LIBRARY ORPINGTON URBAN DISTRICT COUNCIL. REPORT For the year 1940 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health. London: Freame. Manning &Co., (T.U.) I2a, Lee High Road, Lewitham,. S.E.13 Annual Report of M.O.H. Please circulate as quickly as possible. (1) Miss Newham(for Dr. Hutchinson) (2) Dr. Norman-Smith (3) Dr. Lethem (4) Library-To retain Form 26 C/Reg. ORPINGTON URBAN DISTRICT COUNCIL 0F MEDICAL OFFICER OF HEALTH FOR 1940 ERRATUM Birth paragraph on page 1 should read:- "The Birth Rate for the year decreased from 19.4 last year to 17.5 for 1940. The Rate in England and Wales was 14.6". ORPINGTON URBAN DISTRICT COUNCIL REPORT OF MEDICAL OFFICER OF HEALTH FOR 1940 ERRATUM The fourth paragraph on page 1 should read:- "The Birth Rate for the year decreased from 19.4 last year to 17.5 for 1940. The Rate in England and Wales was 14.6". 1 URBAN DISTRICT COUNCIL OF ORPINGTON Health Report for 1940 Gentlemen, I have pleasure in submitting my Annual Health Report for the year 1940, this being the eighteenth one presented by me as Medical Officer of Health for the area concerned. In accordance with the request of the Ministry of Health the Report is again this year curtailed as far as possible, and only contains such information as it is essential to record. The population of the District, as estimated by the RegistrarGeneral at mid-year 1940 was 48,760 as compared with 49,570 last year. The Birth Rate for the year increased from 17.5 last year to 19.4 for 1940. The Rate in England and Wales was 14.6. There was an increase in the Death Rate, viz., 10.9 per thousand of population, as compared with 9.0 last year. The Death Rate for England and Wales was 14.3. There was a decrease in the Infantile Mortality Rate, this being equal to 35 per thousand registered births as compared with 43 last year. The year was a satisfactory one from the point of view of incidence of Infectious Disease, the number of notification certificates received being 505 as compared with 189 last year. The increase is due to a very much larger number of cases of Measles being notified. In presenting this Report, I desire to place on record my appreciation of the help and assistance I have received from the Council and all its Officers. In particular I would like to express my thanks for the loyal and efficient services rendered by the members of the Public Health Department. I am, Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 2 URBAN DISTRICT COUNCIL OF ORPINGTON Public Health Committee Chairman: J. R. Guthrie, Esq. Vice-Chairman : P. H. Baker, Esq. Lt.-Col. K. M. Kjrkhope, c.i.e. W. H. Ayles, Esq. G. E. Barrett, Esq. F. J. Bell, Esq. C. L. Bruce, Esq. A. Carter-Wright, Esq. F. A. Cobb, Esq. G. E. Davis, Esq., ll.b. P. W. Dewberry, Esq. J. P. Earnshaw, Esq. A. H. A. Grenger, Esq. C. S. Hammerton, Esq. F. J. Hyam, Esq., c.c. H. J. Lester, Esq., j.p., f.s.a.a. H. G. Little, Esq. W. E. P. Loraine, Esq. G. T. May, Esq. F. W. Moore, Esq., f.c.a. P. H. Powell, Esq. A. L. Priest, Esq., j.p. G. R. Rickard, Esq. S. Rawlings Smith, Esq. W. C. Sweatman, Esq. W. J. Tarry, Esq. P. W. H. Twyman, Esq. E. Whiddon, Esq. Representatives on the West Kent Joint Hospital Board : C. L. Bruce, Esq. A. L. Priest, Esq., j.p. Representatives on the West Kent Joint Sewerage Board : C. L. Bruce, Esq. A. L. Priest, Esq., j.p. STAFF: Medical Officer of Health : P. N. Cave, m.a., m.d., m.r.c.s., l.r.c.p., d.p.h. Sanitary Inspectors : J. A. Capon, c.r.s.i., m.s.i.a. (Chief Sanitary Inspector and Cleansing Superintendent). F. C. Crowe, m.r.s.i., m.s.i.a. (Deputy Chief Sanitary Inspector, Housing Inspector, Inspector under the Shops Acts and Food and Drugs Inspector). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector and Inspector under the Shops Acts). D. H. Livesey, m.r.s.i., m.s.i.a. (District Sanitary Inspector). R. