AC 4349 PAD 24 Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON. FOR THE YEARS 1924 and 1925. BY GEOFFREY EUGENE OATES, M.D., B.S. (London), M.R.C.P. (London); D.P.H. (Cambridge) ; Barrister-at-Law, Medical Officer of Health. LONDON: WIGHTMAN & Co., Ltd., Printers, REGENCY STREET, WESTMINSTER, S.W. 1. Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON. FOR THE YEARS 1924 and 1925. BY GEOFFREY EUGENE OATES, M.D., B.S. (London), M.R.C.P. (London); D.P.H. (Cambridge) ; Barrister-at-Law, Medical Officer of Health. LONDON: WIGHTMAN & Co., Ltd., Printers, REGENCY STREET, WESTMINSTER, S.W. 1. CONTENTS. page Acute Encephalitis Lethargica 22 Acute Influenzal Pneumonia 22 Acute Polio-encephalitis 22 Acute Polio-myelitis 21 Acute Primary Pneumonia 22 Administrative Work 39 Annual Cleansing 44 Ante-natal Consultation Centres 34,36,58 Anthrax 22 Bacteriological Work 39 Bakehouses 48,49 Births 5 „ Illegitimate 6 „ in Institutions 6 „ Notification 7 Birth-rates 6 Canals, Canal Boats 42,57 Cancer 22 Cerebro-spinal Fever22 Chicken-pox 20 Cholera 22 Combined Drainage 40 Common Lodging Houses 44 Compulsory Repairs 43 Continued Fever 22 Convalescent Homes 39 " Conversions " 43 Cowhouse 50 Cream Regulations 52 Dairies and Milk Shops 50 Day Nurseries 37, 58 Deaths, Causes of 7-12 „ in Institutions 13 Death-rates 13 Diarrhoea 23 Diphtheria 19 ,, Carrier Clinic 20 Disinfection 39 District Inspectors' Work 56 Drainage, Combined 40 „ House 40 Reconstruction Plans 40 Dysentery 22 Erysipelas 21 Food Adulteration 50 „ Destroyed 50 „ Purveyors 50 „ Supervision 49-52 Fouling of Footways by Dogs 41 Glanders 22 Health Visiting 33 Homework (Outworkers) 47,48 Houses Unfit for Habitation 43 Housing 43-46 Hydrophobia 22 Ice Cream 50 Increase of Rent, &c., Acts 44 Infant Consultation Centres 34-36, 58 Infantile Mortality 13-16 page Infectious Disease, Notification of 17 „ „ Prevention of 39,57 Infective Enteritis 23 Legal Proceedings 54 L.C.C. Houses 44 Malaria 22 Marriages 5 Maternity and Child Welfare 32-39 Maternity Nursing 36 Measles 20 Meat Regulations 49 Milk, Dried 52 „ Grants 37 „ (Special Designations) 50 Mortuary 41,57 Nursing 39 Office Work 57 Ophthalmia Neonatorum 21 Outworkers (Homework) 47,48 Overcrowding 43,45 Plague 22 Population 5 Poultry Slaughtering 50 Pneumonia 22 Puerperal Fever 21 Rag and Bone Dealers 41 Rats and Mice Destruction 52 Relapsing Fever 22 Rent Books 45 Scarlet Fever 18 Schools and Infectious Disease 39 Sewer Connections 41 Slaughterhouses 49 Smallpox 20 Smoke Control 41, 57 Staff 39,58 Tenement Houses 43,45 Trade Nuisances 41,57 Trench Fever 22 Tuberculosis, Artificial Pneumothorax treatment 30 „ Deaths'from 24 ,, Dental treatment 30 „ Dispensary treatment 24, 28, 58 „ Home visiting 30 „ Notification 28 „ Regulations, 1921 and 1925 30 „ Supply of Beds and Bedding 30 Tuberculosis Care Committee 32 Typhoid Fever 20 Typhus Fever 22 Underground Rooms 43 Venereal Diseases 58 Verminous Conditions 53 Vital Statistics 4, 5 Water Supply 41,57 Whooping Cough 22 Workshop Supervision 47-49 TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF PADDINGTON. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you my Annual Reports for the years 1924 and 1925 as required by the Statutes and Orders applicable to my office. I took up my duties in Paddington on September 25th, 1925, and it will be evident that a great portion of these reports deals with matters of which I have no personal knowledge. To this extent the reports have been written under conditions of some difficulty, and I have been dependent on information supplied to me by officers in this department. This fact must also excuse the delay which has taken place in the issue of these reports and the scanty comment which I have had to make on the facts and figures submitted. The Ministry of Health have asked that reports issued during the present year may be Survey Reports dealing with the previous five years as a whole, but with the best intention to comply with this request I have found it to be impracticable. A mere summary of the events and statistics of the last five years without the necessary commentary would in my opinion not be worth the time and labour involved, and I do not feel it to be within my power to offer useful criticism of the events of such an important epoch. During the years 1924 and 1925 the health of the Borough continued to be good, but, judging from the death-rate and the infantile mortality, there was no marked improvement. The birth-rate continued to fall, and has now reached the same rate as during the war-time period. From the purely health point of view a lowered birth-rate is advantageous, but there are, of course, cogent reasons for deploring this continued decline in the number of infants born, especially in a borough such as Paddington, which contains a large proportion of the efficient and successful members of the community. The infantile mortality-rate of 72 deaths per 1,000 births reflects a great improvement on pre-war times, but shows the need for further efforts. Boroughs such as Lewisham, Woolwich and Hampstead have infantile mortality-rates of 55, and Lambeth of 45. An infantile mortalityrate of 40 should be our aim, but so far our lowest rates have been 69 in the years 1922 and 1923. An innovation which should have indirect efforts in lowering infantile mortality has been the inauguration of a system of maternity nursing of parturient mothers attended by the students of St. Mary's Hospital. During my short period of office both I and my staff have received much support and consideration from the Council, and this has served to remove many difficulties. I should like to take this opportunity of thanking the staff of the Public Health Department for the loyal help I have received from them, and other members of the Council's staff for many courtesies received. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, G.E. Oates. M.D., M.R.C.P., D.P.H., Medical Officer of Health. Town Hall, Paddington Green, W. 2. June, 1926. SUMMARY OF VITAL STATISTICS. Area of Borough 1,356.1 acres, including waterways 20.0 acres: 1924 1925 Population (Registrar-General's estimate) 146,400 147,100 Density of population per acre 107 108 Census, 1921: Total number of buildings containing dwellings 17,153 (a) Dwellings occupied by non-private families 435 Population inhabiting the same 12,910 (b) Dwellings occupied by private families (Including vacant census night, 938). 38,320 Population enumerated in occupied dwellings 131,351 Occupying 141,959 rooms, averaging 1.08 persons per room, or 0.92 room per person. 1924 1925 Marriages 1,528 1,562 Births 2,505 2,337 Birth-rate 17.11* 15.88* Deaths 1,920 1,780 Death-rate 13.11* 12.10* Infantile Mortality:— Deaths under 1 year 196 170 Mortality 78† 72† Maternal Mortality:— Deaths of women from Diseases or Accidents associated with Childbirth 6 8 Maternal mortality 2.39† 3 .42† Deaths from Phthisis 120 89 Phthisis death-rate 0.81* 0.60* Deaths from all forms of Tuberculosis 149 116 Tuberculosis death-rate 1.01* 0.78* Deaths from Zymotic Diseases 141 62 Zymotic death-rate 0.96* 0.42* Rateable Value £1,551,861 £1,562,442 Product of a Penny Rate £6,287 £6,325 * per 1,000 persons. † per 1,000 births. 5 VITAL STATISTICS. The Metropolitan Borough of Paddington as constituted under the London Government Act, 1899, covers an area of 1,356.1 acres, including 20.0 acres of waterway. It is co-extensive with the Civil Parish and Registration District of the same name. The Borough is divided into nine wards. One of these wards, the Town Ward, is of recent formation, and for statistical purposes in the following report it is grouped as part of the Church Ward, to which it originally belonged. General Summary of Vital Statistics. Year. Estimated Population. Births. Deaths at All Ages. Deaths under One Year. Registered Locally. Transfers. Nett. Registered Locally. Gross Mortality. Transfers. Nett. Registered Locally. Nett. Out. In. Totals. Rates. Out. In. Totals. Mortality. Number. Mortality Totals. Mortality. 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 1914 142,087 2,708 49 274 2,933 20.64 1,892 13.31 347 350 1,895 13.33 312 115 281 96 1915 131,397 2,506 59 267 2,714 20.65 2,304 17.53 370 352 2,286 17.39 343 137 319 117 1916 t 142,169 2,378 61 372 2,689 18.91 ... ... ... ... ... ... 289 121 253 94 c 136,668 ... ... ... ... ... 1,924 14.72 370 326 1,880 14.38 1917 t 136,561 1,834 77 334 2,091 15.31 ... ... ... ... ... ... 290 158 273 135 c 122,507 ... .... ... ... ... 1,997 16.30 321 374 2,050 16.73 1918 t 131,673 1,798 118 337 2,017 15.31 ... ... ... ... ... ... 266 148 235 116 C 117,517 ... ... ... ... ... 1,999 17.01 345 595 2,249 19.13 1919 t 149,941 2,016 154 454 2,316 15.44 ... ... ... ... ... ... 213 105 212 91 C 143,938 ... ... ... ... 1,499 10.41 310 725 1,914 13.29 1920 t 150,128 3,181 251 483 3,413 22.73 ... ... ... ... ... ... 279 87 266 78 C 149,673 ... ... ... ... ... 1,667 11.13 370 410 1,707 11.40 1921 145,600 2,653 296 502 2,859 19.63 1,784 12.25 372 346 1,758 12.07 307 115 263 92 1922 145,300 2,557 288 462 2,731 18.79 1,929 13.27 365 324 1,888 12.99 224 88 189 69 1923 146,200 2,410 275 485 2,620 17.92 1,743 11.92 338 317 1,722 11.77 207 86 180 69 1924 146,400 2,343 284 446 2,505 17.11 2,054 14.03 475 341 1,920 13.11 232 99 196 78 1925 147,100 2,206 312 443 2,337 15.88 2,011 13.67 570 339 1,780 12.10 196 88 170 72 "T "="Total; " C " =Civil. POPULATION. The Registrar-General's estimate of the population of the Borough for the year 1924 was 146,400, and for the year 1925, 147,100. The populations in the various wards have been estimated to be as shown in the following table:— 1924. 1925. The Borough 146,400 147,100 Wards— Queen's Park 15,987 16,064 Harrow Road 27,921 28,055 Maida Vale 22,429 22,535 Westbourne 24,459 24,576 Church (including Town) 25,322 25,443 Lancaster Gate, West 9,673 9,719 Lancaster Gate, East 8,282 8,322 Hyde Park 12,327 12,386 MARRIAGES. During 1924, 1,528 marriages were solemnized in the Borough, being a rate of 20.9 persons per 1,000 of the population. In 1925 the rate was 21.2. BIRTHS. The number of births registered in the Borough during 1924 was 2,343, and, in addition, 162 occurred outside the Borough to Paddington residents in excess of those occurring in Paddington to residents of other localities, making a total of 2,505 births. The birth-rate for 1924 was therefore 17.11 births per 1,000 population. Of the 2,505 births, 1,302 were those of males and 1,203 those of females, and of these 104 males and 101 females were illegitimate. The Registrar-General's final figure for the nett number of births is given as 2,501, but this does not affect the figure for the birth-rate given above. 6 The number of births registered in the Borough during 1925 was 2,206 and, in addition, 131 occurred outside the Borough to Paddington residents in excess of those occurring in Paddington to residents of other localities, making a total of 2,337 births. The birth-rate for 1925 was therefore 15.88 births per 1,000 population. Of the 2,337 births, 1,217 were those of males and 1,120 those of females, and of these 100 males and 80 females were illegitimate. The following table shows the birth-rate during each of the last five years in England and Wales, in London, in Paddington and in each of the wards of the Borough:— 1925 1924 Birth-rates. No. of Births. Birthrates. No. of Births. Birthrates. 