LAM 10 REPORT on the Vital and Sanitary Statistics of the BOROUGH OF LAMBETH DURING THE YEAR 1915. [ With an account (1) of the work done by (a) the Tuberculosis Medical Officers under the Lambeth Tuberculosis Dispensaries Scheme, and (b) the Male and Female Sanitary Inspectors and the Health Visitor and also (2) of the proceedings taken under the Sale of Food and Drugs, the Factory and Workshops, and the Housing and other Acts.] by JOSEPH PRIESTLEY, B.A. M.D. D.P.H., Medical Officer of Health and Chief Executive Tuberculosis Officer. LONDON: Printed by Wightman & Co., Ltd., Regency Street, Westminster, London, S.W. 1916. 3 Public Health Department, Lambeth Town Hall, Brixton Hill, S.W. May, 1916. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Mr. Mayor and Gentlemen, Again I have the pleasure to submit a satisfactory Report— the Report for 1915, dealing with the Vital Statistics of the Borough of Lambeth The death rates are low, as are also the zymotic incidences, results that were not to be anticipated, having regard to the state of England and Wales in general and of London and Lambeth in particular on account of the War. A considerable increase in zymotic incidence was prophesied from the movements of large bodies of troops between England and the Continent, together with a breakdown of the administrative procedure owing to the billeting and encamping of troops, refugees and aliens. Fortunately, these two prophecies have proved false —due, in so far as Lambeth Borough is concerned, to the success of the work carried out by the Council's Public Health Department. Whilst the Council has applied strict economy to its various administrations in accordance with the suggestions of the Local Government Board and other Government Departments, the special work of the Public Health has been allowed to proceed without interference— a wise decision. Extra work has naturally been thrown upon the Public Health Department by reason of the War, and my thanks are due to all Members of the Staff, especially the Clerical Staff (both permanent and temporary), which has worked a large amount of overtime, so as to prevent the routine administrative work of the Department suffering. My thanks are also again due to the Chief Officers and to the Members of the Council for assisting me in carrying out my important duties as Medical Officer of Health and Chief Executive Tuberculosis Officer for the Borough. It may be added, in conclusion, that certain radical alterations have been made in connection with the Statistics contained in this Report in so far as their tabulation and the accompanying letterpress are concerned, with a view to effecting greater simplicity and consequent economy in printing without, however, disturbing the yearly continuity of the Reports of past years. I am, Mr. Mayor and Gentlemen, Your obedient Servant, Medical Officer of Health and Chief Executive Tuberculosis Officer. 4 1. VITAL STATISTICS. The Estimated Civil Populations* of the Borough in 1915 are as follows:— Estimated Civil Populations. I. Wards. Wards. Males. Females. Total. Marsh 9989 10015 20004 Bishop's 14007 15643 29650 Prince's 18627 21184 39811 Vauxhall 13853 15181 29034 Stockwell 13514 17019 30533 Brixton 18630 23727 42357 Herne Hill 14151 17638 31789 Tulse Hill 13098 16850 29948 Norwood 13171 17891 31062 Borough of Lambeth 129040 155148 284188 II. Registration Sub-Districts. Sub-Districts. Males. Females. Total. Lambeth Church 21316 22676 43992 Kennington 21307 24172 45479 Stockwell 27367 32198 59565 Brixton 32781 41363 74144 Norwood 26269 34739 61008 Borough of Lambeth 129040 155148 284188 *N.B.—The estimates of populations for 1915 are estimates of civilian populations only. These estimates are based upon the estimate for the whole Country (England and Wales) and on the number of persons in the Borough according to the Census 1911 and the National Register 1915—the estimate of the civil population of the whole Country (England and Wales), as a whole, being also based upon the number of persons enumerated in 1911 (Census) and the number on the National Register in 1915. 5 III. Parliamentary Divisions (Old). Old Parliamentary Divisions. Males. Females. Total. North 23656 25370 49026 Kennington 32112 35930 68042 Brixton 32279 40607 72886 Norwood 39653 51531 91184 Parliamentary Area of Lambeth 127700 153438 281138 N.B.—The Parliamentary Divisions have not been altered by the London Government Act, 1899, nor by the proceedings that fixed the Boundaries of the Metropolitan Borough, so that the above figures do not agree with those for the borough as a whole, but are comparable with those of the old Parish of Lambeth given in previous Reports. IV. Parliamentary Divisions (Adjusted). * Adjusted Parliamentary Divisions. New Wards. Total. North Marsh Bishop's 49654 Kennington Prince's Vauxhall 68845 Brixton Stockwell Brixton 72890 Norwood Herne Hill Tulse Hill Norwood 92799 * Adjusted Parliamentary Area of Lambeth — 284188 *N.B.—By the adjustment of the old Parliamentary Divisions so as to be co-terminous with the Wards. 6 TABLE A. Giving number of Births and Birth-Rates in each Registration Sub-District of the Borough of Lambeth during 1915 (arranged Quarterly). Registration Sub-Districts. No. of Births. Total for the Year 1915. Rate per 1,000 Inhabitants. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Lambeth Church* 661 589 580 576 2406 54.7 Kennington † 308 289 224 237 1058 23.3 Stockwell § 501 472 460 480 1913 32.1 Brixton 385 372 363 333 1453 19.6 Norwood 317 263 238 230 1048 17.2 Borough of Lambeth 2172 1985 1865 1856 7878 27.7 *Including Lying-in Hospital (543 cases, of which 183 belong to Lambeth)—corrected rate (i.e., excluding all the Lying-in Hospital births) = 42.3. † lncluding Workhouse (117 cases, of which 92 belong to Lambeth)—corrected rate (i.e., excluding all the Workhouse births = 20.7. §Including Maternity Hospital (503 cases, of which 141 belong to Lambeth)—corrected rate (i.e., excluding all the Maternity births) = 23.7. Inner Districts, 37.3 ; Outer Districts, 20.9 per 1,000—uncorrected (whole Borough =27.7).—Inner Districts, 29.6; Outer Districts, 19.3 per 1,000—corrected i.e. excluding all Institutional births ( whole Borough = 23.6.) N.B.—The births in Stockwell Sub-District are divided equally between the Inner and Outer Sub-Districts of the Borough for the purpose of calculating the comparative rates of such Sub-districts. The births are those of infants of (a) civilians and (b) non-civilians, whereas the estimated populations are civil populations only. The rates are, consequently, untrustworthy. 7 TABLE B. Showing Populations (Estimated), Uncorrected Births, Corrected Deaths at all ages, under 1 year, under 5 years, and from the 7 chief Zymotic diseases and Uncorrected Deaths in Public Institutions, in the Borough of Lambeth during 1915, and for the years 1911-1914, together with the averages for the two decennia 1891-1900 (Parish) and 1901-1910 (Borough). Year. Estimated Population. Number of Births Registered. Corrected Numbers of Deaths. Deaths in Public Institutions in Lambeth (uncorrected). Total Ages. Under 1 Year. Under 5 Years. Deaths from 7 Chief Zymotic Diseases. 1915 284188 7878 4653 683 1047 335 2550 1914 297094 8188 4269 728 1020 375 2204 1913 297139 8341 4280 733 1094 369 2015 1912 297550 8168 3925 598 917 287 1872 1911 297957 8405 4380 899 1336 569 1862 Averages— 1901-10 (Borough) 314566.8 8846.9 4709.6 1020.1 1503.5 475.1 1816.8 1891-1900 (Parish) 294049.7 9295.4 5405.3 1358.5 2070.2 700.4 1568.5 Note.—(a) Enumerated Population at Census 1901 was 301,895. (fc) Enumerated Population at Census 1911 was 298,058. (c) Families or separate occupiers = 70,887 (1901) and 70,827 (1911). N.B.—The estimated population for 1915 is the estimate of the civil population only, based upon the 1911 Census and the 1915 National Register. 8 TABLE C. Showing the Birth Rate (uncorrected) per 1,000 population, the General and Zymotic Death Rates (corrected) per 1,000 population, the Infantile Mortality Rates (corrected) per 1,000 total Births and per 1,000 total cor rected Deaths, the Death Rate (corrected) for children under 5 years of age per 1,000 total corrected Deaths and the proportion of Deaths uncorrected in Public Institutions per 1,000 total uncorrected Deaths, in the Borough of Lambeth for the Year 1915 and for the Years 1911-1914, together with the averages for the two decennia 1891-1900 (Parish) and 1901-10 (Borough). The Year. Birth-Rate per 1,000 Population, (uncorrected). Death-Rate per 1,000 Population (corrected.) Corrected Deaths of Children under 1 Year per 1,000 total Births. Deaths of Children under 1 year per 1,000 Deaths (corrected) Deaths of Children under 5 years per 1,000 Deaths (corrected). Zymotic DeathRate per 1,000 Population, (corrected.) Deaths in Public Institutions per 1,000 total Deaths (uncorrected.) 1915 27.7 16.4 86.7 146.8 225.0 1.2 479.1 1914 27.6 14.4 88.9 170.5 238.9 1.3 475.6 1913 28.1 14.4 87.9 171.3 255.6 1.2 450.2 1912 27.4 13.2 73.2 152.3 233.6 0.9 446.9 1911 28.2 14.7 106.9 205.2 305.0 1.9 406.2 Averages— 1901-10 (Borough) 28.1 14.9 115.3 216.7 319.4 1.5 386.0 1891-1900 (Parish) 31.6 18.4 146.1 251.3 382.9 2.4 276.7 9 THE BIRTH-RATE. The total number of Births registered during the year 1915 is 7,878. Of the total 7,878 births, 3,982 are males, and 3,896 females showing an excess of 86 males. Of the total 7,878 births registered, 543 took place in the Lying-in Hospital (York Road), and of these 183 belong to the Borough ; 117 took place in the Workhouse (Brook Street), and of these 92 belong to the Borough ; whilst 503 took place in the Maternity Hospital (Jeffrey's Road), and of these 141 belong to the Borough. Thus, there are 747 births belonging to other districts. The Lying-in Hospital, the Workhouse and the Maternity Hospital tend to abnormally increase the birth-rates in Lambeth Church, Kennington and Stockwell Districts respectively, and the necessary corrections are, consequently, made in a footnote to Table A. The uncorrected birth-rate for Lambeth is 27.7 per 1,000 inhabitants (30.9 for males and 25.1 for females) ; whilst in the various Registration Sub-Districts the birth-rates work out as shown in Table A, from which it will be seen that the un-corrected birth-rate in the Inner Districts is 37.3, and that in the Outer Districts 20.9 per 1,000—the corrected birth-rates (i.e.,. excluding (a) NonLambethian births and (b) all Institutional births) being lespectively (а) 25.1 and (b) 23.6 for the whole Borough, (a) 32.5 and (b) 29.7 for the Inner, and (a) 19.7 and (b) 19.3 for the Outer Districts.* Tables B and C show, for comparison, the number of births, and the birth-rates, for 4 years (1911-1914) in the Borough, together with the averages for the 2 decennia 1891-1900 (Parish) and 1901— 1910 Borough. * N.B.—The births registered are those of infants of (a) civilians and (b) non civilians, whereas the estimated population is civil population only. The rates are, consequently untrustworthy. 10 The birth-rate for Lambeth (Parish and Borough) has been recently slowly, but steadily, declining—a decline not peculiar to Lambeth, nor even to England, but to be found in nearly all civilised countries. Notification of Births Act. The Notification of Births Act, 1907, was adopted throughout the Borough, and came into operation on March 9th, 1908. Since the Act came into force, a total of 51,395 births have been notified up to the end of 1915, viz. : 3,473 in 1908 (10 months), 5,143 in 1909, 6,703 in 1910, 7,094 in 1911, 7,336 in 1912, 7,158 in 1913, 7,397 in 1914, and 7091 in 1915. The notified cases are visited, or such other measures taken in connection therewith, in the way of distributing pamphlets, etc., as are found necessary. In the cases of notified infants who are visited, the methods of feeding are carefully inquired into and instruction given as required, breast-feeding being encouraged as far as possible. The mothers visited are pleased to receive advice as to the proper feeding, clothing, and management generally of their infants, and re-visits paid shew that such advice is acted upon. The systematic re-visiting of newly-born infants is important. It is impossible to give satisfactory statistics of the educational value of the visiting of houses wherein births have been notified, but there is no doubt as to the existence of such value—a result that would, naturally, be increased by systematic re-visiting in addition to the first visiting. In connection with Child Welfare, mention must be made of the number of voluntary agencies that are carrying out excellent work throughout the Borough, supplementing the work of the Council's officials. Having regard to the large number of births notified yearly, voluntary help is a sine qua non with the present Official Staff and a scheme is being prepared by which such voluntary agencies will be recognised by the Council. Returns of all Births (with addresses of mothers), registered in Lambeth, are obtained from the District Registrars. A list of all notified births is sent to the London County Council weekly in pursuance of sub-section 5, of section 2, of the 11 Act, and the Medical Officers of Health concerned are written to in connection with babies born in Lambeth Public Institutions but belonging to Districts outside the Borough—similar information being obtained with regard to Lambethian babies born in institutions outside the Borough. The Registrar-General provides particulars of transferable births registered, and for 1915 the figures for the Borough of Lam beth are as follows :— Inward Transfers. Outward Transfers. Legitimate Males 19 533 Legitimate Females 20 532 Illegitimate Males 27 168 Illegitimate Females 20 158 Totals 86 1391 THE DEATH-RATE. The total number of deaths registered during the year 1915 is 5,323. The deaths of all members of the armed forces of this or other Countries are excluded and not only the deaths of those dying in Institutions as indicated in various tables throughout the body of the Report and in the special tables I. and III. of the Local Government Board (vide Appendix). 1.—General Death-Rates. The uncorrected death-rate for Lambeth is 18.7 per 1,000 inhabitants. These rates are, however, uncorrected, and, on analysing the 5323 total deaths registered in the Borough, it is found that 1,313 represent deaths occurring within the Borough amongst persons not belonging thereto. These deaths are to be deducted, but, on the other hand, there are 643 deaths registered outside the Borough of persons belonging thereto, and these must be added, giving a corrected number of deaths for Lambeth during 1915 of 4,653, and a corrected death-rate of 16.4 per 1,000 inhabitants. 12 Deaths in Out-Lying Institutions. The Outside Institutions, etc., where the 643 Lambethians died during 1915 may be grouped as follows :— I. General Hospitals. Charing Cross 32 Guy's 29 London 4 Middlesex 16 II. Special Hospitals. Bolingbroke 1 Bow Institution 24 Brompton 9 Cancer 5 Catholic Nursing Institute 1 Central London Throat and Ear 2 City of London 2 Consumption Hospl., Kensington 3 Cottage Hospital, Shooter's Hill 1 Downs Sanatorium, Sutton 6 East London Hospital 1 Evelina 15 Friedenheim (St. Columbus) 5 French 1 Gt. Ormond Street 8 Grove 18 Homœopathic 6 Hostel of God 5 Infant's, Vincent Sq. 17 Italian Hospital 4 St. Bartholomew's 8 St. George's 8 Westminster 30 London Temperance Hospital 1 Metropolitan 1 National 2 Northern Fever Hospital 2 Park 5 Poplar Hospital 1 Queen Charlotte Hospital 1 Queen Mary's 1 Queen Alexandra, Military 1 Royal Chest 1 Royal Free 3 Royal Arsenal 1 St. George's Home, Chelsea 1 St. Joseph's, Hackney 1 St. Mary's Hospital 1 St. Peter's 2 St. Luke's House, Kensington 10 South-Eastern 8 Southern 1 Victoria 1 13 III Infirmaries and Workhouses. Belmont Workhouse 1 Camberwell Infirmary 2 Christ Church Workhouse (Southwark) 1 Lewisham Infirmary 2 Lambeth Infirmary 1 Newington Workhouse 4 St. John's Hill Infirmary 1 IV. Asylums. Banstead 30 Camberwell House 2 Cane Hill 28 Caterham 41 Claybury 2 Colney Hatch 4 Darenth 1 Dartford 8 V. Unclassified Places. Clapham Junction Station 1 Clapham Common Pond 2 Deptford Creek 1 Post Office Yard, Giltspur Street 1 Prison Hospital, Wormwood Scrubs 1 St. James' Infirmary (Battersea) 1 St. Pancras Infirmary 1 Southwark Infirmary 3 Wandsworth Workhouse (Lying-in-Ward) 1 Westminster Infirmary 4 Fountain (temporary) 4 Hanwell 8 Horton 10 Leavesden 7 Long Grove, Epsom 35 Manor 4 Peckham House 3 Tooting Bec 75 Private Houses 25 River Thames 4 Streets 10 L.B. & S.C. Rly. (Battersea) 1 Penge Tunnel 1 Summary. I. General Hospitals 127 II. Special Hospitals 185 III. Infirmaries and Workhouses 22 IV. Asylums 262 V. Elsewhere (unclassifiable) 47 Total 643 14 Whether the corrected or uncorrected death-rates for the Borough (as a whole) be taken, they are again satisfactory for the year 1915 (the fifteenth year of the existence of the Borough). Subdividing the death-rates according to Registration Sub-Districts, it is again shown that the Inner Sub-Districts (Lambeth Church,. Kennington, and inner part of Stockwell) have, collectively and individually, suffered more than the Outer Sub-Districts, e.g., outer part of Stockwell, Brixton and Norwood. So, too, if the death rates be sub-divided amongst the Wards it will be noted also that the Inner Wards, e.g., Marsh, Bishop's, Prince's and Vauxhall, have, collectively and individually, suffered more than the Outer Wards, e.g., Stockwell, Brixton, Heme Hill, Tulse Hill and Norwood (vide Tables D (1) and D (2)). The reason for this difference is again to be noted in the fact that the Inner Districts are more congested than the outer. The status of the inhabitants and the general conditions (sanitary and otherwise) under which they live, are also matters to bear in mind, when dealing with this subject. The figures* (corrected) for 1915 are :— (a) Inner Districts—19.3 per 1,000 population. (b) Outer Districts—14.3 per 1,000 population. (c) Whole Borough—16.4 per 1,000 population. Age Periods of Corrected Deaths. The 4,653 corrected deaths during 1915 may be further analysed and tabulated as follows:— 683, i.e., 14.7 per cent. of the total corrected deaths took place under 1 year of age. 364, i.e., 7.8 per cent, between 1 and 5 years. 