AC 4349 PAD 25 Metropolitan Borough of Paddington. ANNUAL REPORT OF THE COUNCIL FOR THE YEAR 1914. APPENDIX. REPORT OF THE Medical Officer of Health. LONDON: HENDERSON & SPALDING, Ltd., Printers, SYLVAN GROVE, OLD KENT ROAD, S.E. Metropolitan Borough of Paddington. report ON The Vital Statistics AND THE WORK OF THE PUBLIC HEALTH DEPARTMENT For the Year 1914.. REGINALD DUDFIELD, M.A., M.B., D.P.H., F.S.S., Medical Officer of Health, R. GALWAY MURRAY, M.R.C.S. EHG., L.R.C.P. LON., D.P.H. CAMB., Acting Medical Officer of Health. SALUS CIVIUM CIVITATIS OPES. CONTENTS. PAGE Acute Poliomyelitis 21 Administrative Work 58 Alcoholism, Mortality from 40 Analytical Work 77 Animal Diseases 22 Bacteriological Examinations, Results of 64 Bakehouses, Inspection of 70 Births and Birth-rates 3 „ Fertility Records 51 „ Notification of 5 „ "Hopeless" 46 „ Illegitimate 5 „ Still-births 6 „ Transferred 4 Canals, Canal Boats Acts 67 Cancer, Mortality from 38 Cerebro-spinal Fever 21 Chickenpox 28 Childbed, Mortality in 20 Childhood, Mortality in 43 Cirencester Street Improvement Scheme 71 Cirrhosis of the Liver, Mortality from 41 "Clarendon Street Area," Vital Statistics of 73 Combined Drainage 66 Common Lodging Houses 75 Dairies and Milkshops 76 Deaths: Mortality 10 Deaths in Institutions—All Causes 42 Diarrhœa, Deaths from 46 „ Infection and Flies 48 Diphtheria 15 Disinfection 58 Drainage Plans 65 Drains, Private, Re-laid 65 Enteric Fever 18 Erysipelas 20 Estimates of Population 1 Factory and Workshop Act, 1901, Work under 67 Food Adulteration, Summary of Samples taken 77 „ Summary of Proceedings 81 Food Supervision 75 Health Visiting 50 Home Workers (Outworkers) 67 House Refuse 65 Housing 70 Housing of the Working Classes Acts 70 Ice Cream, Inspection of Places where made 76 Illegitimates, Births of 5 „ Deaths of 54 Infant Consultations 51 Infants, Mortality among 43 „ „ in Special Areas 54 „ „ „ Wards 44 Influenza, Mortality from 40 Inhabited House Duty, Exemption from 75 Inquests held 41 Institutions, Deaths in 42 Internotification 64 Legal Proceedings, Summary of 80 Manure, Removal of 65 Measles 22 Meat Condemned in Slaughterhouses 75 „ Seized in Shops, &c. 77 Meteorology 2 Milk and Cream Regulations 79 PAGE Milk Supply 76 Milkshops, Trades carried on at 76 Mortality among Infants 43 „ „ ,, "Hopeless Births" 46 „ at ages 1—5 years 54 „ in Childbed 20 „ (Infantile) in Special Areas 54 Mortuaries 60 Mumps 28 Notification of Births 5 „ „ Sickness 6 „ „ Tuberculosis 28 Offensive Refuse 65 Office Work 79 Ophthalmia Neonatorum 22 Other Infectious Diseases 28 Other Septic Diseases 21 Outworkers (Homework) 67 Phthisis, Mortality from 34 Poliomyelitis 21 Population, Estimated 1 Premature Birth 46 Preservatives in Foods 79 Prevention of Infectious Disease 58 Puerperal Fever 19 Pulmonary Tuberculosis 34 Queen's Park Estate 66 Rag and Bone Dealers 65 Rag Flock Act 79 Respiratory Diseases, Mortality from 40 Ringworm 28 Sanatorium Benefit 37 Scabies 61 Scarlet Fever 17 Schools and Infectious Diseases 60 Septic Diseases 19 Sewer Connections 65 Sickness (Notification) 6 Slaughterhouses, Inspection of 75 Smallpox 14 Smoke Prevention 66 "Sore Throat" 61 Special Areas, Infantile Mortality in 54 Suicide, Mortality from 41 Tenement Houses, Annual Cleansing 71 „ „ Vital Statistics 73 Trade Nuisances 65 „ Refuse 65 Tuberculosis: Notification 28 „ Mortality 31 „ Occupations of Cases 33 „ Treatment of 37 Underground Rooms 71 Unsound Food seized 77 Vaccination 15 Vermin 64 Water Supply, Cutting off of 60 Wharves, Inspection of 67 Whooping Cough 25 Workshop Supervision 67 APPENDIX. Tables (Local Government Board, Home Office, and London County Council). TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE BOROUGH OF PADDINGTON. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you the Annual Report for 1914. Since the outbreak of war, some temporary changes in the Staff have occurred. In October your Medical Officer of Health was granted a Captain's commission in the 1st London (City of London) Sanitary Company, and undertook the duties connected therewith. In spite, however, of the newly acquired duties he found time to attend daily at the Town Hall and to transact the business of his Department until February, 1915, when you did me the honour to elect me Acting Medical Officer of Health for the period of the war. Sanitary Inspector S. W. Wingfield also joined the 1st London (City of London) Sanitary Company, and his work has been distributed among the rest of the Staff. Of the Clerical Staff, Mr. H. Ewings was enrolled a member of the 15th County of London (Civil Service) Rifles, Mr. A. J. O. Sheppard. of the 1st London (City of London) Sanitary Company, and Mr. R. I. Fisher, of the 6th Seaforth Highlanders (T.), and their places have been filled by temporary clerks. The decline in the birth-rate continues, but is slightly less than in 1913, and is lower than the average for the last five years. The death-rate is slightly above the average for the preceding five years, but less than in 1913. The infant mortality is low—96 per 1,000—the average being 105 per 1,000. This is due to the absence of mortality from measles and respiratory diseases generally. There was an epidemic of scarlet fever in the autumn, the heaviest on record, but the fatality of which was much below the average. Measles was, by order of the Council, made compulsorily notifiable on 16th March, 1914. My thanks are due to the Staff for the loyal way in which they have co-operated, and for the zeal they have displayed, in executing the orders of the Council and carrying on the work of the Department. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your most obedient servant, R. GALWAY MURRAY, m.r.c.s. eng., l.r.C.p. lon., d.p.h. camb., Acting Medical Officer of Health. Public Health Department, Town Hall, Paddington, W., 1st December, 1915. 1 REPORT. The Borough of Paddington comprises an area of 1,356 statute acres, including 20 of inland water-ways (the Grand Junction and Regent's Canals), parts of Hyde Park and Kensington Gardens (68 acres), the Recreation Ground (27 acres), the disused Church Yard of St. Mary's Paddington Green (5 acres), and Paddington Green (1½ acres). The Borough is co-terminous with the Registration District "No. 1, Paddington," comprising three SubDistricts, viz., "North," "Central," and "South." For municipal purposes the Borough is divided into eight Wards. The grouping of the Wards in the Registration Sub-Districts is set out below: Registration Sub-Districts. Wards. North Paddington Central Paddington South Paddington Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, West. Lancaster Gate, East. Hyde Park. The Borough is situated on the southern side of the range of low hills which culminate in the Hampstead Heights, the slope being (generally) towards the south and west. The subsoil is principally clay, but in places, more particularly in the neighbourhood of the Bayswater Road, pockets of gravel exist, or did exist. In the central parts of the Borough many depressions were filled up years ago with slop and refuse of all descriptions. In the western parts of the Borough the subsoil water lies at a very few feet below the surface of the ground. There are at least two, and possibly more, subterranean watercourses, one of which, running parallel with the Edgware Road, close to the western side thereof, has been found on several occasions, in the course of works of excavation to trace the causes of dampness in cellars. The second, the better known, now forms the Ranelagh Sewer, one of the main sewers of the Metropolis. POPULATION. The estimated population of the Borough at the middle of the year 1914 was 142,087 persons, comprising 60,021 males and 82,066 females, these figures being derived from calculations based on the results of the censuses of 1901 and 1911, according to the Waters' formula recommended in the Annual Reports of the Registrar-General. The numbers of persons for the various Wards will be found in Table II., Appendix. The natural increment in the population, i.e., the excess of births over deaths, was 1,069 in 1911-12, 1,126 in 1912-13, and 1,082 in 1913-14. If no changes had occurred through migration, the total addition to the population since the last census would have amounted to 3,467 persons, whereas the estimate above given shows a loss of 464. As intimated in the last report, it is proposed to calculate each year until the next census an estimated population founded on the numbers of occupied assessments in each Ward, and to B 2 METEOROLOGY. compare this with the result obtained by the use of the Waters' formula. The figures so produced are set out in the following statement:— Estimated Population. Borough. 1911. 1912. 1913. 1914. By Waters' method 142,513 142,362 142,261 142,087 On Occupied Assessments 143,789 145,164 146,691 148,411 Differences +1,276 +2,802 +4,430 +6,324 In accordance with the usual practice, the birth, death, and morbidity rates in this report have been based on the estimate obtained by the Waters' method. METEOROLOGY. The results of the observations made at the Royal Botanic Society's Garden, and published by The Times, are shown in Table I. The summaries of the summer and autumn months given below are of interest in connection with the occurrence of diarrhœa. Last year the prevalence of that disease was most marked at the end of August and the beginning of September, whereas in 1913 the period of exceptional incidence occurred during the autumn months—September-November. Summer. June. July. August. 1912. 1913. 1914. 1912. 1913. 1914. 1912. 1913. 1914. Mean Temperature (9a.m.) 60.0° 62.3° 62.6° 64.6° 59.9° 65.2° 57.4° 61.8° 65.3* Absolute Maximum 81.0° 84.0° 85.0° 88.0° 78.0° 92.0° 70.0° 81.0° 82.0° „ Minimum 44.5° 43.0° 40.0° 46.0° 43.6° 49.0° 44.0° 45.5° 48.0° Total Rainfall 3.40" 0.44" 1.28" 1.30" 1.98" 1.35" 4.98" 1.54" 1.16" No. of Days of Measurement 19 7 12 10 11 13 22 10 11 h. m. H. M. H. M. H. M. H. M. H. M. H. M. H. M. H. M. Total Bright Sunshine 192 22 210 51 263 41 156 26 103 46 178 58 114 8 146 8 174 17 No. of Days of Measurement 28 30 29 30 28 30 27 28 28 Temperature of Earth (mean) 57.2° 58.1° 56.5° 61.8° 59.6° 62.2° 61.0° 60.4° 62.0° Autumn. September. October. November. 1912. 1913. 1914. 1912. 1913. 1914. 1912. 1913. 1914. Mean Temperature (9 a.m.) 55.1° 58-6° 59.9° 45.7° 53.0° 53.0° 43.2° 47.2° 45.4° Absolute Maximum 67.8° 77-0° 80.0° 62.5° 66 5° 66.0° 55.0° 59.5° 61.0° „ Minimum 38.0° 41-5° 37.0° 31.0° 36.5° 36.0° 28.0° 31.0° 30.5° Total Rainfall 2.22" 1-85" 1.06" 2.09" 3.21" 1.28" 1.65" 2.47" 3.60" No. of Days of Measurement 5 11 9 13 14 12 14 16 18 h. m. H. M. H. M. H. M. H. M. H. M. H. M. H. M. H. M. Total Bright Sunshine 114 6 129 46 179 36 77 30 85 32 57 05 20 56 55 33 44 20 No. of Days of Measurement 26 26 30 20 27 25 13 22 21 Temperature of Earth (mean) 57.5° 59.4° 60.7* 52.3° 56.3° 55.7° 49.0° 51 7° 50 8° 3 BIRTHS. TABLE 1. Meteorological Elements. Year. Month. Means at 9 a.m. Extreme Temperatures. Rainfall. Sunshine. Barometer: reduced to sea level. Thermometer Shade. Sun. Max. Grass. Min. Total depth. No. of days of fall. Bright Sunshine registered. No. of days of record. Dry bulb. Wet bulb. Maximum. Minimum. Inches Deg. Deg. Deg. Date. Deg. Date. Deg. Deg. Inches Hrs. Mins. 1914. January 30.14 37.6 37.2 54.6 9th 20.0 24th 70.9 18.0 0.55 8 11 48 12 February 29.75 44.1 43.1 58.0 14th 29.0 27th 97.0 26.0 2.47 14 57 18 21 March 29.60 44.3 42.7 65.0 31st 29.0 11th 115.0 26.0 4.35 24 72 48 20 April 30.08 53.6 50.0 74.0 21st 35.0 26th 120.0 32.0 0.78 8 192 27 29 May 30.08 56.8 52.8 81.0 22nd 37.0 10&26 129.0 34.0 1.56 9 200 31 28 June 30.02 62.6 58.3 85.0 29th 40.0 8th 136.5 38.0 1.28 12 263 41 29 July 29.86 65.2 61.6 92.0 1st 49.0 27th 138.0 43.5 1.35 13 178 58 30 August 30.03 65.3 61.7 82.0 24&29 48.0 8&18 124.0 41.0 1.16 11 174 17 28 September 30.09 59.9 56.7 80.0 7th 37.0 30th 124.0 32.0 1.06 9 179 36 30 October 29.97 53.0 51.6 66.0 3rd 36.0 28th 106.0 29.5 1.28 12 57 05 25 November 29.86 45.4 44.6 61.0 5th 30.5 21st 88.0 25.0 3.60 18 44 20 21 December 29.65 42.2 41.6 55.0 7th 28.5 30th 76.0 24.0 6.45 23 26 56 23 Totals ... ... ... ... ... ... ... ... ... 25.89 161 1,459 45 296 Means 29.92 52.5 50.1 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 92.0 July ... ... 138.0 ... ... ... ... ... Lowest ... ... ... ... ... 20.0 Jan. ... 18.0 ... ... ... ... 1913. Totals ... ... ... ... ... ... ... ... ... 22.52 156 1,207 04 278 Means 29.96 51.3 49.3 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 84.0 June ... ... 125.0 ... ... ... ... ... Lowest ... ... ... ... ... 27.0 Jan. Feb. Mar. Dec. ... 19.0 ... ... ... ... 1912. Totals ... ... ... ... ... ... ... ... ... 27.76 158 1,242 4 251 Means 29.91 50.5 47.9 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 88.0 July ... ... 130.0 ... ... ... ... ... Lowest ... ... ... ... ... 18.0 Feb. ... 10.0 ... ... ... ... 1911. Totals ... ... ... ... ... ... ... ... ... 25.34 143 1,644 4 267 Means 29.99 51.5 49.3 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 96.0 Aug. ... ... 134.0 ... ... ... ...... ... Lowest ... ... ... ... ... 22.0 Feb. ... 12.0 ... ... ... ... 1910. Totals ... ... ... ... ... ... ... ... ... 25.92 168 1,249 22 277 Means 29.89 49.3 46.6 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 82.0 June ... ... 120.0 ... ... ... ... ... Lowest ... ... ... ... ... 19.5 Jan. ... 17.0 ... ... ... ... 1909. Totals ... ... ... ... ... ... ... ... ... 27.08 192 1,460 7 273 Means 29.96 48.7 46.1 ... ... ... ... ... ... ... ... ... ... Highest ... ... ... 85.5 Aug. ... ... 124.0 ... ... ... ... ... Lowest ... ... ... ... ... 19.0 Mar. ... 14.0 ... ... ... ... BIRTHS. During the year 2,708 births were registered in the Borough, comprising 1/399 of males, 1,308 of females, and 1 of a child whose sex was not determinable. For the sake of convenience the last-mentioned birth has throughout this report been included with the figures relating to males. The crude birth-rate was 19.06 per 1,000 persons, as compared with a rate of 19.58 in 1913, and an average for the five years (1909-13) of 19.89. There were 35 twin births—10 less than in 4 BIRTHS. 1913. In 14 cases both the twins were males, in 5 both females, and in 16 the sexes were mixed. The first group includes one instance of twins born to non-resident parents. Sixty-two of the births registered during the year occurred in the Lying-in Wards of the Workhouse, equal to a percentage of 2.3 of the total births in the Borough, as compared with 2.8 per cent. in 1913, 3.2 per cent. in 1912, and 3.8 per cent. in 1911. The births registered locally included those of 49 children born to non-resident parents, 16 of the children (9 males and 7 females) being born in the Workhouse. The inward transfers received at the end of the year from the Registrar-General numbered 274, 137 of each sex. Births in Outlying institutions. "Inward Transfers." Legitimate. Illegitimate. Males. Females. Males. Females. Queen Charlotte's Lying-in Hospital 92 89 21 27 Other Lying-in Hospitals 6 4 3 6 General Hospitals 6 1 1 2 Workhouses 2 4 1 2 Elsewhere 1 1 4 1 206 68 The corrected total of the births during the year was 2,933, comprising 1,503 of males and 1,430 of females. The numbers of births, after correction, to be allocated to the different Wards, are shown in Table 2. The corrected birth-rate for the year was 20.64 per 1,000 persons, as TABLE 2. Births Recorded. Birth-rates. Percentage of Illegitimate to Total Births, 1914. Total. Illegitimate. 1914. 1913. 1909-13. Males. Females. Males. Females. Borough 1,503 1,430 86 95 20.64 20.87 21.11 6.17 Wards. Queen's Park 182 173 6 13 22.52 22.03 23.93 5.35 Harrow Road 386 369 9 17 28.04 27.50 26.88 3.44 Maida Vale 199 202 14 11 18.63 19.45 19.78 6.23 Westbourne 219 223 12 17 18.92 18.97 19.82 6.56 Church 363 343 30 22 28.64 30.24 29.01 7.36 Lancaster Gate West 28 29 2 5 6.08 6.54 6.96 12.28 East 34 30 2 2 7.97 6.98 7.37 6.25 Hyde Park 92 61 11 8 12.19 12.36 13.44 12.42 compared with a rate of 20.87 in 1913, and an average of 21.11 for the five years 1909-13. (See Table I., Appendix.) The rates recorded last year in Queen's Park, Harrow Road, and Lancaster Gate (East) Wards were higher than those recorded in 1913. In the two last-named Wards the rates were in excess of the averages for the preceding quinquennium. In Table II., Appendix, the births allocated to each Ward during the six years 1909-14 are set out. Table 3 has been compiled from the uncorrected totals* given in the Quarterly Reports of *In the case of St. Marylebone the corrected total has always been used on account of the great excess of non-resident births taking place in Queen Charlotte's Lying-in Hospital registered in that Borough. 5 BIRTHS. the Registrar-General, in order to afford a comparison with the rates of adjacent districts covering a series of years. It will be noted that the rate for the Borough (19.07) was exceeded only by the rates for the whole County (24.57) and for Willesden (23.50). TABLE 3. London. Paddington. Kensington. Westminster. St. Marylebone. Hampstead. Willesden. Births, 1914 111,001 2,709 3,019 1,867 2,132 1,213 3,947 1913 113,822 2,834 3,181 1,988 2,221 1,259 3,995 Birth-rates, 1914 24.57 19.07 17.67 12.25 18.97 13.98 23.50 1913 24.71 19.60 18.26 12.63 19.07 14.34 24.01 1909-13 25.20 19.90 17.93 13.86 20.18 14.55 25.22 Illegitimacy.—There were 134 births of illegitimate children registered in the Borough, 71 of whom were males and 63 females. Such births formed 4.9 per cent. of the total births registered, as compared with 5.5 in 1913 and 5.7 in 1912. The births of illegitimate children in the Workhouse numbered 48 (77.4 per cent. of all births in that Institution, the corresponding figure for 1913 being 64.5, and for 1912, 70.3), those of males amounting to 25 and of females 23. Twenty-one of the 134 children were born to non-resident mothers, 11 being born in the Workhouse. The transfers numbered 68 (30 of males and 38 of females), so that the corrected total of such births was 181 (86 of males and 95 of females), equal to 6.2 per cent. of the corrected total of births, exactly the same proportion as in the two preceding years. The numbers of such births allocated to the Wards are given in Table 2, together with the proportions (per cent.) to total births. The highest proportion in any Ward recorded last year was 12.4 per cent. (Hyde Park), and the lowest 3.4 per cent. (Harrow Road). Notification of Births.—The Notification of Births Act, 1907, was adopted by the Council in 1908. During the past year 2,916 notifications were received, of which 170 related to births already notified, so that the nett number notified was 2,746, 38 more than the number registered within the Borough. Midwives notified 1,101 births (37.75 per cent.), medical practitioners, 984 (33.74 per cent.), parents, 522 (17.90 per cent.), and other persons, 309 (10.59 per cent.). The statement given below shows the changes which have taken place in the proportions notified by medical practitioners, &c. Notifications of Births. Percentages of Total Notifications received From 1914. 1913. 1912. 1911. 1910. 1909. Medical Practitioners 33.7 32.1 36.3 23.3 18.9 18.4 Midwives 37.8 36.0 34.5 34.6 36.0 38.3 Parents 17.9 22.8 22.7 36.3 39.7 35.5 Others 10.6 9.1 6.5 5.8 5.4 7.8 The following statement shows the distribution of notifications according to the addresses at which the births were said to have taken place, the total notifications allocated to each Ward being compared with the births registered locally and allocated to the Wards according to the home addresses of the parents. The figure for Westbourne Ward includes 81 notifications of births which took place in the Workhouse Lying-in Ward, and one in the Lock Hospital. Thirty-four births were notified from nursing homes in the Borough. 6 SICKNESS. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. Births registered 336 698 366 396 623 48 59 133 Births notified including 350 697 378 482 619 40 50 119 Legitimate, living 341 677 363 446 595 38 49 116 Legitimate, dead 7 19 15 10 22 2 — 2 Illegitimate, living 2 1 — 25 2 — — 1 Illegitimate, dead — — — 1 — — 1 — Of the 2,708 births registered in the Borough, 2,610 (or 96.4 per cent) had been previously registered. The subjoined statement shows the progress of notification, as judged by the percentage of births registered subsequent to notification. Percentages of Births Registered after Notification. Total Births. Quarters. 1. 2. 3. 4. Registration Areas. 1910. 1911. 1912. 1913. 1914. 1910 76.0 81.0 92.1 84.4 North Paddington . 87.8 96.1 97.2 96.1 97.2 1911 92.3 95.0 96.7 93.2 Central „ . 81.7 95.5 97.2 96.5 97.2 1912 95.5 97.1 96.4 93.6 South „ . 78.3 79.5 85.8 80.9 88.2 1913 95.9 93.4 94.8 96.5 Borough 84.4 94.4 96.4 95.2 96.4 1914 97.0 96.7 96.1 95.6 Illegitimate Births. Borough:- 1910, 74.5. 1911, 93.5. 1912, 94.9. 1913, 91.0 1914, 94.8. The births of children notified as illegitimate numbered 33, and formed 1.2 per cent. of the total births notified, as compared with 2.3 per cent. in 1913 and 2.6 per cent. in 1912. It will be noticed that these proportions are considerably lower than those which were observed among births registered in the Borough (4.9 per cent. in 1914, 5.5 per cent. in 1913, and 5.7 per cent. in 1912). The differences between the figures are to be explained by the fact that in a number of cases the notifications have not shown that the children were illegitimate, so that they have escaped being recorded as such. The large number of notifications of illegitimate births recorded above in Westbourne Ward is due to the presence of the Workhouse Lying-in Wards in that part of the Borough. There were 37 twin births notified during the year, and one birth of triplets. Of the latter only one child (a female) was born alive, the others (males) being still-born. An analysis of the sex composition of the twin births, distinguishing the children still-born, is given below:— Total Births. Illegitimate Births. Twin Births— M.M. M.F. F.F. M.M. M.F. F.F. Both children living 13 15 5 — — — One child dead 1 — 2 — — — Both children dead 1 — — — — — Still-births.—The Notification of Births Act requires the birth of a child born dead after twenty-eight weeks' gestation to be notified. Last year 79 still-births were so reported, 77 of legitimate and 2 of illegitimate children, equal to 2.9 per cent. of the total births notified. In 1913 the percentage was 2.4, and in 1912 2.6. SICKNESS: Morbidity. Table 4 gives the numbers of cases of infectious disease certified during the years 1914 and 1913, no corrections having been made for error of diagnosis. It will be remembered that for statistical purposes the year 1913 contained 53 weeks, consequently comparisons should be based upon the morbidity rates rather than upon the actual numbers of cases. The same remark 7 sickness. applies to other Tables in which figures for the two years are quoted. The rate for scarlet fever was considerably higher last year than in 1913, and increased rates were also recorded for erysipelas, puerperal fever, ophthalmia neonatorum, and acute poliomyelitis. In a later section of the report each disease will receive special consideration. TABLE 4. Notifications. Paddington. Diphtheria. Membranous Croup. Erysipelas. Fever. Cerebrospinal Meningitis. Acute Poliomyelitis. Ophthalmia Neonatorum Scarlet. Enteric. Continued. Puerperal. Cases— 1914 286 3 141 738 10 2 10 1 3 51 1913 293 3 112 484 25 — 8 — 2 22 Morbidity Rates*— 1914 201 0.02 0.98 5.19 0.08 0.01 3.44 0.00 0.02 17.38 1913 2.03 0.02 0.76 3.34 0.17 — 2.80 — 0.01 7.76 1909-13 1.39 0.02 0.77 2.62 0.20 0.00 2.65 * Per 1,000 persons of all ages, except for puerperal fever and ophthalmia neonatorum, per 1,000 births (corrected). TABLE 5. Morbidity Rates. Disease. London. Paddington. Kensington. Westminster. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. Smallpox 0.00 0.00 0.00 — Diphtheria 2.02 1.60 1.50 2.07 2.09 1.44 1.17 0.83 1.01 1.23 1.22 1.09 Erysipelas 1.10 0.88 0.94 0.98 0.76 0.77 0.97 0.64 0.73 0.73 0.47 0.51 Fevers. Scarlet 5.54 3.82 2.95 5.23 3.36 2.62 5.63 3.20 2.03 5.57 2.40 2.12 Enteric 0.17 0.16 0.21 0.07 0.17 0.20 0.06 0.16 0.17 0.32 0.18 0.18 Puerperal 3.58 3.08 2.83 3.37 2.61 2.64 1.87 3.87 2.86 4.64 1 2.69 3.79 Cerebro-spinal 0.01 0.00 0.02 0.00 — 0.03 0.01 0.01 0.01 0.00 — 0.01 A. Poliomyelitis 0.02 0.03 0.02 0.01 — 0.02 0.00 j 0.02 Ophthalmia Neonat 8.08 5.68 17.20 7.20 9.65 5.06 8.35 7.18 Disease. St. Marylebone. Hampstead. Willesden. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. Smallpox — — — — — — — — — Diphtheria 2.09 1.11 1.10 2.66 1.45 1.37 1.75 1.41 1.31 Erysipelas 0.59 0.67 0.89 0.51 0.37 0.44 0.72 0.57 0.61 Fevers. Scarlet 3.84 3.57 2.82 3.24 2.36 1.97 4.52 2.98 2.82 Enteric 0.33 0.16 0.15 0.19 0.17 0.17 0.08 0.10 0.14 Puerperal 4.22 1.79 1.69 5.49 0.75 2.74 2.91 2.72 2.91 Cerebro-spinal 0.00 0.02 0.02 — — 0.02 — — A. Poliomyelitis — 0.01 0.03 0.04 — — Ophthalmia Neonat 8.91 4.03 9.42 8.29 Rates calculated per 1,000 persons of all ages, except in the cases of puerperal fever and ophthalmia neonatorum, per 1,000 births (corrected). 8 SICKNESS. Table 5 has been constructed from the numbers of cases reported in the Quarterly Reports of the Registrar-General, such data being selected to secure uniformity in comparisons. It will be seen that in all districts the rates for scarlet fever were much above those for the preceding year and the five-yearly averages. Morbidity Rates, 1914. Borough and Circumjacent Districts. Maximum Minimum (per 1,000 persons, all ages). Diphtheria Hampstead (2.66) Westminster (1.23) Erysipelas Paddington (0.98) Hampstead (0.51) Scarlet fever Kensington (5.63) Hampstead (3.24) Enteric fever St. Marylebone (0.33) Kensington (0.06) (per 1,000 births). Puerperal fever Hampstead (5.49) Kensington (1.87) Ophthalmia neonatorum Paddington (17.20) Westminster (8.35) In the Charts facing this page are shown the annual morbidity rates based on the numbers of cases of scarlet fever and diphtheria reported each week in the Borough and in the County. The dotted lines represent the averages for the ten years 1904-13. Table 6 has been compiled from the Annual Report of Statistics of Notification issued by the Local Government Board. The continued excessive prevalence of scarlet fever will be noted. TABLE 6. In Extra-Metropolitan England and Wales. At Ports. Cases Reported. Morbidity Rates. Cases Reported. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. Smallpox 56 87 107 0.00 0.00 0.00 7 25 12 Typhus Fever 14 13 28 0.00 0.00 0.00 — — — Scarlet Fever 139,973 113,058 96,149 4.31 3.48 3.00 61 81 31 Diphtheria 50,207 43,182 37,578 1.54 1.33 1.17 32 53 67 Enteric Fever 7,841 7,355 7,561 0.24 0.22 0.23 164 146 124 Continued Fever 64 94 89 0.00 0.00 0.00 5 9 8 Puerperal Fever 1,942 1,635 1,801 2.53 2.13 2.36 1 — — Erysipelas 21,989 18,955 18,728 0.68 0.58 0.58 19 18 21 Pulmonary Tuberculosis 64,403 73,898 77,159 1.98 2.28 2.41 297 308 155 Cerebro-spinal Fever 240 211 0.00 0.00 2 1 Acute Poliomyelitis 416 581 0.01 0.01 — 1 Other Forms of Tuberculosis 20,483 31,762 0.63 1.06 22 10 Plague — — — — — — 2 Ophthalmia Neonatorum* 5,481 Rates per 1,000 persons of all ages, except puerperal fever—per 1,000 births. * The figures given are for 9 months only. NOTIFICATION Rates per 1000 persons 9 SICKNESS. TABLE 7. Notifications: Ward Distribution. 1909-1914. Disease. Diphtheria, including Membranous Croup. Erysipelas. Scarlet Fever. Enteric Fever, including Continued Fever. Puerperal Fever. Year. 1914 1913 1912 1911 1910 1909 1914 1913 1912 1911 1910 1909 1914 1913 1912 1911 1910 1909 1914 1913 1912 1911 1910 1909 1914 1913 1912 1911 1910 1909 Wards. Queen's Park 39 35 53 27 19 21 19 10 14 7 13 9 162 88 47 25 36 61 ... 2 1 2 2 3 1 2 2 ... ... ... Harrow Road 60 54 60 42 24 43 29 30 87 29 27 23 173 117 44 80 75 166 1 8 2 9 7 2 3 3 2 '2 2 ... Maida Vale 56 32 22 24 12 22 24 20 12 17 12 16 87 52 36 34 33 45 2 1 2 9 7 5 2 1 3 3 1 ... Westbourne 39 74 48 33 13 27 24 18 15 20 20 22 70 82 45 14 27 107 4 6 3 3 2 ... 1 3 ... 4 1 Church 62 63 43 31 28 45 28 27 25 35 19 29 165 93 71 47 61 171 3 8 3 7 13 10 3 ... ... 1 2 2 Lancaster Gate, West 7 13 9 9 6 2 3 1 1 2 1 1 19 12 11 3 11 19 ... 1 2 3 2 ... ... 1 1 ... ... ... „ „ East 9 10 2 7 8 6 7 3 3 2 3 1 11 24 4 4 1 12 1 1 1 3 1 2 ... ... ... ... ... ... Hyde Park 17 15 11 5 6 9 7 3 10 5 5 5 51 16 14 19 14 48 1 3 1 3 5 5 1... ... ... 1 ... ... TABLE 8. Notifications: Ward Averages. Wards Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. Year 1914. 190913. 1914. 190913. 1914. 190913. 1914. 190913. 1914. 190913. 1914. 190913. 1914. 190913. 1914. 