1923 1922 1921 England and Wales 710,979 18.3 729,933 18.8 19.7 20.4 22.4 London 82,401 18.0 85,147 18.6 20.1 20.9 22.1 Paddington 2,337 15.88 2,505 17.11 17.92 18.79 19.63 Wards . Queen's Park 203 12.63 220 13.76 15.28 17.26 18.49 Harrow Road 451 16.07 447 16.01 18.36 19.88 20.23 Maida Vale 336 14.09 434 19.35 19.95 19.00 20.89 Westbourne 445 18.14 473 19.33 21.04 20.14 22.65 Church (including Town) 599 23.54 609 24.05 23.84 25.22 25.09 Lancaster Gate, West 76 7.82 81 8.37 8.69 10.10 9.56 Lancaster Gate, East 79 9.49 75 9.05 5.68 9.49 9.59 Hyde Park 148 11.94 166 13.46 13.72 15.03 14.92 The following table shows the course of the birth-rate in the Borough in the past:— BIRTH-RATES. Paddington. 1881-1885 26.66 1886-1890 24.89 1891-1895 24.44 1896-1900 23-29 1901-1905 22.89 1906-1910 21.14 1911-1915 20.88 1916-1920 17.63 1921 19.63 1922 18.79 1923 17.92 1924 17.11 1925 15.88 Illegitimate Births.—These were, in 1925, 180 in number, or 7.70 per cent. of the total number of births. In 1924 the figures were 205 and 8.18 per cent. The proportion of illegitimate births varies remarkably in the different wards as is shown in the table below:— Rate of Illegitimate Births per 100 Total Births. Rate. Rate Ward. 1925 1924. Queen's Park 3.94 3.18 Harrow Road 1.77 4.25 Maida Vale 10.71 9.67 Westbourne 7.41 5.91 Church (including Town) 8.34 10.34 Lancaster Gate West 18.42 13.58 Lancaster Gate East 16.45 14.66 Hyde Park 12.16 14.45 Births in Institutions.—1924. Local. Legitimate. Illegitimate. Total. Paddington Infirmary 74 (4) 62 (8) 136 (12) St. Mary's Hospital 202 (112) 12 (5) 214 (117) Lock Hospital 20 (17) 59 (56) 79 (73) Non-residents shown in ( ) Outlying. Legitimate. Illegitimate. Total. Queen Charlotte's Hospital 233 24 257 Other Lying-in Hospitals 5 2 7 Other Hospitals 18 4 22 Poor Law Institutions 5 5 10 7 1925. Local. Legitimate. Illegitimate. Total. Paddington Infirmary 84 (8) 54 (6) 138 (14) St. Mary's Hospital 267 (131) 10 (4) 277 (135) Lock Hospital 21 (19) 60 (56) 81 (75) Non-residents shown in ( ). Outlying. Legitimate. Illegitimate. Total. Queen Charlotte's Hospital 210 22 232 Other Lying-in Hospitals 9 4 13 Other Hospitals 36 1 37 Poor Law Institutions 8 7 15 Notification of Births Acts, 1907 and 1915.—These Acts require the father of a child, if actually residing in the house where a birth takes place at the time of its occurrence, and any person in attendance upon the mother at the time of, or within six hours after, the birth, to give notice in writing of the birth to the Medical Officer of Health of the district in which the child is born, in the manner provided. Notification applies in the case where a child has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. In practice, it is almost always the doctor or midwife who notifies a birth, and not the father of the child. Notification of Births in 1924. During the year 2,330 live births were notified to the Medical Officer of Health. There were also 74 stillbirths notified. Of the 2,404 living and stillbirths notified, 45.4 per cent. were notified by Medical Practitioners, 36.9 per cent. by Midwives, 5.2 per cent. by Parents and 12.5 per cent. by other persons. A comparison of the Notification Register with the Returns supplied by the local Registrars of Births showed that 96.6 per cent. of the births occurring within the Borough were duly notified. Notification of Births in 1925. During the year 2,237 live births were notified to the Medical Officer of Health. There were also 61 stillbirths notified. Of the 2,298 living and stillbirths notified, 44.9 per cent. were notified by Medical Practitioners, 37.1 per cent. by Midwives, 3.0 per cent. by Parents and 15.0 per cent. by other persons. Of the births registered in the Borough, 96.9 per cent. were notified. Rather more than 3 per cent. of all live births are not notified in accordance with the law, and are not brought to the notice of the Medical Officer of Health until they come to be registered within the statutory period of six weeks. In nearly every case of default a cautionary letter was sent to the person in default, but in no instance did the Maternity and Child Welfare Committee consider it necessary to institute legal proceedings for default. DEATHS. Deaths in 1924.—The number of deaths that were registered during the year as having taken place in the Borough was 2,054. Of these, 475 were of persons whose residence was not in Paddington, 395 dying in Paddington Institutions and 80 in other places in the Borough. There were also reported to the Registrar-General 341 deaths of Paddington persons whose deaths occurred outside the Borough. This correction gives the nett number of deaths for Paddington as 1,920, making an annual deathrate of 13.1. The Registrar-General's final figure for the nett number of deaths is given as 1,922, but this does not affect the figure for the death-rate given above. 1924. Selected Causes of Death Arranged in Four-Weekly Periods. Period ended. Measles. Scarlet Fever. WhoopCough. Diphtheria. Influenza. Phthisis. Cancer. Bronchitis. Pneumonia. Diarrhoea & Enteritis. January 26th 7 1 - 2 4 10 24 25 27 3 February 23rd 12 1 5 2 26 15 15 50 40 — March 22nd 28 — 1 2 14 10 22 34 31 2 April 19th 21 — — 1 11 11 19 17 14 2 May 17th 11 — 1 1 2 18 15 14 11 — June 14th — — — — 2 9 13 8 8 3 July 12th 2 1 — 1 1 6 17 4 4 2 August 9th — — — 1 — 6 16 2 6 1 September 6th — — 1 2 — 8 17 3 3 4 October 4th — — 1 1 — 5 22 6 8 9 November 1st — — — — 5 8 13 6 11 2 „ 29th — — — — — 5 22 13 9 2 December 31st (4 weeks 4 days) — — — 1 4 9 19 13 15 3 Totals 81 3 9 14 69 120 234 195 187 33 8 Causes of Death. 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. Enteric Fever 1 1 1 1 Small-pox... Measles 81 12 5 14 13 10 19 6 1 i 21 12 Scarlet Fever 3 2 1 2 1 Whooping-cough 9 1 4 i 1 2 2 4 Diphtheria, Membranous Croup ... 14 1 1 4 3 2 3 6 6 Influenza ... 69 1 2 1 1 2 7 1 12 7 9 26 7 4 Erysipelas... 2 i 1 1 1 Septicaemia 8 l 1 2 i 2 1 2 3 Pulmonary Tuberculosis 120 1 1 2 2 12 10 29 27 19 15 1 1 38 33 Tuberculous Meningitis ... 11 1 2 \ 1 i 2 1 1 1 ... 6 4 Other Forms of Tuberculosis 18 1 1 3 1 1 2 2 2 1 1 2 1 6 6 Syphilis 7 l 1 1 4 6 1 Cancer 234 i 7 12 55 55 47 57 61 Rheumatic Fever 1 l Alcoholism 4 i 1 i i Inflammation & Softening of Brain 4 1 1 1 1 1 1 Cerebro-spinal Fever Simple Meningitis 6 2 1 1 i i j . . 2 Cerebral Hemorrhage ... 84 i ... i ... 14 8 21 39 17 7 Convulsions 2 i 1 Endocarditis 7 2 i 3 i 3 3 Heart Disease 193 2 2 5 38 37 39 70 17 36 Bronchitis... 195 9 6 4 2 i i 4 2 18 15 45 88 27 35 Lobular (Broncho-) Pneumonia ... 107 25 13 5 11 6 6 l 2 5 6 5 4 18 30 32 Lobar (Croupous) Pneumonia 31 1 4 1 1 1 2 3 6 2 6 4 7 10 Pneumonia 49 1 1 ... 7 2 18 6 7 7 13 6 Other Diseases of Respiratory Organs 18 1 2 6 3 3 3 6 3 Diseases of Stomach 26 5 2 8 6 2 3 10 5 Diarrhoea and Enteritis ... 33 24 9 ... 20 8 Appendicitis 5 i i 2 i 1 2 Obstruction of Intestines 12 1 1 2 5 2 1 4 5 Cirrhosis of Liver 11 ... 2 4 4 1 2 3 Nephritis and Bright's Disease ... 66 6 2 19 10 20 9 26 6 Tumours (Non-malignant), &c.. Female Genital Organs ... 2 1 1 1 Puerperal Fever... 3 1 2 2 Accidents and Diseases of Parturition 3 3 2 Congenital Defects 13 6 6 1 4 Premature Birth 33 20 13 4 8 Developmental Diseases... 22 12 9 1 7 8 Old Age 48 ... 15 33 5 8 Suicide 24 3 4 i 12 i 2 1 4 1 Overlaid in Bed ... , J Other Accidents and Violence 55 1 1 2 2 1 2 2 1 9 1 12 5 3 13 18 12 Homicide .J Execution... Ill-defined Causes 2 1 ,4, 1 All other Causes... 284 3 i 1 4 1 3 3 10 17 52 36 68 85 83 75 All Causes 1920 121 75 29 37 34 35 24 18 28 22 99 99 312 224 299 464 465 417 Uncertified 1 9 Deaths of Residents of the Borough, 1924. Numbers (All Ages) in Each Ward. Causes of Death. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate. Hyde Park. West. East. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Enteric Fever ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 6 2 4 6 5 5 11 13 14 12 ... ... 1 ... 2 ... Scarlet Fever ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... Whooping-cough ... 1 ... 2 ... ... 1 ... 1 1 ... ... ... ... 2 1 Diphtheria, Membranous Croup 1 ... 1 1 ... 1 5 4 ... ... 1 ... ... ... ... ... Influenza 3 4 7 6 3 11 6 7 5 2 1 3 3 4 2 2 Erysipelas ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... Septicaemia 1 ... ... 1 ... 1 1 1 i i ... ... ... 1 ... ... Pulmonary Tuberculosis 8 4 13 9 6 6 11 14 19 10 1 2 1 1 5 10 Tuberculous Meningitis 2 ... 1 ... 1 ... ... 3 1 1 ... ... ... ... 1 1 Other Forms of Tuberculosis 2 2 3 2 1 ... 2 1 ... 2 l ... ... ... 1 1 Syphilis ... ... 1 ... ... ... 2 1 1 ... 2 ... ... ... ... ... Cancer 9 17 29 16 6 28 28 23 18 24 6 5 5 4 9 7 Rheumatic Fever ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Alcoholism ... ... ... ... ... 1 1 ... ... ... ... 1 1 ... ... ... Inflammation and Softening of Brain ... ... ... 1 1 ... ... ... 1 ... 1 ... ... ... ... ... Cerebro-spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Meningitis ... 1 1 ... ... 1 ... 1 1 1 ... ... ... ... ... ... Cerebral Hœmorrhage 2 1 6 9 4 11 9 8 5 7 5 1 ... 5 6 5 Convulsions ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... Endocarditis ... ... 2 1 ... l ... 2 1 ... ... ... ... ... ... ... Heart Disease 8 12 12 25 19 14 11 20 12 19 11 6 4 9 2 9 Bronchitis 8 14 11 23 13 15 17 21 23 31 4 ... 2 3 3 7 Lobular (Broncho-) Pneumonia 4 4 14 9 1 6 10 11 17 22 ... 5 ... 2 1 1 Lobar (Croupous) Pneumonia 5 3 2 3 1 2 3 4 2 1 1 ... ... ... 2 2 Pneumonia 3 ... 8 3 2 5 9 4 5 1 1 2 1 1 4 ... Other Diseases of Respiratory Organs ... ... 1 3 2 2 3 ... 1 2 2 1 ... ... 1 ... Diseases of Stomach ... ... 2 ... 3 ... 2 3 4 2 1 2 1 1 2 3 Diarrhœa and Enteritis ... 1 5 2 2 2 8 1 8 3 ... ... ... ... 1 ... Appendicitis 1 ... ... 1 ... ... ... ... ... 1 ... ... ... 1 1 ... Obstruction of Intestines 1 1 1 ... 1 3 1 1 1 1 ... 1 ... ... ... ... Cirrhosis of Liver ... ... 1 1 ... 3 2 ... ... 1 ... ... ... ... 2 1 Nephritis and Bright's Disease 6 5 6 4 8 ... 9 1 10 5 1 1 1 3 4 2 Tumours (Non-malignant), &c., Female Genital Organs ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... Puerperal Fever ... ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... Accidents and Diseases of Parturition ... ... ... 2 ... ... ... ... ... 1 ... ... ... ... ... ... Congenital Defects ... ... 3 4 1 ... ... ... 1 1 ... 1 1 ... ... 1 Premature Birth. 2 2 2 2 3 1 2 1 9 4 ... 1 2 2 ... ... Developmental Diseases ... ... 3 2 4 ... ... 2 4 5 ... ... 1 ... ... 1 Old Age 1 6 3 5 5 7 2 6 1 2 2 1 ... 2 1 4 Suicide 2 ... 4 1 ... ... 1 ... 9 1 2 l 2 ... 1 ... Overlaid in Bed ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Violence 2 2 4 3 2 ... 4 6 8 5 4 3 2 2 5 3 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Execution. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined Causes ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... All other Causes 19 12 25 25 29 25 19 29 26 21 8 10 6 5 10 15 All Causes 96 95 177 174 127 152 180 191 209 191 55 47 34 48 68 76 In Institutions 47 45 88 71 46 53 97 92 130 104 15 13 8 12 34 27 10 Deaths in 1925.—The number of deaths that were registered during the year as having taken place in the Borough was 2,011. Of these, 570 were of persons whose residence was not in Paddington, 486 dying in Paddington Institutions and 84 in other places in the Borough. There were also reported to the Registrar-General 339 deaths of Paddington persons whose deaths occurred outside the Borough. This correction gives the nett number of deaths for Paddington as 1,780, making an annual deathrate of 12.10 1925. Selected Causes of Death Arranged in Four-Weekly Periods. Period ended. Measles. Scarlet Fever. Whooping cough. Diphtheria. Influenza. Phthisis. Cancer. Bronchitis. Pneumonia. Diarrhœa & Enteritis January 31st (4 weeks 3 days) — — 2 2 5 11 13 23 17 — February 28th — — 3 1 15 4 26 28 15 1 March 28th - — 1 1 11 4 24 20 15 3 April 25th - - 2 2 3 9 14 14 16 — May 23rd - — 2 1 2 7 18 10 10 2 June 20th - — 1 1 1 6 9 1 3 — July 18th — 1 1 1 — 3 19 4 2 1 August 15 th — — — — 1 8 19 1 6 2 September 12th. — — — — — 3 26 5 3 5 October 10th — — — 1 3 7 12 5 5 5 November 7th - - 1 — 1 5 12 8 8 1 December 5th - - — 1 1 12 17 18 14 3 „ 31st (26 days) 10 — - - 5 10 21 24 18 1 Totals 10 1 13 11 48 89 230 161 132 24 11 The following tables show the deaths in 1925 classified according to sex and age, cause of death and the wards of the Borough:— Deaths of Residents of the Borough, 1925. Sex-Age Distribution for Whole Borough. Causes of Death. 