1,047, i.e., 22.5 per cent. under 5 years. 219, i.e., 4.7 per cent. between 5 and 20 years. 497, i.e., 10.7 per cent. 20 to 40 years. 986, i.e., 21.2 per cent. 40 to 60 years. 1,904, i.e., 40.9 per cent. 60 and over. 3,606, i.e., 77.5 per cent. over 5 years. *N.B.—The rates are calculated upon the civil populations (estimates) and the deaths of all members of the armed forces are excluded. 15 Changes in Registration of Deaths. The Registrar-General decided to publish from January 1st, 1911, in his annual reports, an analysis of deaths according to administrative areas instead of registration areas as hitherto, and this decision necessitates a complete distribution of the deaths of persons dying away from their homes to the administrative areas in which they had previously resided. Reports were received quarterly during 1915 from the Registrar-General—a total of 119 deaths—on slips, giving particulars of outside deaths assigned to the Borough of Lambeth, in addition to those reported in the usual way as having occurred in Metropolitan Institutions, which are situated outside Lambeth Borough. The table for the year 1915 (and the previous 4 years) at the end of the Report (Appendix), known as the Local Government Board Table I, shews these corrected statistics of deaths within the Borough of Lambeth (differing slightly, in consequence, from the statistics in the body of the Report), the extra additional figures for the year 1915 being as follows :— Age Periods. Males. Females. Totals. 0— 1 1 1 2 1— 2 2 — 2 2—5 1 1 2 5—15 4 4 8 15—25 12 1 13 25—45 19 12 31 45—65 21 13 34 65 and upwards 16 11 27 Total all ages 76 43 119 16 17 TABLE D (1). Shewing the corrected number of Deaths, with corrected Death- rates (general, zymotic and diarrhœal), in each of the Registration Sub-Districts of the Borough during 1915. The deaths are from all causes, and from the 7 chief zymotic diseases, an are corrected by adding Lambethians who die outside the Borough, by omitting strangers who die within the Borough, and by re-distributing persons (who die in Public Institutions) amongst the Districts from which they have been removed into such Public Institutions for treatment. A. Registratin Sub-Districts. REGISTRATION SUB-DISTRICTS. Total Deaths (corrected). General corrected Deathrate per 1000 of the Population. Small Pox. Measles. Scarlet Fever. Total Deaths (corrected) from Total Zymotic Deaths. Zymotic Death-rate per 1000 of the Population (corrected). Diarrhoea Death-rate per 10000 of the Population (corrected). Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Cholera. 1 Diarrhoea. Lambeth Church 832 18-9 28 3 7 10 — 1 - 28 77 1-8 64 Kennington 972 21-4 31 4 6 17 — 4 — — 41 103 2'3 90 Stockwell* 933 157 13 1 8 14 — 3 — — 17 56 0-9 29 Brixton 1118 151 14 1 16 5 — 1 — — 19 56 08 26 Norwood 798 131 5 8 8 3 — — — 19 43 07 31 ' Borough of Lambeth 4653 16-4 91 17 45 49 — 9 — 124 335 1*2 4-4 *Of the 933 deaths in Stockwell Registration Sub-District, 479 belong to the Inner and 454 the Oouter Stockwell Sub-District respectively. Inner Registration Sub-Districts-death rates (general, 19.3, zymotic, 1.9, diarrhœal, 0.7, per 1,000 population). Outer Registration Sub-Districts-death rates (general, 14.3 zymotic, 0.7 diarrhœal, 0.2, per 1,000 population). N.B.-Of the total deaths (corrected), 58 shew no addresses, and have been included Kennington Sub-District-having occurred in the Workhouse Infirmary (35), or in the Workhouse (23) respectively. 18 19 TABLE D (2). Shewing: the corrected number of Deaths, with corrected Death-rates (general, zymotic and diarrhœal), in each of the Wards of the Borough during 1915. The deaths are from all causes and from the 7 chief zymotic diseases, and are corrected by adding Lambethians who die outside the Borough, by omitting strangers who die within the Borough, and by re-distributing persons (who die in Public Institutions) amongst the Districts from which they _ have been removed into such Public Institutions for treatment. B. Wards. B. Wards. WARDS. Total Deaths (corrected). General corrected Deathrate per 1000 of the Population. Deaths (corrected) from Total Zymotic Deaths. Zymotic Death-rate per 1000 of the Population (corrected). Diarrhœa Death-rate per 10,000 of the Population (corrected). Small Pox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Cholera. Diarrhoea. Marsh 212 10.6 — 7 — 3 5 — 1 — — 13 29 1.4 6.5 Bishop's 620 20.9 — 21 3 4 5 — — — — 15 48 1.6 5.1 Prince's 972 24.4 — 31 4 6 17 — 4 — — 41 103 2.6 10.3 Vauxhall 479 16.5 — 12 1 5 12 — 2 — — 15 47 1.6 5.2 Stockwell 454 14.9 — 1 — 3 2 — 1 — — 2 9 0.3 0.7 Brixton 669 15.8 — 8 — 10 3 — 1 — — 11 33 0.8 2.6 Herne Hill 449 14.1 — 6 1 6 2 — — — — 8 23 0.7 2.5 Tulse Hill 316 10.6 — 1 3 2 1 — — — — 7 14 0.5 2.3 Norwood 482 15.5 — 4 5 6 2 — — — — 12 29 0.9 3.9 Borough of Lambeth 4653 16.4 — 91 17 45 49 — 9 — — 124 335 1.2 4.4 Inner Wards—death rates (general, 19 3 ; zymotic, 19 ; diarrhœal, 0.7). Outer Wards—death rates (general, 14.3; zymotic, 0.7; diarrhœal, 0.2). N.B.—Of the total deaths (corrected), 58 show no addresses, and , . have been included in Bishop's and Princes Wards, having occurred in the Workhouse Infirmary (35) or in the Workhouse (23) respectively. 20 Causes of the 119 Outside Deaths Causes of Death. Male. Female. Cerebrospinal Fever 1 Phthisis (Pulmonary Tuberculosis) 12 6 Other Tubercular diseases 1 2 Cancer, malignant disease 5 3 Heart disease 8 7 Bronchitis 3 — Pneumonia 6 2 Broncho-Pneumonia — 1 Other Lung diseases 1 2 Nephritis and Bright's disease 4 2 Violent deaths 11 2 Suicide — 1 Appendicitis — 1 Nervous diseases 3 — Strangulated Hernia 2 1 Diseases of Digestive System 4 4 Syphilis 1 — Wound (gun shot, shrapnel or bomb) 6 — Not classified above 8 9 76 43 2.—Infantile Mortality Rates. Of the 4,653 corrected deaths, 683 are infants under one year of age. The total number of registered births is 7,878, and, of these, 360 occurred at the Lying-in Hospital, and belong to districts outside Lambeth Borough, 25 occurred at the Workhouse, and belong to districts outside Lambeth Borough, and 362 occurred at the Maternity Hospital and belong to districts outside Lambeth Borough. In this way, the corrected number of births for the Borough is 7,131*. The corrected infantile mortality (i.e., rate of corrected deaths under one year per 1,000 corrected births) is, therefore, 95.8 the annual average for the decennium 1901-10 (Borough) being 1227. In calculating this corrected infantile mortality, it must be remembered that, whilst the births that belong to outside districts, are subtracted, the births of infants of Lambethian mothers who may happen to be residing outside the Borough at the times of such births are not *The Registrar-General returns the corrected number of births for the Borough during 1915 as 6573. 21 added. Taking the uncorrected births and the corrected deaths under 1 year, the infantile mortality rate is 86.7, the annual average for the decennium 1901-10 (Borough), being 114.8. Taking the uncorrected number of births (7878), and the uncorrected number of deaths under 1 year of age (851), the uncorrected infantile mortality is 108. the annual average for the decennium 1901-10 (Borough) being 123'8, and that for the decennium 1891-1900 (Parish) 1505. The chief causes of these deaths under 1 year are debility, atrophy, and inanition, congenital malformations, measles, whooping-cough, bronchitis, and other diseases of the respiratory organs, diarrhoea, and prematurity. In the Registration Sub-Districts, the uncorrected infantile mortality varied from 172 per 1,000 births in Brixton to 64.8 in Stockwell (the low rates of 918 in Lambeth Church, 132.3 in Kennington, and 64 8 in Stockwell,being due to the fact that these Sub-Districts contain the General Lying-in Hospital, the Workhouse and the Maternity Hospital respectively), thus— Total No. of Births (uncorrected) 1915. Total Deaths under 1 year (uncorrected). 1915. Infantile Mortality per 1000 births (uncorrected). 1915. Lambeth Church* 2406 221 91.8 Kennington 1058 140 132.3 Stockwell 1913 124 64.8 Brixton 1453 260 172.0 Norwood 1048 106 101.1 Lambeth 7878 851 108.0 Inner Districts—95.7, Outer Districts—123.8. 3.—Zymotic Death-Rates. The zymotic death rate is made up of the total deaths from the seven principal zymotic diseases, viz., smallpox, measles, scarlet fever, diphtheria (including membranous croup) whooping cough, "fever" (including typhus, typhoid or enteric and simple continued or ill-defined) and diarrhoea. In the Borough during 1915 *Excluding all the Lying-in Hospital births, the rate is 118.6 † Excluding all the Workhouse births, the rate is 148.8. ‡Excluding all the Maternity Hospital births, the rate is 87.9. N.B.—The births and deaths in Stockwell Registration Sub-Districts are divided equally between the Inner and Outer Districts for the purpose of calculating infantile mortality rates for such Districts in this Table. 22 there was registered a total of 448 deaths from these diseases—150 strangers belonging to other districts and 294 parishioners who died within the Borough ; whilst, in addition, 37 parishioners died from these diseases outside the Borough. Subtracting the strangers and adding in the parishioners who died outside the Borough, there is a corrected total of 335, giving a zymotic death-rate (corrected) of 1.2 per 1,000 inhabitants. As in the case of the general death-rates, the zvmotic death-rates vary in the inner and outer districts, viz., 1.9 as compared with 0.7 per 1,000 population respectively (vide Tables D (1) and D (2)). The different rates of mortality from different diseases and groups of diseases during 1914 and 1915 are given in terms of the total deaths (corrected and uncorrected) in Tables F and G, whilst Table F gives also the deaths from the chief infantile diseases-, expressed in terms of the infantile population (i.e., corrected number of births registered). The tuberculosis corrected death-rate for 1915 is 1.8, i.e., 518 deaths from all forms of tuberculosis per 1,000 population, and the consumption (phthisis) death-rate, 1.5, i.e., 413 deaths from pulmonary tuberculosis or consumption (phthisis) per 1,000 population. The details of the deaths in the various Registration Sub-Districts are :— Registration Sub-Districts. Corrected Deaths from Pul. Tub. or Phthisis (consumpt'n) Other Forms Tuberculosis. Total Deaths Tuberculosis (all forms) Phthisis-rate per 1,000 population. Tuberculosis rate per 1,000 population. Lambeth Church 85 26 111 1.9 2.5 Kennington 92 19 111 2.2 2.4 Stockwell 87 25 112 1.5 1.9 Brixton 92 25 117 1.2 1.6 Norwood 57 10 67 0.9 1.1 Borough of Lambeth 413 105 518 *1.5 †l.8 Rates for Inner Districts 1.9* and 2.4†. Rates for Outer Districts l.2*and 1.4†. During the five quinquennia 1891-1895 (Parish), 1896-1900 (Parish), 1901-1905 (Borough), 1906-1910 (Borough), and 1911-1915 (Borough), the yearly averages of deaths from (a) tuberculosis (all forms) and (b) pulmonary tuberculosis or consumption (phthisis) were respectively (a) 675.0, 690.0, 647.4, 567.4 and 500.0, and (b) 478.8, 496.8, 462.8, 421.6 and 386.8. 23 TABLE E. Shewing the number of Deaths (corrected) from the 7 principal zymotic diseases in the Borough of Lambeth during 1915 and during the four previous years 1911-14, together with the yearly averages during the two decennia 1891-1900 (Parish) and 1901-1910 (Borough). Disease. 1911. 1912. 1913. 1914. Total (corrected) Deaths in 1915. Annual average of ten years 1901-1910 (Borough). Annual average of ten years 1891-1900 (Parish). Smallpox - - - - - 6.8 1.1 Scarlet Fever 8 9 14 16 17 31.4 48.8 Diphtheria 42 29 36 50 45 41.6 124.5 Membranous Croup 1 - 1 - - 1.5 6.8 Fever. Typhus - - - - - 0.0 0.3 Typhoid or Enteric 12 13 7 15 9 16.7 34.7 Continued and Relapsing - 1 - - - 0.7 1.7 Diarrhæa 323 82 166 196 124 172.9 196.5 Cholera 2 1 - - - 1.3 8.8 Measles 113 97 98 58 91 110.4 145.6 Whooping Cough 68 55 47 40 49 91.8 143.7 Borough of Lambeth 569 287 369 375 335 475.1 706.1 24 TABLE F. Shewing Classification of Causes of Deaths (corrected) in the Borough of Lambeth during 1914 and 1915. A.—Total Deaths from all causes and at all ages with percentages of such deaths to total deaths (corrected). Class of Disease. Borough 1914. Borough 1915. No. of Deaths (corrected). Percentage of Total Deaths (corrected). No. of Deaths (corrected). Percentage of Total Deaths (corrected). 1.—Zymotic Diseases 473 11.1 510 10.9 Seven Principal 375 8.8 335 7.2 Influenza 33 0.8 85 1.8 II.—Parasitic - - 1 0.02 III.—Dietetic 25 0.6 21 0.5 IV.—Constitutional 959 22.2 968 20.8 Cancer 391 9.2 360 7.8 Phthisis 386 9.04 413 8.9 Tubercular Diseases,excluding Phthisis 109 2.6 105 2.3 Rheumatism (Acute and Chronic) and Gout 22 0.5 24 0.5 V.—Developmental 378 8.9 376 8.1 Old Age 196 4.6 208 4.5 VI.—Local Diseases 2171 50.9 2496 53.6 Circulatory System 611 14.3 635 13.6 Bronchitis 362 8.5 531 11.4 Pneumonia and Broncho-Pneumonia 274 6.4 330 7.1 Pleurisy and Pleuropneumonia 77 1.8 113 2.4 Respiratory System,excluding Phthisis 763 17.9 1036 22.3 VII.—Violence 167 3.9 181 3.9 Suicide 25 0.6 19 0.4 VIII.—Other Causes 96 2.2 101 2.2 25 TABLE F.—continued. B.—Deaths (corrected) of Infants under One Year of age from the chief infantile diseases, and from all causes, expressed in terms of 1000 births (corrected). Borough 1914. Borough 1915. Total Deaths under One Year (Corrected) Proportion to 1000 Births (Corrected).* Total Deaths under One Year (Corrected). Proportion to 1000 Births (Corrected).* From all causes 728 103.5 683 103.9 Diarrhæa 156 22.2 87 13.2 Convulsions 13 1.8 11 1.7 Respiratory Diseases 125 17.8 154 23.4 Premature Births 123 17.5 108 16.4 Tubercular Diseases (including Phthisis) 22 3.1 21 3.2 Measles 16 2.3 19 2.9 Whooping Cough 17 2.4 25 3.8 Suffocation in Bed 11 1.6 11 1.7 Enteritis 4 0.6 11 1.7 Dentition 7 0.9 8 1.2 *N.B.—The Registrar-General gives the corrected Lambeth births for 1914 and 1915 as 7032 and 6573 respectively, and these corrected figures have been used in calculating the above rates. 26 TABLE G. Shewing Classification of Certain Causes of Deaths (uncorrected) in the Borough of Lambeth during 1914 and 1915, given in percentages of the total uncorrected deaths. A.—Deaths at all Ages. Causes of Deaths. Percentage of total Deaths (uncorrected). 1914. 1915. I. Principal Zymotics 9.6 8.4 Influenza 0.7 1.6 Measles 1.6 1.9 Whooping Cough 0.9 0.9 Diarrhæa and Dysentery (including Cholera) 4.6 3.2 II. Rheumatic Fever and Heart Rheumatism 0.3 0.3 III. Diseases of Circulatory System 12.7 11.9 IV. Bronchitis, Pneumonia and Pleurisy 15.9 19.2 Phthisis 7.8 7.9 V. Injuries 4.7 6.2 B—Deaths under 1 Year of Age (per 1000 Births uncorrected). All Causes 105.4 108.0 27 INFECTIOUS DISEASES. 1.—Notifiable Diseases. During 1915, under the Compulsory Notification Clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, 3,774 cases of infectious diseases (excluding tuberculosis) were reported, including the newly notifiable cerebro-spinal fever, 44; polio-myelitis acute, 4; ophthalmia neonatorum, 73; whooping cough, 1607; and chicken pox (notifiable from March 17th to June 30th), 473. These 3,774 cases occurred in 3,062 infected houses, and of the 3,774 cases 1,372, i.e., 36.4 per cent., were removed to hospital, and 2,402, i.e., 63.6 per cent., remained under treatment at their homes. If the newly notifiable diseases be excluded so as to make the 1915 figures strictly comparable with those for previous years, the percentage of cases removed to hospital during 1915 was 84.5, as compared with 82.8, 82.8, 67.9, 54.7 and 31.5 for the five quinquennia 1911-15,1906-10, 1901-5, 1896-1900 and 1891-5, respectively, i.e., since the compulsory notification of infectious diseases came into force under the Public Health (London) Act, 1891. Cerebro-spinal Fever (epidemic Cerebro-spinal Meningitis) or " Spotted " Fever and Acute Poliomyelitis (Acute Polioencephalitis. Particulars as to the cases of cerebro-spinal fever (epidemic crebro-spinal meningitis) or "spotted" fever, and of acute poliomyelitis (acute polio-encephalitis) are set out in the Local Government Board's new Table V. (vide Appendix.) Smallpox, Cholera, Plague, Typhus, Simple continued or ill-defined-Fever, Human Glanders or Anthrax or Hydrophobia. No genuine cases of smallpox*, cholera, plague, typhus, simple continued or ill-defined fever, human glanders or anthrax or hydrophobia were notified during 1915, and no deaths were registered as having occurred from such diseases. Whooping Cough. Whooping cough became compulsorily notifiable throughout the Borough on January 1st, 1913, by order made by the Borough Council on October 5th, 1912, and approved by the Local Government Board on October 31st, 1912. The disease is compulsorily notifiable by both medical men and parents (or relatives) for a trial period of five years. The notifications received (a) from medical men have been as follow :—1913, 1,428; 1914, 1,389; and •One case of notified smallpox (a sailor) proved to be chickenpox (in the opinion of the Hospital Authorities). 