LEW 66 BOROUGH OF LEWISHAM. Annual Report ON THE VITAL STATISTICS & SANITARY CONDITION OF THE BOROUGH OF LEWISHAM AND REPORT OF THE PUBLIC ANALYST For the Year 1908, BY A. WELLESLEY HARRIS, M.R.C.S., D.P.H., &c., Medical Officer of Health and Public Analyst for the Borough of Lewisham; Fellow and Member of the Council of the Royal Sanitary Institute; Fellow of the Royal Society of Medicine; Fellow of the Royal Institute of Public Health; Formerly Medical Officer of Health for the Borough and Port of Southampton, and Medical Superintendent of the Southampton Small-Pox and Fever Hospitals, &c. 3 BOROUGH OF LEWISHAM. EPITOME OF VITAL STATISTICS, 1908. Area in acres, exclusive of area covered by water 6,991 Enumerated population (Census, 1901) 127,495 Estimated population to the middle of 1908 156,627 Average number of persons per house (Census, 1901) 5.6 Total number of Births registered in the Borough 3,632 Birth Rate per 1,000 estimated population 22.8 Total number of Deaths registered in the Borough 1,858 Total number of Deaths of residents of the Borough, after correction for non-residents dying in Public Institutions, and residents dying outside the District 1,757 Deaths of persons under 1 year of age 315 Infantile Death Bate per 1,000 Births registered 87 Total number of Deaths in Public Institutions in the Borough 655 Deaths of non-residents in the Borough 243 Deaths of residents outside the Borough 143 Corrected Death Rate per 1,000 of the estimated population 11.0 4 CONTENTS. Page Bacterioscopic Examinations 60 Births, illegitimate 17 Birth Rates 16 Butter 86 ,, itinerant vendors 87 milk blended 87 Chicken-Pox 59 Cholera contacts 60 Combined drains 68 Coroner's Court and Mortuary 68 Deaths in disease groups 25 infant 28 ,, of residents in other boroughs 43 Death rates 19 „ „ zymotic 22 Diphtheria, deaths 25 notifications 53 Disinfection 69 Enteric fever, deaths 26 „ notifications 53 Factory and Workshop inspections 71 Home Work 73 House-to-house inspections 66 Page Infectious diseases, age periods 49 „ „ attack rates 50 „ notifiable 49 Inspections, routine 79 & 81 Legal proceedings 69 Marriages 19 Measles, deaths 25 „ notifications 59 Milk 85 „ dyed 86 „ on delivery 86 Phthisis, deaths 26 „ voluntary notifications 60 Population 13 Puerperal fever 54 Samples analysed 85 Scarlet fever, deaths 25 „ „ notifications 53 School closure 56 Small-Pox contacts 60 Smoke nuisances 68 Synopsis of tables 7 Unsound Food 69 Women sanitary inspectors 77 Workshops and workplaces 71 Borough of Lewisham. Telephone: "Lee Green 644." After 5 p.m. " Sydenham 1108." Health Department, Town Hall, Catford, S. E. With the Medical Officer of Health's Compliments. 5 To the Mayor, Aldermen, amd Councillors of the Metropolitan Borough of Lewisham. Gentlemen, I have the honour to submit my Annual Report on the Vital Statistics and Sanitary Condition of the Borough for the year 1908, as required by an Order of the Local Government Board. The Borough continues to maintain its reputation as one of the healthiest districts in England. The death rate for the year equalled 11.0 per thousand of the population living at all ages—the lowest in London, except Hampstead—and the lowest rate recorded in Lewisham in any year for which statistics are available. With regard to the Infant Mortality, it is satisfactory to report the mortality rate of 87 per thousand registered births is the second lowest in London and also the lowest on record in this Borough. The following epitome shows interesting comparisons with previous years and the average for six years :— Borough of Lewisham. Year. Average for six years, 1902-7. Year. 1902 1903 1901 1905 1906 1907 1908 Birth Rate 263 26.1 25 6 25.2 23.2 23.7 25.0 22.8 Total Death Rate 13.7 11.1 12.0 11.7 12.0 11.5 12.0 11.0 Infant Mortality Rate 122 92 122 93 113 90 105 87 Zymotic Death Rate 1.70 0.82 1.40 0.83 1.31 0.71 1.13 1.14 Phthisis Death Rate 1.06 0.78 0.84 0.87 0.80 0.90 0.88 0.85 Notifiable *Infectious Diseases: Attack Rate 9.68 6.09 3.93 5.88 6.08 6.45 6.35 7.41 *Not including Puerperal Fever. 6 Reviewing the records relating to Zymotic Diseases it will be found that 1,187 cases of notifiable diseases occurred, compared with 1,028 in 1907. The increase was mainly due to Diphtheria, which was more prevalent during the months of November and December. Lewisham suffered in common with other South Metropolitan Boroughs in this respect. The disease was more virulent in character than in previous years, evidenced by a mortality rate of 0.28 per thousand of the population compared with 0.11 in 1907. It was found that the early closure by your Council of School Class-rooms, in which cases occurred had a most beneficial effect. Our experience has proved that the attempts to exclude carrier cases from schools without closure are futile. Your women sanitary inspectors, in addition to inspections in connection with workshops and workplaces, have rendered valuable assistance in our attempts to prevent the extension of consumption by home visits. They have also assisted in controlling infectious diseases by means of investigations at several schools and visits to homes where necessary. Good results have also followed their visits and inspections of many poor dwellings. In conclusion I again desire to record my appreciation of the excellent work of the staff and the willing assistance I have at all times received from them. I am, Gentlemen, Your obedient Servant, Medical Officer of Health and Public Analyst. May, 1909. 7 SYNOPSIS OF TABLES AND CHARTS. Part I.—Vital Statistics. Table 1.—Population of the Borough in Wards obtained at the Census, April, 1901. Also the estimated population for the years 1905-8. Table 2.—Births and Birth Rates for each Division of the Borough for the years 1902-8. Table 3.—Number of Deaths at various Age Periods and their Percentage to corrected Total Deaths during the years 1902-8. Table 4.—Corrected Death Totals and Death Rates for the years 1902-8. Table 5.—Percentage of Deaths Under One Year of Age to Total Deaths in Wards and Divisions for the years 1902—8. Table 6.—Analysis of Deaths Under One Year of Age during the years 1903-8. Table 7.—Distribution in Wards of Deaths under One Year, in different disease groups during 1908. Table 8.—Corrected Total Deaths, male and female, from All Causes in Wards occurring during the four quarters of the year 1908. Table 9.—Corrected Death Rates from all Causes in Wards, Divisions and the Whole Borough for the four quarters of the year 1908. Table 10.—Deaths in Disease Groups in the three Divisions and the Whole Borough for the year 1908. Table 11.—Death Rates in Disease Groups in the Wards and Divisions of the Borough for the year 1908. 8 Table 12.—Birth and Death Rates of London and Metropolitan Boroughs during the year 1908, after distribution of deaths in Public Institutions. Table 13.—Death Rates in London and the several Metropolitan Boroughs from All Causes and from Certain Diseases during the year 1908, before distribution and after distribution of deaths in Public Institutions. Table 14.—Causes of, and Ages at, Death in the Borough for the year 1908. Table 15.—Residents and Non-Residents dying in Public Institutions situated in the Borough. Table 16.—Deaths from Principal Zymotic Diseases in Wards during the year 1908. Table 17.—Death Rates from Principal Zymotic Diseases and Phthisis, and Infantile Mortality, in the Borough, in the County of London, and in the 76 Great Towns, for the year 1908. Table 18.—Deaths from Principal Zymotic Diseases arranged in Age Groups for the year 1908. Table 19.—Meteorological Table for London for the year 1908. Part II.—Infectious Diseases. Table 20.—Showing Cases of Scarlet Fever and Diphtheria at various Age Periods notified during the year 1908. Table 21.—Number of Cases of Infectious Diseases notified in the ten Wards during the year 1908. Table 22.—Attack Rates from the Principal Infectious Diseases per 1,000 of the population for the Ten Wards and the Whole Borough for the years 1903-8. Table 23.—Attack Rates at All Ages from Small-Pox, Scarlet Fever and Diphtheria in the Metropolitan Boroughs and the County of London for the years 1903-8. 9 Part III.—General. Table 24.—Water Certificates Granted. Table 25.—Houses Examined and Certified under the Customs and Inland Revenue Acts. Table 26.—Details of Inspection of Factories, Workshops and Workplaces with Defects Found. Table 27.—Details of Home Work in the Borough. Table 28.—Details of Workshops and Workplaces in the Borough. Tables 29 and 30.—Register of Sanitary Work for 1908. Part IV.—Report of Public Analyst. Table A.—Showing Number of Samples submitted for Analysis, with Results, for the year ended December 31st, 1908. Table B.—Summary of Samples Analysed in the Borough in each of the years 1898 to 1908 (inclusive). Table C.—Showing Results of Total Samples submitted during the years 1904-8. Table D.—Showing Results of Total Samples of Milk submitted during the years 1904-8. Table E.—Average Composition of Milk Samples submitted in 1908. Table F.—Average Composition of Milk Samples submitted during the years 1902-8. Table G.—Details of Adulterated Samples of Milk for the year ended December 31st, 1908. Table H.—Showing the Number of Samples of Butter submitted in the four quarters of the years 1904-8. Table I.—Details of Adulterated Samples of Butter submitted in 1908. Table J.—Details of Other Adulterated Samples and other Prosecutions during the year 1908. 10 Appendices. I.—Local Government Board Tables Table I.—Vital Statistics of Whole District during the years 1901-8. Table II.—Vital Statistics of Separate Localities in the years 1901-8. Table III.—Cases of Infectious Disease notified during the year 1908. Table IV.—Causes of, and Ages at, Death during the year 1908. Table V.—Detailed analysis of Deaths under one year of age during the year 1908. Charts. Chart A.—Showing Weekly Total Deaths from All Causes, from Respiratory Diseases, and from Infantile Diarrhoea, for the 53 weeks ended January 2nd, 1909. Chart B.—Showing Percentage of Deaths in Eleven Groups to Total Deaths during 1908. Chart C.—Showing Weekly Notifications of All Infectious Diseases, also Weekly Notifications of Scarlet Fever, and Diphtheria, during the year 1908. PART 1. VITAL STATISTICS. report OF THE Medical Officer of Health FOR THE YEAR 1908. VITAL STATISTICS. Population—The estimated population for the year 1908 amounted to 156,627, the figure adopted by the RegistrarGeneral. In the annual report for 1907 we were enabled to estimate the population for that year from the number of occupied houses shown upon the rate books. This information, together with the factors obtained from the census of 1901, gave an estimated population, in 1907, of 155,800 compared with 152,532, the figure adopted by the Registrar-General for the same period, showing a difference of over 3,000. Taking into consideration the fact that building operations have been to a very large extent suspended during the past twelve months, there is reason to believe the estimated population for the year 14 under review is very much more correct than the estimated population of 1907. For 1908, the number of occupied houses was not available, and the population has been calculated upon the assumption that the increase in the population maintained the same rate of progression each year as it did during the intercensal period, 1891-1901. The population thus obtained, 156,627, compared with 152,532 for 1907, shows an increase in one year of 4,095 persons. The increase in the population by natural increment, i.e., the excess of births over deaths, amounted to 1,774. It may be assumed, therefore, that the difference of 2,321 between the total estimated increase and that shown by the natural increment is due to immigration into the district. In order to make the statistical returns in this report comparable with other districts and with the Returns of the Registrar-General, a period of 53 weeks ended January 2nd, 1909, has been taken. All mortality statistics contained in the report are based upon the figures recorded during this period. The various rates are per 1,000 persons estimated to be living in either Ward, Division or whole Borough, except where otherwise stated. The death rates calculated for the wards Brockley, Catford and Forest Hill, are, in all probability, somewhat higher than they should really be. When the next census is taken it will probably be found that the population of these Wards has increased more in proportion than during the last intercensal period, owing to the very large building operations which have taken place during recent years. 15 Table 1. Showing the Population of the Borough, in Wards, obtained at the Census, April, 1901; also the Estimated Population for the years 1905, 1906, 1907 and 1908. Ward. Enumerated Population Census, April 1st, 1901. Population Estimated to June 30th, 1905. Population Estimated to June 30th, 1906. Population Estimated to June 30th, 1907. Population Estimated to June 80th, 1908. Church 6412 6790 6880 6971 7062 Manor 6734 7207 7320 7433 7548 South 5503 5597 5620 5643 5666 Lee Division 18649 19594 19820 20047 20276 Blackheath 6729 6830 6855 6880 6904 Lewisham Village 13842 14622 14808 14995 15183 Lewisham Park 11145 15417 16437 17464 18497 Brockley 10952 11510 11643 11777 11913 Catford 23203 30524 32273 34033 35805 Lewisham Div. 65871 78903 82016 85119 88302 Forest Hill 18051 18270 18322 18374 18427 Sydenham 24924 27653 28305 28962 29622 Sydenham & Forest Hill Div. 42975 45923 46627 47336 48049 Whole Borough 127495 144420 148463 152532 156627 16 BIRTH RATES. The total number of Births registered in the Borough of Lewisham during the year 1908 was 3,632. Of this total 1,881 were males and 1,751 females. The birth rate for Lewisham is therefore 22.8 per 1,000 inhabitants, compared with 23.7 in the previous year, and 25.0 the average for the past six years. The birth rate for London was 25.2 per 1,000, or 2.4 per 1,000 in excess of this Borough. Of the total births, 473 were registered in the Lee division, 2,058 in Lewisham division, and 1,101 in Sydenham and Forest Hill division. Declining Birth Rate.