The Royal Borough of Kensington. ANNUAL REPORT (ABRIDGED) OF THE MEDICAL OFFICER OF HEALTH. 1916. Vail & Co., Printers and Stationers, 170, Farringdon Road, E.C. To the Mayor, Aldermen and Councillors of the Royal Borough of Kensington. Mr. Mayor, Ladies and Gentlemen,— In accordance with the instructions of the Local Government Board, the Report submitted herewith on the health of the Borough during the year 1916 has been limited to the essential facts and figures of which a permanent record is necessary for reference in future years. I already owe so much to Dr. L. C. Parkes for his administration of the Public Health Department in my absence, that I have not asked for his assistance in the preparation of the Report. For the returns and statements which it contains Dr. Parkes is therefore in no way responsible. On my return to duty on October 31st, I learned with the greatest regret of the death of Mr. A. E. Friend, Sanitary Inspector for No. 9 District, after 24 years in the service of the late Vestry and the present Council. The Council has also lost a valuable officer by the resignation on October 25th of Miss Looker, Lady Sanitary Inspector. Her place has fortunately been filled by the return of Miss de Chaumont from service in one of the military hospitals in Egypt. The Council are no doubt aware of the ability with which Mr. G. M. Pettit, Chief Sanitary Inspector, has supervised the work of the Public Health Department in the various difficulties arising out of a state of war. To Mr. Pettit and the staff of the department I desire to take this opportunity of tendering my thanks for the zeal and loyalty they have shown in attaining under Dr. Parkes a high standard of efficiency. I have the honour to be, Ladies and Gentlemen, Your obedient Servant, J. E. SANDILANDS, Medical Officer of Health. Public Health Department, Town Hall, Kensington, W. 5th May, 1917. VITAL STATISTICS. Population. —To meet the diminution and abnormal constitution of the population caused by the war, the Registrar-General has estimated the population of Kensington in 1916 as 165,535 for the purpose of calculating the birth rate, and as 15'2,]44 for the calculation of death rates. Table A. District. Population. Births, Deaths and Rates per 1,000. D. B. Births. Rate. Deaths. Rate. 3,027 165,535 15.4 The Borough 18.3 152,144 2,337 24.7 North Kensington 77,787 84,633 2,090 1,346 17.3 10.7 11.8 South Kensington 74,357 80,902 865 884 15.8 St. Charles 20,075 21,842 567 26.0 317 28.8 18.7 Golborne 22,574 24,562 708 423 Norland 516 25.4 18.7 18,707 20,353 350 Pembridge 16,431 17,876 299 16.7 256 15.6 11.8 12.7 Holland 17,890 19,466 230 228 Earl's Court 15,555 16,924 219 12.9 212 13.6 6.5 7.8 Queen's Gate 12,614 13,724 89 99 217 11.8 14.5 Redcliffe 16,865 18,349 245 Brompton 11,433 - 12,439 - 110 8.8 100 8.6 I Unknown 72 107 Dividing the two population's given for the Borough in 1916 by the Census population in 1911, which was 172,317, the following factors will be obtained, namely, .9606 and .883. The populations for the various districts in the Borough have been in each case arrived at by multiplying the census population of the district by the second factor to obtain the death rate population shown in the first column of the table, headed " D," and by the first factor, .9606, to obtain the birth rate population in the second column, which is headed " B." Births.—The number of births registered was 3,027, after correction for inward and outward transfers. Distributed according to sex and legitimacy the births were as follows:— Legitimate Male. Female. Total. 1,378 2,828 1,450 Illegitimate 99 100 199 Total 1,549 3,027 1,478 The birth rate for the Borough was 18.3 per ],000 as compared with a rate of 20.0 in the decennium 1901-10. The number of births and birth rates for the Borough and its constituent districts have been shown in Table A. In four years before the war the illegitimate births numbered 172 (1911),183, 163, and 151 (1914). The increase to 199 in the present year is accordingly only an increase of 16 above the figure for the year 1912. 2 Notification of Births.