190913. Diphtheria. Quarter 1 9 9 16 11 18 6 18 11 14 11 4 2 4 3 5 2 2 7 6 16 11 9 4 7 12 18 9 2 1 3 1 1 1 3 10 4 10 8 17 3 9 6 12 8 — 2 — — 6 2 4 13 12 18 15 12 9 5 8 18 14 1 3 2 3 5 4 Year 39 31 60 45 56 22 39 37 62 42 7 8 9 7 17 9 Scarlet Fever. Quarter 1 45 8 35 21 23 8 12 13 55 14 4 2 2 1 5 3 2 20 11 18 25 19 7 8 11 38 23 3 2 2 2 7 9 3 28 14 45 24 17 9 18 13 36 25 3 2 2 3 9 5 4 69 18 75 26 28 16 32 18 36 27 9 5 5 3 30 5 Year 162 51 173 96 87 40 70 55 165 89 19 11 11 9 51 22 Enteric Fever. Quarter 1 — — 1 1 — 1 2 1 — 2 — — — 0 — 1 2 — 0 — 2 — 1 1 1 — 1 — 1 — — — 0 3 — 1 — 1 2 2 — 1 — 2 — 0 — 1 1 1 4 — 1 — 1 — 1 1 0 3 3 — 0 1 0 — 1 Year ... — 2 1 5 2 5 4 3 3 8 — 1 1 1 1 3 c 10 DEATHS DEATHS: Mortality. During the year the deaths registered in the Borough numbered 1,892, comprising 949 of males, 942 of females, and one of a child whose sex could not be determined. In order to avoid a separate classification, the latter death will be included with those of males. The crude* mortality rate was 13.31 per 1,000 persons of all ages, being 1.02 below the rate for 1913 (14.33) and 0.98 below the average rate for the five years 1909-13. The average rate for the quinquennium 1904-08 was 14.95. (See Table I., Appendix.) The crude and partially corrected rates for each quarter of the year are given below. Mortality Rates: Crude. Paddington. Per 1,000 persons. Quarter— 1st. 2nd. 3rd. 4th. 1914 15.43 12.25 11.85 13.74 1913 18.08 12.37 12.03 14.62 1909-13 16.96 13.20 11.27 14.20 Mortality Rates: Partially Corrected. Paddington. Per 1,000 persons. Quarter— 1st. 2nd. 3rd. 4th. 1914 15.20 11.32 10.73 14.08 1913 17.62 11.11 10.74 13.65 1909-13 15.89 11.87 10.04 12.80 The fully corrected number of deaths for the year was 1,895, 923 of males and 972 of females, the "corrected" mortality being 13.33 per 1,000 persons of all ages, 0.35 lower than TABLE 9. Mortality Rates: Corrected. (per 1,000 individuals of each sex). Area. Mortality Rates. Persons. Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Borough 13.33 13.68 13.24 15.37 15.36 15.10 11.84 12.45 11.85 Wards. Queen's Park 14.27 14.20 13.86 14.02 14.69 13.23 14.40 13.57 12.35 Harrow Road 12.92 14.36 14.12 14.03 13.52 14.43 11.95 15.10 13.76 Maida Vale 13.38 12.63 12.55 17.06 15.06 15.23 10.98 11.07 10.70 Westbourne 14.13 15.06 13.89 15.64 16.59 15.78 13.07 13.91 12.66 Church 17.85 18.63 17.82 18.56 20.27 19.56 17.23 17.19 16.44 Lancaster Gate, West 6.19 7.62 7.42 10.93 8.97 8.99 3.73 6.90 6.62 East 7.84 7.23 7.62 12.94 11.13 10.12 5.68 5.68 6.38 Hyde Park 11.55 9.75 10.49 14.09 13.50 13.78 11.40 7.65 8.71 * "Crude" mortality rates have been calculated on the deaths registered within the Borough. "Partially corrected" rates, on numbers obtained by deducting the deaths of non-residents recorded within the Borough and adding the deaths (reported weekly) of residents of the Borough occurring in other parts of the Metropolis; and "Corrected" rates, on the numbers obtained by adding the deaths of residents of the Borough in other parts of England and Wales, such deaths being reported quarterly. "Standardised" rates are "corrected" rates multiplied by "standardising factors" to make the adjustments necessary for variations in the sex-age compositions of the populations of the various districts referred to. These last have on former occasions been designated "corrected" rates, and those now called "corrected" rates, "nett." 11 DEATHS TABLE 10. Sex-Age Mortality Rates. Per 1,000 Individuals in each Group. Age Group. Area. Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 0—5. Borough 36.87 42.33 43.03 28.35 37.02 35.01 Wards. Queen's Park 28.66 31.41 32.96 26.57 42.46 31.86 Harrow Road 32.62 30.00 35.80 23.45 25.56 26.25 Maida Vale 36.76 35.57 41.85 26.18 28.38 29.24 Westbourne 39.34 46.03 46.38 27.37 43.53 36.92 Church 51.30 66.52 62.07 43.61 53.70 54.05 Lancaster Gate, West 22.39 21.69 21.66 17.70 — 15.27 Do. East — 40.74 18.69 — 7.02 20.48 Hyde Park 29.62 35.02 33.67 15.48 33.19 33.13 5—15. Borough 3.12 2.94 2.96 2.47 2.40 2.49 Wards. Queen's Park 2.57 5.62 3.71 1.91 2.45 1.83 Harrow Road 3.56 3.47 3.05 2.22 1.30 2.21 Maida Vale 2.25 0.74 2.27 3.00 5.13 3.70 Westbourne 3.63 2.39 2.46 3.29 3.22 2.58 Church 2.69 2.63 3.52 3.04 1.69 2.99 Lancaster Gate, West — 4.18 4.00 — 3.01 2.96 Do. East 4.18 — 0.78 — — 0.63 Hyde Park 6.45 2.04 1.96 1.92 1.81 1.72 15—25. Borough 2.68 2.04 2.29 2.12 1.81 1.93 Wards. Queen's Park 2.68 3.24 2.55 2.36 1.51 2.22 Harrow Road 1.95 1.41 2.82 4.15 3.60 3.16 Maida Vale 4.45 2.16 2.15 0.79 1.16 1.40 Westbourne 2.46 2.37 1.74 1.85 2.51 1.79 Church 2.76 3.17 3.05 5.00 2.63 2.60 Lancaster Gate, West 1.26 1.24 1.27 — 0.69 1.53 Do. East 4.03 — 2.03 0.71 0.69 1.39 Hyde Park 2.42 — 1.15 1.05 0.51 0.99 25—65. Borough 12.94 12.35 12.03 7.94 7.56 7.70 Wards. Queen's Park 14.48 13.12 12.53 12.19 7.97 8.58 Harrow Road 11.11 10.02 11.65 7.12 10.59 9.45 Maida Vale 14.19 12.82 11.80 8.22 7.48 7.03 Westbourne 13.75 15.83 13.36 7.77 7.11 8.34 Church 14.96 15.22 14.54 12.13 10.28 10.74 Lancaster Gate, West 7.59 4.87 6.80 1.50 4.51 4.21 Do. East 13.49 6.67 7.63 4.27 3.93 4.03 Hyde Park 10.77 11.32 11.83 8.02 4.92 5.58 65 and upwards. Borough 81.00 80.45 79.83 71.18 76.37 69.70 Wards. Queen's Park 77.67 85.25 85.10 81.80 78.21 74.48 Harrow Road 91.73 102.59 89.47 68.46 88.91 79.59 Maida Vale 85.19 77.88 79.55 62.28 65.12 65.83 Westbourne 58.03 53.50 60.70 69.00 70.62 57.56 Church 105.85 101.06 107.60 94.16 104.74 86.29 Lancaster Gate, West 78.05 73.78 58.04 42.37 64.83 56.04 Do. East 62.89 69.37 64.07 57.55 57.24 63.19 Hyde Park 86.42 79.66 82.30 82.35 59.48 70.77 12 deaths. TABLE 11. Mortality Rates. Per 1,000 persons of all ages. Disease. London. Paddington. Kensington. Westminster. St. Marylebore. Hampstead. Willesden. 1914 1913 1909-13 1914 1913 1909-13 1914 1913 1909-13 1914 1913 1909-13 1914 1913 1909-13 1914 1913 1909-13 1914 1913 1909-13 All Causes 14.33 14.16 14.26 12.99 13.41 13.06 13.12 13.64 13.40 12.70 12.65 12.51 13.96 14.02 14.29 10.29 10.68 9.92 10.25 10.07 10.64 Smallpox — — 0.00 — — — — — — — — 0.00 - — — — — — — — — Measles 0.31 0.33 0.45 0.02 0.37 0.34 0.08 0.48 0.37 0.03 0.14 0.16 0.01 0.27 0.33 0.02 0.24 0.17 0.05 0.40 0.28 Scarlet Fever 0.07 0.03 0.05 0.05 0.04 0.05 0.09 0.01 0.02 0.06 0.04 0.04 0.07 0.08 0.07 0.02 0.04 0.02 0.02 0.04 0.04 Diphtheria 0.15 0.09 0.11 0.14 0.08 0.07 0.07 0.02 0.07 0.09 0.05 0.07 0.15 0.05 0.06 0.11 0.03 0.11 0.12 0.05 0.10 Whooping Cough 0.20 0.15 0.23 0.17 0.25 0.24 0.04 0.16 0.20 0.13 0.04 0.10 0.17 0.08 0.21 0.18 0.12 0.11 0.20 0.14 0.27 Enteric Fever 0.03 0.02 0.03 0.02 0.04 0.03 0.00 0.02 0.03 0.05 0.01 0.03 0.05 0.04 0.03 0.04 0.01 0.03 0.01 0.02 0. 02 Diarrhœa* 27.64 27.50 22.45 26.64 23.21 22.70 19.63 23.82 22.11 16.24 23.34 16.88 27.67 16.58 16.63 8.64 13.57 6.76 19.44 12.38 17.88 Phthisis 1.39 1.30 1.32 1.02 1.08 1.04 1.09 1.07 0.98 1.34 1.31 1.24 1.29 1.35 1.32 0.63 0.57 0.63 0.87 0.81 0.85 Other Tuberculous Diseases 0.32 0.30 0.38 0.24 0.21 0.29 0.45 0.16 0.26 0.15 0.28 0.28 0.27 0.18 0.17 0.16 0.07 0.17 0.30 0.17 0.31 Cancer 1.15 1.11 1.11 1.48 1.27 1.19 1.48 1.08 1.15 1.13 1.41 1.27 1.22 1.32 1.31 1.31 1.13 1.08 0.92 0.95 0.90 All data, except those relating to other tuberculous diseases and cancer, have been taken from the Quarterly Reports of the Registrar-General. * Rates in this case per 1,000 births. 13 deaths. the rate (13.68) for 1913. Last year's rate was slighter higher than the mean rate for the five years 1909-13, but lower than the mean rates for the periods 1904-08 and 1904-13. Table 9 gives the mortality rates for each sex in the Borough, and in each of the Wards, and Table 10 the sex-age-group mortalities for the same areas. The total numbers of deaths (persons) allocated each year since 1909 to each Ward are shown in Table II. of the Appendix, the sex-age distribution of deaths of residents of the Borough during 1914 from selected causes in Table III., and a distribution by sex and causes of deaths allocated to each Ward in Table IV. The total death-rates (Table 9) last year were in excess of the averages in Queen's Park, Maida Vale, Westbourne, Church, and Hyde Park Wards. The mortality among males was above the average in Queen's Park, Maida Vale, Lancaster Gate (West and East), and Hyde Park Wards, and that among females in Queen's Park, Maida Vale, Westbourne, Church, and Hyde Park Wards. With regard to the sex-age-group mortalities (Table 10), the rates recorded in the whole Borough were above the averages in all groups except those of males and females 0—5 years and females 5—15 years. Table 11 has been compiled from data extracted from the Quarterly Reports of the Registrar-General. The total mortality in the Borough is compared with the like rates for the Metropolis and the districts circumjacent to the Borough. With the exception of the rate for the County, the highest rate for 1914 included in the Table is that of St. Marylebone (13 96). The lowest is that for Willesdan (10.25). Tables 12 and 13 give the Standardised Mortality Rates for All Causes, Pulmonary Tuberculosis and Cancer. A description of this method of comparing mortalities will be found in the Report for 1913. TABLE 12. Standardised Mortality Rates. All Causes. Pulmonary Tuberculosis. CANCER. Factor. Standardised Mortality Rates. Factor. Standardised Mortality Rates. Factor. Standardised Mortality Rates. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. London 1.0000 14.38 14.16 13.52 .9628 1.33 1.25 1.29 .9634 1.10 1.07 1.07 Paddington .9941 12.91 13.30 12.23 .9198 0.93 0.99 0.80 .8542 1.26 1.08 1.05 Kensington .9957 13.06 13.58 12.90 .9217 1.00 0.99 0.85 .8117 1.20 0.88 1.08 Westminster 1.0540 13.38 13.33 13.03 .8422 1.12 1.10 0.98 .8484 0.95 1.20 1.17 St. Marylebone 1.0198 14.23 14.30 14.06 .8932 1.15 1.20 1.12 .8556 1.04 1.13 1.01 Hampstead 1.0572 10.87 11.29 10.35 .9021 0.57 0.51 0.58 .8657 1.12 0.98 1.03 Willesden 1.0500 10.76 10.57 10.53 Factors for "all causes" calculated in General Register Office, those for pulmonary tuberculosis and cancer by the Medical Officer of Health of the County. 14 smallpox. TABLE 13. Standardised Mortality Rates. All Causes. Pulmonary Tuberculosis. CANCER. Factor. Standardised Mortality Rates. Factor. Standardised Mortality Rates. Factor. Standardised Mortality Rates. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. Borough .99495 13.26 13.61 12.36 .92067 0.98 0.98 0.75 .85887 1.27 1.10 1.06 Wards. Queen's Park 1.01124 14.37 14.32 11.71 .98003 1.54 1.39 0.68 1.00377 1.52 1.11 0.94 Harrow Road .95489 12.34 13.71 12.91 .94456 1.26 0.95 0.98 .89191 1.62 1.07 1.39 Maida Vale 1.00243 13.41 12.66 11.34 .90899 0.89 0.83 0.64 .92744 1.50 1.58 1.23 Westbourne .87683 12.38 13.21 10.85 .93040 0.91 1.09 0.75 .72294 1.27 1.22 0.92 Church 1.00290 17.90 18.68 16.88 .96137 1.44 1.48 1.19 .98841 1.36 1.18 1.30 Lancaster Gate West 1.13407 7.02 8.64 9.21 .83572 0.17 0.62 0.27 .78849 1.01 0.50 1.02 East 1.15924 9.08 8.38 9.25 .85441 - 0.31 0.21 .85240 0.45 0.72 0.10 Hyde Park 1.11855 12.91 10.90 11.75 .83898 0.60 0.52 0.53 .85079 0.74 0.66 0.93 Kensington .99158 13.01 13.52 12.85 .98653 1.07 1.05 1.04 .77233 1.14 0.83 1.03 Westminster 1.08952 13.83 13.78 13.45 .90340 1.21 1.18 1.05 .92004 1.04 1.30 1.27 St. Marylebone 1.02191 14.26 14.33 14.09 .89491 1.15 1.21 1.13 .87213 1.06 1.15 1.03 Hampstead 1.05805 10.89 11.31 10.36 .90256 0.57 0.51 0.58 .86961 1.14 0.98 1.03 Willesden 1.05790 10.84 10.65 10.61 .98611 0.86 0.80 0.92 1.13904 1.05 1.08 1.09 Calculated by the Department. SMALLPOX. No case of smallpox has been recorded in the Borough since 1906. In the Metropolis 2 cases were reported during the past year, as compared with 4 in 1913, 5 in 1912, and 72 TABLE 14. Vaccination Returns. Children Born. Successfully Vaccinated. Insusceptible to Vaccination. Died Unvaccinated. Per cent. of Children Born. (Cols. 1.4.) Vaccination Postponed. Exempted under Act. "Rest." Per cent. of Children Born. (Cols. 6.8.) Cols. 1 2 3 4 5 6 7 8 9 1901 3,364 2,676 5 313 89.0 23 34 313 11.0 1902 3,262 2,692 12 291 89.8 35 19 276 10.1 1903 3,315 2,621 10 296 88.2 48 32 308 11.7 1904 3,311 2,578 8 307 87.4 52 22 344 12.6 1905 3,188 2,495 11 261 86.8 61 40 320 13.2 1906 3,174 2,545 9 224 87.5 36 41 319 12.5 1907 3,092 2,349 7 255 86.4 28 97 356 15.6 1908 3,098 2,346 8 244 83.8 28 201 271 16.1 1909 2,920 2,242 11 207 84.2 27 243 190 15.7 1910 2,916 2,093 6 232 79.9 26 356 203 20.1 1911 2,821 2,014 10 228 79.8 31 367 171 20.2 1912 2,808 1,990 5 185 77.6 34 388 206 22.4 1913 2,794 1,903 3 197 75.2 40 445 206 24.8 1914 Jan.-June 1,388 882 5 66 68.7 35 299 101 31.3 15 diphtheria. in 1911. The cases reported in extra-metropolitan districts during 1914 numbered 56, as compared with 87 in 1913 and 107 in 1912. (See Table 6.) In addition, 7 cases were discovered on inspection of ships in home ports, making a total of 65 for the whole of England and Wales. No records are available of the number of certified cases of the disease which were subsequently proved to have been wrongly diagnosed. Vaccination.—Table 14, which has been constructed from'returns supplied by the Vaccination Officer, shows the steady increase in the proportion of unvaccinated infants. In 1913 (the last year for which complete returns are available) the percentage had risen to 24.8. DIPHTHERIA* During the past year 289 certificates of diphtheria were received, 7 less than in 1913. The morbidity rate was equal to 2.03 per 1,000 persons, as compared with 2.05 in 1913 and an average rate for the five years 1909-13 of 141. (See Table 4.) The local rate derived from the figures published in the Quarterly Reports of the Registrar-General was 2'07. (See Table 5.) As will be seen in the chart facing page 8, the prevalence of the disease was above the average during practically the whole of the year, both in Paddington and in the Metropolis generally. The numbers of cases recorded as belonging to- each Ward in each quarter of the year are shown in Table 8, against the corresponding averages for the years 1909-13. The variations in the morbidity rates in the different Wards are shown below. Diphtheria: Morbidity. Per 1,000 persons. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. 1914 2.47 2.23 2.60 1.67 2.51 0.75 1.12 1.35 1913 2.23 1.94 1.46 3.07 2.42 1.58 1.22 1.10 1909-13 1.94 1.63 1.06 1.56 1.66 0.88 0.82 0.70 Twenty-eight out of the 289 cases recorded last year occurred in local institutions, viz., the Victoria Orphanage (17 cases), the Orphanage of Mercy (6 cases), and the Infirmary and Workhouse (5 cases). The effect of the cases in the two orphanages is apparent in the morbidity rate for the Maida Vale Ward (2.60), which is higher than the rate recorded in each of the other Wards. There were 16 cases in which the original diagnosis of diphtheria was not confirmed, the percentage of "errors" being 5 5, as compared with 12.5 in 1913 and 6.0 in 1912. The 289 notified cases occurred in 263 houses, 22 of which furnished two or more patients. The following statement shows the house distribution of the notifications after the exclusion of the cases referred to above as occurring in institutions. Diphtheria: House Distribution. Notifications. 1914. 1913. 1912. 1911. 1910. 1909. Houses with 2 cases 19 15 20 9 2 10 „ 3„ 2 2 4 5 — 1 „ 4 „ 1 — 1 1 — 1 „ 5 „ — 1 1 — — — „ 7 „ — 1 — — — — * Unless otherwise stated, cases of membranous croup are included in the figures of "diphtheria." 16 diphtheria. The distribution of the multiple cases (after elimination of "errors") is shown below. Diphtheria: 1914. Distribution of Cases. (After correction.) Houses with 2 cases 17 Families with 2 cases 15 „ 3 „ 2 3 „ 2 „ 4 „ 1 Bacteriological tests were known to have been applied in respect of 117 of the cases notified. In 114 instances the Klebs-Loffler bacillus was present, while in three it could not be found, although the clinical symptoms were those of diphtheria. Of the 289 notified cases, 269 were removed to hospital, equal to 93.1 per cent. of the total notifications, as compared with 94.9 per cent. in 1913, and an average of 933. (See Tables 15 and 16.) There were 20 deaths among the notified cases, 14 of which occurred in hospital. After deducting the death of a patient who was subsequently found not to be suffering from diphtheria, the fatality per 100 definite cases was 6.9, as compared with 4.2 in 1913, and an average (1909-13) of 5.9. (See Table 16.) TABLE 15. Wards, &c. Diphtheria. Scarlet Fever. Enteric Fever. Cases. Deaths. Cases. Deaths. Cases. Deaths. Totals Reported. Removed to Hospital. At Home. In Hospital. Totals Reported. Removed to Hospital. At Home. In Hospital. Totals Reported. Removed to Hospital. At Home. In Hospital. Queen's Park 39 (4) 39 (4) - 2 162 (7) 153 (6) 2 1 - - - - Harrow Road 60 (-) 56 (-) 2 8 173 (6) 166 (6) - 1 1 1 - - Maida Vale 56 (4) 50 (4) - - 87 (5) 74 (4) - - 2 (1) 2 (1) - 1 Westbourne 39 (3) 35 (3) 2 2 (1) 70 (6) 66 (5) - - 4 (1) 2 1 (1) - Church 62 (3) 61 (3) 2 1 165 (13) 163 (12) - 4 3 (1) 3 (1) - 1 (1) Lancaster Gate, West 7 (-) 6 (-) - - 19 (-) 18 (-) - - - - - - East 9 (-) 7 (-) - - 11 (-) 8 (-) - - 1 - 1 - Hyde Park 17 (2) 15 (2) — 1 51 (-) 47 (-) — — 1 1 — — Borough 1914 289 (16) 269 (16) 6 14 (1) 738 (37) 695 (33) 2 6 12 (3) 9 (2) 2(1) 2 (1) „ 1913 296 (37) 281 (36) 1 14 (4) 484 (26) 464 (22) — 7 (1) 25 (6) 24 (6) - 8 (2) Note.—The figures in parentheses indicate the numbers of "errors of diagnosis." TABLE 16. Diphtheria. Scarlet Fever. Enteric Fever. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Removed to Hospital (1) 93.1 94.9 93.3 9.42 95.9 95.3 75.0 96.0 77.2 Fatality (2)—Total 6.9 4.2 5.9 1.1 1.5 1.9 22.2 31.5 16.4 At Home 30.0 7.1 7.5 5.1 — — 50.0 — 13.2 In Hospital 4.3 4.1 5.8 0.9 1.6 2.0 14.4 33.3 13.9 Mortality (3) 0.13 0.09 0.07 0.05 0.04 0.04 0.01 0.04 0.02 (1) Per cent. of reported cases. (2) Per cent. of cases corrected for errors of diagnosis. (3) Per 1,000 persons of all ages. 17 scarlet fever. TABLE 17. Mortality Rates: Corrected. Per 1,000 persons, all ages. Wards. Diphtheria. Scarlet Fever. Enteric Fever. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Queen's Park 0.12 0.06 0.09 0.13 0.12 0.07 - 0.12 0.04 Harrow Road 0.41 0.03 0.08 0.03 0 .03 0.03 — — 0.02 Maida Vale — 0.12 006 — 0.04 0.02 0 .05 — 0.02 H'estbourne 0.08 0.08 0.08 — — 0.03 — 0.08 0.03 Church 0.16 0.16 0. 09 0.16 0.08 0.13 — 0.04 0.03 Lancaster Gate, West — — 0.04 — — 0 .02 — — East — — 0.07 — — — — Hyde Park 0.08 0.23 0.05 - 0 .07 0.03 0.16 0 07 0.05 SCARLET FEVER. The figures in Table 6 show that the prevalence of the disease throughout the country was more marked last year than in 1913. Seven hundred and thirty-eight (738) cases were reported in the Borough during the year, equivalent to a morbidity rate of 5.19 per 1,000 persons, as compared with a rate of 3.34 in 1913, and an average of 2.62 for the five years 1909-13. The curves in the chart facing page 8 indicate that the outbreak reached its maximum point in the fourth quarter, both in Paddington and in the County. The total of 738 cases notified last year is the highest attained since 1901, the first year for which there are complete records for the area constituting the present Borough. High figures, however, were recorded in 1906 (715 cases), 1908 (631 cases), and 1909 (629 cases). From the statement given below it will be seen that the morbidity rates for last year were higher than the averages in all Wards, the excess ranging from 0 26 per 1,000 persons in Lancaster Gate (West) Ward to 7"09 in Queen's Park Ward. Scarlet Fever : Morbidity. Per 1,000 persons. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 10.27 6.44 4.04 2.99 6.69 2 .03 1.37 4 .06 1913 5.45 4.27 2.39 3.90 3.69 1.26 2.94 1.24 1909-13 318 3.55 1.90 2.40 3.52 1.22 1.11 1.71 In 37 cases (5 per cent, of the total) it was found after notification that the original diagnosis had been erroneous. The proportion of " errors " in 1913 was 5.4, the average for the five years 1909-13 being 7'3. The 738 notifications were reported from 576 houses, in 107 of which there were two or more cases. The house distribution of notified cases during the past five years is given below. Scarlet Fever. {Notifications.— Uncorrected.) 1914. 1913. 1912. 1911. 1910. Houses with 2 cases each 66 47 32 16 23 ,, 3 1 ,, 32 16 8 3 9 ,, 4 ,, 5 5 — 2 3 „ 5 „ 3 — — 1 1 ,, 6 „ 1 1 — — — ,, 7 ,, — — 1 — — „ 10 ,, 1 — — — d 18 enteric fever. The house distribution of multiple cases, after excluding errors of diagnosis, is shown below, together with the number of cases per family. Scarlet Fever. ( Cases.— Corrected.) 1914. 1913. 1912. 1911. 1910. Houses with 2 cases each 62 42 29 14 21 ,, 3 ,, 31 16 8 2 7 ,, 4 ,, 4 4 — 1 2 ,, 5 „ 3 — — 1 1 ,, 6 „ 1 1 — — — ,, 10 „ — 1 — — — Families with 2 cases each 66 46 27 14 21 ,, 3 „ 26 12 8 2 6 ,, 4 ,, 4 6 — 1 1 ,, 5 ,, 2 — — 1 1 „ 8 „ — 1 — — — Of the 738 persons notified to have scarlet fever during the year, 695 (including 33 of the 37 cases of erroneous diagnosis) were removed to hospital, equivalent to 94.2 per cent, of the total notifications, as compared with 95.9 per cent, in 1913, and an average of 95.3 per cent, for the five years 1909-13. From September 29th to December loth considerable difficulty was experienced in securing hospital accommodation, it being necessary in several instances to make application to the Metropolitan Asylums Board on nine successive days before removal of the patients could be effected. The deaths among the notified cases numbered 8, 6 of which occurred in hospital. The fatality during the year was IT per cent., as compared with 1.5 per cent, for 1913, and 1.9 per cent, for the five years 1909-13. It would appear, therefore, that the disease last year was of a comparatively mild type. The mortality for the Borough was 0.05 per 1,000 persons, against 0.04 in 1913, and an average of 0.05. It will be seen in Table 11 that lower rates were recorded in Hampstead and Willesden (0.02 in each case), but that in the three other adjacent districts the rates were in excess of that of the Borough. ENTERIC FEVER * Last year 10 cases of enteric fever and 2 cases of continued fever were reported, as compared with 25 cases of enteric fever in 1913, and 15 in 1912. The morbidity rate was 0.08 per 1,000 persons, being 0'09 below that for 1913, and 0.12 below the average for the five years 1909-13 (Table 4). In only one of the circumjacent districts (Kensington) was a lower rate recorded. Two of the cases notified as enteric fever and one of those notified as continued fever were subsequently found to have been wrongly diagnosed. The corrected total for the two diseases is therefore 9, giving a morbidity rate of 0.06 per 1,000 persons. The morbidity rates in the different Wards are set out below. No cases were reported from Queen's Park and Lancaster Gate (West) Wards. Enteric Fever : Morbidity. Per 1,000 persons. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 — 0.03 0.09 0.17 0 .12 - 0.12 0 .08 1913 0.12 0.11 0.03 0.24 0.31 0.10 0.12 0 .23 1909-13 0.12 0.17 0.22 0.13 0.32 0.17 0.20 0.26 * Otherwise Typhoid Fever. Cases reported as Continued Fever are included in the statistics of Enteric Fever. 19 SEPTIC DISEASES. Of the 9 definite cases, 3 were believed to have been imported. Two of the patients were ill when they landed in this country from abroad. There were 4 deaths among persons reported to have the disease, but in 2 of the fatal cases (one each of enteric fever and continued fever) the illness had been erroneously diagnosed. The fatality (Table 16) among definite cases was 22.2 last year, as compared with 31.5 in 1913, and an average of 16.4 for the five years. The Widal test was known to have been used in three instances before notification, in each of which a positive reaction was obtained. In one case, however, the diagnosis based on the result of the test was subsequently rejected. The mortality from enteric fever last year was at the rate of 0.02 per 1,000 persons, as compared with 0.04 in 1913, and an average of 0.03. Lower rates were recorded in Kensington (0.00) and Willesden (0.01). (See Table 11.) The Ward mortalities will be found in Table 17. SEPTIC DISEASES. Puerperal Fever.— Ten cases of this disease were reported during the past year, the total for 1913 being 8, and the average for the five years 1909-13, 7.6. The numbers of cases reported from each of the Wards during the past six years are given in Table 7. The morbidity rate was 3.44 per 1,000 births last year (Table 4), as compared with a rate of 2.80 in 1913, and an average for the preceding five years of 2.65. According to the data used in the preparation of Table 5, the local rate was 337 last year. Higher rates were recorded in Westminster (4.64), St. Marylebone (4.22), and Hampstead (5.49), and lower in Kensington (1.87) and Willesden (2.91). In Extra-Metropolitan England and Wales (Table 6) last year's rate was 2.53 per 1,000 births, as compared with 2.13 in 1913 and 2.36 in 1912. The morbidity rates in the different Wards of the Borough are shown below. Puerperal Fever: Morbidity. Per 1,000 births. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 2.81 3.97 4.98 — 4.24 — — 6.53 1913 5.63 3.99 2.63 2.21 — 16.12 — — 1909-13 2.13 2.48 3.87 3.83 1.37 6.35 — 1.25 Eight of the confinements were attended by medical practitioners and 2 by midwives. The patients were all delivered of living children. Four cases were removed to the Paddington Infirmary, 1 to St. Mary's Hospital, and 1 to the North-Western Hospital, the remaining 4 being kept at home. Three of the notified cases terminated fatally. In one of these it was found that the patient's permanent address was not in the Borough, consequently the death does not appear in the local "corrected" statistics. There were also 3 deaths of patients who had not been notified, making a nett total of 5 deaths belonging to the Borough. (See Tables III. and IV., Appendix.) Inquests were held touching 3 deaths (1 notified case and 2 non-notified cases), the findings of the Juries being: (1) "Puerperal septicaemia and erysipelas of the face, such erysipelas following injury to the nose. Although the Jury are unable to say the exact nature of such injury, they are satisfied it was accidental." (2) "Miscarriage. Septicaemia brought about by accidental infection." And (3) "Syncope when suffering from general peritonitis (pneumococcal) after a miscarriage attended by an untrained woman." The mortality per 1,000 births in the Borough last year was the same as the rate for the County (1.68). Lower rates were recorded in Kensington (1.24) and Marylebone (1.40). (See Table 18.) 20 SEPTIC DISEASES. Mortality in Childbed.— In addition to the 5 deaths from puerperal fever, there were 7 others from "accidents and diseases of parturition." The mortality from such causes was at the rate of 2.36 per 1,000 births last year, as compared with 2.47 in 1913, and an average of 2.55. Higher mortality rates were observed in all the circumjacent districts, except Willesden (1.45). The total mortality in childbed in the Borough (Table 18) was 4.04 per 1,000 births, as compared with 3.52 in 1913 and an average of 3.45 for the five years 1909-13. The mortality rates recorded in the Wards of the Borough are given below. Mortality in Childbed: Total Per 1,000 births registered. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 2.81 5.29 9.97 — 4.24 — — — 1913 — 5.31 — 8.86 1.31 16.12 — — 1909-13 4.15 3.02 0.96 3.87 3.58 12.94 10.13 7.61 TABLE 18. Mortality in Childbed. London. Paddington. Kensington. Westminster. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. Puerperal Fever— Morbidity 3.58 3.09 2.83 3.37 2.82 2.64 1.87 4.08 2.86 4.64 3.01 3.79 Fatality 46.82 39.82 48.42 50.00 27.50 34.21 66.66 38.46 51.11 40.00 33.33 40.48 Mortality 1.68 1.23 1.36 1.68 1.05 0.90 1.24 1.57 1.46 1.86 1.00 1.53 Accidents and Diseases of Parturition— Mortality 1.78 1.53 1.43 2.36 2.47 2.55 2.49 1.57 2.63 4.18 3.01 2.59 Total Mortality in Childbed 3.46 2.76 2.79 4.04 3.52 3.45 3.73 3.14 4.09 6.04 4.02 4.12 St. Marylebone. Hampstead. Willesden. 1914. 1913. 190913. 1914. 1913. 190913. 1914. 1913. 190913. Puerperal Fever— Morbidity 4.22 1.80 1.69 5.49 0.79 2.73 2.91 2.75 2.91 Fatality 33.33 50.00 50.00 42.85 200.00 58.82 58.33 18.18 35.08 Mortality 1.40 0.90 0.82 2.35 1.58 1.59 1.70 0.50 1.02 Accidents and Diseases of Parturition— Mortality 609 4.50 4.02 3.14 1.58 1.93 1.45 1.75 2.34 Total Mortality in Childbed 7.49 5.40 4.84 5.49 3.17 3.52 3.15 2.25 3.36 All rates per 1,000 births registered, except "Fatality," per 100 cases notified. Erysipelas.— One hundred and forty-one cases were notified last year, the morbidity rate being 0.98 per 1,000 persons, as compared with a rate of 0.76 in 1913, and an average (1909-13) of 0.77 (Table 4). Table 5 shows that the rate recorded in the Borough was practically the same as that for Kensington, but that lower rates were observed in all other adjacent districts. 51 ACUTE POLIOMYELITIS. The notified cases comprised 53 in males and 88 in females. In 25 instances (13 in males and 12 in females) the attacks were stated to have followed on injury. In 7 instances the part of the body affected was not recorded, the remaining 134 attacks being distributed as follows:— Head and neck 108 Males, 42 (7) Females, 66 (7) Arm, hand 6 ,, 4 (3) „ 2 (2) Trunk 2 „ 1 (1) „ 1 (1) Leg, foot 18 „ 6 (2) „ 12 (2) Note.— The figures in parentheses indicate the numbers of cases in which a history of a wound was obtained. Thirty-two of the patients received institutional treatment, equivalent to 22.7 per cent., as compared with 24.1 per cent. in 1913 and 16.2 per cent. in 1912. Twenty-five of the patients were admitted to the Paddington Infirmary, 6 to various hospitals, and 1 to a nursing home. There were 8 deaths among the 141 patients, equal to a fatality of 5.6 per cent., as compared with 1.7 per cent. in 1913 and 2.6 per cent. in 1912. One death occurred in a patient who was not notified, making a total of 9 deaths during the year. Other Septic Diseases.— The deaths classified under this general heading totalled 17 last year, the mortality being 0.12 per 1,000 persons, as compared with 0.04 in 1913 and an average (1909-13) of 0.08. The numbers of deaths from the several diseases are shown below. Other Septic Diseases. Deaths recorded 1914. 1913. 1912. 1911. 1910. 1909. Erysipelas 9 2 3 9 3 4 Pyæmia 4 1 1 1 3 2 Infective endocarditis 4 2 1 6 4 3 Noma — — 1 — — — Carbuncle — — — — 1 1 Cellulitis — — — — 4 3 Angina Ludovici — — — 3 — — Septic pneumonia — — — — — — Cancrum oris — 2 — 1 1 — The following figures show the mortality rates recorded in the different Wards of the Borough:— Other Septic Diseases: Mortality Rates. Per 1,000 persons. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 0.13 0.11 0.09 0.08 0.23 — 0.12 0.08 1913 — — 0.09 0.08 — — 0.12 — 1909-13 0.07 0.05 0.08 0.13 0.11 0.07 0.10 0.08 CEREBRO-SPINAL FEVER. During the past year 2 cases of posterior basic meningitis were reported (1 after death). No case of the disease was reported in 1913, but 7 cases were reported (1 after death) in 1912. The following particulars relate to last year's cases:— R. P., f., æt. 2 mos., sickened 17-ii. 14, died in infirmary, 21.ii.14. W. W. P., m., æt. 6 mos., sickened 28.iii.14, died at home, 28.iv.14. ACUTE POLIOMYELITIS. Three cases of the disease were notified during the year, as compared with 2 in 1913 and 6 in 1912. Two of the patients were admitted to the Metropolitan Asylums Board's 22 MEASLES. hospitals, and one received treatment as an out-patient at the Children's Hospital, Paddington Green. Brief histories of the cases are given below. A. H., f., æt. 2 yrs., sickened ? i.14, admitted M.A.B. 6.iii.l4, discharged 15.iv.14. Some atrophy of the muscle of right leg at time of discharge. M. H., f., æt. 3 yrs., sickened 11.v.14, attended Out-patients' Dept. C.H.P.Gn. from 19.v.14 to 7.vii.l4. Some wasting present, but improvement in power of movement of the right leg. F. F., m., æt. 3 yrs., sickened 19.ix.14, admitted M.A.B. 24.ix.14, died 30.ix.14. ANIMAL DISEASES. No cases of anthrax, glanders, or hydrophobia in man were reported during the year. Three outbreaks of glanders among horses stabled in the Borough were reported, but no illness was traced among the stable hands. OPHTHALMIA NEONATORUM. Fifty-one cases were notified during the year, as compared with 22 in 1913 and 31 in 1912. Two of the notifications were forwarded by midwives, in pursuance of the provisions of the Public Health (Ophthalmia Neonatorum) Regulations, 1914, the remaining 49 coming from medical practitioners. The morbidity rates recorded in the individual Wards of the Borough are given below. It should be stated, however, that owing to the Workhouse Lying-in Wards being situated in Westbourne Ward, the rates for that Ward cannot be strictly compared with those of the other Wards. Ophthalmia Neonatorum: Morbidity. Per 1,000 births. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 11.27 6.62 12.46 40.72 22.66 17.54 — 13.07 1913 8.45 9.30 2.37 11.08 7.88 —. — — 1912 5.01 7.14 6.86 21.00 11.74 — — 17.64 The cases reported from the Workhouse numbered 9, as compared with 3 in 1913 and 5 in 1912. In 25 cases out of the 51 it was reported that the births of the infants had been attended by midwives. Five swabs were received for bacteriological examination (to determine the presence or absence of the gonococcus), one of which proved " positive." In 23 instances assistance was given by the District Nurses in the treatment of the eyes. Two other cases of slight inflammation of the eyes were brought to the notice of the Department by the London County Council's Inspector. Three of the notified infants died during the year. Injury to the eyes is reported to have resulted in 2 out of the remaining 47 cases, viz., loss of sight of right eye in one instance and small opacities in both eyes in the other. A full description of the routine established for watching over the disease will be found in Appendix B to the report for 1911. MEASLES. The compulsory notification of measles came into operation in the Borough on March 16th, 1914, by virtue of an Order made by the Council extending to this disease, for a period of six months, the provisions of Section 55 of the Public Health (London) Act, 1891. This was followed by a further Order in which no limit of time was specified. Both Orders received the approval of the Local Government Board. The number of cases reported during the year was 393 (169 in males and 224 in females), 313 of which were notified by medical practitioners. In addition to these, 31 cases of "German 23 MEASLES. measles" came to the knowledge of the Department. The quarterly totals shown in the subjoined statement have been taken from the weekly tabulations, and include a certain number of cases of "German measles" which do not appear in the corrected annual totals. Measles: Recorded Cases. Borough. According to Weekly Tabulation. Quarters 1. 2. 3. 4. Year. Corrected Total. Year. 1909 133 366 76 127 702 709 1910 571 1,066 72 389 2,098 2,085 1911 659 424 91 135 1,309 1,281 1912 326 423 181 438 1,368 1,374 1913 585 462 175 12 1,234 1,230 1914 40 116 49 225 430 393 The morbidity of the disease last year was 2.76 per 1,000 persons of all ages, as compared with 8.71 in 1913 and 9.81 in 1912, and an average of 9.75. (See below.) The morbidity rates for the individual Wards will be found in Table 19. TABLE 19. Measles: Ward Distribution. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. 1914. Cases 34 68 52 101 104 5 6 23 Deaths — 1 — — 2 — - 1 Morbidity. 1914 2.15 2.53 2.41 4.35 4.22 0.53 0.74 1.82 1913 12.60 7.95 7.97 6.88 15.25 3.22 5.48 3.39 1909-1.3 13.00 12.82 8.69 8.20 13.03 4.12 3.79 5.13 Fatality. 1914 — 1.47 — — 1.92 — — 4.35 1913 4.04 3.79 4.17 8.12 5.86 — 2.27 — 1909-13 2.29 1.84 2.64 5.09 6.62 2.12 1.97 2.42 Mortality. 1914 - 0.03 — — 0.08 — — 0.08 1913 0.49 0.28 0.31 0.54 0.86 — 0.12 — 1909-13 0.29 0.23 0.23 0.42 0.86 0.09 0.07 0.13 Measles: Morbidity Rates. Per 1,000 of each sex and persons. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 5.59 17.56 11.09 11.01 9.89 11.03 2.81 Females 4.62 13.37 9.24 8.93 7.85 8.80 2.73 Persons 5.03 15.15 10.03 9.81 8.71 9.75 2.76 24 measles. The 393 cases occurred in 292 houses, giving an average of 13 cases per house, as compared with 1.8 in 1913 and 1912. There were 101 secondary cases, equal to 25.7 per cent. of the total cases reported, as compared with 45.2 per cent. in 1913 and 44.7 per cent. in 1912. The distribution of attacks in houses with two or more cases is given below. Measles: House Distribution. Borough. 1909. 1910. 1911. 1912. 1913. 1914. Houses with 2 cases 104 290 196 191 188 51 „ 3 „ 55 164 97 108 89 16 „ 4 „ 21 55 36 36 38 2 „ 5 „ 9 22 13 15 6 3 „ 6 „ - 7 2 3 2 — „ 7 „ 1 6 — 3 1 — „ 8 „ — 1 — 1 1 — „ 9 „ - 1 — — 1 — „ 13 „ - — — — 1 — „ 18 „ — — — — 1 - Only 4 deaths (all of males) from this disease were recorded during the year, giving a fatality per 100 known cases of 1.0 for persons and 2.4 for males. The mortality was 0 03 per 1,000 persons and 0.06 per 1,000 males. (See below.) Measles: Fatality. Per 100 known cases. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 5.3 3.5 4.4 2.4 4.2 3.9 2.4 Females 4.8 3.6 . 3.4 2.2 5.3 3.7 — Persons 5.0 3.6 3.8 2.3 4.7 3.8 1.0 Measles: Mortality. Per 1,000 of all ages of each sex and persons. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 0.29 0.61 0.44 0.26 0.41 0.40 0.06 Females 0.21 0.46 0.28 0.19 0.41 0.31 — Persons 0.26 0.52 0.35 0.22 0.41 0.35 0.03 The mortality rate for last year obtained from the data published by the Registrar-General (Table 11) was 0.02 per 1,000 persons, the rates for the circumjacent districts ranging from 0.01 in Marylebone to 0 08 in Kensington. It will be noted that these rates are all much below those for 1913 and for the five years 1909-13. Sex-age Incidence.— The variations in morbidity, fatality and mortality, according to the sex and age of the patient, are shown in Table 20. Hospital Isolation.— The admission of cases of measles to the hospitals of the Metropolitan Asylums Board was suspended from the middle of June, owing to the increasing number of scarlet fever patients requiring accommodation. No cases were recommended for admission before that date. During the year 13 patients received treatment in other institutions (including 7 in the local Infirmary), that number being equal to 3.3 per cent. of the total known cases. There were 4 deaths among the patients admitted to institutions, representing a fatality of 30.7 per cent. No deaths occurred among the patients kept at home. The appended figures show 25 WHOOPING COUGH. the fatalities at home and in institutions during the past four years. As a rule, only patients seriously ill or whose home conditions are unsatisfactory are removed to institutions, so that the fatality among them is usually much higher than among those remaining at home. Measles: Fatality. Per 100 cases. 1914. 1913. 1912. 1911. At home — 3.9 2.3 3.3 In institutions 30.7 13.6 2.7 12.8 TABLE 20. Measles: Sex-Age Distribution. 0— 1— 2— 3— 4— 5— 13— 15— M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1914. Cases 9 17 20 16 21 18 19 24 29 15 61 101 - 7 10 26 Deaths 2 — 2 — — — — — — — — — — — — — Morbidity. 1914 6.43 12.99 15.97 12.55 17.64 15.18 16.47 20.32 23.75 12.09 7.54 12.25 — 4.45 0.22 0.39 1913 27.97 33.71 59.62 66.23 66.72 55.92 74.10 67.83 78.11 86.66 23.24 25.51 8.01 12.61 0.27 0.36 1909-13 28.74 28.69 61.72 64.76 63.65 61.02 65.69 63.02 80.81 85.56 31.39 35.21 2.94 6.21 0.23 0.26 Fatality. 1914 22.2 - 10.0 - - - - - - - - - - - - - 1913 15.0 14.9 16.2 21.0 3.8 6.0 1.1 4.7 - 1.0 1.6 0.4 - - - - 1909-13 14.5 15.4 13.8 13.4 5.4 5.7 1.4 1.5 1.1 0.9 0.5 0.5 — - — 1.1 Mortality. 1914 1.43 - 1.59 - — - — - — — — — — - — — 1913 4.19 5.02 9.66 13.73 2.56 3.33 0.81 3.19 - 0.83 0.36 0.12 - - - - 1909-13 4.16 4.42 8.51 8.71 3.46 3.46 0.91 0.94 0.92 0.77 0.14 0.19 - - - 0.00 WHOOPING COUGH. Cases of whooping cough come to the knowledge of the Department chiefly by means of the "Form 84" forwarded by the head-teachers of schools on the exclusion of children who are either sufferers or who come from homes where the disease exists. The corrected total arrived at after a careful analysis of the cases at the end of the year was 558, being 3 more than the number derived from the weekly tabulation. (See below.) Whooping Cough: Recorded Cases. Borough. According to Weekly Tabulation. Corrected Total. Quarters 1. 2. 3. 4. Year. Year. 1909 234 243 72 26 584 561 1910 137 182 95 134 548 518 1911 403 219 49 15 686 632 1912 87 126 49 142 404 377 1913 284 194 111 64 653 644 1914 64 244 175 72 555 558 The morbidity rate last year was 3.92 per 1,000 persons of all ages, as compared with 4.52 in 1913 and 264 in 1912, and an average (1909-13) of 3.83. (See next page.) The morbidity rates recorded in the Wards are shown in Table 21. E 26 WHOOPING COUGH. Whooping Cough: Morbidity Rates. Per 1,000 individuals of each sex and persons. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 4.33 3.86 5.03 3.06 4.87 4.23 4.45 Females 3.62 3.45 3.99 2.33 4.27 3.53 3.54 Persons 3.92 3.63 4.43 2.64 4.52 3.83 3.92 The 558 cases occurred in 324 houses, equal to an average of 17 per house, the same as in 1913. In 1912 the percentage was 18. There were 234 secondary cases, equal to 419 per cent. of the total known cases, as compared with 436 per cent. in 1913 and 46.2 per cent. in 1912. The house distribution for houses with two or more cases is set out below. Whooping Cough: House Distribution. Borough 1909. 1910. 1911. 1912. 1913. 1914. Houses with 2 cases 98 95 102 61 110 88 „ 3 „ 41 38 51 24 41 43 „ 4 „ 12 11 15 9 19 6 „ 5 „ 2 1 7 7 4 8 „ 6 „ 1 2 1 2 3 2 „ 7 „ — — 1 — 1 — „ 8 „ 1 — — — — — There were 26 deaths (12 of males and 14 of females) from whooping cough during the year, giving a fatality of 4.6 per 100 known cases, as compared with 5.7 in 1913 and 5.5 in 1912, and an average of 6.3 for the five years 1909-13. (See next page.) The fatality rates recorded in the Wards are shown in Table 21. TABLE 21. Whooping Cough. Ward Distribution. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. 1914. Cases 85 119 61 87 120 — 19 67 Deaths 4 3 5 7 6 — — 1 Morbidity. 1914 5.39 4.43 2.83 3.72 4.86 - 2.36 5.34 1913 7.11 7.84 3.75 2.99 4.23 1.61 3.74 1.57 1909-13 6.36 5.72 2.64 2.56 4.95 1.83 1.49 1.55 Fatality. 1914 4.7 2.5 8.2 8.0 5.0 - - 1.5 1913 7.9 2.8 2.5 11.4 10.4 - 3.3 - 1909-13 5.2 5.3 8.6 7.3 7.9 1.2 1.6 9.0 Mortality. 1914 0.25 0.11 0.23 0.30 0.24 - - 0.08 1913 0.55 0.22 0.09 0.33 0.43 - 0.12 - 1909-13 0.33 0.30 0.23 0.18 0.39 0.02 0.02 0.14 27 WHOOPING COUGH. Whooping Cough: Fatality. Per 100 known cases. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 6.4 9.4 7.2 5.9 4.4 6.6 4.5 Females 6.3 4.6 7.0 5.2 6.8 6.0 4.7 Persons 6.4 6.7 7.1 5.5 5.7 6.3 4.6 The mortality rate last year was 0.18 per 1,000 persons, as compared with 0.25 in 1913 and an average (1909-13) of 0.24. (See below.) The rates for the Wards are shown in Table 21. whooping Cough: Mortality. Per 1,000 individuals of each sex and persons. Borough. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. Males 0.28 0.36 0.36 0.18 0.21 0.28 0.20 Females 0.23 0.15 0.28 0.12 0.29 0.21 0.17 Persons 0.25 0.24 0.31 0.14 0.25 0.24 0.18 Table 11 shows that lower mortality rates were recorded in Kensington (0.04) and Westminster (0.13). Sex-Age Incidence.— Morbidity, fatality, and mortality rates based on the ages and sexes of the patients are given in Table 22. TABLE 22. Whooping Cough: Sex-Age Distribution. 0— 1— 2— 3— 4- 5— 13— 15— M. F. M. F- M. F. M. F. M. F. M. F. M. F. M. F. 1914. Cases 30 20 23 30 32 29 26 38 51 50 104 123 1 1 — — Deaths 8 5 3 4 1 5 — — — — - - - - - - Morbidity. 1914 21.43 15.28 18.37 23.53 26.89 24.47 22.55 32.18 41.77 40.32 12.86 14.92 0.65 0.63 - — 1913 17.48 27.26 21.75 36.34 24.80 29.21 29.31 27.13 31.73 36.66 16.72 18.29 - 0.52 0.02 0.03 1909-13 18.45 24.26 20.73 23.50 18.55 23.43 24.69 25.01 31.46 33.44 12.75 14.12 0.10 0.41 — — Fatality. 1914 26.6 25.0 13.0 13.3 3.1 17.2 — — — — — — — — — — 1913 16.0 18.5 25.9 22.2 6.9 11.5 — — — 4.5 — 1.3 — — — — 1909-13 28.6 21.2 231 15.2 5.1 503 0.6 7.4 1.4 2.9 VI 0.6 — — — — Mortality. 1914 571 382 239 314 0 83 422 - - - - - - - - - - 1913 2.79 5.02 5.64 8.07 1.71 3.33 — — — 3.33 — 0.12 — — — — 1909-13 5.27 5.13 4.79 3.58 0.94 1.25 0.15 1.87 0.46 0.93 0.14 0.09 - - 0.01 0.02 Hospital Isolation.— In the early part of last year three patients suffering with whooping cough, were admittted to one of the hospitals of the Metropolitan Asylums Board. After the middle of June, however, the Board were unable to receive any further cases of this disease. Seventeen patients received treatment in other institutions (including 11 in the Paddington Infirmary). Among the 21 cases treated in institutions there were 9 deaths, equivalent to a fatality of 42.8 per cent.; while the deaths among the patients nursed at home numbered 17, giving a fatality of 3.1. (See below.) Whooping Cough : Fatalities. Per 100 cases. 1914. 1913. 1912. 1911. At home 3.1 4.0 4.2 6.7 In institutions 42.8 29.6 21.4 14.2 28 TUBERCULOSIS. OTHER INFECTIOUS DISEASES. The Department receives information (on "Form 84") from the teachers of the public elementary schools of cases of chickenpox, mumps, ringworm, "blight," "sore throat," &c., and weekly returns are prepared of the cases of the first three. Most of these diseases will be dealt with under "School Attendance," but the results of the weekly tabulations may be briefly referred to here. Chickenpox.— Five hundred and forty cases were included in the weekly returns last year, as compared with 608 in 1913. The corrected total was 555 cases in 337 houses, as compared with 599 cases in 376 houses in 1913. The disease was most prevalent in the first and second quarters of the year. Mumps.— The cases (uncorrected) numbered 247 last year. In 1913, 203 cases were reported, and in 1912, 341. Ringworm.— The number of reported cases last year was 198, as compared with 148 in 1913 and 267 in 1912. Borough (according to weekly tabulation). Quarters. 1. 2. 3. 4. Year. Chickenpox 1909 100 73 43 128 344 1910 220 103 55 140 520 1911 129 147 100 131 507 1912 192 135 52 90 469 1913 74 217 99 218 608 1914 205 190 64 81 540 Mumps 1909 211 114 30 65 420 1910 31 23 3 12 69 1911 40 39 10 134 223 1912 159 71 39 72 341 1913 97 59 24 23 203 1914 64 103 32 48 247 Ringworm 1909 45 49 40 42 176 1910 41 24 13 24 102 1911 37 43 31 54 165 1912 69 71 45 82 267 1913 46 48 24 30 148 1914 72 65 32 27 196 TUBERCULOSIS. Notification. During the past year, 1,379 certificates were received, 239 of which had to be transferred to the medical officers of health of other districts in which the patients resided, so that the total number belonging to the Borough was 1,140. In 1913 the nett number of certificates was 1,311, and in 1912, 1,362. The notifications relating to patients who had not been previously reported numbered 545, comprising 396* of pulmonary tuberculosis and 149 of other forms of the disease. In 1913 the number of new cases notified was 836. The sources from which last year's notifications were received are set out in Table 23. * Fourteen of these cases, however, were already known to the Department as "Suspects." 20 TUBERCULOSIS. Of the new patients reported during the year, 17 (9 males and 8 females) could not be allocated to any of the Wards of the Borough. The distribution of the remaining cases (distinguishing the sexes) is shown below. Tuberculosis: Notifications. 1914. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. Males 39 58 45 47 72 6 4 15 Females 25 50 34 40 70 7 7 9 Persons 64 108 79 87 145 13 11 24 Morbidity: Persons. 1914 4.06 4.02 3.67 3.72 5.88 1.39 1.37 1.91 1913 6.32 5.49 4.79 6.91 8.26 2.10 1.46 3.03 1912 6.38 7.04 4.50 7.38 8.63 1.29 1.74 2.36 An analysis of the institutions, other than the local Infirmary, from which certificates were received is here given. "General" Hospitals 8 (8) Asylums Board Hospitals 3 (5) "Chest" „ 4 (4) Poor Law Institutions 2 (5) "Tuberculosis" „ 2 (3) Lunatic Asylums 7 (3) " Children's" „ 2 (2) Sanatoria 11 (12) Other "Special" ,, 2 (2) "Homes." 4 (8) Figures for 1913 shown in parentheses. TABLE 23. Tuberculosis: Notifications. 1914. Quarters. Year. 1. 2. 3. 4. Total Certificates received* 417 361 291 310 1,379 Certificates forwarded on 81 72 59 27 239 New Cases certified 185 138 101 121 545 Numbers of Certificates received from— Private Practitioners 89 (10)† 73 (8) 54 (5) 60 (10) 276 (33) District Medical Officers 14 (4) 17 (7) 8 (5) 13 (12) 52 (28) Medical Superintendents of— Paddington Infirmary 66 (49) 84 (64) 53 (43) 74 (53) 277 (209) Sanatoria 42 (37) 43 (42) 40 (37) 40 (39) 165 (155) Paddington Tuberculosis Dispensary 52 (16) 28 (13) 41 (17) 44 (20) 165 (66) Other Institutions 63 (35) 38 (17) 32 (24) 45 (27) 178 (103) School Medical Inspectors 2 2 2 4 (1) 10 (1) Other Medical Sources 8 4 2 3 17 *Including 17 communications from Medical Officers of Health of other districts notifying the removal of consumptive persons into Paddington. †The numbers of certificates received which related to cases previously reported are shown in parentheses. The figures are to be read : "89 certificates relating to new cases and 10 to old." 30 TUBERCULOSIS. Of the new cases reported during the year one form of the disease was certified in 518 nstances, and two forms in 27. The following statement shows the parts of the body affected:— Tuberculosis: Notifications. 1914. Patients certified for the first time with the disease in one part of the body only—518. Part affected. Head and Neck 10 Respiratory System 380 Meninges 9 Lung 376 Eye 1 Larynx 3 Digestive System 11 Pleura 1 Bowels 7 . . Urinary System 4 Peritoneum 4 Kidney 4 Organs of Generation 1 Testicle 1 Cutaneous System 1 Lymphatic System 78 Osseous System 29 Head and Neck 65 Head and Neck 2 Axilla 1 Thorax 1 Mesentery 4 Spine 10 Groin 1 Arm, Hand 3 Not specified 7 Leg, Foot13 "Generalised" Tuberculosis 4 Patients certified for the first time with the disease in two parts of the body—27. Parts affected. Larynx. Pleura. Bowels. Kidney. Peritoneum. Cutaneous System. Cervical Glands. Axillary Glands Inguinal Glands. Lymphatics (general). Totals. Abdomen. Upper Extremities. Lower Extremities. General. Lungs 5 2 1 1 - - — — — 10 — — 1 20 Bowels - — - - - 1 — — — — — 1 — 2 Spine - - - - - - — — 1 — — — — 1 Cutaneous system— Head and Neck - — - - - - — 1 — — — — — 1 Thorax - — - - - 1 1 — — — — — — 2 Cervical Lymphatic Glands - - - - - - - - - - 1 - - 1 In 11 instances of "repeat" notifications additional manifestations of the disease were reported, as shown in the following analysis:— Tuberculosis: Notifications. 1914. Secondary Certificates. Secondary Sites. Lungs. Larynx. Pleura. Peritoneum. Osseous System. Leg. Cervical Glands. "Generalised" Tuberculosis. Primary Site. Lungs — 1 1 1 — — 3 — Lungs and Mesenteric Glands — — — — — — 1 — Lungs and Hip — — — — 1 1 — — Cervical Glands 1 - - - - - - 1 31 TUBERCULOSIS. The sex-age distribution of the 545 new cases of tuberculosis (all forms) reported during the year is shown in the top section of Table 24. The lower portion of this table relates to patients reported as "suspect" by the staff of the Paddington Tuberculosis Dispensary. Table 25 gives the occupations of the new patients, together with the occupations of all persons dying from tuberculosis during the year. TABLE 24. Tuberculosis. Sex-Age Distribution of New Cases Reported and Deaths. 1914. Ages (years). All Ages. 0— 1— 5— 10— 15— 25— 35— 45— 55— 65— 75— Males. Females. Persons. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Medically Certified Cases. Cases— Pulmonary 1 - 7 5 29 16 6 10 43 39 47 47 35 35 28 15 13 13 4 3 - - 213 183 396 Other Forms 6 4 15 19 31 13 12 10 5 8 4 4 5 6 2 3 2 — — — - — 82 67 149 Totals 7 4 22 24 60 29 18 20 48 47 51 51 40 41 30 18 15 13 4 3 — — 295 250 545† Deaths— Pulmonary — — 1 1 2 — — 1 10 5 6 2 5 8 4 4 4 4 - 1 - — 32 26 58 Other Forms 1 3 3 2 1 - - - - 1 - 1 2 - — 2 - - - - - — 7 9 16 Other Causes P. - - - - 1 - - - - - 2 - - - 2 2 - 1 - - - - 5 3 8 O.F — - - - - - - - 1 - - - - - - - - - - - - — 1 - 1 Totals 1 3 4 3 4 — — 1 11 6 8 3 7 8 6 8 4 5 — 1 — — 45 38 83 Not Medically Certified Cases. Cases — — 9 9 18 25 14 14 3 14 6 22 1 13 3 4 - 2 — — — — 54 103 157 Deaths— Pulmonary - - - - - - - - - - - - - - - - - - - - - - - - - Other Forms - - - - - - - - - - - - - - - - - - - - - - - - - Other Causes — — — — — — — — — — 1 — — — 1 — — — — - — 2 — 2 Totals — - - - - - - - - - 1 - - - 1 - - - - - - — 2 — 2 + Including 14 cases previously reported as "Suspects." MORTALITY. The total number of deaths during the year from all forms of tuberculosis was 186*, beiner the same as in 1913, but 13 more than in 1912. Deaths from Tuberculosis:—All Forms. Borough. 1902 213 1907 219 ( + 3) 1911 212 (+ 42) 1903 231 (+18) 1908 190 (— 29) 1912 163 (- 49) 1904 218 (-13) 1909 204 (+ 14) 1913 186 ( + 23) 1905 292 (+ 74) 1910 170 (— 34) 1914 186 + ( 0) - 1906 216 (- 76) *Thirty-eight of the deaths were recorded without previous notification. The disease was discovered at post-mortem examinations in 13 instances (2 of the examinations taking place on the Coroner's order). 32 TUBERCULOSIS. The deaths from pulmonary tuberculosis (see below) numbered 151, viz., 144 from "chronic phthisis" and 7 from "acute." Tuberculosis. Deaths of Residents: Borough. Variety. Site. Ages. All Ages. Persons. All ages 0- 5- 10- 15- 20- 25- 30- 35- - 40- 45- 50- 55- 60- 65- 70- 75- 80- 1914. 1913. 1912. Pulmonary: Chronic Phthisis M. 2 1 1 3 8 4 11 7 4 13 6 8 4 ... 1 1 ... 74 144 154 95 F. 1 1 2 4 10 7 11 4 6 8 5 3 5 3 ... ... ... 70 Acute Phthisis M. ... 1 ... ... 1 1 1 ... ... 1 ... ... ... ... ... ... ... 5 7 2 22 F. ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 Acute Miliary M. 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 10 F. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meninges M. 7 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 17 16 17 F. 6 ... ... 1 1 1 ... ... ... ... ... ... ... ... ... ... ... 9 Mesentery M. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 5 F. 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Other Abdominal Organs M. ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 2 2 3 F. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Spine M. ... ... l ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 F. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Joints M. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... - 1 4 F. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Organs M. ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 2 2 2 F. ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... l Generalised M. 5 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 7 10 3 3 F. 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 3 Totals M. 15 4 2 4 9 5 12 8 4 15 6 9 4 ... 1 1 ... 99 F. 11 1 3 5 11 9 11 4 6 10 5 3 5 3 ... ... ... 87 Persons— 1914 26 5 5 9 20 14 23 12 10 25 11 12 9 3 1 1 ... 186 1913 18 7 4 11 8 17 18 19 23 13 13 9 12 6 7 1 ... 186 1911 26 8 2 4 10 8 27 15 18 15 8 8 9 2 3 ... ... 163 The total mortality from all forms of the disease was 1.29, as compared with 1.28 in 1913 and 112 in 1911, and an average of 1.30 for the five years 1909-13. The mortality rates observed in the Wards are shown below. Tuberculosis: All Forms. Mortality per 1,000 persons. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 1.65 1.79 1.21 1.19 1.78 0.42 0.12 0.79 1913 1.85 1.26 1.02 1.25 1.85 0.74 0.48 0.77 1909-13 1.50 1.51 1.18 1.41 1.82 0.36 0.34 0.87 In the following statement the rates for the Borough are compared with those recorded in the circumjacent districts and the county. Tuberculosis: All Forms. Mortality per 1,000 persons. London. Paddington. Kensington. Westminster. St. Marylebone. Hampstead. Willesden. 1914 1.71 1.26 1.54 1.49 1.56 0.79 1.17 1913 1.60 1.29 1.23 1.59 1.53 0.64 0.98 1909-13 1.70 1.33 1.24 1.52 1.49 0.80 1.16 Sex-age and Ward distributions of the deaths from each form of tuberculosis will be found in Table 26. The mortality from pulmonary tuberculosis in the Borough was at the rate of 1.05 per 1,000 persons last year, as compared with 1.07 in 1913 and 0.82 in 1912. The mortality from all other forms of tuberculosis was 0.24 in 1914, 0.21 in 1913 and 0.32 in 1912. The rates for the circumjacent districts will be seen in Table 11. 33 TUBERCULOSIS. TABLE 25. Tuberculosis. Occupations—New Cases and Deaths. 1914. Pulmonary. Other Forms. New Cases. Deaths. New Cases. Deat Occupations. Indoor. M. F. M. F. M. F. M. F. Domestic Duties— Housewives — 61 — 32 — 4 — 1 Do. and other occupation — 4 — — — 1 — — Servants 2 34 1 11 — 9 — 1 Charwomen 6 — 1 — — — — Laundry Workers — 1 — — — — — — Clerks 16 2 9 2 1 — — — Shop Assistants, Keepers 17 2 6 3 — 1 — 1 Dressmakers, Tailors 2 9 2 7 1 1 — Bootmakers ... 4 — 3 — — — — — Skilled Artizans 14 — 8 — 2 — — — Waitresses, Barmen, &c. 3 3 1 — 2 — — — Others 3 3 2 1 — 1 — — Outdoor Building Trades 9 — 5 — 1 — — — Painters 3 — — — — — — — Labourers 1 — — — — — — — Road Traffic 18 — 9 — 4 — 1 — Railwaay 4 1 3 — 1 — — — Postmen — — — Gardeners 1 — — — — — — — Street Merchants 3 — 1 — — — — — Others 1 — — — — — — — Food Trades. Bakers — 1 — — — — — — Butchers, Fishmongers 3 — 2 Dairymen 3 — — — — — — — Others 2 — — — — — — — Miscellaneous. School Life 31 19 3 4 42 23 1 — Unskilled Workers 14 — 8 1 3 — — — Professional 4 6 2 Other 19 4 5 — 1 1 1 — Commercial Traveller, &c. 3 — 1 — — — — — Infants 10 5 2 1 18 21 15 10 No occupation or occupation not stated 23 22 6 9 6 5 2 — 213 183 79 72 82 67 20 15 34 TUBERCULOSIS. The mortality rates for the Wards of the Borough are given below. Tuberculosis : Mortality. Per 1,000 persons of all ages. Queen's Harrow Maida Lancaster Gate, Hyde Park. Road. Vale. Westbourne. Church. West. East. Park. Pulmonary Tuberculosis. 1914 1.46 1.38 0.98 0.98 1.50 0.21 — 0.71 1913 1.42 1.01 0.91 1.17 1.54 0.74 0.36 0.62 1909-13 1.15 1.18 0.92 1.17 1.30 0.34 0.29 0.67 All other Forms. 1914 0.19 0.41 0.23 0.21 0.28 0.21 0.12 0.08 1913 0.43 0.25 0.12 0.08 0.31 — 0.12 0.15 1909-13 0.35 0.33 0.26 0.24 0.52 0.02 0.05 0.20 Standardised mortality rates (i.e., rates corrected for differences in the sex-age composition of the populations) have been calculated for pulmonary tuberculosis and will be found in Tables 12 and 13. In Table 24 the deaths of persons certified for the first time during the year have been distributed on the same lines as the notifications. A distribution according to occupations will be found in Table 25. During the past year 21 persons who had been certified to be definitely tuberculous, and 6 who were suspected to be so, died from causes other than tuberculosis. Particulars of these deaths are set out in the following statement. During the past year 21 persons who had been certified to be definitely tuberculous, and 6 who were suspected to be so, died from causes other than tuberculosis. Particulars of these deaths are set out in the following statement. Sex. Age at Death. Year Notified. Date of Death, 1914. Died at Cause of Death. Notes. Notified as Pulmonary Tuberculosis. M. 34 1914 Nov. 17 Home Acute bronchitis F. 6 1912 April 6 ” Sarcoma of kidney F. 56 1914 Feb. 22 ” Valvulardisease of heart, duration unknown: Pleurisy F. 46 1914 Nov. 14 ” Bronchitis Certified three times as pulmonary tuberculosis M. 5 1914 Nov. 21 ” Empyema M. 54 1912 Jan. 2 ” Chronic bronchitis Certified three times as pulmonary tuberculosis. F. 17 1913 Sept. 11 ” Valvular disease of heart (mitral and aortic) F. 48 1914 April 19 ” Heart complaint F. 50 1911 Dec. 25 ” Cancer of left lung and pleura Certified twice as pulmonary tuberculosis. M. 72 1913 Oct. 20 ” Chronic bronchitis, one year : Hemiplegia, two hours M. 73 1912 Tune 25 ” Asthma and bronchitis F. 41 1912 Mar. 26 Padd.Wkhse. Cerebral haemorrhage : Disease of heart Inquest: Post-mortem. F. 65 1911 Feb. 5 ” Morbus cordis : Bronchitis Admitted Infirmary 1910. M. 58 1908 Jan. 26 Padd. Infy. Carcinoma ventriculi, perforation : General peritonitis Admitted Infirmary 1909, 1910, 1913, 1914 : M. 45 1914 Nov. 26 ” Carcinoma of gall bladder mortem examination. Post-mortem examination. M. 54 1910 July 25 ” Gastric ulcer M. 33 1913 May 20 Chg.Cr. Hosp. Acute septic nephritis M. 49 1914 Oct. 14 Banstead Asl. Carcinoma of pancreas Post-mortem examination. M. 4 1913 May 15 Qn. My. Hosp. Bronchiectasis M. 22 1913 May 11 Wick, N.B. Heart disease 35 tuberculosis. Sex. Age at Death. Year Notified. Date of Death, 1914. Died at Cause of Death. Notes. Notified as Other Forms of Tuberculosis. M. 16 1914 (Meninges) Feb. 20 S. Geo. Hosp. Meningitis (cerebral): Cause unknown Under Observation as "Suspects." F. 11 Since 1911 Dec. 2 Homce. Hosp. Nephritis F. 72 1912 May 12 Home Cerebral hemorrhage F. 5 1913 Nov. 23 Wmn's. Hosp. for Children. Gastritis: Acute bronchitis M. 37 1913 Mar. 19 Home Septic pneumonia, due to carbuncle M. 26 1914 Dec. 6 Univ. Coll. Hosp. Chronic otitis media M. 45 1914 Dec. 14 Padd. Infy. Chronic interstitial nephritis: Pericarditis Post-mortem examination. Since 1904, when the Tuberculosis Register was first established, the names of 4,986 persons who were either certified as definitely tuberculous or reported as suspected to be suffering from the disease, have been entered. At the close of last year the Register contained 1,800 live entries, representing 1,262 "definit" cases and 538 "suspect." The subjoined statement gives the number of cases reported during each of the past twelve years and the number of known "survivors" at the end of 1914. Total Cases reported. Known to have died from all causes during the year Reported "Arrested." Diagnosis Varied. Removed. Restored to Register. On Register at end of 1914, "Survivors. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1903 4 2 2 1904 20 5 1 1 1 1 10 1 1905 18 10 3 1 — 1 — — — 3 1906 57 17 5 7 1 1 1 1 — 1 i 2 16 4 1907 84 14 12 6 — 1 1 3 8 35 4 1908 173 25 11 i 4 E 1 2 13 32 62 4 15 1909 629 65 25 12 £ 2 1 42 39 309 5 131 1910 610 42 34 15 5 4 47 16 280 4 171 1911 671 69 25 18 8 41 33 277 4 204 1912 1,017 76 45 28 88 75 373 8 340 1913 1,015 105 55 53 58 288 5 461 1914 688* 85 18 21 95 469 In addition 14 cases were notified which had previously been reported as " Suspect." Of the 151 deaths recorded last year as due to pulmonary tuberculosis, 75 occurred at the patients' homes (34 of males and 41 of females) and 76 in institutions (45 of males and 31 of females). The proportion of deaths in institutions was equal to 50.3 per cent, of the total deaths, as compared with 49.3 per cent, in 1913 and 53.8 per cent, in 1912. In the following statement the numbers and percentages of deaths in the various classes of institutions are shown for the past five years. Pulmonary Tuberculosis. Numbers of Deaths. Percentages of Total Deaths. 1914. 1913. 1912. 1911. 1910. 1914. 1913. 1912. 1911. 1910. Poor Law Institutions 43 48 46 56 35 28 5 30.7 39.3 34 3 27.5 "Homes of Rest" 7 7 5 6 8 46 4.4 4.3 36 6.2 General Hospitals 3 5 4 6 7 19 3.2 3.4 3.6 5.5 Special Hospitals 2 3 3 5 3 13 1.9 2.5 3.0 2.3 Lunatic Asylums 13 4 5 7 3 86 2.5 4.3 4.2 2.3 Approved Sanatoria 8 9 53 5.7 36 TUBERCULOSIS. TABLE 26. Tuberculosis: Deaths. Ward Distribution. Ward. Year. Ages 0— 1— 5— 15— 25— 65— All Ages. In Institutions. Variety Site. M. F. M. F. M. F. M. F. M. F. | M. F. M. F. M. F. Queen's Park. 1914 Pulmonary ... ... ... ... 1 1 3 3 8 7 ... ... 12 11 7 6 Meningeal ... l ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Abdominal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other 1 ... ... ... ... ... l ... ... ... ... ... 2 ... 1 ... All forms ... l l ... ... 1 1 4 3 8 7 ... ... 14 12 8 6 1913 " ... ... l 1 3 3 1 2 11 5 2 1 19 11 12 1 1912 M • 4 * i ... ... 1 2 1 1 2 4 2 1 1 9 7 4 2 Harrow Road. 1914 Pulmonary ... ... ... 1 ... 2 3 3 14 11 1 1 18 18 9 5 Meningeal ... ... 2 2 ... ... ... 1 ... ... ... ... 2 3 1 1 Abdominal ... I ... ... ... ... ... ... ... ... ... ... ... 1 Oiher ... ...l ... ... 1 ... ... ... 2 1 ... ... 3 2 2 2 All forms ... ... 2 2 3 1 2 3 4 16 12 1 1 23 24 12 8 1913 " ... ... 1 ... ... 1 2 2 4 13 9 2 1 18 17 9 10 1912 " ... 1 ... 1 ... ... 1 4 2 15 9 ... 1 21 13 12 5 Maida Vale. 1914 Pulmonary ... ... ... ... ... ... 4 1 10 5 ... 1 14 7 8 3 Meningeal ... ... 1 ... ... ... ... ... ... 1 ... ... 1 1 1 ... Abdominal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other ... ... 2 ... ... ... ... ... 1 ... ... ... 3 ... 2 ... All forms ... ... 3 ... ... ... 4 1 11 6 ... 1 18 8 11 3 1913 " ... ... ... 1 1 ... ... 1 1 11 3 2 2 15 8 8 3 1912 " ... ... ... 3 1 ... 1 ... 2 9 5 1 ... 13 9 10 5 4 Westbourne. 1914 Pulmonary ... ... 1 ... 2 1 ... 2 10 7 ... ... 7 5 Meningeal ... ... 1 1 1 ... ... ... ... ... ... ... 2 1 ... 1 Abdominal ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... Other ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 1 1 All forms ... ... 3 2 3 1 ... 2 10 7 ... ... 16 12 8 7 1913 " ... ... ... ... l ... l 3 2 10 11 1 1 14 16 8 8 1912 " ... 1 1 ... 3 ... l ... ... 12 8 ... ... 14 13 11 5 Church. 1914 Pulmonary l ... ... ... ... ... 2 4 13 15 1 1 17 20 11 8 Meningeal ... ... 2 1 ... ... ... ... ... ... ... ... 2 1 1 ... Abdominal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other 1 ... 1 ... 1 ... ... ... ... 1 ... ... 3 1 2 ... All forms 2 ... 3 1 1 ... 2 4 13 16 1 1 22 22 14 8 1913 " ... 3 ... 3 I 1 1 1 3 16 16 1 1 25 22 15 12 1912 " ... 2 3 5 2 1 2 2 1 15 15 ... ... 25 23 20 13 Lancaster Gate, West. 1914 Pulmonary ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... 2 ... Meningeal ... 1 1 ... ... ... ... ... ... ... ... ... 1 1 1 ... Abdominal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All forms ... 1 1 ... ... ... ... ... 2 ... ... ... 3 1 3 ... 1913 " ... ... ... ... ... ... ... ... 1 3 3 ... ... 3 4 ... 1 1912 " ... ... ... ... ... ... ... ... ... 2 1 ... ... 2 1 1 ... Lancaster Gate, East. 1914 Pulmonary ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningeal ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 Abdominal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All forms ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 1913 " ... ... ... ... ... ... ... ... ... 3 1 ... ... 3 1 2 1 1912 " ... ... 1 ... ... ... ... ... ... 1 1 ... ... 1 2 ... ... Hyde Park. 1914 Pulmonary ... ... ... ... ... ... ... 1 3 5 ... ... 3 6 1 3 Meningeal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Abdominal ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Other ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All forms ... l ... ... ... ... ... 1 3 5 ... ... 3 7 1 3 1913 " ... ... ... 1 ... ... ... ... ... 4 5 ... ... 5 5 2 ... 1912 " ... ... ... ... ... ... ... ... ... 8 1 1 ... 9 1 5 1 37 TUBERCULOSIS. The proportions of deaths in institutions observed among the residents of the Wards during the past three years are compared below. The figure for Lancaster Gate, West, Ward (100 per cent.) is accounted for by the fact that the two deaths allocated to that Ward both occurred in institutions. Queen's Harrow Maida Lancaster Gate, Hyde Park. Road. Vale. Westbourne. Church. West. East. Park. 1914 56.5 38.8 52.4 52.2 54.0 100 0 — 44.4 1913 47.8 53.5 55.0 50.0 53.8 14.3 66.6 12.5 1912 27.2 46.4 46.6 68.4 67.7 33.3 — 62.7 Treatment of Tuberculosis. Insured Persons.—Last year 113 applications for sanatorium benefit were made to the London Insurance Committee by residents of the Borough, that total including repeat applications from 4 persons who had previously received sanatorium treatment during the year, so that the nett number of patients was 109. The results of the applications were as follow:— Total applications put in 113 by men 77 by women 36 Applicants found ineligible 7 Applications abandoned 6 Applications remaining incomplete 9 by reason of removal from Borough 1 owing to death of applicant 4 carried forward to 1915 4 Applications granted 91 Form of benefit granted— Admission to sanatorium 69 Domiciliary treatment. 7 ,, hospital 15 The institutions to which the patients were sent are set out below:— Hospitals. Sanatoria. Brompton 8† Downs 37 Metropolitan 4‡ Winchmore Hill . 26 City Road 1 Other 6 Victoria Park 1 St. George's Home 1 Four patients died in the institutions to which they had been sent (equal to a fatality of 4.7 per 100 admissions), 53 were discharged after treatment, and 23 were still under treatment at the end of the year. Seventeen patients admitted during 1913 were also discharged from sanatoria, &c., during the past year, making, with the above-mentioned 53, a total of 70 completed cases. The subsequent history of these is hereunder briefly given:— Died 6 Known to the Department, and state of Removed from original address and health reported at the close of the year lost sight of 18 to be Marked off register as "disease arrested" 3 Good 11 Marked off register as "error" 1 Fairly good 13 Reported to have enlisted 1 . Indifferent 11 Admitted to other institutions (Infirmary, &c.) 6 * The 91 applications granted referred to 87 patients, †Three patients subsequently transferred to the Frimley' Sanatorium. ‡Two patients found to be non-tuberculous. 38 CANCER. The report for 1913 contained information as to the health conditions of 45 patients who had been discharged from institutions before the end of that year. The further history of these patients up to the end of the past year, together with the history of three others who could not be traced in 1913, but who were found during 1914, is as follows:—Died, 6; removed and lost sight of, 6; under treatment in institutions, 4; enlisted, 1; disease arrested, 1; state of health of remaining 30 reported as, good in 13 instances, fairly good in 4 instances, and indifferent in 13 instances. Uninsured Persons.—Thirteen patients (8 children and 5 adults) were recommended for institutional treatment under the London County Council's Scheme, A of whom were admitted to sanatoria and 8 were awaiting vacancies at the end of the year. The remaining case was not proceeded with as the parents of the child declined the treatment. Dispensary Treatment.—On July 28th the Council, after consideration of the Tuberculosis Scheme submitted to them by the Public Health Committee, resolved to enter into agreements with the Paddington Tuberculosis Dispensary and St. Mary's Hospital for the diagnosis and treatment of patients living in the Borough. At the close of the year negotiations were still proceeding. The work of the Paddington Tuberculosis Dispensary was carried on as in the past. The medical officer reports that during the year 900 patients made 7,231 attendances. New patients numbered 651, and included 126 (males 56, females 70) who were found to be definitely suffering with pulmonary tuberculosis, and 181 who were suspected to have the disease. In addition, there were 55 patients with other forms of tuberculosis, making the total of 181 "definit" cases (males 85, females 96), 84 (or 51.9 per cent.) being under the age of 15 years. The School for Tuberculous Children which the Dispensary maintained at Poplar Square was closed at the end of the year, most of the children being transferred to the Open Air School at Kensal House. CANCER. The deaths included under this heading numbered 211 last year, or 26 more than the maximum previously attained. The figures for the preceding five years were:—185 in 1913, 175 in 1912, 167 in 1911, 165 in 1910, and 156 in 1909. The mortality recorded during the past year was at the rate of 1'48 per 1,000 persons, as compared with a rate of 128 in 1913, and an average of 1.19 for the five years 1909-13. The mortality rates for the Wards are set out below. It will be noted that the rates were above the averages in all Wards except Lancaster Gate, East, and Hyde Park, the Ward showing the greatest excess (0.51) being Harrow Road. Cancer: Mortality. Corrected. Borough. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster West. Gate, East. Hyde Park. 1914 1.52 1.82 1.62 1.75 1.38 1.28 0.62 0.87 1913 1.11 1.20 1.70 1.69 1.19 0.63 0.85 078 1909-13 1.03 1-31 1.50 1.27 1.09 1.00 .-82 0.92 Table 11 shows that the rate recorded in Kensington last year (1.48) equalled that for the Borough, but that the rates were lower in the remaining circumjacent districts, the lowest being that for Willesden (0.92). Standardised mortality rates are given in Tables 12 and 13. As stated in the previous report, the rates calculated by the Department (Table 13) permit a continuous comparison to be made between the rates of the circumjacent districts and those of the Wards of the Borough. It will be seen that among the districts the highest rate is that for the Borough (1.27), and among the Wards that for Harrow Road (1.62). 39 CANCER. TABLE 27. Cancer : Malignant Disease. 1914. Borough. Site of Disease. Carcinoma. Cancer. Epithelioma. Scirrhus. Sarcoma. Malignant Disease. Other Forms. All, Forms. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. I. Nervous System. 1 (a) Brain — — 1 — — — — — — — 1 — — — 2 — II. Organs of Special Sense. III. Respiratory System. (a) Larynx 3 — — — 1 — — — — — — — — — 4 — (b) Lungs — 1 — — — — — — — — — — — — — 1 IV. Circulatory System ... V. Digestive System. (a) Mou:h. (i.) Tongue 2 — 1 — — — — — — — — — — 3 — (ii.) Glands, &c. 2 — 1 3 2 — — T — — — — — 7 2 (b) Throat. (i.) Pharynx 1 — — — — — — — — — — — 1 — (ii.) Oesophagus 6 — 1 — — — — — — 1 — — — 8 — (c) Intestines. (i.) Stomach 11 11 1 1 — — — — — — 1 2 — — 13 14 (ii.) Intestine 4 10 1 2 1 — — 7 11 (iii.) Rectum 3 10 — 2 — — — — — — 1 — — — 4 12 (d) Organs. (i.) Liver ... 6 6 2 5 — — — — — — — 1 — — 8 12 (ii.) Pancreas 3 1 — — — — — 1 — — — — — — 3 2 VI. Lymphatic System. (a) Head and Neck. (i.) Thyroid Gland 1 — — — — — — — — — — 2 — — 1 2 (ii.) Cervical Glands — — — — — — — — 1 — — — — — 1 — (b) Thorax. (i.) Mediastinal Glands — — 1 — 1 — 2 VII. Urinary System. (a) Kidney — 1 — — — — — — — 2 4 — — — 4 3 (b) Bladder 1 1 — — — — — — — — — — — 1 1 (c) Prostate 2 — — — — — — — — — — — — — 2 — VIII. Generative System. (a) Ovary — 3 — — — — — — — — 2 — — 5 (b) Uterus — 18 6 — 1 — — — 1 — 26 (c) External Genitals — — 1 2 — — 1 2 (d) Breast — 19 — 7 V— — — 5 — — — 1 — — — 32 IX. Osseous System. (a) Head and Neck 1 1 1 1 — — __ 2 i — 5 2 (d) Extremities — — — — — — — — — — — — — — — — (ii.) Lower — — — — — — — — — 1 — — — — — 1 X. Cutaneous System — — — — — — — — — — — — — — — — (a) Head and Neck 1 1 1 i(*) — 2 2 (d) Extremities — 1 — — 1 (ii.) Lower — — — — — — — — — — — — — — — — XI. Insufficiently described — — — — — — — — — — — — — — 1 — Totals 47 82 9 22 5 6 — 6 6 5 10 10 3 — 80 131 Ages at Death. 0— _ _ _ _ _ _ _ _ _ 1 _ _ _ _ _ 1 10— _ _ _ _ _ _ 1 _ _ 1 _ 15— _ — _ — — — 20_ ____ 1 _ 1 25— _ 2 1 _ _ _ 1 1 1 3 35— 2 7 1 2 2 _ — 4 10 45— 16 20 4 5 1 1 1 1 — — — _ — 22 27 55— 15 21 4 10 3 1 2 1 2 2 3 1 — 26 39 65— 7 18 1 4 1 1 3 1 5 4 _ — 16 29 75— 7 14 — 2 | 1 2 1 — 2 — 0_ 1 1 1 — 10 21 (*) Rodent ulcer of nose. 40 OTHER DISEASES. A distribution of the last year's deaths, distinguishing the variety of new growth, the parts affected, and the ages of the deceased, is given in Table 27. Institutional Treatment.—Of the 211 deaths recorded last year 88 occurred in institutions of various descriptions, equal to 41.7 per cent, of the total. The deaths in Poor Law institutions numbered 43, in hospitals 31 (including 11 in Middlesex Hospital), the remainder in lunatic asylums, nursing homes, &c. Cancer. Institutional Treatment. Borough. Per cent, recorded Deaths. Males. Females. Persons. 1914 40.6 3.88 4.17 1913 58.4 35.8 43.8 1909.13 47.5 34.8 39.9 OTHER DISEASES. Epidemic Influenza.—Twenty-nine deaths were attributed to this cause during the past year, as compared with 33 in 1913 and 23 in 1912. The mortality rate last year was 0.20 per 1,000 (Table 28), or 0'06 below the average for the five years 1909-13. There were no deaths in Hyde Park Ward. TABLE 28. Other Diseases. Disease. Year. Borough. Queen's Park. Harrow Koad. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. Epidemic Influenza 1914 020 019 0-15 037 0 26 020 011 0 24 1913 0.23 0.24 0.11 0.31 0.41 0.08 0.21 0.12 0.31 1909-13 0.26 0.20 0.27 0.28 0.26 0.21 0.22 0.27 0.34 Respiratory Diseases 1914 1.85 2.15 1.93 1.21 1.71 3.16 0.85 0.87 1.43 1913 2.31 2.91 2.76 1.79 1.88 4.00 0.51 1.34 1.00 1909-13 2.25 2.55 2.63 1.82 2.18 3.58 0.90 1.03 1.45 Alcoholism 1914 0.06 0.06 0.04 0.05 0.08 _ _ _ 0.32 1913 009 003 014 004 0'16 031 1909-13 0.07 0.02 0.06 0.12 0.05 O.1l 0.07 0.12 0.09 Cirrhosis of the Liver 1914 0.14 0.12 0.04 0.28 0.34 0.08 0.11 _ _ 1913 0.13 _ 0.03 0.23 0.08 0.20 _ 0.31 1909-13 0.10 0.10 0.08 0.12 0.10 0.11 0.07 0.05 0.08 Suicides 1914 0.16 _ 0.12 0.23 0.13 0.24 0.21 0.49 0.08 1913 0.14 — 0.03 0.14 0.08 0.27 0.41 — 0.07 1909-13 0.11 0.11 0.05 0.09 0.08 0.13 0.24 0.10 0.15 Respiratory Diseases.—The deaths from bronchitis and the pneumonias numbered 263, 74 less than in 1913. In 1912 the number was 324. The mortality from these causes was 1'85 per 1,000 last year, as compared with an average of 2'25. Alcoholism.—Nine deaths (3 of males and 6 of females) were certified to have been due to alcoholism (acute or chronic) last year, as compared with 13 (males 7, females 6) in 1913 and 9 (males 3, females 6) in 1912. The mortality was 0 06 last year, or 0.01 below the average for the preceding five years, As in 1913, the highest mortality (0.32) was recorded in Hyde Park Ward, while in three Wards no death was attributed to this cause. INQUESTS. 41 Cirrhosis of the Liver.—Twenty deaths (10 of each sex) were certified to have been due to the various forms of cirrhosis, as compared with 19 (males 9, females 10) in 1913 and a like number (males 8, females 11) in 1912. The mortality was at the rate of 0.14 per 1,000, or 0.01 in excess of the average. The principal form of cirrhosis of the liver is that due to alcohol, to which form 17 deaths were ascribed last year, 9 of males and 8 of females. In 1913 there were 15 deaths (males 5, females 10), and in 1912, 16 (males 8, females 8). Suicides.—There were 24 deaths from suicide during the year (18 of males and 6 of females), giving a mortality rate of 0.16 per 1,000, or 0.05 in excess of the average. The highest rate (0.49) was observed in Lancaster Gate, East, Ward. INQUESTS. Two hundred and fifty (250) inquests were held locally during the past year, as compared with 244 in 1913 and 215 in 1912. Among the 250 deaths inquired into there were 64 of non-residents. Outside the Borough 26 deaths of residents formed the subjects of inquests, 14 within the Metropolis and 12 in other parts of England and Wales. The corrected total of inquests on deaths of residents was 212 (120 on males and 92 on females), as compared with 194 (males 122, females 72) in 1913, and 152 (males 86, females 66) in 1912. The 212 deaths were equal to 112 per cent, of all deaths of residents. In 1913 the percentage was 9.8, and in 1912, 86. An analysis of the "findings of the juries" will be found in Table 29. The principal increases recorded were under the headings "Accident" and "Suicide" in the case of males, and under " Accident " in the case of females. A summary of the principal forms of violence, &c., brought to light by the inquiries is appended. Traffic accidents (not found by the juries as due to "accidental causes" in every case) caused 20 deaths, motor traffic (of all forms; accounting for 12, horse traffic 2, tramways and railways 1 each, and falls from vehicles 4. Three deaths were ascribed to suffocation of infants in bed with the parents. Deaths through Misadventure (12). 2 of the deaths entered as due to diseases ; 10 due to violence (poisoning, drug, &c., 4 ; coal gas, 2 ; ptomaine, 2 ; surgical narcosis, 1; fall from horse 1). Accidental Deaths (70). Accidents, contributory only, 13 (deaths entered to primary diseases). Want of attention and care at birth, 3. Deaths due solely to accident, 54. Agencies:— Traffic, 20 (15 males, 5 females); overlaid in bed (infants), 3; asphyxia (through defective geyser), 1; falls, 20 (12 males, 8 females); burns and scalds, 6 (2 males, 4 females); firearms, 1 (male); occupational poisoning, 1 (male); suffocation, 2 (males). "Open " (14) (2 of infants). Deaths entered as due to diseases, 5. Drowning, 5 ; fall, 1. Various forms of injury, 3. Murder (2). Infants (one newly-born). Suicide (24). By poison, 5 (veronal, cyanide of potassium, salts of lemon, chlorcdyne, and coal-gas 1 each). By firearms, 6; by hanging, 6; by cut throat, 3; by jumping from window, drowning, railway train and van, 1 each. Neglect (12). With the exception of the death of an infant by choking, all deaths were entered to diseases. Alcohol was returned as the primary cause in 6 instances. G 42 DEATHS IN INSTITUTIONS. TABLE 29. Inquests. Findings of the Juries. 1914. 1913. 1909-13. m. f. M. f. M. f. Natural Causes 41 37 59 50 42 31 Misadventure 7 5 5 7 6 5 Accidents 41 29 34 16 27 19 Murder 1 1 _ 4 0 1 Suicide 18 6 13 7 10 6 "Neglect" 5 7 5 6 2 3 "Open" 7 7 6 2 4 2 Totals 120 92 122 72 9V 67 * Including 2 deaths by execution in 1909. DEATHS IN INSTITUTIONS. The deaths taking place in the local institutions decreased from 890 in 1913 to 791* last year. In 1912 the number of such deaths was 798. During the five years 1909-13 the average annual number was 833. (See Table VII., Appendix.) Particulars of the causes of death in the different institutions will be found in Table VIII. Appendix. The total of 791 deaths included 326 of non-residents of the Borough. In outlying institutions there were 265 deaths of residents of the Borough, an increase of 63 above the annual average for the five years 1909-13. The total number of residents dying in institutions of all classes (except private nursing homes) was 759 last year, as compared with 789 in 1913 and 677 in 1912, and an annual average of 678 for the five years 1909-13. Last year's total was equivalent to 40.0 per cent, of the total number of deaths recorded, the corresponding figure for 1913 having been 399, and the average for the years 1909-13, 35.9.† The proportions of institutional deaths belonging to the various Wards are shown below, as also are the percentages of deaths in the different classes of institutions. Percentages of Deaths in Institutions of all Classes. Queen's Harrow Maida West- Lancaster Gate, Hyde Park. Road. Vale, bourne. Church. West. East. Park. 1914 42 4 36 .0 36. 8 37.9 52.5 22.4 22.2 34.5 1913 44.5 35.6 36.1 38.5 50.9 23.6 27.1 30.4 1909-13 39.6 32.9 31.9 35.2 47.7 22.3 20.7 30.2 Percentages of Deaths in Institutions of Different Classes. Rate-supported Institutions. Voluntary Institutions Poor Metropolitan Lunatic (excluding Nursing Law. Asylums Board. Asylums. Homes). 1914 223 20 39 116 1913 22.2 2.8 2.8 12.0 1909.13 20.7 1.7 2.7 1.11 *There were in addition 34 deaths in the nursing homes in the Borough last year, as compared with 47 in 1918. †The deaths of males in institutions numbered 387, or 419 per cent, of all deaths of males, and of females, 372, equal to 38.2 per cent, of all deaths of females. In 1913 the percentages were —for males 44.8, and for females 35.3. MORTALITY IN CHILDHOOD. 43 MORTALITY IN CHILDHOOD. By "childhood" is here meant the age-group 0-5 years. The mortality rates observed among males and during the past year are compared with those for 1913 and the averages for 1909-13 in Table 10 (page 11). The rate among males was 36.87 per 1,000 estimated living during 1914, as compared with 42.33 in 1913, and an average of 43.03 for the five years 1909-13. Among females the mortality was at the rate of 28.55 last year, as compared with a rate of 37 02 in 1913, and an average of 35 01. Mortality at Ages under One Year. Infantile Mortality. Owing to the changes which have been introduced within recent years in the methods of correcting the returns of births and deaths, it is necessary, with a view to the preservation of the continuity of the records, to submit three rates of infantile mortality, viz.:— Crude rates, based on the numbers of births and deaths registered locally without any corrections for births or deaths of non-residents within the Borough, or for the like belonging to the Borough but occurring in outlying areas ; Netl rates, derived from the births corrected by the exclusion of children born to nonresident parents, and the deaths corrected by the exclusion of those of non-residents, and the inclusion of those of residents of the Borough taking place in outlying metropolitan districts; and Corrected rates, calculated from births and deaths completely corrected for transfers (births and deaths) both outwards and inwards. Last year 293 deaths at ages under one year were registered within the Borough, including 48 of non-resident children. In 1913 the corresponding numbers were 342 and 66 respectively. The crude rate of infantile mortality was 115 per 1,000 births for the whole year, ranging from a minimum of 71 in the second quarter to a maximum of 133 in the third. Infantile Mortality Rates. Crude. Quarters 1. 2. 3. 4. Year. 1914 111 71 133 121 115 1913 155 83 107 140 120 1909-13 133 100 122 141 124 The nett mortality per 1,000 births for the whole year was 106, or 3 per 1,000 less than the rate recorded in 1913. (See below.) Infantile Mortality Rates. Nett. Quarters 1. 2. 3. 4. Year. 1914 103 64 130 134 106 1913 130 67 109 128 109 1909-13 120 93 114 128 114 The corrected rate for the year was 96 per 1,000 births, as compared with 101 in 1913, and an average of 106. (Table 30.) The rates for both sexes were below those observed in 1913 and in the five years 1909-13. The actual number of deaths at ages under one year will be found in Table II., Appendix, and the causes of death (at each month of life, distinguishing the sexes) in Table X. The rate of mortality for the whole county, deduced from data given in the Quarterly Reports of the Registrar-General, was 102 per 1,000 births last year, or 2 per 1,000 less than the rate recorded in 1913, and 4 per 1,000 less than the average. The corresponding rates for the districts circumjacent to the Borough are given on the next page. 44 MORTALITY IN CHILDHOOD. Infantile Mortality Per 1,000 births. Deduced from the Quarterly Reports of the Registrar-General. London. Paddington. Kensington. Westminster. St. Marylebone. Hampstead. Willesden. 1914 102 103 100 92 98 84 86 1913 104 107 188 106 90 77 83 1909-13 106 112 132 101 98 72 94 Fully Corrected.* 1914 104 95 94 80 98 80 ? TABLE 30. Infantile Mortality Rates. Per 1,000 births. (Fully corrected.) Males. Females. Persons. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Borough 107 115 117 83 86 94 96 101 106 Queen's Park 88 108 104 86 117 93 87 113 99 Harrow Road 77 77 101 57 58 73 67 67 87 Maida Vale 110 85 105 84 65 77 97 76 91 Westbourne 115 136 124 67 111 107 93 146 120 Church 162 164 157 128 105 122 146 137 140 Lancaster Gate, West 107 100 89 68 — 55 83 48 71 East — 154 59 — 32 73 _ 88 62 Hyde Park 65 67 84 82 106 99 72 88 91 The highest rate recorded in any metropolitan area was that of Shoreditch (141 per 1,000), and the lowest that of Chelsea (67 per 1,000). No deaths of infants under one year of age occurred in Lancaster Gate, East, Ward during the past year; the mortality (persons) observed in the remaining Wards of the Borough ranged from 72 in Hyde Park to 146 in Church. An examination of the following mortality rates shows that the only age-groups with rates above the averages were those of males aged 3-6 months and females 9-12 months. Among the rates for groups of diseases, those from "Diarrhoeal Diseases" (both sexes), "Tuberculous Diseases" (females), and "All other Causes" (both sexes) were in excess of the averages. Corrected Mortality Rates. Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Under 1 month 38-58 33.11 41.39 27.97 29.74 29.27 Aged 1-3 months 19 96 27.92 2299 18.88 16.22 20.42 Under three months 5854 61.03 64.38 46.85 45.97 4.-69 Aged 3-6 " ... 23 95 19.48 20.36 16.78 20.96 18.38 „ 6.9 „ ... 931 19.48 19.05 8.39 9.46 12.25 „ 9.12 „ ... 15 95 14.93 13.80 11.19 10.14 14.29 Corrected Mortality Rates. [##] Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13.[/##] I. " Common Infectious Diseases 731 6-49 919 ... 3.48 10.14 8.84 II. " Diarrhoeal Diseases " .. 22-62 25-97 21-02 ... 26.57 15.55 21.10 III. " Tuberculous Diseases " .. 199 1-94 3-28 ... 3.48 2.02 2.72 IV. " Developmental Diseases " .. 35-92 33-11 45-34 ... 25.87 35.15 34.04 V. " Other Causes " . 27 94 38-96 29-57 ... 14.68 19.60 22.46 All other Causes . 11-97 8-44 9-19 ... 8.39 4.05 5.44 * From Table XXII. appended to Report for Fourth Quarter, 1914. 45 mortality in childhood. TABLE 31. Hopeless Births. Days. Weeks. Months. Totals. 0— 1— 2— 3— 4— 5— 6— 1- 2- 3— 1—2 1914. 1913. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Premature Birth 9 2 2 1 - 1 - 2 - - - - - - 1 2 3 - 2 - - - 17 8 19 20 Congenital Defects 1 — — — — — 2 — — 1 — — 1 — — 2 — — — — — — 4 3 1 3 Atelectasis 3 — — — - — 1 — — — — — — — — — — 1 — 1 — — 4 2 5 4 Injury at Birth — — — — - — — - — - — — 1 — — — — — - — — — 1 - — — Debility at Birth — 1 — — - — — — 1 — — 1 — — — — 3 — 1 - — — 5 2 4 3 Atrophy, Debility - - - - - - - - - - - - - - - - - - - - - - - - - - 13 3 2 1 - 1 3 2 1 1 - 1 2 - 1 4 6 1 3 1 - - 31 15 29 30 Diarrhœal Diseases — — — — - — — — — — — — — — — — — 1 — 1 1 1 1 3 2 1 Respiratory Diseases - - - - - - - - - - - - - - - - 3 - 1 1 1 1 7 2 3 3 Convulsions - - - - - - - - - - - - - 1 - - - - - - - - - 1 5 2 Other Causes 1 1 — — 1 — — — — — — — — - 1 2 — — 1 2 1 — 5 5 5 — Totals 1914 14 4 2 1 1 1 3 2 1 1 - 1 2 1 4 6 9 2 5 5 3 2 44 26 1913 16 12 3 3 1 1 1 1 1 1 1 1 — 2 6 3 4 7 3 - 8 5 44 36 46 MORTALITY IN CHILDHOOD. Hopeless Births.