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). Health Visitor : Mrs. L. Russell. Clerk and Shorthand Typist: Miss I. Chamberlain. 3 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 20,842 Registrar-General's estimate of population, mid-1940 48,760 Number of occupied houses, December, 1940 15,567 Rateable Value of District, December, 1940 £483,715 Sum represented by a penny rate £1,791 VITAL STATISTICS. Total M. F. Birth Rate per 1,000 of estimated population 17.5 Live births Legitimate 1 1 TT/^ r~V -MT" r"\ O J 818 420 398 Illegitimate 39 23 16 Total births 857 443 414 Stillbirths 20 11 9 Rate per 1,000 (live and still) births 23.2 Deaths 504 273 231 Rate per 1,000 of estimated population 10.9 Deaths from Puerperal causes Deaths Rate per 1,000 total (live and still) births Puerperal Sepsis Nil Nil. Other puerperal causes Infant Deaths : Number of deaths All Infants 30 Rate per 1,000 live births 35 Legitimate Infants 28 Rate per 1,000 legitimate live births 35 Illegitimate Infants 2 Rate per 1,000 illegitimate live births 51 Deaths from Cancer (all ages) 89 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) 2 4 Health Report for 1940 VITAL STATISTICS. Births. During the year 857 Births were registered as belonging to the District, of which 443 were males and 414 were females. This is equal to an Annual Birth Rate of 17.5 per thousand of population, as compared with 19.4 last year. The Birth Rate for England and Wales was 14.6. Deaths. The number of Deaths registered during the year was 504 (273 males and 231 females). This gives a Death Rate of 10.9 per thousand of population, as against 9.0 last year. The Death Rate for England and Wales was 14.3. Infant Deaths. Thirty deaths (28 legitimate and 2 illegitimate) were registered as occurring in infants under one year of age. The Infantile Mortality Rate for the year was 35 per thousand registered births, as compared with 43 last year. INFECTIOUS DISEASE. The year 1940 was a satisfactory one from the point of view of incidence of Infectious Disease. During the year 505 notifications were received, as against 189 last year. This increase is due to a very much larger number of cases of Measles being notified, viz.: 324 as against 15 last year. The following Table shows the number of cases notified, together with the number removed to Hospital, and the total deaths : Number Notified Removed to Hospital Deaths Scarlet Fever 62 46 — Diphtheria 42 42 3 Typhoid Fever 2 1 — Erysipelas 18 — — Puerperal Pyrexia 18 — — Pneumonia 10 — 31* Cerebro-spinal Fever 14 1 1 Dysentery 1 — — Encephalitis Lethargica 1 — — Whooping Cough 12 — —— Chicken Pox 1 — — Measles 324 — — TOTALS 505 90 35 ♦All forms 5 DIPHTHERIA IMMUNISATION CLINIC. A Diphtheria Immunisation Clinic was established by the Bromley Rural District Council, and was first opened on the 24th May, 1929. During the year the following work was done : Number of sessions held 66 Number of attendances 1,746 Number of new cases 550 Only children over seven years of age were tested, after 31st October, 1940. Number Tested Total Per Cent. Positive M. F. 203 173 376 73.4% The monthly attendances were : January 14 July 57 February 65 August 196 March 44 September 31 April 132 October 17 May 170 November 323 June 80 December 617 The number of new cases attending from each Ward were : Biggin Hill 60 Chelsfield 26 Crofton 164 Cudham 13 Downe — Goddington 103 Green St. Green 38 Knoll 83 St. Mary Cray 47 Knockholt 9 Farnborough 7 Leaves Green — 6 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1940. Provisional figures based on Weekly and Quarterly Returns. England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Populations 25,000 to 50,000 at 1931 Census London