—Of the registered births 2,861 occurred in Kensington, and of this number 2,560, or 89 per cent., were notified to the Medical Officer of Health within 36 hours, or at most a few days of their occurrence. The total number of births notified, including still births which are not registerable, was 2,812. Details are given in the following Table:— Source of Notification. Number of Births Notified. Total Births. Still Births. Live Births. Midwives 1,448 33 1,415 344 10 334 Parents 713 26 Medical Practitioners 687 6 Other Persons 124 130 75 Births in the Borough 2,635 2,560 4 Institutions outside the Borough 177 173 79 2,812 Total 2,733 Midwives.—Slightly over one half of the births were notified by midwives. Births Notified by Midwives. Nature of Practice. Number of Midwives. Cases per Midwife. Total Cases. Queen Charlotte's Hospital 3 permanent 105—241 549 2 temporary 27— 35 Extern Department Kensington Maternity Association 2 permanent 41—101 192 2 temporary 24— 26 Kensal Gospel Mission 2 48 15— 33 Private practice 3 133—148 418 5 10— 60 143 „ „ 35 1— 9 98 „ „ Total private practice 43 659 ... Totals 54 1,448 ... Deaths.—The net deaths belonging to the borough numbered 2,337, and were equivalent to a death rate of 15 - 4 per thousand, as compared with a death rate of 14 - 3 in the ten years 1901-10 (vide Appendix, Table I. and Table V. in previous reports). The mortality in the several wards has already been shown in Table A. The principal causes of death in the several age periods of life are set out in Table 111., Appendix. Infantile Mortality.—The deaths among infants under the age of one year numbered 258, the infantile mortality rate being equivalent to 85 deaths per 1,000 births. This figure is no less than 7 per 1,000 below the lowest infantile death rate ever recorded in Kensington, namely 92 in the year 1912. The steady reduction in the number of deaths in infants in each succeeding quinquennium has been due to the work of the Council's Lady Health Visitors and to that of the five voluntary schools for mothers and the baby clinic. The exaggerated fall in 1916 has been due to the absence of hot weather and drought in the summer and early autumn months. The following Table shows the mortality among infants in the different wards:— Table B. INFANTILE MORTALITY. District. Deaths under one year. Deaths per 1,000 Births. 95 North Kensington 199 South Kensington 58 67 55 97 St. Charles Golborne 61 86 Norland 63 122 20 66 Pembridge Holland 18 78 Earl's Court 11 50 7 79 Queen's Gate Redcliffe 13 60 9 82 Brompton Unknown 1 - The Borough 258 85 The principal causes of deaths in the first four weeks and in the later months of infancy will be found in Table IV., Appendix. The same table shows that the mortality amongst illegitimate infants, of whom no less than 42 died, was equivalent to a rate of 211 per 1,000, as compared with a rate of 76 per 1,000 among those born in wedlock. Health Visitors.—The Health Visitors visit infants notified under the Notification of Births Act, cases of ophthalmia in the newly born, infants suffering from tuberculosis and notified cases of puerperal fever. They assist in the work of the voluntary schools for mothers. During the year 1,762 infants were visited shortly after birth and 4,511 visits in all for the purposes mentioned above were made. The staff during six months of the year was limited to two Health Visitors. Maternity and Child Welfare —An exhaustive report on the provision made in the Borough under this head was submitted by Dr. L. C. Parkes, the acting Medical Officer of Health, on 1st June, 1916. Conditions have not materially since that date except in that progress has been made towards the appointment of a special committee in connection with maternity and child welfare under the powers conferred by the Notification of Births (Extension) Act, 1915. INFECTIOUS AND OTHER DISEASES. The seasonal incidence of the chief epidemic infectious diseases is given in the following Table for the thirteen four-weekly periods in the year:— Notifications — Monthly Period ending Corrected Tctal 29 Jan. 26 Feb. 25 Mar. 17 June 15 July 2 Dec. 20 Ma y 30 Dec. Total. 22 Apl. 12 Aug. 9 Sep. 7 Oct. 4 Nov. 17 21 ! 