—This term has been introduced to designate births which are registered at the same time as, or subsequently to, the deaths of the children. Last year 70 such instances were noted in the local returns, as compared with 80 in 1913 and 88 in 1912. Last year's total included two deaths (one of each sex) of non-resident children. An analysis of the causes of death in the instances recorded last year will be found in Table 31, together with the totals for 1913. Seven of the deaths occurred in institutions, viz., 2 each at the Infirmary and Lock Hospital, and 1 each at the Workhouse, St. Mary's Hospital, and the Children's Hospital. Out of the 70 children, 8 were illegitimate, and 10 were the products of twin births, including 5 complete twins. Inquests were held with reference to 10 of the deaths. The 7 deaths from "Congenital Defects" comprised 3 from congenital malformation of the heart, and 1 each of the spine, brain, digestive and urinary organs. The deaths during the first twenty-four hours of life were distributed as here set out. Deaths during First Day of Life.—1914. Interval after Birth. (Hours.) Under 1. 0-12. 12-24. Males 1 7 7 Females 1 2 2 Premature Birth.—The deaths attributed to this cause numbered 44 (25 of males and 19 of females), as compared with 62 in 1913 and an average (1909-13) of 56 (32 males and 24 females). Included in the total for last year were the deaths of three pairs of twins. The proportion of deaths of illegitimate children was 22 per cent., as compared with 13 per cent. in 1913. Fifteen of the deaths took place in institutions, including 8 in the Paddington Infirmary and Workhouse and 7 in lying-in hospitals. In eighteen instances the duration of pregnancy was stated, being 6-7 months in 7, 7-8 months in 7, and 8-9 months in 4. Diarrhœa.—The deaths from the "Diarrhœal Diseases" at all ages numbered 83 last year, as compared with 82 in 1913 and 54 in 1912, the mortality being at the rate of 0.58 per 1,000 persons in 1914, 0.56 in 1913, and 0.38 in 1912. The average for the five years 1909-13 was 0.52 per 1,000. The mortality rates in the Wards (see below) ranged from zero in Lancaster Gate, East, to 1.46 in Church. "Diarrhœa." Mortality at all Ages. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate. Hyde Park. West. East. 1914 0.76 0.33 0.46 0.59 1.46 0.11 — 0.08 1913 0.43 0.51 0.41 0.80 1.19 — — 0.15 1909-13 0.44 0.45 0.41 0.69 1.05 0.11 0.12 0.18 Last year's deaths comprised 78 at ages under two years (38 of males and 40 of females) and 5 at higher ages, viz., 2 (one of each sex) at ages 2-5 years, 1 (male) between 5 and 15 years, 1 (male) between 45 and 65 years, and 1 (female) over 65 years. In the following paragraphs the deaths at ages under two years only will be discussed. In accordance with the practice adopted by the Registrar-General the rates of mortality for deaths at ages under two years have been calculated by the use of the corrected number of births. The 78 deaths recorded in the Borough last year were equivalent to a mortality of 2659 per 1,000 births, the corresponding rate for 1913 having been 24.18. On page 48 will be found the rates obtained from the numbers of deaths given in the Quarterly Reports of the Registrar-General. 47 MORTALITY IN CHILDHOOD. TABLE 32. Diarrhœa. Distribution of Known Attacks and Deaths. Week ending Dates of Onset. Dates of Death. 1914. All Cases. 1914. All Deaths. Recovering. Dying. * Deaths. 1914. 1913. 1912. Cases Dying. Deaths. 1914. 1913. 1912. June 6 1 - - 1 6 1 - - - - - 13 — — — — 5 6 — — — 1 1 20 — — — - 5 6 — — — 1 — 27 2 — — 2 12 5 — — — — 2 July 4 2 — — 2 9 3 — — — — 1 11 5 — 3 8 6 6 — 1 1 2 2 18 3 — — 3 11 4 — — — 1 — 25 6 — — 6 13 10 — 3 3 — — August 1 2 3 — 5 8 14 — — - 1 7 8 5 4 1 10 16 13 — — — 2 3 15 11 1 1 13 18 4 — — - 1 3 22 14 1 1 16 18 3 2 2 4 1 1 29 16 1 2 19 21 4 1 3 4 5 1 September 5 25 5 3 33 9 5 4 1 5 4 4 12 12 2 7 21 14 3 6 4 10 1 — 19 5 3 - 8 12 5 3 7 10 6 3 26 4 1 - 5 14 5 2 1 3 4 1 October 3 4 - - 4 5 9 2 - 2 2 - 10 2 - - 2 10 6 4 — 4 5 1 17 - - - - 8 4 1 1 2 3 1 24 5 - - 5 9 4 1 — 1 3 2 31 2 - - 2 7 4 - - - 3 1 November 7 3 - - 3 4 3 2 1 3 4 2 14 4 1 - 5 4 2 1 1 2 2 2 21 2 1 — 3 6 1 - - - 1 1 Before June 1 5 — - 5 2 - - — - - - After November 21 — 1 — 1 — - 2 — 2 1 - No date recorded 9 8 7 24 22 24 — — — — - Totals 1914 149 32† 25 206 31 25‡ 56 1913 209 31† 34 274 23 31 54 1912 115 14 25 154 14 25 39 § * By "Dying" is meant "fatal cases known during life," and by "Deaths" those "known on registration of death only." † (1914) Including 1 death from a cause other than diarrhœa. (1913) Including 8 deaths from causes other than diarrhœa. Hence differences in the corresponding column of second half of the table. ‡ Excluding 7 deaths from diarrhoea in institutions, the disease not having been contracted in the Borough. § „ 5 „ „ „ „ „ „ „ 48 MORTALITY IN CHILDHOOD. "Diarrhœal Diseases." Mortality at ages under 2 years. Rates per 1,000 births. London. Paddington. Kensington. Westminster. St. Marylebone. Hampstead. Willesden 1914 27.64 26.64 19.62 16.24 27.67 8.64 19.44 1913 27.50 23.21 23.82 23.34 16.58 13.57 12.38 1909-13 22.44 22.70 22.11 16.88 16.62 6.76 17.88 The quarterly distribution of the deaths at ages under 2 years recorded last year was— 1st quarter, 6 deaths (male 1, females 5); 2nd quarter, 3 (males 2, female 1); 3rd quarter, 44 (22 of each sex); 4th quarter, 25 (males 13, females 12). In the subjoined statement the numbers of deaths allocated to the different Wards during the past year are shown in comparison with the corresponding numbers for 1913 and the averages for the preceding five years. "Diarrhœal Diseases." Deaths recorded at ages under 2 years. Borough. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. 1914 78 10 9 10 14 34 — — 1 1913 73 7 12 8 16 29 — — 1 1909-13 72 6 11 8 15 28 1 1 2 Since 1911 the deaths from the diarrhœal diseases have been entered under the headings of "diarrhœa" and "enteritis." Last year 28.2 per cent. of the deaths recorded came under the former heading and 71.8 per cent. under the latter. In 1913 the proportions were 15.6 and 84.3 per cent. respectively, and in 1912, 54.5 and 45.4 per cent. The proportion of deaths occurring in institutions was 60.3 per cent. last year, as compared with 53.1 per cent. in 1913 and 68.1 per cent. in 1912. The "Diarrhœa Register" was opened on June 1st and closed on November 21st. The co-operation of the local hospitals and Poor Law Medical Officers was accorded as in previous years, and the School for Mothers made arrangements to supply the special preparations of milk which have been useful on former occasions. The attacks in children under 2 years of age made known to the Department last year through inquiries at the hospitals and the reports received from the Poor Law Medical Officers numbered 167. In addition, 83 cases in persons over that age were discovered. An examination of the records kept at the Infirmary showed that 8 other cases in children had been treated there during the time the "Diarrhœa Register" was open, making a total of 175 cases in children aged 0-2 years. Among the 175 cases there were 32 deaths, while 25 deaths (at ages 0-2 years) took place without the Department being aware of the patients' illness. The dates of onset of all cases and deaths are shown week by week in Table 32. The fatality among cases known during life was 17.7 per cent. last year, as compared with 12.9 per cent. in 1913 and 10.8 per cent. in 1912. As in previous years, fly counts were obtained at selected spots in the Borough. The average weekly numbers of flies per "cemetery" are given in Table 33, together with certain meteorological records. The weekly variations in the temperature, rainfall, numbers of flies, and cases of diarrhœa and deaths during 1914 and 1913 are compared in the diagrams facing page 50. 49 MORTALITY IN CHILDHOOD. TABLE 33. Week of Inquiry. Cases. Deaths. Flies. Average per "Cemetery." Earth Temperature. Weekly Mean at 3 ft. Air Temperature. Weekly Mean. Total Rainfall. Inches. 1914. 1913. 1912. 1914. 1913. 1912. 1914 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. ° ° ° ° ° ° 1 1 6 1 — — — - 7 6 54.34 57.18 56.17 55.4 50.0 54.2 0.26 0.12 0.99 2 — 5 6 — 1 1 4 10 11 54.70 57.08 56.73 55.7 56.9 58.1 0.65 0.14 0.39 3 — 5 6 — 1 — 10 15 15 56.78 58.47 58.11 62.2 62.3 61.7 0.34 0.41 0.65 4 2 12 5 — — 2 17 22 20 58.60 59.29 59.95 60.6 48.7 60.2 0.34 0.06 0.30 5 2 9 3 — — 1 27 24 18 60.65 59.82 59.73 67.7 59.9 58.7 0.09 0.21 0.36 6 8 6 6 1 2 1 24 33 30 61.45 59.40 60.75 62.3 57.2 67.0 0.64 1.33 0.20 7 3 11 4 — 1 — 33 38 36 62.65 59.61 63.65 65.8 60.0 65.8 0.33 0.52 0.04 8 6 13 10 3 — — 36 41 34 63.24 59.45 63.22 62.5 57.7 64.8 0.31 0.05 0.16 9 5 8 14 — 1 7 47 54 44 61.80 59.73 63.09 59.8 59.5 57.8 0.13 0.00 0.54 10 10 16 13 — 2 3 37 49 34 61.78 60.24 61.57 59.5 57.1 57.6 0.88 0.09 1.26 11 13 18 4 — 1 3 62 48 36 61.80 60.10 60.48 64.0 60.7 56.2 0.02 0.14 0.23 12 16 18 3 4 1 1 64 47 44 62.19 60.58 60.22 62.1 60.9 57.2 0.01 0.36 1.27 13 19 21 4 4 5 1 55 44 44 62.48 60.62 59.74 64.4 62.8 56.9 0.17 0.51 1.33 14 33 9 5 5 4 1 65 37 24 62.48 60.63 59.08 63.4 59.1 54.8 0.00 1.43 0.21 15 21 14 3 10 1 — 85 57 9 62.40 59.96 58.01 62.4 58.0 52.4 0.47 0.06 0.02 16 8 12 5 10 6 3 61 66 12 61.14 59.03 57.38 57.1 54.9 53.6 0.14 0.60 0.00 17 5 14 5 3 4 1 38 75 10 58.87 58.46 56.20 52.5 60.2 51.5 0.12 0.13 0.02 18 4 5 9 2 2 — 31 64 6 57.34 58.75 55.11 53.8 58.5 48.8 0.00 0.22 2.30 19 2 10 6 4 5 1 37 52 4 56.62 57.84 52.62 52.9 52.9 46.0 0.00 1.28 0.00 20 — 8 4 2 3 1 34 54 8 55.82 56.30 51.93 51.3 52.8 49.8 0.19 0.12 0.13 21 5 9 4 1 3 2 20 30 5 55.19 55.31 51.55 51.6 49.3 45.4 0.13 0.69 0.88 22 2 7 4 — 3 1 13 29 4 54.54 54.25 51.17 50.2 54.1 49.1 0.64 1.27 0.55 23 3 4 3 3 4 2 18 13 2 53.34 53.53 49.54 51.5 48.3 47.2 0.42 0.40 0.18 24 5 4 2 2 2 1 11 11 1 52.77 51.92 49.31 48.1 49.0 43.3 0.39 1.50 0.17 25 3 6 1 - 1 1 - 3 — 50.24 51.15 48.30 38.7 48.9 46.2 0.74 0.63 0.31 If 50 MORTALITY IN CHILDHOOD. Table 34 shows the sex-age distribution of attacks and deaths during the three years. It will be noticed that last year the attacks among males at ages under one year were again more numerous than those among females, and that attacks among females aged 1-2 years exceeded those among males. The differences between the numbers, however, were not so pronounced as in 1913. TABLE 34. Known Cases. Deaths. Recovering. Dying. Totals. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. 1914. 1913. 1912. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. K. Ages in Months. 0—3 9 6 11 5 11 4 1 5 6 3 - 1 10 11 17 8 11 5 4 3 4 4 3 3 3—6 5 7 12 14 4 5 8 3 9 1 2 3 13 10 21 15 6 8 6 3 8 3 5 3 6—9 9 13 21 15 13 13 3 1 4 2 2 1 12 14 25 17 15 14 1 2 3 4 5 1 9—12 18 7 20 14 9 7 1 8 4 1 1 3 19 15 20 15 10 10 3 1 1 2 — — Under 1 year 41 33 64 48 37 29 13 17 23 7 5 8 54 50 87 55 42 37 14 9 16 13 13 7 Aged 1—2 years 36 39 48 62 23 26 1 1 3 — — 1 37 40 51 62 23 27 2 — 3 2 2 3 Totals 77 72 112 110 60 55 14 18 26 7 5 9 91 90 138 117 65 64 16 9 19 15 15 10 148 222 115 32 33 14 181 255 129 25 34 25 An analysis of the attacks at ages under nine months shows that of the total known attacks (66) 22 were in infants fed exclusively at the breast, 35 were entirely artificially fed (hand reared), and 9 had a mixed diet of breast and bottle food. The total fatality among these children was 303 per cent.; that among those fed at the breast only, 27.2 per cent.; among those artificially fed, 342 per cent.; and among those on a mixed diet, 22.2 per cent. There were 19 deaths at ages under nine months of children whose illness was not known during life, 18 of those children being fed artificially, and one on a mixed diet. "Diarrhœa." At ages 0-9 months. Method of Feeding. Recovering. Known Cases. Dying. Total. Deaths. M. F. M. F. M. F. M. F. Breast 7 9 3 3 10 12 — — Artificial 12 11 7 5 19 16 11 7 Mixed 2 5 1 1 3 6 — 1 Totals 21 25 11 9 32 34 11 8 Of the 56 deaths included in Table 32, 33 (58.9 per cent.) occurred in institutions, including 29 in the local Infirmary. The 56 deaths included 9 (16.6 per cent.) of illegitimate children, 5 being males and 4 females. Health Visiting.—The services of the Visitor employed by the School for Mothers were retained by the Council until the beginning of November, 1914, when the permanent staff of the Department was strengthened by the appointment of an additional Woman Sanitary Inspector. The work of health visiting was thus carried on uninterruptedly throughout the year. The infants visited numbered 2,221, the calls numbering 4,608. In each case a copy of the booklet on "Infant Rearing" was left with the mother. Breast-feeding was reported in 1,896 instances, artificial in 171, and mixed in 154, the proportions of infants receiving each form of diet being:— Breast 85.4 (88.5) per cent Artificial 7.7 (7.6) Mixed 6.9 (3.8) The figures in parentheses show the proportions among infants visited during 1913. The live births notified during the year numbered 2,665. 1913. 1914. 51 MORTALITY IN CHILDHOOD. Except in a few instances, in which for special reasons earlier calls were made, the first visits paid varied from the 11th day after birth onwards. No analysis has been made Of children found to be fed at the breast, but the subjoined statement of the ages of the other children will serve to indicate approximately the intervals which elapse between birth and the first visit. Birth Visiting. Ages of Children at First Visit. Methods of Feeding. Artificial. Mixed. Weeks. 0- 3 1 1- 20 21 2- 52 46 3- 34 31 Months. 0- 109 99 1- 51 48 2- 9 3 3- 2 4 Totals 171 154 Among the children visited 81 were known to have died before the end of the year. Sixtytwo of those children were found to be breast fed when visited, 13 artificially, and 6 were on a mixed (breast and bottle) diet. The 81 deaths were equivalent to a mortality of 36 per 1,000 children visited, that among the breast fed being 32, that among the artificially fed 76, and that among those on a mixed diet 39. The causes of death are set out below:— Diarrhœa Diseases 31 Respiratory Diseases 18 Atrophy and Debility 6 Congenital Defects 5 Whooping Cough 4 Influenza 2 Premature Birth 2 Overlaid in bed 2 Other Causes 11 Twenty-eight of the deaths occurred in institutions, including 20 in the Infirmary. In addition to the visits above recorded, 4,259 visits were paid to 632 infants by the visitors of the School for Mothers. A further "Consultation Centre" was opened by the School in November of last year, so that there are now three centres at which infant consultations are held. During the year 4,051 attendances were made by 671 infants. The special centre for children over 1 and under school age was open on ten occasions, the consultations being attended by 43 children with a total attendance of 109. Fertility Records.—In the course of the visits on new-born infants, information was obtained as to the frequency of pregnancy, miscarriages, &c., with regard to 2,183 families. The 2,183 mothers had been pregnant 7,763 times, and had given birth to 7,473 living children, of whom 919 were dead at the time the last child (that of 1914) was born. The number of pregnancies of individual women varied from 1 (612 women) to 19(2 women). In Table 35 the data collected have been analysed* to show the frequency of miscarriages, still births, &c., associated with each successive order of pregnancy, the table being divided into two sections, of which the upper half relates to families in which no children were reported as having died after birth, and the lower to those families which admitted losing children who had been born alive. The former group included 1,035 women who had been pregnant 3,692 times. On 169 occasions pregnancy had terminated in miscarriage (103) or still-birth (66), the remaining 3,523 pregnancies resulting in 3,554 living children, all of whom were reported to be alive at the time of inquiry. The miscarriages formed 2.8 per cent. of the total number of pregnancies and the still-births l.8 per cent. The women, up to the time of their deliveries in 1914, had families averaging 343 living children per 100 women. * The table deals only with the pregnancies subsequent to the first. Last year 615 children born to 612 primiparous women were included among the infants visited. 52 mortality in childhood. TABLE 35. Fertility Records. Multi parse. Order of Pregnancy. No. of Mothers. Miscarriages. Still-births. Children Born Alive. Dying after Birth. 0 1 2 3 4 5 6 9 0 1 2 3 4 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 19 1 2 3 4 5 6 7 8 9 2 385 382 3 .. .. .. .. .. .. 374 11 .. .. .. .. 11 369 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. None 3 245 231 14 .. .. .. .. .. .. 236 8 1 .. .. .. 1 19 220 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 4 152 143 9 .. .. .. .. .. .. 142 7 3 .. .. .. .. 3 14 130 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 103 95 4 4 .. .. .. .. .. 102 1 .. .. .. .. .. .. 4 4 92 3 .. .. .. .. .. .. .. .. .. .. .. 6 69 57 10 .. 2 .. .. .. .. 64 3 2 .. .. .. .. .. 2 2 12 50 3 .. .. .. .. .. .. .. .. .. .. 7 38 32 2 3 .. 1 .. .. .. 32 2 3 1 .. .. .. .. 2 3 3 .. 30 .. .. .. .. .. .. .. .. .. .. 8 24 21 1 1 .. .. .. 1 .. 23 .. .. 1 .. .. .. 1 .. .. 1 1 1 20 .. .. .. .. .. .. .. .. .. 9 8 6 1 .. .. .. .. 1 .. 4 2 .. 1 .. 1 .. .. 1 1 .. 1 1 1 3 .. .. .. .. .. .. .. .. 10 7 3 2 1 .. 1 .. .. .. 7 .. .. .. .. .. .. .. .. .. .. 1 .. 1 2 3 .. .. .. .. .. .. .. 11 2 .. .. 1 .. .. .. .. 1 2 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 14 2 1 .. 1 .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. Totals 1,035 971 46 11 2 2 .. 2 1 988 34 9 3 .. 1 12 393 248 145 113 56 35 22 6 3 .. 1 .. 1 .. .. .. 2 34 34 .. .. .. .. .. .. .. 34 .. .. .. .. .. .. 33 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 34 .. .. .. .. .. .. .. .. 3 69 68 1 .. .. .. .. .. .. 66 3 .. .. .. .. .. 4 61 4 .. .. .. .. .. .. .. .. .. .. .. .. .. 61 8 .. .. .. .. .. .. .. 4 85 82 3 .. .. .. .. .. .. 80 4 1 .. .. .. .. 1 7 70 6 1 .. .. .. .. .. .. .. .. .. .. .. 69 14 2 .. .. .. .. .. .. 5 58 52 5 1 .. .. .. .. .. 57 1 .. .. .. .. .. .. 1 6 49 2 .. .. .. .. .. .. .. .. .. .. .. 34 19 4 1 .. .. .. .. .. 6 59 52 4 3 .. .. .. .. .. 52 5 2 .. .. .. .. 1 1 2 8 42 5 .. .. .. .. .. .. .. .. .. .. 37 18 3 1 .. .. .. .. .. 7 47 38 6 3 .. .. .. .. .. 41 3 3 .. .. .. .. .. .. .. 6 9 31 1 .. .. .. .. .. .. .. .. .. 24 17 4 2 .. .. .. .. .. 8 46 37 7 1 1 .. .. .. .. 41 4 1 .. .. .. .. .. .. .. 1 2 11 31 1 .. .. .. .. .. .. .. .. 18 17 7 3 1 .. .. .. .. 9 44 35 2 7 .. .. .. .. .. 37 5 2 .. .. .. .. .. .. .. 1 1 6 6 29 1 .. .. .. .. .. .. .. 16 18 8 1 .. 1 .. .. .. 10 30 18 6 5 1 .. .. .. .. 25 3 1 1 .. .. .. .. .. .. 1 .. .. 5 7 15 2 .. .. .. .. .. .. 11 13 5 1 .. .. .. .. .. 11 17 10 2 4 .. 1 .. .. .. 15 .. 2 .. .. .. .. .. .. .. .. .. 1 2 4 .. 9 1 .. .. .. .. .. 3 9 4 1 .. .. .. .. .. 12 14 7 3 3 1 .. .. .. .. 10 2 2 .. .. .. .. .. .. .. .. .. .. .. 2 4 3 5 .. .. .. .. .. 2 8 1 2 1 .. .. .. .. 13 11 6 1 2 2 .. .. .. .. 9 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 3 3 4 .. .. .. .. 1 2 1 2 2 2 .. 1 .. 14 12 6 2 3 1 .. .. .. .. 10 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 3 5 .. .. .. 1 1 3 1 1 3 2 .. .. 15 7 5 .. 2 .. .. .. .. .. 6 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 4 .. .. 1 1 .. 2 1 .. 2 .. .. 18 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 19 2 1 .. 1 .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. 1 Totals 536 451 42 35 6 1 1 .. .. 485 35 14 2 .. .. .. 39 71 82 72 57 54 45 43 22 19 11 9 6 4 1 1 312 145 42 17 7 6 5 1 1 Note.—The italic figures indicate multiple births (twins). 53 MORTALITY IN CHILDHOOD. TABLE 36. Infantile Mortality. Special Areas. Special Area. 1914. Infantile Mortality.* Births. Deaths. 1914. 1913. 1909-13. Ward. V. "Hall Park" 137 22 160 96 101 "North Wharf" 89 8 90 132 159 "Clarendon Street" 267 50 187 173 172 IV. "Alfred Road" 128 15 117 105 115 III. "Amberley Road" 97 13 134 129 127 I. "Queen's Park" 235 18 76 115 100 TABLE 37. Infantile Mortality. Causes of Death and Mortality Rates. Cause of Death. Deaths. Infantile Mortality.* Combined Areas. Rest of Borough. Combined Areas. Rest of Borough. Not Certified — — — — Measles 1 1 1.05 0.50 Diphtheria — 1 - 0.50 Whooping Cough 5 8 5.24 4.04 Diarrhœa (all forms) 46 26 48.27 13.13 Premature Birth 15 29 15.74 14.64 Congenital Defects 2 8 2.10 4.04 Injury at Birth 2 1 2.10 0.50 Want of Breast Milk - 2 - 1.01 Atrophy, Debility 1 7 1.05 3.53 Atelectasis 5 7 5.24 3.53 Debility at Birth 2 11 2.10 5.55 Tuberculous Diseases 3 5 3.15 2.52 Erysipelas 1 - 1.05 - Syphilis 2 7 2.10 3.53 Rickets - - - - Meningitis 2 1 2.10 0.50 Convulsions - 1 - 0.50 Respiratory Diseases 27 19 28.33 9.59 Suffocation (Overlaid) 1 2 1.05 1.01 Other Causes 11 19 11.54 9.59 All Causes 126 155 132.21 78.28 Ages at Death. Under 1 month 28 70 29.38 36.36 Aged 1—3 months 26 31 27.28 15.65 Under 3 months... 54 101 56.66 51.01 Aged 3—6 „ 36 24 37.77 12.12 6-9 „ 10 16 10.49 8.08 9-12 „ 26 14 27.28 7.07 * Corrected rates. 54 MORTALITY IN CHILDHOOD. In the families which had lost children, there were 536 mothers who had been pregnant 3,459 times, 139 (4.0 per cent.) of the pregnancies being reported to have been interrupted by miscarriage, and 69 (2.0 per cent.) to have resulted in still-born children. The remaining 3,251 pregnancies yielded 3,304 living children. In this group the families averaged 616 children per 100 women. Of the 3,304 children born alive, 919 were reported to have been dead at the time of the inquiry, equal to a mortality of 278 per 1,000. Mortality in Special Areas.—The infantile mortality rates recorded in the "Special Areas" are given in Table 36. It will be seen that last year's rate in Hall Park (160) was greatly in excess of that for 1913 (96), and of the average for the five years (101). On the other hand, the rates in "North Wharf" and "Queen's Park" were much lower than those for 1913 and the averages. The effect produced on the mortality in the various Wards by the elimination of the figures relating to the Special Areas is shown in the following statement:— Infantile Mortality. Wards. I.—Queen's Park. III.—Maida Vale. IV.—Westbourne. V.—Church. 1914. 1913. 1909-13. 1914. 1913. . 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Whole Ward 87 113 99 97 76 91 93 146 120 146 137 140 Special Area(s) 76 115 100 134 129 127 117 105 115 162 148 148 Rest of Ward 108 107 99 . 85 63 83 82 132 115 108 109 112 The total mortality for the combined "Areas" was 132 per 1,000 births, as compared with 78 in the "Rest of the Borough." In 1913 the corresponding rates were 133 and 85 respectively. An examination of the rates given in Table 37 shows that the diarrhœal and respiratory diseases were almost entirely responsible for the high mortality in the "Areas." At Ages One to Five Years. For the purpose of measuring the mortality at these ages the numbers of survivors at each age are taken out annually. It was estimated that at the beginning of the year there were 10,394 children aged from 1-5 years in the Borough, among whom 104 deaths were recorded during the succeeding twelve months. The mortality in the whole group was at the rate of 1000 per 1,000 survivors last year, as compared with a rate of 1672 in 1913, and an average of 13 99. The unusually low rate recorded last year is attributable to the reduced mortality at ages 1-2 years and 2-3 years. (See below.) Mortality Rates. Per 1,000 Estimated Survivors. Ages 1- 2- 3- 4- Males. Females. Persons. Males. Females. Persons. Malts. Females. Persons. Males. Females. Persons. 1914 198 14.1 16.9 7.7 10.1 8.9 8.1 10.3 9.2 7.0 2.3 4.6 1913 37.7 39.6 38.6 12.8 13.3 13.0 5.4 9.9 7.6 3.8 9.5 6.6 1909-13 33.9 29.1 31.5 12.0 11.8 11.9 6.6 6.4 6.4 5.7 6.0 5.9 Table 38 shows the mortality rates from certain selected causes of death. Attention is drawn to the exceptionally low mortalities from measles and the respiratory diseases last year. The sex-age rates recorded in each Ward of the Borough will be found in Table 39. Mortality among Illegitimate Children. The deaths of 55 illegitimate children were recorded last year in the Borough, including 12 of non-resident children. In outlying districts 12 other deaths were recorded belonging to the Borough; the corrected total thus equals the first-mentioned figure. The number of such deaths in 1913 was 54, and in 1912, 44. MORTALITY IN CHILDHOOD. 55 Inquests were held last year with reference to 7 of the deaths. The deaths comprised 29 of males and 26 of females, one of each sex being over the age of 5 years. At ages under 1 year there were 48 deaths (27 of males and 21 of females), and at ages 1-5 years 5 (1 of a male and 4 of females). Two deaths were allocated to Hyde Park Ward, 1 to Lancaster Gate, West, Ward, and the remainder to the five northern Wards. The maximum number allocated to any Ward was 19 (Church Ward, 9 of males and 10 of females). The deaths are distributed according to cause, sex, and age, in the appended statement. Causes of Death. 0- 1- 5- M. F. M. F. M. F. Whooping Cough 1 - — 2 — - Tuberculosis - 1 1 1 — - Syphilis - 1 — — — - Respiratory Diseases 5 1 — — — - Diarrhœa. 5 9 — — 1 - Premature Birth 4 5 — — — - Congenital Defects, Diseases 2 1 — 1 — - Atrophy, Debility 2 1 — — — — Violence 2 — — — — - Other Causes 6 2 — — — 1 All Causes 27 21 1 4 1 1 The infantile mortality among these children was at the rate of 304 per 1,000 children (of both sexes), which rate was 70 per 1,000 above that for 1913 and 29 per 1,000 above the average. The rate for legitimate children was 82 per 1,000 last year. (See below.) Mortality Rates Per 1,000 Births (Corrected). Legitimate. Illegitimate. Males. Females. Persons. Males. Females. Persons. 1914 94 69 82 337 273 304 1913 104 72 89 267 310 234 1909-13 107 84 95 284 266 275 The occupations of the mothers were as follow:— Servants 32 "Servant" 13 Housekeeper 3 General Servant 9 Cook 2 Housemaid, Parlourmaid 5 Others 16 Dressmaker 7 Shop Assistant 1 Laundress 2 Nurse 1 Waitress 2 Charwoman 1 Tailoress 1 Lamp Shade Maker 1 Occupation not stated 7 56 mortality in childhood. TABLE 38. Mortality among Young Children 1— 2— 3— 4—5 Males. Females. Males. Females. Males. Females. Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Measles 1.46 8.87 7.96 - 12.64 8.25 - 2.39 3.19 - 3.13 3.31 - 0.77 0.87 - 3.03 0.91 - - 0.57 - 0.79 0.75 Scarlet Fever 0.73 0.73 0.29 0.74 0.74 0.28 - 0.79 0.29 0.77 0.78 0.45 0.81 0.77 0.59 0.79 0.75 0.15 - - 0.28 - - 0.44 Whooping Cough 2.20 5.17 4.46 2. 96 7.44 3.40 - 1.59 0.89 2.32 3.13 1.21 - - 0.14 1.59 - 1.75 0.77 - 0.43 0.76 1.58 0.91 Diphtheria — — 0.29 0.74 — 0.14 0.76 - 0.14 0.77 - 0.29 0.81 1.54 0.73 3.17 2.28 0.89 2.32 1.52 0.73 - 1.58 0.60 Diarrhœa 0.73 0.73 2.75 0.74 0.74 2.48 - - - - - 0.15 0.81 - - - - - - - 0.14 - - - Enteritis 2.20 4.43 1.17 0.74 1.48 0.88 - - 0.15 0.77 0.78 0.31 - — — — 0.75 0.29 — — - — — — Congenital Malformations - - 0.29 0.74 - 0.15 - - 0.30 - - - - - - - - 0.15 - - - - 0.79 0.15 Atrophy and Debility - - - - - - - - - - - - - - - - - - - - - - - - Tuberculous Diseases 2.93 0.73 3.64 2.22 1.48 1.46 3.07 2.39 1.50 0.77 2.34 2.12 1.62 0.77 1.15 0.79 0.75 0.75 1.55 0.76 1.01 0.76 - 0.58 Syphilis - 0.73 0.14 - - 0.14 - - - - - - - - - - - - - - - - - - Rickets - - 0.29 - - 0.43 - - - - - - - - - - - - - - - - - - Convulsions - 0.73 0.72 - - 0.14 - 0.79 0.16 0.77 - 0.14 - - - - - - - - 0.14 - - - Dentition - - - 0.74 - - - - 0.15 - - - - - - - - - - - - - - - Respiratory Diseases 5.13 12.57 7.98 1.48 11.16 7.37 3.07 3.99 4.18 1.55 2.34 1.65 0.81 0.77 1.15 - 0.75 0.59 - - 0.71 - 0.79 0.88 Accident and Violence 1.46 — — 0.74 — 0.44 0.76 — 0.15 0.77 — 0.29 0.81 - 0.14 0.79 - 0.15 0.77 1.52 0.59 — - - Other Causes 2.93 2.95 3.38 2.22 3.72 3.41 — 0.79 1.00 1.55 0.78 1.02 2.43 0.77 1.48 3.17 1.51 0.76 1.55 — 0.86 0.76 3.97 1.68 57 mortality in childhood. TABLE 39. Mortality among Young Children. 1— 2— 3— 4—5 Males. Females. Males. Females. Males. Females. Males. Females. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. 1914. 1913. 1909-13. Queen's Park 38.2 33.0 28.2 12.7 44.4 31.0 5.7 11.5 11.8 17.4 39.7 17.1 11.6 12.0 4.4 13.8 5.5 3.3 6. 1 — 7.3 — — 3.4 Harrow Road 14.4 21.5 19.8 17.0 22.1 17.6 3.1 9.3 10.7 6.4 3.2 5.8 12.6 3.1 3.5 9.6 10.0 3.1 9.2 3.3 5.0 3.4 11.1 6.7 Maida Vale 14.8 34.0 37.7 16.1 31.9 20.9 5.0 5.9 7.7 5.5 5.3 6.6 11.9 5.9 8.9 — 5.2 10.9 12.0 5.9 1.2 — 11.8 4.5 Westbourne 29.6 36.4 41.2 15.6 47.3 26.8 9.4 11.4 10.8 — 16.0 12.1 5.7 — 2.9 31.5 10.5 7.1 4.7 4.9 6.1 10.6 15.1 6.1 Church 20.9 65.3 53.3 15.6 71.2 54.5 11.0 17.3 19.2 24.4 13.0 21.2 3.5 7.1 11.0 6.6 12.9 8.8 3.6 6.7 7.8 — 11.3 9.2 Lancaster Gate West — — 6.2 — — 14.6 34.5 — — — — 7.4 — — — - - — — — 6.9 — — — East — 62.5 27.3 — - 14.8 — 25.0 11.4 — — 7.4 — — 6.7 — — 6.1 - — 11.7 — — 6.2 Hyde Park — 31.2 16.8 — — 10.2 15.6 31.7 8.5 - - 2.7 — 12.0 6.9 — 25.0 10.3 12.2 - 7.4 - — 2.2 I 58 ADMINISTRATIVE WORK. ADMINISTRATIVE WORK. The engagement by the Council of the Health Visitor employed by the School for Mothers was terminated in November upon the appointment of an additional Woman Inspector. One Male Inspector enlisted for military service. Arrangements were made for his duties (inspection of houses let in lodgings) to be performed by the remaining members of the Staff. No other changes in the Staff of Inspectors took place during the year. Summaries (a) of the principal items of work carried out during the year by the District Inspectors will be found in Table 40, (b) relating to Food, Housing and Miscellaneous Matters in Table XII., Appendix, and (c) of Classifications of Outworkers, Factory and other premises, and inspections made under the Factory Acts in Table XI., Appendix. Prevention of Infectious Disease.