28 1915, 1,607; and (b) from other sources as follow:—1913, 612; 1914, 581; and 1915, 507. The total 2.114 cases notified during 1915 occurred in 1548 infected houses, and of these 2,114 cases 49 died. The arrangements for the isolation in hospital of cases of whooping cough (and the same applies to measles and German measles) are unsatisfactory. The Metropolitan Asylums Board under their special orders only admit the cases to their hospitals when there is room, and the same applies to the Poor Law Institutions. Typhoid Fever. During 1915 the incidence of typhoid or enteric in the Borough was small—32 cases notified and 9 deaths registered; 6 of the cases were traced to sources outside the Borough, 9 proved not to be suffering from the disease, and 4 were secondary, i.e., derived from previous cases (notified or unnotified). No case could be traced definitely and conclusively to infected ice creams, water, milk, fried or shell fish or watercress, though in four instances there was a history of oysters having been consumed by the patients two or three weeks prior to their attacks. In connection with the alleged danger from shell fish, it may be mentioned that the Local Government Board has issued an Order, in pursuance of the Public Health (Regulations as to Food) Act, 1907, known as the Public Health (Shell Fish) Regulations, 1915, which came into force on March 1st, 1915. These regulations prohibit the sale of shell fish likely to cause danger to the public health. Tuberculosis. Details of the work carried out during 1915 at the Dispensaries connected with the Lambeth Municipal Tuberculosis Dispensaries Scheme are to be found in the Appendix. The distribution of tuberculosis, as a disease, throughout the Borough, during 1915, can be gauged from the official notifications that have been received under the Public Health (Tuberculosis) Regulations, 1912, which came into force on February 1st, 1913, making tuberculosis (both pulmonary and other forms) compulsorily notifiable, all previous Regulations* being then revoked. All these sources of notifications received during 1915 are set out in Table H specially prepared for the Local Government Board and Tables H (I) and H (II) dealing with (a) Wards, and (b) Registration Sub-Districts. In each case notified, from whatever source, a visit is paid (unless the notifying medical man is of opinion that such an official visit is unnecessary), leaflets are distributed, instructions are given 29 as to simple precautionary measures to be taken, and disinfection is carried out as required, but with due regard to privacy, special instructions being given to the officers to avoid doing anything likely to cause pain or annoyance to the patients or their friends as the result of the official action taken on notification. Taking all the primary notifications of (a) tuberculosis (all???forms) and (b) pulmonary tuberculosis (consumption or phthisis) received during 1915—totals of 1,318 and 1,020 respectively, the incidences upon the Inner and the Outer Districts (Registration Sub-Districts and Wards), are as follows (stated per 1,000 population):— (a) Tuberculosis (all forms). 1. Wards— Inner—6.2, viz.: Marsh, 6.1; Bishop's, 9.9; Prince's 4.7; Vauxhall, 4.6. Outer—3.5, viz.: Stockwell, 3.9; Brixton, 3.6; Heme Hill, 4.2; Tulse Hill, 2.1; Norwood, 3.5. 2. Registration Sub-Districts— Inner—6.2, viz.: Lambeth Church, 8.9; Kennington, 4.7; Inner Stockwell, 4.6 Outer—3.5, viz.: Outer Stockwell, 3.9; Brixton, 3.9; Norwood, 2.8. Borough of Lambeth =4.6. (6) Tuberculosis (Pulmonary). 1. Wards— Inner—4.7, viz.: Marsh, 4.9; Bishop's, 6.9; Prince's, 3.4; Vauxhall, 3.4. Outer—2.8, viz.: Stockwell, 3.2 ; Brixton, 3.0; Heme Hill, 3.2; Tulse Hill, 1.8; Norwood, 21. 2. Registration Sub-Districts— Inner—4.7, viz.: Lambeth Church, 6.6; Kennington 3.4; Inner Stockwell, 3.7. Outer—2.8, viz.: Outer Stockwell, 3.2; Brixton, 3.1 Norwood, 2.3. Borough of Lambeth =3.6. *Public Health (Tuberculosis) Poor Law Regulations, 1908, which came into force on January 1st, 1909, Public Health (Tuberculosis in Hospitals) Regulations, 1911, which came into force May 1st, 1911, and Public Health (Tuberculosis) Regulations, 1911, which came into force on January 1st, 1912. b 30 31 metropolitan borough of lambeth. TABLE H. Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications received during the period from 2nd January, 1915, to the end of the week ending the 1st January, 1916. Number of Notifications on Form A. Number of Notifications on Form B. Number of Notifications on Form C. Number of Notifications on Form D. Age-Periods. Primary Notifications. (Medical.) *Total Notifications (i.e., including cases previously notified by other Doctors). (Medical.) Primary Notifications (Medical.) † Total Notifications (i.e.. including cases previously notified by other Doctors). (Medical.) Cases admitted to Cases discharged from O to 1. 1 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. upwards. Total | Under 5. 5 to 10. 10 to 15. Total." Poor Law Institutions. (Medi Sanatoria. cal.) Poor Law Institutions. (Medi Sanatoria. cal.) Pulmonary— Males 2 8 20 24 34 57 131 127 86 51 15 555 686 — 2 3 5 6 101 165 126 159 Females 1 2 17 28 35 64 122 84 60 25 18 456 557 — 3 1 4 4 39 84 52 85 N on-Pulmonary— Males 11 29 40 26 10 1 9 2 2 — 2 132 144 1 3 4 8 8 5 11 3 17 Females 9 24 37 33 16 4 11 9 4 2 2 151 158 2 3 2 7 7 7 16 6 12 * Re-notifications (Form A)=232 (males 131, females 101), pulmonary and 19 (males 12, females 7) non-pulmonary. † Re-notifications (Form B)=l (male 1), pulmonary and 0 non-pulmonary. N.B.—Pulmonary—474 private, 291 hospitals, 205 dispensaries, 41 Poor Law Officers and 10 schools=1021 total primary notifications (Forms A and B). Non-Pulmonary—137 private, 78 hospitals, 62 dispensaries, 6 Poor Law Officers and 14 schools=297 total primary notifications (Forms A and B). 32 METROPOLITAN BOROUGH OF LAMBETH. TABLE H (1.). Public Health (Tuberculosis) Regulations, 1912. Summary of Notification Certificates (Forms A, B, C, D,) received during the period from January 2nd, 1915, to the end of the week ending January 1st, 1916. I. WARDS. Wards. 1915. Tuberculosis (All Forms.) Pulmonary. Non-Pulmonary. A. B. C. D. A. B. C. D. Primary. Total. Primary. Total. Poor Law. Sanatorium. Poor Law. Sanatorium. Primary. Total. Primary. Total. Poor Law. Sanatorium. Poor Law. Sanatorium. Marsh 98 118 2 2 15 10 21 8 18 20 4 4 — 3 — 1 Bishop's 205 253 1 1 44 31 46 36 87 91 3 3 1 4 — 2 Prince's 134 166 3 3 16 27 30 27 50 54 1 1 — 3 2 6 Vauxhall 109 127 — — 17 34 32 28 24 26 1 1 1 4 2 4 Total Inner Wards 546 664 6 6 92 102 129 99 179 191 9 9 2 14 4 13 Stockwell 97 129 — — 14 33 14 33 22 25 1 1 2 2 2 3 Brixton 127 153 2 2 14 36 13 31 24 24 1 1 — 4 — 2 Home Hill 103 131 — — 9 32 7 35 25 29 4 4 — 3 — 4 Tulse Hill 53 63 1 2 5 19 5 25 9 9 — — 1 3 1 5 Norwood 85 103 — — 6 27 10 21 24 24 — — 7 1 2 2 Total Outer Wards 465 579 3 4 48 147 49 145 104 111 6 6 10 13 5 16 Borough of Lambeth 1,011 1,243 9 10 140 249 178 244 283 302 15 15 12 27 9 29 33 METROPOLITAN BOROUGH OF LAMBETH. TABLE H (II.) Public Health (Tuberculosis) Regulations, 1912. Summary of Notification Certificates (Forms A, B, C, D,) received during the period from January 2nd, 1915, to the end of the week ending January 1st, 1916. Registration Sub-Districts. 1915. Tuberculosis (All Forms). Pulmonary. Non-Pulmonary. A. b. C. D. A. b. C. D. Forms. Primary. Total. Primary. Total. Poor Law. Sanatorium. Poor Law. Sanatorium. Primary. Total. Primary. Total. Poor Law. Sanatorium. Poor Law. Sanatorium. Waterloo 98 118 2 2 15 10 21 8 18 20 4 4 — 3 — 1 Lambeth Church 189 199 1 1 22 27 22 18 77 91 2 2 — 3 — 2 Kennington 150 220 3 3 38 31 54 45 60 54 2 2 1 4 2 6 Stockwell (Inner) 109 127 — — 17 34 32 28 24 26 1 1 1 4 2 4 Total Inner Districts 546 664 6 6 92 102 129 99 179 191 9 9 2 14 4 13 Stockwell (Outer) 97 129 — — 14 33 14 33 22 25 1 1 2 2 2 3 Brixton 230 284 2 2 23 68 20 66 49 53 5 5 — 7 6 Norwood 138 166 1 2 11 46 15 46 33 33 — — 8 4 3 7 Total Outer Districts 465 579 3 4 48 147 49 145 104 111 6 6 10 13 5 16 Borough of Lambeth 1,011 1,243 9 10 140 249 178 244 283 302 15 15 12 27 9 29 34 Chickenpox. During 1915 the London County Council made an Order (confirmed by the Local Government Board), rendering cases of chickenpox compulsorily notifiable throughout the Borough (and the rest of the metropolis) from March 17th to June 30th. The reasons for the issuing of the Order were (a) the danger of smallpox being introduced through the medium of troops, refugees, &c., and (b) the difficulty that arises at times in diagnosing as between smallpox (in one of its many modified, forms) and chicken-pox. During this notifiable period (3½ months) 473 cases of chickenpox were notified by medical men—66 from March 17th to March 31st, and 407 from April 1st to April 30th. The 473 notified cases occurred in 429 infected houses. Diphtheria and Membranous Croup. During 1915, 44 vials of antitoxin were distributed under the Antitoxin Order, 1910, free of cost to medical practitioners practising within the Borough. During 1915 an outbreak of diphtheria in connection with a public institution was under investigation—a total of 68 cases, 2 girls and 65 boys and 1 assistant matron of the boys' department, extending over a period of three months. The majority of the cases were bacteriological diphtheria, though many shewed also the usual clinical symptoms. The type of the disease was mild—only 1 death (a boy) occurring. The usual precautionary measures were taken, viz., isolation of cases at hospital, bacteriological examinations of contacts and suspects, examinations of water and milk supplies, the use of antitoxin as a prophylactic, disinfection, &c. After careful enquiries into the usual channels through which diphtheria is spread, nothing was found satisfactorily to explain the outbreak, but it was noted that cats were kept as pets at the institution, and it was deemed advisable to make an examination of the cats' throats and noses with a view to discovering if the diphtheria germs were being transferred to the patients from such animals or vice versa. There were 9 cats in all and 3 (belonging to the boys' department) shewed the true diphtheria germ in their throats or noses, 1 (belonging to the girls' department) the pseudodiphtheria germ, whilst the remaining 5 proved negative in so far as the diphtheria germ (true or pseudo) was concerned, but shewed the presence of stephylococci and streptococci. These 5 cats were connected with the girls' department (3), the laundry (1), and the lodge (1). It is interesting to note that there were 3 infected (diphtheria) cats found in the boys' department, which furnished 97 1 per cent. of the total cases comprising the outbreak, and in this connection the superintendent reported that the boys were oftener found to be fondling and playing with cats as pets than the girls. There is still the doubt as to whether the cats infected the boys or the boys the cats, but as an extra precautionary measure the cats were all destroyed, and the outbreak afterwards ceased. 35 During 1915 no school was closed for diphtheria, but 2 schools (9 class rooms) were disinfected on account of cases amongst the scholars. During 1915, 4 cases of membranous croup were notified (no deaths), all the patients being removed to hospital. Puerperal Fever and Ophthalmia Neonatorum. The numbers of cases notified and deaths registered, during 1915, from these two diseases were, respectively, 26 and 73 (notified cases), and 12 and 0 (registered deaths). Having regard to the total number of births registered (7,878) the incidences of these two diseases are small. Both are preventible and caused through neglect or want of care on the part of those in charge of the mother during the puerperium and of the infant during the first few days or weeks of life. During 1915 two instances of neglect on the part of midwives were reported, and in one, a prima facie case was established and reported to the Central Midwives Board by the London County Council as the local supervising authority, with the result that the midwife's name was taken off the roll. Erysipelas. During 1915, 177 cases were notified and 14 deaths registered from erysipelas, a septic disease. The majority of the cases notified were of a mild type, and not such as were anticipated by the framers of the Notification Acts. Scarlet Fever. No school outbreak of scarlet fever occurred during 1915, necessitating closure, but in 6 instances (4 public and 2 private schools) class rooms were disinfected on account of cases amongst the scholars—a total of 26 class rooms. 2.—Non-Notifiable Diseases. Chickenpox. In addition to the 473 cases of chickenpox which were notified during 1915 between March 17th and June 30th, during which period the disease was compulsorily notifiable, 728 other cases were reported voluntarily through schools or otherwise—151 in the first quarter, 184 in the second, 128 in the third and 265 in the fourth. The total 1,201 cases occurred in 1,089 infected houses. 36 Measles. During 1915, 1,880 cases of measles were notified voluntarily through schools or otherwise—774 in the first quarter, 832 in the second, 205 in the third, and 69 in the fourth, and 91 deaths were registered from the same disease. The 1,880 cases occurred in 1,612 infected houses. 73 schools (infants' departments) were dealt with, representing 80 different class rooms or grades, and a total of 1,056 children excluded for periods varying from a few days to a few weeks on account of outbreaks of the disease in connection therewith (a total of 146 cases of measles). An Order, dated November 27th, 1915, entitled the Public Health (Measles and German Measles) Regulations, 1915, has been issued by the Local Government Board, making measles and German measles compulsorily notifiable on and after January 1st, 1916. The notification is dual by (1) medical man in attendance and (2) parents, guardians and other persons in charge of the patients. Diarrhœa. During 1915, there has been a marked decrease in the number of deaths from diarrhoea—124, as compared with yearly averages of 191.6, 219.4, 208.6, 140.2 and 178.2 during the five quinquennia 1891-1895, 1896-1900, 1901-1905, 1906-1910 and 1911-1915, respectively. Of the 124 deaths registered during 1915, 112, i.e., 90.3 per cent. occurred amongst children under 5 years of age and 87, i.e., 70.2 amongst infants under 1 year of age. The 4 ft. earth thermometer first registered 56° F. on June 9th, rising to a maximum of 61° F. on August 14th, and remaining at such maximum until August 23rd, and sinking to 56° F. again on October 13th. The readings of the 4 ft. earth thermometer were taken in Regent's Park, and the information was obtained through the courtesy of the the Secretary of the Royal Botanical Society. 20 deaths (11 in infants under 1 year of age) were registered during 1915 from enteritis. Practical measures were again taken to prevent epidemic diarrhœa (and other diseases) in infants and to promote hygienic conditions in their feeding and environment, as follows:— (a) Visiting of houses wherein births were notified under the Notification of Births Act, 1907, or wherein deaths were registered as having occurred from epidemic diarrhoea; (b) Teaching of proper feeding and care and management of infants by the Council's officers at the Infants' Consultations held at 66, York Road; 37 (c) Issuing of special leaflets or posters during the summer, dealing with (1) precautions to be taken against summer diarrhœa, (2) the danger of the areas of infection and the contamination of food by flies, (3) the importance of removing at once all accumulations of refuse and other offensive matters from the neighbourhood of dwellings, (4) the value of cleanliness generally, &c. Epidemic Influenza. During 1915, 85 deaths were registered from epidemic influenza —54 in the first quarter, 15 in the second, 7 in the third, and 9 in the fourth, the annual averages for the two decennia 1891-1900 (Parish) and 1901-1910 (Borough) being 107.5 and 53.2, respectively. 3.—" Contacts "and " Suspects." During 1915 many "contacts" or "suspects" were watched in connection with different diseases, as follow:— (a) Smallpox. 14 smallpox "contacts," who arrived from abroad (Rangoon, Barcelona, Austria, Alexandria, and Flushing) per SS. "Burma," "Onward," "Victoria," "Invicta," and "Mecklinburgh," respectively; and 25 smallpox "contacts" (War Belgium Refugees), connected with a case of smallpox (a charwoman) at the Earl's Court Camp. (b) Typhoid or Enteric Fever. 