16 14 9 15 20 212 14 200 21 Scarlet Fever 28 19 i 9 9 11 13 8 16 153 146 Diphtheria 16 14 15 8 11 10 10 11 10 20 Enteric Fever 2 3 1 0 3 3 1 1 0 0 1 4 1 19 3 2 0 21 20 Cerebro-Spinal F. 2 4 2 3 1 1 0 1 1 1 48 217 127 88 54 26 12 13 24 967 967 Measles* 88 117 138 15 Deaths — I I 0 65 3 1 2 7 5 1 28 65 5 Influenza 3 2 8 0 0 Measles† 0 0 1 3 0 2 0 0 0 6 6 0 0 0 3 1 12 12 Whooping Cough - 0 0 1 1 2 1 1 0 1 1 0 4 3 3 2 10 8 4 3 55 55 Diarrhœa 3 5 1 2 7 * Includes German Measles. + Does not include German Measles. A complete list of the cases of the various infectious diseases notified during the year will be found in Table II., Appendix. In this Table the cases of each disease are classified according to the District of the Borough and the age period in which they occurred. The deaths from the infectious diseases are shown in Table 111., Appendix. In the cases of Scarlet Fever, Diphtheria and Enteric Fever the number of persons attacked and the case mortality were below the average of past years. Cerebro-Spinal Fever. —The prevalence of this disease did not attain epidemic dimensions. Twenty genuine cases were notified and 14 deaths occurred. In London as a whole 436 cases of cerebro-spinal fever and 102 deaths were recorded. Measles - Only 6 deaths from Measles occurred as compared with 80 to 90 deaths which have been registered in years of epidemics of a fatal type. Diarrhœa. —55 deaths at all ages were registered as due to Diarrhoea or Enteritis. In epidemic years, with excessive heat in the summer months, the deaths from the same causes under the age of two years alone range from 80 to 150. Small Pox.—No cases of Small Pox occurred in Kensington. Only three cases were notified in London during the year. Puerperal Fever. —Ten cases, about the average annual number, were notified during the year. The deaths from puerperal fever numbered 8 as compared with an average mortality of 5. Four cases were notified by the Medical Superintendent of the Kensington Infirmary. Among the remainder there was no instance of more than one case of puerperal fever occurring in the practice of the same midwife or doctor during the year. The dates on which the Infirmary cases occurred were March 18th, April 9th, May 27th and December 14th. Ophthalmia Neonatorum.—Twenty-six cases of ophthalmia in newly born infants were notified during the year. The results recorded were as follows: — Recovered with unimpaired vision in both eyes - - 21 cases One eye vision impaired—one eye vision normal 1 case Death during course of treatment 2 cases Left district during course of treatment - 2 cases Tuberculosis.—Three hundred persons were notified for the first time as suffering from tuberculosis of the lungs; 129 new patients were notified as suffering from other forms of tuberculosis. Under both heads there has been a considerable drop in the number of notifications received, as compared with previous years. The deaths from consumption or tuberculosis of the lungs numbered 186, from other forms of tuberculosis 54. The mortality from tuberculosis in contrast with number of notifications showed no diminution as will be seen from the following figures : — Deaths from Tuberculosis and Death Rates per 1.000. Tuberculosis of Lungs. Other Tuberculous Diseases. Tuberculosis—All Forms. Death Rate. Death Rate. Deaths. Death Rate. Deaths. Deaths. Deaths from Tuberculosis in Wards. District. Tuberculosis of Lungs. Other Forms. Deaths. Death Rate. Deaths. Death Rate. North Kensington 1.63 47 0.60 127 South Kensington 59 0.79 17 0.23 1.63 0.35 St. Charles 34 7 Golborne 1.82 0.62 41 14 0.59 Norland 39 2.08 11 0.79 0.30 Pembridge 13 5 0.73 0.28 Holland 13 5 0.84 0.26 Earl's Court 13 4 Queen's Gate 6 0.48 0 - Redcliffe 14 0.83 4 0.24 Brompton 0.44 0.26 5 3 - - Unknown 8 1 1.22 The Borough 186 0.35 54 Forms of Tuberculosis in Persons Notified. Number Site of Disease of Cases. Lungs 300 Larger joints and bones above wrist and ankle 17 Lymphatic glands other than mesenteric 29 Vertebral column (Spine) 6 Smaller joints and bones of wrist, ankle, hand, foot 9 Mesenteric glands, bowel, peritoneum 47 Meninges of brain 17 Skin 3 Other parts 1 Total cases 429 Cancer.