—The year 1907 had credit for the lowest birth rates on record for England and Wales (26.3), the 76 Great Towns (27.0) and London (25.6). During 1908, however, England and Wales, according to the RegistrarGeneral's Returns, shows a slight increase, the rate being 26*5 per 1,000 inhabitants. On the other hand the birth rate for the 70 Great Towns remained stationary with 27.0 and the London rate has fallen to 25.2. On examining Table 2 it will be seen that 22.8 is the lowest rate recorded in Lewisham, and 2.2 below the average rate for the past six years. The wide range in the birth rates of the various districts is shown by the following extreme rates recorded amongst the 76 Great Towns:—Hastings 15.5, Hornsey 16.1, Bournemouth 17.1, Halifax 19.0, Bradford 20.2, Northampton 20.9, Brighton 17 21.3—Hanley 33.0, Sunderland 33.0, Swansea 33.1, Tynemouth 34.3, St. Helen's 34.7, Merthyr Tydfil 35.6, Middlesbrough 35.9, and Rhondda 40.3. In London the lowest rates were Hampstead 14.9, City of London 14.9, City of Westminster 16.7, Kensington 19.2, Holborn 19.6. and Stoke Newington 19.7; on the other hand the highest were Bethnal Green 32.6, Bermondsey 32.5, Stepney 32.1, Shoreditch 32.0, Poplar 31.5, and Finsbury 31.1. Illegitimacy.—During the year 1908, 4,338 infants were registered in London as having been born out of wedlock. This figure gives a proportion of 35 per 1,000 total births, whilst the average proportion in the preceding ten years was 34. In Lewisham of the 3,632 registered births, 91 or 25.1. per 1,000 births were recorded as being illegitimate, compared with 25.4, 23.8 and 33.3 per 1,000 in the three previous years. On reviewing the returns of illegitimate births in this Borough it is found that 50 per cent. of these children were born to domestic servants. 18 Table 2. Births and Birth Rates for each Division of the Borough for the years 1902-1908. Division. 1902. 1903. 1904. 1905 1906. 1907. 1908. Total Number of Births. Birth Bate per 1000 persons. Total Number of Births. Birth Rate per 1000 persons. Total Number of Births. Birth Rate per 1000 persons. Total Number of Births. Birth Rate per 1000 persons. Total Number of Births. Birth Rate per 1000 persons. Total Number of Births. Birth Rate per 1000 persons. Total Number of Births. Birth-rate per 1000 persons. Lee 481 25.4 486 25.4 469 24.2 454 23.2 445 22.5 446 22.2 473 23.0 Lewisham 1857 26.6 1979 27.2 1967 25.9 2027 25.7 1871 22.8 2063 24.2 2058 22.9 Sydm. & Forest Hill 1153 26.3 1098 24.7 1153 25.5 1152 25.1 1130 24.2 1113 23.5 1101 22.6 Whole Borough 3491 26.3 3563 26.1 3589 25.6 3633 25.2 3446 23.2 3622 23.7 3632 22.8 County of London 130478 28.5 130906 28.4 129335 27.9 126620 27.1 124880 26.5 121408 25.6 122898 25.2 19 MARRIAGE RATE. The number of Marriages registered in the Borough during the year amounted to 992, compared with 1,03.2 in 1007. The Marriage Rate was 12.7, a decrease of 0.8 per 1,000 on 1007, while the Marriage Rate for the whole of London was equal to 15.0, and for England and Wales 14.0 per 1,000. MORTALITY. The total number of Deaths registered in the Borough amounted to 1,858, compared with 1,881 for the year 1007. After deducting the deaths of non-residents (243) dying within the Borough, and adding those of residents (143) who died outside the district, a corrected total of 1,757 is obtained, compared with 1,749 in 1907. The corrected total deaths in Lewisham, 1,757, is equivalent to a Death Rate of 11.0 per 1,000 living at all ages, and compares most favourably with the death rate for England and Wales of 14.7 per 1,000 of the population. The death rate for the County of London was 13.8, which is the lowest on record. The rate for the 76 Great Towns equalled 14.0 per 1,000. Compared with other Metropolitan Boroughs, Lewisham again has the second lowest death rate in London. Hampstead is the lowest with 8.5, followed by Lewisham 11.0, Woolwich 11.4, Wandsworth 11.6, Battersea 12.2, Stoke Newington 12.3 per 1,000 of the population living at all ages. 20 The districts having the highest death rates in London were Bermondsey 18.8, Finsbury 18.6, City of London 17.7, Shoreditch 17.4, Bethnal Green 17.1, Holborn 16.4, and Stepney 16.4. (See Table 12) The death rate for Lewisham, 11.0 per 1,000 for the year 1908, shows a decrease of 0.5 over the previous year, and it is satisfactory to note this is the lowest rate recorded during any period for which statistics are available. On sub-dividing the corrected deaths into the three divisions of the Borough, it will be noted that the mortality rate (i.e., the number of deaths per 1,000 persons estimated to be living in each Division referred to), was lowest in the Lee Division, 10.2, and highest in the Lewisham Division, 11.2, the Sydenham and Forest Hill Division being 11.1. (See Table 9), Carrying the sub-division a step further, the death rates from all causes in the individual Wards show Brockley to have suffered the highest mortality (12.5); on the other hand South claims the lowest mortality for the year with 10.1 per 1,000. (See Table 9). Age in relation to Deaths.—A division of the registered deaths at various age periods is arranged in Table 3. This Table shows a slight decrease of deaths among children under one. The relation of age periods to mortality from zymotic diseases is set out in Table 18. Of the 181 deaths from these diseases, 79.6 per cent. occurred among children under live years of age. The distribution of zymotic deaths in ward localities appears in Table 16. 21 Age Period. 1902. 1903 1904. 1905 1906. 1907. 1908. ANALYSIS OF DEATHS. Table 3. Number of Deaths at Various Age Periods and their Percentage to Corrected Total Deaths during the years 1902-1908. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Number of Deaths. Percentage to Total Deaths. Deaths under 1 yr. 428 23.54 328 21.68 440 26.21 338 19.99 391 22.00 325 18.58 315 17.93 Over 1 & under 5 yrs. 200 11.00 142 9.39 140 8.34 130 7.69 160 9.00 146 8.35 163 9.28 „ 5 „ 15 „ 86 4.73 61 4.03 39 2.32 59 3.49 57 3.21 60 3.43 64 3.64 „ 15 „ 25 „ 86 4.73 76 5.02 85 5.06 63 3.72 68 3.83 65 3.72 61 3.47 „ 25 „ 65 „ 547 30.09 478 31.59 470 27.99 547 32.35 596 33.54 577 32.99 593 33.75 Over 65 years 471 25.91 428 28.29 505 30.08 554 32.76 505 28.42 576 32.93 561 31.93 Total 1818 100.0 1513 100.0 1679 100.0 1691 100.0 1777 100.0 1749 100.0 1757 100.00 22 Seasonal Mortality.—The highest mortality occurred during the first and last quarters of the year, the death-rates from all causes being 14.8 and 10.0 per 1,000 respectively. The lowest death-rate was 9.0 for the third quarter. Chart A shows deaths from all causes recorded weekly and the seasonal effect with regard to Infantile Diarrhoea and diseases of the Respiratory Group. Table 10 gives the total deaths in 12 classes registered in each quarter, from which it will be seen that deaths from diseases of the respiratory organs and infective diseases were the highest during the first quarter of the year. ZYMOTIC DEATH RATE. The Zymotic death rate is calculated upon the total deaths occurring at all ages from the principal infectious diseases, viz.:—Small-Pox, Measles, Diphtheria, Scarlet, Typhus and Typhoid Fevers, Whooping Cough, Dysentery, Epidemic Diarrhoea and Epidemic Enteritis. For the year under review, the zymotic death rate for Lewisham amounted to 1.14 per 1,000 persons, showing an increase of 0.48 over that of the previous year. This increase in the zymotic death rate is due not only to an increase of Measles, Diphtheria and Epidemic Diarrhœa and Enteritis, but to these diseases assuming a more fatal form. The deaths from Measles in 1907 amounted to 17, compared with 47 in 1908, Diphtheria 17, compared with 44, and Epidemic Diarrhoea and Enteritis 10, compared with 48. 23 The Lewisham zymotic death rate, 1.14, compares favourably with the rates 1.85 for the County of London, 1.59 for the 76 Great Towns, and 1.29 for England and Wales during the same period, but it is slightly above the average (1.13) for the past six years. Of the total 181 deaths in Lewisham from the principal infectious diseases, Measles accounted for 47, Scarlet Fever 11, Whooping Cough 30, Diphtheria 44, Enteric Fever 4, Dysentery 2, Epidemic Diarrhoea 11, and Epidemic Enteritis 32. (See Table 16). The death rates from the above diseases for the whole Borough, the County of London, and the 76 Great Towns, have been calculated and are set out in Table 17. 24 Table 4. Corrected Death Totals and Death Rates for the years 1902-1908. Locality. 1902. 190.5. 1904. 1905 1906. 1907. 1908 Total Number of Deaths. Death rate per 1,000 oi' the population. Total Number of Deaths. Deathrateper 1,000 of the population. Total Number of Deaths. Death rateper 1.000 ot the population. Total Number of Deaths. Death rateper 1,000 of the population. Total Number of Deaths. Death rateper 1,000 of the population. Total Number of Deaths. Death rate per 1000 of the population. Total Number of Deaths. Death rateper 1,000 of the population. Lee Division 220 11.6 218 ll.l 198 10.0 186 9.5 211 10.6 214 10.7 211 10.2 Lewisl) am Division 991 14.2 816 11.2 941 12.4 966 12.2 1000 12.2 995 11.7 1005 11.2 Sydm. & Forest Hill Division 607 13.8 484 10.9 545 12.1 589 11.7 566 12.1 540 11.4 541 11.1 Whole Borough 1818 13.7 1513 11.1 1679 12.0 1691 11.7 1777 11.97 1749 11.5 1757 11.0 County of London 80105 17.2 69787 15.2 74556 161 70442 15.1 71155 11.5 69268 14.6 67858 18.8 25 ANALYSIS OF DEATHS AT ALL AGES IN RELATION TO DISEASE GROUPS. GLASS I.—Infective Diseases (229). Small-Pox.—No deaths occurred from this disease. Measles.—Measles was recorded as the cause of 47 deaths, equal to a death rate of 0.29 per 1,000 of the population, compared with 0.11 in 1907. This disease was the most fatal zymotic disease during 1908. It is not a notifiable disease, consequently the case mortality cannot be obtained, but school notifications show that the disease was more prevalent last year, than in 1907 {see page 60). Scarlet Fever.—Eleven deaths were notified in the Borough, equal to a mortality rate of 0.07 per 1,000 of the population, compared with 0.08 in 1907. The actual number of cases notified amounted to 600, compared with 584 in 1907. From this it will be seen that during the year under review, more cases of Scarlet Fever existed. On considering the case mortality it is found that of the 600 recorded cases 1.83 per cent. proved fatal, compared with 2.05 per cent. in 1907. Diphtheria.—There were 44 deaths from Diphtheria, giving a mortality rate for the Borough of 0.28 per 1,000 of the population, compared with 0.11 in 1907. The number of notifications amounted to 458, compared with 287 during 1907. The case mortality was 9.61 per cent. of the actual cases, compared with 5.98 per cent. in 1907, showing that not only was this disease more prevalent but its variety more severe. Whooping Cough.—Thirty deaths were attributed to Whooping Cough during 1908, compared with 50 in 1907. Of the 80 deaths 28 occurred among children under five years of age. "Whooping Cough was the most fatal zymotic disease in 1907, when it was responsible for a death-rate of 0.33 per 1,000. 26 Great improvement has taken place during 1908, the death rate being only 0.19 per 1,000. Enteric Fever.—There were four fatal cases, equal to a death rate of 0.03 per 1,000. The case mortality was equal to 12.9 per cent. of the persons affected, compared with 3.7 per cent, for the preceding year. Epidemic Diarrhoea and Epidemic Enteritis.—The total deaths recorded in the year from these two diseases amounted to 43 (compared with 10, 111 and 32 in 1907, 1906 and 1905 respectively), equivalent to a death rate of 0.27 per 1,000, compared with 0.07, 0.75 and 0.22 in 1907, 1906 and 1905 respectively, (See Tables 14 and 16). Deaths from other Infective Diseases were:—Dysentery, 2; Influenza, 28; Puerperal Fever, 2; Erysipelas, 1; Venereal Disease, 5; Septicaemia not Puerperal, 6; Pyaemia, 2; and Infective Endocarditis, 2; and Other Septic Diseases, 2. CLASS II.—Tuberculous Diseases (191).—Phthisis.—This disease was responsible for 135 deaths, or 7.7 per cent. of the total 1,757 deaths from all causes. This mortality is equal to a death rate of 0.85 per 1,000 (compared with 0.90 in 1907) for the whole Borough, the lowest rate of the Ten Southern Metropolitan Boroughs. Of the remaining London sanitary districts, only Hampstead, with 0.78, is lower. The district having the highest mortality from this cause was Finsbury, with 2.15 per 1,000. The death rate for the County of London was 1.32. The position of Lewisham, therefore, in comparison with other Boroughs, is most satisfactory. In addition to Phthisis, 56 deaths were registered as due to various forms of tubercular disease. {See Table 14). CLASS III.—Malignant Diseases (151).—Cancer was the stated cause of 110 deaths (compared with 102 in 1907) equal to a mortality rate of 0*69 per 1,000. On sub-dividing these deaths, 27 22 were registered in Lee, .51 in Lewisham, and 37 in Sydenham and Forest Hill. For other diseases of this Class see Table 14. CLASS IV.—Neryous Diseases (98). — This class was responsible for 1)8 deaths, equal to 5.6 per cent. of the total deaths. Of this number 28 were cases of insanity, 15 meningitis, and 12 convulsions; of the latter 10 were children under 1 year. GLASS V.—Diseases of Heart and Circulation (248). Diseases of Heart and Blood Vessels accounted for 248 deaths, equal to 14.1 per cent. of the total deaths. Seventy-three deaths were due to valvular heart disease and endocarditis, and 60 to cerebral hemorrhage. CLASS VI.—Respiratory Diseases (251).—This class was the cause of 251 deaths, equal to 14.3 per cent. of the total deaths from all causes. The highest number of deaths were registered during the eighth week. (See Chart A). Bronchitis and pneumonia were the most fatal, particularly to children under 5 years of age. (See Table 14). CLASS YII.—Digestive Diseases (182).—To this class 182 deaths, or 10.4 per cent. of the total deaths, were assigned; children under 1 year were the sufferers in 80 cases. Cirrhosis of the Liver (frequently associated with alcoholism) was the certified cause of 11) deaths, compared with 18 in 1907. CLASS VIII. Diseases of Urinary Organs (73).—Seventythree, or 4.2 per cent. of the total deaths were recorded in this class. CLASS IX. —Diseases of Generative Organs (5).—Only 5 deaths were registered in this group. CLASS X.—General or Constitutional Diseases (267).— Of the 2(57, or 15.2 per cent. of the total deaths due to disease in this class, old age claimed 139 of the total, premature birth was the certified cause of 50, and alcoholism 7. 28 CLASS XI.—Accidents (43).