4 typhoid or enteric fever "contacts," who arrived from abroad (Boulogne, Calais, Vienna and Dieppe), per SS. "Onward," "The Queen," "Invicta," and "Sussex," respectively. (c) Typhus Fever. 2 typhus fever "contacts," who arrived from abroad (Montenegro and Servia), per SS. "Victoria." (d) Plague. 1 plague "contact" who arrived from abroad (Bombay), per SS. "Umtata." b2 38 39 TABLE I. Shewing the total numbers of cases of infectious diseases notified (a) compulsorily under the Notification Clauses of the Public Health (London) Act, 1891, and the Orders and Regulations made thereunder, and (b) voluntarily through schools and from other sources, in the Borough of Lambeth, during 1915, together with the total numbers of deaths registered from the same diseases, and the case mortality per 100 persons for each disease. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals for 1915. Case mortality Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths per 100. (a) Compulsorily notified. Cholera — — — — — — — — — — — Smallpox — — — — — — — — — — — Scarlet Fever 255 7 215 4 212 3 218 3 900 17 1.9 Diphtheria 133 11 103 11 100 11 98 12 434 45 10.4 Membranous Croup 1 — 2 — 1 — — — 4 — 0.0 Typhus — — — — — — — — — — — Typhoid or Enteric 11 1 5 1 10 5 6 2 32 9 28.1 Continued and Relapsing Fever — — — — — — — — — — — Erysipelas 48 6 49 3 29 1 51 4 177 14 7.9 Puerperal Fever 6 3 5 2 4 3 11 4 26 12 46.1 *Plague — — — — — — — — — — — *Cerebro-Spinal Fever 13 7 18 17 11 7 2 — 44 31 70.5 *Poliomyelitis acuta 1 — 1 — 1 — 1 — 4 — 0.0 *Ophthalmia Neonatorum 19 — 19 — 22 — 13 — 4 — 0.0 *Whooping Cough (medical men) 301 16 618 16 22 382 9 13 306 8 73 1,607 49 2.3 ,, (other sources) 90 218 104 95 507 *Chickenpox (March 17th to June 30th) 66 — 398 — 9 — — — 473 — 0.0 *Tuberculosis— Pulmonary (primary) 257 123 270 102 258 86 235 102 1,020 413 40.5 Non-pulmonary (primary) 49 30 68 29 91 25 90 21 298 105 35.2 (b) Voluntarily notified. Measles 774 58 832 23 205 8 69 2 1,880 91 4.8 Chickenpox 151 — 184 — 128 — 265 — 728 91 0.0 Totals 2,175 262 3,005 208 1,567 158 1,460 158 8,207 786 9.6 *Plague was made compulsory notifiable an September 19th, 1900. Cerebro-Spinal Fever on March 12th, 1907. myelities acuta on September 1st, 1911, Opthalmia Neonatorum on March 13th, 1911. Whooping Cough on January 1st, 1913, and Tuberculosis (all forms) on February 1st, 1913. Chiken-pox was compulsorily notifiable as follow: 1902 (February 7th to December 31st), 1903 (January 1st to 6th), 1904 (April 8th to November 8th), and 1911 (March 22nd to June 22nd), and 1915 (March 17th to June 30th), the number of cases notified being respectively 1,560, 40, 556, 238 and 473. 40 41 TABLE J. Shewing the number of medical Certificates for the compulsorily Notifiable Infectious Diseases under the notification clauses of the Public Health (London) Act, 1891, or the Orders and Regulations made thereunder, received in the Borough of Lambeth during 1915 and during the four years 1911-1914, together with the averages for the two decennia 1891-1900 (Parish) and 1901-1910 (Borough). Disease. Borough of Lambeth. Annual Average, 1901-10 (Borough) 10 years. Annual Average, 1891-1900 (Parish) 10 years. Totals, 1915. No. of cases notified. No. of cases removed to Hospital. Per cent. of cases removed 1911. 1912. 1913. 1914. Cholera 1 — — — 0.2 11.5 — — — Smallpox — — — — 49.9 22.0 — — — Scarlet Fever 761 604 1,370 1,745 1105.1 1331.3 900 841 93.4 Diphtheria 398 328 385 550 379.8 715.1 434 393 95.2 Membranous Croup 4 5 7 6 10.4 26.2 4 4 100.0 Typhus — — — — 0.1 1.1 — — — Typhoid or Enteric 60 61 38 48 100.5 189.6 32 24 75.0 Continued and Relapsing — 1 2 2 4.1 25.7 — — — Erysipelas 241 216 206 231 241-4 347.0 177 46 25.9 Puerperal 21 24 25 23 17.0 18.9 26 21 80.8 *Plague — — — — — — — — — *Cerebro-Spinal Fever 9 7 7 5 11.5 — 44 29 65.9 *Poliomyelitis acuta 9 10 6 10 — — 4 3 75.0 *Ophthamlmia Neonatorum 69 76 57 57 - - 73 - 0.0 *Whooping Cough - - 1,428 1,389 - - 1,607 11 0.7 *T uberculosis— Pulmonary (primarv) 1,057 1,822 1,571 1,250 - - 1,020 - - Non-pulmonary (primary) - - 456 273 - - 298 - - Chickenpox (March 17th to June 30th) 238 - - - — - 473 — — Totals 2,868 3,154 5,558 5,589 1912.5 2658.4 5,092 1,372 26.9 *Plague was made compulsorily notifiable on September 19th, 1900, Cerebro Spinal Fever ("Spotted Fever") on March 12th, 1907, Poliomyelitis acuta on September 1st, 1911; Ophthalmia Neonatorum on March 13th, 1911, Pulmonary Tuberculosis (Poor Law cases) on Jan. 1st, 1909, Pulmonary Tuberculosis (Hospital cases) on May 1st, 1911, Pulmonary Tuberculosis (Private cases) on Jan. 1st, 1912, and Tuberculosis (Pulmonary and Non-pulmonary) on February 1st, 1913, and Whooping Cough on January 1st, 1913, whilst Chicken-pox was compulsorily notifiable as followss: —1902 (February 7th to December 31st), 1903 (January 1st to 6th), 1904 (April 8th to November 8th), 1911 (March 22nd to June 22nd) and 1915 (March 17th to June 30th), the numbers of cases notified being respectively 1560, 40, 556, 238 and 473. N.B. —Of the patients removed to Hospital, the following were reported not to be suffering from the diseases notified:— Scarlet fever 70; diphtheria 23; typhoid or enteric 9; cerebro-spinal fever 1; Measles 5. 42 43 TABLE K. TABLE K. [Local Government Board Old Table A.] Table of DEATHS during the year 1915 in the Borough of Lambeth,. classified according to Diseases, Ages, and Localities. Mortality from all Causes at subjoined Ages. Mortality from subjoined Causes, distinguishing Deaths of Children under Five Years of Age. Names of Localities adopted for the purpose of these Statistics, public institutions being shewn as separate localities. At all ages. Under 1 year l ana under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Scarlatina. Diphtheria. Fevers. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. Cerebro-Spinal Fever. Appendicitis. All other Diseases. Total. Puerperal. Enteric or Typhoid. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. (a) (6) (c) (d) (e) (f) (g) (h) (i) (j) (k) Royal Infirmary (Women and Children) 112 37 22 19 9 7 8 9 1 Under 5 — 1 — — — 3 — 7 — 1 22 — — 2 3 — 39 78 5 upwds. — — — — — — — — 1 — 2 10 — — — 2 19 34 King George Hospital 78 — — — — 36 42 — — Under 5 — — — — — — — 2 — — — — — — — — — — 5 upwds. — — — — — — — — — 2 3 — — 59 — 1 11 78 General Lying-in Hospital, 31 28 — — — 1 1 1 - Under 5 — — — — — — — — — — — — — — — — 28 28 5 upwds. — — — — — — — — — — — — — — — — 3 3 St. Thomas's Hospital 515 52 27 27 56 41 132 132 48 Under 5 — 3 — — — 3 — 20 — — 19 — — 10 9 — 41 106 5 upwds. — 4 5 — 2 1 — 3 2 14 l5 23 — 53 3 37 245 409 Remainder of Lambeth Church 444 104 30 24 15 11 50 105 105 Under 5 — — — — — 24 7 10 — — 52 — — 4 1 — 60 158 5 upwds. — — — — — — — — 1 35 71 51 4 26 1 — 97 286 Lambeth Workhouse 31 5 — — — — — 2 24 Under 5 — — — — — — — — — — — — — — — — 5 5 5 upwds. — — — — — — — — — — 7 17 — — — — 2 26 Lambeth Infirmary 1039 56 22 15 18 35 187 311 395 Under 5 — 1 — 1 — 8 2 18 — — 27 — — 2 1 — 33 93 5 upwds. 1 — 2 5 10 — — — 2 166 164 184 — 27 3 3 379 946 St. Peter's House 48 — — — — — — 6 42 Under 5 — — — — — — — — — — — — — — — — — — 5 upwds. — — — — — — — — — — 19 9 — — — — 20 48 Remainder of Kennington 408 79 23 25 8 17 35 94 127 Under 5 — — — — — 21 14 23 — — 30 — — 1 1 — 37 127 5 upwds. — — — — — — — 1 3 39 76 39 17 4 — — 102 281 South-Western Hospital 154 7 12 35 49 20 19 12 — Under 5 15 22 — — — 9 1 — — 3 — — — 2 — 2 54 5 upwds. 15 26 1 10 — 5 — — — — 6 2 — — 22 1 12 100 Clapham Maternity 14 11 — — — 1 2 — — Under 5 — — — — — — — — — — — — — — — — 11 11 5 upwds. — — 1 — — — — — — — — — — — —! — 2 3 Remainder of Stockwell 580 106 24 24 12 10 60 142 202 Under 5 — — — — — 10 13 11 — 1 48 — — 5 11 — 65 154 5 upwds. — — 1 — 1 1 — — 1 50 109 68 13 5 1 1 175 426 44 45 TABLE K. TABLE K. [Local Government Board Old Table A.] Table of DEATHS during the year 1915 in the Borough of Lambeth, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics, public institutions being shewn as separate localities. Mortality from all Causes at subjoined Ages. Mortality from subjoined Causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Fevers. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. Cerebro-Spinal Fever. Appendicitis. All other Diseases. Total. Scarlatina. Diphtheria. Puerperal. Enteric or Typhoid. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) 'King's College Hospital 222 51 14 24 30 13 40 38 12 Under 5 — 3 — — — — 2 17 — — 15 — — 6 1 — 45 89 5 upwds. — 2 — 1 — — — — 1 5 6 20 — 26 1 3 65 133 Belgrave Hospital 159 107 26 21 5 — — — — Under 5 — 1 — — — 1 — 22 — — 35 — — 1 2 — 92 154 5 upwds. — — — — — — — — — — — — — — — — 2 5 1st London General Hospital 39 — — — — 25 13 1 — Under 5 — — — — — — — — — — — — — — — — — — 5 upwds. — — — — — — — — — 4 1 — — 24 1 — 9 39 4th London General Hospital 59 — — — — 20 30 9 — Under 5 — — — — — — — — — — — — — — — — — — 5 upwds. — — — 1 — — — — — 4 7 5 — 23 — 2 17 59 Remainder of Brixton 735 102 18 18 17 30 86 167 297 Under 5 — 2 — — — 12 5 12 — — 35 — 2 7 — — 63 138 5 upwds. — 1 2 — 2 1 — 2 5 57 133 118 24 26 — 1 225 597 Lambeth Workhouse Schools 40 21 9 5 3 2 — — — Under 5 — — — — — 1 5 6 — — 2 — — — — — — 35 5 upwds. — — — — — — — — — — — — — — — — 2 5 British Home of Incurables 9 — — — — — 2 4 3 Under 5 — — — — — — — — — — — — — — — — — — 5 upwds. — — — — — — — — — — — — — — — — 8 9 Remainder of Norwood 606 85 14 13 11 13 58 149 263 Under 5 1 1 — — — 4 3 13 — — 16 — 5 4 2 1 — 112 5 upwds. — 1 — — 1 1 — 3 2 37 98 91 18 14 2 1 225 494 Totals 5323 851 241 250 233 282 765 1182 1519 Under 5 \ 16 34 — 1 — 96 52 159 — 3 304 — 7 42 23 1 604 1342 5 upwds. \ 16 34 15 20 16 9 — 11 18 415 719 638 77 287 34 52 1620 3981 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 643 49 22 17 31 40 138 165 181 Under 5 2 7 — — — 5 1 6 — — 21 1 — 2 3 — 40 88 5 upwds. 3 6 2 2 2 1 — 4 1 62 53 83 2 42 5 1 286 555 Deaths occurring within the district among persons not belonging thereto 1313 217 79 87 108 167 292 243 120 Under 5 10 18 — — — 16 4 53 — 1 67 — — 12 11 — 191 383 5 upwds. 10 18 5 14 4 4 — 3 4 66 56 87 1 80 23 34 421 930 46 47 TABLE L. TABLE L. Table of Civil Population, Births and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health (by notification), during the year 1915, in the Borough of Lambeth, classified according to Diseases and Localities. [Local Government Board Old Table B.] Registration Sub-Districts. Population at all Ages. Registered Births 1915. New Cases of Sickness in each the knowledge of the Medical during Locality, coming to Officer of Health 1915. Number of such Cases removed from their Homes in the several Localities for Treatment in Isolation Hospital during 1915. Census 1911. Estimated 1915. [Civil Population.) 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 Scarlatina. Diphtheria. Membranous Croup. Fevers. Cerebro-spinal Fever. Polio-myelitis Acuta. Ophthalmia. Whooping Cough. Chicken-Pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Erysipelas. Cerebro-spinal Fever. Polio-myelitis Acuta. Ophthalmia. Whooping Cough. Chicken-Pox. Typhoid or Enteric. Continued & Relapsing. Puerperal. Erysipelas. Typhoid or Enteric. Continued & Relapsing. Puerperal. (a) (b) (c) (d) Lambeth Church 47910 43992 2406 142 81 3 5 — 4 24 17 — 9 448 139 134 71 3 3 — 4 11 14 — — 4 — Kennington 48609 45479 1058 146 56 — 7 — 3 33 2 2 22 315 76 142 51 _ 6 — 3 4 — 2 — 2 — Stockwell 62608 59565 1913 140 78 1 7 — 6 34 11 — 18 240 82 133 75 1 6 — 5 12 7 — — 2 — Brixton 76650 74144 1453 196 139 — 12 — 7 58 3 2 20 271 72 179 127 — 8 — 4 8 1 1 — 1 — Norwood 62281 61008 1048 276 80 — 1 — 6 28 11 — 4 333 104 253 69 — 1 — 5 11 7 — — 2 — Totals 298058 284188 7878 900 434 4 32 — 26 177 44 4 73 1607 473 841 393 4 24 — 21 46 29 3 — 11 — N.B.—-In addition to the above new cases of infectious sickness coming to the knowledge of the Medical Officer of Health by compulsory medical cation under the Notification Clauses of the Public Health (London) Act, 1891, or the Orders and Regulations made thereunder, the following cases were notified voluntarily, viz.: Chicken Pox 728, Measles 1880, and Whooping Cough 507. 48 BOROUGH OF LAMBETH. SUMMARY OF VITAL AND MORTAL STATISTICS, etc., FOR 1915. Area of Borough—4,080-4 statute acres (inclusive of land and inland water, but exclusive of tidal water 82.1 and foreshore 31.1 statute acres respectively), divided into 5 Registration SubDistricts, 4 Parliamentary Divisions, and 9 Wards. The Parliamentary Divisions and Wards are not co-extensive but the Registration Sub-Districts and the Wards are. Civil Population—estimated 1915—284,188 (males 129,040, and females 155,148). *Density—69-6 persons per statute acre (inclusive of land and inland water, but exclusive of tidal water and foreshore). Births (uncorrected)—7,878 being 27.7 per 1,000. Deaths (corrected)—4,653 being 16.4 per 1,000. Infantile Mortality (corrected)—683 deaths (corrected) under 1 year, being 86.7 per 1,000 total (uncorrected) births, or 95.8 per 1,000 total (corrected) births. Zymotic Death-rate (corrected)—1.2 per 1,000 (total corrected zymotic deaths, 335). *The densities (based upon the estimated civil populations) vary in the different Registration Sub-Districts as follows—Lambeth Church (354.3 acres) 124.2, Kennington (398.3 acres) 114.2, Stockwell (583 acres) 102.2, Brixton (1026.6 acres) 72.2, and Norwood 1718.2 acres) 35.5 per statute acre respectively. 49 II— SANITARY WORK. (Dealing with the sanitary circumstances and.-administration of the Borough of Lambeth.) Return shewing the Number of Notices served in the Borough of Lambeth, from the 1st January to the 31st December, 1915. Number of Notices served 12,752 .4. COMPULSORILY NOTIFIABLE INFECTIOUS DISEASES* (Public Health (London) Act.) No. of Notices served 3774 No. of Infected Houses 3062 Scarlet Fever 757 Typhoid 25 Diphtheria 354 Membranous Croup 4 Puerperal Fever 26 Erysipelas 173 Cerebro-Spinal Fever 40 Acute Polio-Myelitis 4 Ophthalmia Neonatorum 73 Whooping Cough 1177 †Chicken-Pox 429 B. GENERAL NUISANCES AND DRAINAGE DEFECTS. (Public Health (London) Act, and Metropolis Local Management Acts.) No. of Notices served 8978 Works, Structural— Drainage Defective 976 Intercepting Traps with Fresh Inlets required 111 Ventilating Pipes required 198 Indoor Sinks connected with Drain 201 Rain Water Stacks connected with Drain 476 Bath Waste connected with Drain 196 Traps Defective, or of Obsolete Pattern 674 Closet Pan and Connections Defective 781 Water Supply to Closet Defective 849 Closet Dilapidated 559 Draw-off Main for Drinking Purposes required 301 Dust Bins Defective 902 Premises Dilapidated 876 Ventilation under Floors required 297 Roofs Dilapidated 860 Soil Pipes Defective 97 * Excluding tuberculosis, † Compulsorily notifiable from March 17th to June 30th, 1915, 50 Paving Defective 1045 Damp and Unwholesome Houses 272 Dung Receptacles required 19 Defective Water Pipes 58 No W.C. Accommodation 9 9757 Works, not Structural— Cisterns Dirty 391 Manure Accumulations 59 Underground Rooms occupied 24 Animals Improperly Kept 31 Stopped Drains 306 Overcrowding 41 Foul Urinals 14 Refuse Accumulations 256 No Water Supply or Defective Water Supply 568 Dirty Premises 6041 7731 TABLE M. PARTICULARS OF SANITARY WORK carried out by the Sanitary Staff in Lambeth Borough dur ing 1915, and during the 4 previous years (1911-1914, together with Yearly Averages for (a) the 10 year s1901 1910 (Borough), and (b) the 24 Years 1877-1900 (Parish). Year. Total Number of Notices (excluding those served under the Housing Acts). Sanitary Works, Structural and Permanent. Sanitary Works, Not Structural. 1915 12752 9757 7731 1914 15109 10175 6478 1913 14397 9167 5154 1912 12506 8679 4044 1911 12440 8008 3103 Yearly Average for 10 Years 19011910 (Borough) 13108.4 9348.4 3049.7 Yearly Average for 24 Years 18771900 (Parish) 5944.6 4756.9 2135.9 51 MALE SANITARY INSPECTORS.* During 1915 there has been no change in the personnel of the Male Sanitary Staff. Details of the work carried out are to be found in Tables M. and N. Contravention of By-laws. 1. Drainage Cases. Several cautionary letters were sent to builders, who had carried out drainage work (a) without giving previous notice, or (b) contrary to the requirements of the L.C.C. By-laws. In the latter case, the work was altered so as to comply with the requirements. 2. Removal of offensive matters. Several cautionary letters were sent to contractors whose employees had removed through the streets offensive matters during prohibited hours contrary to the requirements of the L.C.C. By-laws. The war caused a difficulty owing to vans and horses having been commandeered by the Government. Infected Houses and Drainage Defects Found. A routine sanitary inspection is made of infected houses, i.e., houses at which infectious disease is notified compulsorily, with the exception of ophthalmia neonatorum, whooping cough, chicken-pox, and tuberculosis, and the sanitary inspection includes the testing of the drains with the chemical test. Of 1,383 infected houses dealt with during 1915— (a) 83, i.e., 6.0 per cent. were found to have defective drains, i.e., a result was obtained with the chemical test employed. (b) 599, i.e., 43.3 per cent. showed defects in drains, traps, fittings and appliances. (c) 784, i.e., 56.7 per cent. showed no defects. For comparison, the yearly averages for the past 25 years may be stated. They are as follow:— *There are 12 District Male Sanitary Inspectors, viz., F. E. Baxter, J. M. Jones, J. S. Smith, J. Barfoot, G. J. Gavin, T. H. Hooper, T. H. Jackson, W. Wallis, W. W. Howes, J. M. Scorrer, J. S. Clements and A. Farran, and one special male Inspector for Food and Drugs (W. J. Perrin). 