—The visiting and supervision of cases of the principal infectious diseases was divided between the District Inspectors and the Women Inspectors, the former taking scarlet fever, diphtheria, enteric fever, and erysipelas, and the latter puerperal fever, tuberculosis, and ophthalmia neonatorum. A re-arrangement was made with regard to the visits in connection with measles, whooping cough, chicken-pox, and school sickness, whereby the District Inspectors undertook these during eight months of the year and the Women Inspectors during the remaining four months. The District Inspectors made 4,808 calls during the past year, as compared with 2,258 in 1913 and 1,976 in 1912. The great increase in the number of visits recorded last year is to be accounted for partly by the prevalence of scarlet fever and partly by the fact that during a portion of the year the District Inspectors visited cases of the minor infectious diseases which in former years were visited by the Women Inspectors. Last year 1,005 patients were removed to hospital, as compared with 777 in 1913 and 523 in 1912. The patients nursed at home last year numbered 48, 20 more than in 1913 but 5 less than in 1912. The Women Inspectors made 7,167 calls with reference to the diseases assigned to them, calls in connection with tuberculosis numbering 5,758. The number of visits made by the two Women Inspectors for all purposes totalled 10,301, as compared with 10,592 in 1913 and 10,627 in 1912. A quarterly distribution of their visits is given below. Quarters 1. 2. 3. 4. 1914 2,755 2,576 2,792 2,178 1913 2,070 2,858 2,649 3,015 1912 2,644 2,837 2,322 2,824 1911 2,028 1,863 2,133 1,308 1910 1,878 2,425 1,493 1,483 Visits by the Temporary Health Visitor in connection with new-born children are dealt with under "Health Visiting." Last year 3 patients suffering with whooping cough were admitted to the hospitals of the Metropolitan Asylums Board. There were no admissions to these hospitals for measles, but several patients suffering with this disease were admitted to the Infirmary, and others removed privately to the London Fever Hospital. The admissions for measles numbered 100 in 1913 and 74 in 1912, and for whooping cough 32 both in 1913 and 1912. During the year seven warning letters were issued to midwives who had been in attendance on cases of puerperal fever. No letters were issued in 1913, but in 1912, 6 were sent out. Disinfection.—Last year 2,927 rooms were sprayed, as compared with 3,100 in 1913 and 2,274 in 1912. Three hundred and fifty-one rooms were disinfected after consumption, the figures for 1913 and 1912 being 348 and 318 respectively. 59 administrative work. TABLE 40. Report of the Work of the District Inspectors during the Year 1914. Quarters. No. of Complaints received. Inspection of Dwelling Houses. Sanitary Works Completed in Dwelling Houses. To Regulate Keeping of Animals. Drainage, &c. Water Supply. Dust Receptacles. Miscellaneous. "House-to-House." On Complaint or after Illness. Cellar Dwellings. Re-inspection of all kinds. Entire Reconstruction. Drains Relaid, Trapped, or Ventilated. Drains Repaired and made Sound. Waste-pipes Disconnected. New Waste-pipes Provided. Rainwater-pipes Disconnected. W.C., New Provided, Repaired, &c. Soil-pipes, New Provided. Soil-pipes Repaired. Soil-pipes Ventilated. Services Separated. Supplies Reinstated. Cisterns, New Provided. Cisterns, Cleansed, Repaired, &c. New Provided. Repaired, &c. Drains Cleared, Flushed, &c. Houses Rooms Cleansed,' Whitewashed, &c. Cases of Overcrowding Abated. Cellar Dwellings Closed. Yards and Areas Paved and Drained. Roofs Repaired. Manure Receptacles Reconstructed, &c. Accumulations Removed. Improperly kept, Removed. First 119 - 441 — 3,692 31 18 18 21 43 12 93 32 1 9 11 5 — 15 15 — 9 30 — — 2 6 - 1 - Second 134 — 510 — 2,951 26 10 29 16 35 6 83 22 2 3 10 1 5 4 21 1 11 26 - 3 5 2 1 6 1 Third 78 43 519 — 2,824 22 19 15 11 10 4 46 11 3 4 4 1 2 9 53 3 9 23 3 1 3 2 — 10 - Fourth 96 — 382 — 3,459 22 27 16 18 41 7 81 15 3 9 8 5 — 16 36 3 9 22 - - 2 7 — 4 — Year 427 43 1,852 — 12,926 101 74 78 66 129 29 303 80 9 25 33 12 7 44 125 7 38 101 3 4 12 17 1 21 1 60 ADMINISTRATIVE WORK. The bedding, clothes, &c., dealt with by the contractors weighed 54 tons (61 tons in 1913 and 50 tons in 1912), while the expenditure amounted to £1,085. Twenty complaints were received with reference to disinfection, relating chiefly to missing articles, which were subsequently returned. Water Supply.—During the year 29 notices of discontinuance of supply were received from the Metropolitan Water Board in pursuance of Section 48 of the Public Health (London) Act, 1891, as compared with 44 in 1913 and 62 in 1912. The causes for the cutting off of supply during the past year were reported to have been:— Premises vacated 7(17) Defective water fittings 8(7) Non-payment of rates 14(20) 1 he italic figures show the corresponding numbers in 1913. The inhabited houses from which the supply was cut off numbered 20. In 4 instances the supply was restored without notice being served by the Department. Three summonses were issued, two being in respect of houses regarding which Closing Orders under the Housing Acts had already been made by the Council, but which had not been vacated. The tenants were ordered to leave within three days. In the remaining instance a Closing Order was made by the Magistrate. mortuary.—During the year 321 bodies were deposited at the Paddington Green Mortuary, being 12 less than in 1913. Number of bodies deposited 321(333) Coroner's cases 259(253) Awaiting burial:— Infectious 3(2) Non-infectious 59(78) P.M. examinations 119(120) The italic figures show the corresponding numbers in 1913. Schools.— Last year 1,407 notices were sent to head-teachers of schools in connection with the notified diseases (excluding measles) and 1,917 with reference to other diseases, measles, whooping cough, and chicken-pox. The figures for 1913 were 863 and 3,091 respectively. In addition, 677 letters were sent re "school sickness." Table 41 shows the numbers of attacks of the infectious diseases of which cognizance is taken by the Department in the persons of scholars (P.A. cols.), and the frequencies of attacks (P.N.A. cols.) in the persons of non-scholar members of families of school children. Scarlet Fever.—Last year 450 scholars were attacked with scarlet fever, as compared with 298 in 1913 and 139 in 1912, the non-resident children included in those figures numbering 61 in 1914, 49 in 1913, and 23 in 1912. The attack rates last year were 30.1 per 1,000 in Provided Schools and 167 in Non-Provided, the corresponding rates for 1913 being 13'6 and 18.6, and for 1912, 6.8 and 8.0. The attacks in other members of scholars' families numbered 172 last year, as compared with 93 in 1913 and 72 in 1912. Last year the ratios in Provided and NonProvided Schools were 10.2 and 7.2 respectively. In consequence of undue prevalence of the disease, special inspections of children were made either by the assistant medical officers or the school medical inspectors of the London County Council at Beethoven Street (three times), Droop Street, Essendine Road, Kilburn Lane (twice), "Moberly," and St. John's (Titchborne Row) Schools. At another school (Campbell Street) it was considered necessary to close one of the class rooms in the Infants' Department from February 4th to March 16th. Forms "M.O. 117," reporting suspicious absences from school, were received from the School Medical Officer with reference to:— Moberly School, during January, relating to one child ; Campbell Street School, during February, relating to one child ; and Essendine Road School, during February, relating to two children. 61 ADMINISTRATIVE WORK. Many other children were specially referred by the School Medical Officer to the Medical Officer of Health, all of whom were kept under observation and not allowed to resume attendance at school until certified free from any indications of infectious disease. Diphtheria.—The attacks of diphtheria in scholars of Provided Schools numbered 74 last year, as compared with 47 in 1913 and 87 in 1912, the ratios per 1,000 scholars being 7.5, 4.7, and 8.7 respectively. There were 64 cases in Non-Provided Schools, giving a ratio of 7.2 per 1,000 scholars. The figures for 1913 and 1912 were 72 (ratio 8.1) and 50 (ratio 5.6) respectively. Special inspections with "swabbings" were made at St. John's School, Titchborne Row, in February. On bacteriological examination, however, each swab gave a negative result. Forms "M.O. 87 " were received with regard to— Moberly School, during January, February, and March (one child); Campbell Street School, in February (one child), in August (one child), and in October (two children); and St. Luke's School, Fernhead Road, in June (six children), in July (two children), and in September (two children). Several of the children above referred to were subsequently certified to be suffering with diphtheria and were removed to hospital. Measles.—"Unprotected" children were excluded from school on 14 occasions only (see below), as compared with 73 in 1913 and 89 in 1912. "Unprotected" Children Excluded: Measles. School Exclusion, School Exclusion, (Infants' Department). Class-room. Date of. Duration of. (Infants' Department). Class-room. Date of. Duration of. Holy Trinity K Feb. 9 11 days Moberly C May 21 15 days Westmoreland Rd. R. C. C „ 16 18 „ „ „ Nov. 30 9 „ St. Saviour A „ 24 10 „ Wilberforce C „ 25 4 „ „ „ Apr. 27 11 „ Kilburn Lane C June 22 11 „ „ C Dec. 7 9 „ „ D July 9 13 „ Amberley Road G May 4 18 „ St. Paul J Nov. 11 9 „ Beethoven Street F „ 20 9 ,, „ H Dec. 3 4 „ Sore Throat.—Three hundred and one attacks of sore throat among children attending school were reported during the year. In 1913 the number was 326, and in 1912, 377. The ratios of attacks among children attending the Provided Schools were 26.0 per 1,000 in 1914, 23.6 in 1913, and 33.8 in 1912, and among those attending the Non-Provided Schools 51, 10.9, and 5.0 respectively. (See Table 42.) The seasonal distribution of the cases reported during the past three years is shown below:— Jan. Feb. Mch. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec. 1914 50 73 21 13 23 17 7 14 17 27 41 11 1913 1 2 4 — 2 8 10 — 21 44 133 111 1912 82 90 98 30 10 18 14 3 6 18 23 6 Of the children reported last year, 5 were ultimately certified to have diphtheria and 1 scarlet fever. Ringworm.—Two hundred and thirty-five children were excluded from school last year for this complaint, as compared with 205 in 1913 and 287 in 1912. The ratios of exclusions in Provided Schools were 13.1 in 1914, 11.5 in 1913, and 16.8 in 1912 per 1,000 scholars, and in the Non-Provided Schools, 11.8 in 1914, 10.3 in 1913, and 13.6 in 1912. The school distribution is given in Table 42. No action was taken during the past year by the Department with reference to reported cases, but the school nurses kept them under close supervision. Scabies.—The exclusions last year numbered 74, being 19 more than in 1913, and 28 more than in 1912. The attacks reported from the Provided Schools were at the rate of 3.1 per 1,000 scholars, as compared with 2.2 in 1913 and 3.3 in 1912. In the Non-Provided Schools the ratios were 4.6, 3.7, and 1.4 respectively. All the reported cases were visited by the Inspectors, the parents pressed to obtain proper treatment, and the bedding and personal clothing stoved whenever consent could be obtained. 62 ADMINISTRATIVE WORK. TABLE 41. Places Provided. Notified Diseases. Non-notified Diseases. Scarlet Fever. Diphtheria. Measles. Chickenpox. Whooping Cough. p.a. p.n.a. p.a. p.n.a. p.a. p.n.a. p.a. p.n.a. p.a. p.n.a. Provided— Amberley Road 1,610 28 15(1) 11 1 12 14 28 10 8 26 Beethoven Street 1,161 50(2) 10 7 2 7 4 28 13 26(1) 11 Campbell Street 972 55(2) 11(2) 11 13(5) 10 11 8 2 18 11 Droop Street 1,100 34(2) 13(2) 8(1) 2 3 3 22 7 11(1) 5 Essendine Road *1,821 39(3) 19(1) 13 7(1) 14(1) 3 84(4) 19(1) 14 12 Moberly 1,586 30(6) 21(6) 12(2) 2(1) 21(4) 7 23(1) 5 22(1) 18 Kilburn Lane 1,323 59(21) 12(4) 11(2) 3(2) 14(2) 2 40 8 4 — Royal Oak (Temporary) 270 2 - 1 — 2 — 2 — 4 2 Totals 9,843 297(36) 101(16) 74(5) 30(9) 83(7) 44 235(5) 64(1) 107(3) 80 Ratios per 1,000 30.1 10.2 7.5 3.0 8.4 4.4 23.8 6.5 10.8 8.1 Non-Provided— Bayswater Jewish 396 5(3) 2(1) 2(2) 1(1) 3(2) 2(2) 19(2) 7 9(1) 3 Desborough St. (R.C.) 523 10 3 2 - 6 4 6 1 9 6 Holy Trinity 410 13 4 4 - 12 2 16 8 8 3 St. Augustine 1,171 9(9) 8(6) 5(2) 5(4) 2 - 26(6) 7(1) 21(6) 5(2) St. James 332 3 - 1 1 - - 6 - 17 11 St. John, Kilburn Lane 190 2(2) 1(1) 1 - 1 1 7(4) 4 5(4) 6(3) St. John, Titchborne St. 474 17(1) 3(1) 5(1) 1(1) 7 1 1 — 20(3) 7 St. Luke 424 9(1) 1(1) 18(4) 2 1 1 26 3 17 11 St. Mary, Paddington Green 170 3 - - - - 2 - - - - St. MaryandSt. Michael (R-c.) 246 - 1 - 2 2(2) 2 3(2) 1 6(2) 3 St. Mary Magdalene 490 2 3 1 — 18 2 7 7 2 2 St. Matthew 410 4 1 1 — — 1 6 1 1 — St. Michael, Star Street 460 12 6 3 2 — — 3 1 33 11 St. Paul 405 2 3 - — 31 16 4 1 19 7 St. Peter 545 10 3 4(1) 4 2 4 7 - 5 4 St. Saviour 512 13 5(1) 4 1 6 6 11 4 — 2 St. Stephen 791 17(4) 6(1) 5 2(1) 6(2) 4 19(1) 7 10(2) — Wilberforce 842 16(3) 14(1) 8(1) 4 6 3 5 — 33(6) 17(1) Totals 8,791 147(23) 64(13) 64(11) 25(7) 103(6) 51(2) 172(15) 53(1) 215(24) 97(6) Ratios per 1,000 16.7 7.2 7.2 2.8 11.7 5.8 19.5 6.02 24.4 11.0 Special— Bravington Road (M.D.) 85 — - — — 1 — 1 2 2(1) — Kensal Ho. {Tuberculosis) 90 2(1) 3(2) 1(1) - - - - - 1(1) — 2(1) 3(2) 1(1) — 1 — 1 2 3(2) — Secondary— Saltram Crescent — 1(1) — - - - - - - - Paddington and Maida Vale High 4(1) 3(2) — — 17(1) — 4 — - — 4(1) 4(3) — — 17(1) — 4 — - - "p.a."—Patient attending school—"Scholars." "p.n.a."—Patient not attending school—"Contacts." Non-resident cases shown in parentheses are included in the figures preceding them. * Including 176 in Physically Defective Department. .63 administrative work. TABLE 42. Places Provided. "Sore Throat." Ringworm. Scabies. Other Complaints. Vermin. T. B. (Mx.) G. I. T. B. (Mx.) G I. T. B. (Mx.) G. I. T. B.( Mx.) G. I. T. B. (Mx.) G. I. Provided— Amberley Road 1,610 7 - 7 — 26 5 17 4 13 4 7 2 10 4 4 2 113 28 42 43 Beethoven Street 1,161 24 (2) 22 5 (3) 2 - - - - 34 (1) 33 1 1 — — Campbell Street 972 51 12 30 9 26 6 9 11 2 1 1 — 55 6 13 36 18 2 7 9 Droop Street 1,100 33 30 3 — 10 7 — 3 3 1 2 — 7 5 2 — — — — — Essendine Road* 1,821 21 4 7 10 18 4 5 9 5 2 1 2 11 3 — 8 17 — 9 8 Harrow Road (Royal Oak) 270 - - - - 9 (3) 6 4 (2) 2 1 - — 1 38 — 2 36 Kilburn Lane 1,323 75 49 11 15 19 11 2 6 1 — - 1 33 7 5 21 — — — — Moberly 1,586 45 6 — 39 16 2 5 9 3 — 1 2 33 2 — 31 5 — 1 4 Totals 9,843 256 101 (2) 58 95 129 35 (6) 38 50 31 8 (2) 12 9 184 27 (1) 24 132 192 31 61 100 Non-provided— Bayswater Jewish 396 - — — — 17 8 (9) — — 5 (5) — — — — — 1 — — 1 Holy Trinity 410 6 6 — — 2 — — 2 — — - — 7 — 1 6 — — — — Our Lady of Dolours (R. C.) 523 - - - - 15 4 7 4 8 - 6 2 3 2 — 1 25 10 4 11 St. Augustine 1,171 - - — — 5 1 1 3 - - - - - - - - 17 10 3 4 St. James 332 - - - - 10 (6) 4 - - - - 1 - - 1 - - - - St. John, Kilburn Lane 190 - - — — 4 — 1 3 — — - — 1 - — 1 — — — — St. John, Titchborne Street 474 11 (11) - 2 - - 2 1 (1) - 7 (3) 4 - - - - St. Luke 424 7 — — 7 8 1 4 3 — — — — 9 — — 9 — — — — St. Mary, Paddington Green 170 - - - - - - - - 1 - 1 - - - - - - - - - St. Mary of the Angels 246 — — — — 2 — — 2 1 — 1 — — — — — 6 2 3 1 St. Michael (R.C.) St. Mary Magdalene 490 3 - 3 — 2 - 2 — 3 1 2 — — - — — 82 34 39 9 St. Matthew 410 — - — — 8 1 1 6 5 2 — 3 — - — — — — — — St. Michael, Star Street 460 2 - 2 — 3 — — 3 4 1 3 — 7 - — 7 7 3 2 2 St. Paul 405 5 (5) - 8 (8) - 8 (7) 1 2 - - 2 4 (4) - St. Peter 545 3 (1) 2 4 - - 4 - - - - 5 (3) 2 6 (4) 2 St. Saviour 512 3 2 - 3 - 1 2 1 - 1 - 8 - 7 1 27 2 24 1 St. Stephen 791 2 - — 2 7 2 1 4 2 2 — - 4 2 — 2 - - - - Wilberforce 842 3 — 2 1 4 — 3 1 2 — 2 — 16 2 1 13 18 1 17 — Totals 8,791 45 8 (17) 8 12 104 17 (23) 21 43 41 6 (13) 16 6 70 6 (6) 9 49 193 62 (8) 92 31 Special— Bravington Road 85 - - - - 2 1 1 - - - - - 5 4 1 — 9 5 4 - Kensal House 90 — — — — — — — — 2 1 1 — 4 3 1 — — — — — Totals 175 — — — — 2 1 1 — 2 1 1 — 9 7 2 — 9 5 4 — * Including 176 in Physically Defective Department. 64 ADMINISTRATIVE WORK. Other Complaints.—Two hundred and sixty-three children were excluded last year for ailments too varied to admit of separate classification. The figures for 1913 and 1912 were 151 and 52 respectively. In the Provided Schools the ratio last year was 18.6 per 1,000 (7.2 in 1913 and 1.6 in 1912), and in the Non-Provided 7.9 (9.1 in 1913 and 4.1 in 1912). It is noteworthy that 21 of the children so reported were subsequently certified to be suffering from infectious illnesses, viz., scarlet fever in 18 instances and diphtheria in 3. Vermin.—Last year 394 children were reported dirty and verminous, as compared with 434 in 1913 and 319 in 1912. In the Provided Schools the ratios were 19.5 per 1,000 in 1914, 25.4 in 1913, and 17.9 in 1912; and in the Non-Provided Schools, 21.9, 21.1, and 16.0 respectively. The Department co-operates with the Education Officers by visiting the homes with a view to taking action as to dirty and verminous conditions existing therein. Use is made of the by-laws relating to cleanliness of rooms and bedding, and also of the "Verminous Provisions" of the London County Council (General Powers) Act, 1904. The Council has resolved to establish a cleansing (or disinfesting) station in connection with one of the branch public baths to be erected in the Borough. Internotification.—There is a complete system of interchange of information with the Medical Officers of Health of the adjacent districts as to cases of infectious disease at the homes of school children. Last year the "inward" exchanges received related to 547 cases of various diseases (see below), as compared with 597 in 1913 and 610 in 1912. Disease. Kensington. Willesden. Hampstead. Marylebone. Scarlet Fever 109(66) 108(101) 3(2) 57(14) Diphtheria 26(30) 34(70) 5(—) 17(2) Enteric Fever —(—) —(—) —(—) —(1) Measles 13(24) 5(55) —(1) 1(—) Whooping Cough 2(6) 35(48) 1(—)—(—) Chickenpox 10(8) 37(48) —(—) —(—) Other Sickness 36(19) 45(75) —(—) 3(—) Vermin —(16) —(11) —(—) —(—) 196(169) 264(408) 9(3) 78(17) The figures in parentheses are the numbers for 1913. bacteriological Work.—Last year the number of specimens submitted for examination rose to 1,757. In 1913 the specimens numbered 1,005, in 1912, 656, and in 1911, 316. An analysis of the results of the examinations made last year is given below:— Bacteriological Work. Diphtheria. Enteric Fever. Tuberculosis. Ophthalmia. Cerebro-spinal Meningitis. Other. Pos. Neg. Hoffman. Pos. Neg. Pos. Neg. Pos. Neg. Pos. Neg. Pos. Neg. Primary 79 437 17 5 7 59 186 1 3 - 2 9 2 Repeats 90 810 46 — — 1 13 - - - - - Totals 169 1,247 63 5 7 60 199 1 3 — 2 9 2 1914 1,479 12 259 4 2 11 1913 722 29 240 6 7 1 1912 530 12 112 2 - 1911 210 34 51 1 20 1910 114 26 54 1 5 1909 122 27 26 2 — 65 ADMINISTRATIVE WORK. The increase in the number of specimens examined for the diphtheria bacillus was mainlydue to outbreaks of the disease at the Victoria Orphanage and the Orphanage of Mercy. From the former institution 684 swabs (78 positive, 584 negative, and 22 Hoffman) were received, and from the latter 76 (6 positive, 68 negative, and 2 Hoffman). In 11 instances it was found that repeat examinations yielded positive results, although previous specimens taken from the same children had proved negative. Forty-three swabs (1 positive only) were taken by the Medical Officer of Health at the Town Hall, mostly from persons connected with the milk trade. The total proportion of positive results was 13.9 per cent. last year, as compared with 19.1 in 1913 and 19.6 in 1912. In the case of tuberculosis only was the proportion higher than in 1913. (See below.) Proportion (per cent.) of "Positive" Results. Diphtheria. Enteric Fever. Tuberculosis. 1914 11.4 41.6 23.1 1913 18.6 44.8 17.0 1912 17.7 47.0 28.4 Offensive Refuse.— Trade Refuse.—The bulk of the trade refuse produced in the Borough is removed by the Council. Three complaints were received during the year with reference to vegetable and other refuse. In each case the removal of the refuse was effected and the premises were kept under observation. Manure.—The usual notices for the removal of manure on three days in each week were posted in all the mews during the month of June. Following the outbreak of the war some difficulty was experienced in securing the regular removal of manure owing to the means of transport not being available. At no time, however, did any serious nuisance arise. Complaints of accumulations at 14 mews received attention. House Refuse.—A weekly collection of refuse is the general rule in the Borough, but a second collection is made each week during the months of July—September from all houses in the "Clarendon Street Area." Extra collections (without charge) are also made in certain cases upon the recommendation of the Medical Officer of Health. Last year 175 applications for more frequent removal were dealt with by the Medical Officer of Health. A second collection in each week was recommended in 133 instances, as compared with 69 in 1913 and 59 in 1912. Trade Nuisances.—One complaint was received relating to smells from trade premises. The business complained of (dyeing) was shortly afterwards discontinued. Rag and Bone Dealers.—There were 32 of these dealers carrying on business in the Borough last year, 15 handling every description of goods, 8 rags and metals, 6 second-hand clothes, 2 cat's meat, and 1 rabbit and other skins. Eighty inspections were made of the premises where animal matters are dealt in. Drainage Work.—During the past year reconstruction of the drainage was carried out at 175 houses, the same number as in 1913. In 1912 there were 223 reconstructions, and in 1911, 227. Seventy-eight defective drains were repaired and made sound, chiefly by means of the machine process, as compared with 73 in 1913 and 98 in 1912. One hundred and forty-three old drains were tested and found sound last year, as against 100 in 1913 and 66 in 1912. Deposit of Drainage Plans.—Three hundred and twelve plans were received last year for work in connection with drains and sanitary fittings, as compared with 344 in 1913 and 352 in 1912. The correspondence arising from the deposit of plans comprised 646 letters and forms in 1914, 734 in 1913, and 705 in 1912. One summons was issued last year for a breach of the by-laws requiring the deposit of plans. The defendant was fined £1, with 10s. costs. Seivcr Connections.—During the past year 15 Orders with regard to defective sewer connections were issued under Section 85 of the Metropolis Management Act, 1855. In addition, 23 K 66 ADMINISTRATIVE WORK. new connections were put in by house-owners without the issue of Orders. An amended form of Order, drafted by Counsel with a view to meeting the difficulty referred to in the last Annual Report, was adopted by the Council in April, 1914. Combined Drainage.—Six systems examined last year were found to be defective, and were reconstructed by the Council, viz.:— Wither's Garage, Edgware Road, and 13 and 15, Kildare Gardens. 3, Connaught Street. 109 and 111, Westbourne Grove. 37 and 39, Richmond Road. 37 and 38, Leinster Gardens. 12 and 14, Westmoreland Road. Orders under Section 74 of the Metropolis Management Act, 1855, were made sanctioning the construction of combined drains at:— 10-20, Ashworth Road (Sub-soil drains). 11, Coburg Place. 22-28 „ „ 11 and 12, Westbourne Street Mews. 18 and 20, Chilworth Street. 15 and 16, Prince's Mews. 32 and 34, Westbourne Terrace, and 26-30, Craven Road. Queens Park Estate.—No complaints of rats were received during the year. Inspections were made at 150 houses after the occurrence of infectious disease, the drains being chemically tested at 50 without result. Damp-proof courses were provided at 203 houses, and 200 roofs were repaired. Smoke Prevention.- Twenty-two (22) premises were kept under special observation last year (see list below), the total time given to this work amounting to 134½ hours. Sixteen premises were so watched in 1913, and 20 in 1912. The total time during which "black smoke" was observed last year was 60 minutes, as compared with 23 minutes in 1913 and 32 minutes in 1912. Other shades of smoke were observed during 81 hours, as compared with 50½ hours in 1913 and 47⅓ hours in 1912. 1914. "Black Smoke" 60 minutes "Smoke" 81 hours. No Smoke 52¼ hours. Six complaints of smoke, not necessarily "black smoke," were received during the year, with reference to factories (3), asphalt boiling (1), milk depot (1), and general smith (1). Smoke Observations. Address. Business. Chimney Shaft of 3 & 4, Amberley Wharves Paper Works Steam Boiler 27, Beethoven Street Laundry „ „ 29, „ „ „ „ 8, Bristol Gardens Baking Bakers' Ovens 17, Clifton Road „ „ „ 77, Edgware Road Restaurant Kitchen Stove 189, „ ,, „ „ 401, „ Baking Bakers' Ovens — Goldney Place Printed String Making Healing Boiler — Harrow Road Goods Yard Hydraulic Works Steam Boilers 223-5, Harrow Road Bedding „ „ 313, „ Infirmary „ „ 88, Herries Street Laundry „ „ 48, Hormead Road Asphalt Boiling Asphalt Boilers 5-10, North Wharf Refuse Destroying Steam Boilers 50, Porchester Road Fish Curing Smoke Hole — Praed Street St. Mary's Hospital Heating Apparatus - „ G.W.R. Hotel Kitchen Stove 133-59, Queen's Road General Stores Steam Boilers 120, Shirland Road Dairy „ „ 250, „ Milk Depot Washing Boiler 8, South Wharf Builders' Merchant Travelling Crane 67 WORKSHOP SUPERVISION. Canals, Wharves.—These are systematically inspected at least once a week. One complaint was received with reference to smells from the canal, but on inspection no nuisance was discovered. A complaint relating to fumes from a dust destructor at one of the wharves was also investigated, but no action was deemed necessary. The customary cleansing of the canal basin was carried out at Easter, when about 368 tons of mud and refuse were removed, being 20 tons less than the amount removed in 1913. New concrete was laid down over some 1,334 square yards of the canal bottom. Canal Boats.—The annual report of the Examining Officer was presented to the Council in February last and subsequently forwarded to the Local Government Board. The inspections of boats numbered 206, and the infringements of the Acts discovered, 38. Twenty-five notices were served. At the close of 1913, 168 boats were on the Register, of which only about 55 were known to be working in and out of the basin. During the past year one boat was registered on account of structural alterations, having been converted from a tug into a houseboat, to be permanently moored, and to be occupied by a watchman ; 7 boats were re-registered owing to change of ownership, and one re-registered owing to a change in the name of the boat. The total number of boats on the Register at the end of the year was 176, of which only 63 can be traced. One case of erysipelas (male, aged 40 years) was notified during the year from a canal boat. There were no deaths among the boat population. Of the 148 children found to be living on boats, 78 were of school ages. WORKSHOP SUPERVISION. Registration.—At the close of 1913 there were 1,421 workshop premises on the Registers of the Department. Last year 138 premises were removed from and 163 added to the Registers, the effective entries at the close of the year numbering 1,446. The premises on the Registers included 137 factories, 30 of them being laundries, 933 workshops, 19 domestic workshops, 32 workplaces, and 295 premises in the occupation of "single workers," 259 of whom are on the Registers of Outworkers. An analysis of the occupations carried on at the premises (of all descriptions), with the latest known numbers of persons working therein, will be found in Table 43, the numbers of outworkers being shown by the figures in parentheses. Notices relating to 73 new workshops were received from the Home Office during the year, 65 of which were already on the Registers of the Department. Hotne Work.—Employers of outworkers (home workers) forwarded 59 lists in February of last year and 58 in August, or a total of 117 lists, as compared with 118 in 1913, 117 in 1912, and 125 in 1911. The addresses included in those lists numbered 575, of which 361 were forwarded to other districts. From other districts 379 addresses (in 55 lists) of home workers residing in the Borough were received, the number in 1913 having been 372 in 61 lists. The numbers of lists received from other districts last year are shown below:— City of London 11(17) Finsbury 2(3) Hampstead 7(6) St. Pancras 2(-) City of Westminster 6(8) Shoreditch 2(2) Kensington 5(6) Ealing 1(-) Islington 4(1) Hackney 1(-) St. Marylebone 4(4) Hammersmith 1(-) Willesden 3(6) Holborn 1(2) Bethnal Green 2(2) South wark 1(-) Chelsea 2(3) Note.—The italic figures in parentheses relate to 1913. 68 WORKSHOP SUPERVISION. TABLE 43. Factories, Workshops, and Workplaces. 