Administrative County Orpington Urban District *Rates per 1,000 Civilian Population : Births :— Live 14.6 16.0 15.7 13.7 17.5 Still 0.55 0.64 0.55 0.44 0.41 Deaths:— All Causes 14.3 15.8 12.8 17.8 10.9 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.02 0.02 0.00 0.00 Diphtheria 0.06 0.07 0.05 0.01 0.06 Influenza 0.32 0.29 0.30 0.18 0.12 Smallpox — — — — — Measles 0.02 0.02 0.02 0.01 0.00 Notifications :— Enteric 0.07 0.06 0.10 0.06 0.04 Cerebro Spinal Fever 0.32 0.33 0.29 0.28 0.28 Scarlet Fever 1.63 1.53 1.57 0.82 1.27 Whooping Cough 1.34 1.29 1.35 0.22 0.24 Diphtheria 1.16 1.29 1.21 0.61 0.86 Erysipelas 0.33 0.36 0.30 0.35 0.36 Smallpox 0.00 — — — — Measles 10.24 9.23 9.99 1.78 6.64 Pneumonia 1.20 1.37 1.00 0.87 0.20 Rates per 1,000 Live Births : Deaths under 1 year of age 55 61 54 50 35 Deaths from Diarrhœa and Enteritis under 2 years of age 4.6 5.9 4.4 5.8 2.44 Rates per 1,000 Total Births (Live and Still) : Maternal Mortality :— (excluding Abortion) Puerperal Infection (No. 147) 0.52 0.00 Others 1.64 Not available 0.00 Total 2.16 0.00 Notifications :— Puerperal Fever 11.96 13.90 9.73 3.34 — Puerperal Pyrexia 13.30* including Puerperal Fever. 20.52 *A dash ( — ) signifies that there were no deaths. 7 TUBERCULOSIS. The following Table shows the number of new cases of Tuberculosis notified, together with the number of deaths registered : NOTIFIED DEATHS Males Females Total Males Females Total Pulmonary 31 31 62 10 3 13 Non-Pulmonary 5 1 6 3 — 3 TOTALS 36 32 68 13 3 16 Treatment for cases of Tuberculosis is undertaken by the Kent County Council, and during the year the following number of patients have been treated : Number receiving sanatorium treatment 47 Number receiving dispensary treatment 14 Dispensary supervision only 201 PUBLIC HEALTH ACT, 1936 (Section 176). PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action under the above was required to be taken during the year. ISOLATION HOSPITAL. This District is served by the West Kent Joint Hospital. and during the year the following number of patients were admitted from this area :— Scarlet Fever 46 Typhoid Fever 1 Diphtheria 42 Cerebro-spinal Fever 1 LABORATORY WORK. The bacteriological work in connection with this District is carried out at the County Laboratory, Maidstone, and during the year the following number of examinations have been carried out : 8 Positive Negative Total Swabs for Diphtheria 17 158 175 Sputa for Tubercle 25 120 145 Widals for Typhoid — 3 3 TOTALS 42 281 323 In addition, the following number of emergency examinations have been made by Dr. J. Byers, at the West Kent Joint Hospital Board's Laboratory: Positive Negative Total Swabs for Diphtheria 13 107 120 Swabs for Haemolytic Streptococci — 1 1 TOTALS 13 108 121 DRAINAGE. The houses in the main portion of the District are on the water carriage system, and most of the houses are connected to the public sewers. No extensions to the sewers were made during the year. SANITARY STATISTICS. No. of houses connected to the sewer No. of houses not connected to sewers No. of houses not provided with a piped water supply No. of wells still in use for purpose of domestic supply 12756 3012 393 6 Sanitary Conveniences. W.C's. Pan or Pail Closets Midden Privies Ashpits separate from Midden Privies Cesspools No. of No. of houses into 15441 294 13 – 2290 2705 9 WATER SUPPLY. The greater portion of the District is supplied with water from the mains of the Metropolitan Water Board. In some outlying parts, however, water is obtained from deep wells and from rain water collected from the roofs of houses and stored in tanks. Forty-eight samples of the piped supply were taken for bacteriological examination during the year. The water was found to be satisfactory in each case. PUBLIC CLEANSING. The collection of bouse refuse throughout the District is carried out by direct labour, the greater portion of the area having a weekly collection. No alteration in the collection or method of disposal took place during the year. HOUSING. 