52 Yearly Averages. 1891-1900. (10 years.) 1901-1905. (5 years.) 1906-1910. (5 years.) 1911-1915 (5 years.) Number of infected houses 2246.1 1682.6 1719.2 1623.2 Houses with defects found 1150.0 911.2 1033.6 798.6 Houses with defective drains 438.3 214.6 166.6 102.8 Houses with no defects found 1088.1 771.4 685.6 824.6 Unsound Food. Several consignments of unsound food (including 70 tons of wheat, 280 bags of peas, 10 bales of Russian bacon, 705 boxes of sultanas, and 51 wild rabbits), discovered within the Borough, were inspected, condemned and destroyed or otherwise dealt with under the supervision of the Sanitary Inspectors and the details reported to the Council at the time. In the case of the damaged wheat and peas, the food was allowed to be made into poultry food or dod biscuits. Inspection of Market Thoroughfares. The market thoroughfares were under bi-weekly special inspections by the Sanitary Inspectors, 2 Inspectors being on duty at a time—Saturday night (9 to 12) and Sunday mornings (9 to 12). The market thoroughfares are Atlantic Road, Wandsworth Road New Cut, Lower Marsh, and Lambeth Walk. These systematic inspections are of value in securing wholesome food being exposed on stalls and in shops for sale. No official seizures under the Act were necessary. Outside Urinals of Public Houses. The outside urinals connected with public houses were under inspection, and notices were served as required. Male Public Conveniences. The male public conveniences situated within the Borough are under the supervision of the male Inspectors. House-to-House Inspections. House-to-house inspections are dealt with under the Housing Town Planning, etc., Act, 1909. 53 Other Inspections. The work in connection with disinfection, smoke abatement inspection of factories and workshops and outworkers' premises bake-houses, restaurants, and dining (coffee) rooms, births, the milk depot, the tuberculosis dispensaries, etc., and the carrying out of Food and Drugs and Housing Acts, is dealt with under separate headings. Legal Proceedings. It is again satisfactory to note that, during 1915, in only 2 cases was it found necessary to resort to legal proceedings before the Court in connection with Sanitary work under the Public Health and Metropolis Management Acts, in one case an order being made for the work to be done, and in the other the summons being withdrawn, the work having been completed. These legal proceedings had reference to (a) defective roof of a workplace and (b) defective flushing apparatus to w.c. of a private house. TABLE N. SUMMARY OF WORK DONE BY THE MALE SANITARY INSPECTORS DURING 1915. Inspections 7867 Re-inspections 54151 Complaints attended to 10053 Water Certificates issued 60 Revenue Act Certificates dealt with 57 Drains tested (with chemical, water or smoke test) 5206 Sanitary Works completed 4727 Plans of drainage reconstructions received 195 Premises the Drains of which have been totally or partly reconstructed 251 Samples of Food and Drugs taken 1844 Notices— Public Health (London) Act, 1891 (Preliminary or Intimation 5983 and Statutory 2977) 8960 Metropolis Local Management Acts 18 Sanitary Nuisances abated— (a) Structural 9757 (b) Non-Structural 7731 Summonses issued— Public Health Act 2 Food and Drugs Acts 26 Convictions obtained— *Public Health Act 1 † Food and Drugs Acts 18 * 1 summons was withdrawn. † 8 Summonses were withdrawn. 54 FEMALE SANITARY INSPECTORS.* During 1915, there has been no change in the personnel of the Female Sanitary Staff, with the exception that, from January 1st to February 4th, 1915, Miss M. Davis was allowed leave of absence to act as a nurse in France in connection with the War, her appointment being temporarily filled meanwhile. Work of Female Sanitary Inspectors. The two Female Sanitary Inspectors carried out, during 1915, duties in connection with the inspection of (a) Factories, Workshops (Work-places), Shops, Out-Workers' Homes, Laundries, Restaurants, etc., wherein women and girls are employed; (b) the Female Underground Conveniences (belonging to the Council), and other Female Sanitary Conveniences (Railway Stations, Hospitals, etc.); (c) Houses wherein births occurred or deaths amongst infants under 1 year of age, or deaths from infantile diarrhœa; (d) Schools wherein there were infectious disease outbreaks; (e) Houses wherein cases of tuberculosis or ophthalmia neonatorum were notified, etc. The year's work, 1915, may be tabulated as follows:— Work carried out by the Two Female Sanitary Inspectors during the Year, 1915, †Workshops visited and inspected— (a) Dressmakers 20 (b) Milliners — (c) Laundries 16 (d) Tailors 6 (e) Upholsterers — (f) Dyers — (g) Blouses 7 (h) Ties 3 (i) Others (e.g.), embroidery, toys, mineral waters, shirts, underclothing, boxes, mackintoshes, &c. 25 Work rooms inspected 32 Workshopst re-inspected 10 Workrooms re-inspected 4 Workshops†: workshops therein measured 85 Workshopst newly discovered and registered 11 *There are 2 female Sanitary Inspectors, viz., Miss F. M. Dawson, and Miss M. Davies. †Workshops include Work-places. 55 Workshops* removed from Register — Workshops* reported to H.M. Inspector 6 Workshops* reported by H.M. Inspector 12 † Premises visited, but not inspected, owing to the persons or patients concerned being out or, if employees, being no longer employed 1129 Female Conveniences visited and inspected— Public (visits paid) 260 Private — Schools visited— Public (visits paid) 80 Private — Special places visited and inspected— (a) Private Houses}: 2273 (b) Outworkers 201 Outworkers and Private Houses§ re-inspected 516 Written Intimation and Statutory Notices served 125 No. of Workshops*, etc., in which defects were found 128 No. of Workshops*, etc., in which no defects were found... 2503 Nuisances referred to M.O.H., for attention by male inspectors 8 Particulars of Defects Found. Work shops* etc.— 'Workrooms— Overcrowded 5 Damp 7 Dirty 29 Ill-ventilated 2 Badly-lighted — Insufficiently warmed 1 Otherwise — * Workshops include Work-places. † Births (465), Workshops (5), Out-workers (215), Diarrhoea cases (16), Schools (1), Tuberculosis cases (364), Ophthalmia cases (7), and special Complaints (56). † Births (1256), Diarrhoea cases (59), Tuberculosis cases (851), Puerperal lever (5), Ophthalmia cases (65), and special Visits (37). § Births (105), Diarrhoea cases (3), Tuberculosis cases (225), Out-workers (2), Puerperal fever cases (6), Ophthalmia cases (17?). and special Complaints (8). 56 Defective or dirty— Yards 11 Floors 16 Roofs 26 Windows 2 Ceilings 21 Rain Water Pipes 1 Sink Wastes 4 Water supply 3 Premises generally 27 Sanitary Appliances: Water Closets— Dirty 4 Ill-lighted — Unventilated 3 Choked 6 Defective 8 Defective Flushing Tanks and Water Supply 9 Sanitary Appliances: Drainage— Choked 1 Defective 2 Unventilated — Sanitary Appliances: Dustbins— Wanting 4 Defective 23 Sanitary Appliances: Lavatories— Dirty 2 Defective — * No separate suitable sufficient W.C. accommodation for the sexes 2 Miscellaneous defects, e. £., accumulations, personal uncleanliness, etc. 2 FEMALE HEALTH VISITOR.† Work of Female Health Visitor. The Council's Health Visitor has been engaged during 1915 in the systematic visiting of houses wherein births had been notified, in looking after the milk depot children (at the depot and at their own homes), in assisting in inspecting infants notified as suffering * The Sanitary Accommodation Order 1903 does not apply to the Metropolis. † There is one female health visitor, viz., Nurse T. McHugh. 57 from ophthalmia neonatorum, and in making enquines in connection with some of the notified tuberculosis cases—this last mentioned work being carried out on a separate day or days from those devoted to other visiting, etc. The work may be summarised as follows:— Visits and Revisits made in connection with— 1st Q. 2nd Q. 3rd Q. 4th Q. Total Births 520 362 387 205 1474 Ophthalmia cases 7 12 14 29 62 Depot children 6 6 6 12 30 Milk Depots— York Road 15 15 16 16 62 Moffat Institute* 75 66 63 58 262 Special cases 8 1 15 13 37 Tuberculosis cases 89 103 91 95 378 West Norwood Intant Waif are Centre - - - 11 11 Premises, but no one: found at home 126 118 122 76 442 FACTORIES AND WORKSHOPS. Factories. During 1915, 9 new factories were added to the Register, consisting of (a) laundry, 1; (b) engineering, 2; (c) mineral waters, 1; (d) beer bottling, 1; (e) van building, 1; (/) toy maker, 1; (g) adhesive making, 1; and (h) sausage making, 1. The Inspection of Factories by the Sanitary Inspectors is limited to that of the sanitary accommodation provided for the workers (such accommodation to be separate, sufficient and suitable), and sanitary defects, when found, are reported by the Factory Inspectors to the Council for amendment by the Council's officers (12 being reported during 1915). * Used as a branch (distributing centre) in connection with the Council's York Road Milk Depot. 58 Workshops. During 1915, 38 new workshops were added to the Register, consisting of the following:— Name of Trade or Business. No. of Workshops. Dressmakers 9 Laundries 5 Milliners 1 Tailors 4 Blouses 2 Underclothing 4 Mantles 3 Rag doll makers 2 Embroidery 1 Army clothing 2 Shopfitting 1 Not classified 4 Total 38 Full particulars concerning these factories and workshops were entered up in the Register shewing that, at the time of inspection, there were 87 workrooms, in which were working 600 persons—204 males and 396 females, as follow:— M. F. Total. Children — — — Young Persons 7 73 80 Adults 197 323 520 OUT-WORKERS. Lists of out-workers require to be sent in to the Council by employers, engaged in the special trades scheduled in the Home Work Order, 1911, twice yearly, viz. : on or before February 1st and August 1st respectively. During 1915, 14 February and 12 August lists were received, dealing with 147 and 139 out-workers respectively. Of the 286 out-workers, 120 belonged to Lambeth and 166 elsewhere. Particulars of the latter were sent to the Authorities concerned, whilst, in return, 163 lists were received from various outside authorities dealing with 1007 workers, of whom 973 belonged to Lambeth and 34 to districts outside Lambeth 59 TABLE O. FACTORIES AND WORKSHOPS REGISTERED DURING 1915. Numbers of Rooms and Persons Employed. Wards. No. of Factories. No. of Workshops. No. of Workrooms. Children. Young Persons. Adults. TOTALS. M. F. M. F. M. F. M. F. Total. Marsh 4 1 13 - - 6 - 90 13 96 13 109 Bishop's — 1 1 — — — — 3 2 3 2 5 Prince's 1 3 9 — — 1 1 67 8 68 9 77 Vauxhall 1 4 13 — — — 14 2 37 2 51 53 Stockwell — 3 5 — — — — — 10 — 10 10 Brixton — 10 17 — — — 48 30 130 30 178 208 Heme Hill 1 8 14 — — — 7 3 77 3 84 87 Tulse Hill 2 7 14 — — — — 2 45 2 45 47 Norwood 1 1 - - - 3 - 1 - 4 4 Total 9 38 87 — — 7 73 197 323 204 396 600 60 Of the total 1093 Lambeth out-workers reported during 1915, 149 were new out-workers, i.e., not previously registered, as follow :— Mantles 2 Furs 3 Blouses and skirts 12 Millinery 8 Ties, belts, and braces 16 Dresses — Children's underclothing and costumes 6 Nurses' Uniforms 3 Bag stringing 8 Women's clothing 6 Boxes and boxmaking 1 Tailors 22 Flag Making 2 Embroidery 12 Brushes 1 Waistcoats 2 Artificial flowers 13 Shirts 10 Paper Bags 2 Fancy Goods 4 Wire Working 1 Button-hole Making 1 Umbrellas 1 Boots and shoes 10 Army Bags 2 Knitting 1 - Total 149 The Wards, in which the houses (wherein the 149 new outworkers were found to be working) are situated, are as follow:— Wards. No. Wards. No. Marsh 8 Heme Hill 20 Bishop's 9 Tulse Hill 23 Prince's 22 Norwood 11 Vauxhall 4 Stockwell 20 Borough of Lambeth 149 Brixton 32 DISINFECTING DEPARTMENT.* Details of work done during 1915, in connection with the Disinfecting Department, are subjoined. A total of 5092 cases of infectious diseases, notified compulsorily by medical men, was reported and dealt with, including cases of cerebro-spinal fever (44), acute polio-myelitis (4), ophthalmia neonatorum (73), chickenpox (473), and whooping cough (1607) and tuberculosis—pulmonary (1020) and non-pulmonary (298), whilst the following diseases were, in addition, notified by school teachers and others, viz. : measles (1880), chickenpox (728), cancer (72), whooping cough (507), verminous houses (621), verminous rooms (1,080), verminous bedding (4165 articles), or clothing (431 articles), and others (345†). 1372 patients were removed to hospital. * The Stafl consists of 1 Superintendent (W. Lockyear), 4 Disinfectors, 4 Drivers, 1 Boiler Attendant, and 1 Yard and Stable Attendant. t Mumps, scabies, ringworm, influenza, &c. 61 Summary of work carried, out by the Disinfecting Department in the Borough of Lambeth during 1915. Total No. of rooms disinfected by Council 9792 Do. articles do. 31648 Cases in which bedding was disinfected at home* 3622 Do. do. do. at Chamber 2631 Do. do. do. destroyed (998 articles) 57 Premises disinfected and disinfectants supplied 15259 No. of Cleansing Notices served in connection with infected houses 1397 Certificates of Medical Practitioners received in lieu of disinfection by the Council 8 Schools disinfected† (103 rooms) 18 Certificates of disinfection left with occupiers of disinfected premises 6794 Library books disinfected; 175 Mattresses re-tabbed by Council 689 Cabs (taxis) disinfected 3 Articles of bedding, etc., disinfected. Beds 1929 Bolsters 2009 Pillows 5115 Mattresses 1984 Palliasses 173 Quilts 1370 Chair Cushions 345 Clothing (articles) 5306 Sheets 1863 Blankets 6570 Rugs and Mats 38 Carpets 8 Extras (i.e., articles not included above) 4938 Total 31648 * The number is increased, compared with previous years, owing to bedding no longer being 1 emoved to the disinfecting station in the cases of Measles, Chicken-pox and Whooping Cough. † Scarlet Fever 6, Mea>les 9. Diphtheria 2, Cerebro-Spinal Fever 1. ‡ 150 Public Library and 25 Private library Books. C 62 Articles of bedding, etc., destroyed. Beds 31 Bolsters 15 Pillows 19 Mattresses 31 Palliasses 26 Quilts 7 Chair Cushions 6 Clothing (articles) 51 Sheets — Blankets 32 Rugs and Mats — Carpets — Extras (i.e., articles not included above) 780 Total 998 Practically all the disinfection was carried out by the Council's staff—only 8 certificates being received from Medical Practitioners during 1915, certifying that disinfection had been carried out. The numbers of verminous houses and rooms disinfected and cleansed during 1915, and the six previous years are:— Year. Houses. Rooms. 1909 148 387 1910 207 646 1911 268 535 1912 580 1109 1913 649 927* 1914 195 935† 1915 621 1080‡ Refuge for Disinfection. The refuge for disinfection in the Borough, viz., at Wanless Road, has not been called into use during 1915. * Bedding 1245 and clothing 141, in addition. † Bedding 1186 and clothing 268, in addition. ‡ Bedding 4165 and clothing 431, in addition. 63 TABLE P. DISINFECTION STATISTICS. For eight years prior, and twenty-two years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1915. Yearly average for 8 years preceding the Notification Act, 1882-1889 (Parish). Yearly average for 11 years succeeding the Notification Act, 1890-1900 (Parish). Yearly average for 14 years succeeding the Notification Act, 1901-5 & 1906-14 (Borough) 1915. 1901-5. (5 years) 1906-14. (9 years) No. of Cases in which Bedding, etc., has been disinfected At Home 142.8 240.8 16.6 1656.0* 3622* At Chamber 452.8 2333.3 2337.0 3000.6 2631 No. of Cases in which Bedding, etc., has been destroyed 45.7 121.6 74.2 98.8 57 No. of Articles of Bedding, etc., disinfected 2253.2 15600.4 34632.4 24198.1 31648 No. of Articles of Bedding, etc., destroyed 113.0 489.4 710.0 350.2 998 Premises disinfected and disinfectants supplied 916.8 6191.7 11738.4 17364.2 15259 This number is increased for 1906 onwards, on account of bedding no longer being removed to the Disinfecting Station as a routine in connection with Measles, Whooping Cough and Chicken-pox. N.B.—The Statistics for 1901-1915 refer to the present Borough ; those for all previous years to the late Parish. 64 SMOKE ABATEMENT. During 1915, 33 smoke nuisances were served. No legal proceedings were taken. The smoke nuisance increased owing to the coal strike and the difficulties arising out of the war. The L.C.C. and the Coal Smoke Abatement Society reported, during 1915, nuisances as follows :— 1. London County Council—18 letters dealing with alleged smoke nuisances connected with : Doulton & Co., Ltd. (High Street), J. C. & J. Field, Ltd. (15, Upper Marsh), Sir J. Causton & Sons, Ltd. (Clapham Road), J. A. Sharwood & Co., Ltd. (Offley Road), Frederick Hygienic Laundry, Ltd. (Langton Road), Lambeth Guardians Workhouse (Renfrew Road), Rogers & Cook, Ltd. (274, South Lambeth Road), A. Beattie & Co. (39, Lower Kennington Lane), C. Hammerton & Co., Ltd., Brewery (Stockwell Green), Waterloo & City Electric Railway Co. (Waterloo Station), and J. Oakey & Sons, Ltd. (Westminster Bridge Road). 