—Forty-three fatal accidents occurred, 6 of which were due to overlaying. GLASS XII.—Violence, Suicides, &c. (19). — Sixteen residents of the Borough committed suicide. NOTE:—Chart B contains a diagramatic comparison of deaths occurring in various groups. Inquests:—During the period under review 119 inquests were held in the Borough, in relation to which 74 post mortem examinations were made. Thirteen of these inquests were in respect to non-residents who had died in the Borough, representing 5 post mortcms. On the other hand 17 inquests, with 13 post mortcms, were held in other districts on residents of this Borough. INFANT MORTALITY. This mortality is measured by the proportion of deaths of children under one year to every thousand births registered. England and Wales.—During the year under review the infant mortality rate throughout England and Wales was 121 per 1,000 births, which, with the exception of that recorded in the previous year (118 per 1,000), is the lowest on record. The returns for the 76 Great Towns show a slight increase, the rates being 128 in 1908, against 127 in 1907. The lowest infant mortality figures were registered in Hornsey 62, Ley ton 77, Hastings 81, and Bournemouth 83. The towns having the highest rates were Stockport 1(38, Rochdale 168, Merthyr Tydfil 178, Rhondda 184, and Burnley 200. In London the infant mortality rate amounted to 113 per 1,000 births, compared with 116 in 1907. The lowest rates in the Metropolis were recorded in Hampstead 69, Lewisham 87, City of London 92, Stoke Newington 92, Woolwich 94, and CHART B. Showing Percentage of Deaths in Eleven Groups to Total Registered Deaths in 1908. 29 Wandsworth 97. The highest in Bermondsey 144, Shoreditch 139, Finsbury 133, Bethnal Green 132, Southwark 131, and Stepney 130. In the Borough of Lewisham the infant mortality rate amounted to 87 per 1,000 births, compared with 90 in the preceding year, and 105, the mean rate for t.lie six years 1902-7. This rate is the second lowest in London and the lowest rate recorded in the history of Lewisham during any period for which statistics are available. Causes of Death.—During the year 315 deaths occurred among children under one year, compared with 325 in 1907. Of these 315 deaths, 70 were recorded as due to conditions which must be considered unavoidable, namely, Premature Birth (50) Congenital Defects and Injury at Birth. Again, 64 were registered under the headings of Atrophy, Debility, and Marasmus, diseases mainly due to errors of feeding. Bronchitis and Pneumonia were responsible for 45, Suffocation and Overlaying for eight deaths, diseases which in all probability could have been prevented. Diarrhoeal diseases, which include all forms of diarrhoea, enteritis not tuberculous, gastritis, gastro-intestinal catarrh, gastro-enteritis, muco-enteritis, to a very great extent preventable diseases, were responsible for 49. Seven deaths were certified as Measles and 17 Whooping Cough, compared with 2 and 18 respectively in 1907. Thirteen deaths were due to some form of tubercular disease (consumption), and 3(i to diseases unclassified or ill-defined, such as convulsions. The Percentage of deaths under three months to total deaths under one year was practically the same, the figures being as follows:— Year 1903 1904 1905 1906 1907 1908 Rate 56% 50% 57% 51% 58% 57% 30 Table 5. Percentage of Deaths under one year of age to Total Deaths in Wards and Divisions for the years 1902-1908. District. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Church Wd. per cent. 11.8 per cent. 11.3 per cent. 19.7 per cent. 12.7 per cent. 18.4 per cent. 14.3 per cent. 10.8 Manor Ward 16.4 26.4 26.0 9.4 20.5 20.0 12.7 South Ward 20.3 14.8 13.3 11.8 17.3 5.6 12.1 Lee Division 15.9 17.4 20.7 11.3 19.0 14.5 11.8 Blackheath Ward 14.5 13.8 13.9 17.0 17.3 8-8 15.3 Lew. Milage Ward 18.5 22 2 27.6 20.7 19.3 18.0 21.2 Lew.Pk. Wd. 25.1 20.8 31.5 20.5 21.9 20.0 19.6 Brockley Ward 26.2 20.0 27.2 15.7 22.7 20.8 17.2 Catford Wd. 34.6 32.7 31.3 260 24.9 19.8 20.3 Lew. Div. 26.9 24.9 28.2 21.5 22.0 18.7 19.5 Forest Hill Ward 21.7 13.4 18.6 17.5 20.0 19.1 17.7 Sydm. Ward 20.6 21.4 29.1 22.4 25.1 20.7 17.1 Sydm. & Forest Hill Division 21.0 18.2 24.8 20.2 23.1 20.0 17.4 Whole Borough 21.68 23.54 26.21 19.99 22.0 18.6 17.9 81 Disease. 1903. 1904. 1905. 1906. 1907. 1908. Table 6. Analysis of Deaths under one year of age, during the years 1908-1908. Number of Deaths under 1 year. Percentage Deaths to total Deaths under 1 year. Number of Deaths under 1 year. Percentage Deaths to total Deaths under 1 year. Number of Deaths under 1 year. Percentage Deaths to total Deaths under 1 year. Number of Deaths un^er 1 year Percentage Deaths to total Deaths under 1 year. Number of Deaths under 1 year. Percentage Deaths to total deaths under 1 year. Number of Deaths under 1 year. Percentage Deaths to total Deaths under 1 year. Common Infectious Diseases 10 3.0 29 6.6 23 6.8 17 4.3 20 6.2 25 7.9 Diarrhœal Diseases 60 18.3 122 27.7 59 17.5 123 31.5 41 12.6 49 15.6 Wasting Diseases 124 37.8 151 34.3 189 41.1 147 37.6 162 49.8 140 44.4 Tuberculous Diseases 14 4.3 14 3.2 10 3.0 14 3.6 9 2.8 18 4.1 Respiratory Diseases 53 16.2 64 14.5 43 12.7 46 11.8 50 15.4 47 14.9 Diseases classified under other headings 67 20.4 60 13.6 64 18.9 44 11.3 43 13.2 41 13.0 Total 328 100.0 440 100.0 338 100.0 391 100.0 325 100.0 315 100.0 Note.—For detailed list of these diseases see I ableIV . of the Loeal Government Board Tables (page 104). 32 Distribution in Wards.—The following table shows the distribution of infant deaths in the various wards of the Borough. The highest mortality rates were in the Lewisham Park, Manor and Forest Hill Wards:— Table 7. Ward. Common Infectious Diseases. Diarrheal Diseases. Wasting Diseases. Tubercular Diseasts. Ke^piratc ry Diseases. Other Diseases. Total Infant Deaths. Death rate per 1000 of the Population. Church - 1 5 - 1 1 8 1.1 Manor - - 6 - 3 1 10 1.3 South - 2 2 - 2 1 7 1.2 Blackheath - 1 9 - — 1 11 1.6 Lew. Village 3 8 14 1 7 6 39 2.5 Lew. Park 5 12 12 1 9 3 42 2.2 Brockley 6 1 9 1 2 7 26 2.1 Catford 4 14 40 2 5 13 78 2.1 Forest Hill. 3 4 20 4 7 3 41 2.2 Sydenham 4 6 23 4 11 5 53 1.8 Total 25 49 140 13 47 41 315 2.0 33 Table 8. Corrected total Deaths from All Causes in Wards occurring during the four quarters of the year 1908. Localities. First Quarter. Second Quarter. Third Quarter. Fourth Quarter.* Whole Year. M. F. Total M. F. Total M. F. Total M. F. Total M. F. Total ChurchWard 17 12 29 1 15 16 8 4 12 6 11 17 32 42 74 Manor Ward 8 13 21 8 15 23 13 6 19 7 9 16 36 43 79 South Ward 8 9 17 8 5 13 5 6 11 9 8 17 30 28 58 Blackheath Ward 9 13 22 13 4 17 11 7 18 6 9 15 39 33 72 Lewisham Village Ward 19 33 52 17 14 31 30 20 50 22 29 51 88 96 184 Lewisham Park Ward 24 29 53 24 22 46 25 25 50 36 29 65 109 105 214 Brockley Ward 34 32 66 18 19 37 9 9 18 15 15 30 76 75 151 Catford Ward 57 55 112 54 48 102 44 39 83 45 42 87 200 184 384 Forest Hill Ward 41 37 78 27 19 46 23 20 43 28 36 64 119 112 231 Sydenham Ward 42 66 108 27 45 72 15 32 47 39 44 83 123 187 310 The Whole Borough 259 299 558 197 206 403 183 168 351 213 232 445 852 905 1757 * 14 weeks period. 34 Table 9. Corrected Death Rates from All Causes in Wards, Divisions, and the Whole Borough, for the four quarters of the Year 1908. Localities. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. 1908. Church Ward 16.5 9.1 6.8 9.0 10.3 Manor Ward 11.2 12.2 10.1 7.9 10.3 Southward 12.0 9.2 7.8 11.2 10.1 Lee Division 13.3 10.3 8.3 9.2 10.2 Blackheath Ward 12.8 9.9 10.4 8.1 10.3 Lew. Village Ward 13.7 8.2 13.2 12.5 11.9 Lew. Park Ward 11.5 10.0 10.8 13.1 11.4 Brock ley Ward 22.2 12.5 6.1 9.4 12.5 Catford Ward 12.6 11.4 9.3 9.1 10.6 Le wish am Division 13.9 10.6 10.0 10.5 11.2 Forest Hill Ward 17.0 10.0 9.4 12.9 12.3 Sydenham Ward 14.6 9.8 6.4 10.4 10.3 Sydenham & Forest Hill Division 15.5 9.9 7.5 11.4 11.1 Whole Borough 14.3 10.3 9.0 10.6 11.0 County of London 17.0 12.7 11.9 13.7 13.8 76 Great Towns 17.9 13.7 13.3 14.8 14.9 England and Wales 17.7 13.8 12.8 14.5 14.7 35 Table 10. Deaths in Disease Groups in the Three Divisions and the whole Borough for the year 1908. Disease Classes. Lee Division. Lewisnam Division. Sydenham and Forest Hill Division Whole Borough ISt Qr. 2nd Qr. 3rd Qr. 4th* Qr. Whole Year. 1st Qr. 2nd Qr. 3rd Qr. 4th* Qr. Whole Year 1st Qr. 2nd Qr. 3rd Qr. 4th* Qr. Whole Year 1st Qr. 2nd Qr. 3rd Qr. 4th* Qr. Whole Year I. Infective 7 5 6 5 23 54 24 22 44 144 20 10 11 21 62 81 39 39 70 229 II. Tuberculous 9 2 4 2 17 30 34 27 26 117 18 17 5 17 57 57 53 36 45 191 III. Malignant 9 7 4 5 25 16 17 19 20 72 19 12 9 14 54 44 36 32 39 151 IV. Nervous 2 4 6 4 16 14 20 11 13 58 8 1 6 9 24 24 25 23 26 98 V. Heart & Blood Vessel? 7 9 4 6 26 36 40 41 34 151 26 19 14 12 71 69 68 59 52 248 VI. Respiratory 11 3 3 9 26 54 26 18 33 131 47 20 12 15 94 112 49 33 57 251 VII. Digestive 7 6 5 3 21 33 16 30 22 101 15 10 13 22 60 55 32 48 47 182 VIII. Urinary 8 — 1 2 6 15 14 7 7 43 5 7 2 10 24 23 21 10 19 73 IX. Generative Organs - — — 1 1 — 2 — — 2 1 — 1 — 2 1 2 1 1 5 X. General 8 16 8 11 43 42 31 35 38 146 25 15 17 21 78 75 62 60 70 267 XI. Accidents 3 — — 2 5 10 4 4 7 25 2 5 — 6 13 15 9 4 15 43 XII. Violence 1 — 1 — 2 1 5 5 4 15 — 2 — — 2 2 7 . 6 4 19 Totals 67 52 42 50 211 305 233 219 248 1005 186 118 90 147 541 558 403 351 445 1757 * Note.—There are 14 weeks in the 4th Quarter. 36 Table 11. Death Rates per 1,000 of the population, in Disease Groups, in the Wards and Divisions of the Borough for the year 1908. Wards and Divisions. Disease Class 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Church Manor South Lee Blacklieath Lewisham Village Lewisham Park Brockley Catford Lewisham Forest Hill Sydenham Sydenham and Forest Hiil Whole Borough I. Infective 0.8 0.9 1.7 1.1 1.0 1.8 1.9 2.1 1.3 1.6 1.6 1.0 1.3 1.4 II. Tuberculous... 1.0 1.0 0.3 0.8 0.7 1.2 1.6 1.6 1.2 1.3 1.4 1.0 1.2 1.2 III. Malignant 1.3 1.4 0.9 1.2 0.4 0.7 1.1 0.6 0.9 0.8 1.0 1.2 1.1 0.9 IV. Nervou 0.8 0.8 0.7 0.8 0.1 0.6 0.5 0.7 0.8 0.6 0.4 0.5 0.5 0.6 V. Heart and Blood Vessels 1.3 0.8 1.9 1.3 2.3 2.1 1.2 2.1 1.5 1.7 1.5 1.4 1.5 1.6 VI. Respiratory 1.0 1.6 1.2 1.3 1.3 1.8 1.7 1.5 1.2 1.5 2.0 1.9 1.9 1.6 VII. Digestive 1.0 1.0 1.0 1.0 0.9 1.0 1.3 1.1 1.2 1.1 1.5 1.0 1.2 1.1 VIII.Urinary 0.4 0.1 0.3 0.03 0.7 0.5 0.3 0.7 0.4 0.5 0.7 0.3 0.5 0.5 IX. Generative Organs 0.1 _ 0.0 - _ — 0.1 0.0 0.0 - 0.1 0.0 0.0 X. General Diseases 22 22 1.7 2.1 2 6 1.6 1.4 1.4 16 1.6 1.5 16 1.6 1.7 XI Accidents 0.4 0.1 0.2 0.2 0.3 0.4 0.2 0 4 02 03 0.4 0.2 03 0 3 XII. Violence . 0.3 . 0.1 . 0.2 0.2 0.3 0.1 0.2 0.1 0.0 0.0 0.1 Total Deaths 10.3 10.3 10.1 10.2 10.3 11.9 11.4 12.5 10.6 11.2 12.3 10.3 11.1 11.0 87 Table 12. Birth and Death Rates of London and Metropolitan Boroughs during the year 1908, after distribution of Deaths in Public Institutions. Boroughs Births. Per 1000 Persons Living. Deaths from Deaths under 1 year to 1000 Births All Causes Principal Epidemic Diseases Small-Pox Measles Scarlet Fever — Diphtheria Whooping-Cough T yphus Enteric Fever l3yrexia\ (Origin uncertain) Diarrhoea i'hthisis CntyofL'nd'n West. 25.2 13.8 1.35 — 0.31 0.11 0.15 0.20 1 — 0.05 0.00 0.53 1.32 113 Padding to n 22.1 12.4 0.87 — 0.23 0.10 0.10 0.07 — 0.03 — 0.34 1.01 103 Kensington. 19.2 12.9 0.92 — 0.17 0.05 0.15 0.04 — 0.03 — 0.48 0.98 119 Hainmersmith 25.4 14.0 1.09 — 0.12 0.09 0.10 0.15 — 0.04 — 0.59 1.26 120 Fulbain 27.0 12.4 1.59 — 0.41 0.10 0.18 0.19 — 0.06 — 0.65 1.14 116 Chelsea 20.4 14.5 1.18 — 0.16 0.10 0.16 0.22 — 00.7 — 0.47 1.27 107 Ctyof Wstnistr 16.7 12.8 0.58 — 0.13 0.04 0.09 0.05 — 0.03 — 0.24 1.23 102 North. St. Marylebone 20.6 14.2 0.85 — 0.19 0.10 0.11 0.10 - 0.05 — 0.30 1.16 101 llampstead 14.9 8.5 0.40 — 0.05 0.07 0.05 0.05 - 0.05 — 0.13 0.78 69 St. Pan eras 24.6 14.7 1.06 — 0.19 0.08 0.09 0.29 — 0.04 — 0.37 1.51 107 Islington 24.7 13.2 1.01 — 0.23 0.09 0.16 0.16 — 0.05 — 0.32 1.24 102 Stoke Nwingtn 19.7 12.3 0.82 — 0.18 0.09 0.02 0.11 — 0.07 — 0.35 1.07 92 Hackney 23.3 13.2 1.52 — 0.31 0.13 0.19 0.18 — 0.03 — 0.68 1.22 115 Central. Holborn 19.6 16. 4 1.07 — 0.20 0.13 0.09 0.14 — 0.09 — 0.42 2.11 113 Finsbury 31.1 18.6 2.09 0 .45 0.13 0.16 0.26 — 0.12 0.97 2.15 133 1/ City of London 14.9 17.07 0.40 — 0.15 — 0.10 0.05 — — — 0.10 1.79 92 East. Slioreditch 32.0 17.4 2.09 — 0.44 0.25 0.11 0.20 — 0.09 — 1.00 2.00 139 Hethnal Green 32.0 17.1 2.48 _ 0.78 0.30 0.21 0 .32 — 0.10 - 0.77 1.61 132 Stepney 32.1 16.4 2.53 — 0.84 0.17 0.24 0.41 — 0.04 0.00 0.83 1.56 130 Poplar 31 .5 15.9 2.26 — 0.47 0.21 0.19 0.42 — 0.08 0.89 1.34 123 South. South wark 29 .2 16.3 1.76 — 0.36 0 .1 1 0.15 0.23 — 0.03 — 0.88 1.88 131 Bermondsey 32.5 18.8 2.30 0.82 0.19 0.18 0.17 — 0.09 0.01 0.84 1.89 144 Lambeth 24.6 13.3 1.18 0.31 0.13 0 .14 0.15 — 0.02 — 0.43 1.45 104 Battersea 24.9 12.2 1.19 — 0.26 0.18 0.12 0.21 — 0.03 — 0.44 1.19 106 Wandsworth 25.2 11.6 0.93 — 0.15 0.07 0.13 0.21 — 0.02 — 3.35 3.96 97 Camberwell 24.2 12.7 1.06 — 0.19 0.08 0.14 0.19 — 0.02 — 0.44 1.12 104 Deptford 26.4 13.8 1.32 — 0.28 0.06 0.08 0.20 — 0.07 — 0.63 1.16 122 Greenwich 23 .5 12. 6 1.25 0.14 0.05 0.16 0.28 — 0.08 — 0.54 1 10 120 Lewisham 22.8 11.0 1.14 — 0.29 0.07 0.28 0.19 — 0.03 - 3.28 3.85 87 Woolwich 23.8 11. 4 0.92 0. 07 0.07 0.16 0.24 — 0. 02 — 3.36 1.20 94 In this Table 0.00 indicates that the deaths were too few to give a rate of 0*005; where no death occurred, — is inserted, t Called Simple Continued Fever previous to 1901. 88 * Table 13. Death.rates during 1908 in London and the several Metropolitan Boroughs, from All Causes, and from Certain Diseases (1) before Distribution, (2) after Distribution of Deaths in Public Institutions, etc. Boroughs. Death.rates per 1000 Living. All Causes. Scarlet Fever. Diphtheria Enteric Fever Phthisis Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distri bution County of London 14.0 13.8 0.10 0.11 0.15 0.15 0.05 0.05 1.30 1.32 West. Paddington 13.6 1. 4 —- 0.10 0.07 0 .10 0.03 0.03 0.98 1.01 Kensington 14.8 12.9 —- 0.05 0.01 0.15 0.02 0.03 1.62 0.98 Hammersmith 13.9 14.0 —- 0.09 0.03 0.10 0.05 0.04 1.16 1.26 Fulham 11.5 12.4 0.32 0.10 0.54 0.18 0.11 0.06 1.06 1.14 Chelsea 21.7 14.5 — 0.10 0.05 0.16 0 .05 0.07 2.49 1.27 City of Westm'r 14.1 12.6 0.01 0.04 0.03 0.09 0.05 0.03 0.67 1.23 North. St. Maryleboue 13.2 14.2 0.01 0.10 0.03 0.11 0.02 0.05 0.67 1.16 Hampstead 10.6 8.5 0.53 0.07 0.48 0.05 0.07 0.05 1. 