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 3 ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... 3 ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 10 3 7 ... 3 1 2 2 2 ... ... ... ... ... ... ... ... ... ... 2 6 Scarlet Fever 1 1 ... ... ... ... ... 1 ... ... ••• ... ... ... ... ... ... ... ... 1 ... Whooping-cough 13 4 9 1 5 1 2 z 1 ... 1 ... ... ... ... ... ... ... ... 3 5 Diphtheria, Membranous Croup 11 5 6 1 3 ... ... 2 3 2 ... ... ... ... ... ... ... ... ... 5 6 Influenza 48 18 30 ... 2 ... 1 ... ... ... 2 2 3 2 4 4 5 10 13 4 8 Erysipelas 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Septicæmia 5 1 4 ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 ... 1 1 1 Pulmonary Tuberculosis 89 55 34 ... ... ... ... ... ... 1 2 15 7 20 17 15 6 4 2 25 21 Tuberculous Meningitis 11 6 5 ... 1 2 ... 1 ... 2 2 1 1 ... 1 ... ... ... ... 6 5 Other Forms of Tuberculosis 16 10 6 2 ... 1 ... 2 ... 1 1 ... 1 2 1 1 3 1 ... 9 6 Syphilis 4 4 ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... ... ... 2 ... Cancer 230 102 128 ... ... ... ... ... ... 2 ... 3 ... 4 16 46 49 47 63 59 60 Rheumatic Fever 5 2 3 ... ... ... ... ... ... 1 1 ... ... ... ... 1 2 ... ... 2 1 Alcoholism 5 1 4 ... ... ... ... ... ... ... ... ... ... ... 1 1 2 ... 1 ... ... Inflammation & Softening of Brain 11 6 5 ... ... ... ... ... ... ... ... ... ... ... 2 3 2 3 1 4 3 Cerebrospinal Fever 6 1 5 1 2 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... 1 5 Simple Meningitis 7 3 4 1 ... ... ... 1 1 ... 1 ... ... ... 1 1 1 ... ... 1 3 Cerebral Hæmorrhage 67 27 40 ... ... ... ... ... ... ... ... ... ... 2 2 12 13 13 25 15 10 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Endocarditis 14 9 5 ... ... ... ... ... ... 2 1 ... 1 5 ... 1 2 1 1 7 3 Heart Disease 231 95 136 ... ... ... ... ... ... 1 ... 1 2 4 11 30 33 59 90 28 47 Bronchitis 161 82 79 6 2 1 1 1 ... ... 1 ... ... 4 1 26 15 44 59 41 33 Lobular (Broncho-) Pneumonia 77 34 43 15 12 5 7 4 ... 1 ... 1 3 1 4 1 7 16 25 22 Lobar (Croupous) Pneumonia 32 22 10 1 1 ... ... 1 ... ... 2 2 1 4 2 7 2 7 2 10 5 Pneumonia 23 11 12 1 1 ... ... ... 1 ... ... ... ... 2 2 2 4 6 4 2 2 Other Diseases of ratory Organs 13 10 3 ... ... 2 ... ... ... ... ... ... ... ... ... 4 1 4 2 5 ... Diseases of Stomach 24 18 6 1 1 ... ... ... ... ... ... ... ... 6 2 9 1 2 2 12 3 Diarrhœa and Enteritis 24 15 9 14 5 1 1 ... 1 ... ••• ... ... ... ... ... 1 ... 12 7 Appendicitis 14 10 4 ... ... ... ... 1 ... 1 1 1 2 2 ... 1 1 4 ... 4 3 Obstruction of Intestines 14 7 7 ... 2 ... 2 ... ... 1 ... 1 ... 1 ... ... ... 4 3 6 5 Cirrhosis of Liver 15 9 6 ... ... ... ... ... ... ... ... ... ... 2 2 4 3 3 1 4 4 Nephritis and Bright's Disease 55 28 27 ... ... ... ... ... ... 1 ... ... 1 2 ... 9 12 16 14 24 11 Tumours (Non-malignant), &c., Female Genital Organs 7 ... 7 ... ... ... ... ... ... ... ... ... ... ... 4 ... 2 ... 1 ... 5 Puerperal Fever 3 ... 3 ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... 3 Occidents and Diseases of Parturition 5 ... 5 ... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... 2 Congenital Defects 10 6 4 6 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 4 Premature Birth 40 22 18 22 18 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 4 Developmental Diseases 21 15 6 15 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 ... Old Age 68 16 52 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 16 51 7 17 Suicide 25 14 11 ... ... ... ... ... ... ... ... ... 1 5 4 9 4 ... 2 2 2 Overlaid in Bed ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and lence 62 35 27 3 3 1 1 3 2 2 2 1 2 3 1 15 5 7 11 26 9 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined Causes 2 1 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All other Causes 297 146 151 2 4 ... 2 4 ... 2 3 4 1 20 13 40 40 74 88 85 78 All Causes 1780 857 923 93 77 15 20 21 15 19 21 31 26 98 96 248 214 332 454 465 410 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Deaths of Residents of the Borough, 1925. Numbers (All Ages) in Each Ward. Causes of Death. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate. Hyde Park. West. East. M. F. M. F. M. F. M. F. M. F. m. F. M. F. M. F. Enteric Fever 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... 1 ... ... 2 1 1 1 ... 4 ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Whooping-cough 3 3 1 1 ... 2 ... ... ... 1 ... 1 ... 1 ... ... Diphtheria, Membranous Croup ... ... ... ... 2 ... ... 5 3 1 ... ... ... ... ... ... Influenza 2 4 ... 6 4 2 3 6 1 9 3 1 2 ... 3 2 Erysipelas ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... Septicaemia ... 1 ... 1 ... ... ... 1 ... 1 1 ... ... ... ... ... Pulmonary Tuberculosis 8 3 14 8 7 4 9 8 11 8 1 ... ... ... 5 3 Tuberculous Meningitis 2 2 1 ... ... ... 1 1 2 ... ... 1 ... ... ... 1 Other Forms of Tuberculosis ... ... 3 2 2 ... 2 1 3 2 ... ... ... ... ... 1 Syphilis 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... ... Cancer 8 17 16 14 16 28 20 27 23 19 5 7 5 5 9 11 Rheumatic Fever ... ... 1 1 ... ... ... 1 1 1 ... ... ... ... ... ... Alcoholism ... ... ... ... 1 ... ... 1 ... 3 ... ... ... ... ... ... Inflammation and Softening of Brain ... 2 ... ... 3 1 2 2 ... ... 1 ... ... ... ... ... Cerebro-spinal Fever 1 ... ... ... ... ... ... 4 ... ... ... ... ... 1 ... ... Simple Meningitis ... ... ... 1 ... 2 1 ... ... ...i. . 1 1 1 ... ... ... Cerebral Hæmorrhage 2 4 5 6 2 6 5 8 8 6 2 2 3 3 ... 5 Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Endocarditis ... 2 1 1 2 ... 1 1 3 1 1 ... ... ... 1 ... Heart Disease 11 18 14 30 16 14 19 35 18 17 3 8 4 6 10 8 Bronchitis 11 7 17 19 14 11 16 20 15 11 9 3 1 2 6 6 Lobular (Broncho)- Pneumonia 3 5 7 8 1 7 5 8 14 10 1 3 1 ... 2 2 Lobar (Croupous) Pneumonia ... ... ... 1 6 1 6 2 5 4 2 ... 3 1 ... 1 Pneumonia 2 2 1 2 2 1 1 3 2 1 2 2 1 ... ... 1 Other Diseases of Respiratory Organs 1 ... ... ... 2 1 2 ... 2 ... ... 2 1 ... 2 ... Diseases of Stomach 2 ... 3 2 1 ... 3 ... 3 2 1 1 2 ... 3 1 Diarrhœa and Enteritis 1 2 6 1 3 ... 3 4 2 2 ... ... ... ... ... ... Appendicitis 1 ... 3 1 2 1 1 1 1 ... 1 ... ... 1 1 ... Obstruction of Intestines ... 1 1 2 2 ... 2 1 2 2 ... ... ... ... ... 1 Cirrhosis of Liver ... 1 ... ... 3 2 1 ... 3 1 1 1 ... ... 1 1 Nephritis and Bright's Disease 2 5 4 1 3 5 5 3 12 6 ... 4 ... 1 2 2 Tumours ,'Non-malignant;, &c.. Female Genitail Organs ... ... ... ... ... ... ... 3 ... 4 ... ... ... ... ... ... Puerperal Fever ... ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... ... Accidents and Diseases of Parturition ... 1 ... ... ... ... ... 1 ... 2 ... 1 ... ... ... ... Congenital Defects 1 ... 1 1 ... 1 ... ... 3 1 ... ... ... ... 1 1 Premature Birth. 3 2 5 4 3 3 1 3 9 3 ... ... 1 2 ... 1 Developmental Diseases ... ... 1 1 2 ... 3 1 4 3 ... ... ... ... 5 1 Old Age 1 5 4 9 3 10 4 15 3 8 1 1 ... 1 ... 3 Suicide 4 ... 1 2 ... 1 2 2 5 2 1 2 ... 1 1 1 Overlaid in Bed ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents and Violence 2 ... 7 5 8 7 2 6 13 3 ... 2 2 2 1 2 Homicide ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill-defined ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... All other Causes 10 12 28 25 22 20 23 24 28 33 14 12 10 13 11 12 All Causes 83 100 147 156 134 133 145 199 202 73 45 55 37 40 64 67 In Institutions 42 45 81 85 61 48 88 91 130 93 17 10 9 11 37 27 13 The following table shows the deaths and death-rates during each of the last five years in England and Wales, in London, in Paddington and in each of the wards of the Borough:— 1925. 1924. Death-rates. No. of Deaths. Deathrates. No. of Deaths. Deathrates. 1923. 1922. 1921. England and Wales 473,006 12.2 472,715 12.2 11.6 12.8 12.1 London 53,594 11.7 55,887 12.2 11.4 13.5 12.5 Paddington 1,780 12.10 1,920 13.11 11.77 12.99 12.07 Wards. Queen's Park 183 11.39 191 11.94 10.71 12.03 11.19 Harrow Road 303 10.80 351 12.57 12.09 12.70 12.35 Maida Vale 267 11.84 279 12.43 12.72 13.07 12.64 Westbourne 344 13.99 371 15.16 12.97 14.21 14.34 Church (including Town) 375 14.73 400 15.79 12.69 15.51 12.46 Lancaster Gate, West 100 10.28 102 10.54 9.62 9.68 10.49 Lancaster Gate, East 77 9.25 82 9.90 9.06 10.21 7.89 Hyde Park 131 10.57 144 11.68 9.99 11.60 10.27 The following table shows the course of the death-rate in the Borough in the past:— DEATH-RATES—PADDINGTON. 1881-1885 16.23 1886-1890 16.19 1891-1895 17.17 1896-1900 15.51 1901-1905 15.33 1906-1910 14.52 1911-1915 14.06 1916-1920 14.62 1921 12.07 1922 12.99 1923 11.77 1924 13.11 1925 12.10 Deaths in Institutions. 1924. 1925. Local. Total Nonresidents. Total Nonresidents. Paddington Infirmary 563 29 544 28 St. Mary's Hospital 251 182 278 198 Paddington Green Children's Hospital 70 50 55 39 Hospital for Women and Children (Lock Hospital) 11 10 12 12 St. Luke's Hospital* 133 124 223 209 1,028 395 1,112 486 Deduct Non-residents 395 486 633 626 * Opened January, 1924. Paddington Residents. Outlying. 1924. 1925. Hospitals of Metropolitan Asylums Board 29 16 Poor Law Institutions 31 30 Lunatic Asylums 56 76 Voluntary Hospitals (General) 77 94 ,, ,, (Special, including Sanatoria) 56 33 249 249 Total Deaths of Paddington residents in institutions 882 875 INFANTILE MORTALITY. During the year 1924 there were 2,505 births and 196 deaths of children under the age of twelve months in the Borough. These figures give an infantile mortality-rate (deaths of infants under 12 months to each 1,000 births) of 78. The corresponding figures for the year 1925 are 2,337 births, 170 deaths and an infantile mortalityrate of 72. 14 The following table gives the births and the infantile deaths and death-rates for the years 1924 and 1925 in England and Wales, in London, in the Borough and the various wards of the Borough. The infantile mortality rates for 1921, 1922 and 1923 are given for comparison. 1925. 1924. Infantile Mortality-rate. No. of Births. No. of Deaths of children under 1 year of age. Infantile Mortality rate. No. of Births. No. of Deaths of children under 1 year of age. Infantile Mortality rate. 1923. 1922. 1921. England and Wales 710,979 53,008 75 729,933 54,813 75 69 77 83 London 82,401 5,536 67 85,147 5,904 69 61 75 81 Paddington 2,337 170 72 2,505 196 78 69 69 92 Wards— Queen's Park 203 18 88 220 11 50 78 58 68 Harrow Road 451 30 66 447 39 87 53 50 67 Maida Vale 336 17 50 434 22 50 83 68 73 Westbourne 445 31 69 473 39 82 78 87 114 Church (including) Town) 599 55 91 609 70 115 71 83 115 Lancaster Gate.West 76 4 52 81 4 49 36 82 130 Lancaster Gate, East 79 4 50 75 7 93 21 51 126 Hyde Park 148 11 74 166 4 24 59 43 71 The following table shows the changes in infantile mortality during 30 years in England and Wales, in London and in Paddington:— Infantile Mortality Rates, 1896-1925. Period. England and Wales. London. Paddington. 1896-1900 156 162 161 1901-1905 138 139 128 1906-1910 117 114 104 1911-1915 109 110 108 1916 91 89 94 1917 96 104 135 1918 97 108 116 1919 89 85 91 1920 80 75 78 1921 83 80 92 1922 77 74 69 1923 69 60 69 1924 75 69 78 1925 75 67 72 The tables on page 15 provide analyses of the causes of deaths of infants in 1924 and 1925 according to the age at death. 