1. Inspection of Dwelling Houses during the year. (1) (a) Total number of houses inspected for housing defects (Under Public Health or Housing Acts)... 436 (6) Number of inspections made for the purpose ... 1,089 (2) (a) Number of dwelling houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling houses (exclusive of those ferred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 225 2. Remedy of Defects during the year without service of formal notices : Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 167 3. Action under Statutory Powers during the Year: (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936 : (1) Number of dwelling houses in respect of which notices were served requiring repairs — 10 (2) Number of dwelling houses which were rendered fit after service of formal notices : (a) By owners — (b) By Local Authority in default of owners — (b) Proceedings under the Public Health Acts : (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 6 (2) Number of dwelling houses in which defects were remedied after service of forma) notices : (a) By owners 5 (b) By Local Authority in default of owners — (c) Proceedings under sections 11 and 13 of the Housing Act, 1936 : (1) Number of dwelling houses in respect of which Demolition Orders were made — (2) Number of dwelling houses demolished in pursuance of Demolition Orders — (d) Proceedings under section 12 of the Housing Act, 1936 : (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. Housing Act, 1936—Part IV—Overcrowding : (a) (i) Number of dwelling houses overcrowded at end of year 53 (ii) Number of families dwelling therein 63 (iii) Number of persons dwelling therein 185 (b) Number of new cases of overcrowding reported during the year 19 (c) (i) Number of cases of overcrowding relieved during year 4 (ii) Number of persons concerned in such cases 15 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which you may consider it desirable to report — Number of new houses erected during the year : By the Local Authority — By other persons — 11 HEALTH VISITOR. The Council employs one full-time Health Visitor, who works under the supervision of the Medical Officer of Health. Cases Visited. Number of Visits. Tuberculosis. Primary— Pulmonary 56 56 Non-Pulmonary 5 5 Re-Visits- Pulmonary 173 232 Non-Pulmonary 54 94 Measles 144 153 Scarlet Fever 6 15 Small Pox and Diphtheria Contacts 4 7 Other Visits 90 112 Totals 532 674 The visits to cases of Tuberculosis have been as follows :— Primary Revisits Other Visits P. N.P. P. N.P. January 4 1 22 7 9 February 6 1 18 9 27 March 3 — 26 8 12 April 1 — 30 12 17 May 4 — 4 2 14 June 8 — 20 9 18 July 3 — 16 6 62 August 4 — 16 8 38 September 6 — 12 6 16 October 4 — 24 7 20 November 7 2 24 11 32 December 6 1 20 9 22 TOTALS 56 5 232 94 287 Ophthalmia Neonatorum Nil. 12 MATERNITY AND CHILD WELFARE. The work in connection with Maternity and Child Welfare is under the control of the Kent County Council. The following Clinics and Centres have been established in this District: ANTE-NATAL CLINICS. Address. Sessions held. Total attendance. Orpington—Methodist Hall 1st, 3rd and 5th Tuesdays. Each Friday. 830 St. Mary Cray—Village Hall 2nd and 4th Wednesdays 384 INFANTS WELFARE CENTRES. Chelsfield—Reading Room Cudham—Village Hall Cudham—Big Teapot Pavilion, Biggin Hill. Downe—Gospel Hall Farnborough — Methodist Church Hall. Green St. Green—Baptist Schoolroom. Orpington — Methodist Church Hall, Sevenoaks Road. Petts Wood—St. Francis Hall. St. Mary Cray—Village Hall 1st and 3rd Tuesdays 415 1st and 3rd Wednesdays 257 Each Thursday 1,066 2nd and 4th Tuesdays 235 Each Friday 1,273 Each Friday 1,868 Mondays and Tuesdays 5,052 Thursdays 1,615 Tuesdays 2,778 MIDWIVES. The supervision of Midwives is carried out by the Kent County Council. 