57 0.78 St. Pancras 15.2 14.7 0.00 0.08 0.05 0.09 0.05 0.04 1.56 1.51 Islington 12.8 13.2 0.05 0.09 0.06 0.16 0.03 0.05 1.45 1.24 Stoke Nevvington 9.0 12.3 — 0.09 — 0.02 — 0.07 0.56 1.07 Hackney 13.6 13.2 0.21 0.13 0.31 0 19 0.07 0.03 1.31 1.22 Central Holborn 19.2 16.4 — 0.13 0.05 0.09 0.09 0.09 1.37 2 .11 Finsbury 9.7 18.6 — 0.13 0.03 0.16 0.03 0.12 0.89 215 City of London 49.8 17.7 0.05 — 0.36 0.10 0.41 — 2.66 1.79 East. Shoreditch 16.4 17.4 0.02 0.25 0.03 0.11 0.02 0.09 2.11 2.00 Bethnal Green 16 .9 17.1 — 0.30 0.07 0.21 0.04 0.10 1.83 1.61 Stepney 17.6 16 .4 0.01 0.17 0.14 0.24 0.05 0.04 1.37 1.56 Poplar 16.2 15.9 0.05 0.21 0.06 0.19 0.07 008 1.55 1.34 South. South wark 13.9 16.3 0.00 0.11 0.09 0.15 0.02 0.03 0.95 1.88 Bermondsey 15.1 18.8 0.02 0.19 0.02 0.18 0.05 0.09 1.69 1.89 Lambeth 14.4 13.3 0.11 0.13 0.17 0.14 0.05 0.02 1.41 1.45 Battersea 12.1 12.2 0.02 0.13 0 02 0 12 0.01 0.03 1.10 1.19 Wandsworth 11.0 11.6 0.22 0.07 0.20 013 0.01 0.02 0.98 0.96 Camber well 13 .8 12.7 0.00 0.08 0.02 0 .14 0.02 0.02 1.64 1.12 Deptford 10 .5 13.8 0.48 0.06 0. 49 0.08 0.13 0.07 0.70 1.16 Greenwich 10.5 12.6 0.41 0.05 0. 55 0.16 014 0.08 1.67 1.10 Lewisham 11.7 11.0 0.47 0.07 0.52 0.28 0.03 0.03 0.83 0 .85 Woolwich 10.5 11.4 0.01 0.07 0.04 0.16 0.01 0.02 1.10 1.20 The deaths ' before Distribution ' are those actually registered in the several Boroughs without any coirection whatever. 39 Table 14. Causes of, and Ages at, Death in the Borough of Lewi sham for the year 1908. Causes oF DEath. Deaths Whoi.e Borough Borough Divisions Deaths in Public Institutions in the Borough. Deaths of Residents outside the Borough Deaths of Non-residents in the Borough Under 1 year 1 and under 5 years 5 and under IS years 15 and under 25 years 25 and under 65 years 65 years and over Total all Ages Lee Levvisham Sydenham and Forest Hill Class I.—Infective Diseases ) 1 2 3 4 5 6 7 8 9 10 11 12 13 1 Small-Pox — — - - - - 2 Measles 7 37 2 — 1 — 47 3 28 16 1G 3 3 Scarlet Fever — 6 5 — — — 11 1 8 2 75 2 66 4 Typhus Fever — — — — — — — - - - - - 5 Plague — - — — — — — - - - - 6 Influenza — — — 2 11 5 28 5 19 4 1 - 1 7 Whooping Cough 17 11 2 - — — 30 3 20 7 2 - - 8 Diphtheria 1 22 19 2 — — 44 3 2G 15 72 1 40 9 Enteric Fever — — — — 4 — 4 1 1 2 3 - 1 10 Epidemic Diarrhoea 8 3 — — — 11 1 9 1 1 - - 11 Epidemic Enteritis 25 7 — — ■ — — 32 5 21 6 17 - 1 12 Dysentry — — — — 2 — 2 2 1 1 - 13 Venereal Diseases 5 — — — — - 5 4 1 1 2 - 14 Puerperal Septicemia Fev — — — 1 1 2 - 2 2 - 15 Infective Endocarditis — — — 1 1 — 2 - 1 1 1 - - 16 Erysipelas — — — — 1 — 1 - - 1 1 - - 17 Septicoemia not Puerperal 1 — 2 1 2 — 6 - 4 2 2 3 - 18 Pyasmia — — — 1 1 - 2 1 1 1 2 1 Class II.— Tuberculous Diseases 19 Other Septic Diseases 1 — — — — 1 - - 2 - - - 20 Phthisis 1 2 1 21 103 7 135 13 83 39 42 8 5 21 Meningitis 6 10 4 2 1 — 23 2 12 9 11 2 3 22 Peritonitis 1 2 1 — 2 - 6 - 4 2 3 1 2 23 Scrofula — - - - - - - - - - 24 Other Tuberculous Dis 5 7 2 10 3 27 2 18 7 13 1 - Class III. Malignant Diseases 25 Cancer, Carcinoma — 1 — 2 58 49 110 22 51 37 27 1 15 3 2G Sarcoma 1 — 1 2 2 — 6 1 3 2 - 3 - 27 Other Malignant Diseases — — — 3 19 13 35 2 18 15 8 4 1 28 Meningitis (not Tuber.) 6 5 2 1 I 15 3 8 4 4 )- 3 Class IV.— Nervous Diseases 29 Insanity (G. P. Insane) — — 1 - 19 8 28 5 17 6 7 13 o 2 30 Epilepsy — 1 1 — 10 1 13 1 9 3 6 2 1 31 Convulsions 10 2 — 12 1 11 - 32 Locomotor Ataxy — — — — 2 - •; 1 - 1 - 1 - 33 Paraplegia, Dis. of Cord — — 2 1 3 1 1 1 3 - 2 34 Other Nervous Diseases - - 1 1 17 6 25 4 12) 9 7 6 - Class V.— Diseases of Heart and Blood Vessels A 35 Valvular Disease, Endocarditis - - . 1 5 33 34 73 10 46 17 17 8 1 36 Cerebral Hemorrhage — — — — 29 31 60 2 40 18 26 1 13 37 Thrombosis — — 2 5 7 3 4 - - - 38 Apoplexy, Hemiplegia. — — — _ 7 8 15 3 9 3 - - - 39 Aneurysm — — 5 5 3 2 - - - 40 Embolism — 6 2 8 1 4 3 - 1 - 41 Thrombosis, not Cerebral 1 1 2 - 1 1 - - - 42 Other Dis. Heart and Blood Vessels 7 1 2 — 28 40 78 10 45 -i- 23 21 6 17 40 Table 1$—continued. Causes of Death Deaths Whole Borough Borough Divisions Deaths in Public Institutions in Borough Deaths of Residents outside Borough Deaths of Non-residents in Borough Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 65 years 65 years and over Total all Ages | Lee Lewisham Sydenham and Forest Hill 1 2 3 4 5 6 7 8 9 10 11 12 13 Class VII.— Class VI.— Digestive Respiratory Diseases Diseases 43 Croup (not Spasm, or Membranous) 1 - - - - - 1 - 1 - - - - 44 Bronchitis 19 6 — 2 24 79 130 13 71 46 57 3 26 45 Pneumonia 26 17 1 — 31 23 98 11 49 38 22 7 5 46 Asthma Emphysema - — — — 1 2 3 1 1 1 —- — — 47 Pleurisy — 1 1 1 3 1 7 — 4 3 — — — 48 Other Respiratory Dis. 3 3 — 1 1 4 12 1 5 6 2 — 1 49 Enteritis (not Epidemic) 3 1 — — 1 1 6 — 6 — — — — 50 Gastro Enteritis 4 5 — — — — 9 — 5 4 — 1 — 51 Peritonitis (not Puerperal) - 4 1 1 2 8 1 5 2 4 3 52 Cirrhosis of Liver - — — — 14 5 19 1 13 5 4 2 2 53 Gastric Ulcer Perforation of) - 1 1 4 1 7 1 3 3 3 1 1 Class VIII.— Urinary Diseases 54 Other Digestive Diseases 79 7 2 2 24 19 133 18 69 46 44 11 2 55 Nephritis, Acute — — — — 1 1 2 — 2 — 1 — — 56 Brigilt's Disease — — 1 4 28 22 55 6 28 21 9 7 2 57 Other Urinary Diseases — — — — 6 10 16 — 13 3 6 2 2 Class IX. 58 Generative Organs, Diseases of 4 1 5 1 2 2 2 1 1 59 Old Age — — — — — 139 139 27 71 41 76 4 21 60 Premature Birth 56 - - - - - 56 6 34 16 3 — 1 Class X.— General Diseases 61 Chronic Rheumatism — — — — 1 2 3 2 1 — — — — 62 Rheumatic Fever — 2 2 2 3 —- 9 — 5 4 2 — 1 63 Parturition, Diseases and Accidents of - - - - 3 - 3 1 2 - 1 - - 64 Alcoholism — — — — 7 — 7 — 4 3 1 — — 65 Gout — — — — 1 — 1 — -— 1 1 — 1 66 Diabetes Melletus — — — — 8 5 13 3 8 2 — 1 1 67'All Other Diseases 12 2 3 — 12 7 36 4 21 11 10 4 1 Class XLAccidents t 68 Burning — — 1 — 1 3 5 1 2 2 1 1 — 69 Overlaying 6 — — — — — 6 1 4 1 — — — 70 Poison — — — — 3 1 4 1 1 2 1 — — 71 Drowning — 1 — — 2 — 3 1 2 — — 2 — 72 Other Accidents 2 — 2 1 14 6 25 1 16 8 12 6 7 Class XII.Vio lence 1 73 Homicide 2 — — — 1 — 3 1 2 — — 2 — 74 Suicide — — — 1 13 2 16 1 13 2 2 2 1 Grand Totals 315 163 64 61 593 591 1757 211 1005 541 655 143 243 Note—Columns 1 to 10 include deaths of Residents in the Borough, in outside Districts and in Public Institutions. 41 Table 15. Residents and Non Residents dying in Public Institutions situated in the Borough. Institution. Deaths of Residents. Deaths of N onltesidents. Total. The Park Hospital 41 108 149 Lewisham Infirmary 315 22 337 Lewisham Workhouse 37 2 39 Bermondsey (St. Olave's) Workhouse — 82 82 St. John's Hospital 10 14 24 Home for Sick Children, Lower Sydenham 10 8 18 Greenwich Union Workhouse, Grove Park 1 1 Flower House, Southend Catford 2 2 4 Totals 415 239 654 In addition to the above, deaths of non-residents occurred as follows:—One in a public highway, one at Blackheath, and two in Lee. 42 Deaths of Residents Belonging to the Borough occurring in Public Institutions, in districts outside, during the year 1908. Feyer Hospitals:— Other Institutions :— Brook Hospital 1 Blackheath and Charlton Fountain Hospital 1 Cottage Hospital 1 North West Hospital 1 Brompton Hospital 1 South East Hospital 1 Camber well Infirmary 1 Cent. London Sick Asylum, Cleveland Street 1 General HospitalsChildren's Hospital, Great Ormonde Street 3 Charing Cross Hospital 3 East London Children's Guy's Hospital 13 Hospital, Shadwell 1 King's College Hospital 2 Evelina Hospital (Children) 3 London Hospital 6 Friedenheim Hospital 1 London Temperance Hosp. 1 Greenwich Infirmary 1 Middlesex Hospital 1 Hostel of God, Clapham 2 Miller Hospital, Greenwich 3 National Hospital, Queen's Royal Free Hospital 1 Square 1 St. Bartholomew's Hospital 3 Plumstead Infirmary 1 St. George's Hospital 1 Salvation Army Maternity St. Thomas's Hospital 9 Home 1 Seamen's Hosp'l, Greenwich 3 St. Mark's Hospital 2 West London Hospital 1 St. Pancras Infirmary 1 Westminster Hospital 8 St. Peter's Hospital 1 St. Saviour's Hospital .1 Tunbridge Wells Homœ- Asylums:- Pathic Hospital 1 Victoria Hospital o Banstead Asylum 3 Wandsworth Infirmary 1 Camber well House Asylum 2 Cane Hill Asylum 3 Various:— Caterham Asylum 3 Claybury Asylum 4 Kiver Thames 1 Colney Hatch Asylum 1 Cannon Street Station 1 Darenth Asylum 1 East India Docks 1 Dartford Heath Asylum 21 Hermitage Wharf, Wapping 1 Han well Asylum 1 Deptford Bridge 1 Leavesden Asylum 1 Sharratt Street, Deptford 1 Long Grove Asylum 2 South Street, Greenwich 1 Manor Asylum 1 City Almshouses, Stockwell 1 Peckham House Asylum 4 Belsize Boad, Hampstead 1 43 Table 16. Deaths from Principal Zymotic Diseases in Wards, during the year 1908. Localities Small-Pox Measles Scarlet Fever Diphtheria Whooping Cough Typhus Fever Enteric Fever Pyrexia *(origin uncertain) Epidemic Diarrhoea & Epidem itEnteritis Dysentery Totals Death Rates from Principal Zymotic Diseases. Church Ward - — — 1 2 - — — 1 — 4 0.56 Manor Ward — 1 — 2 — - - - 2 — 5 0.65 South Ward — 2 1 — 1 — 1 - 3 — 8 1.39 Lee Division — 3 1 3 3 - 1 — 6 — 17 0.83 Blackheath Wd — 2 — 3 — — — — 1 6 0.86 Lew. Vill. Wd. — 4 — 2 8 — — 7 1 22 1.43 Lew. Pk Wd — 6 — 5 4 — 1 — 14 1 31 1.65 Brockley Ward — 8 1 4 5 — — — — — 18 1.49 Catford Ward — 8 7 12 3 — — — 8 — 38 1.04 Lewisham Div — 28 8 26 20 — 1 — 30 2 115 1.28 Forest Hill Wd — 15 — 5 1 — 1 — 3 25 1.34 Sydenham Ward — 1 2 10 6 — 1 — 4 — 24 0.80 Sydenham and Forest Hill Div. — 16 2 15 7 — 2 — 7 — 49 1.00 Whole Borough — 47 11 44 30 — 4 '— 43 2 181 1.14 County of London — 1524 548 724 984 — 225 2 2592 6599 1.35 76 Great Towns 1 5069 1718 2578 4751 - 1251 10748 26116 1.59 * Originally termed Simple Continued Fever. 44 Table 17. Death Rates from principal Zymotic Diseases and Phthisis, and Infantile Mortality in the Borough and its Divisions, in the County of London, and in the 76 Great Towns, for the Year 1908. Disease. Lee Division. Lewisham Division. Sydenham and Forest Hill Div. Whole Borough County ol London. 76 Great Towns. Small-Pox - - - - - 0.00 Measles 0.15 0.31 0.33 0.29 0.31 0.31 Scarlet Fever 0.05 0.09 0.04 0.07 0.11 0.10 Diphtheria 0.15 0.29 0.31 0.28 0.15 0.16 Whooping Cough 0.15 0.22 0.14 0.19 0.20 0.29 Enteric Fever 0.05 0.01 0.04 0.03 0.05 0.08 EpidemicDiarrhœa and Enteritis 0.29 0.33 0.14 0.27 0.53 0.65 Dysentery — 0.02 — 0.01 Total Zymotic Death Rates 0.83 1.28 1.00 1.14 1.35 1.59 Infantile Mortality Rate 53 95 85 87 113 128 Phthisis Death Rate 0.63 0.93 0.80 0.85 1.32 — Comparative Hates for other Boroughs will be found in Table 12. 45 Table 18. Deaths from Principal Zymotic Diseases arranged in Age Groups, for the year 1908. Ages. Small.Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever, Epidemic Diarrhoea and Enteritis. Dysentry. Totals in Age Groups. Under 1 year — 7 — 1 17 — 33 — 58 1 and under 5 years — 37 6 22 11 — 10 — 86 5 and under 15 years — 2 5 19 2 — — — 28 15 and under *25 years — — — 2 — — — — 2 25 years and upwards — 1 — — — 4 — 2 7 Total all ages — 47 11 44 30 4 43 2 181 Note.—Typhus Fever should be included in the list of Principal Zymotic Diseases. It is omitted in the above table, as no cases occurred during the year. 46 Table 19. Meteriological Table for London for the Year 1903. (Deduced from Observations at Greenwich, under the Superintendence of the Astronomer Royal.) 1907. Month. Barometer. AIR TEMPERATURE. Bright Sunshine. Rain and other forms of Precipitation Mean pressure at 32 F. at Station Level (Bar. 159 ft. above M.S.L.) Mean of Absolute Minimum & Maximum. Total possible. Total observed Total Fall. Most in a day. Minimum A Maximum B Minimum. Day of Month Maximum. Day of Month. Amount Day of Month Ins ° ° ° ° Hours Hours Ins. Ins. January 29.983 30.9 41.7 .18 6&12 54 27 259 57 1.51 0.95 8 February 29.919 35.7 47.5 28 3 55 17 286 63 1.46 0.41 17 March 29.681 33.9 47.6 24 15 59 24 364 102 2.22 0.55 25 April 29.772 36.8 51.7 28 9 62 29 418 137 2.10 0.46 23 May. 29.834 47.2 66.2 38 24 77 19 488 200 1.53 0.53 30 June 29.914 49.7 71.0 42 7 82 4 494 262 2.07 0.95 4 July 29.844 53.2 73.0 47 20 84 3 493 202 3.66 1.04 13 August 29.822 51.4 70.1 47 31 83 3 446 214 3.28 0.72 28 September 29.818 47.7 66.4 36 13 80 30 375 165 1.22 0.36 3 October 29.966 46.0 62.9 33 25 79 2 333 133 1.97 0.69 17 November 29.889 39.8 52.1 22 10 59 1 266 77 0.76 0.22 21 December 29.763 35.3 43.5 12 30 54 13 244 22 2.00 0.32 29 Year 29.850 42.3 57.6 12 — 84 — 4466 1634 23.78 1.04 — PART 2. INFECTIOUS DISEASES. 49 NOTIFIABLE INFECTIOUS DISEASES. The infectious diseases notifiable under Section 55 of the Public Health (London) Act, 1891, are:—Small.Pox, Cholera, Diphtheria, Membranous Croup, Erysipelas, the diseases known as Scarlatina or Scarlet Fever, and the Fevers known by any of the following names:—Typhus, Typhoid, Enteric, Relapsing, Continued or Puerperal. The total number of cases notified during the year amounted to 1,220, of which number 923, or 75.65 per cent., were removed for isolation to the Metropolitan Asylums Board s Hospitals or other Institutions. In 33 instances, or 3.57 of the cases removed, the Hospital authorities returned the patient as not suffering from any notifiable disease. Deducting these from the gross total, we have a corrected total of 1187 cases of infectious disease notified as occurring in the Borough during the year, an increase of 159 over the number notified in the preceding year, which was 1028. In 190(5, 910 cases were notified. Age Periods.—45.8 per cent. of the Scarlet Fever cases, compared with 46.7 per cent. in 1907, and 53 per cent. of the Diphtheria cases, compared with 52.6 per cent in 1907, occurred among children aged six years and under. The following figures show the percentage of cases occurring among children of the age of six years and under to the total notifications of Scarlet Fever and Diphtheria:— Age. Scarlet Fever. Diphtheria. 1906. 1907. 1908. 1906. 1907. 1908. 6 years and under 47.8% 46.7% 45.8% .54.9% 52.6% 53.0% 5 „ „ 39.0% 35.8% 34.5% . 44.6% 44.3% 41.3% 4 „ „ 28.0% 25.5% 22.6% 32.0% 25.4% 27.2% 50 Table 20. Age Periods of Scarlet Fever and Diphtheria, notified during the year 1908. Age Periods. Scarlet Fever. Diphtheria. Number of Cases. Percentage to Total Cases N umber of Cases. Percentage to Total Cases. Under 1 year 2 0.33 . . 