15 Infantile Mortality in Paddington.—1924. Cause of Death. Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Rate per 1,000 Births. All Causes— Certified 38 7 6 6 57 40 39 33 27 196 78.24 Uncertified — — — — — — — — — — — Small-pox — — — — — — — — — — - Chicken-pox — — — — — — — — — - - Measles — — — — — — 3 4 10 17 6.79 Scarlet Fever — — — — — — — — — - - Whooping-cough — — — — — — 1 3 1 5 1.99 Diphtheria and Croup — — — — — 1 — — — 1 0.40 Erysipelas — — — — — 1 — — — 1 0.40 Tuberculous Meningitis (30) — — — — — — 1 — — 1 0.40 Abdominal Tuberculosis (31) — — - - - - - - - - - Other Tuberculous Diseases — — — — — — — — 1 1 0.40 Meningitis (not Tuberculous) (61) — — — — — 2 1 — — 3 1.20 Convulsions (71) 1 — — — 1 — — — 1 2 0.80 Laryngitis (87b) — — — — — — — — — — — Bronchitis — — — 1 1 4 6 2 2 15 5.99 Pneumonia (all forms) (91) and (92) 1 — 1 — 2 7 9 15 8 41 16.37 Diarrhœa and Enteritis — 2 1 — 3 11 10 5 4 33 13.17 Gastritis (103a) — — — — — — — — — — - Syphilis — — — — — 1 1 — — 2 0.80 Rickets (36a) — — — — — — — — — — — Suffocation, overlying — — — — — — — — — — - Injury at Birth (152c) 2 1 — — 3 — — — — 3 1.20 Atelectasis (152b) 3 — — 1 4 1 — — — 5 1.99 Congenital Malformations (150) 8 1 1 — 10 — — 2 — 12 4.79 Premature Birth (151a) 21 2 2 3 28 5 — — - 33 13.17 Atrophy, Debility and Marasmus (151B) 1 1 — 1 3 3 5 1 — 12 4.79 Other Causes 1 — 1 — 2 4 2 1 — 9 3.59 Totals 38 7 6 6 57 40 39 33 27 196 78.24 Nett Births in the Year Legitimate 2,300. Illegitimate 205. Nett Deaths in the Year Legitimate Infants 166. Illegitimate Infants 30. Note.—The numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the Detailed International List of Causes of Death, 1909. Infantile Mortality in Paddington.—1925. Cause of Death. Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Rate per 1,000 Births. All Causes— Certified 52 8 5 4 69 27 30 22 22 170 72.73 Uncertified — — — — — — - - - - - Small-pox — — — — — - - - - - - Chicken-pox — — — — — — - - 1 1 0.43 Measles — — — - - 1 - 2 - 3 1.28 Scarlet Fever — — - - - - - - - - - Whooping-cough — — — — — 2 1 1 2 6 2.57 Diphtheria and Croup — — — — — — - 1 3 4 1.71 Erysipelas 1 — — — 1 - - - - 1 0.43 Tuberculous Meningitis (30) — — — — — — - 1 - 1 0.43 Abdominal Tuberculosis (31) — — — - - - - 1 - 1 0.43 Other Tuberculous Diseases - - - - - - - 1 - 1 0.43 Meningitis (not Tuberculous) (61) — — — — — - - - 1 1 0.43 Convulsions (71) — — — - - - - - - - - Laryngitis (87b) — — — — — - - - - - - Bronchitis — — — — — 1 3 2 2 8 3.42 Pneumonia (all forms) (91) and (92) — 2 3 1 6 7 8 4 6 31 13.26 Diarrhœa and Enteritis - 1 - - 1 6 4 4 4 19 8.13 Gastritis (103a) — — — — — - 1 - - 1 0.43 Syphilis — — — — - - - - - - - Rickets (36a) — — - - - - - - - - Suffocation, overlying — — — — — - - - - - - Injury at Birth (152c) 2 — — — 2 - - - - 2 0.85 Atelectasis (152b) 4 — — - 4 - - - - 4 1.71 Congenital Malformations (150) 4 2 1 — 7 2 1 - - 10 4.28 Premature Birth (151a) 31 2 — 2 35 5 - - - 40 17.11 Atrophy, Debility and Marasmus (151b) 3 - 1 1 5 2 4 - 1 12 5.13 Other Causes 7 1 — — 8 1 8 5 2 24 10.27 Totals 52 8 5 4 69 27 30 22 22 170 72.73 Nett Births in the Year Legitimate 2,157. Illegitimate 180. Nett Deaths in the Year Legitimate Infants 158. 1 Illegitimate Infants 12. Note.—Ihe numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the Detailed International List of Causes of Death, 1909. 16 It has been customary in previous annual reports to make a note of infantile mortality in special localities. The following is a summary of the results. Infantile Mortality in Special Areas. Areas. 1925. 1924. Infantile Mortality. Births. Deaths. Births. Deaths. 1925. 1924. 1923. 1922. 1921. Church (and Town) Ward— Hall Park 92 8 87 6 87 69 45 88 81 North Wharf 67 4 66 7 59 106 95 41 111 Clarendon Street 214 27 219 35 126 160 51 116 163 Rest of Ward 226 18 237 22 79 93 89 61 86 Westbourne Ward— Alfred Road 120 7 116 13 58 112 69 147 134 Rest of Ward 325 25 357 26 77 73 81 66 108 Maida Vale Ward— Amberley Road 60 4 85 5 66 59 115 91 28 Rest of Ward 276 12 349 17 43 49 76 64 81 Queen's Park Ward— Queen's Park 125 11 136 5 88 37 94 60 68 Rest of Ward 78 7 84 6 89 71 48 56 68 Totals for 6 Areas 678 61 709 71 90 100 74 96 109 Rest of Borough 1,659 109 1,796 125 65 70 67 58 86 The following table has been supplied by Dr. F. W. Alexander, Medical Officer of Health of Poplar:- 1925. Cities and Boroughs. Estimated population to the middle of year. Births. Annual rate per 1,000 persons living. Zymotic Deaths. Annual rate per 1,000 persons living. Death-rate per 1,000 living. Deaths of Infants under one year to 1,000 births. London 4,602,000 18.0* ? 11.7* 67* West Districts. Paddington 147,100 15.9 0.4 12.1 72 Kensington 179,600 15.8 0.5 13.2 78 Hammersmith 134,500 17.5 0.7 11.9 65 Fulham 163,700 16.9 0.5 10.7 76 Chelsea 64,820 14.4 0.4 13.6 69 City of Westminster 139,600 10.7 0.37 12.3 69 North Districts. St. Marylebone 106,100 14.1 0.5 11.6 63 Hampstead 88,040 12.0 0.19 10.2 55 St. Pancras 215,900 17.9 0.8 12.7 72 Islington 339,200 19.4 0.39 12.26 63 Stoke Newington 53,190 15.8 0.34 11.2 61 Hackney 228,300 17.9 0.49 10.9 65 Central Districts. Holborn 43,315 12.16 0.43 12.51 63 Finsbury 77,560 22.6 0.8 13.6 59.8 City of London 13,340 7.5 0.53 11.8 60 East Districts. . Shoreditch 107,300 24.6 1.2 13.3 88 Bethnal Green 119,800 21.9 1.3 12.0 80.6 Stepney 255,370 21.2 0.94 11.9 73 Poplar 168,500 22.7 0.9 11.7 75 South Districts. Southwark 189,000 21.2 0.9 13.1 77 Bermondsey 123,000 23.4 ? 12.6 78 Lambeth 311,100 24.6 0.5 12.1 44.8 Battersea 172,100 18.5 0.4 10.5 58.1 Wandsworth 340,900 14.31 0.33 10.43 52 Camberwell 275,400 17.7 0.5 11.1 64.7 Deptford 115,900 18.8 0.8 12.1 63 Greenwich 103,936 18.8 0.57 11.23 70 Lewisham 185,600 15.6 0.3 10.3 55 Woolwich 140,740 18.3 0.4 10.8 55 * These provisional figures are taken from a table furnished by the Registrar-General. Other figures supplied by Medical Officers of Health. 17 THE PREVALENCE OF DISEASE. The following diseases are compulsorily notifiable in Paddington:— Acute Encephalitis Lethargica. Acute Influenzal Pneumonia. Acute Polio-encephalitis. Acute Polio-myelitis. Acute Primary Pneumonia. Anthrax. Cerebro-spinal Fever. Chicken-pox. Cholera. Continued Fever. Diphtheria and Membranous Croup. Dysentery. Erysipelas. German Measles. Glanders. Hydrophobia. Malaria. Measles. Ophthalmia Neonatorum. Plague. Puerperal Fever. Relapsing Fever. Scarlatina or Scarlet Fever. Small-pox. Trench Fever. Tuberculosis. Typhoid or Enteric Fever. Typhus Fever. The following table summarises the numbers of notifiable diseases notified in the years 1916 to 1925:— Analysis of Notification Certificates (Uncorrected for Errors). 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. 1924. 1925. Anthrax - - - - - 1 1 - - - Cerebro-spinal Fever 9 7 3 7 1 2 2 1 1 5 Chicken-pox — - 207 — — — 22 465 395 459 Continued Fever — - — — — — — — — — Diphtheria 209 227 254 255 461 442 401 219 278 336 Dysentery — — — (a) 3 1 2 — 2 1 — Acute Encephalitis Lethargica — — — (a) 3 2 7 2 3 12 7 Typhoid Fever 23 12 13 10 19 13 8 13 15 18 Erysipelas 105 66 56 76 81 83 77 54 69 64 Malaria — — — (a) 64 24 7 5 2 9 1 Measles 546 2,701 11,004 1,258 1,427 163 2,117 372 3,215 1,254 Membranous Croup 2 2 4 4 3 3 — 1 2 1 Ophthalmia Neonatorum 20 27 22 30 29 34 15 22 18 23 Acute Influenzal Pneumonia — — — (a)87 45 27 72 33 87 88 „ Primary Pneumonia — — — (a)83 96 105 254 302 369 265 „ Polio-encephalitis 4 1 — 5 2 1 — 2 4 3 „ Polio-myelitis Puerperal Fever 8 7 2 15 15 16 8 5 9 15 Scarlet Fever 272 124 150 261 502 827 529 323 290 264 Small-pox — — — — — — — 1 — — Tuberculosis—Total 526 502 451 391 383 335 312 338 379 400 Pulmonary 388 355 325 284 277 244 204 222 242 231 Other Forms 138 147 126 107 106 91 108 116 137 169 (a) First Year of Notification. The following tables furnish an analysis of some of the notifiable diseases according to age, sex and ward of the Borough, in the years 1924 and 1925:— 1924. Notifications. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate. Hyde Park. West. East. A.—Ward Distributio n. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Diphtheria and Memb. Croup 27 20 32 34 17 13 25 27 30 32 7 4 2 2 2 6 Typhoid Fever - — — 2 — 1 3 — 1 3 1 3 — — — 1 Erysipelas 6 3 6 8 4 4 7 9 6 7 1 — — 2 2 4 Ophthalmia Neonatorum — 1 3 2 2 2 1 — 3 3 — 1 — — -— — Pneumonia—a. Influenzal 6 8 8 8 7 8 9 8 6 12 — 2 —. 1 2 2 „ A. Primary 28 13 41 23 30 22 41 27 50 62 1 7 2 3 9 10 Puerperal Fever — 1 — 1 — 2 — 2 — 1 — 2 — — -— — Scarlet Fever 17 11 42 45 31 15 24 24 22 23 2 7 4 5 6 12 B.—Sex-Age Distribution: Borough. 0— 1— 5— 15— 25— 35— 45— 55— 65— M. F. M. F. M. F. M. F. M F. M. F. M. F. M. F. M. F. Diphtheria and Memb. Croup 5 1 59 40 55 49 15 35 6 7 2 4 — 2 — — — — Typhoid Fever — — - 3 — — 1 3 2 2 — 2 2 — — — — — Erysipelas 2 1 4 2 5 3 1 4 3 4 5 7 3 5 6 4 3 7 Qeumonia—A. Influenzal 2 2 9 8 2 1 4 6 5 4 6 8 5 8 3 8 2 4 „ A. Primary 34 27 50 63 27 14 13 6 14 14 18 13 18 11 13 8 15 11 Scarlet Fever — 1 43 36 92 73 7 22 3 6 3 2 — 1 — 1 — — 18 1925. Notifications. Queen's Park. Harrow Road. Maida Vale. Westbourne. Church. Lancaster Gate. Hyde Park. West. East. A.—Ward Distribution. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Diphtheria and Memb. Croup 8 10 44 37 21 24 30 16 40 55 3 6 1 6 2 4 Typhoid Fever 1 — 1 2 1 2 2 2 1 1 1 2 1 1 — - Erysipelas 4 8 7 8 5 5 3 4 4 8 — 4 — — 3 1 Ophthalmia Neonatorum 2 — 1 1 — 3 4 1 9 2 — — — — —- Pneumonia—A. Influenzal 8 6 10 3 13 5 9 8 8 9 1 1 1 2 2 2 Pneumonia—A. Primary 20 32 20 24 19 11 37 13 40 33 3 1 1 — 7 4 Puerperal Fever — — — 5 — 1 — 4 — 5 — — — — — - Scarlet Fever 21 22 26 27 13 24 22 19 24 37 5 2 8 4 3 7 B.—Sex-Age Distribution: Borough. 0— 1— 5— 15— 25— 35— 45- 55— 65— M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Diphtheria and Memb. Croup 7 6 60 54 66 75 10 32 4 14 2 4 — 1 — 2 — — Typhoid Fever — — — — — 1 — 2 1 2 1 2 3 2 3 1 — — Erysipelas — 1 2 1 1 1 1 4 2 6 7 6 5 5 6 9 2 5 Pneumonia—A. Influenzal 1 3 3 3 5 2 8 6 10 5 10 3 6 6 3 2 6 6 Pneumonia—A. Primary 24 18 44 43 21 13 13 5 11 9 14 4 7 8 6 5 7 13 Scarlet Fever 2 1 39 44 66 68 11 18 2 5 2 6 — — — - — — SCARLET FEVER. During 1924 there were 290 cases of scarlet fever notified. Of these there was 1 case under the age of 1 year, 79 between the ages of 1 and 5 years, 165 between the ages of 5 and 15 years, 29 between the ages of 15 and 25 years, 14 between the ages of 25 and 45 years, and 2 cases aged 45 years and upwards. Of the 290 cases, 269 were removed to an Isolation Hospital. The remaining cases were treated at home, proper facilities being available for isolation and treatment. Only 3 deaths from scarlet fever occurred, the disease being usually of a mild type. During 1925 there were 264 cases of scarlet fever notified. Of these there were 3 cases under the age of 1 year, 83 between the ages of 1 and 5 years, 134 between the ages of 5 and 15 years, 29 between the ages of 15 and 25 years, 15 between the ages of 25 and 45 years, and none over 45 years of age. Of the 264 cases, 253 were removed to an Isolation Hospital. Only 1 death occurred. Seasonal prevalence.—The following tables show the numbers of cases notified in each fourweekly period during 1924 and 1925. 1924. Notifications. Scarlet Fever. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London ... 740 671 678 712 812 929 843 827 807 1,131 1,208 1,136 1,233 11,727 Paddington 35 16 18 21 20 29 29 14 16 22 22 21 27 290 Wards— Queen's Park 3 3 — 1 4 1 — — 1 2 6 4 2 27 Harrow Road 5 2 5 5 1 14 13 4 6 6 5 10 10 86 Maida Vale 13 1 4 3 6 2 5 2 2 3 3 2 2 48 Westbourne 4 2 3 3 2 5 5 4 4 3 5 2 7 49 Church (and Town) 4 7 5 6 2 3 3 1 1 7 2 1 2 44 Lancaster Gate, West 3 — — 1 1 1 — 1 — — — — 1 8 Lancaster Gate, East 1 1 1 — 3 2 — — 1 1 — • — — 10 Hyde Park 2 — — 2 1 1 3 2 1 — 1 2 3 18 19 1925. Notifications. Scarlet Fever. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. totals. London 876 807 742 830 855 800 980 797 782 1,315 1,318 1,214 979 12,295 Paddington 29 22 25 17 12 19 11 21 19 18 25 24 22 264 Wards— Queen's Park 7 3 2 1 3 1 2 2 5 8 6 3 — 43 Harrow Road 9 8 4 6 2 3 3 4 1 — 4 3 6 53 Maida Vale 3 3 4 3 — 3 2 6 4 2 — 3 4 37 Westbourne 4 3 3 2 2 5 — 3 1 2 4 5 7 41 Church (and Town) 4 4 8 1 3 5 2 4 8 5 5 8 4 61 Lancaster Gate, West 1 — — 1 2 2 1 — — — — — — 7 Lancaster Gate, East 1 — 3 1 — — — 1 — 1 3 1 1 12 Hyde Park — 1 1 2 — — ' 1 1 — — 3 1 - 10 DIPHTHERIA. (Including Membranous Croup). During 1924 there were 280 cases of diphtheria notified. Of these there were 6 cases under the age of 1 year, 99 between the ages of 1 and 5 years, 104 between the ages of 5 and 15 years, 50 between the ages of 15 and 25 years, 19 between the ages of 25 and 45 years, and 2 aged 45 years and upwards. Of the 280 cases, 267 were removed to an Isolation Hospital. The remaining cases were treated at home, proper facilities being available for isolation and treatment. Fourteen deaths from this disease occurred during 1924, 9 of the deaths being those of children under the age of 5 years. During 1925 there were 337 cases of diphtheria notified. Of these there were 13 cases under the age of 1 year, 114 between the ages of 1 and 5 years, 141 between the ages of 5 and 15 years, 42 between the ages of 15 and 25 years, 24 between the ages of 25 and 45 years, and 3 aged 45 years and upwards. Of the 337 cases, 329 were removed to an Isolation Hospital. The remaining cases were treated at home. Eleven deaths from this disease occurred during 1925, 9 of the deaths being those of children under the age of 5 years. Comparison with previous years is as follows :— 1919 17deaths. 1920 25 „ 1921 22 „ 1922 25 „ 1923 14 „ 1924 14 ,, 1925 11 ,, Seasonal prevalence.—The following tables show the numbers of cases notified in each fourweekly period during 1924 and 1925. 1924. Notifications. Diphtheria and Membranous Croup. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London 779 742 695 655 741 817 684 721 606 890 1,163 1,027 1,231 10,751 Paddington 17 20 27 19 15 19 12 18 15 16 27 37 38 280 Wards— Queen's Park 1 1 4 4 — 7 5 5 3 3 5 7 2 47 Harrow Road — 4 5 5 7 4 2 2 3 4 5 11 14 66 Maida Vale 3 2 7 2 1 — 1 3 — — 3 6 2 30 Westbourne 4 4 3 7 2 1 3 4 3 6 7 5 3 52 Church (andTown) 6 7 7 1 3 6 1 2 5 3 6 5 10 62 Lancaster Gate, West — 1 — — 2 1 — — — — — 3 4 11 Lancaster Gate, East 1 — 1 - — — — 1 1 — — — — 4 Hyde Park 2 1 — - — — — 1 - — 1 - 3 8 20 1925. Notifications. Diphtheria and Membranous Croup. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London 1,061 1,018 1,002 854 810 797 902 780 834 1,081 1,326 1,119 1,013 12,597 Paddington 30 22 21 16 29 29 31 18 9 27 47 24 34 337 Wards— Queen's Park 1 2 4 2 2 1 1 2 - - 1 - 2 18 Harrow Road 10 5 6 4 6 9 9 3 1 12 7 3 7 82 Maida Vale 2 4 3 - 6 6 5 3 3 3 5 2 2 44 Westbourne 6 5 3 4 10 4 2 6 2 6 11 9 8 76 Church (and Town) 8 4 4 5 4 7 12 2 3 6 20 9 11 95 Lancaster Gate, West 1 - - 1 - 2 1 - - - 1 1 2 9 Lancaster Gate, East 2 2 - - 1 - 1 1 - - - - - 7 Hyde Park - - 1 - - - - 1 - - 2 - 2 6 Diphtheria Carriers.—During 1924 and 1925, 25 persons were referred to the Diphtheria Carrier clinic at St. Mary's Hospital. One patient failed to attend, one attended only once, one other was still in attendance at the end of the year, and the remaining 22 patients were found to be free from infection after periods varying from two to eighteen weeks. The total number of patients referred to the clinic since its inception in 1920 is 73. Anti-diphtheritic serum.—This is stocked at the Town Hall and supplied to poor persons on the order of doctors. During 1924, 21 phials of 8,000 units and 9 phials of 500 units were distributed. During 1925, 11 phials of 8,000 units, 4 phials of 4,000 units and 11 phials of 500 units were distributed. SMALL-POX. No cases of the disease were notified during 1924 and 1925. A number of persons who had been in contact with the disease on board a ship or in another district were kept under observation. CHICKEN-POX. Chicken-pox has been notifiable in Paddington since November 28th, 1922. In no other metropolitan Borough is the disease notifiable. In the year 1924, 395 cases of chicken-pox and in the year 1925, 459 cases were notified. TYPHOID FEVER. Fifteen cases of this disease were notified in 1924, of which three probably contracted the disease before arriving in the Borough. Eighteen cases of the disease were notified in 1925, of which 4 were errors in diagnosis, and of which four probably contracted the disease before arriving in the Borough. It was found impossible to trace the source of infection in most of the cases, except in a few cases where nurses or relatives were infected by patients whom they were nursing. MEASLES. Measles has been notifiable in the Borough since 1914 under various Orders and Regulations, those at present in operation being "The Metropolitan Borough of Paddington (Measles and German Measles) Regulations, 1920." In addition to the cases medically certified a number of cases come to the knowledge of the Department through reports from schools, parents, etc. There were, in 1924, 3,215 cases certified by medical practitioners, and 914 reported from other sources, the corresponding figures for 1925 being 1,254 and 296. The Women Inspectors visit all cases of measles, and, where necessary, arrange for the attendance of the District Nurses. During 1924 the Inspectors' visits totalled 4,751, and during 1925, 1,976. One hundred and fifty-six (156) cases were attended by the District Nurses in 1924, and 56 in 1925. The visits paid by the Nurses numbered 2,150 in 1924, and 950 in 1925. Notices are sent to the Head Teachers of schools in all cases where the patients are school children, or where there are school children living in infected houses. The following tables show the number of cases notified in each four-weekly period during 1924 and 1925. 21 Measles. Notified and Reported Cases, 1924. Four-Weekly Periods. Period No. i. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. Borough 304 792 966 911 474 259 171 103 18 25 26 60 20 4,129 Wards— Queen's Park 76 75 67 96 71 68 26 10 - - - 1 - 490 Harrow Road 38 139 242 229 112 71 67 43 6 4 5 4 1 961 Maida Vale 13 193 190 141 42 26 18 15 2 3 4 1 2 650 Westbourne 84 105 147 129 83 17 12 10 4 10 14 41 8 664 Church (and Town) 60 207 250 199 103 47 27 10 4 6 2 3 5 923 Lancaster Gate, West 10 20 13 16 21 5 - - 1 - - 2 1 89 Lancaster Gate, East 10 21 18 25 11 7 - 2 - 2 1 6 2 105 Hyde Park 13 32 39 76 31 18 21 13 1 - - 2 1 247 Measles. Notified and Reported Cases. 1925. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. Borough 23 28 66 119 162 104 47 25 20 37 52 219 648 1,550 Wards– Queen's Park. - 2 2 1 3 3 2 7 4 4 5 58 110 201 Harrow Road 6 2 18 21 36 36 9 6 7 4 14 24 167 350 Maida Vale 5 5 8 16 23 18 11 2 2 2 - 68 112 272 Westbourne 4 4 6 21 16 19 9 2 4 20 17 14 91 227 Church (and Town) 4 6 24 52 68 21 12 7 1 5 9 29 73 311 Lancaster Gate, West 2 2 3 3 1 - 1 - 1 1 4 3 25 46 Lancaster Gate, East 2 4 2 4 8 2 1 - 1 - 1 2 15 42 Hyde Park - 3 3 1 7 5 2 1 - 1 2 21 55 101 OPHTHALMIA NEONATORUM. Eighteen cases of purulent eye-discharge of the new-born were notified in 1924 and 23 in 1925, all by medical practitioners. In no instance was there any permanent impairment of vision, so far as could be ascertained. When one considers that this disease was at one time a common cause of life-long blindness, the above results, which are now usual, are a striking example of how much good may result from organised and persistent efforts directed against an easily controlled disease. As soon as a case of this disease is notified, intensive efforts are made by the Council's staff to ensure that proper treatment is carried out. Daily visits are paid and private or charitable medical treatment is invariably enforced. Where necessary the infant and its mother are removed to a hospital, provision of this accommodation being ample. All necessary nursing attention is given by home visiting on the part of the Paddington and St. Marylebone Nursing Association. A few cases of slight discharge from the eyes of infants reported by midwives to the London County Council are referred to this Department and receive constant attention, no doubt preventing at times the onset of the more severe form of the disease. During 1924, 3 cases were referred to the District Nursing Association, 67 visits being paid. In 1925 there were also 3 cases nursed, 75 visits being paid. PUERPERAL FEVER. There were 9 cases notified in 1924 and 15 in 1925. Arrangements for institutional treatment in the Infirmary and other Hospitals are adequate. ERYSIPELAS. Sixty-nine cases were notified in 1924, 24 of which were removed to a hospital. Sixty-four cases were notified in 1925, 30 of which were removed to a hospital. ACUTE POLIO-MYELITIS. This disease, commonly known as infantile paralysis, is of uncommon occurrence. It occasionally shows evidence of being spread by personal infection and for this reason remains on the list of notifiable diseases. As a matter of fact, its chief interest lies in its after-effects, deformities 22 such as club-foot often resulting. It is probable that many cases of this disease do not come to the knowledge of this Department, but whenever possible observation is kept on the patient for many years with a view to securing that the patient receives any necessary remedial treatment. In 1924 two cases of the disease in children aged 5 and 7 were reported. In 1925 three cases were reported in children aged 10 months, 1 year and 3 years. ACUTE POLIO-ENCEPHALITIS. This obscure and rare disease is apparently of a similar nature to acute polio-myelitis. Only two cases were reported in 1924 and none in 1925. ACUTE ENCEPHALITIS LETHARGICA. There were 12 cases of this disease notified in 1924 and 7 cases in 1925. CEREBRO-SPINAL FEVER. There was 1 case of this disease notified in 1924 and 5 cases in 1925. DYSENTERY. One case of Amoebic Dysentery was notified in 1924, the patient having contracted the disease in Jamaica. No case was notified in 1925. MALARIA. Nine cases of this disease were reported in 1924 and one case in 1925. In every instance the disease was contracted abroad. ACUTE PRIMARY PNEUMONIA. Three hundred and sixty-nine cases of this disease were notified in 1924 and 265 in 1925. ACUTE INFLUENZAL PNEUMONIA. Eighty-seven cases of this disease were notified in 1924 and 88 in 1925. Under their agreement with the Council, the Paddington and St. Marylebone District Nursing Association rendered valuable assistance in the home nursing of cases of pneumonia. 1,665 visits to 75 cases were made in 1924, and 1,677 visits to 74 cases in 1925. ANTHRAX, CHOLERA, CONTINUED FEVER, GLANDERS, HYDROPHOBIA, PLAGUE, RELAPSING FEVER, TRENCH FEVER, TYPHUS FEVER. No cases of these diseases were notified during 1924 and 1925. WHOOPING-COUGH. This disease is not notifiable in Paddington, but a few cases are brought to notice and visited. In 1924 9 children died from the disease, all under the age of five years. In 1925 13 children died from the disease, all under the age of 15. The District nurses paid 45 visits to 3 cases in 1924, and 80 visits to 6 cases in 1925. CANCER. The deaths from cancer are growing in number year by year in every part of_the country, including Paddington. It is now the commonest cause of death. The number of deaths for previous years is shown in the list following:— Numbers of Deaths in Paddington. 