2. Coal Smoke Abatement Society—8 letters dealing with alleged smoke nuisances connected with :— Sunny Bank Laundry (Vauxhall Park), Lion Brewery Co. (Belvedere Road), Meredith Bros. (Belvedere Road), Holloway. Bros. (Belvedere Road), St. Thomas's Hospital (Westminster Bridge), J. Dewar & Sons, Ltd. (Commercial Road), J. C. & J. Field (Upper Marsh), and Vauxhall Brewery, Ltd. (Bond Street). UNDERGROUND CONVENIENCES.* The conveniences were kept under regular supervision and inspection during 1915. During 1915 there has been an alteration in the personnel of the attendants, Thomas Rhodda having resigned on July 10th, 1915, Charles Lester having died on April 21st, 1915, and E. Guerrier having joined His Majesty's Forces on February 8th, 1915. The vacancies have been temporarily filled. ANALYSIS OF FOOD AND DRUGS, WATER, &e. 1.—Food and Drugs. (a) Formal Samples. 800 formal samples were purchased within the Borough, and submitted to the Public Analyst for analysis Of the 800 samples 63 (i.e., 7-9 per cent, were reported by the Analyst to be adulterated and 26 summonses were issued, with the result that 18 convictions were obtained. The staff consists of 19 male and 17 female attendants. There are 8 maie and 7 lemale conve uences. 65 The annual averages of the two decennia 1891-1900 (Parish) and 1901-10 (Borough), are respectively: (1) Number of formal samples taken, 501.9 and 1352.4, of which 74 -6 and 89.1 (i.e., 14.9 and 6.6 per cent.) were found on analysis to be adulterated; (2) number of summonses taken out, 53.1 and 63.8, with 52.3 and 48.5 convictions. (b) Informal Samples. 1044 informal samples were purchased within the Borough, and submitted to the Public Analyst for analysis. Of the 1044 samples 119 were reported by the Analyst to be adulterated. (c) Formal and Informal Samples. 1844 formal and informal samples were purchased within the Borough, and submitted to the Public Analyst for analysis. Of the 1844 samples 182 (i.e., 9-9 per cent.) were reported by the Analyst to be adulterated. Details of the 1844 articles submitted by the Food and Drugs Inspector during 1915 are as follow :— (a) Milk. 1. Formal Samples. The 46 adulterations were as follows :— (1) Extraneous water 12, varying from a minimum 1 to a maximum 12 per cent., viz., 1, 1, 1, 2, 3, 4, 5, 6, 6, 7, 8, and 12 respectively. (2) Deficiency in milk-fat 31, varying from a minimum 1, to a maximum 20 per cent., viz., 1, 1, 2, 2, 4, 4, 4, 4, 4, 5, 5, 5, 56, 6, 6, 7, 7, 7, 7, 7, 7, 7, 7, 10, 10, 10, 10, 17, 18, and 20 respectively. (3) Extraneous water and deficiency in milk fat (3), viz., 3 and 10,3 and 16, and 8 and 2 per cent, respectively. In 33 cases no summonses were taken out for the following reason:— Amounts of adulteration too small (33), viz. : (a) extraneous water, 1, 1, 1, 2, 3; (b) Deficiency in milk fat, 1, 1, 2, 2, 4, 4, 4, 4, 4, 5, 5, 5, 5, 6, 6, 6, 7, 7, 7, 7, 7, 7, 7, 7, 10, 10, 10, and 10 respectively. Of the 13 summonses issued there were 8 convictions, 4 summonses were withdrawn (in 2 the Magistrate being satisfied with the evidence for the defence, in 2 warranties being proved, and in 1 the defendant having joined the Army). 66 2. Informal Samples. No informal samples of milk were taken. (b) Butter. 1. Formal Samples. 181 samples of butter were taken, and of these 16 (i.e., 8.8 per cent.) were declared by the Analyst to be adulterated, the adulterations consisting of (1) added margarine (13), varying from a minimum 40 per cent. to a maximum 100 per cent., viz., 40, 60, 60, 72, 90, 95, 99, 100, 100, 100, 100, 100, and 100 respectively; (2) preservatives present (3) varying from a minimum 0.18 per cent, to a maximum 0.30 per cent. crystallised boric acid, viz., 0.18, 0.21 and 0.30 respectively. In 3 cases no summonses were taken out for the reason that the amount of adulteration (boric preservative) was too small, viz., 0.18, 0.21 and 0.30 respectively. Of the 13 summonses issued, there were 10 convictions and 3 summonses were withdrawn, the defendants having absconded. 2. Informal Samples. 773 samples were taken, and, of these, 110 (i.e., 14.2 per cent.) were declared by the Analyst to be adulterated. (c) Other Articles. Details are to be found in Table Q. Registration of Margarine Factories. During 1915, 1 margarine factory was registered, viz., 110c, Brixton Hill. Since the Margarine Act, 18S7, came into force within the Borough the following premises have been registered in addition to the above: 233, Wandsworth Roard; 417, Brixton Road; 413, Norwood Road; 71, Robsart Street; 75, Atlantic Road; 114, Camberwell New Road; 32, Commercial Road; 14, Vassail Road; 92, Lambeth Walk; 266, Brixton Road; 64, Stamford Street; 21, Lower Marsh; *11-13, Gray Street; †7, Juxon Street; 15, New Cut; 448 and 450, Brixton Road; Wessex House (Oakley Street) ; 22, Wilcox Road ; 58, Patmos Road ; 63, New Cut; 166, Norwood Road ; 13, Westow Hill; 66, Brixton Road ; 240, Brixton Road ; 23, Electric Avenue; 253, Wandsworth Road; 147, Lambeth Walk ; 55, New Cut ; 44, Lower Marsh ; 218, Railton Road ; 220, Coldharbour Lane ; and 106, Lambeth Walk. 2. Water. Two samples of water were submitted for analysis during 1915. * Registration was withdrawn on May 29th, 19)3. t Registration was withdrawn on Nov. 23rd, 1911, and renewed on July 13th, 1914. 67 Public Health (Milk and Cream) Regulations, 1912. All samples of milk are examined by the Public Analyst, as a routine, for the presence of preservatives, and, of the total samples of milk taken during 1915 (554 formal), in no single instance were preservatives found. No samples of cream were taken formally during 1915. The action taken during 1915 under the Public Health (Milk and Cream) Regulations, 1912, may be tabulated as follows :— Headings of Report of Administration during 1915. 1. Milk; and cream not sold as preserved cream:— (a) (b) No. of samples examined for the presence of a preservative. No. in which a preservative was reported to be present. Milk 554 — Cream — — Nature of preservative in each case in column (b) and action taken under the Regulations in regard thereto—Nil. 2. Cream sold as preserved cream :— (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the label as to preservatives were correct:— (1) Correct statements made — (2) Statements incorrect — Total — (b) Determinations made of milk fat in cream sold as served cream:— (1) Above 35 per cent. — (2) Below 35 per cent.— Total — (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V. (1) and the proviso in Article V. (2) of the Regulations have not been observed Nil. (d) Particulars of each case in which the Regulations have not been complied with and action taken Nil. 3. Thickening substances. Any evidence of their addition to cream or to preserved cream and action taken where found Nil. 4. Other observations (if any) Nil. 68 TABLE Q. SALE OF FOOD AND DRUGS ACTS. Samples procured, together with the results of the analyses, during the year 1915 :— Samples. Formal. Informal. Number Analysed. Number Adulterated. Number Analysed. Number Adulterated. Milk* 554 46 - - Butter 181 16 773 110 Lard 38 — 2 — Coffee — — 13 — Margarine 2 - — — Mustard 3 - 20 — Pepper 2 - 29 — Arrowroot — - 9 — Vinegar † — - 17 3 Sago — - 9 — Oatmeal — - 9 — Ground Rice — — 7 — Flour (Wheaten) — — 2 — Cocoa — — 9 — Dripping 19 — — — Drugs‡ 1 1 53 2 Rice — — 29 — Olive Oil — — 6 — Tapioca — — 9 Cheese - — 7 — Ground Ginger - — 2 — Bread — — 1 — Tea — — 12 — Chocolate Powder — — 3 — Baking Powder — — 12 — Cream § — — 9 4 Preserved Cream — — 2 — 800 63 1044 119 * 1 Sample was separated milk (not adulterated). † The 3 adulterations were 24%, 24% and 25% deficiencies in Acetic Acid. ‡ The drugs (54) were:—Eucalyptus Oil (10), Glycerine (6), Gregory's Powder (10). Tartaric Acid (4), Ammoniated Tincture of Quinine (15), Cream of Tartar (6), and Bicarbonate of Soda (3). The adu terations being (a) formal (1) Cream of Tartar containing 44 parts of lead per million and (b) informal (2) Cream of Tartar containing 44 parts of lead per million, and Gregory Powder made with Carbonate and not with Oxide of Magnesium § The 4 adulterations were 0.16%, 016%, 0 20% and 0.20 Crystallised Boric Acid. 69 MUNICIPAL MILK DEPOT.* The statistics for 1915 are subjoined. 314 new infants and children were entered upon the Register and fed, their ages being at the time of commencing the milk:— Under 3 months 109 9—12 months 54 3—6 months 70 Over 12 months 38 6—9 months 43 314 Of the 109 infants under 3 months, 10 were aged 14 days or under, viz. :—3, 7, 10, 14, 14, 14, 14, 14, 14, and 14 days respectively. These 314 infants and children may be classified, as to their states of health at the time of being put upon the milk, as follows :— Healthy, i.e., showing no sign of wasting or disease, though below par constitutionally 135, weakly 19, wasting 111, diseased 49. The diseases from which the 49 infants and children were actually suffering at the time of being put upon the milk were : Diarrhoea 6, bronchitis 12, pneumonia 8, broncho-pneumonia 3, indigestion 4, rickets 2, gastritis 3, sickness and diarrhoea 4, measles 5, whooping cough 1 and jaundice 1. The periods during which the 314 infants and children continued to use the milk were:— 26 weeks and over 30 Under 4 weeks— 13—26 weeks 63 2—4 weeks 45 6—13 weeks 77 Under 2 weeks 58 4—6 weeks 41 314 An average of 91 infants and children were fed per week at the Depot, necessitating the distribution for the year of 171,599 bottles of milk mixture, whilst, in addition, milk was also supplied as follows:— 1. Lambeth Infirmary—using 12,939 pint bottles of milk mixture ; 2. Lambeth Workhouse—using 3,654 pint bottles of milk mixture ; 3. Lambeth Schools Infirmary—using 31,501 pint bottles of milk mixture ; *The Staff consists of a Manageress (Miss V. Berkeley), one permanent Assistant (Miss Middlecote) and one temporary Assistant. Miss Berkeley succeeded Miss Paterson (resigned) on July 8th, 1915. c2 70 4. Invalids—using 1,313 pint bottles of milk mixture ; 5. Nursing mothers—using 496 pint bottles of milk ture ; 6. Children over 2 years of age—using 3,929 pint bottles of milk mixture. A total of 8,737½ gallons of milk and 726½ pints of cream were used during 1915. Weekly medical consultations with mothers were held at the Dep6t, the babies being weighed, the weights and other details tabulated in the Register, whilst the babies were visited also at their homes by the Health Visitor when required. Milk was distributed not only from the Depot, but also from the Moffatt Institute (Upper Kennington Lane), the latter branch dep6t (distributing centre) being used for the convenience of the mothers living in the Vauxhall District. The most conclusive proof of the value of a Milk Depot, in so far as the infants and children fed are concerned, is to be found in the medical histories of individual cases, which show again and again, in the case of the Depot, that those infants and children who appear to be seriously ill and wasting, if not moribund, as the result of improper or irregular feeding, at the time of commencing the milk, actually recover and become strong and healthy. The educational value, too, of a Milk Depot must not be lost sight of. BAKEHOUSES. There are, within the Borough, 214* Bakehouses (135 above ground and 79 underground), and these were inspected officially during 1915, and the necessary annual white-washing and cleaning carried out, as required. DAIRIES, MILKSHOPS AND MILK STORES. During 1915, 28 applications for registration were received and dealt with by the Council as follow:— 1.—Applicants not registered, the premises being " unsuitable " (i.e., not in accordance with the Council's requirements)—2. Wards and Addresses of Premises. Names of Applicants. Dates of Refusal by Council. MARSH Nil. BISHOP'S Nil. PRINCE'S. * 72 were certified during 1903—4 as " suitable " for occupation as underground bakehouses under section 101 Factory and Workshop Act, 1901. 71 Wards and Addresses of Premises. Names of Applicants. Dates of Registration by Council. 115, Dorset Road Perrotti, Armando 9th Dec. VAUXHALL. Nil. STOCK WELL Nil. BRIXTON 53, Langton Road Turner Kate 16th Sept. HERNE HILL Nil. TULSE HILL Nil. NORWOOD Nil. 2.—Applicants registered, the premises being " suitable " (i.e., in accordance with the Council's requirements)—26. Wards and Addres es of Premises. Names of Applicants. Dates of Registration by Council. MARSH. 6, Lanfranc Street Bean, Harry Oct. 14th. 30, Boyce Street Wagner, Fredk. Henry Nov. 9th. BISHOPS. 3, Berkeley Street Bullock, Henry J. July 8th. PRINCE'S. 170, Upper Kennington Lane Sayers, Geo. William Mar. 11th. 101, Dorset Road Ireland, Gertrude M. Mar. 25th. 334, Kennington Road Carrington, Arthur May 6th. 27a, Upper Kennington Lane Palmer, Margaret Sept. 16th. 72 Wards and Addresses of Premises. Names of Applicants. Dates of Refusal by Council. VAUXHALL. 198-200, South Lambeth Road Schmidt, Emily Jane Feb. 25th. 35, Wyvil Road Keen, Charles Alfred April 22nd. 1a, Bolney Street Cain, Nora June 10th. STOCKWELL. 24, Sidney Road Darrell, Edward A. Sept. 16th. 98, Stockwell Road Rowlands, Rebecca Dec. 9th. 89, Landor Road Powell, Thomas L. Dec. 9th. BRIXTON. 56, Brixton Road Phillips, Jesse May 6th. 21, Smith Street Rowley, William, H. P. July 8th. 23, Warham Street Hansford, Hannah, E. Nov. 9th. 66, Kenbury Street Curtis, Thomas Dec. 9th. 102, Lothian Road Lock, Fredk. Reuben Dec. 9th. 53, Chryssell Road Wilkinson, Frederick Dec. 9th. HERNE HILL. 411, Coldharbour Lane Hall, John May 20th. 32, Milkwood Road Potter, Florence June 10th. 28, Trelawn Road Cobb,John Sept. 16th. 5a, Cambria Road Hill, William H. Sept. 16th. TULSE HILL. 97, Acre Lane Davies, Samuel May 6th. 148, Cornwall Road, Brixton Hill Jones, Gwelym Dec. 9th. NORWOOD. 3, Lower Terrace, Woodcote Place Bacon, George May 20th. 73 During 1915 the following registrations have been withdrawn from the Register:— Addresses. Names of Applicants. Dates of previous Registration by Council. 30, Cavendish Grove Patching, Florence Aug. 30th, 1914. (Withdrawn March 11th, 1915.) 109, Hamilton Road, West Norwood Bacon, George Aug. 12th, 1914. (Withdrawn September 16th, 1915.) COWHOUSES. There were, within the Borough, at the end of 1914, 10 registered Cowhouses, and, at the Annual Licensing Meetings of the London County Council, held on October 28th and December 9th, 1915, the licences were renewed with the exception of (1) 15, Croxted Road, (2) 24, Distin Street, and (3) 34, Ingleton Street. 74 LIST OF THE 7 COWHOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1915. Wards. Situation of Premises. No. of Sheds. Names of Licensees. Marsh 6, Coral Street, Lower Marsh ... 1 Owen, William. Bishop's 36a, Tracey Street 1 Evans, Anne. Vauxhall 38, Hartington Road 1 Williams, John Morgan. Norwood 93, Clive Road 1 Wraight, Dumbrill & Co., Ltd. „ Elder Road Dairy 2 Bacon, Charles. „ 156, Hamilton Road, 3 Grant, George Ephraim. „ 76 & 78, Gipsy Hill 3 French, Frederick William. 75 SLAUGHTER-HOUSES. There were within the Borough, at the end of 1914, 17 registered Slaughter-houses, and at the Annual Licensing Meetings of the London County Council, held on October 28th and December 9th, 1915, the licenses were renewed with the exception of 152, Clapham Road. List of the 16 Slaughter-Houses licensed, in the Borough of Lambeth during 1915. Wards. Situations of Premises. Names of Licensees. Marsh 99 Lower Marsh Bacchus, James „ 106 „ „ Thomas, Robert Edwin Bishop's . 151, Lambeth Walk Milton, Robert William Prince's ... 60, Kennington Park Road Grellier, Frederick „ 406, Kennington Road Parsons, Bernard William Stockwell 27, Bedford Road, Pooley, John Peed Brixton Near Railway Hotel Electric Lane Ford, Henry, & Co., Ltd. „ Industry Terrace (Canterbury Road) Ranstead, Joseph William Heme Hill 207, Coldharbour Lane Clark, Albert John „ 309, Coldharbour Lane Ford, Henry, & Co., Ltd. „ 77, Dulwich Road Atkin, Jim Cook 76 Wards. Situations of Premises. Names of Licensees. Tulse Hill 12, Lower Tulse Hill Rooksby, Walter „ 45, New Park Road Spindler, Morris G. Norwood 125, Hamilton Road Newbury, Alfred Birkin „ 120, High Street Crouch, William, and Dale, Albert „ 121, High Street Hindle, Richard John HOUSING OF THE WORKING CLASSES. HOUSING, TOWN PLANNING, ETC., ACT, 1909. House-to-House Inspections and Closing-Orders. No house-to-house inspections were carried out during 1915 on account of the war, and, consequently no representation for a Closing Order was necessary. In connection with the closing of houses under the Housing, Town Planning, etc., Act, 1909, a total of 101 dwelling-houses within the Borough have been represented by the Medical Officer of Health as being unfit for human habitation from the time the Act came into force (December 3rd, 1909) until the end of 1915, and Closing Orders have been made by the Borough Council, as the Local Authority, in connection therewith under Section 17 of the Act, with the result that:— (a) 76 houses have been closed and since demolished ; (b) 25 houses have been rendered fit for human habitation. In addition to these 101 dwelling-houses, 27 others have been dealt with under Section 15 of the Act, and voluntarily closed and since demolished by the owners. 