—The deaths from cancer numbered 229. Deaths from Cancer, 1916. Parts Affected. Sex. Total. Male. Female. Buccal Cavity, No. 39 1 11 10 33 Stomach, Liver, etc., No. 40- 20 53 Peritoneum, Intestines, Rectum, No. 41 24 34 58 Female Genital Organs, No. 42 29 29 - Breast, No. 43 1 30 31 2 - 2 Skin, No. 44 21 45 Other and unspecified Organs, No. 45 24 148 229 Totals 81 The numbers following the description of the parts affected refer to the classification of causes of death adopted by the Registrar-General for use in England and Wales. 6 FOOD SUPPLY. Milkshops.—At the end of the year there remained on the Council's Register 191 premises where milk was sold. Of these premises 123 were milkshops, 34 were general shops and 34 were restaurants. Cowsheds —The licence of the only cowshed in the Borough was renewed by the London County Council for ten cows. The number kept does not as a rule exceed four. Ice-cream. —At the end of the year 188 premises were shown in the Register of places where ice-cream is prepared or sold as compared with 209 premises at the end of the year 1915. Bakehouses. —There are 85 bakehouses in the Borough, and of this number 65 are underground. Slaughter-houses. —Eight slaughter-houses were licensed by the London County Council in October. Special conditions as to notice and hours of slaughtering attach, as reported last year, to the licence of the house in the Walmer Road, where a considerable number of pigs are killed. Other Premises Used for Sale, &c., of Food. —These premises are entered in a Register under the date on which they were finally inspected and found to comply as regards structure with the sanitary regulations in S. Bof the London County Council (General Powers) Act, 1908. At the end of the year the following shops or premises remained on the Register, namely:— Provision Res- Butchers' Fried Fish Fish- Green- Other Dealers. taurants. Shops. Shops. mongers. grocers. Shops. 255 165 114 42 53 71 15 Unsound Food —The unsound food surrendered and destroyed during the year is shown in the following list:— Fowls, decomposed 19 Rabbits, decomposed 24 Pigs' carcase and organs, tuberculosis 2 Pig's carcase and organs, septicaemia of traumatic origin 1 Pigs' plucks, echinococcus cysts 3 Pig's pluck, inflammation of lungs 1 Pigs' heads, tuberculosis 15 On 13th November, 1916, twenty-six boxes of unsound dates exposed for sale were seized. The dates were mouldy and swarming with fruit mites. They were being sold at 1½d. per box, the market price for sound dates at Covent Garden on the same day being 10d. per box. Legal proceedings were instituted against the vender, who was fined £5. Sale of Food and Drugs Acts. —During the year the Sanitary Inspectors collected 700 samples, 676 of foods, 24 of drugs, under the above Acts and submitted them to the Public Analyst for analysis. Of the samples submitted 78, or 11 per cent., were reported as adulterated. Proceedings were taken in 32 cases for adulteration or other offences, the fines and costs inflicted amounting to £132 16s. Cream.—In 12 prosecutions the samples submitted consisted of cream adulterated by the addition of boric acid in amounts varying from 19.334 to 30.989 grains per pound. Convictions were obtained in 10 cases and fines from £3 to £10 were inflicted. In two cases the cream was sold as preserved cream, the presence of boric acid being declared. The amount present was 24 grains per pound in the first case and 27 grains in the second. In each case the defendant was fined £10. Two cases in which the cream contained 19334 and 22 grains of boric acid respectively were dismissed. HOUSING OF THE WORKING CLASSES. Lodgings provided by the Council.—The Council provide within the Borough 120 tenements of one, two, or three rooms for the working-class tenements. Latterly all the Council's tenements have been let. Houses Let in Lodgings. —The number of houses let in lodgings on the Council's register at the end of the year was 2,064. In 1913, 187 of the registered houses were let in furnished lodgings at a charge of 1s. per night per room. The lodgings in the remainder of the registered houses are let unfurnished. The inspections and re-inspections of lodging houses numbered 7,596. Notices requiring the remedy of defects found were served in 611 instances, and 14 cases of overcrowding were abated. The owner of one lodging house was summoned for failing to carry out sanitary repairs and for breach of the by-laws for houses let in lodgings. 