1925 230 1924 234 1923 206 1922 191 1921 226 1920 194 1919 170 1918 164 1917 201 1916 205 1906 164 23 INFECTIVE ENTERITIS. This disease is notifiable in seven London boroughs, but not in Paddington. In this borough information as to the existence of the disease is obtained wherever possible, and arrangements are in force whereby cases of the disease attending St. Mary's Hospital, Paddington Green Children's Hospital and Paddington Infirmary are notified informally to the Health Department of the Council. By this means a large proportion of the worst cases of the disease are brought to notice. During 1924 the number of cases reported was 92 under the age of 2 years, and 23 over the age of 2 years. The deaths numbered 33, all under the age of 1 year. During 1925 the number of cases reported was 148 under the age of 2 years, and 47 over the age of 2 years. The deaths numbered 24, 21 of these occurring in children under the age of 2 years. Practically all the cases of the disease occurred during the months June to November, the maximum incidence being in August; hence the more popular name for the disease, Summer Diarrhoea. The connection between infective enteritis and house-flies is a close one, and a good deal has been written on this subject in past annual reports. As in previous years, during 1924 and 1925, weekly fly-counts were made in various parts of the borough. It is proposed to analyse the figures of these counts in relation to the prevalence of infective enteritis in a subsequent annual report. Any effective measures against infective enteritis must be largely preventive. None the less every effort is made to assist mothers who have a child suffering from the disease. A health visitor visits as often as may be necessary, and for nursing the services of the District Nursing Association are available. With a view to impressing on mothers certain essential points, a card drawn up in a simple and dogmatic manner has been prepared for use. It is as follows:— METROPOLITAN BOROUGH OF PADDINGTON. Precautions Against Summer Diarrhœa. 1. Flies carry the infection of Summer Diarrhœa, therefore kill every fly you can. 2. All food and milk should be covered to prevent flies getting to it. Kitchen refuse should at once be burnt or placed in a dustbin which has a tightly fitting cover. 3. Bottle-fed babies are more likely to get Diarrhoea than breast-fed babies, therefore avoid weaning baby during the summer months, if possible. 4. Boil all milk before use. 5 All feeding-bottles should be cleansed by running water, then put into a pan of cold water and brought to the boil, teat included. 6. If a baby or child shows signs of summer Diarrhoea or of sickness give a dose of castor oil, after which starve completely for twenty-four hours, except to give little drinks of cold water which has been boiled, put into a jug and kept covered. Do not give one drop of milk during the twenty-four hours. Keep the child warm, especially the lower part of body and the feet, during this time. It the Diarrhoea continues go at once for the doctor. 7. Diarrhœa is Infectious. The napkins of a baby with Diarrhoea should be rinsed at once in cold water, then washed and boiled before being used again. A mother should always wash her hands after changing the napkin and before giving baby a feed, or a child a meal. 8. Keep baby's face covered with a net so that flies cannot get to it. 9. Summer Diarrhoea is often fatal to babies, and even if they recover, it leaves harmful after-effects. G. E. OATES, M.D., Town Hall, Medical Officer of Health. Paddington Green, W. 2. TUBERCULOSIS. Tuberculosis of all kinds is notifiable, and particulars of the number of notification certificates received during the years 1924 and 1925 are set out in the tables appended hereto. Owing to the fact that a case of tuberculosis may be notified in several boroughs or districts, the number of notification certificates received is only a very imperfect guide to the amount of tuberculosis in the borough. There is also the consideration that notification is more strictly enforced in some districts than in others. However, recent alterations in procedure tend to make the number 24 of cases on the tuberculosis register serve as a guide as to the real prevalence of the disease. One can also take the annual number of deaths as being a measure of prevalence. This is probably the most exact method which can be used at the present time. From pulmonary tuberculosis there were 120 deaths in 1924 and 89 in 1925. From tuberculous meningitis there were 11 deaths in 1924 and 11 in 1925. From other tuberculous diseases there were 18 deaths in 1924 and 16 in 1925. The number of deaths from tuberculosis of all kinds was 149 in 1924 and 116 in 1925. In recent years the number of deaths was as follows :— 1919 133 1923 127 1920 146 1924 149 1921125 1925 116 1922 143 DISPENSARY TREATMENT OF TUBERCULOSIS. For administrative purposes the borough is divided into two dispensary areas, the line of division passing down Inverness Terrace, Porchester Road, Ranelagh Road, Formosa Street (to its junction with Shirland Road), Shirland Road (to its junction with Kilburn Park Road), and Kilburn Park Road. The portion of the borough to the east of this line is served by the St. Mary's Hospital Dispensary, and the portion to the west of the line by the Paddington Tuberculosis Dispensary. Paddington Tuberculosis Dispensary, 20, Talbot Road. This is a voluntary agency supported by voluntary subscriptions and a grant from the Paddington Borough Council, which amounted to £1,288 annually during 1924 and 1925. The following notes on the work of this dispensary have been furnished by Dr. R. S. Walker, Tuberculosis Officer. Accommodation.—Basement comprises : Kitchen, back room (boiler room), scullery, pantry. Ground Floor : Secretary's office, waiting-room, pharmacy, office. First Floor : Medical Officer's room, dressing-rooms, nurses' room. Second Floor: Committee room, dentist's room. Third Floor : Laboratory, porter's bedroom. One bathroom, three water closets. Staff.—Medical officer, dental surgeon, two nurses, secretary, dispenser (part time), porter and wife. Times of Sessions.—New Patients: Monday and Wednesday, at 9.30 a.m. Old Patients: Monday, Tuesday, Thursday and Friday, at 2 p.m. Working Adults: Monday, at 6 p.m. Dental Clinic : Tuesday, at 2 p.m. Records and Clerical work.—Card index and Register system of all medical records. Complete records of all Home Conditions and other sociological data are kept by the secretary. Bacteriological work.—This work has during the last few years been done outside the dispensary owing to insufficient staff. After the appointment of a Bacteriologist it is proposed to undertake the whole of the sputum examinations for the borough. Co-operation with Borough Council.—Every effort has been made to co-operate the work of the dispensary with that of the Borough Public Health Department. In order that there should not be any overlapping or inconsistency of work between the two, the Medical Officer of Health and the Tuberculosis Officer have agreed upon co-ordinative measures whereby the most efficient results may be obtained. Co-operation with general hospitals, etc.—By courtesy of St. Mary's Hospital and Paddington Green Children's Hospital, all patients presenting themselves at the dispensary for examination and found not to be suffering from Tuberculosis, but from some other condition requiring special treatment other than that which can be given by a general practitioner, are referred to the special department concerned at one of these hospitals. The same procedure applies to Tuberculous patients developing complications. All school children who are not definitely suffering from Tuberculosis but who require special care, are notified on special cards to the London County Council district Medical Officer. These children are referred back to the dispensary by the school Medical Officer if progress is not considered satisfactory. All children suspected to have Tuberculosis by the School Medical Officer at the school clinics are sent to the dispensary for treatment. This dispensary has a Tuberculosis Open-Air School in the near vicinity of which the Tuberculosis Officer is the Medical Officer. Co-operation with General Practitioners.—It is realised that the co-operation and confidence of the general practitioners in the methods and activities of the dispensary are essential if the campaign to eradicate the disease is to be successful. Under a special arrangement and by a series of special 25 forms as set out in Mem. 286, all insured patients are examined and reported on at regular intervals by the Tuberculosis Officer and the panel doctor respectively. The general practitioners are invited to attend the dispensary whenever their patients are being examined, and are at liberty to see any medical records or study special methods of treatment, and so on. Following up "suspect" cases.—In case of "Suspects" two methods are adopted; the patient either attends the dispensary at short intervals for observation, or is referred to hospital for an observation bed, the particular method adopted in the case depending on the urgency of the diagnosis and the patient's circumstances. Examination of contacts.—Of the total number of contacts in 1925, 70 per cent. Were examined. It is usual to examine contacts in their homes, but if more convenient to the patients, they are examined at the dispensary. Methods of diagnosis.—Tuberculin is only used for diagnostic purposes percutaneously. X-ray and blood examinations are only done in special cases. Treatment.—Tuberculins, vaccines and some special chemical preparations are used. Ultra Violet irradiation. A number of children with Tubercular Adenitis have been treated with Tuberculin percutaneously, but as this treatment has only recently been applied, it is not possible to assess the value of this particular method of administering Tuberculin. Treatment of non-pulmonary cases.—All forms of Tuberculosis other than Pulmonary and Glands are referred to St. Mary's or some other general hospital. Arrangements for finding employment.—The dispensary Case Committee endeavours to find suitable employment for patients. Occupation.—The majority of the patients are employed in offices and shops; the remainder in motor trade and as general labourers. As a result of experience, we find clerking is suitable employment for ex-sanatorium patients. Difficulties encountered.—The dispensary premises are too small and very noisy; this latter nuisance is growing worse. Return as to Work carried out in connection with the Paddington Tuberculosis Dispensary for the Year 1924. (The return relates only to persons ^ residing in the area which is served by the Dispensary.) Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. " (a) All persons (including "Contacts") Adults. Children under 15. m. 1 191 192 57 4 126 1 4 F. 4 225 229 43 4 167 6 9 m 6 182 188 1 45 132 3 7 r F. 9 178 187 2 22 144 6 13 Total 20 776 796 103 75 569 16 33 Adults. Children under 15. m 2 73 75 4 1 69 1 - (b) "Contacts" (included in (a) ) F. 3 99 102 7 - 93 2 - M. 2 92 94 1 11 80 2 - f. 6 101 107 1 6 96 4 - (c) Insured persons 1 included in (a) ) m 1 148 149 45 4 99 1 - f. 4 81 85 25 3 53 ' 4 - 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* ... 340 2. Total number of attendances of ~| Insured... 1,525 patients at the Dispensary > during the year.... ... ... J Uninsured 3,564 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis ... ... 