77 Comparison may be made with similar work (closure of dwelling houses) carried out under the Housing of the Working Classes Act, 1890, Section 32, from the date upon which it came into force (viz., August 18th, 1890) up to the introduction of the Housing, Town Planning, etc., Act, 1909—a period of 19 years—during which a total of 385 houses were dealt with by notices served by the late Vestry and the present Borough Council, under Section 32 of the Housing of the Working Classes Act, 1890, on the representation of the Medical Officer of Health that such dwelling houses were unfit for human habitation, viz. :— (a) 1891 to 1900 (10 years)—old Vestry 337 (b) 1901 to 1909 (9 years)—Borough Council 48 Total 385 COMMON LODGING HOUSES. The 6 Common Lodging Houses (for men) within the Borough were inspected during 1915, but in no case was any sanitary defect found. The 6 common lodging houses were again licensed by the London County Council at the Annual Licensing Meeting held June 29th, 1915, in accordance with the requirements of Section 46 of Part ix. of the London County Council (General Powers) Act, 1902:— Dates when registered originally. Situations of premises. Authorised No. of Lodgers. 27th January, 1905 10a Belvedere Crescent 99 18th July, 1900 108 Lambeth Walk (c.h.) (house in rear) 39 30th October, 1890 55 Belvedere Road 49 21st December, 1883 90-92 Westminster Bridge Road 197 24th October, 1885 89 & 91 Wandsworth Road 188 12th February, 1887 106 Wandsworth Road 133 78 HOUSES LET IN LODGINGS. During 1915 no houses were registered under the new by-laws. 372 houses are registered under the old by-laws. REVENUE ACT, 1903. [And Section 35 of the Housing, Town Planning, etc., Act, 1909). During 1915, 57 certificates under the Revenue Act, 1903, in connection with tenements (or dwellings) so constructed as to afford suitable, separate accommodation for each of the families inhabiting the same, were applied for, and of these 29 were granted unconditionally and 28 were refused. (1) Certificates granted unconditionally. Blocks or Houses. Tenements. 76, Central Hill 1 2 10-11, Chester Street 2 12 97-98, 99-100, Lollard Street 4 8 St. Dominic, Salter's Hill (formerly 5, Brinsley Villas) 1 2 340, South Lambeth Road 1 2 191, Tulse Hill 1 3 10 29 (2) Certificates granted conditionally. Nil. (3) Certificates refused. Blocks or Houses. Tenements. 41, 42, 43, Alexandra Road, Upper Norwood 3 6 168-170, Clive Road, West Norwsod 2 4 3-13 (odd numbers), Langley Lane 6 18 11 28 79 OFFENSIVE TRADES. No nuisance was reported in connection with the following three offensive trades, which art registered as established within the Borough, and which are under the supervision of the Borough Council:— 1. Fat Melters—15, Upper Marsh (Messrs. J. C. & J. Field) 2. Soap Boilers—15, Upper Marsh (Messrs. J. C. & J. Field). 3. Tripe Boilers—103, Lambeth Walk (Messrs. Bennett, Son & Co.). REFUSE AND MANURE DEPOTS. The 13 Public Depots, situated in the Borough, have been under constant (daily, during the summer months) supervision. Since the outbreak of war there has been great difficulty in disposing of refuse, partly owing to want of railway facilities and partly due to scarcity of horses and labour. Notices have been served and cautionary letters sent as required, but a liberal interpretation has had to be placed upon the By-laws governing the depositing of refuse and offensive matters during the process of removal at contractors' yards, wharves, &c. MORTUARIES AND CORONERS' COURTS.* The 2 Coroners' Courts (High Street and Wanless Road) are under the jurisdiction of the London County Council and the 2 Mortuaries, which are attached thereto, are under the jurisdiction of the Borough Council. The following are the details of work done during 1915 at the two mortuaries and coroners' courts :— (a) †Number of bodies received, 473—277 at High Street and 196 at Wanless Road. (b) Post-mortem examinations conducted 215—113 at High Street and 102 at Wanless Road. (c) Number of inquests held 445—253 at High Street and 192 at Wanless Road. *The Council's Mortuary Keepers are :—Joshua Fazey (Wanless Road) and Robert William Harriss (High Street). There is also a Deputy Mortuary Keeper. †3 Infectious bodies were received—1 at High Street (Diphtheria) and 2 at Wanless Road (epidemic cerebro-spinal meningitis or " spotted fever"). 80 BACTERIOLOGICAL LABORATORY. TABLE R. Shewing the numbers of pathological samples examined and the results obtained at the Bacteriological Laboratory during 1915 and the previous 4 years 1911-1914, together with the averages for the 10 years 1901-1910 (Borough). Year. Sputa. Suspected Tuberculosis. Tub. Bac. found. Blood. Suspected Typhoid or Enteric Fever. Reaction obtained. Throat & Nose. Membranes and Secretions. Suspected Diphtheria. Klebs-Loeffler Bac. found. Other Sundry Samples. Result obtained. Pos. Neg. Total Pos. Neg. Total Pos. Neg. Total Pos. Neg. Total 1915 155 390 545 12 34 46 99 937 1036 8 24 32* 1914 411 733 1144 14 28 42 108 730 838 6 12 18 1913 614 870 1484 12 35 47 130 867 997 18 19 37 1912 296 305 601 31 26 57 55 442 497 12 10 22 1911 87 139 226 22 33 55 78 589 667 7 21 28 Average of 10 years 1901-1910 62.8 124.4 187.2 19.4 39.6 59.0 36.6 448.6 485.2 3.7 9.1 12.8 (Borough) * Hair for tinea tonsurans 2 (negative), pleuritic effusion for tubercle bacillus (negative), urine for mucus casts and oxalates 2 (positive), swabs from throats and noses for meningococcus 2 (negative), smearings from urethra for gonococcus 2 (positive), smearings from vagina for gonococcus 19 (4 positive and 15 negative). N.B.—The Bacteriological Laboratory was originally established and fitted up in 1899 by the late Vestry, and since then (up to the end of the year 1915), 18455 examinations have been conducted there, in connection with the following suspected diseases, viz. : tuberculosis 6551, typhoid or enteric fever 1,076, diphtheria 10,532 and others 296. 81 CLERICAL STAFF.* During 1915 there has been no permanent change in the personnel of the clerical staff, but two assistant clerks and two boy clerks joined the Army and their places have been filled temporarily by the appointment of a male clerk (under military age), a female typist, and two boy clerks. * The Clerical Staff consists of 2 Chief Clerks, Class I. (W. R. Lawrence and A. L. Baxter, the latter acting also as Special Clerk to the Medical Officer of Healthy 2 Assistant Clerks, Class II. (W. J. Lawrence and A. E. Ruel), and 2 Boy Clerks, Class III. (W. E. Crowley and T. N. Charlton). APPENDIX. 2 Local Government Board New Tables. TABLE I. VITAL STATISTICS OF THE BOROUGH OF LAMBETH DURING 1915 AND PREVIOUS FIVE YEARS (1910-14). Year. Population estimated to Middle of each Year. Births. Total Deaths registered in district. Transferable Deaths.‡ Nett Deaths belonging to the District. Uncorrected. Number. Nett. Number. * Rate. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. * Rate per 1,000 Nett Births. Number. * Rate Number. † Rate. 1 2 3 4 5 6 7 † 8 † 9 10 11 12 13 1910 327074 8373 7344 22.5 4348 13.3 795 527 691 94.1 4080 12.5 1911 297957 8405 7292 24.5 4584 15.4 852 712 905 124.0 4444 14.9 1912 297550 8168 6953 23.3 4189 14.1 823 634 600 86.3 4000 13.4 1913 297139 8341 7238 24.4 4476 15.1 883 780 737 74.2 4373 14.7 1914 297094 8188 7022 23.6 4630 15.6 1008 745 734 104.5 4367 14.7 §1915 284188 7878 6573 23.1 5323 18.7 1313 762 685 97.6 4772 16.8 §N.B.—The population estimated for 1915 is the civil population only. Notes.—This Table is arranged to show the gross births and deaths in the Borough, and the births and deaths properly belonging to it with the corresponding rates. For years before 1911 the corrected rates are slightly different. The rates are calculated per 1000 of the estimated gross population, and no deductions have been made from the population for large Public Institutions for the sick or infirm. *In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the Borough. In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly corrected by subtraction of the deaths under 1, included in the number given in Column 8, and by the addition of the deaths under 1 included in the number given in Column 9. †Columns 8 and 9 are prepared from the returns made by the local Registrars of Deaths in accordance with the rule in the next paragraph; the RegistrarGeneral supplied the particulars of extra deaths (119) to be entered in Column 9; and all such deaths are included in this Column, unless an error has been detected, and its correction has been accepted by the Registrar-General. For Column 4 the Registrar-General has furnished a statement of the number of births needing to be added to or subtracted from the total supplied by the local Registrar (1391 outward and 86 inward transfers). ''Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, are not included in Columns 8 or 9, except in certain instances. In Column 8 the number of transferable deaths of "non-residents" which are deducted and in Column 9 the number of deaths of "residents" registered outside the district which are added are stated in calculating the nett death-rate of the Borough. Census, 1911. Area of Borough in acres (exclusive of area covered by water), 4079.6 Average number of persons per house (estimated), 6.7. Number of inhabited houses, 44123. Total population at all ages, 298058. 3 Local Government Board New Tables. TABLE II. CASES OF INFECTIOUS DISEASE NOTIFIED WITHIN THE BOROUGH OF LAMBETH DURING THE YEAR 1915. notifiable disease. number of cases notified. total cases notified in each locality. (e.g., Parish or Ward) of the District. total cases removed to hospital. At all Ages. At Ages—Years. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65 65 and upwds. Small-pox — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 438 9 99 266 33 30 — 1 84 56 79 139 80 397 Erysipelas 177 5 5 7 24 53 60 23 24 33 34 58 28 46 Scarlet Fever 900 9 189 555 90 53 4 — 142 146 140 196 276 841 Typhus Fever — — — — — — — — — — — — — — Enteric Fever 32 1 1 8 8 10 4 — 5 7 7 12 1 24 Relapsing Fever — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — Puerperal Fever 26 — — — 6 20 — — 4 3 6 7 6 21 Plague — — — — — — — — — — — — — — Pulmonarv Tuberculosis* 1020 3 10 98 190 464 222 33 290 153 206 232 139 — Other Forms of Tuberculosis† 298 20 56 148 31 31 8 4 101 62 48 54 33 — Cerebro-spinal Fever 44 8 12 11 7 4 2 — 17 2 11 3 11 29 Polio myelitis acuta 4 — 4 — — — — — — 2 — 2 — 3 Ophthalmia Neonatorum 73 73 — — — — — — 9 22 18 20 4 — Whooping Cough‡ 1607 193 851 547 7 6 3 — 448 315 240 271 333 11 Chicken Pox 473 41 183 231 14 1 3 — 139 76 82 72 104 — Isolation Hospitals, Name and Situation—Hospitals of the Metropolitan Asylums Board (one situated in the Brixton SubDistrict and Stockwell Ward of the Borough of Lambeth). Total available beds provided by the Board—8555. Number of Diseases that can be concurrently treated—All usual notifiable infectious diseases and (partly) Measles and Whooping Cough. *Excluding all renotifications (232) of pulmonary tuberculosis, and notifications under Form C (389) and under Form D (422) of the 1912 Regulations. †Excluding all renotifications (19) of non-pulmonary tuberculosis, and notifications under Form C (39) and under Form D (38) of the 1912 Regulations. ‡Whooping Cough became compulsorily notifiable within the Borough of Lambeth on January 1st, 1913. 4 5 Local Government Board New Tables. Table III. CAUSES OF, AND AGES AT, DEATH (CORRECTED) DURING THE YEAR 1915. BOROUGH OF LAMBETH. Causes of Death. Nett Deaths at the subjoined Ages of "Residents" whether occurring within or without the District (a). Total Deaths whether of "Residents" or "Nonresidents " in Institutions in the District (b). All ages. Under 1 year 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 4653 4318 626 170 163 133 137 566 1014 1509 2550 Uncertified 335 57 14 17 23 18 45 90 71 Typhus Fever — — — — — — — — — — Enteric Fever 9 — — 1 4 — 2 2 — 21 Continued Fever — — — — — — — — — — Small-pox — — — — — — — — — — Measles 91 19 33 33 6 — 5 — — 31 Scarlet Fever 17 — 1 7 3 1 — — — 31 Whooping Cough 49 25 13 1 1 — — — — — 10 Diphtheria and Croup (See note (d)) 45 1 3 19 22 — 6 — — 63 Influenza 85 5 1 1 2 1 3 30 39 1 Erysipelas 14 — — — 1 — 1 6 4 12 Cerebro-Spinal Fever 31 8 1 6 9 4 — 2 — 48 Polio-myelitis acuta — — — — — — 5 — — — Venereal Diseases 21 7 1 — — — 175 4 4 — Phthisis (Pulmonary Tuberculosis) 413 — 1 1 15 69 1 130 22 199 Tuberculous Meningitis (See note (e)) 35 8 8 8 7 3 1 — — Other Tuberculous Diseases 70 13 13 8 13 6 7 8 2 — Rheumatic Fever 15 — — — 6 1 6 1 1 6 Cancer, malignant disease (See note (f)) 360 — — 1 — 1 49 171 138 — Bronchitis 531 52 18 8 5 — 23 120 305 355 Broncho-Pneumonia 192 78 39 23 1 2 8 19 22 Pneumonia (all other forms) 233 17 11 9 7 6 37 82 64 Other diseases of Respiratory organs 80 7 2 5 1 1 13 24 27 — Diseases of Circulatory System 635 — 1 — 8 20 71 175 360 271 Diseases of Nervous System 343 20 2 6 7 8 39 109 152 — Diarrhoea (See note (g)) 124 87 16 9 4 — 4 2 2 95 Enteritis (See note (f)) 20 11 — — 1 — 4 2 2 — Appendicitis and Typhlitis 20 — — 1 3 4 4 7 1 49 Alcoholism (See note (h)) 21 — — — — — 6 14 1 — Cirrhosis of Liver 28 1 — — — — 3 15 9 — Nephritis and Bright's Diseases 164 1 — — 3 3 29 65 63 — Puerperal Fever (See note (i)) 12 — — — — 2 10 — — 12 Other accidents and diseases of Pregnancy and Parturition 11 — — — — 1 10 — — — Congenital Debility and Malformation, including Premature Birth (See note (i)) 238 235 — — 3 — — — — — Violent Deaths, excluding Suicide 162 18 1 13 14 9 33 32 42 233 Suicides 19 — — — — 3 5 10 1 Other Defined Diseases 549 65 15 10 10 10 51 70 318 1113 Diseases ill-defined or unknown 16 5 4 — 1 — 1 4 1 Notes to Table iii. (a) All "Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are included, with the other deaths in columns 2-10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales who have died in the District, are in like manner excluded from these columns. For the precise meaning of the term "transferable deaths" see footnote to Table I. The total deaths in column 2 of Table III. equal the figures for the year in column 12 of Table I. (d) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or non-residents, are entered in the last column of Table III. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as "Certified"; all other deaths are to be regarded as " Uncertified." (d)This heading includes all deaths from croup except those certified as due to "spasmodic," "stridulous," "catarrhal" or " false" croup. (e) Under "Tuberculous Meningitis" are included deaths from Acute Hydrocephalus. (/) Under "Cancer" are included deaths under such headings as Carcinoma, Scirrhus, Epithelioma, Rodent ulcer, Sarcoma, Cancer, and Malignant Disease. (g) Under this heading are included deaths registered as due to Epidemic diarrhoea, Epidemic enteritis, Infective enteritis, Zymotic enteritis, Summer diarrhoea, Choleraic diarrhoea, Cholera (other than Asiatic), Gastro-enteritis, Gastro-intestinal catarrh, Muco-enteritis, Colitis, etc. Deaths from Diarrhoea secondary to some other well-defined disease are included under the latter. For "Dysentery" see note at foot of Table III. (h) Under this heading are included deaths from Delirium tremens, acute and chronic alcoholism, etc., but not those certified as due to organic disease attributed to alcoholism. The number of the latter may with advantage be stated separately, though this statement cannot be included in Table III. (i) Under "Puerperal Fever" are included deaths under such headings as Pyaemia, Septicaemia, Sapraemia, Pelvic peritonitis, Peri- and Endo-metritis occurring in the Puerperium. (j) Under this heading are included also deaths from Atrophy and Marasmus of Infants, and want of Breast-milk, but not from Atelectasis. 6 7 Local Government Board New Tables. TABLE IV BOROUGH OF LAMBETH—INFANTILE MORTALITY, 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. Under 1 week. 1-2 weeks 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Total Deaths under 1 year. All Causes Certified 116 33 24 26 199 124 124 86 93 626 Uncertified 13 1 1 1 16 12 13 9 7 57 Chicken Pox — — — — — — — C7 Measles — 1 1 — 2 1 3 2 11 19 Diphtheria and Croup — — — — — — — — 1 1 Whooping Cough 1 — — — 1 1 3 7 13 25 Diarrhoea — 1 1 — 2 12 39 24 10 87 Enteritis (Epidemic) — — 1 — 1 5 5 — 11 Influenza — 1 1 — 2 — 2 1 — 5 Cerebro-Spinal Fever — — — — — 2 2 3 1 8 Tuberculous Meningitis — — — — — 2 1 2 3 8 Abdominal Tuberculosis — — — — — 2 2 1 — 5 Other Tuberculous Diseases — — — — — 2 2 2 2 8 Congenital Malformations 17 4 2 3 26 6 8 1 2 43 Premature Birth 73 10 5 4 92 13 2 1 — 108 Atrophy, Debility and Marasmus 11 5 8 3 27 32 15 7 3 84 Atelectasis 11 — — 2 13 — 1 — — 14 Erysipelas — — — — - Syphilis — — 1 — 1 3 2 1 — 7 Rickets — — — — — — — 2 2 4 Meningitis (not Tuberculous) — — — — 2 2 2 1 7 Convulsions 2 1 — 1 4 2 2 1 2 11 Gastritis 1 2 1 — 4 4 1 2 — 11 Dentition — — — — — — 2 2 4 8 Laryngitis — — — — — 1 — — — 1 Bronchitis 1 3 1 6 11 16 12 4 9 52 Pneumonia — — — — — 4 3 6 2 15 Broncho Pneumonia — 2 — 6 8 13 18 14 25 78 Pleuro ,, — 1 1 2 Suffocation, overlaying 6 6 3 2 — 11 Accident, other than Suffocation 1 — — — 1 1 — 1 3 6 Other causes not classified above 5 4 3 2 14 8 10 7 5 44 Totals 129 34 25 27 215 136 137 95 100 683 8 9 TABLE V. Local Government Board New Tables. poliomyelitis, and polio-encephalitis and cerebro-spinal fever BOROUGH OF LAMBETH. Particulars of cases of acute of Lambeth, during 1915. notified within the Borough Total number of Cases notified. NUMBER OF CASES. 