1 to 2 years 15 2.50 9 1.98 2 „ 3 „ 19 3.16 30 6.55 3 ,, 4 ,, 47 7.83 31 6.77 4 „ 5 „ 53 8.83 55 12.00 5 „ 10 „ 265 44.16 229 50.00 10 „ 15 „ 110 18.33 54 11.79 15 „ 25 „ 56 9.33 30 6.55 25 years and over 33 5.50 20 4.36 At all ages 600 100.00 458 100.00 Attack Rates represent the number of cases occurring to every 1,000 persons living at all ages. These rates are useful for comparison with other Boroughs in regard to the incidence of infectious diseases. (See Table 23). The attack rate from all infectious diseases (excluding Puerperal Fever) during the year amounted to 7.41 per 1,000 of the population, compared with 6.45 in 1907, and 6.08 in 1906. This increase is due to a rise in the attack rate from Diphtheria as will be seen in Table 22. The attack rate for the County of London was 7.36, compared with 8.61 in 1907. The attack rates for the Wards will be found in Table 22. It will be seen that {South Ward, Lee, had the largest 51 number of cases in proportion to its population, having an attack rate of 9,90 per 1,000. The lowest attack rate was in Sydenham Ward, 4,58 per 1,000. Table 21. Number of Cases of Infectious Diseases notified in the Ten Wards and the Whole Borough during the Year 1908. Wards. Scarlet Fever. Diphtheria. Enteric Fever Puerperal Fever. Erysipelas. Continued Fever. Total. 1 Church 24 4 2 — 5 — 35 2 Manor 84 12 — 1 6 — 53 3 South 84 16 3 — 4 — 57 Lee Division 92 32 5 1 15 — 145 4 Blackheath 28 19 — — 2 — 44 5 Lewisham Village 64 59 1 — 10 — 134 6 Lewisham Park 81 51 10 — 14 — 156 7 Brockley 35 50 1 — 6 — 92 8 Catford 192 131 4 1 20 2 350 Blackheath and Lewisham Division 395 310 16 1 52 2 776 9 Forest Hill 58 51 5 1 10 — 125 10 Sydenham 55 65 5 3 13 — 141 Sydenham and Forest Hill Division 113 116 10 4 23 — 266 Whole Borough 600 458 31 6 90 2 1187 52 Table 22. Attack rates from the Principal Infectious Diseases per 1,000 of the population for the ten Wards, and the whole Borough in the years 1905.1908. Wards. Diseases Scarlet Fever Diphtheria Enteric Fever Erysipelas Total 1905 1906 1907 1908 1905 1906 1907 1908 1905 1906 1907 1908 1905 1906 1907 1908 1905 1906 1907 1908 Church 20.6 1.88 3.44 3.34 1.18 1.16 0.57 0.55 0.29 — 0.28 0.26 0.73 0.72 0. 85 0.69 4.56 3.77 5.15 4.87 Manor 8.74 3.82 2.82 4.43 1.38 0.95 0.94 1.56 — 0.13 0.27 — 1.11 0.27 0.13 0.78 11.10 5.19 4.17 6.78 South 5.89 3.73 2.66 5.94 0.71 1.60 0.35 2.77 0.35 — 0.17 0.52 0.17 0.17 0.35 0.69 7.14 5.51 3.54 9.90 Blackheath 3.36 6.27 2.47 3.27 1.75 2.04 0.29 2.71 — 0.29 — — 0.58 0.58 0.29 0.28 5.71 9.19 3.05 6.27 Lewisham Village 4.85 4.52 2.73 4.14 0.75 1.21 1.93 3.82 0.34 — 0.20 0.06 0.82 0.40 0.53 0.64 7.24 6.28 5.40 8.68 Lewisham Park 3.76 4.74 5.89 4.31 0.84 1.70 1.71 2.71 0.13 0.12 0.28 0.53 0.64 1.03 0.68 0.75 5.44 7.66 8.58 8.30 Brockley 4.77 3.51 4.75 2.89 0.34 1.46 1.35 4.13 0.26 — 0.17 0.08 1.21 1.28 0.67 0.49 6.60 6.27 6.96 7.60 Catford 3.66 3.62 5.40 5.27 0.81 2.14 2.23 3.60 0.29 0.12 0.14 0.11 0.78 0.65 0.55 0.55 5.60 6.53 8.64 9.53 Forest Hill 3.93 3.49 3.70 3.09 1.69 1.58 1.63 2.72 0.27 0.21 0.10 0.26 0.82 0.38 0.54 0.53 6.78 5.67 5.98 6.62 Sydenham 1.69 2.50 1.84 1.82 0.90 1.59 2.71 2.15 0.18 0.24 0.16 0.16 0.57 0.67 0.60 0.43 3.61 5.01 5.32 4.58 Whole Borough 3.79 3.65 3.82 3.77 0.98 1.64 1.88 2.87 0.22 0.13 0.17 0.19 0.75 0.65 0.56 0.56 5.88 6.08 6.45 7.41 CHART C. Showing Weekly Notifications of all Infectious Diseases, and Weekly Notifications of Scarlet Fever and Diphtheria, during the year 1908. 58 SCARLET FEVER.—The total number of cases notified during the year amounted to 617, compared with 603 in 1907. Of this number, 516, or 83 per cent., were removed to the Metropolitan Asylums Board's Hospitals. Subsequently 17 cases were returned to their homes and stated not to be suffering from any notifiable disease. Deducting this number, a corrected total of 600 is obtained, compared with 584 in 1907, equal to an attack rate of 3.77 per 1,000 persons, compared with 3.82 in 1907. The attack rate for the County of London was 4.53 per 1,000. An examination of the attack rates for the various Wards shows that the highest occurred in South Ward, Lee (5.94 per 1,000) and that the Ward least affected was Sydenham, with . 1.82 per 1,000. Fourty.four per cent, of the cases occurred among children between the ages of 5 and 10 years, and 22.6 per cent, to children under the age of five years. Case Mortality.—Eleven deaths occurred in the Borough from Scarlet Fever, equal to 1.83 per cent, of the cases notified, compared with 2.05 in the previous year. DIPHTHERIA.—F our hundred and seventy.two cases of Diphtheria were notified, compared with 300 in 1907, and of this number 372, or 79 per cent., were removed to hospital. Twelve patients were returned home as not suffering, giving a corrected total of 458, an increase of 171 over the number for 1907 (287). The attack rate per 1,000 of the population amounted to 2.87, compared with 1.88 in the preceding year. The rate for the County of London was 1.64 per 1,000. Brockley Ward suffered most from this disease, having 50 cases, equal to an attack rate of 4.13 per 1,000. Church * 54 Ward, Lee, was least affected, having an attack rate of only 0.55 per 1,000. Case Mortality.—Fourty.four deaths occurred from this disease, equal to 9.6 per cent, of the cases notified, compared with 5.92 per cent, in the previous year. ENTERIC or TYPHOID FEVER.—Thirty.five cases were notified, 19 of which were removed to Hospital. Four cases were returned home as not suffering, giving a corrected total of 81, an increase of four on the previous year. The attack rate for the whole Borough was 0.19 per 1,000, compared with 0.17 in 1907. The highest attack rate was in Lewisham Park Ward, 0.53 per 1,000. The case mortality equalled 12.8 per cent., against 3.7 per cent, in 1907. ERYSIPELAS.—Ninety cases of Erysipelas were notified, compared with 80 in the preceding year. Twelve cases were removed to the Infirmary. PUERPERAL FEVER.—Six cases of Puerperal fever were notified, four of which were removed to the Infirmary for treatment. Two of the cases proved fatal. Case 1 Fairlawn Park, (Sydenham. Case 2 Laleham Road, Catford. Case 3 Springfield, Sydenham. Case 4 Taunton Road, Lee. Case 5 Rowland Grove, Sydenham. Case 6 Wastdale Road, Forest Hill. 55 Table 23. Attack Rates per 1,000 persons living at all ages from Small.Pox, Scarlet Fever and Diphtheria in the Metropolitan Boroughs and the County of London for the Years 1905.1908. Borough. Small.Pox. Scarlet Fever. Diphtheria. All Notifiable Infectious Diseases. 1905. 1906 1907. 1908. 1905. 1906. 1907. 1908 1905. 1906. 1907. 1908. 1905. 1906. 1907. 1908. Battersea — — — — 4.77 5.83 5.39 6.16 1.08 1.53 1.98 1.96 7.13 8.51 8.66 9.18 Bermondsey — 0.00 — — 5.82 7.69 7.98 4.93 1.29 2.61 2.49 1.94 8.73 12.16 11.98 8.68 Bethnal Green 0.03 0.04 — — 6.09 4.97 9.87 7.58 2.33 1.92 2.22 2 09 10.53 9.24 14.45 12.19 Camber well 0.04 0.02 — — 4.46 4.23 5.69 3.70 0.91 1.29 1.47 1.40 7.04 6.87 8.48 6.09 Chelsea — — — — 3.03 362 2.93 2.28 0.72 2.16 2.12 1.85 5.15 6.82 5.97 5.07 Deptford 0.01 0.00 — — 5.30 5.56 6.69 6.05 1.29 2.64 2.74 1.74 8.30 9.93 11.05 9.48 Finsbury 0.01 — — — 4.88 4.60 5.24 4.19 1.42 2.31 1.61 1.74 8.01 8.52 8.25 7.44 Fulham — — — — 4.96 4.16 4.02 3.42 1.81 2.49 3.64 2.29 8.21 7.79 8.89 6.76 Greenwich 0.03 — — — 2.77 5.38 6.18 3.86 1.40 3.88 2.40 2.01 5.42 10.62 9.64 0.32 Hackney 0.01 0.03 0.01 4.66 4.54 7.78 5.34 1.68 1.68 2.34 1.63 8.40 7.99 11.99 8.31 Hammersmith — — — 3.02 3.62 4.76 3.12 2.03 2.33 1.76 1.62 6.53 7.24 7.55 5.59 Hampstead - — 0.01 — 2.04 4.31 3.52 2.97 0.74 1.10 1.23 0.68 3.52 6.23 5.64 4.34 Holborn 0.01 — — — 2.76 2.47 2.86 3.51 0.81 1.18 1.16 0.90 4.65 4.94 5.02 5.73 Islington 0.00 0.00 — — 3.49 4.03 3.51 3.98 1.02 1.27 1.39 1.49 5.62 6.54 5.97 6.46 Kensington — — — — 1.87 2.65 2.93 2.44 0.72 0.98 1.38 1.26 3.79 4.62 5.26 4.73 Lambeth — — — 3.27 4.00 4.65 4.45 1.46 1.33 1.03 106 5.96 6.49 6.65 6.44 Lewisham 0.05 — — — 3.79 3.65 3.82 3.77 0.98 1.64 1.88 2.87 5.88 6.08 6.45 7.41 London, City of — — 0.10 — 3.38 5.28 4.79 2.71 0.71 0.84 1.38 1.48 5.35 7.44 7.45 5.06 Paddington 0.01 0.00 — — 1.88 4.81 3.86 4.45 0.65 1.22 1.13 0.98 3.82 7.28 6.10 6.36 Poplar — 0.01 0.01 — 5.81 3.34 7.53 7.34 2.88 1.45 2.11 1.81 10.38 6.52 11.30 10.68 St. Marylebone — — 0.01 — 2.14 3.07 3.42 3.19 1.01 1.09 1.00 0.92 4.80 5.70 5.77 5.42 St. Pancras 0.01 — 0.00 0.01 4.17 3.37 3.59 3.95 1.21 1.18 1.48 1.28 6.71 5.95 6.10 6.18 Shoreditch 0.01 — 0.01 — 6.80 5.40 7.60 5.12 1.56 1.24 1.93 1.79 9.11 8.25 11.08 8.94 South wark — — — — 3.72 7.02 6 09 3.62 1.45 1.91 2 02 1.26 7 00 11.06 9.80 6.26 Stepney 0.03 0.01 — — 6.03 3.93 10.15 7.45 2.09 1.96 2.44 2 08 10.29 7.70 14.60 11.23 StokeNewington 0 .02 — — — 3.36 2.53 4.71 3.68 1.49 0.88 2.21 1.18 5.62 4.49 7.80 5.59 Wandsworth 0.00 — — — 5.61 3.91 4.71 4.28 1.31 2.03 2.27 2.01 8.33 7.27 8.09 7.25 Wtmstr., City of 0.01 — — 0.01 2.09 3.08 2.43 3.61 0.68 1.20 0.84 1.08 3.79 5.30 4.19 5.44 Woolwich 0.05 — — — 4.09 4.12 7.90 4.50 2.18 3.03 2.16 2.76 7.31 8.15 11.26 8.18 London County 0.01 0.00 0.00 0.00 4.15 4.30 5.40 4.53 1.38 1.70 1.85 1.64 7.01 7.42 8.61 7.36 *Not including Puerperal Fever. 56 SCHOOL CLOSURE. The following is a list of schools closed either by this Council or the London County Council with a view of preventing the spread of infectious diseases:— On Account of Measles. Holbeach Road L.C.C. School.—Infants Department closed by the Council on January 7th for three weeks. Stillness Road L.C.C. School.—Infants' Department closed by Council on February 4th for three weeks. Gordonbrock L.C.C. School.—Class.rooms C, F, G and H. in the Infants' Department closed by Council on 12th February for three weeks. Brockley Road L.C.C. School.—Infants' Department closed on 2nd March for one week by London County Council (extended to two weeks). Plassy Road L.C.C. School.—Infants' Department closed by Council on March 19th for three weeks. Holbeach Road L.C.C. School.—Class.rooms F and G in the Infants' Department closed by Council on April 1st for two weeks. Holbeach Road L.C.C. School.—Infants' Department closed by Council 011 April 7th for two weeks. Northbrook School, Lee.—Lower Room in the Infants' Department closed by Council 011 May 26th for three weeks. St. Bartholomew's School, Sydenham.—Class.room B in the Infants' Department closed by London County Council on May 13th for two weeks. St. Stephen's School, Lewisham.—Room B in the Infants' Department closed by Council on May 27th for two weeks. 57 Kilmorie Road L.C.C. School.—Infants' Department closed by Council on May 27th for two weeks. Northbrook School, Lee.—Upper Room in Infants' Department closed by Council on June 16th for three weeks. Christ Church School, Forest Hill.—Infants' Department closed by Council on June 25th for two weeks. Manor Lane L.C.C. School.—Infants' Department closed by Council on July 3rd for two weeks. Sydenham Hill Road L.C.C. School.—Class.room D in the Infants' Department closed by London County Council on July 7th until after Summer holidays. Rathfern Road L.C.C. School.—Room A in the Infants' Department closed by Council on July 16th for one week. Holbeach Road L.C.C. School.—Class.room H in the Infants' Department closed by Council 011 September 15th for three weeks. St. Mary's School, Lewisham.—Babies' Room closed by London County Council on October 8th for 12 days. Holbeach Road L.C.C. School.—Class.room E in the Infants' Department closed by Council on October 22nd for three weeks. Stillness Road L.C.C. School.—Class.room D in the Infants' Department closed by Council on November 11th for three weeks. Whole of Infants' Department closed by Council on November 24th for three weeks. On account of Diphtheria. Hither Green L.C.C. School.—Class.room D in the Infants' Department closed by Council on November 30th for two weeks. 58 Rathfern Road L.C.C. School.—Class.room B in the Infants Department closed by Council on February 27th for two weeks. Gordonbrock L.C.C. School.—Class.room F in the Infants' Department closed by Council on March 26th for two weeks. Torridon Road L.C.C. School.—Infants' Department closed by the Council on November 5th for two weeks. Torridon Road L.C.C. School.—Classrooms C and D in the Infants' Department closed by Council on November 24th for two weeks. On account of Scarlet Fever. Plassy Road L.C.C. School.—Class.room F in the Girls' Department closed by Council on March 24th for two weeks. The following is a list of the Schools at which children under the age of compulsory school attendance, i.e., under five years old, were excluded owing to the prevalence of Measles in the neighbourhood of the School:— Sydenham Hill Road L.C.C. School.—Infants' Department, for three weeks, July 6th. . Church Street School, Lee.—Infants' Department, for three weeks, July 6th. Brockley Road L.C.C. School.—Infants' Department, three weeks, September 22nd. Holy Trinity School, Sydenham.—Exclusion by London County Council, September 22nd. St. Mary's School, Lewisham.—Infants' Department, three weeks, October 6th. 59 Dalmain Road L.C.C. School.—Infants' Department, three weeks, October 13th. Lewisham Bridge L.C.C. School.—Infants' Department, Room D, for ten days, October 22nd, by London County Council. Ennersdale L.C.C. School. — Infants' Department, Room D, for ten days, October 22nd, by London County Council. Lewisham Bridge L.C.C. School.—Infants' Department, three weeks, November 3rd. Holbeach Road L.C.C. School.—Infants' Department, three weeks, November (5th. MEASLES, WHOOPING COUGH, AND CHICKEN POX. These diseases, which are not compulsorily notifiable, are brought to our notice chiefly by notifications from the Head Teachers of the Elementary Schools in the Borough, in compliance with the regulations contained in the School Management Code. Measles.—The number of cases of Measles brought to our notice in this manner shows a considerable increase over the preceding year, 1,174 cases being notified, as compared with 546 in 1907. Where cases occurred in the poorer districts the houses were visited by the Women Sanitary Inspectors with the object of impressing upon the parents the very infectious nature of the disease, and the need of exercising every precaution to prevent its spread. Seven hundred and four visits were made for this purpose. Chicken.Pox.—Four hundred and four school children were notified to be suffering from this disease, compared with 413 in 1907. The Women Sanitary Inspectors made 221 visits to various homes on this account. 