133 4. Number of cases in which the period of observation at the Dispensary exceeded two months ... ... ... ... ... ... 30 5. Number of insured patients under domiciliary treatment on December 31stf ... 53 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year ... ... ... ... ... ... 12 7. Number of persons referred to affiliated hospital for consultation ... ... ... 32 8. Number of consultations with 1 Insured... 8 medical practitioners at the > homes of patients J Uninsured 16 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 468 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes ... ... ... ••• 2,364 11. Number of specimens of sputum examined in connection with the work of the Dispensary ... ... ... ... ... 213 * Insured persons under domiciliary treatment by Insurance practitioners are excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases are included under Head 5. † All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners are included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispensary. 26 Return as to Work carried out in connection with the Paddington Tuberculosis Dispensary for the Year 1925. (The return relates only to persons residing in the area which is served by the Dispensary.) Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. (a) All persons (including "Contacts") Adults. Children under 15 \M. 1 159 160 58 4 85 4 9 F. 6 211 217 47 3 153 4 10 M. 3 165 168 2 56 105 2 3 F. 6 169 175 3 31 125 10 6 Total 16 704 720 110 94 468 20 28 (b)"Contacts" included in (a)) Adults. Children under 15 M. 1 47 48 4 - 42 - 2 F. 2 93 95 3 - 87 - 5 m. 2 83 85 - 20 61 1 3 F. 4 90 94 - 5 79 6 4 (c) Insured persons (included in (a) ) m. 1 121 122 46 - 65 4 7 F. 4 81 85 24 2 53 2 4 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 606 2. Total number of attendances of ("Insured 2,071 patients at the Dispensary during the year Uninsured 4,200 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 104 4. Number of cases in which the period of observation at the Dispensary exceeded two months 30 5. Number of insured patients under domiciliary treatment on December 31 st† 74 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 44 7. Number of persons referred to affiliated hospital for consultation 36 8. Number of consultations with ("Insured 18 medical practitioners at the homes of patients Uninsured 3 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 479 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 1,944 11. Number of specimens of sputum examined in connection with the work of the Dispensary 162 * Insured persons under domiciliary treatment by Insurance practitioners are excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases are included under Head 5. † All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners are included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispensary. St. Mary's Hospital Tuberculosis Dispensary. This dispensary is voluntary and was subsidised by a grant of £1,070 from the Paddington Borough Council for the year 1925. The following notes on the work of this dispensary have been furnished by Dr. A. B. Porteous, Tuberculosis Officer. Accommodation.—This consists of a consulting room with two examination rooms attached, and a large waiting-room. It is situated in the basement of the hospital, and is in close touch with, but separate from the other out-patient departments of the hospital. In common with these it suffers somewhat from lack of light and air. Staff.—This consists of the Tuberculosis Officer and one sister. The majority of the clerical work and all the record keeping is done by the dispensary staff, but the lady almoner of the hospital assists by filling in assessment forms and also in interviewing patients in financial need, in writing letters re housing repairs, getting patients to convalescent homes, etc. Times of Sessions.—Monday, Wednesday and Friday, at 2 p.m. Thursday, at 6 p.m. Bacteriological Work.—This is done by the Tuberculosis Officer and consists in examination and culture of Sputa, and other discharges, pus, etc. Secondary autogenous vaccines are made, guinea pigs inoculated, etc., as needs require. Complement fixation tests are frequently carried out through the agency of the Inoculation Department of the hospital. Co-operation with Borough Council and, its Officers is close. Representatives, i.e., doctor and sister attend care-committee meetings at the Town Hall, where all difficulties regarding patients are brought up for consideration. The After Care Committee does most of the work of finding employment for patients, one of the most difficult problems with which we are faced. Co-operation with General and Special Hospitals.—This dispensary is at a great advantage in being attached to a general hospital; the services of consultants are always available during clinic hours. Patients suffering from ailments other than Tuberculosis can be quickly transferred. The Eye, Skin and Throat Departments are especially useful. M. O. 303 cards are used to refer delicate children or contacts to the school clinics. Some children are sent to cripple schools and some to Kensal House Open-Air School, but a distinct drawback to the latter is the difficulty of taking and fetching the children, which has prevented several suitable cases being admitted there. 27 The Arrangements for Co-operation of Medical Practitioners, and the working of the arrangements set out in Mem. 286 have not worked very successfully up till now. Many forms have been sent out to doctors, but very few are returned unless constantly written for. Also from the patient's point of view, " He objects to being bothered." Consultations are willingly held, but the forms seem to be ignored. Cases in which the Diagnosis is Doubtful, who cease to attend before the diagnosis is completed, are followed up by the sister with a view to clearing the register. Home Contacts.—So far we have found the examination and supervision of home contacts fairly simple, the patients and their relatives falling in with the wishes of the Tuberculosis Officer willingly. Special Methods as to Diagnosis and Treatment.—X-rays, Complement Fixation tests, bactericidal and serological tests, inoculation into guinea-pigs are special methods used in diagnosis. In treatment Tuberculin (B.E.), secondary vaccines, X-rays, artificial sunlight, induction of artificial pneumothorax are all exploited in suitable cases. In this connection very valuable help is given to us by the Inoculation Department in lending the Tuberculosis Officer beds when required for such cases. Sanocrysin was used in one case during the year, which is doing well now, though the treatment was very strenuous and apparently dangerous at first. In the Treatment of Non-pulmonary Tuberculosis special apparatus has been installed in the dispensary for the making of spinal jackets, hip-plasters, etc. Beds are often required for these cases, and are lent through the courtesy of the Inoculation Department as before mentioned. The patients are afterwards transferred as a rule to Lowestoft or Margate by the L.C.C. Splints and other surgical requirements can usually be obtained through the lady almoner. A Light Department was started a year ago and much good work has been done in the surgical cases both in improving the general condition of the patients and in the treatment of ulcers, sinuses, lupus, etc. Incidence of Tuberculosis locally.—In this district no special occupational incidence of Tuberculosis is noted, except the general one that the indoor and sedentary worker is more liable. It has been observed that many of the cases reside in basements, and also that further cases are not uncommon in the same rooms even after disinfection having been carried out, new tenants have come in. The Tuberculous Mother.—Six cases of pregnant women were admitted into the maternity wards of St. Mary's Hospital for their, confinements during the year. Return as to Work carried out in connection with the St. Mary's Hospital Tuberculosis Dispensary for the Year 1924. (The return relates only to persons residing in the area which is served by the Dispensary.) Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. (a) All persons (including "Contacts") Adults. Children under 15. m 3 68 71 24 8 38 1 - f. 10 95 105 14 9 76 5 1 m. 3 69 72 1 10 56 5 - f. 5 37 42 - 3 36 3 - Total 21 269 290 39 30 206 14 1 Adults. Children under 15. m. - 17 17 - - 16 1 - (b) "Contacts" included in (a)) f. 2 35 37 - - 35 2 - 'M. 2 40 42 -— 2 40 - - f. 2 26 28 - 3 23 2 - (c) Insured persons (included in (a) ) M. 2 51 53 19 6 27 1 - f. 5 26 31 5 5 19 2 - 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 262 2. Total number of attendances of ("Insured 1,901 patients at the Dispensary during the year Uninsured 3,116 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 63 4. Number of cases in which the period of observation at the Dispensary exceeded two months 18 5. Number of insured patients under domiciliary treatment on December 31st† 12 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 21 7. Number of persons referred to affiliated hospital for consultation 76 8. Number of consultations with Insured 3 medical practitioners at the homes of patients Uninsured 2 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 120 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 1,477 11. Number of specimens of sputum examined in connection with the work of the Dispensary 115 * Insured persons under domiciliary treatment by Insurance practitioners are excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases are included under Head 5. † All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners are included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispensary. 28 Return as to Work carried out in connection with the St. Mary's Hospital Tuberculosis Dispensary for the Year 1925. (The return relates only to persons residing in the area which is served by the Dispensary.) \ Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary. NonPulmonary. (a) All persons (including "Contacts") Adults. Children under 15. M 1 73 74 22 5 46 1 - f 5 89 94 19 5 70 - M. 5 47 52 1 10 37 4 - 3 35 38 - 7 31 - - Total 14 244 258 42 27 184 5 - Adults. Children under 15. m 1 17 18 - - 18 - - (b) "Contacts" (included in (a)) f. 2 35 37 2 - 35 - - M. - 22 22 - - 22 - - F 2 21 23 - 4 19 - - (c) Insured persons (included in (a) ) M. 1 57 58 19 4 34 1 - F 2 32 34 7 5 22 - - 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 220 2. Total number of attendances of fInsured 2,045 patients at the Dispensary during the year Uninsured 2,797 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 64 4. Number of cases in which the period of observation at the Dispensary exceeded two months 9 5. Number of insured patients under domiciliary treatment on December 31st† 15 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 27 7. Number of persons referred to affiliated hospital for consultation 103 8. Number of consultations with Insured medical practitioners at the homes of patients Uninsured 3 9. Number of other visits paid by Tuberculosis Officer to the homes of patients 136 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 1,490 11. Number of specimens of sputum examined in connection with the work of the Dispensary 157 * Insured persons under domiciliary treatment by Insurance practitioners are excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases are included under Head 5. t "All insured persons in the dispensary area who- are actually receiving domiciliary treatment from Insurance practitioners are included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispensary. Public Health (Tuberculosis) Regulations, 1912. (Summary of Notifications on Forms A and B received during the year 1924.) Tuberculosis of the Lungs. Other Tuberculosis. Male. Female. Total. Male. Female. Total. Primary Notifications— 0— 1 year - - - - 2 2 1— 5 years - - - 19 7 26 5—10 - 2 2 26 18 44 10—15 2 7 9 14 6 20 15—20 10 11 21 3 4 7 20—25 15 15 30 3 6 9 25—35 39 37 76 3 4 7 35—45 „ 26 27 53 3 - 3 45—55 14 9 23 2 - 2 55—65 9 4 13 1 - 1 65 years and over 3 5 8 - 1 1 Total 118 117 235 74 48 122 Cases re-notified 93 80 173 17 12 29 Total Notifications on Form A 211 197 408 91 60 151 Primary Notifications by School Medical Officers— 0— 5 years - - - 1 1 2 5—10 1 - 1 7 1 8 10—15 - - - 2 - 2 Cases re-notified - 1 1 1 1 2 Total Notifications on Form B 1 1 2 11 3 • 14 29 1924. No. of Notifications on Forms C and D. Poor Law Institutions. Sanatoria. C. d. C. d. Pulmonary Tuberculosis— Male 10 17 94 58 Female 15 28 65 44 Non-Pulmonary Tuberculosis— Male ... 