861 houses were reported as having been cleansed in accordance with the requirements of By-Law 16. Common Lodging Houses.—The Common Lodging Houses in the Borough number 20 and contain accommodation for some 627 persons. Eleven are for male and 9 for female lodgers. Housing (Inspection of District) Regulations. 1910. —The house-to-house inspections for the purpose of these Regulations and the detection of nuisances numbered 1,864. This figure does not include re-inspections, inspections on complaint or inspections of registered lodging houses for the purpose of enforcing the lodging house by-laws. In accordance with the directions in the Local Government Board Circular of 4th August, 1915, only urgently necessary work has been required, with the result that it has not been possible to proceed with the scheme of housing work which had been instituted on the lines laid down in the regulations. Closing Orders. —The Closing Order in respect of No. 9, Talbot Grove was determined on 6th June, 1916, the premises having been rendered fit for human habitation. Inland Revenue Acts.—Under these Acts 50 certificates were issued by the Medical Officer of Health, in respect to 50 tenements in 22 houses containing a total number of 53 separate dwellings. Water Supply to New Houses.—During the year 25 newly erected houses were inspected and certified before occupation as having a proper and sufficient supply of water. Remedy of Defects.—A tabular statement showing in detail the work carried out under the direction of the Sanitarv Inspectors for the remedy of various sanitary defects in dwelling houses is entered month by month and for the year in the registers of the Public Health Department. The registers are available for reference and render the publication of a detailed statement in the Annual Report unnecessary. In four cases legal proceedings were instituted against persons who had failed to comply with the sanitarv requirements of the inspectors. In each case an order was made by the Justices for the work required to be carried out. Fines amounting to £4 were inflicted. FACTORIES AND WORKSHOPS. The Council is required to keep a register of workshops and is responsible for the sanitary conditions of all workshops and workplaces in the Borough. For the sanitary condition of factories the Home Office is directly responsible, the duties of the Council in factories being limited to securing the provision of suitable and sufficient sanitary conveniences for the persons employed. Where women are employed the inspections are made by the Council's Lady Sanitary Inspector. The following list shows the number of workshops and factories in the Borough. 8 (A ) Premises on which female labour is employed— Workshops. Factories. Dressmakers and ladies' tailors 402 4 Laundries 146 60 Other premises 217 11 Total (A) 765 75 (B) Premises on which female labour is not employed— Bakehouses 71 14 Bootmakers 170 8 Builders 118 9 Tailors 114 0 Printers 0 16 Other Premises 491 138 Total (B) 964 185 Workshops and factories in the Borough 1729 260 Home Work.—The following figures show the approximate number of out-workers and home-workers in the Borough:— Out-workers in workshops and factories 106 Out-workers in domestic workshops 24 Out-workers in their own homes 167 Total out-workers 297 The number of out-workers' lists received were as follows: — Number of Lists. Number of Names thereon. Once in the year 9 49 Twice in the year 68 918 Totals 77 967 SANITARY WORK Sanitary Inspectors (Male). —The last monthly report of the Medical Officer of Health for the year 1916 set forth in tabular form the principal items of the work of the male sanitary inspectors during the year. The same return in greater detail, showing the number of inspections made, the sanitary notices and summonses issued and the sanitary works completed, is available for reference in registers kept for the purpose in the Public Health Department. Lady Sanitary Inpector. —A summary of the monthly reports shows that the Lady Sanitary Inspector who worked single handed