60 The following is a summary of the cases notified from Schools:— Number of children suffering. Children excluded on account of infection in their homes. Measles 1174 598 Chicken.Pox 404 201 Whooping Cough 416 78 Mumps 158 54 Ringworm 241 — VOLUNTARY NOTIFICATION OF PHTHISIS. During the year 57 cases of Phthisis were notified as existing in the district. Sixteen of the certificates were endorsed with the request that no visits should be made from this Department. The other 41 homes were visited and details of the precautions necessury to prevent the spread of the disease to others explained. SMALL.POX AND CHOLERA. During the year information was received from various Port Medical Officers of the arrival in this district of persons who, during the voyage, had come in contact with small.pox and cholera patients. These persons were immediately visited, and kept under observation during the full period of incubation. In no case was there any development of the disease. The number of contacts visited was:—Small.pox 11) and Cholera 2. BACTERIOSCOPIC EXAMINATIONS. Facilities were continued for the examination of specimens from doubtful cases of Diphtheria, Phthisis and Typhoid Fever. The total number of examinations made 61 amounted to 538, compared with 453 in the previous year. The details of the examinations were as follows:— 1905. 1906. 1907. 1908. re Diphtheria negative 72 148 248 269 positive 34 68 93 144 doubtful 1 1 2 4 re Phthisis negative 22 41 55 50 positive 7 20 21' 36 re Typhoid Fever negative 4 6 15 21 positive 2 3 3 9 doubtful — — — 1 re Cerebro-spinal Fever negative - - 3 - Food Samples, &c. 2 9 13 4 Totals 144 296 453 538 PART 3. GENERAL 65 Table 24. Water Certificates Granted after inspection in accordance with Section 48 of the Public Health (London) Act, 1891, during the years 1903.8 Ward. Number of Water Certificates Granted. 1903 1904 1905 1906 1907 1908 Church _ 12 40 23 33 29 Manor 17 41 9 7 46 101 South 30 25 33 47 13 17 Lee Division 47 78 82 77 92 147 Blackheath 5 - 5 1 - - Lewisham Village 72 56 10 5 24 11 Lewisham Park 159 71 67 114 55 87 Brockley 112 109 154 120 84 72 Catford 495 270 297 258 322 177 Lewisham Division 843 506 533 498 485 347 Forest Hill 199 139 95 63 30 42 Sydenham 210 176 208 156 157 98 Sydenham &Forest Hill Division 409 315 303 219 187 140 Whole Borough 1299 899 918 794 1 764 634 66 Table 25. Houses Examined and Certified under the Customs and Inland Revenue Acts during 1908. Name of Street. Applications. Certificates Date. Number of Houses. Number of Dwellings. Granted. Refused. Blackheath Hill 1 3 3 January Blagdon Road 1 2 2 - December Bradford Road 2 4 4 - February Burnt Ash Hill 1 3 3 - December Farley Road 7 14 14 - March George Lane 2 4 4 - May Limes Grove 3 6 6 - March and July Leyland Road 1 3 — 3 May Laleham Road 3 6 6 — February Miall Road 4 8 8 — April Radford Road 2 4 — 4 May St. Germains Road 1 1 — 1 May Sydenham Road 5 10 10 —_ October & Nov. Tressillian Road 1 2 2 — April Whatman Road 10 20 20 — January Totals 44 90 82 8 HOUSE.TO.HOUSE INSPECTION. During the year house.to.house inspection was made of 866 dwellings, distributed in the following roads and streets:— Brookdale Road, Carthage Street, Collins Street, Doggett Road, Drysdale Road, Elmira Street, (including Pettit's Buildings), Elswick Road, Engleheart Road (old part only), Harwich Place, Hope Cottages (Bertrand Street), Hurst Cottages (Loampit Yale), Jerrard Street, Lethbridge Road (the 67 part in our Borough), Merton Place (part only in our Borough), Pear Tree Cottages (Loampit Yale), Porson Street, Regent Street, Shrubbery Road, Sparta Street (including Vine Cottages), Vian Street, Wildfell Road and Terrace, and Wilmore Place. The following is a summary of the principal nuisances found and shows the need for systematic inspection:— Defective drains 43 Yent shafts and soil pipes defective 62 Water closets and apparatus defective 70 Insufficient water supply to water closets 151 Defective yard traps, sink wastes, gullies, &c. 481 Dirty premises 492 Overcrowding 10 Drinking water cisterns defective 122 Defective roofs 197 Damp premises 97 Insufficient floor ventilation 41 Defective yard pavings 184 Offensive accumulations 17 Animals so kept as to cause a nuisance 2 Other minor nuisances (ashbins, &c.) 829 Total 2,298 The whole of the above.mentioned defects were remedied on the service of notices, and no summary proceedings were necessary. Very little overcrowding was discovered, only ten cases coming to our notice, but as proof of the necessity of this work we need only mention that out of the 866 house inspected only 91, or 10.5 per cent., were without a nuisance of some kind, whilst 492, or 56.8 per cent., required cleansing notices. 68 COMBINED DRAINAGE. It was found necessary to serve notices under the Metropolis Management Acts upon the respective owners in order to obtain the necessary alteration and amendment of the followingcombined drains :— Algernon Road, 177 to 191. „ „ 193 to 199. ,, „ 201 to 207. Albion Road, 14 to 18. Belle Yue Mansions, 1 to 20. Blythe Vale, 48 to 54. Clyde Place, 1 to 7. Devonshire Road, 12 & 14. Doggett Road, 2 to 16. Elsinore Road, 23 to 27. Faversham Road, 2 to 12. Ketnble Road, 18 to 24. LowerWinchester Road, 9-17. Thurston Road, 57 to 66. SMOKE NUISANCES. The Inspector entrusted with this duty made 182 investigations, compared with 176 during 1907. The observations were made in respect of laundries 45, breweries 30, silk mills 11, jam works 31, flour mills 4, railway engines 16, sawmills and joiners' shops 16, and miscellaneous 29. Twelve intimation and one statutory notices were served upon the occupiers for the abatement of the nuisances reported. The service of notices, together with the calls of the Inspector, produced the necessary abatement, no legal proceedings being necessary. CORONERS COURT AND MORTUARY. One hundred and thirty bodies were removed to the public Mortuary, 11 of which were from outside districts and 16 from the Lewisham Union Infirmary. Inquests were held in 126 cases, and post-mortem examinations carried out in 85 instances. The portion of the Mortuary specially allocated for infectious disease was made use of for the bodies of three persons. 69 DISINFECTION. During the year 3,021 rooms were disinfected by formalin spray, and textile articles such as bedding, clothing, &c., (in all 105,726 articles), removed from infected homes to the Council's Disinfecting Station for treatment in the steam disinfector. UNSOUND FOOD. The following parcels of food were surrendered as unfit for human consumption and subsequently destroyed:— 1 trunk mixed fish roes 2 trunks cole fish 3 large boxes of sand dabs 1 box hake 1 box herrings 2 boxes plaice 1 sack escallops 1 barrel apples 1 parcel lemons 1 parcel tomatoes 69 cauliflowers. LEGAL PROCEEDINGS. The following is a Summary of the Legal Proceedings instituted by order of your Council:— Proceedings under the Sale of Food and Drugs and Margarine Acts:— Adulterations : Summonses issued 16 Convictions obtained 11 Fines imposed £28 10s. Costs imposed £10 15s. 6d. One summons was not proceeded with as there was insufficient evidence with regard to the ownership of the business. Details of the above are set out in Tables F, G, and I of the Report of the Public Analyst, in Part IV. of this Report. 70 Proceedings taken under the Public Health (London) Act, 1891, or Bye-laws made thereunder:— For fitting and fixing a water closet pan and trap at 18, Barmeston Road,. without giving the necessary notice to the Sanitary Authority, S. & S. were fined 10s. and £1 3s. costs. For failing to comply with a notice requiring the abatement of a nuisance arising from the accumulation of foul liquid in the cellar at 07, Engleheart Road, a summons was issued. The property in the meantime changed hands and the nuisance was abated by the new owner, consequently the summons was not proceeded with. For permitting a newly erected dwelling-house to be used for human habitation without a water certificate, L.G.E.L. were fined 10s. and 14s. 6d. costs. A summons was issued for the abatement of a nuisance arising from the dirty condition of the premises at 40, Brightfield Road. On the owner carrying out the necessary works the summons was withdrawn upon payment of £1 3s. costs by the defendant. On application, an order was made by the Magistrate requiring the abatement of a nuisance caused by the absence of a proper and sufficient supply of water at 13, Longton Grove, M.M., the defendant, having to pay £3 3s. costs. The tenant afterwards vacated the premises and the water supply was reinstated by the owner. A closing order was made by the Court for non-compliance with notice requiring the abatement of a nuisance caused by the absence of a water supply at 52, Nelgarde Road, the defendant, G.R.S., having to pay 5s. costs. The water supply was subsequently re-instated and the order cancelled. 71 A similar order was made in respect of 79, High Street, Sydenham. The premises were subsequently vacated, the water supply re-instated, and the closing order cancelled. ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. Workshops:—There are in the borough 570 workshops, containing 928 workrooms to which provisions of the Factory and Workshop Act apply. The number of workers found on inspection amounted to 2186, of which 505 were men, 1376 women, and 305 young persons. The largest proportion of these workers were engaged in the dressmaking, laundry, and millinery trades, there being 1343 women, 250 young persons and 35 men so employed. These premises are inspected by the women sanitary inspectors (see work of women sanitary inspectors, page 77), together with the workshops employing women in other trades. Only 33 women and 55 young persons were employed in all other trades. In workshops employing male labour, 505 men were engaged. Domestic and Part-Time Work Places.—There are 261 part-time and domestic workplaces, i.e., private houses, places or rooms, where no power is used, and in which only the occupiers themselves are employed. Besides these there are 54 restaurants and 49 stable yards, contractors' yards, &c., which might be termed workplaces. For the purpose of their inspection a special clause was added to section 2 of the Public Health (London) Act. On the whole the sanitary condition of the workshops in the Borough is very satisfactory. Where defects were found a verbal complaint to the owner was very often sufficient for the immediate remedy of same. 72 Table 26. Inspection of Factories, Workshops & Workplaces. (1) Premises, Inspections Notices served. Proceedings Factories (including factory laundries) 139 14 — Workshops (including workshop laundries) 1170 75 — Workplaces (other than outworkers' premises) 361 28 — Total 1670 117 — Statement of Defects Found. (2) Particular.-. Defects. Referred to H.M. Inspector. No. of Prosecutions. Found. Remedied. Dealt with under Public Health (London) Act— Want of cleanliness 90 90 — — Want of ventilation 2 2 — — Overcrowding 7 7 — — Want of drainage of floors 2 2 — — Other nuisances 62 62 — — Sanitary accommodation Insufficient 2 2 — — Defective or unsuitable 35 35 — —— Not separate for sexes 2 1 — — Under the Factory and Workshop Act— Illegal occupation of underground bakehouse (s. 101) — — — — Breach of special sanitary requirements for bakehouses ss. (97 100) 29 29 — — Other offences — — — — Total 231 230 — — Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. 73 Table 27. HOME WORK. (3). NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances Notices served. Prosecutions. Instances Orders made, Sec. 110. Prosecutions, Sections 109, 110. Twice in the year. Once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers.! Contractors. Workmen. Con- tractors. Workmen. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Wearing Apparel— (1) making, &c. 70 — 192 17 — 29 123 62 — — — 261 — — — — — — (2) cleaning and washing — — — — — — — — — — — — — — — — — — Lace, lace curtains and nets — — — — — — 5 — — — — 8 — — — — — — Artificial flowers — — — — — — — — — — — — — — — — — — Nets, other than Wire Nets. — — — — — — — — — — — — — — — — — — Tents — — — — — — — — — — — — — — — — — Sacks — — — — — — — — — — — — — — — — — — Furniture and Upholstery 2 — 4 — — — — — — — — 5 — — —— — — — Fur pulling — — — — — — — — — — — — — — — — — — Feather sorting — — — — — — — — — — — — — — — — — — Umbrellas, &c. — — — — — — 1 — — — — 1 — — — — — — Carding, &c., of buttons, &c. — — — — — — — — — — — — — — — — — — Paper Bags and Boxes — — — — — — 1 — — — — 1 — — — — — — Basket making — — — — — — — — — — — — — — — — — — Brush making — — — — — — — — — — — — — — — — — — Racquet and tennis balls — — — — — — — — — — — — — — — — — — Stuffed Toys — — — — — — — — — — — — — — — — — — File making — — — — — — — — — — — — — — — — — — Electro Plate — — — — — — — — — — — — — — — — — — Cables and Chains — — — — — — — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — — — — — — — Locks, Latches and Keys — — — — — — — — — — — — — — — — — — Pea picking — — — — — — — — — — — — — — — — — — Total 72 — 196 17 — 29 130 62 — — — 276 — — — — — — If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list is included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers are assigned in columns 3 and 4 (or G and 7) into their respective classes. The figures in columns 2, 3 and 1 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The figures in columns 3 and 4 are (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 75 Table 28. Workshops (sec. 131) and Workplaces and Workrooms on the Register at the end of 1908. Class of Work No. Number of Rooms. Number of Workers Allowed. Number of Workers Found. Part Time and Domestic. Workplaces. Day. Artificial Light Overtime. Men. Women. Young Persons Number. No. of Rooms. Dress 199 238 1560 1384 956 2 681 200 42 42 Millinery 46 52 279 269 167 — 117 49 5 5 Laundry 76 333 1092 1026 666 33 545 1 54 96 Tailor 43 46 199 187 126 82 19 — — — Boot 70 71 251 233 157 103 — 11 68 68 Joiner 19 31 532 497 376 37 — 4 7 7 Smith 26 29 339 311 239 59 — 8 6 6 Furrier 2 2 10 10 6 2 1 — — — Cycles 14 19 127 110 84 27 — 5 13 13 Coachbuilder 7 16 197 186 142 25 — 3 — — Cabinet and Upholsterer 17 26 327 314 226 36 3 7 8 8 Blindmaker 2 2 11 11 7 4 — — — — Photographer and Pictureframer 11 16 78 72 51 20 2 5 14 14 Jeweller 12 13 63 56 38 16 — 6 23 23 Piano 2 2 9 9 6 2 — 1 2 2 Saddler 10 10 51 45 34 19 — 1 3 3 Mason 2 3 31 31 20 5 — 2 2 2 Lathrender 2 4 22 18 14 5 — — — — Various 10 15 98 94 63 28 8 2 14 — Total 50 928 5276 4863 3378505 1376 305 261 289 Note :—Not including Bakehouses (98), Restaurants (54) and Stable- yards, See. (49). This figure includes 65 Outworkers. Including 137 Home-workers. 