13 REGULATED TRADES. Number No. of Visits No. of Defects found No. of Defects remedied Dairies 74 111 3 3 Cowsheds Slaughterhouses : Licensed 17 134 — — Registered Bakehouses 20 10 1 1 Piggeries 10 46 — — Other food preparing places 270 136 — — Factories 171 7 — — Workplaces — — — — Common Lodging Houses 1 2 — — Houses Let in Lodgings — — — — TOTALS 563 446 4 4 MILK (SPECIAL DESIGNATIONS) ORDER, 1936. During the year the Council granted the following number of licences under the above Order : Tuberculin Tested 6 Pasteurised 10 MEAT. The following Table shows the work done in connection with the slaughtering of animals for human consumption :— MEAT—CARCASES INSPECTED AND CONDEMNED. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) 28 3 17 68 948 Number inspected 28 3 17 68 948 All diseases except Tuberculosis : Whole carcases condemned – – – 1 2 Carcases of which some part or organ was condemned – – – 1 3 Percentage of the number inspected a affected with diseases other than Tuberculosis 17.85 – – 1.85 0.53 TUBERCULOSIS ONLY Whole carcases condemned – – – – – Carcases of which some part or organ was condemned – – – – 4 Percentage of the number inspected affected with tuberculosis – – – – 0.42 14 SHOPS ACTS. During the year 106 visits were paid to shops within the District, and on no occasion was it found necessary to take any formal action. FOOD AND DRUGS ACT, 1938. This is the first complete year since the administration of the general provisions as to Food and Drugs under the above Act was undertaken by the District Council, the work previously being carried out by the County Council. 99 Formal and 104 Informal Samples were taken during the year. Of these 1 formal sample and 3 informal samples were reported as being not genuine. A full description of the articles analysed and the administrative action taken is set out in the following tables. Number and Description of Samples submitted for Analysis to the Public Analyst during the Year 1940. FORMAL SAMPLES Description of Samples Number of Samples Submitted Number Genuine Number not genuine Bread and Butter 1 1 – Butter 2 2 – Cooking Fat 1 1 — Ground Almonds 1 1 — Lard 1 1 — Malt Vinegar 2 2 — Margarine 1 1 — Milk, New 70 69 1 Shredded Suet 1 1 – Sausages, Beef 4 4 — Sausages, Pork 14 14 — Whiskey 1 1 — TOTALS 99 98 1 INFORMAL SAMPLES Description of Samples Number of Samples Submitted Number Genuine Number not Genuine Aspirin Tablets 2 2 — Blanc Mange Powder 1 1 — Butter 2 2 — Camphorated Oil 1 1 — Castor Oil 1 1 — Coffee 1 1 — Cocoa 3 3 — Cooking Fat 2 2 — Cream 1 1 — Crystallised Ginger 1 1 — Curry Powder 1 1 — Custard Powder 1 1 — Coconut, Desiccated 1 1 — Fish Paste 6 6 — 15 Description of Samples Number of Samples Submitted Number Genuine Number not Genuine Flour 1 1 — Game Paste 1 1 — Gravy Powder 1 1 — Iodine, Tincture of 2 2 — Jam 2 2 — Lard 3 3 — Lardex 1 1 — Margarine 4 4 — Meat Paste 2 2 — Minced Meat 1 1 — Milk, Condensed 3 3 — Mint Sauce 2 2 — Mustard 1 1 — Oatmeal 1 1 – Oats, Rolled 1 1 — Ointment, Boracic 4 4 — Ointment, Sulphur 2 2 — Ointment, Zinc 4 4 — Pepper 3 3 — Pearl Barley 1 1 — Peas, Tinned 1 1 — Pickle 1 1 — Pills, Iron 1 1 — Pudding Powder 1 1 — Rice 1 1 — Salad Cream 1 1 — Sauce 1 1 — Sausages, Beef 4 3 1 Sausages, Pork 10 8 2 Sausage Meat 1 1 — Soup, Tinned 2 2 — Sild, Tinned 2 2 — Suet 6 6 — Sugar 1 1 — Table Jelly 1 1 — Tea 2 2 — Vaseline 1 1 — Vinegar, Malt 3 3 — TOTALS 104 101 3 ACTION TAKEN REGARDING SAMPLES REPORTED TO BE NOT GENUINE No. of Sample Description of Sample Nature of Adulteration Action taken 55 Pork Sausages Contained