1914. Business. No. of Premises. No. of Rooms. Employees. Women. Young Persons. (Males and Females.) Men. s. Clothing— Boot-making 99(67) 108(67) — - 218(67) 218(67) Corset-making 12(3) 13(3) 14(3) — — 14(3) Dressmaking 348(42) 700(42) 1,099(42) 320(33) — 1,419(75) Furriers 9(2) 18(2) 13(2) — 26 39(2) Mantle-making 7(6) 7(6) 10(6) — — 10(6) Millinery 45(4) 45(4) 60(4) 11(2) — 71(6) Millinery and Dressmaking 24 46 88 38 — 126 Outfitting and Plain Needlework 47(28) 49(28) 176(28) - - 176(28) Tailoring 207(111) 253(132) 60(40) 12 360113) 432(153) „ Ladies' 38(10) 52(10) 26(5) - 80 106(5) Various 15(12) 15(12) 15(12) - 3 18(12) Fancy Work— Embroidery and Art Needlework 13(9) 18(9) 25(16) 11(11) — 36(27) Cleansing— Dyers and Cleaners' Receiving Offices 17(2) 24(2) 24(2) - 24(2) Laundries 101(4) 270(4) 806(4) — 35 841(4) „ Receiving Offices 28(2) 33(2) 33(2) - - 33(2) Other Businesses— Blind-making 7 14 10 - 13 23 Bookbinding and Printing 24 45 45 18 258 321 Carpentry and Joinery 15 35 — — 130 130 Chaff-cutting 11 17 — — 20 20 Cycle and Motor Works 76 124 — — 590 590 Farriers and General Smiths 24 29 — — 70 70 Florists 16 22 55 10 12 77 Jewellery and Clock-repairing 12(2) 16(2) - — 30(2) 30(2) Metal-working 23 40 - — 100 100 Saddlery 9 10 — — 20 20 Trunk-making and Repairing 14 15 - - 11 11 Umbrella-making 8(2) 8(2) 6(2) - 2 8(2) Undertaking 9(2) 16(2) 1(1) - 98 99(1) Upholstery 57(19) 88(29) 120(29) - 120 240(29) Wig-making and Hair-work 19 26 20 - 26 46 Various 112(10) 126(12) 150(12) 25 450(12) 625(24) 1,446(337) 2,282(370) 2,856(210) 445 (46) 2,672 (194) 5,973(450) workshop SUPERVISION. 69 At the close of the year the Registers contained 343 effective entries, 295 being homes of single workers. Inspections.—The inspections of all descriptions numbered 3,310 last year (3,695 in 1913), 349 being first inspections (360 in 1913). Complaints.—The Home Office forwarded 13 complaints, 4 of which were withdrawn, leaving 9, being the same number as in 1913. The matters complained of were :— Defective water-closet apparatus 3 (4) Dirty conditions of workrooms 3 (2) Overcrowding of workrooms (1) Insufficient water-closet accommodation 2 (1) Inadequate ventilation of workroom 1 (1) TABLE 44. Inspections of Workshops, &c. 1914. 1913. Workshops — On registers end of previous year 1,421 1,514 Added during year 163 200 Removed „ 138 293 On registers end of year 1,446 1,421 Inspections 349 360 Re-inspections and miscellaneous calls ... 2,961 3,335 Rooms measured 55 75 Workrooms used as bedrooms 101 86 Workrooms without Abstracts 57 84 Notices served, Totals 4 9 Written intimations 2 6 Under Sec. 4 Public Health — 2 37 (London) — — 38 Act, 1891 2 1 By-laws, under same Act — — Nuisances dealt with— Discovered. Abated. Discovered. Abated. Overcrowding 12 12 21 21 Dirty conditions 40 40 89 89 Deficient ventilation 5 5 7 7 Temperature too low — — — — Sanitary conveniences— Insufficient 2 2 — — Not separately provided 2 2 1 1 Badly placed — — 1 1 Defective 47 47 35 35 Vapour, effluvia not removed— Gas fumes 4 4 22 22 Drains — — — — Accumulations of refuse 1 1 6 6 Other nuisances or offences — — 5 5 Totals 113 113 187 187 70 housing. Deficient Ventilation.—The numbers of workshops (new and old) reported to be insufficiently ventilated in 1911 and each succeeding year are 2, 7, and 5. Sanitary Conveniences.—Generally speaking, these continue to be kept in a satisfactory condition. It should be noted that the figures given below include defects found at the first inspection of workshops, &c., on their registration. Water-Closet Accommodation. 1902. 1903. 1908. 1909. 1910. 1911. 1912. 1913. 1914. Insufficient 9 2 2 — 3 — — — 2 Not separately provided 33 4 2 2 2 3 2 1 — Badly placed 18 13 3 1 8 3 1 1 — Unventilated 8 — — — — — — — — Defective 29 23 11 13 16 13 29 35 47 Sickness.—Sixty-two (62) cases of infectious diseases occurred in workshop premises, but only 23 in the families of workers. There were 16 cases on outworkers' premises, 9 occurring in outworkers' families. The figures for each disease are shown below :— Scarlet fever 21 (4) Whooping cough 7 (-) Diphtheria 9 (3) Chickenpox 8 (1) Puerperal fever — (-) Erysipelas 1 (-) Measles 17 (2) Note.—The figures in parentheses refer to outworkers' premises. Bakehouses.—At the end of 1913 64 bakehouses were on the Register, 16 of which were "level" and 48 "underground." Last year 3 "underground" bakehouses went out of use, 1 "level" bakehouse was opened, and 1 "level" and 1 "underground" were re-opened. At the end of the year there were 64 bakehouses on the Register, 17 "level "and 47 "underground," including 14 factories (5 "level" and 9 "underground "). Thirty (30) inspections were made during the year of the factory bakehouses, and 211 of the workshop. HOUSING. Housing of the Working Classes Acts. The following premises were specially inspected for the purposes of these Acts, viz.:— Cirencester Street, Nos. 40, 42, 43, 44 and 48. Inverness Terrace, Nos. 2 and 4 (underground rooms), Junction Mews, No. 7. Queen's Mews, No. 32. Upper Brook Mews, No. 20. Detailed inspections of 224 other houses were made for various reasons during the year. These houses might also be counted as inspected for the purposes of the Housing Acts, but those named above were specially reported upon with a view to action (Closing Order, etc.) being taken. The defects found in two of the above-mentioned houses were dealt with under the Public Health (London) Act, 1891. With regard to the remaining 8, notice under Section 15 of the Act of 1909 was served in respect of :— Upper Brook Mews, No. 20. Closing Orders were made by the Council under Section 17 (2) of the Act in respect of :— Cirencester Street, Nos. 40, 42, 43, 44 and 48. Closing Orders were made by the Council under Regulations pursuant to Section 17 (7) of the Act in respect of underground rooms at Inverness Terrace, Nos. 2 and 4. HOUSING. 71 The Closing Order with respect to No. 43, Cirencester Street was determined after the completion of the necessary works of repair. At the end of the year the other Closing Orders were still in operation. Cirencester Street Improvement Scheme.—The question of paving and laying out the open space was considered from time to time by the Public Health Committee, but no recommendation on the subject was made to the Council during the year. Underground Rooms.—In addition to the rooms dealt with under the regulations pursuant to Section 17 (7) of the 1909 Act, underground rooms at the following premises were closed under the provisions of Section 96 of the Public Health (London) Act, 1891 :— Bouveiie Street, No. 6. Chippenham Road, Nos. 3 and 4. Cirencester Street. Nos. 2a. 3. 5, 23, 25, 27, 29, 31, 33, 35, 37, 39, 40, 41, 42, 44, 45. 46, 47, 48, 49, 50, 51, 52, 55. 56, 58, 59, 60, 61, 63, 64, 65, 66, 68, 69, 70, 71, 72, 73, 74, 76, 80, 83, 87, 89, 93, 95, 97, 99, 101 and 103. Harrow Road, No. 102. Tenement Houses. Registration.—During the year 60 houses were added to and 11 removed from the Register, which at the close of the year comprised 1,425 premises. Supervision.—The inspections of houses made for purposes other than "annual cleansing" numbered 2,886 last year, as compared with 2,206 in 1913 and 2,977 in 1912. The defects discovered and remedied are set out in Table 45. Annual Cleansing.—There were 1,445 houses on the Register at the beginning of April. The two Special (Lodging) Houses Inspectors were again assisted by two of the District Inspectors, who gave their whole time to this work during the months of May-July. The rooms cleansed last year numbered 2,040, as compared with 1,959 in 1913 and 1,488 in 1912. To effect that result 8,895 inspections were required, 96 cases (3 resulting in summonses) being referred to the Council's Solicitor. Notices Issued.—The notices issued during the year for all purposes numbered 2,634, as compared with 2,360 in 1913 and 1,892 in 1912. The notices comprised 395 "written intimations" (339 in 1913), 168 "statutory notices" (83 in 1913), 1,749 by-law notices (1,608 in 1913), and 322 notices under the various General Powers Acts of the London County Council, including 265 for verminous rooms (280 in 1913), 44 for the provision of additional water taps (35 in 1913), and 13 for the abolition of disused brick and wood dust-bins (15 in 1913). Housing Conditions.—Owing to shortage of Staff it has not been found possible to complete the data relating to the enumeration of the inhabitants of Registered Streets* It is hoped, however, that the usual particulars with regard to housing will be included in the next report. Overcrowding.—In the course of the past year 188 tenements were found to be overcrowded, as compared with 183 in 1913. An analysis of the figures for the two years is given on page 73. * Registered Streets, 1914:— Albert Street. Cuthbert Street. Kensal Road. Statham Street. Alfred Place. Dartington Terrace. Kent's Place. Star Street. Alfred Road. Desborough Street. Modena Street. Torquay Street. Amberley Road. Dudley Street. Netley Street. Victoria Street. Braden Street. Elcom Street. North Wharf Road. Waverley Road. Braithwaite Place. Green Street. Oliver Mews. Waverley Terrace. Brindley Street. Hall Place. Orchard Street. Wellings Place. Campbell Street. Hall Place West. Philip Terrace. Westbourne Terrace Carlton Mews. Hampden Street. Pressland Street. North. Church Place. Hasborough Street. Ranelagh Road. Senior Street. Woodchester Street. Cirencester Street. Hermitage Street. Woodfield Place. Clarendon Street. Hethpool Street. Southam Street. Crompton Street. Howell Street. South Wharf Road. 72 housing. TABLE 45. Sanitary Defects Remedied in Tenement Houses. 1914. 1913. Drain defective 13 12 „ choked 10 2 „ untrapped — 1 „ unventilated or improperly ventilated 11 4 Manhole cover defective 9 5 Surface inlet improperly trapped — 2 Gully choked 11 17 Ventilating pipe improperly constructed — 1 Soilpipe defective 1 2 „ improperly constructed — — „ unventilated or improperly ventilated — 1 Water-closet choked 49 45 „ defective 123 72 „ insufficiently flushed 30 15 ,, flushing apparatus defective 74 86 „ without water supply 44 28 „ foul 34 37 „ improperly constructed 1 2 „ accommodation insufficient 15 15 „ without door 11 24 „ without external light or ventilation - - Rainwater pipe not disconnected from drain or soilpipe - - ,, defective 42 38 ,, choked 20 2 Wastepipe defective 27 17 ,, choked 19 7 „ not provided 2 1 Other drainage defects 10 8 Cistern defective 13 8 „ dirty 33 62 „ without proper cover 15 10 „ cover defective 15 19 Dustbin defective 85 147 „ not provided 10 12 „ insufficient 12 8 „ disused and not abolished 12 16 Paving defective in area or yard 78 185 ,, ,, wash-house 90 41 Guttering defective 33 36 Premises damp 18 16 Rooms dirty 2,040 1,959 „ verminous 366 502 Roof defective 213 192 Accumulation of refuse 14 34 Animals improperly kept 18 5 Water supply to premises insufficient 29 37 Other defects or nuisances 336 107 housing. 73 Overcrowding in Tenement Houses. As found on Inspections made for Total. Registration. Annual Cleansing. Routine Purposes. Tenements 188 (183) 5(4) 164 (146) 19 (33) Rooms 194 (234) 5(4) 169 (192) 20 (38) Occupants, total 910 (958) 20 (20) 786 (761) 104 (177) Under 10 years of age 354 (419) 8(7) 290 (327) 56 (85) Aged 10 years and upwards 556 (539) 12 (13) 496 (434) 48 (92) Overcrowding abated— By voluntary re-arrangement of occupants 34 (46) 2(1) 32 (45) -(-) By voluntary removal 26 (30) 1(-) 25 (30) -(-) Under notice 13 (93) 1(3) -(57) 12 (33) Cases held over 115 (14) 1(-) 114 (14) -(-) Note.— The figures in parentheses relate to 1913. The proportion of children to the total population living in overcrowded conditions as discovered at annual cleansing* decreased last year to 36.9 per cent. In 1913 the percentage was 42.9, and in 1912, 44.5. Vital Statistics. —No data being available with regard to the numbers of inhabitants of Registered Streets in 1914, the figures obtained at the enumeration made in 1913 have been used in the calculation of the morbidity and mortality statistics given in Table 46. It is thought that the results so obtained are sufficiently approximate for the purpose of comparison. The total morbidity rate was 13.57 per 1,000 persons of all ages, as compared with 8.03 in the Rest of the Borough. In 1913 the corresponding rates were 9.61 and 6.06 respectively. The increased rates recorded last year were mainly due to scarlet fever and diphtheria in the Registered Streets and to scarlet fever only in the Rest of the Borough. The total mortality rate in the Registered Streets was 23.99 per 1,000, and that in the Rest of the Borough 11.72. In comparison with the corresponding rates for 1913, last year's rate in the Registered Streets shows a decrease of 5.9 per cent., and that for the Rest of the Borough a decrease of 0.9 per cent. It will be noted that there are striking differences between the rates from diarrœhal diseases (2.51 in the Registered Streets, 0.29 in the Rest of the Borough), tuberculous diseases (2.99 in the Registered Streets and 1.05 in the Rest of the Borough), and the respiratory diseases (3.89 in the Registered Streets and 1.53 in the Rest of the Borough). Clarendon Street Area. —At the time of the annual cleansing, 79 rooms in 77 tenements were found to be overcrowded, the inhabitants of the overcrowded tenements numbering 409 persons, of whom 134 were under 10 years of age. A special report with regard to the basement rooms in Cirencester Street was submitted to the Public Health Committee in February, 1914. Upon their recommendation the Council subsequently ordered notices to be served under Section 96 of the Public Health (London) Act, 1891, with respect to underground rooms at 58 houses. Morbidity and mortality rates in the area and the rest of the Borough are given in Table 47. The morbidity rate from diphtheria was lower in the area (1.98) last year than in the Rest of the Borough (2.03), but in all other instances higher rates were recorded in the area. It will be noted that the mortality rate in the area dropped from 30.82 in 1913 to 26.63 in 1914, the latter rate being slightly below the average for the five years 1907-11. The infantile mortality last year was at the rate of 183 per 1,000 births. In 1913 the rate was 173, and in 1912, 175. * The numbers obtained at the annual cleansing are to be preferred as a test of overcrowding, because the instances of overcrowding found at other times include repeated overcrowding by certain families who appear to be unable to recognise the fact that the sizes of their families demand more accommodation. There are some halfdozen families who are found time after time in different homes, but always overcrowded. There is no legal machinery for dealing with such cases except the usual routine of notices and prosecutions. l 74 housing. TABLE 46. Registered Streets: Morbidity and Mortality Statistics. Disease. Registered Streets. Rest of the Borough. 1914. 1913. 1914. 1913. Morbidity*— Smallpox — — — — Diphtheria and Membranous Croup 336 2.40 1.83 1.95 Erysipelas 1.87 1.14 0.85 0.71 Scarlet Fever 7.64 5.08 4.82 3.07 Enteric (and Continued) Fever 0.05 0.52 0.07 0.12 Puerperal Fever 0.05 0.05 0.07 0.05 All Diseases 13.57 9.61 8.03 6.06 Mortality*— Smallpox — — — — Measles 0.11 1.77 0.01 0.19 Scarlet Fever 0.21 0.05 0.03 0.04 Whooping Cough 0.64 0.78 0.11 0.17 Diphtheria 0.16 0.15 0.14 0.09 Enteric Fever — 0.20 0.02 0.01 Diarrhœal Diseases 2.51 2.46 0.29 0.26 Erysipelas 0.21 — 0.04 0.01 Puerperal Fever 0.05 0.05 0.03 0.01 Pulmonary Tuberculosis {Phthisis) 2.24 1.99 0.88 0.93 Other Tuberculous Diseases 0.75 0.37 0.17 0.18 Alcoholism — 0.15 0.07 0.07 Cancer 1.55 1.56 1.47 1.23 Premature Birth 0.53 0.67 0.27 0.38 Developmental Diseases 0.64 0.94 0.23 0.13 Bronchitis 2.24 2.46 0.88 1.07 Pneumonia 1.65 2.62 0.65 0.83 Cirrhosis of Liver 0.16 0.15 0.14 0.12 Accidents and Diseases of Parturition 0.11 0.05 0.04 0.04 Suicides 0.05 0.15 0.18 0.13 Other Causes 10.15 9.02 6.02 5.82 All Causes 23.99 25.51 11.72 11.82 TABLE 47. " Clarendon Street Area." Rest of Borough. 1896-1900. 1907-11. 1914. 1913. 1914. 1913. Morbidity*— Diphtheria 1.86 1.60 1.98 5.51 2.03 1.86 Erysipelas 2.08 1.63 2.15 2.11 0.94 0.71 Scarlet Fever 5.21 7.79 8.27 5.67 5.06 3.16 Enteric Fever 0.96 0.75 0.16 0.48 0.06 0.16 Puerperal Fever 0.05 — — — 0.07 0.07 Mortality*—All Causes— All ages 28.88 26.75 26.63 30.82 12.75 12.87 0—10 years 46.87 41.55 35.87 45.18 10— „ 20.40 19.83 21.84 23.40 Institution Deaths† 30.2 54.2 51.5 60.5 38.9 37.7 *Rates per 1,000 persons. †Per 100 deaths. food supervision. 75 Common Lodging Houses. Seven houses (6 for men and 1 for women) were licensed last year, the same number as in 1913. The deaths among the lodgers numbered 15, as compared with 20 in 1913 and 9 in 1912. The causes of death were certified to have been due to— Phthisis 4 Bronchitis Heart disease 2each Influenza Cancer Alcoholism l each Nephritis leach Pyaemia Old age Premature Birth Inhabited House Duty. Last year two new applications for certificates for the abatement or remission of this duty were received, one of which was not carried through. Two certificates (including one relating to an application mentioned in the 1913 report) were issued, covering 10 tenements or separate occupations. FOOD SUPERVISION. The number of slaughterhouses in the Borough remained unchanged. They are situated' as here set out:— Bishop's Mews, No. 1. Southwick Mews, No. 15. Edgware Road, No. 275. Chippenham Mews, No. 18. Portsdown Mews (at rear of No. 249, Maida Vale). Harrow Road, No. 125. Upper Brook Mews, No. 6. The slaughterhouses are systematically inspected by the Meat Inspector, and by the Medical Officer of Health at least once a year. No grounds for objection to the renewal of the licences were discovered. The Inspector was present at the slaughterhouses while killing was taking place on 380 occasions (408 in 1913). The animals slaughtered comprised 61 bullocks and 2,770 sheep last year, as compared with 37 bullocks and 3,482 sheep in 1913. The following parts (organs) were destroyed at the slaughterhouses. Sheep. Livers, 8—parasitic 6, abscesses 2. Bullocks. Livers, 6—parasitic 2, abscesses 2, tubercular 2. „ Lungs, 2—tubercular. ,, Heart, 1—tubercular. ,, Head and tongue, 2—tubercular. Food Purveyors.—There are 585 premises at which the trade in foodstuffs is carried on, the numbers of each class of trade being as here exhibited. Butchers 86 Milkshops, Dairies 119 ,, Pork only 10 Refreshment houses 101 Fishmongers 30 Fried fish shops 28 Game, Poultry 10 Ice cream makers, vendors 120 Fruiterers, Greengrocers 68 Margarine dealers 13 There are, further, 7 places where fish curing is carried on, 8 where sausages and saveloys are made, and 2 factories for making artificial ice. The costermongers' stalls in the Borough are kept under close supervision, and on Saturdays every stall is inspected at least twice. The Inspector reports that he made 1,040 inspections of food premises, other than costermongers' stalls, during the year, distributed as set out below:— Butchers' shops 454 Milkshops 164 Greengrocers' shops 19 Restaurants, &c. 190 Fishmongers' shops 28 Ice cream shops, barrows 114 Fried fish shops 55 Fish curers' premises 16 76 food supervision. Premises where food is stored or sold are liable to inspection under the Public Health (London) Act, 1891—for the discovery of unsound food, nuisances, etc.—and under the London County Council (General Powers) Act, 1908. The inspections referred to above were mainly for the discovery of unsound food. Milk Supply.—There is only one cowshed in the Borough, certified for ten cows, but usually not containing more than four, situate at— Star Street, No. 39. The Food Inspector visits the premises at least once a quarter and the Medical Officer of Health once a year. The shed has always been found clean and well kept. Dairies and Milkshops.—At the close of 1913 there were 123 names on the Register of milk vendors. During 1914 six new entries were made and ten names were removed. One application to be registered was refused, and three businesses were transferred to new proprietors. Proceedings were taken against three persons for selling milk without being registered. The Register contained 119 names at the close of last year, the class of businesses carried on in connection with the sale of milk being sufficiently indicated by the following statement. Dairies, wholesale 7(5) Grocers' shops 10(1) Dairies, retail 77(86) Provision Dealers 1(1) Refreshment houses 10(9) Bakers' shops 4(4) General dealers 10(17) These premises are inspected at least once a year, more frequent inspections depending on the known character of the proprietors. A copy of the regulations relating to the sale of milk is left with each proprietor at the beginning of each year. Three cases of scarlet fever occurred during the year at premises where the sale of milk was carried on, 7 cases of diphtheria, 14 of scarlet fever, and 1 of measles in the homes of milk roundsmen living and working in the Borough, and 4 cases of scarlet fever in the homes of men working in other boroughs but living in Paddington. The roundsmen were in all cases put off duty until they had been seen by the Medical Officer of Health, or the medical officer of the dairy, and certified as free from infection. When there has been any contact with diphtheria, swabs are taken from the throat and nose of the roundsman before he is allowed to return to work. There was no evidence of any spread of infection through any milk supply. One milk vendor was prosecuted for selling milk from infected premises. The Magistrate imposed a fine of £2, with 2s. costs. Ice Cream Making.—A register of makers and vendors of ice cream is kept under the provisions of Part VIII. of the London County Council (General Powers) Act, 1902. At the close of 1913, 116 names were on the Register, to which 10 names were added and from which 6 were removed during the past year. At the close of 1914 the Register contained 120 effective entries. The businesses with which the sale of ice cream is combined arc indicated by the subjoined statement. Sweetstuffs 55 Bakers 7 Newspapers and Tobacco 20 Confectioners 8 Restaurants 14 Greengrocers 2 General Dealers 12 Milk Shops 2 There are also 6 barrowmen resident in the Borough who have regular pitches, and 6 others not resident in Paddington. The latter are known to be residents of Kensington, St. Marylebone, and Willesden (2 each). All barrowmen are required to indicate on their barrows where they make the ice cream. Two cases of scarlet fever occurred at premises where ice cream is sold. ANALYTICAL WORK. 77 UNSOUND AND DISEASED FOOD. In addition to the small quantity of flesh food dealt with at the time of killing and destroyed at the slaughterhouses, 6,952 lbs. of food-stuffs were condemned and destroyed last year, as compared with 1,401 lbs. in 1913 and 10,109 lbs. in 1912. There were no prosecutions Food-stuffs Destroyed, 1914. Meat (Butchers' shops) :—Pork, 7 lbs.; Sheeps' livers, 9 lbs. Fish:—Dog fish, 100 lbs.; Plaice, 28 lbs.; Haddocks, 140 lbs. ; Kippers, 12 lbs. Fruit, &c.:—Onions, 86 lbs.; Oranges, 80 lbs.; Cherries, 60lbs.; Strawberries, 40lbs,; Peaches, 10 lbs.; Apricots, 5 lbs.; Greengages, 30 lbs.; Raspberries, 26 lbs.; Currants, 5lbs.; Melons, 30 lbs.; Mushrooms, 6 lbs.; Lettuce, 60 lbs. Summary. Meat 16 lbs. Per G.W.R. Co.:— Fish 280 „ Pig 70 lbs. Fruit, &c. 438 ,, Bacon 448 ,, Fowls 20 ,, Cabbages 4,368 „ 4,906 „ Discovered in a private house after the death of the occupier:— Lentils 112 lbs. Tinned Sardines 80 lbs. Oats 256 „ ,, Salmon 2 „ Macaroni 70 „ „ Peaches 2 „ Green Peas 100 „ Infants' Food 70 „ Ox Tongues 120 ,, Tinned Milk 450 ,, Total 1,312 „ Bombay Duck 50 ,, ANALYTICAL WORK. Food Adulteration.—Last year the samples submitted to the Public Analyst numbered 600, of which 58 were found to be adulterated. The numbers of adulterated samples in 1913 and 1912 were 61 and 43 respectively. The proportion of samples found to be adulterated in each of the last six years is shown below. Percentage of total Samples adulterated. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. 8.6 9.0 8.3 17.4 10.1 10.7 9.6 Table 48 contains a complete list of the samples taken during the year. Of the 281 samples of milk, 66 were taken at the Paddington Terminus in the course of transit, under contract, at the request of the consignees. Sixteen of the Station samples were found to be adulterated, equivalent to 24.2 per cent., as compared with 48.7 per cent. in 1913 and 50 per cent. in 1912. Station Samples. Percentage adulterated. 1909. 1910. 1911. 1912. 1913. 1909-13. 1914. 24.3 14.9 19.1 50.0 48.7 32.4 24.2 Samples are taken at irregular intervals on Sundays and Bank Holidays. Last year 58 samples were taken (48 on Sundays and 10 on Bank Holidays), 2 of which (4T per cent.) were reported to be adulterated. In 1913 the proportion was 6.7 per cent. Excluding the samples taken at the Railway Terminus the proportion of adulterated samples of milk obtained in the Borough was 3.6 per cent., as compared with 6.1 per cent. in 1913. Of the 316 samples other than milk, 34 (equal to 10.8 per cent.) were adulterated. 78 analytical work. TABLE 48. Samples taken under the Sale of Food and Drugs Acts, &c. Total. Found Adulterated. Percentage Adulterated. Milk 281* 23 8.2 Skimmed Milk 3 1 33.3 Condensed Milk 1 — - Cream 7 1 14.3 Preserved Cream 6 — - Butter 46 9 19.6 Butter on Bread 1 1 100.0 Margarine 5 — — Cheese 23 — — Lard 21 — — Dripping 2 — — Coffee 12 — — Cocoa 11 — - Jam 6 — — Rice 5 — — Sago 4 — — Arrowroot 3 — — Flour 18 — — Vinegar 6 1 16.6 Mustard 5 — — Pepper 5 — — Sauces 7 — — Olive Oil 7 — — Salad Oil 8 — — German Sausage 18 8 44.4 Brawn 11 2 18.1 Fish and Meat Pastes 11 — — Sausage 7 3 42.8 Mincemeat 6 — — Saveloy 1 — — Spirits 10 — — Wines 8 — — British Wines 9 9 100.0 Camphorated Oil 6 — — Ammoniated Tincture of Quinine 6 — — Glycerine 4 — — Tincture of Camphor 3 — — Easton's Syrup 3 — — Blaud's Pills 3 — — Sweet Spirits of Nitre 2 — — Syrup of Squills 1 — — Apples 1 — — Sweets 1 — — Cake 1 - - 600 58 9.6 *Including 66 taken at Paddington (G.W.R.) Terminus in course of delivery: 16 adulterated. OFFICE (CLERICAL) WORK. 79 British Wines.—The 9 samples taken during the year were all found to contain alcohol. The amount of proof spirit present varied from 18 to 28½ per cent. Preservatives in Foods.—Appended is a complete list of the food-stuffs, other than cream samples, which were found to contain preservatives, with the amount thereof present in each case. German Sausage 21 grs. Boric Acid per pound. „ 20½ „ ,, 11 9/10 „ 10½ „ 9¾ 7 „ „ 7 „4 9/10 Sausages 7¾ „6 3/10 „3½ Brawn 11 9/10 „5½ No proceedings were instituted, but in all instances cautionary letters were sent to the vendors of the samples. Vinegar.—One sample of vinegar was found to be deficient in acetic acid to the extent of 8½ per cent. A letter of caution was sent to the vendor. Milk and Cream Regulations, 1912.—All the samples of milk were examined with a view to the detection of preservatives, but no case of the addition of such substance was reported. Out of 7 samples of "fresh" cream, 1 was found to contain boric acid amounting to 33½ grs. per lb. The vendor was cautioned. The 6 samples of preserved cream which were taken all complied with the Regulations as regards the declarations on the labels and the amount of milk fat they contained. Rag Flock Act.—Forty-five samples were taken under this Act, 13 being described as from "re-makes" and 32 from new material. In the latter samples the maximum impurity found present was equivalent to 31 parts of chlorine per 100,000 parts of rag flock and the minimum 7½ parts. In the re-makes the maximum impurity was equivalent to 270 parts and the minimum 12½ parts. As stated in the previous report, the decision given in the case of Jordan v. Gamble has practically rendered the Act useless as regards re-makes. OFFICE (CLERICAL) WORK. The appended summary is given merely as a record of certain items of the work of the Clerical Staff. Numerical statements cannot be submitted of the multifarious tasks of preparing reports, posting up indices in various forms, and generally recording the work of the Department for future reference. Letters received 5,321 (5,763) ,, despatched 4,981 (4,981) Entries in Postage Book 14,880 (14,175) Certificates dealt with relating to cases of infectious disease (including consumption) 3,023 (2,818) Notices sent re above and other diseases 6,236 (6,494) Entries in Register of Births 3,084 (3,082) Complaints received 791 (747) Plans dealt with 312 (344) New openings in Journals 472 (576) Disinfection Orders (duplicate) 2,239 (2,921) Notices to abate nuisance 1,972 (1,541) The figures in parentheses are the returns for 1913. 80 legal proceedings. LEGAL PROCEEDINGS. The fines imposed last year amounted to £66 11s. 6d. and the costs awarded £23 1s. 0d. With the exception of those under the Notification of Births Act, all fines are paid to the Council's account. Fines and Costs. "Health" Cases. "Adulteration" Cases. £ s. d. £ s. d. 1914 18 11 0 71 1 6 1913 43 17 9 34 19 6 1912 15 8 0 41 19 0 1911 19 5 6 50 9 0 1910 13 15 0 125 8 6 1909 52 6 6 86 6 6 The averages of fines and costs imposed with respect to "adulteration" cases are shown below:— Average per Conviction. 1914. 1913. 1912. 1911. 1910. 1909. Fine £2 3 4 £1 10 11 £0 8 11 £0 13 0 £2 3 8 £13 9 Costs 0 11 0 0 15 9 0 8 11 0 14 3 0 12 2 0 12 2 LEGAL PROCEEDINGS, 1911. Public Health (London) Act, 1891. Fines. Costs. Section 4. £ s. d. 46, Cirencester Street Premises without water supply Closing Order made. 65, Clarendon Street „ „ „ „ 25, Elgin Terrace Roof defective, &c. Summons withdrawn on payment of 1 1 0 23, Kensal Road Drains defective, etc. Work done. 0 3 0 21, Lanark Villas Premises without water supply Closing Order made 1 7 0 231, Portnall Road Drains defective; premises dirty Work done. 0 10 6 14, Waverley Road Back addition wet By-laws. Order made. 0 16 0 18 and 20, Albert Street Annual cleansing not carried out £9 7s. (including costs) 95, Cirencester Street „ „ „ Work done. Sum mons withdrawn. 