76 Other Matters (5). Failure to affix Abstract required by Section 133 of the Factory and Workshop Act, 1901, and notified to H.M. Inspector of Factories 23 Action taken in matters referred Notified by H.M. In- by H.M. Inspectors as remedi- spector 8 able under the Public Health (London) Act, but not under the Reports of action taken, Factory Act (Sec. 5). sent to H.M. Inspector 6 Underground Bakehouses (Section 101) :— In use during 1903 23 Certificates granted in 1903 23 1904 - 1908 nil In use at end of 1908 22 Workshops and Workplaces on the Register at the end of 1908 Workshops (details in Table 28) 570 Workplaces part time and domestic (details Table 29) 261 Bakehouses 76 ,, underground 22 Restaurants (workplaces) 54 Workplaces (stable yards, contractors' yards, etc.) 49 Total 1032 77 WORK OF WOMEN SANITARY INSPECTORS. During the year Miss Jones and Miss Moynihan have performed most useful work in connection with the Health Department. The total number of visits made by these inspectors amounted to 4,828, reporting 290 nuisances. Many defects they were able to have remedied without the service of legal notices. It was, however, necessary to serve 201 intimation notices and 42 statutory notices, which were all complied with. In addition to their principal duties, viz., that of visiting and inspecting workrooms where women were employed, the homes of outworkers, &c., they made 241 visits to schools which were of great assistance in our efforts to check and prevent the spread of infectious diseases; 704 visits were made to homes in relation to measles, 221 re chicken pox, and 409 re whooping cough and other non-uotiliable diseases. Under the Factory and Workshop Act, 669 visits were made to factories, workshops, workplaces and laundries where women are employed, and 210 to homes of outworkers. Three hundred and fifteen visits were made after deaths of infants under one year and 934 selected homes at which births occurred. This work was carried out tactfully and without friction. We frequently received communications requesting a visit from the women inspectors. Seventeen visits were made in regard to puerperal fever and 224 re phthisis homes and deaths, also essentially work for women sanitary inspectors. SUMMARY OF VISITS OF WOMEN SANITARY INSPECTORS. During the year under review the Women Sanitary Inspectors have made 4,828 visits throughout the Borough. 78 The following is a summary of the work done:— Factory and Workshop Act.— Miss Jones. Miss Moynihan. Total. To Factories ... 17 23 40 „ Workshops 161 143 304 „ Workplaces 94 49 143 ,, Laundries 113 69 182 „ Outworkers' homes 82 128 210 Infectious Diseases.— To Phthisis homes 41 18 59 Re Phthisis deaths 98 67 165 ,, Chicken-pox 145 76 221 „ Measles 393 311 704 ,, Puerperal fever 16 1 17 ,, School Notifications 325 84 409 Other Visits.— On complaint from residents 46 11 57 To Selected homes from which births were registered 509 425 934 Investigations re Infant mortality 137 178 315 To Schools 150 91 241 Re-visits and re-inspections 414 137 551 Miscellaneous inquiries 87 189 276 Total 2828 2000 4828 Nuisances, Defects, &c.— Abstract not affixed in workshops 13 4 17 Overcrowding of Workshops 4 4 8 Other nuisances in workshops 26 19 45 Total number of nuisances found 187 103 290 Notices, &c.— Intimation notices served 152 49 201 Statutory notices served 23 19 42 Verbal notices complied with 35 54 89 79 Table 29. ROUTINE INSPECTIONS. Premises. Number of Places No. of Inspections 1908. No. of Notices 1908. No. of Prosecutions 1908. On Register at end of 1907. Added in 1908. Removed in 1908. On Register at end of 1908 Milk premises 165 66 53 178 337 7 — Cow sheds 14 — — — 153 1 — Slaughter houses 16 — — — 126 — Other offensive Trade premises — — — — — — — Ice cream premises — — — — — — — Registered houses Let in Lodgings 15 — — — 162 a 7 — b34 Restaurants 53 10 9 54 80 17 — Bakehouses 99 — 1 98 318 17 — Stable Yards, etc. 49 3 3 49 54 5 — Not in use at present. a Overcrowding, b Other conditions. Total number of intimation notices served for all purposes, 2379. Overcrowding :—Number of dwelling rooms overcrowded 10, and workrooms 8—remedied all, proceedings, nil. Underground rooms :—Illegal occupation dealt with and number of rooms closed, nil. Insanitary Houses:—Number closed under the Public Health (London) Act and Housing of the Working Classes Act, nil. Premises cleansed under Section 20 of the London County Council (General Powers) Act, 1904, . 80 Number of persons accommodated during the year in shelter provided under Section 60 (4) of the Public Health (London) Act, 1891, nil. Revenue Acts: —Houses for which application were received 44, number of tenements comprised therein 1)0, certificates granted 8*2, refused 8, deferred nil. Prosecutions under By-laws under the Public Health (London) Act:— (a) For prevention of nuisance arising from snow, ice, salt, filth, &c. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, &c. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, &c., of dwelling houses — (e) In connection with the removal of offensive matter, &c. — (f) As to cesspools and privies, removal and disposal of refuse, &c. — (g) For securing the cleanliness of tanks, cisterns, &c. — (h) With respect to water-closets, earth-closets, &c. 1 (i) With respect to sufficiency of water supply to water-closets— (j) With respect to drainage, &c. (Metropolis Management Act, Section 202) (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (Bylaws) Act, 1899) — Mortuaries :— Total number of bodies removed 130 Total number of infectious bodies removed 3 Note.—This table was formulated to meet the requirements of the London County Council. 81 Table 30. REGISTER OF SANITARY WORK. (Male Inspectors ) For the year ended 31 st December, 1938. Description of Work Lewisham Division. Sydenham and Forest Hill Division. Lee Division Workshops House to House Total for Wholo Boro. Mr. J. A. K. Cooper Mr. H. King Mr. H. L. Hyde Mr. E. T. Pidwell Mr. B. A. Knappett Mr. R. White Mr. J. Daltry Mr. A. H. Gray Complaints by Residents 105 101 49 86 121 201 07 6 676 Premises inspected 551 540 614 983 579 742 150 1035 6544 Re-inspections of Works in pro gress 2178 1970 2110 1410 1769 1939 806 7757 19939 Intimation Notices served 265 208 237 152 210 214 100 792 2178 Statutory Notices ordered 229 159 198 117 94 184 44 102 1127 Statutory Notices served 39 55 36 46 49 42 3 43 313 Premises repaired, cleansed, &c. 116 70 145 145 100 95 188 512 1381 Defective Roofs, Stackpipes, &c., remedied 43 17 54 69 56 38 11 387 675 Drains re-constructed 139 73 117 61 44 101 — 15 550 Drains repaired 43 66 47 57 71 62 9 45 400 Drains ventilated 13 18 57 24 14 61 — 21 208 Stackpipes, Sinks, Bath Wastes, &c., disconnected from drains 61 53 86 38 43 126 — 189 596 / Gulley Traps provided 82 66 128 110 196 212 — 105 899 Water Closets reconstructed 88 64 90 119 119 106 4 52 642 Water Closets repaired 34 26 42 30 41 65 116 25 379 Water Closets supplied with water 39 34 48 6 2 81 3 170 383 Soil Pipes reconstructed 52 34 70 36 60 36 — 10 298 Soil Pipes repaired and ventilated 15 6 10 24 10 21 24 35 145 Dustbins provided 37 28 62 54 15 88 16 193 493 Water Supply to Houses reinstated 4 15 5 8 22 8 — 3 65 Cisterns repaired, cleansed or covered 5 13 17 57 17 14 61 129 313 Water Certificates issued 4 4 47 74 6 148 173 178 634 Premises over-crowded 5 6 11 — 3 — — 11 36 Yards paved 52 19 68 26 73 75 55 208 576 Removal of offensive accumulations 13 23 16 31 36 21 4 28 172 Dung Vaults erected or repaired 3 — 1 — 3 1 4 12 Animals improperly kept 4 4 5 2 8 3 4 3 33 Visits to houses let in lodgings 10 — 152 — — — — 162 Bake-house inspections — — — 21 7 15 275 — 318 Milk-shop — — — 32 22 30 253 — 337 Cow-shed 9 38 9 24 11 62 — — 153 Workshop — — — 3 2 — 532 — 537 Slaughter-house 28 6 7 41 11 33 — — 126 House-to-house — — — — — — — 865 865 Legal proceedings 1 2 — 2 — 2 — — 7 PART 4. REPORT OF PUBLIC ANALYST 85 REPORT OF THE PUBLIC ANALYST FOR THE YEAR ENDED DECEMBER 31st, 1908. SAMPLES SUBMITTED.—During the period under review . 532 samples were submitted for analysis. Of this number, 412 were purchased by your inspectors in conformity with the provisions of the Sale of Food and Drugs Acts. The remaining 120 samples were purchased as test samples, and without declaration to vendors. ADULTERATED SAMPLES.—Of the 412 official samples submitted, 34, or 8.25 per cent, were adulterated, compared with 7.26 per cent, in the previous year (1907) and 9.29 per cent, in 1906. TEST SAMPLES.—These are samples purchased by assistants without following the formalities prescribed by the Food and Drugs Acts, the purchases being made in a manner similar to that adopted by the ordinary householder. Of the 120 samples so purchased, 14, or 11.67 per cent., were found to be adulterated, compared with 19.15 per cent, in 1907. PURCHASE OF SAMPLES BY DEPUTY.—This practice was adopted in 174 purchases, and resulted in the detection of sophistication in 30 cases, or 17.2 per cent. MILK.—Of the 263 samples submitted, 24, or 9.13 per cent., were adulterated or below the standard fixed by the Board of Agriculture, compared with 1907, when the adulterated samples equalled 6.60 per cent. 86 Dyed Milk .—Of the milks examined during 1908. 51.5 per cent, were artificially coloured, compared with 66.4 per cent, in 1907 and 77.4 in 1906. From these figures it would appear that the practice of colouring milk with various colouring matters to suit the demands of the public is slowly decreasing in this Borough. Annatto is the material most commonly used, but aniline dyes are not infrequently reverted to. Sunday Samples.—Seven samples of milk were obtained on Sundays, two of which (Nos. 111 and 252) were below standard. Average Composition.—The average composition of all samples of milk submitted during 1908 was well above the standard, with 3.50 per cent. Milk Fat and 8.80 per cent. Solids Not Fat. The average composition of the genuine samples alone was 3.58 per cent. of Milk Fat and 8.81 per cent. Solids Not Fat. (See Table E). Milk Samples taken in course of Delivery. — Thirtytwo samples were taken in course of delivery, as follows:— Park Fever Hospital 17 ; Railway Stations 6 ; Lewisham Union Infirmary 4; Lewisham Workhouse 1 ; Bermondsey Workhouse 2; Shops 1; Private Dwelling Houses 1. Of these samples thus obtained four were below standard (Nos. 1, 2, 111 and 252). In the first three instances the proceedings were instituted against the consignor, but failed on his proving warranty. In the fourth case the consignor was cautioned. BUTTER.—Ninety-three samples were purchased in conformity with the Food and Drugs Acts, of which number, 6, or 6.45 per cent, (compared with 7.76 per cent, in 1907) proved adulterated. In addition, 68 test samples were taken, 6, or 82, per cent, of which were adulterated. 87 Itinerant Vendors.—During the year careful watch was kept on an itinerant butter vendor whom, we had reason to believe, was supplying margarine in our district. The suspicion was confirmed by the purchase of test samples. Finally an official sample was obtained (No. 62), which led to the conviction of the vendor, a fine of £3 and £1 3s. 6d. costs being imposed. Milk Blended Butter.—Thirty-nine samples of butter submitted to me were milk blended, 11 being "test" samples and 28 officially purchased. Under the Butter and Margarine Act, 1907, milk blended butter can only be sold under special conditions set out in Section 9, as follows :— (1) " Milk blended butter shall be dealt with under such " name or names as may be approved by the Board of " Agriculture and Fisheries, and under the conditions " applicable to the sale or description of margarine, with " the substitution of an approved name for the word " ' margarine,' and with this modification, that, in any " case where, in order to comply with those conditions, " the article is delivered to the purchaser in a wrapper, " there shall, in addition to the approved name, be " printed on the wrapper in such manner as the Board " approve such description of the article setting out the " percentage of moisture or water contained therein, as " may be approved by the Board." The milk blended butters which have been purchased by your inspectors, were sold in wrappers without any description or distinctive marks. It will be noted that the wrapper giving the description of the article has to be approved of by the Board of Agriculture. 88 Table A. Showing number of Samples submitted for Analysis, with Results for the year ended December 31st, 1908. (a) Samples taken officially and in accordance with the provisions of the Sale of Food and Drugs Acts. Article. Total. Genuine. Adulterated. Percentage Adulterated. Milk 263 239 24 913 Skimmed Milk 6 5 1 1667 Butter 93 87 6 645 Margarine 1 1 — — Coffee 26 25 1 385 Coffee and Chicory 1 1 — — Cocoa 3 3 — — Mustard 3 3 — — Rum 2 2 — — Gin 7 7 — — Whiskey 6 4 2 33.33 Compound Tincture of Bark 1 1 — — Total official samples 412 378 34 8.25 (b) Test Samples purchased without the formalities of the Act. Milk 3 3 — — Butter 68 62 6 88.2 Coffee 23 21 2 8.70 Cocoa 4 4 — — Mustard 4 4 — — Pepper 6 6 — — Sugar 1 1 — — Demerara Sugar 1 1 — — Castor Sugar 1 1 — — Vinegar 6 3 3 50.00 Camphorated Oil 3 — 3 100.00 Total "test" samples 120 106 14 11.67 Total all samples 532 484 48 9.02 89 Table B. Summary of Samples {not including test samples) Analysed in the Borough in each Year. 1898-1908. Year. No. of Samples (not including Test Samples Genuine. Adulterated. Percentage Adulterated. No. of Prosecutions Fines and Costs imposed. 1898 Total Samples 36 31 5 13.88 2 Fines £3, costs 15s. 6d. 1899 Total Samples 41 37 4 9.75 1 Fines £5, costs 14s. 6d. 1900 Total Samples 68 61 7 10.29 7 Fines £14 15s., costs £2 13s. 6d. 1901 Total Samples 3 — 3 100.00 2 Fines £5, costs £1 1s. 1902 Total Samples 458 389 69 15.07 34 Fines £123, costs £24 18s. 6d. 1903 Total Samples 451 390 61 13.53 19 Fines £50 15s., costs £11 7s. 1904 Total Samples 416 376 39 9.38 26 Fines £88 10s., costs £18. 1905 Milk 282 476 438 38 7.98 19 Fines £56 4s., costs £10 4s. Butter 91 Various 103 1906 Milk 275 495 449 46 9.29 14 Fines £108, costs £6 13s. 6d. Butter 99 Coffee 37 Wines and Spirits 12 Drugs 8 Sundries 64 1907 Milk 292 496 460 36 7.26 17 Fines £30 10s., costs £10 12s. Butter 116 Coffee 41 Wines and Spirits 10 Drugs 5 Sundries 32 1908 Milk 269 412 378 34 8.25 15 Fines £28 10s., costs £10 15s. 6d. Butter 93 Coffee 26 Wines and Spirits 15 Drugs 1 Sundries 8 90 Table C. Showing Total Samples submitted with results during the years 1904-1908. (Test samples not included). Quarter. No. of Samples. No. Adulterated. Percentage Adulterated. 