during the greater part of the year paid in all 3,079 visits—802 to factories and workshops, 944 to cases of tuberculosis, 1,025 to cases of measles and whooping cough, and 308 for other purposes. Disinfection. —The disinfecting staff disinfected rooms in 962 tenements or dwelling houses. The bedding from 739 households was disinfected by steam or by washing and boiling at the disinfection station at Wood Lane. The number and weight of the articles dealt with was as follows: — Articles disinfected only 9,420 Articles disinfected and washed 878 Total number of articles 10,298 Total weight of articles 34 tons 12 cwt. 9 Verminous Persons. —The following number of verminous persons were cleansed at the cleansing station in Mary Place:— Suffering from pediculosis 1,286 persons. Suffering from scabies or itch 92 persons. Total number 1,378 persons. Adults, 155. Children, 1,223. Number of baths given, 3,134. For the purpose of payment by the London County Council for the cleansing of school children, any child bathed more than one month after the date of its first attendance is counted as a new case. The summary of the monthly reports presented to the Public Health Committee was based on this method of counting, and accordingly showed a higher total of new cases than the total given above, in which no child has been counted more than once. Verminous Rooms. —347 verminous rooms were cleansed in response to notices, 5 verminous beds were destroyed and 65 dirty beds were cleansed. In addition 138 verminous beds were disinfected by steam at Wood Lane and 129 verminous rooms were fumigated by the Council's disinfecting staff. Rag Flock. —Two samples of rag flock were taken from makers of bedding and submitted for analysis. Both samples complied with the standard of cleanliness laid down by the regulations. Mortuary.—During the year 284 bodies were deposited at the Mortuary. In 138 cases post-mortem examinations were made and 213 bodies were deposited for the holding of inquests at the instance of the coroner. 27 bodies were deposited in the Chapel of Rest. APPENDIX. Local Government Board Tables I —IV. TABLE I. Vital Statistics of Whole District during 1916 and previous Years. Year. 1 Population estimated to Middle of each Year. 2 Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District Uncorrected Number. 3 Nett. of Nonresidents registered in the District. 8 of Residents not registered in the District. 9 Under 1 Year of Age At all Ages. Rate.* 13 Number. 4 Rate. 5 Number. 6 Rate. Rate per 1,000 Nett Births 11 Number 10 Number. 12 13.9 1911 2,389 172,300 18.7 15.7 3,037 3,223 2,712 399 135 722 435 172,000 14.7 2,287 13.3 1912 19.3 446 2,524 3,068 3,318 683 305 92 171,700 490 14.0 1913 19.4 2,614 15.2 695 2,409 3,173 3,335 371 111 2,624 18.4 767 2,289 171,400 15.3 432 13.4 1914 3,153 3,019 298 95 19.9 †155,795 3,074 16.9 1915 3,100 942 493 2,917 19.7 119 2,636 365 15.4 3,183 429 20.9 1,275 ‡165,535 B 152,144 D 3,027 1916 2,861 258 85 2,337 18.3 * Rates calculated per 1,000 of estimated population. Civil Population as estimated by the Registrar-General, and upon which the rates in this Table are based. B. Population as estimated by the Registrar-General for the calculation of Birth rate. D. „ „ „ „ Death rate. At Census of 1911. Area of District in acres (exclusive of area covered by water) 2291 Total population at all ages 172,817 Total families or separate occupiers 38,118 TABLE II. Cases of Infectious Disease notified during the Year, 1916. Notifiable Disease. Number of Cases Notified. Total Cases Notified in each Ward. Total Cases Removed to Hospital. At all Ages. At Ages.—Years. St. Charles. Golborne. Pembridge. Holland. Earl's Court. Queen's Gate. Norland. Brompton. Redcliffe. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... 21 14 47 70 14 10 3 7 1 1 19 14 7 14 19 Diphtheria (including Membranous croup) 146 31 131 1 28 2 4 14 ... 20 7 6 10 5 Erysipelas 7 25 14 11 85 16 29 1 27 25 ... 44 29 ... 16 7 112 23 14 18 16 Scarlet fever 14 200 54 173 ... ... Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 2 2 1 ... 6 ... 2 2 2 6 6 ... 1 3 5 19 ... 7 ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... Relapsing fever 1 ... ... ... 