0-1 year. 1-5 years. 5-10 years. 10-15 years. 15-20 years. [20-30 years. Over 30 years. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Cases. Deaths. Permanent Paralysis* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis * Cases. Deaths. Permanent Paralysis* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis * Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Cases. Deaths. Permanent Paralysis.* Acute Polio-myelitis 4 - - - - - - 1 - 1 3 - 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Cerebro-Spinal Fever 44 7 7 -I - 1 1 - 8 6 - 4 1 - 3 2 - 4 3 - 2 2 - 2 2 - 2 - - 3 3 - 3 1 - 1 1 — 2 - - 2 2 - Number of cases removed to Isolation Hospital. *i.e., Recovered with permanent Paralysis of one or more groups of muscles. Acute Polio-myelitis — — 2 1 — — — — — — — — — — Cerebro-Spinal Fever 4 — 2 4 5 1 2 1 2 4 1 1 2 — 10 11 LAMBETH BOROUGH.-Corrected Deaths registered from all causes during the year, 1915. Note. The Deaths of Non-Residents occurring in Public Institu- tions in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. (A.) REGISTRATION SUB-DISTRICTS. Sub-Districts. Sub-Districts. Total. Lambeth C0hurch. Kennington. Stockwell. Brixton. Norwood. No Address. All Ages. M. F. M. F. M. F M. F. M. F M. F M. F. I. Specific Febrile,or Zymotic Diseases 65 43 66 59 37 54 47 47 42 42 3 5 260 250 510 II. Parasitic Diseases - - - - — 1 — — — — — 1 1 III Dietetic Diseases 3 1 - - 2 4 1 7 1 2 — — 7 14 21 IV. Constitutional Diseases 113 72 95 84 102 88 113 114 74 96 15 2 512 456 968 V. Development Diseases 26 32 33 64 33 30 40 54 25 39 — — 157 219 376 VI. Local Diseases 233 186 245 223 267 260 290 324 213 223 22 10 1270 1226 2496 VII. Deaths from Violence 29 15 15 10 24 11 36 20 9 11 — 1 113 68 181 VIII. Deaths from Ill-defined and not Specified Causes 6 8 12 8 16 5 15 9 13 8 — — 62 38 100 Totals 475 357 466 448 481 452 542 576 377 421 40 18 2381 2272 4653 (B.) AGE PERIODS. AGE. PERIODS. Total. Under 1 Year. 1-2 2-5 Under 5 Years. 5-15 15-20 20-25 25-40 40-45 45-60 60-65 65 and over. Over 5 Years. All Ages. M. F. M. F. M. F. M. F. M. F. m F m F. m F m F m F m F m F M F M F I. Specific Febrile or Zymotic Diseases 79 75 39 33 49 38 167 146 26 26 1 3 — 4 11 17 5 6 25 7 6 9 19 32 93 104 260 250 510 II. Parasitic Diseases — — — — — — — — — — — — — — — — — — — 1 — — — — — 1 1 1 III. Dietetic Diseases — — — — — — — — — — 1 3 1 1 3 7 2 2 — 1 7 14 7 14 21 IV Constitutional Diseases 13 13 18 6 11 9 42 28 27 18 15 19 26 25 97 74 37 39 145 113 43 28 80 112 470 428 512 456 968 V Developmental Diseases 84 81 - — — — 84 81 2 1 — — — — — — — — — — 3 — 68 137 73 138 157 219 376 VI. Local Diseases 143 88 47 36 25 35 215 159 20 21 9 12 14 15 95 79 68 38 238 203 139 84 472 615 1055 1067 1270 1226 2496 VII. Deaths from Violence 9 9 1 — 8 5 18 14 12 2 1 3 4 4 17 10 10 1 29 6 4 3 18 25 95 54 113 68 181 VIII. Deaths from Ill-defined and not Specified Causes 57 32 1 3 — — 58 35 — 1 — — — — — 1 — — — — — 1 1 — 4 3 62 38 100 T otals 385 298 106 78 93 87 584 463 87 69 26 37 44 481 221 184 121 85 443 337 197 127 658 922 1797 1809 2381 2272 4653 d 12 (C.) SUMMARY OF CORRECTED DEATHS. No. of Deaths. Total. No. of Deaths. Total. M. F. M. F. I.—Specific Febrile or ZymoticDiseases. Brought forward 2064 2052 4116 1. Miasmatic Diseases 171 158 329 VI.—Local Diseases—continued. 2. Diarrhceal „ 65 59 124 3. Malarial „ — — — 6. Diseases of Lymphatic System... 3 3 6 4. Zoogenous „ — — — 7. Diseases of Gland-like Organs of Uncertain Use 1 4 5 5 Venereal „ 13 8 21 6. Septic „ 11 25 36 8. Diseases of Urinary System 121 77 198 II.—Parasitic Diseases — 1 1 9. Diseases of Reproductive System (a) Diseases of Organs of Generation — 6 6 III.—Dietetic Diseases 7 14 21 (b) Diseases of Parturition 11 11 10. Diseases of Bones and Joints 3 4 7 IV.—Constitutional Diseases 512 456 968 11. Diseases of Integumentary System 14 9 23 V.—Developmental Diseases 157 219 376 VII.—Violence. VI.—Local Diseases. 1. Accident or Negligence 98 58 156 1. Diseases of Nervous System 169 174 343 2. Homicide 2 1 3 2. Diseases of Organs of Special Sense 5 4 9 3. Suicide 12 7 19 4. Execution — — — 3. Diseases of Circulatory System 303 332 635 5. Air raid 1 2 3 4. Diseases of Respiratory System 537 499 1036 5. Diseases of Digestive System 114 103 217 VIII.—Ill-defined and not Specified Causes 62 38 100 Carried forward 2064 2052 4116 Total 2381 2272 4653 13 London County Council Table. SANITARY PROCEEDINGS DURING 1915. (Return prepared for the London County Council.) Premises. Number of Places. Number of Inspections,1915. Number of Notices, 1915. Number of Prosecutions,' 15. On register at end of 1914. Added in 1915. Removed in 1915. On register at end of 1915. Milk premises* 215 26 2 239 1434 32 — Cowsheds 10 — 3 7 20 2 — Slaughter-houses 17 — 1 16 192 8 — Other offensive trade premises 3 — — 3 72 3 — Registered houses let in lodgings 372 — — 372 2232 22 — Bakehouses 214 — — 214 428 — — Restaurant Kitchens 248 — — 248 — — — *During 1915 28 new applications were received, 26 approved, and 2 refused (the premises being "unsuitable"). 14 Total number of Intimation or Preliminary Notices served for all purposes 5983 Overcrowding— Dwelling rooms overcrowded 41 Remedied 41 Prosecutions Underground Rooms— Illegal occupation 24 Closed 24 Insanitary houses— Closed (under the Public Health (London) Act, 1891) — Closed (under the Housing of the Working Classes Acts, including the Housing, Town Planning, etc., Act) _ Verminous rooms cleansed 1080 Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number provided 1 Persons accommodated — Revenue Act, 1903— Houses for which applications were received 21 Tenements comprised therein 57 15 Revenue Act, 1903, continued— Tenements for which Certificates were— (a) granted 29 ” ” ” (b) refused 28 ” ” ” (c) deferred — Common Lodging Houses— Certificates granted 6 Number of Prosecutions under By-laws, under Public Health Act, 1891 - Mortuaries— Number of bodies 473 (infectious cases 3). 16 Home Office Tables. BOROUGH OF LAMBETH, 1915. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection of Factories, Workshops and Workplaces including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries.) 9 125 — Workshops (Including Workshop Laundries) 77 Workplaces (Other than Outworkers' Premises included in Part 3 of this Report.) - Total 86 125 — 17 2.—Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. No. of Prosecutions. Found. Remedied. Referred to H.M. Inspctor. Nuisances under the Public Health Acts* :— Want of Cleanliness 29 29 Want of Ventilation 2 2 — — Overcrowding 5 5 — — Want of drainage of floors — — — — Other nuisances 153 153 — — Sanitary accommo- dations Insufficient — — — — Unsuitable or defective 30 30 — — Not separate for sexes 2 2 — — Offences under the Factory and Workshops Act:— Illegal occupation of underground bakehouse(S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) — — — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Totals 221 221 — — * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, as remediable under the Public Health Acts. 18 19 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. OUTWORK in UNWHOLESOME PREMISES. Sections 108. OUTWORK IN INFECTED PREMISES. Sections 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions Instances. Orders made (S. 110) Prosecutions (Section 109,110) Sending Twice in the year. Sending Once in the year. V Failing to keep or permit inspection of Lists. Failing to send Lists. Lists. Outworkers.† Lists. Outworkers. Contractors. Workmen- Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— Nil. Nil. Nil. Nil. Nil. 10 Nil. Nil. (1) Making, &c 18 2 127 2 5 8 — (2) Cleaning and washing — — — — — — — — Household linen — — — — — — — — Lace, lace curtains and nets — — — — — — — — Curtains & furniture hangings — — — — — — — — Furniture and upholstery — — — — — — — — Electro-plate — — — — — — — — File making — — — — — — — — Brass and brass articles — — — — — — — — Fur pulling — — — — — — — — Cables and chains — — — — — — — — Anchors and grapnels — — — — — — — — Cart gear — — — — — — — — Locks, latches and keys — — — — — — — — Umbrellas, &c. — — — — — — — — Artificial flowers — — — — — — — — Nets, other than wire nets — — — — — — — — Tents — — — — — — — — Sacks and bag stringing 2 — 84 — — — — — Racquet and tennis balls — — — — — — — — Paper bags and boxes 2 — 21 — — — — — Brush making — — — — — — — — Pea picking — — — — — — — — Feather sorting — — — — — — — — Carding, &c., of buttons, &c. — — — — — — — — Stuffed toys — — — — — — — — Basket making — — — — — — — — Printing 2 — 39 — — — — — Cigarette making — — — — — — — — Total 24 2 271 2 5 8 — — — — — — 10 — — * If an occupier gives out work of more than one of the classes specified of workers in each class of work, the list should be included among those the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into has been done. † The figures required in columns 2, 3 and 4 are the total number of the duty of sending two lists each year and of the entries of names of outnumbers, as there will be two lists for each employer. The figures in of individual outworkers whose names are given, since in the February often be repeated. in column 1, and subdivides his list in such a way as to show the number in column 2 (or 5 as the case may be) against the principal class only, but their respective classes. A footnote should be added to show that this lists received from those employers who comply strictly with the statutory workers in those lists. The entries in column 2 must necessarily be even columns 3 and 4 will usually be (approximately) double of the number and August lists of the same employer the same outworker's name will 20 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1915. (1) . Number. (2) Bakehouses 214 Restaurants 296 Laundries 213 Dressmakers 338 Tailors 146 Milliners and Mantle Makers 90 Blouse Makers 81 Other Businesses 405 Total number of workshops on Register 1783 5.—Other Matters. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 6 Action taken in matters referred by H.M. Inspector as remediable under the Public Notified by H.M. Inspector 12 Health Acts, but not under the Factory and Workshop Act (s. 5) Reports(of action taken) sent to H.M. Inspector 12 Other — Underground Bakehouses (s. 101) :— Certificates granted during 1915 In use at the end of 1915 72 Note.—The Factory and Workshop Act, 1901 (s.132) requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented otherwise than in print, it is unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, workplaces or homework. The duties of Local Authorities and the Medical Officer of Health under the Acts are detailed in the Home Office Memoranda, issued to all Districts, Councils and Medical Officers of Health. Metropolitan Borough of Lambeth. Lambeth Municipal Tuberculosis Dispensaries Scheme. REPORT For the Year ending December 31st, 1915, of Work carried out at the two Tuberculosis Dispensaries by * S. NICOL GALBRAITH, M.B., D.P.H., Tuberculosis Medical Officer, Central Dispensary, and R. C. WINGFIELD, B.A., M.D., M.R.C.P.(Lond.), Tuberculosis Medical Officer, Branch Dispensary. N.B.—The Report is in the form of tables i. to v. * Dr. S. NICOL GALBRAITH left the Council's service on November 1st, 1915, having been appointed Medical Officer of Health for Newark, and his place was filled by the temporary appointment of Dr. ELEANOR GORRIE. 22 23 LAMBETH TUBERCULOSIS DISPENSARIES SCHEME REPORT, 1915. Tables 1. to V. Central Dispensary. Branch Dispensary. Insured. Not Insured. Total Insured. Not Insured. Total. Males. Females. Males. Females. Males. Females. Males. Females. TABLE 1. 1.—Total Attendances. (a) New Patients 198 148 224 392 962 146 90 155 304 695 (b) Old Patients 1442 1212 1095 2728 6477 846 307 321 1541 3015 Totals 1640 1360 1319 3120 7439 992 397 476 1845 3710 II.—Particulars of New Patients. A.—Age Periods and Sex— (1) Under 15 — — 170 172 342 — — 121 153 274 '2) 15 and over 198 148 54 220 620 146 90 34 151 421 (a) 15—25 46 76 15 37 174 37 53 11 39 140 (b) 25—35 62 44 12 87 205 41 19 10 44 114 (c) 35—45 60 12 14 48 134 33 11 5 38 87 (d) 45—55 26 8 7 28 69 27 7 4 21 59 (e) 55—65 19 1 1 13 34 7 — 3 8 18 (f) 65 and over 2 -i— 2 4 1 1 "«i 1 8 B—Lengths of Attendances,— (1) One month and over 88 52 72 139 351 56 39 38 79 212 (2) Under one month* 127 89 147 248 611 90 51 117 225 483 TABLE II. C—Sources of Cases— (1) Medical men 157 79 38 55 329 70 43 12 25 150 (2) Charitable Societies — 1 — 6 7 9 3 2 12 26 (3) Out Patients' Department (St. Thomas's Hospital) — — — — — 26 13 33 67 139 (4) Others {e.g., Public Health Departments Patients, etc.) 24 29 109 187 349 25 8 14 46 93 (5) " Contacts " 34 32 72 139 277 16 23 94 154 287 TABLE III. D—Results of diagnosis— 1. Ordinary Patien ts— (a) Tuberculosis 112 42 27 73 254 82 36 30 80 228 (b) Suspected Tuberculosis 53 61 117 168 399 49 29 27 66 171 2. " Contacts "— (a) Tuberculosis 7 9 9 8 33 1 — — — 1 (b) Suspected Tuberculosis 26 36 71 143 276 14 25 98 158 295 3. Tuberculin— Diagnostic — 1 43 34 78 — — — — — /Positive Reaction — — 8 11 19 — — — — — \Negative Reaction — 1 35 23 59 — — — — — * Including cases sent for opinion only, cases unfit or unsuitable to attend, cases classified as suspected tuberculous (including non-tuberculous or doubtful), "contacts," and cases belonging and transferred to other Districts. 24 25 Tables i. to V.—continued. Central Dispensary Lranch Dispensary Insured Not Insured. Total. Insured. Not Insured. Total. Males. Females. Males. Females. Males. Females. Males Females. TABLE IV. *E—Nature of Treatment— 1. Routine (total cases treated one month and over) including— 88 52 72 139 351 56 39 38 79 212 2. Institutional— (a) Sanatoria (including Tuberculosis Hospitals) 44 15 10 19 88 28 22 9 22 81 (b) General Hospitals 2 2 4 1 — 5 (c) Poor Law Institutions 3 2 1 5 11 — — — — — 3. Tuberculin— Remedial — 3 2 2 7 6 8 7 9 30 TABLE V. F—Results of Treatment— 1. Routine (Total cases treated one month and over)— (a) Fit for work 48 31 60 117 256 65 25 22 58 170 Fit for work and remaining so 29 11 36 78 154 33 24 20 39 116 Not fit for work but becoming fit ... 19 20 24 39 102 14 7 18 15 54 (b) Unfit for work 38 20 12 18 88 11 8 21 2 42 Fit for work but not remaining so 3 2 2 — 7 2 — 3 1 6 Not fit for work and remaining so 35 18 10 18 81 10 6 19 1 36 (c) Deaths 2 1 — 4 7 — — — — — 2 Institutional (Sanatorium)— (a) Fit for work 30 6 4 12 52 14 20 16 19 69 Fit for work and remaining so 4 2 2 4 12 10 8 14 5 37 Not fit for work but becoming fit 26 4 2 8 38 7 6 11 8 32 (b) Unfit for work 15 8 4 7 34 3 3 3 1 10 Fit for work but not remaining so 1 — 2 — 3 1 — 2 — 3 Not fit for work and remaining so 14 8 2 7 31 2 3 1 1 7 (c) Deaths 1 1 — — 2 1 1 — — 2 (3) Tuberculin— (a) Fit for work — 2 2 2 6 8 3 12 3 26 Fit for work and remaining so — — — — — 6 3 8 2 19 Not fit for work and becoming fit — 2 2 2 6 4 2 1 — 7 (b) Unfit for work — 1 — — 1 1 1 2 o — 4 Fit for work but not remaining so — — — — — 1 1 2 — 4 Not fit for work and remaining so — 1 — — 1 — — — — — (c) Deaths — — — — — — — — — — * 249 visits (insured persons 121, uninsured persons 128) were paid to patients own homes by the Tuberculosis Medical Officer, and 1,066 visits (insured persons 485, non-insured persons 581) by the Tuberculosis Nurse in connection with the Council's Central Tuberculosis Dispensary. The Tuberculosis Medical Officer connected with the Council's Branch Tuberculosis Dispensary at St. Thomas' Hospital does not visit at the patients' own homes. INDEX. (ii.) GENERAL INDEX. page Introductory letter 3 Vital Statistics 4—48 Estimated populations 4—5 Births and Birth-rates 9—11 Deaths and Death-rates 11—23 (a) General 11—20 (b) Infantile 20—21 (c) Zymotic 21—23 Infectious Diseases 27 (а) Notifiable 27—35 (б) Non-Notifiable 35—37 (c) " Contacts" and " Suspects" 37 Local Government Board, Old Table A 42—45 Local Government Board, Old Table B 46—47 Summary 48 Sanitary Work 49—81 Notices Served 49—50 (а) Infectious Diseases 49—50 (б) General Nuisances and Drainage Defects 49—50 Male Sanitary Inspectors 51—53 Female Sanitary Inspectors 54—56 Female Health Visitor 56—57 Factory and Workshops 57—59 Outworkers 59—60 Disinfecting Department 60—63 Smoke Abatement 64 Underground Conveniences 64 Analysis of Food and Drugs, &c. 64—68 Public Health (Milk and Cream) Regulations 67 Milk Depot 69—70 Bakehouses 70 Dairies, Milkshops and Milkstores 70—73 Cowhouses 73—74 Slaughterhouses 75—76 Housing of the Working Classes 76—77 (a) House to House Inspections 76 (b) Closing Orders 76-77 (iii.) page Common Lodging Houses 77 Houses let in Lodgings 78 Revenue Act, 1903 78 Offensive Trades 79 Refuse and Manure Depots 79 Mortuaries and Coroners' Courts 79 Bacteriological Laboratory 80 Clerical Staff 81 Appendix 2—25 Local Government Board, New Tables i., ii., iii., iv., v. 2—9 Mortality Tables (corrected deaths) 10—12 (а) Registration, Sub-Districts 10—11 (b) Age Periods 10—11 (c) Summary 12 London County Council Table 13—15 Home Office Tables, 1,2,3,4,5 16—20 Lambeth Tuberculosis Dispensaries Scheme— Report for 1915 (Tables I. to V.) of the work carried out at the two Tuberculosis Dispensaries 21—25