1904 1905 1906 1907 1908 1904 1905 1906 1907 1908 1904 1905 1906 1907 1908 First 114 123 146 126 79 16 13 12 9 12 14.04 10.57 8.22 7.14 15.19 Second 67 103 88 119 147 12 9 6 5 13 18.90 8.74 6.82 4.20 8.84 Third 123 129 102 123 104 7 6 15 11 7 5.69 4.65 14.71 8.94 6.73 Fourth 112 121 159 128 82 4 10 13 11 2 357 8.26 8.18 8.60 2.44 Total for Year 416 476 495 196 412 39 38 46 36 34 9.38 7.98 9.29 7.26 8.25 Table D. Showing results of Total Samples of Milk submitted during the Years 1904-1908. Quarter. No. of Samples. No. Adulterated. Percentage Adulterated. 1904 1905 1906 1907 1908 1904 1905 1906 1907 1908 1904 1905 1906 1907 1908 First 58 88 63 55 53 9 8 6 5 9 15.52 9.09 9.52 909 16.98 Second 48 53 41 77 100 10 5 4 5 12 20.83 9.43 9.76 6.49 12.00 Third 91 68 77 95 55 6 3 12 8 3 659 4.41 15.58 8.42 5.45 Fourth 53 69 84 61 55 2 4 5 1 —- 3.77 5.80 5.95 1.64 — Total for Year 250 278 265 288 263 27 20 27 19 24 10.80 7.19 10.19 6.60 9.13 91 Table E. Average Composition of Milk Samples submitted in 1908. Period. Average Composition of all samples submitted genuine and adulterated. Average Composition of genuine samples. Board of Agriculture Standard. Percentage of Milk fat. Percentage of Solids not fat. Percentage of Milk fat. Percentage of Solids not fat. Percentage of Milk fat. Percentage of Solids not fat. First Quarter 3.34 8.88 3.50 8.91 3.0 8.5 Second „ 8.49 8.79 3.60 8.80 Third „ 3.55 8.76 3.59 8.75 Fourth „ 8.61 8.79 8.71 8.79 Total for Year 3.50 8.80 3.58 8.81 92 Table F. Average Composition of Milk Samples submitted during the Years 1902-1908. Period. Average Composition of all samples submitted genuine and adulterated. Average Composition of genuine samples. Board of Agriculture standard. Percentage of Milk Fat. Percentage of Solids not Fat. Percentage of Milk Fat. Percentage of Solids not Fat. Percentage of Milk Fat. Percentage of Solids not Fat. Year 1902 3.55 8.62 3.66 8.71 3.0 8.5 „ 1903 3.67 8.63 3.81 8.72 „ 1904 3.68 8.69 3.69 8.74 „ 1905 3.58 8.75 3.62 8.78 „ 1906 3.56 8.74 3.62 8.77 „ 1907 3.47 8.81 8.53 8.88 „ 1908 3.50 8.80 3.58 8.81 93 Table G. Details of Adulterated Samples of Milk during the Year ended December 31st, 1908. No. Adulteration. Remarks. 1 11 per cent. deficient in milk fat Taken on delivery ; proceeding 2 8 per cent. deficient in milk fat taken; contractor proved warranty. 77 16 per cent. deficient in milk fat Vendor fined £3 and £1 3s. costs. 78 5 per cent. deficient in milk fat Vendor cautioned. 81 56 per cent. deficient in milk fat Vendor fined £5 and £1 3s. costs, or in default one month's imprisonment.. 94 9 per cent. added water Vendor fined £2 and £1 3s. costs. 102 5 per cent. deficient in milk fat Vendor cautioned. 105 13 per cent. deficient in milk fat Vendor fined £2 and £1 3s. costs 111 13 per cent. deficient in milk fat Taken on delivery; proceedings taken ; defendant (same as for Nos. 1 & 2) proved warranty. 119 3 per cent. deficient in milk fat Vendor cautioned. 133 10 per cent. deficient in milk fat Summons withdrawn: insufficient evidence of ownership of business. 134 5 per cent. deficient in milk fat Vendor cautioned. 151 5 per cent. deficient in milk fat Vendor cautioned. 153 36 per cent. deficient in milk fat Vendor proved warranty; case dismissed. 210 5 per cent. deficient in milk fat Vendor cautioned. 220 10 per cent. deficient in milk fat Vendor fined £5 and £1 3s. costs ; second offence. 221 3 per cent. deficient ill milk fat Vendor cautioned. 223 3 per cent. deficient in milk fat Vendor cautioned. 224 3 per cent. deficient in milk fat Vendor cautioned. 230 3 per cent. deficient in milk lat Vendor cautioned. 252 6 per cent. deficient in milk fat Taken on delivery; consignor cautioned. 295 5 per cent. deficient in milk fat Vendor cautioned. 300 3 per cent. added water. Vendor cautioned. 303 20 per cent. deficient in milk fat Vendor fined£1 and 12s. Gd. costs. 518 Separated milk: 4 per cent. added water Declared at the time of purchase; no action. 94 Table H. Showing the number of samples of Butter submitted in the Four Quarters of the years 1904-1908. Quarter. No. of Samples. No. Adulterated. Percentage Adulterated. 1904 1905 1906 1907 1908 1904 1905 1906 1907 1908 1904 1905 ; 1906 1907 1908 First 35 22 33 34 20 5 3 4 1 3 14 29 1362 1212 2-94 1500 Second 9 17 23 25 34 1 — 1 — 1 1111 — 4-35 — 2 94 Third 22 21 9 20 18 1 — 1 2 1 4-55 — 11-11 10 00 5-56 Fourth 35 31 34 37 21 — 4 6 6 1 — 1290 1765 16-22 4-76 Total for year 101 91 99 116 93 7 7 12 9 6 693 7-69 1212 7-76 6 45 Table I. Details of Adulterated Samples of Butter for the Year ended December 31s£, 1908. No. Adulteration. Results. 6 Margarine "Test" sample; see No. 62 9 Margarine "Test" sample; see No. 62 29 Margarine "Test" sample 62 92 per cent. foreign fab Vendor fined £3 and £1 3s. 6d. costs 136 Suspected mixtures of cocoanut oil, although samples barely complied with the standard test 137 158 Margarine "Test" sample 184 93 per cent, foreign fat Vendor fined £4 and £1 3s. costs ; second offence 348 30 per cent, foreign fat Vendor fined £2 and 14s. Gd. costs 441 Margarine "Test" sample 461 Margarine "Test" sample 470 80 per cent, foreign fat Vendor fined £1 and 12s. 6d. costs 95 Table J. Details of Other Samples Adulterated during the year ended December 31st, 1908. No. Article. Adulteration. Remarks. 17 Coffee 10 per cent, chicory Test sample 352 Coffee 20 per cent, chicory Vendor fined 10s. and 14s. 6d. costs 356 Coffee 20 per cent, chicory Test sample 386 Whiskey Slightly below standard No action 387 Whiskey Slightly below standard No action 400 Vinegar Wood vinegar Test sample 401 Vinegar Wood vinegar Test sample 402 Vinegar Wood vinegar Test sample 18 Camphorated oil Mineral oil used as a solvent instead of olive oil Test sample 19 Camphorated oil Deficient in camphor Test sample 26 Camphorated oil Deficient in camphor Test sample APPENDICES. 99 I.—Local Government Board Tables. Table I. Vital Statistics of Whole District during the Years 1901-1908. Year Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District Nett Deaths at all Ages belonging to the District. Under 1 Year of Age At all Ages. Number. Rate.* Number. Rate per 1000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1901 128480 3320 25.9 426 128 1875 14.5 613 289 82 1668 13.0 1902 132432 3491 26.3 438 125 1942 13.9 568 241 117 1818 13.7 1903 136405 3563 26.1 330 93 1566 11.5 480 152 99 1513 11.1 1904 140401 3589 25.6 448 125 1799 12.8 542 210 90 1679 12.0 1905 144420 3633 25.2 338 93 1804 12.5 569 232 119 1691 11.7 190G 148463 3446 23.2 391 113 1888 12.7 616 228 117 1777 12.0 1907 152532 3622 23.7 325 90 1881 12.3 660 275 143 1749 11.5 1908 156627 3632 22.8 315 87 1858 11.7 655 243 143 1757 11.0 Note.—Figures for years prior to 1901 are unobtainable. * Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. Area of District in Acres (exclusive of area covered by water) — 6,991 At Census of 1901—Total population at all ages — 127,495 „ ,, Number of inhabited houses — 22,750 „ „ Average number of persons per house 5.6 100 Table II. Vital Statistics of Separate Localities in the Years 1901-1908. Names of Localities. LEE. LEWISHAM. SYDENHAM & FOREST HILL. WHOLE BOROUGH. Year. Population estimated to middle of each Year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 Year Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. 1901 18708 398 255 — 66631 1882 856 43146 1040 557 — 128480 3320 1668 — 1902 18925 481 220 37 69672 1857 991 261 43835 1153 607 130 132432 3491 1818 428 1903 19147 486 213 37 72731 1979 816 203 44527 1098 484 88 136405 3563 1513 328 1901 19370 469 193 40 75808 1967 941 263 15223 1153 545 135 140401 3589 1679 410 1905 19594 454 186 21 78903 2027 966 209 45923 1152 539 108 144420 3633 1691 338 190G 19820 445 211 40 S2016 1871 1000 220 46627 1130 566 131 148463 3446 1777 391 1907 20047 446 214 31 85149 2063 995 186 47336 1113 540 108 152532 3622 1749 325 1908 20276 473 211 25 S8302 2058 1005 196 48049 1101 541 91 156627 3632 1757 315 Institutions within the District receiving sick and infirm persons from outside the District:—Lewisham Union Infirmary; Lewisham Union Workhouse; Greenwich Union Workhouse, Grove Park ; Park Fever Hospital; Bermondsey (St. Olave's) Union Workhouse; St. John's Hospital, Morden Hill; Home for Sick Children, Lower Sydenham ; Flower House Asylum, Southend. Outside Institutions in which deaths of residents of this District have occurred were:—Brook Hospital, Fountain, North West and North East; Charing Cross, Guy's, King's College, 101 London, London Temperance, Middlesex, Miller (Greenwich), Royal Free, St. Bartholomew's, St. George's, St. Thomas', Greenwich Seamen's, West London and "Westminster Hospitals; Banstead, Camberwell House, Cane Hill, Caterliam, Claybury, Colney Hatch, Darenth, Dartford Heath, Han well, Leavesden, Long Grove, Manor and Peckham House Asylums; Blackheath and Charlton Cottage Hospital, Brompton Hospital, Camberwell Infirmary, Central London Sick Asylumn (Cleveland Street), Great Ormonde Street Children's Hospital,East London Children's Hospital (Shadwell), Evelina Hospital (Children), Friedenheim Hospital, Greenwich Infirmary, Clapham Hostel of God, Queen's Square National Hospital, Plumstead Infirmary, Salvation Army Maternity Home, St. Mark's Hospital, St. Pancras Infirmary, St. Peter's Hospital, St. Saviour's Hospital, Tunbridge Wells Homoepathic Hospital, Victoria Hospital and Wandsworth Infirmary. Corrections were also made for deaths occurring as follows:—River Thames, Cannon Street Station, East India Docks, Hermitage Wharf (Wapping), Deptford Bridge, Sharratt Street (Deptford), South Street (Greenwich), City Almshouses (Stockwell) and Belsize Road (Hampstead). 102 Table III. Cases of Infectious Disease Notified during the Year 1908. Notifiable Disease. Cases notified in whole district. Total Casks Notified in each Locality at all Ages. No. of Cases Removed to Hospital from each Locality. Total Cases Removed to Hospital At all Ages At Ages—Years. Lee. Lewisham. Sydenham and Forest Hill. Lee. Lewisham. Sydenham and Forest Hill. Under 1 1 to 5. 5 to 15 15 to 25 25 to (55 65 and upwards Small-Pox — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — Diphtheria including Membranous croup 458 — 125 283 30 20 — 32 310 116 26 245 89 300 Erysipelas 90 1 5 4 9 58 13 15 52 23 3 5 4 12 Scarlet fever 600 2 134 375 56 33 — 92 395 113 78 320 101 499 Typhus fever — — — — — — — — — — — — — — Enteric fever 31 1 2 3 11 14 — 5 10 10 3 8 4 15 Relapsing fever — — — — — — — — — — — — — — Continued fever 2 — 1 1 — — — — 2 — — — — — Puerperal fever 6 — — — 1 5 — 1 1 4 1 — 3 4 Plague — — —1 — — — — — — — — — — — Totals 1187 4 207 666 107 130 13 145 776 266 111 578 201 890 103 Table IV. Causes of, and Ages at, Death during Year 1908. Causes of Death. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. All Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Lee Division. Lewisham Division. Sydenham & Forest Hill Division. 1 2 3 4 5 6 7 8 9 10 11 12 Small-Pox — — — — — — — — — — — Measles 47 7 37 2 — 1 — 3 28 16 16 Scarlet fever 11 — 6 5 — — — 1 8 2 75 Whooping-cough 30 17 11 2 — — — 3 20 7 2 Diphtheria and membra nous croup 44 1 22 19 2 — — 3 26 15 52 Croup 1 1 — — — — — — 1 — — Fever Typhus — — — — — — — — — — — Enteric 4 — — — — 4 — 1 1 2 3 Other continuec — — — — — — — — — — — Epidemic influenza 28 — — — 2 11 15 5 19 4 1 Cholera — — — — — — — — — — — Plague — — — — — — — — — — — Diarrhoea (all forms) 49 37 10 — — 2 — 6 35 8 20 Enteritis (Gastro-Enteritis, &c.) 20 12 6 — — 1 1 — 14 6 — Puerperal fever 2 — — — 1 1 — — — 2 2 Erysipelas 1 — — — — 1 — — — 1 1 Phthisis (Pulmonary Tuberculosis) 135 1 2 1 21 103 7 13 83 39 42 Other tubercular diseases 56 12 19 7 2 13 3 4 34 18 27 Cancer, malignant disease. 151 1 1 1 7 79 62 25 72 54 35 Bronchitis 130 19 6 — 2 24 79 13 71 46 57 Pneumonia 98 26 17 — — 31 23 11 49 38 22 Pleurisy 7 — 1 1 1 3 1 — 4 3 — Other diseases of Respiratory organs 15 3 3 — 1 2 6 2 6 7 2 Alcoholism 26 — — — — 21 5 1 17 8 5 Cirrhosis of liver Venereal diseases 5 5 — — — — — — 4 1 1 Premature birth 56 56 — — — — — 6 34 16 3 Diseases and accidents of parturition. 3 — — — — 3 — 1 2 — 1 Heart diseases 248 7 1 3 5 111 121 26 151 71 64 Accidents 43 8 1 3 1 20 10 5 25 13 14 Suicides 16 — — — 1 13 2 1 13 2 2 All other causes 531 102 20 19 15 149 226 81 288 162 188 All causes 1757 315 163 64 61 593 561 211 1005 541 655 104 Table V. INFANTILE MORTALITY DURING THE YEAR 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4. Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Cause f Certified 68 13 16 15 112 44 24 17 25 27 9 17 11 8 11 10 315 ' (Uncertified — — — — ~ — — — — — — - - Common Infectious Diseases Small-pox — — — — — — — — — — — — — — — — — Chicken-pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — 1 — — — 2 1 3 7 Scarlet Fever — — — — — — — — — — — — — — — — — Diphtheria: Memb. Croup — — — — — — — — — — — — 1 — — — 1 Whooping Cough — — — 1 1 — 1 — 1 2 1 3 2 — 3 3 17 Diarrhoeal Diseases Diarrhoea, all forms — — — — — 1 3 5 7 5 3 5 3 2 2 1 37 Enteritis Muco-enteritis 1 — 1 1 3 — 2 — 1 — — — — — 1 — 7 Gastro-enteritis Gastritis, Gastro- — — 1 1 2 2 — 1 — — — — — — — — 5 intestinal Catarrh Wasting Diseases Premature Birth 39 3 6 a 51 5 — — — — — — — — — — 56 Congenital Defects 9 2 — — 11 a 1 1 1 1 — — — — — — 18 Injury at Birth 1 — 1 — 2 — — — — — — — — — — — 2 Want of Breast-milk — — — — — — — — — — — — — — — — — Atrophy, Debility, 12 5 4 3 24 17 8 2 3 3 2 3 1 — 1 — 64 Marasmus Tuberculous Diseases Tuberculous Meningitis — — — — — — — — — 1 1 — — 3 1 — 6 Tuberculous Peritonitis: — — — — — — 1 — — 2 — — — — — — 3 Tabes Mesenterica Other Tuberculous Diseases — — — — — — — — 1 — — 1 2 — — — 4 Other Causes Erysipelas — — — — — — — — — — — — — — — — — Syphilis — — — — — 2 2 — — 1 — — — — — — 5 Rickets — — — — — — — — — — — 1 — — — — 1 Meningitis (not Tuberculous) — — — — — — — — 2 2 — — 1 — — 1 .6 Convulsions 3 2 — — 5 1 — 3 — 1 — — — — — — 10 Bronchitis — — 2 3 5 3 2 2 2 3 — 1 — 1 — — 19 Laryngitis — — — — 1 — — — — 1 — — — — 2 Pneumonia — — — 2 2 6 2 1 4 5 — 1 1 — 2 2 26 Suffocation, overlaying 1 — — — 1 2 2 1 1 — — 1 — — — — 8 Other Causes 2 1 1 1 5 1 — 1 2 — 2 — — — — 11 68 13 16 15 112 14 24 17 25 27 9 17 11 8 11 10 315 Population (estimated to middle of 1908), 156,327. Births in the year—legitimate, 3,541; illegitimate, 91. Deaths from all causes at all ages, 1,757. Deaths in the year—legitimate 309, illegitimate 6.