3 7 3 Puerperal fever ... ... ... 2 1 1 ... 2 ... ... 1 10 ... 6 ... Anthrax 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 5 4 4 Cerebro-Spinal Meningitis 1 2 3 1 ... 5 ... 2 5 ... 3 2 3 20 17 Poliomyelitis ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... Pulmonary Tuberculosis 50 66 1 5 40 24 57 119 25 71 7 62 27 9 24 13 300 156 26 4 25 43 14 11 15 7 13 2 *Other forms of Tuberculosis 30 40 3 1 17 5 129 81 6 26 ... 1 2 Ophthalmia Neonatorum ... 2 ... ... ... ... ... 10 ... 26 4 1 4 24 147 196 23 263 1 204 115 74 Measles and German Measles 428 88 89 188 1175 240 142 128 66 81 30 217 704 356 175 266 Totals 371 395 394 138 284 313 167 123 2113 210 671 In 2 cases the Ward was unknown. TABLE III. Causes of, and Ages at, Death during the Year 1916. Causes of Death Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. Under 1 year. 1 and under 2 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. 2 and under 5 years. All Ages. 2,337 - 258 - 63 - 59 - 56 - 68 - 280 - 583 - 970 - All causes Certified Uncertified Enteric Fever ... ... ... ... ... 2 ... ... 2 Small-pox ... ... ... ... ... ... ... ... ... Measles 6 2 3 1 ... ... ... ... 2 ... Scarlet Fever ... 2 ... ... ... ... ... ... Whooping-Cough 12 6 2 4 ... ... ... ... ... 5 Diphtheria, and Croup 9 1 1 2 ... ... ... 65 ... ... 1 7 17 40 Influenza ... ... 2 ... Erysipelas 1 1 ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 186 1 2 9 28 85 52 9 ... Tuberculous Meningitis 21 3 3 8 3 1 3 ... ... 13 6 2 Other tuberculous diseases 33 2 4 4 2 ... Cancer, Malignant disease 100 229 ... 1 ... ... 1 22 105 ... Rheumatic Fever ... ... ... ... ... ... ... ... 3 Meningitis 30 6 5 7 5 4 ... 226 ... Organic Heart Disease 360 1 10 23 100 ... ... ... 198 6 1 1 1 13 127 Bronchitis 11 38 22 8 18 38 49 Pneumonia (all forms) 193 39 13 6 3 Other diseases of Respiratory Organs 31 2 1 1 7 17 ... ... 8 2 Diarrhœa and Enteritis 55 32 3 ... 1 3 6 2 Appendicitis and Typhlitis 7 ... ... 3 2 ... ... ... 4 Cirrhosis of Liver 21 ... 11 ... 6 ... ... ... Alcoholism 1 ... ... 1 ... ... ... ... ... Nephritis and Bright's Disease 74 ... 1 5 33 35 ... ... ... Puerperal Fever 8 7 ... ... ... 1 ... ... ... Other accidents and diseases of Pregnancy and Parturition ... ... 3 ... ... 5 ... 2 ... Congenital Debility and Malformation including Premature Birth 1 2 ... 109 ... ... 106 ... 1 ... Violent Deaths, excluding Suicide 82 5 8 6 6 17 20 19 2 Suicide 14 ... ... ... 4 8 ... ... Other Defined Diseases 5 328 579 33 3 6 6 56 142 2 Diseases ill-defined or unknown 3 ... ... ... ... 1 ... ... 258 59 970 280 63 56 68 583 2,337 TABLE IV. INFANT MORTALITY DURING THE YEAR 1916. Nett Deaths from stated Causes, at Various Ages, under One Year of Age. Cause of Death. Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. 39 Certified Uncertified 62 52 258 22 12 10 106 36 25 ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... 2 ... 2 ... Measles ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... Whooping-cough ... ... 1 ... 4 ... 1 ... 2 ... 1 ... ... 1 Diphtheria and Croup ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... 2 1 3 Tuberculous Meningitis ... ... ... ... ... ... 13 4 4 Abdominal Tuberculosis ... ... 3 2 ... ... ... ... 1 1 Other Tuberculous Diseases ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... 2 2 6 ... ... 2 ... Convulsions 3 1 1 ... 1 ... 5 ... 2 ... Laryngitis ... ... ... ... ... ... ... ... ... ... 1 3 2 Bronchitis 2 11 1 ... 2 2 ... 8 8 Pneumonia (all forms) 4 2 4 13 39 ... 6 ... 6 15 ... ... Diarrhœa ... 1 2 6 ... ... Enteritis 2 17 1 3 5 3 ... 2 ... 4 Gastritis ... ... ... 1 2 ... 1 ... ... ... Syphilis ... 1 1 2 ... ... 4 1 ... ... Rickets ... ... ... ... ... ... ... ... ... Suffocation, overlaying ... 1 1 1 2 3 ... ... ... ... ... ... Injury at birth 6 6 ... ... ... ... ... 6 ... Atelectasis ... 3 ... ... 3 3 ... ... ... ... 9 Congenital Malformation 13 5 2 2 4 ... ... ... ... Premature Birth 43 3 ... 47 34 5 1 14 ... ... 19 16 Atrophy, Debility, and Marasmus 9 2 2 46 8 ... 6 3 2 1 17 Other causes 9 3 3 3 2 1 2 52 258 10 106 25 22 12 39 36 i 62 Nett Births in the year Nett Deaths in the year of 2,828. illegitimate, 199. legitimate infants, 216. illegitimate infants, 42.