sulphur dioxide to the extent of 147.2 parts per million Formal sample taken (Proved satisfactory) 64 New Milk Deficient in fat to the extent of 23.6% Warning letter 88 Pork Sausages Contained sulphur dioxide to the extent of 512.0 parts per million Formal sample taken (Proved satisfactory) 104 Beef Sausages Contained sulphur dioxide to the extent of 307.2 parts per million Formal sample taken (Proved satisfactory) 16 SWIMMING BATHS AND POOLS. There is one public swimming pool and one privately owned swimming bath in the District. Inspections were made during the year, and no action was found necessary. CAMPING SITES. No licences for Camping Sites were issued during the year. SMOKE ABATEMENT. A number of observations were made during the year with respect to nuisances arising from the emission of smoke. ERADI BUGS. Council Houses.—Strict supervision is exercised to eradicate bed bugs, and all necessary action is taken where premises are found to be infested. Other Houses.—Where infestation of houses is brought to the notice of the Council, the premises are inspected and all necessary advice and assistance is given to the occupiers. During the year the following number of houses were found to be infested. Number Number infested. Remedied. Council houses 3 3 Other Houses 1 1 NURSING FACILITIES. No change has been made in the nursing facilities for the District during the year. LEGAL PROCEEDINGS. It was not found necessary to institute legal proceedings to enforce the abatement of nuisances during the year. NURSING AND MATERNITY HOMES. The powers under the Public Health Act, 1936, relating to Nursing Homes have been delegated to the District Council by the County Council. There are two registered premises within the District, the number of beds available being : 8 for maternity cases and 5 for other cases. ADOPTIVE ACTS AND BYE-LAWS. No Acts or Bye-laws were adopted during the year, 17 Table I.—CASES OF INFECTIOUS DISEASE NOTIFIED DURING 1940. Disease Total No. Notified Number of cases notified Removed to Hospital At ages—years Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 62 — 1 3 1 2 30 11 4 6 3 1 – 46 Diphtheria 42 — 1 2 6 4 19 6 1 2 1 — — 42 Typhoid Fever 2 — — — — — — — — — — 1 1 1 Erysipelas 18 — — — — — — 2 1 2 1 6 6 — Puerperal Fever 18 — — — — — — — 1 3 1 — — — Pneumonia 10 — 1 — 1 1 — — — — 2 4 1 — Measles 324 2 15 22 23 29 180 24 12 15 2 — — — Whooping Cough 12 4 2 — 2 — 1 1 1 1 — — — — Chickenpox 1 — — — — — 1 — — — — — — — Cerebro Spinal Fever 14 1 — 1 — — — — 4 4 1 3 — 1 Dysentary 1 — — — — — — — — — 1 — — — Encephalitis Lethargica 1 — — — — — — 1 — — — — — — TOTALS 505 7 20 28 33 36 231 45 24 46 12 15 8 90 18 Table II.—DEATHS REGISTERED AS OCCURRING DURING 1940. Cause of Death Males Females Total Typhoid Fever — — — Cerebro-spinal Fever 1 — 1 Scarlet Fever — — — Whooping Cough — — — Diphtheria 1 2 3 Tuberculosis of respiratory system 12 3 15 Other tuberculosis diseases 3 — 3 Syphilitic diseases 4 1 5 Influenza 2 4 6 Measles — — — Poliomyelitis and Polioencephalitis — — — Acute Infantile Encephalitis — — — Cancer of Bronchial Cavity 4 2 6 Cancer of Stomach and Duodenum 10 2 12 Cancer of the Breast — 10 10 Cancer, all other forms 26 15 41 Diabetes 2 3 5 Intra cranial vesc. lesions 20 21 41 Heart disease 62 63 125 Other diseases of circulating system 8 9 17 Bronchitis 12 16 28 Pneumonia 16 15 31 Other respiratory diseases 2 2 4 Ulcer of Stomach and Duodenum 4 1 5 Diarrhoea (under 2 years) 2 —- 2 Appendicitis 5 — 5 Other digestive diseases 6 6 12 Nephritis 4 3 7 Post and post-abort, sepsis — — — Other maternal causes — — — Premature Birth 7 4 11 Congenital malformation and birth injury 3 2 5 Suicide 1 1 2 Road traffic accidents 4 1 5 Other violent causes 31 24 55 All other causes 21 21 42 Totals 273 231 504