8, Modena Street Overcrowding Rooms vacated. Summons withdrawn. By-laws pursuant to Section 202 Metropolis Management Act, 1855. £ s. d. £ s. d. 16, Sale Street Plans of new drainage not submitted 1 0 0 0 10 0 Notification of Births Act, 1907. £ s. d. £ s. d. 1 Parent 0 3 0 0 2 0 2 Medical practitioners (total) 0 5 0 0 10 0 Housing, Town Planning, &c., Act, 1909. 2 Tenants, 42, Cirencester Street Failing to vacate premises after Notice of Closing Order Premises vacated. Summonses withdrawn. 3 Tenants, 48, ,, ,, ,, ,, ,, ,, Ordered to leave within 3 days. Dairies, Cowsheds and Milkshops Orders. £ s. d. £ s. d. W. B. Carr, 292, Kilburn Lane Selling milk without being registered 0 2 6 — F. Denby, 71, Lancefield Street „ „ „ 0 5 0 — A. O. Gorvin, 47, Kilburn Pk. Rd. „ „ „ — 0 7 0 — Jones, 600, Harrow Road Selling milk from infected premises 2 0 0 0 2 0 legal proceedings. 81 SUMMARY OF LEGAL PROCEEDINGS DURING 1914 Under Sale of Food and Drugs Acts, 1875-1907, &c. Fines. Costs. £ s. d. £ s. d. Milk 17% fat abstracted — 1 17 6 „ 10% „ „ 14% „ „ 14% „ Summonses dismissed. „ .12% ,,_ Evidence given that milk was „ 14% „ sold in the same state as „ 11% „ received from the cows. „ 13% „ 11% „ 12% „ 10 0 0 ... 0 13 6 „ 10% „ 5 0 0 ... 0 13 6 „ 7% „ 2 10 0 „8% „ 2 10 0 0 13 6 „ 6% „ 0 3 6 0 12 6 6% Summonses dismissed. 6% added water ^ Evidence given that milk was 8% sold in the same state as 15% received from the cows. (2) „ 13% „ 3 0 0 0 12 6 6% „ - 0 17 6 „ 6% „ and8% fat abstracted 0 10 0 0 12 6 Margarine Sold from unlabelled bulk Summons dismissed. „ „ 0 5 0 0 17 6„ Sold in an insufficiently stamped wrapper 0 15 0 0 2 0 „ Sold in an unstamped wrapper 0 1 0 0 17 C „Sold from unlabelled bulk 0 1 6 0 2 0 „ „ 1 0 0 0 12 6 (3) „„ 1 0 0 (or 5 days in default of payment). f Butter 85% foreign fat 0 10 0 0 17 6 Margarine Sold in an unstamped wrapper — 0 2 0 Butter 85% foreign fat 5 0 0 0 17 6 Margarine Sold in an unstamped wrapper — 0 2 0 Butter 86½% foreign fat 1 0 0 0 17 6 Margarine Sold in an unstamped wrapper 1 0 0 0 2 0 Butter 40% foreign fat 2 0 0 0 17 6 Margarine Sold in an unstamped wrapper 0 1 0 0 2 0 Butter 85% foreign fat 5 0 0 0 17 6 Margarine Sold in an unstamped wrapper 0 1 0 0 2 0 Butter 81% foreign fat 10 0 0 0 17 6 Margarine Sold in an unstamped wrapper 0 1 0 0 2 0 Butter 55% foreign fat 1 0 0 0 17 6 Margarine Sold in an unstamped wrapper — 0 2 0 „ Sold from unlabelled bulk — 0 2 0 Butter 87½% foreign fat 1 0 0 0 17 6 Margarine Sold in an unstamped wrapper — 0 2 0 NOTES. Samples purchased from one and the same vendor are bracketed together. Fines. Costs. Previous proceedings :— £ s. d. £ s. d. March 9th, 1906 6 summonses in respect of milk deficient in cream 1 15 0 1 10 6 (1) Oct. 9th, 1908 10 „ „ „ containing boric acid 0 10 0 1 18 6 April 26th, 1912 19 „ „ „ deficient in cream 7 0 0 4 3 6 (2)March 10th, 1898 Selling butter containing 88% foreign fat 2 0 0 0 12 6 Dec. 8th, 1899 „ milk „ 15% added water 5 0 0 0 12 6 (3)Dec. 12th, 1913 „ butter „ 77% foreign fat 0 1 0 0 17 6 „ margarine in unstamped wrapper Summons withdrawn 0 2 0 (4)Nov. 30th, 1906 „ butter containing 82% foreign fat 2 0 0 0 12 6 July 15th, 1910 Name and address not on hand-can 0 5 0 0 7 6 (4)May 10th, 1912 Selling milk containing 4% added water 0 10 0 0 12 6 „ „ „ „ 6% „ 0 10 0 0 2 0 May 2nd, 1913 „ butter „ 81% foreign fat 2 0 0 0 17 6 (5)Feb. 1st, 1901 „ „ „ 85% „ 5 0 0 1 3 0 Nov. 13th, 1901 „ „ „ 65% „ 5 0 0 0 12 6 (6) Nov. 23rd, 1900 „ „ „ 84% „ 2 0 0 1 3 0 Aug. 7th, 1908 „ „ 70½% „ 2 0 0 0 12 6 Oct. 10th, 1908 „ „ „ 8l½% „ 5 0 0 0 12 6 M 82 vital statistics APPENDIX. TABLE I. L.G.B. Year. Estimated Population. Births. Deaths at All Ages. Deaths under One Year. Registered Locally. Transfers. Nett. Registered Locally. Gross Mortality. Transfers. Nett. Registered. Nett. Out. In. Totals. Rates. Out. In. Totals. Mortality. Number. Mortality. Totals. Mortality. 1904 143,528 3,295 - - - - 2,228 15.52 387 173 2,014 14.03 490 148 449 - 1905 143,388 3,184 29 144 3,299 23.01 2,210 15.41 410 161 1,961 13.68 441 139 391 118 1906 143,246 3,152 41 175 3.286 22.94 2,041 14.25 395 197 1,843 12.87 395 125 353 107 1907 143,103 3,074 49 181 3,206 22.40 2,154 15.05 372 232 2,014 14.07 396 128 354 110 1908 142,958 3,149 69 216 3,296 22.68 2,079 14.30 400 217 1,896 13.04 374 118 348 105 1909 142,811 2,895 62 198 3,031 21.22 2,154 15.08 409 219 1,964 13.75 347 119 311 102 1910 142,663 2,909 57 170 3,022 21.18 2,004 14.05 384 175 1,795 12.58 353 121 294 97 1911 142,513 2,815 57 230 2,977 21.46 2,074 14.55 407 259 1,926 13.51 399 141 387 126 1912 142,362 2,774 50 267 2,991 21.18 1,889 13.27 372 254 1,771 12.44 326 117 295 98 1913 142,229 2,832 55 242 3,019 20.87 2,071 14.33 407 315 1,979 13.68 342 121 305 101 Averages 1904-08 143,243 3.171 - - - - 2.142 14.95 393 196 1,945 13.57 419 132 379 — 1909-13 142,520 2,845 56 221 3,008 21.11 2,038 14.29 396 244 1,887 13.24 353 124 318 105 1904-13 142,878 3,008 — — — — 2,090 14.62 394 210 1,916 13.41 386 128 348 ~~~~ 1914 142,087 2,708 49 274 2,933 20.64 1,892 13.31 347 350 1,895 1333 312 115 281 96 Total population 142,551 census, Area of Borough (stat. acres) Total 1,356.1 Number of inhabited houses 16,686 1911. Waterways 20.0 Average number of persons per house 8.5 births and deaths. 83 TABLE II. Wards. . Borough. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. Populations. 1909 142,811 16,307 27,176 1 20,445 23,518 25,274 9,020 7,994 13,076 1910 142,663 16,196 27,109 20,665 23,485 25,146 9,092 8,002 12,969 1911 142,513 16,084 27,041 20,886 23,452 25,017 9,164 8,009 12,860 1912 142,362 15,970 26,972 21,111 23,418 24,888 9,237 8,016 12,750 1913 142,229 15,872 26,912 21,307 23,390 24,773 9,302 8,019 12,654 Averages 142,520 16,090 27,044 20,876 23,454 25,024 9,161 8,006 12,865 1914 142,087 15,764 26,851 21,517 23 357 24,651 9,369 8,029 12,549 Births. 1909 3,031 382 741 392 470 743 63 48 192 1910 3,022 406 717 407 468 720 70 58 176 1911 2.977 383 726 405 458 726 50 69 160 1912 2,991 399 700 437 476 681 64 64 170 1913 3,019 355 752 422 451 761 62 57 159 Averages 3,008 385 727 413 465 726 62 59 171 1914 2,933 355 755 401 442 706 57 64 153 Deaths: All Ages. 1909 1,964 202 377 272 324 491 73 62 163 1910 1,795 198 391 246 293 440 54 54 119 1911 1,926 222 383 277 365 414 65 66 134 1912 1,771 185 365 239 290 419 75 64 134 1913 1,979 229 393 274 358 469 72 59 125 Averages 1,887 207 382 262 326 446 68 61 135 1914 1,895 224 347 288 330 440 58 63 145 Deaths: Under One Year. 1909 311 28 55 36 50 116 4 4 18 1910 294 37 70 34 49 87 2 3 12 1911 386 48 83 44 70 113 7 3 18 1912 295 37 56 43 44 91 5 3 16 1913 305 40 51 32 56 104 3 5 14 Averages 318 38 63 38 54 102 4 3 16 1914 281 31 51 39 41 103 5 — 11 84 deaths of residents of the borough. TABLE III. Deaths of Residents of the Borough, 1914. Sex-Age Distribution for Whole Borough. Causes of Death. 1 All Ages. Deaths at Ages In Public Institutions. 0— 1— 2- 5— 15— 25— 45— 65— p. M. f. M. f. M. f. m. f. m. f. m. f. M. f. M. f. m. f. m. f. Enteric Fever 3 1 2 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 2 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 4 4 ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... Scarlet Fever 8 5 3 ... ... 1 1 1 2 3 ... ... ... ... ... ... ... ... ... 4 3 Whooping Cough 26 12 14 8 5 3 4 1 5 ... ... ... ... ... ... ... ... ... ... 5 4 Diphtheria, Membranous Croup 20 11 9 1 ... ... 1 5 6 5 2 ... ... ... ... ... ... ... ... 9 6 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 29 10 19 1 2 ... ... ... ... ... ... ... ... 2 2 4 3 3 12 1 ... Erysipelas 9 5 4 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 2 1 2 2 3 Other Epidemic Diseases 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Other Septic Diseases 8 2 6 ... 1 ... ... ... ... ... ... 1 ... ... 2 ... 3 1 ... 2 4 Pulmonary Tuberculosis, A. Phthisis 151 79 72 1 ... ... ... 1 1 3 4 12 14 28 29 32 21 2 3 45 30 Tub. Meningitis, A. Hydrocephalus 17 8 9 ... 2 ... 2 7 2 1 ... ... 2 ... 1 ... ... ... ... 4 3 Other Forms of Tuberculosis 18 12 6 2 3 4 1 ... ... 2 ... 1 ... 1 ... 2 2 ... ... 8 3 Syphilis 12 7 5 6 3 ... ... ... ... ... 1 ... ... 1 ... ... 1 ... ... 3 2 Cancer 211 80 131 ... ... ... ... ... ... 1 1 ... 1 5 13 48 66 26 50 37 51 Rheumatic Fever 1 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Alcoholism 9 3 6 ... ... ... ... ... ... ... ... ... ... 2 3 1 2 ... 1 1 4 Inflammation and Softening of Brain 11 3 8 ... ... ... ... ... 1 ... ... ... ... 2 ... ... 3 1 4 1 5 Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Meningitis 11 7 4 1 2 2 1 ... 1 2 ... 1 ... ... ... 1 ... ... ... 4 1 Cerebral Hæmorrhage 63 28 35 ... ... ... ... 1 ... ... ... ... ... 1 2 7 13 19 20 4 7 Apoplexy 8 3 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 4 1 ... Convulsions 3 ... 3 ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 Endocarditis 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... Heart Disease 242 103 139 ... ... ... ... 1 1 ... 1 1 4 13 18 38 40 50 80 39 51 Bronchitis 151 63 88 10 6 3 1 1 ... ... ... ... ... 3 ... 16 17 30 64 28 33 Lobular (Broncho-) Pneumonia 45 30 15 16 6 2 1 4 ... ... ... ... ... 1 ... 4 4 3 4 11 3 Lobar (Croupous) Pneumonia 19 10 9 1 ... ... ... ... ... ... 1 ... 1 3 2 6 2 ... 3 4 6 Pneumonia 48 26 22 5 2 2 ... ... 2 1 1 ... 1 7 3 8 3 3 10 3 2 Other Diseases of Respiratory Organs 24 12 12 ... 2 1 1 1 ... 1 ... ... 1 ... ... 6 5 3 3 4 6 Diseases of Stomach 11 8 3 1 ... ... ... ... 1 ... ... ... ... 2 2 4 ... 1 ... 4 2 Diarrhoea and Enteritis 83 41 42 34 38 4 2 1 1 1 ... ... ... ... ... 1 ... ... 1 26 24 Appendicitis 10 5 5 ... ... ... ... ... ... 1 ... ... 1 1 1 3 1 ... 2 3 2 Obstruction of Intestines 18 7 11 2 ... ... ... ... ... 1 1 ... ... ... 3 1 6 3 1 3 6 Cirrhosis of Liver 20 10 10 ... ... ... ... ... ... ... ... ... ... 1 3 7 4 2 3 3 3 Nephritis and Bright's Disease 57 37 20 ... ... ... ... ... ... 1 3 ... ... 6 1 20 7 10 9 16 7 Tumours (N.-M.), &c., Female Genital Organs 6 ... 6 ... ... ... ... ... ... ... ... ... ... ... 4 ... 2 ... ... ... 2 Puerperal Fever 5 ... 5 ... ... ... ... ... ... ... ... ... 2 ... 3 ... ... ... ... ... 5 Accidents and Diseases of Parturition 7 ... „ 7 ... ... ... ... ... ... ... ... ... 3 ... 3 ... 1 ... ... ... 4 Congenital Defects 12 6 6 5 5 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 3 Premature Birth 44 25 19 25 19 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 9 Developmental Diseases 40 25 15 25 14 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 4 Old Age 65 19 46 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 18 46 7 14 Suicide 24 18 6 ... ... ... ... ... ... ... ... 2 1 6 3 8 2 2 ... 3 ... Overlaid in Bed 3 2 1 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Violence 70 41 29 4 2 2 1 3 2 2 1 5 1 6 4 13 6 6 12 16 12 Homicide 2 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined Causes 2 ... 2 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 All other Causes 263 152 111 8 4 1 ... 2 3 3 7 4 1 23 13 48 28 63 55 71 43 All Causes 1,895 923 972 162 119 27 19 29 29 31 25 28 33 116 113 281 245 249 389 387 372 Uncertified 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... deaths of residents of the borough. 85 TABLE IV. Deaths of Residents of the Borough, 1914. Numbers (all Ages) in each Ward. Causes of Death. Lancaster Gate, Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Hyde Park. m. F. M. F. m. F. m. f. m. f. West. East. m. F. m. F. m. f. Enteric Fever ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... 1 ... Scarlet Fever 2 1 1 ... ... ... ... ... 2 2 ... ... ... ... ... ... Whooping Cough 2 2 1 2 2 3 4 3 3 3 ... ... ... ... ... 1 Diphtheria ... 2 7 4 ... ... 1 1 2 2 ... ... ... ... 1 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 2 1 3 ... 5 2 4 2 3 ::: 1 1 1 ... ... Erysipelas 1 ... 1 1 ... ... ... 1 3 1 ... ... ... ... ... 1 Other Epidemic Diseases ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... 1 ... 1 1 1 ... 1 ... 2 ... ... 1 ... ... ... Pulmonary Tuberculosis 12 11 18 18 14 7 13 10 17 20 2 ... ... ... 3 6 Tub. Meningitis ... 1 2 3 1 1 2 1 2 1 1 1 ... 1 ... ... Other Forms of Tuberculosis 2 ... 3 3 3 ... 1 1 3 1 ... ... ... ... ... 1 Syphilis ... ... ... ... 2 1 1 ... 3 4 ... ... ... ... 1 ... Cancer 7 17 26 23 11 24 12 29 12 22 7 5 3 2 2 9 Rheumatic Fever ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Alcoholism ... 1 1 ... ... 1 1 1 ... ... ... ... ... ... 1 3 Inflammation and Softening of Brain ... ... ... 1 1 1 1 2 1 2 ... 1 ... ... ... 1 Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Meningitis 3 2 ... ... ... ... 2 ... 1 2 ... ... ... ... 1 ... Cerebral Haemorrhage 5 1 4 6 3 7 6 6 4 10 1 1 1 2 4 2 Apoplexy ... ... 1 2 ... 1 1 ... ... ... ... ... ... 2 1 ... Convulsions ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... ... Acute Endocarditis 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Organic Disease of the Heart 12 22 16 24 20 22 23 22 19 35 3 1 4 3 6 10 Bronchitis 7 12 15 13 6 7 6 20 26 20 1 4 ... 3 2 9 Lobular (Broncho-) Pneumonia 5 ... 5 4 4 3 2 1 11 4 1 ... ... 1 2 2 Lobar (Croupous) Pneumonia 1 1 3 2 1 1 ... 3 1 2 1 ... 2 ... 1 ... Pneumonia 7 1 2 8 2 2 4 4 10 4 ... 1 ... 1 1 1 Other Diseases of Respiratory Organs ... 2 3 2 4 1 2 2 3 1 ... ... ... 1 ... 3 Diseases of Stomach 2 ... 1 ... ... ... 3 1 2 ... ... ... ... ... ... 2 Diarrhoea and Enteritis 6 6 5 4 3 7 8 6 18 18 1 ... ... ... ... 1 Appendicitis 1 ... ... ... ... 1 ... 2 1 1 ... ... 1 1 2 ... Obstruction of Intestines ... 4 1 1 2 1 2 ... 1 3 ... ... ... 1 1 1 Cirrhosis of Liver ... 2 ... 1 2 4 5 3 2 ... 1 ... ... ... ... ... Nephritis 5 2 6 1 6 3 4 5 9 6 1 ... 1 ... 5 3 Tumours(N.-M.),&c., Fem. Gen. Orgs. ... ... ... 1 ... ... ... 2 ... 2 ... ... ... ... ... 1 Puerperal Fever ... ... ... 3 ... 2 ... ... ... ... ... ... ... ... ... ... Accidents and Diseases of Parturition . . . 1 ... 1 ... 2 ... ... ... 3 ... ... ... ... ... ... Congenital Defects ... ... 1 3 1 1 1 1 3 1 ... ... ... ... ... ... Premature Birth 4 2 11 3 4 7 2 1 3 6 1 ... ... ... ... ... Developmental Diseases 2 1 5 3 4 1 4 2 7 5 1 1 ... ... 2 2 Old Age 1 3 6 9 4 4 3 13 2 8 ... 1 1 2 2 6 Suicide ... ... 2 1 5 ... 2 1 3 3 2 ... 3 1 1 ... Overlaid in Bed 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Other Accidents and Violence 4 4 6 3 6 4 5 6 11 4 2 1 3 2 4 5 Homicide ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined Causes ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... All other Causes 17 9 21 16 29 16 26 22 24 23 9 5 10 8 16 12 All Causes 111 113 176 171 145 143 150 180 213 227 35 23 31 32 62 83 In Institutions 43 52 73 52 52 54 62 63 122 109 8 5 5 9 22 28 86 transferred deaths. TABLE V. Transferred Deaths. 1914. (Included in Table III.) Causes of Death. All Ages. Under 1. 1-5. 5-15. 15-25. 25-65. 65 and upwards. Institutions. P. M. f. M. f. M. f. M. F. M. f. M. f. M. f. M. f. Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Pulmonary Tuberculosis, A. Phthisis 8 5 3 ... ... ... ... ... ... ... 3 5 ... ... ... 3 ... Cancer... 6 4 2 ... ... ... ... ... ... ... ... 2 1 2 1 2 2 Organic Disease of Heart 4 ... 4 ... ... ... ... ... ... ... 1 ... ... ... 3 ... 1 Bronchitis 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Pneumonia 5 1 4 ... 1 ... ... ... ... ... ... 1 1 ... 2 ... 1 Other Diseases of Respiratory Organs 2 ... 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 Appendicitis 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Cirrhosis of Liver 2 2 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... Nephritis and Bright's Disease 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Old Age 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Suicide 4 4 ... ... ... ... ... ... ... 1 ... 2 ... 1 ... ... ... Accident and Violence 5 5 ... ... ... 1 ... ... ... ... ... 4 ... ... ... ... ... Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other Causes 30 16 14 1 1 1 2 ... 1 ... ... 9 7 5 3 7 3 All Causes 71 40 31 1 2 2 2 ... 1 1 4 26 10 10 12 12 9 TABLE VI. Transferred Deaths. 1914. (Included in Table IV.) Causes of Death. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate, Hyde Park. West. East. Diphtheria ... ... ... ... ... ... ... ... Epidemic Influenza . . . ... 1 ... ... ... ... ... Pulmonary Tuberculosis, A. Phthisis ... 1 1 4 ... ... ... 2 Cancer 2 1 2 ... ... 1 ... ... Organic Disease of Heart 1 1 ... ... 2 ... ... ... Bronchitis ... ... ... ... 1 ... ... ... Pneumonia ... 1 1 ... 1 1 1 ... Other Diseases of Respiratory Organs ... ... ... ... ... ... ... 2 Appendicitis ... ... ... ... ... ... 1 ... Cirrhosis of Liver ... ... 2 ... ... ... ... ... Nephritis and Bright's Disease ... ... ... 1 ... ... ... ... Old Age ... ... ... 1 ... ... ... ... Suicide ... 1 2 ... 1 ... ... ... Accident and Violence 1 2 ... ... 1 ... ... ... Homicide ... ... ... ... ... ... ... ... Ill-defined Causes ... ... ... ... ... ... ... ... All other Causes ... 1 6 9 3 3 4 4 All Causes 4 8 15 15 9 5 6 9 Institutions 1 3 3 9 3 1 ... 1 deaths in institutions. 87 TABLE VII. Deaths in Institutions. Local Institutions (Uncorrected). Outlying Institutions. Corrected Totals. Equal to per cent. of all Deaths. Totals. Workhouse. Infirmary. St. Mary's Hospital. Children's Hospital. | Lock Hospital. Home of Compassion. Women's Hospital for Children. Totals. Metropolitan Asylums Board. General Hospitals. Special Hospitals and Homes. Lunatic Asylums. Poor Law Institutions. 1904 780 66 261 360 92 1 Opened in 1908 Opened for In-patients Autumn, 1913. 154 27 43 31 46 7 582 29.89 1905 806 91 233 387 91 4 146 13 48 81 49 5 578 29.47 1906 775 48 266 356 98 7 172 35 45 38 43 11 597 32.39 1907 770 22 325 332 88 3 205 27 60 36 59 23 655 32.52 1908 825 57 316 351 91 — 10 187 30 59 43 42 13 662 34.91 1909 813 96 253 362 88 5 9 193 25 49 42 57 20 628 31.97 1910 808 105 270 310 104 8 11 160 16 66 26 41 11 632 35.20 1911 854 105 293 383 56 9 8 196 45 51 29 59 12 665 34.52 1912 798 119 275 304 95 5 Closed 211 29 90 34 46 12 677 38.23 1913 890 139 306 339 99 6 252 56 93 34 56 13 789 39.86 Averages 1904-08 791 57 280 357 92 3 — - 173 26 51 36 48 12 613 31.51 1909-13 833 113 281 339 88 7 — - 202 34 70 33 52 13 678 35.93 1904-13 812 85 280 348 90 5 - - 187 30 60 35 50 12 645 33.66 1914 791 123 301 273 75 8 — 11 265 39 82 48 75 21 759 40.05 TABLE VIII. Deaths in Local, Public Institutions, 1914. Causes of Death. Workhouse. Infirmary. Lock Hospital. Children's Hospital. St. Mary's Hospital. Women's Hospital for Children. Nursing Homes. Enteric Fever ... ... ... ... 3 ... ... Measles ... 2 ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... Whooping Cough ... 5 ... ... ... 1 ... Diphtheria, Membranous Croup ... 1 ... 1 1 ... ... Croup ... ... ... ... ... ... ... Epidemic Influenza ... 1 ... ... ... ... 1 Erysipelas 2 2 ... ... 1 ... ... Other Septic Diseases ... 1 ... ... 9 ... ... Pulmonary Tuberculosis, Acute Phthisis. 1 43 ... 1 7 1 1 Tub. Meningitis, A. Hydrocephalus ... 1 ... 8 5 1 ... Other Forms of Tuberculosis ... 5 ... 7 5 ... ... Syphilis 2 ... 5 ... 1 ... ... Cancer 7 34 ... ... 49 ... 9 Rheumatic Fever ... ... ... 1 ... ... ... Alcoholism 3 1 ... ... ... ... ... Inflammation and Softening of Brain 1 ... ... ... ... ... ... Cerebro-spinal Fever ... ... ... 2 ... ... ... Simple Meningitis ... 2 1 1 4 ... 2 Cerebral Hæmorrhage 4 5 ... ... 4 ... 1 Convulsions ... ... ... ... ... ... ... Heart Disease, all forms 33 42 ... 1 14 1 3 Bronchitis 31 25 ... 2 2 ... 1 Lobular(Broncho-) Pneumonia ... 7 ... 3 1 1 3 Lobar (Croupous) Pneumonia 1 5 ... 1 3 ... ... Pneumonia ... 1 ... 1 5 ... ... Other Diseases of Respiratory Organs ... 4 ... 2 4 ... ... Diseases of Stomach ... 3 ... ... 7 1 ... Diarrhoea and Enteritis 1 34 1 13 3 l ... Appendicitis ... ... ... ... 8 ... 3 Obstruction of Intestines ... 5 ... 3 9 ... 1 Cirrhosis of Liver 2 1 ... ... 6 ... ... Nephritis and Bright's Disease 4 9 ... 3 15 1 1 Tumours (N.-M.), &c., Fern. Gen. Orgs ... ... ... ... 4 ... 1 Puerperal Fever ... 4 ... ... ... ... 1 Accidents and Diseases of Parturition ... ... 3 ... ... 2 l ... Congenital Defects 1 ... ... 5 2 ... ... Premature Birth 2 6 ... ... ... ... 1 Developmental Diseases ... 3 ... 1 1 1 ... Old Age 12 5 ... ... ... ... ... Suicide ... 1 ... ... 6 ... ... Other Accidents and Violence 1 11 1 7 35 1 ... Homicide ... ... ... ... 1 ... ... Ill-defined Causes ... ... ... ... 1 ... ... All other Causes 15 29 ... 12 55 ... 5 All Causes 123 301 8 75 273 11 34 Non-residents 9 12 8 59 202 7 20 deaths of residents outside the borough. TABLE IX. Deaths of Residents outside the Borough, 1914. Causes of Death. Hospitals of Metropolitan Asylums Board. General Hospitals. Special Hospitals and Homes. Lunatic Asylums. Poor Law Institutions. Elsewhere. Enteric Fever 1 ... ... 1 ... ... Measles 2 ... ... ... ... ... Scarlet Fever 7 ... ... ... ... ... Whooping Cough 1 1 1 ... ... 1 Diphtheria, Membranous Croup 13 ... ... ... ... ... Croup . . . ... ... ... ... ... Epidemic Influenza ... ... ... ... ... 1 Erysipelas ... ... ... ... ... ... Other Septic Diseases 1 1 ... ... ... ... Pulmonary Tuberculosis, Acute Phthisis 2 1 16 12 1 6 Tub. Mening., A. Hydroceph. 1 2 ... ... ... ... Otiier Forms of Tuberculosis 2 ... ... ... 3 1 Syphilis ... 1 1 1 ... ... Cancer 1 19 10 5 3 8 Rheumatic Fever ... ... ... ... ... ... Alcoholism ... ... ... ... ... 1 Inflammation and Softening of Brain ... ... ... 5 ... ... Cerebro-spinal Fever ... ... ... ... ... ... Simple Meningitis ... 1 ... ... ... ... Cerebral Hæsmorrhage 1 1 ... 2 ... 8 Convulsions l ... ... ... ... ... Heart Disease ... 7 ... 9 3 7 Bronchitis ... 3 ... 2 1 1 Lobular (Broncho-) Pneumonia ... 1 1 1 1 ... Lobar (Croupous) Pneumonia ... ... ... 4 ... i Pneumonia ... 1 l ... ... 5 Other Diseases of Respiratory Organs . 1 ... 2 ... ... 1 Diseases of Stomach ... ... ... ... ... 1 Diarrhoea and Enteritis 2 6 1 ... 3 1 Appendicitis ... 3 ... ... ... 3 Obstruction of Intestines ... 2 ... ... ... ... Cirrhosis of Liver ... 1 ... ... ... 2 Nephritis and Bright's Disease ... 2 1 4 ... 2 Tumours (N.-M.), &c., Fem. Genital Organs ... 1 ... ... ... ... Puerperal Fever 1 1 ... ... ... ... Accidents and Diseases of Parturition ... 2 ... ... ... 1 Congenital Defects ... ... ... ... 1 ... Premature Birth ... 7 ... ... 1 Developmental Diseases ... 3 ... ... ... 1 Old Age ... ... ... 4 ... 2 Suicide ... 1 ... ... ... 7 Other Accidents and Violence ... 1 ... ... 1 8 Homicide ... ... ... ... ... ... Ill-defined Causes ... ... ... ... ... All other Causes 2 20 4 25 4 18 All Causes 39 82 45 75 21 88 Transferred Deaths* ... 4 8 5 3 51 *Included in the figures given above. DEATHS UNDER ONE YEAR. 89 table x. Deaths under One Year. Group. Causes of Death. Days. Weeks. Months. Totals under One Year. Males. Females. 0— 0— 1— 2— 3— 0— 1— 2— 3— 4 — 5— 6— 7— 8- 9- 10— 11— 1914 1909-13 1914 1909-13 m. f. m. f. m. f. m. f. m. f. m. f. m. F. m. f. m. f. m. f. m. F- m. f. m. f. m. f. m. f. m. f. \f. f. I. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chickenpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 6 ... 6 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 0 ... 0 Whooping Cough ... ... ... ... ... ... 1 ... ... ... 1 ... 2 ... ... ... ... 1 ... ... 1 ... ... ... 1 1 ... 1 2 ... ... 1 1 1 8 8 5 7 II. Diarrhœa ... ... ... ... ... ... ... ... ... 1 ... 1 3 1 ... 2 3 ... 1 1 1 ... 1 ... ... 1 1 ... ... 1 ... 1 1 1 11 13 9 15 Enteritis ... ... ... ... ... ... ... 2 ... ... ... 2 ... 3 2 6 7 2 2 3 4 4 3 ... ... ... 1 2 1 2 ... 2 3 3 23 19 29 16 III. Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 Other Forms do. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 2 ... 3 2 1 1 IV. Congenital Malformations 2 ... 5 1 ... 2 ... ... ... ... 5 3 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 10 5 8 Premature Birth 10 5 14 12 2 3 3 ... 3 1 22 16 1 1 ... ... 2 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 25 32 19 24 Atrophy and Debility ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 5 9 3 5 Debility at Birth 1 1 2 2 ... ... 3 1 1 ... 6 3 ... 1 2 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 8 10 5 6 Injury at Birth ... 1 1 1 ... ... 1 ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 1 3 Atelectasis 5 1 7 4 ... ... ... ... ... 1 7 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 4 5 3 Want of Breast Milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... 1 V. Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 0 ... 0 Syphilis 2 ... 3 ... ... 1 ... ... 1 ... 4 1 1 ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 6 4 3 2 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 0 ... 0 Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 3 2 2 Convulsions ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 1 3 Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 0 ... ... Bronchitis ... ... ... ... 1 ... 1 ... 1 ... 3 ... 1 4 2 ... 1 1 ... ... ... ... 1 ... 1 1 ... ... ... ... 1 ... ... ... 10 12 6 10 Pneumonia ... ... ... ... 1 1 2 ... ... 1 4 9 2 ... 3 ... 2 ... 2 1 ... i 1 1 1 ... 1 1 1 ... 3 ... 2 2 22 20 8 14 Suffocation (overlaid) ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 1 2 Other Causes 2 1 3 1 1 2 ... ... ... 2 4 5 3 2 ... 2 1 ... ... 1 ... ... ... 2 ... ... 1 3 ... ... 1 ... 1 17 14 12 8 All Causes 22 9 36 22 5 9 11 3 6 6 58 40 15 14 15 13 20 9 6 8 10 7 6 2 5 4 3 6 9 3 5 5 10 8 162 119 Uncertified Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Averages 1909-13 21 16 40 26 9 7 8 6 6 4 63 43 21 18 14 12 11 10 9 9 11 8 10 6 10 5 9 7 7 8 8 7 6 6 179 139 1914. 1909-13. 1914. 1909-13. Corrected Births—Total M. 1,503 1,522 Illegitimate m. 86 90 F. 1,430 1,469 f. 95 85 90 factories, workshops, laundries, workplaces and homework. TABLE XL 1.—Inspections. Including Inspections made by Sanitary Inspectors. H.O. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 96 1 - Workshops (including Workshop Laundries) 2,737 3 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) 28 — — Total 2,861 4 — 3.—Home Nature of Work. Outworkers' Lists, Section 107. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Twice in the year. Once in the year. Outworkers. Outworkers. Lists. Contractors. Workmen. Lists. Contractors. Workmen. Wearing Apparel— (1) making, &c. 88 20 490 9 - 19 88 (2) cleaning and washing 6 - 10 - - - 6 Furniture and upholstery 4 - 48 - - - 4 Electro-plate 2 2 — - — — 2 Umbrellas, &c. 2 — 2 - — — 2 Artificial flowers 4 — 4 - — — 4 Brush making 2 - 2 - - - 2 Total 108 22 556 9 - 19 108 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the year. Number. Workshops 1,295 Do. Bakehouses 50 Total number of workshops on Register 1,345 factories, workshops, laundries, workplaces and homework. 91 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances wider the Public Health Acts:— Want of cleanliness 40 40 - - Want of ventilation 5 5 - - Overcrowding 12 12 - - Want of drainage of floors — — - - Other nuisances — - - insufficient 2 2 - - Sanitary accommodation unsuitable or defective 47 47 - - not separate for sexes 2 2 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — - — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) 5 5 — — Total 113 113 - — Work. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109, 110. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (SS. 109,110). Failing to keep or permit inspection of lists. Failing to send lists. - - - - - 16 - - — — — — — - — — — — — — — - - — — — — — — - — — — — — — — - - — — — — — — - — — - - - - - - - — — — — - 16 - — 5.—Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 57 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5) Notified by H.M. Inspector 13 Reports (of action taken) sent to H.M. Inspector 12 Other — Underground Bakehouses (S. 101):— Certificates granted during the year — In use at the end of the year 38 92 proceedings during 1914. TABLE XII. PROCEEDINGS DURING 1914. LC.C. Premises. Number of Places— Number of Inspections, 1914. Number of Notices, 1914. Number of Prosecutions, 1914. On Register at end of 1913. Added in 1914. Removed in 1914. On Register at end of 1914. Milk premises 123 6 10 119 164 ... 4* Cowsheds ... 1 ... ... 1 4 ... ... Slaughter-houses ... 7 ... ... 7 380 ... ... Other offensive trade premises ... ... ... ... ... ... ... Ice cream premises 116 io 6 120 114 2 ... Registered houses let in lodgings 1,376 60 11 1,425 8,781 (a) 13 (a) 1 (b) 2,631 (b) 2 (a) For overcrowding. (b) For other conditions (.including annual cleansing). Total number of intimation notices served for all purposes 793 Overcrowding, 1914— Number of dwelling rooms overcrowded 197 Number remedied 80 Number of prosecutions 1 Underground rooms— Illegal occupations dealt with during year 115 Number of rooms closed 115 Insanitary houses— Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing Acts 5 Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 355 Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — Revenue Acts— Number of houses for which applications were received during year 5 Number of tenements comprised therein 17 ((a) granted 2 Number of tenements for which certificates were (b) refused ( (c) deferred 15 Number of prosecutions under By-laws under Public Health Act, 1891— (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. - (i) With respect to sufficiency of water supply to water closets — (j) With respect to drainage, &c. (Metropolis Management Act, Sec. 202) — (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 1 Mortuaries— Total number of bodies removed 321 Total number of infectious bodies removed 3 *Three summonses for selling milk without being registered, and one for selling milk from infected premises.