children between the ages of 2 and 5 years have been evacuated to the country and some are still away. 164 children suffering from various ailments attended the Clinic at 10 John Street for treatment. HEALTH VISITORS The total number of visits made by the Health Visitors was 2,354.The number of attendances at the clinics was 669. SANITARY CIRCUMSTANCES AND ADMINISTRATION. During the year 14,078 inspections (including reinspections) were carried out by the Sanitary Inspectors. Included in this total number were 82 inspections on complaints of nuisance, and 165 with reference to infectious disease. The number of inspections of Factories, Workshops and Workplaces was 1,627.Defects were found and remedied in 4 instances. 155 Intimation notices, 19 statutory notices under the Public Health (London) Act 1936, and 304 notices under the byelaws as to Houses-let-ln-Lodgings were served during the year. No legal proceedings were necessary during the year to secure compliance with notices served under the Public Health (London) Act 1936. DISINFECTION During the year 347 rooms were disinfected after cases of infectious or other disease. Of these 10 were rooms which had been occupied by tuberculous persons. In addition 43 rooms were disinfested of vermin. At the disinfecting station 6,644 articles of bedding, clothing etc. were disinfected. CLEANSING STATION The number of verminous persons cleansed during the year was 105 males and 7 females. 32 persons (6 males, 20 females and 6 children) were cleansed for scabies. Under the scheme arranged with the London County Council 367 attendances were made by children from elementary schools for cleansing at the station. -4- HOUSING The number of house to house inspections and the number of inspections of houses after complaints or the occurrence of infectious disease was 4,363 (3241 being first inspections). The number of intimation notices served was 130 and the number of statutory notices 17. OVERCROWDING 8 fresh cases of overcrowding occurred during the year. Whenever possible arrangements are made with the London County Council for the provision of accommodation for overcrowded families. 20 such families were provided with accommodation by the London County Council. 4 families secured accommodation otherwise. At the end of the year 317. families were known to be overcrowded. INSPECTION AND SUPERVISION OF FOOD. MILK. The number of milk premises on the register is 150 and 170 inspections and re-inspections of these premises were made. MILK (SPECIAL DESIGNATIONS) ORDER 6 licences to sell "Pasteurised" milk, 3 sell "Tuberculin Tested" milk and 5 supplementary licences, 3 to sell "Pasteurised" milk and 2 to sell "Tuberculin Tested" milk, were granted during the year. PUBLIC HEALTH (MEAT) REGULATIONS. 105 inspections of butchers shops and market stalls were made during the year. INSPECTION OF OTHER PREMISES WHERE FOOD IS PREPARED OR OFFERED FOR SALE. Under this head are included the following premises Bakehouses; kitchens of hotels, restaurants and eating houses; tripe, offal and other meat shops; fried fish eel and other fish shops; premises where ice cream is made; and other places where food is prepared for sale. 1,424 inspections were made of these premises during the year. 14 notices under the Food By-laws were served requiring remedy of defects. UNSOUND FOOD. 30 cwt. and 5 lbs. of tinned foods, bacon, meat,offal etc. were surrendered. - 5 - FOOD & DRUGS ACT 1938. During the year 676 samples were submitted to the Borough Analyst for analysis; of these 72 were taken as "formal" and 504 "informal". Of this total 12 proved to be adulterated, all having been purchased informally. In each case a further sample was taken and found to be genuine. Mo legal proceedings were taken. INFECTIOUS DISEASE AND OTHER DISEASES. The total number of notifications received during the year was 262, as follows:- Diphtheria 7 Enteric Fever 1 Scarlet Fever 20 Whooping Cough 7 Cerebro-Spinal Fever 7 Measles 39 Puerperal pyrexia 3 Rheumatism 1 Pneumonia 14 Pulmonary Tuberculosis 44 Erysipelas 12 Non-pulmonary do. 3 Ophthalmic neonatorum 4 DIPHTHERIA IMMUNISATION CLINIC 125 new cases attended the Clinic during the year. WHOOPING COUGH IMMUNISATION CLINIC The Council established in October 1939, a Clinic for active immunisation against whooping cough, at the Maternity and Child Welfare Clinic, 10 John Street. The-Clinic is hold on Wednesday afternoons of each week. The outstanding feature of our experience during the short period is the absence of reaction in nearly every care. 70 children have attended the clinic. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS 1930 The total number of cases of tuberculosis in the Borough on December, 1940 was 335 (pulmonary - nales 184, females - 82; non-pulmonary - males 34, females 35). TUBERCULOSIS DISPENSARY The number of new cases examindd was 73; 33 of these were definitely tuberculous. l6 contacts were also examined and all of these were found to be non-tuberculous. The number of attendances was 447 and 627 visits to the homes of patients were made by the Dispensary Visitor. The total number of cases on the register on the 31st December was 250. - 6 - Artificial pneumo-thorax treatment 18 patients received treatment. The total cost (£190. 1ls. 6d. was borne by the Council). Extra Nourishment 21 cases received extra nourishment. The total cost (£110. 19s. 4d ) was borne by the Council. Dental treatment. One patient received dental treatment. The total cost (£4. 10s. Od.) was borne by the Council. J. A. STRUTHERS, M. D., MR.C.P., P.P.H. , Medical Officer of Health.