5 4 21 15 Female 5 14 21 11 C—Upon admission. D—Upon discharge. Public Health (Tuberculosis) Regulations, 1912. (Summary of Notifications on Forms A and B received during the year 1925. Tuberculosis of the Lungs. Other Tuberculosis. Male. Female. Total. Male. Female. Total. Primary Notifications— 0— 1 year - - - - - - 1— 5 years 1 - 1 17 16 33 5—10 „ - - - 49 24 73 10—15 „ 3 6 11 14 9 23 15—20 „ 9 9 18 5 6 11 20—25 „ 19 22 41 2 4 6 25—35 „ 27 40 67 1 4 5 35—45 ,, 23 18 41 5 2 7 45—55 „ 25 3 28 - 1 1 55—65 „ 7 3 10 1 1 2 65 years and over 5 3 8 - - - Total 121 104 225 94 67 161 Cases re-notified 89 63 152 18 9 27 Total Notifications on Form a ... 210 167 377 112 76 188 Primary Notifications by School Medical Officers— 0— 5 years - - - - - - 5—10 - - - 2 1 3 10—15 - 1 1 2 1 3 Cases re-notified - - - 4 1 5 Total Notifications on Form B — 1 1 8 3 11 1925. No. of Notifications on Forms C and D. Poor Law Institutions. Sanatoria. c. d. c. d. Pulmonary Tuberculosis— ( Male 25 42 99 77 Female 20 34 76 42 Non-Pulmonarv Tuberculosis— Male 3 13 19 7 Female - 7 18 14 C—Upon admission. D—Upon discharge. 30 Public Health (Tuberculosis) Regulations, 1921. Cases removed from Register :— 1924. 1925. By reason of— Death 132 115 Removal 107 143 Recovery of patient or variation of diagnosis 124 238 Totals 363 496 Of the patients who removed from the borough during 1924, the new addresses were obtainable in 50 instances, and particulars of the cases were transmitted to the Medical Officers of Health of the respective districts. The number of cases so dealt with in 1925 was 70. In 1924, 7, and in 1925, 12 cases were added to the register of patients who had removed into the borough from other districts. The number of cases remaining on the Tuberculosis Register at the close of 1925 was 1,798. Ex-Soldiers and Sailors Suffering from Tuberculosis (viz., Pensioners whose disease has been held to be attributable to, or aggravated by, War service.) 1924. 1925. Number of tuberculous War pensioners visited 79 65 Number ot visits 267 239 Visits Paid to Homes of Tuberculous Patients. 1924. 1925. By Council's Women Inspectors 1,77S 2,296 By Tuberculosis Officers 617 640 By Dispensary Nurses— 20, Talbot Road n2,364 1,944 St. Mary's Hospital 1,477 1,490 6,236 6.370 The Public Health (Prevention of Tuberculosis) Regulations, 1925. These regulations came into force on July 31st, 1925. By their provisions persons who are aware that they are suffering from tuberculosis of the respiratory tract may not enter upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk or the handling of vessels used for containing milk. Furthermore, if a local authority, on the report in writing of their Medical Officer of Health, are satisfied that a person residing in their district who is engaged in any such occupation mentioned above is suffering from tuberculosis of the respiratory tract and is in an infectious state, they may by notice in writing require such person to discontinue his employment or occupation on or before the date specified in the notice, such date being not less than seven days after the service of such notice, and such person shall thereupon comply with the said notice. Aggrieved persons have the right of appeal to a court of summary jurisdiction, and in every case adequate compensation has to be paid to every person who suffers damage from the exercise of the powers of the regulations in any matter as to which he is not himself in default. No use has so far been made of these regulations. Supply of Beds and Bedding.—In certain instances, so that separate sleeping of patients may be arranged, beds and bedding are supplied on loan by the Council. Five sets were so supplied in 1924, and 7 in 1925. Of these, 6 were returned before the close of 1925 on account of the removal or death of the patient. During the two years new articles were purchased at a cost of £4. Artificial Pneumothorax Treatment.—By arrangement with Brompton Hospital patients recommended for this treatment are given refills at a cost to the Council of 10s. 6d. per refill. During 1924 3 patients were provided with refills (1 on 1 occasion, 1 on 8 occasions, and 1 on 13 occasions), and during 1925, 5 patients (1 on 1 occasion, and the remaining 4 on 2, 7, 13 and 15 occasions respectively). Dental Treatment.—Dental treatment is provided for tuberculous persons attending either of the Tuberculosis Dispensaries, by arrangement with the British Dental Hospital, of 31, Camden Road, N.W. 1. The agreement provides for the payment by the Paddington Borough Council of £120 per annum, and in return for this the British Dental Hospital provide the services of a Dental Surgeon for one half-day weekly, together with the necessary equipment, drugs, etc. 31 The dental clinic is installed at the Paddington Tuberculosis Dispensary, 20, Talbot Road, where a room and the necessary attendance is provided by the Dispensary Committee. Arrangements have also been made for the supply of dentures by the Dental Hospital. During 1924 2 patients were supplied with complete dentures, 1 with partial dentures, and in 4 cases dentures were repaired. For 1925 the figures were, complete dentures 3, partial 4, repairs 5. Grants towards the cost of dentures supplied at the Clinic were made by the Council to the value of £12 2s. 6d. in 1924, and £10 15s. in 1925. In addition one patient receiving treatment in sanatorium was supplied with partial dentures, towards the cost of which the Council made a grant of £1 18s. When patients are able to contribute towards the cost of their dentures, arrangements are usually made for payment to be accepted by instalments. Particulars of the dental work done during the two years are shown in the subjoined tables. British Dental Hospital. Summary of Dental Treatment for the Year, 1924. Particulars of Patients. Number of Attendances. Number of Fillings. Number of Scalings. Extraction Cases. Dentures. Number of Dressings. Number for Advice. Denture Visits. Number of New Patients. Simple. Root. Without Anaesthetic. Local Administration. Gas Administration. Number of Teeth Extracted. Upper. Lower. Re-models. Repairs. Women 52 4 — 3 — 9 6 39 2 2 — 1 — 7 23 9 Children 57 33 — 2 1 23 2 58 — — — — 2 8 — 23 Men 27 3 1 3 i 4 1 17 1 1 - 3 2 4 6 14 Total 136 40 1 8 2 36 9 114 3 3 — 4 4 19 29 46 Summary of Dental Treatment for the Year 1925. Particulars of Patients. Number of Attendances Number of Fillings. Number of Scalings. Extraction Cases. Dentures. Number of Dressings. Number for Advice. Denture Visits. Number of New Patients. Simple. Root. Without Anaesthetic. Local Administration. Gas Administration. Number of Teeth Extracted. U pper. Lower. Re-models. Repairs. Women 65 4 — 5 — 13 8 61 4 4 — — 1 10 27 13 Children 85 38 — — 1 14 28 136 — — — — 1 15 — 19 Men 59 6 — 8 — 13 12 82 2 2 2 2 — 6 13 23 Total 209 48 — 13 1 40 48 279 6 6 2 2 2 31 40 55 32 The Borough Tuberculosis Care Committee. On December 31st, 1925, the constitution of the Tuberculosis Care Committee was as follows :— Representing. Paddington Borough Council Councillor Mrs. R. M. Drury. ,, ,, Councillor Miss G. L. Kemp-Welch, J.P. „ ,, Dr. G. E. Oates, M.O.H. „ ,, Miss F. M. Nicolas, Sanitary. Inspector. ,, ,, Miss L. M. O'Kell, Sanitary Inspector. British Red Cross Society Miss A. V. Edden. Charity Organisation Society Mrs. G. S. Warren. ,, ,, Miss P. Bethell. Insurance Committee Miss R. Russen. Invalid Children's Aid Association Miss E. M. Barber. London County Council Dr. A. W. Sikes (Divisional Medical Officer). ,, „ Miss D. Whitmore (District Organiser of School Care Committees). Paddington Tuberculosis Dispensary Mrs. B. Freyberg. ,, ,, ,, Miss E. J. McGaw (Yice-Chairman). „ „ ,, Miss E. Lewis. ,, ,, ,, Dr. R. S. Walker (Tuberculosis Officer). „ ,, ,, Miss T. Hall (Secretary to the Dispensary). „ „ „ Nurse D. Head. „ ,, „ Nurse A. B. Munro. Paddington and St. Marylebone War Pensions Committee Mr. S. G. Last, J.P. Paddington and St. Marylebone District Nursing Association Miss S. M. Marsters. Paddington Board of Guardians Miss H. C. Davidson (Chairman). Panel Committee Dr. J. J. Gibb. St. Mary's Hospital Dr. A. B. Porteous (Tuberculosis Officer). ,, ,, Sister W. M. Lindsey. ,, „ Miss E. Wilson (Lady Almoner). United Services Fund Miss M. M. Barthorp. Local Social Worker The Hon. Miss E. C. Godley. Paddington and St. Marylebone Employment Committee Councillor M. J. Marks, L.D.S. Kensal House School — From January 1st, 1924, to August 30th, 1924, Miss D. Warren acted as whole-time paid secretary to the Committee. From August 31st onwards, following Miss Warren's resignation, the Medical Officer of Health acted as Honorary Secretary to the Committee, an allowance of £50 per annum being allocated to certain members of the clerical staff for clerical assistance. The Social work of the Tuberculosis Care Committee is ancillary to the work of the Public Health Committees of the Borough Council and London County Council in the sphere of the prevention and treatment of tuberculosis. The principal duties performed are : (1) The assessment of patients' contributions, who are receiving institutional treatment at the hands of the London County Council. (2) The co-ordination of the various agencies which can be invoked to assist patients and their dependants. No funds are available in the hands of the Committee for the assistance of patients. The Committee has met two or three times a month at the Town Hall, and the attendance of members has been well maintained. MATERNITY AND CHILD WELFARE. Health Visitors. These officers, two in number, work under the control of the Maternity and Child Welfare Committee of the Council. Their duties are :— (1) To visit the homes of all newly-born children where considered necessary. (2) To make enquiries concerning stillbirths and deaths of infants and young children. (3) To visit and give advice to parents in cases of ophthalmia of the new-born, infective enteritis and other important diseases. (4) To investigate all cases of puerperal fever. (5) To investigate applications for the supply of milk to necessitous families. The Health Visitors do not attend any consultations at the Paddington School for Mothers, but attend alternately once a fortnight at the Infant Consultation Centre at Queen Charlotte's Maternity Hospital. The work performed by the Health Visitors is summarised in the appended tables, which also show how many infants were breast-fed and other interesting information. 33 HEALTH VISITING. 1924. 1925. Births— Primary visits 1,701 1,821 Repeat „ 3,645 3,485 5,346 5,306 Ante-natal— First visits 513 562 Revisits 293 421 806 983 VISITS re SICKNESS. Puerperal Fever 28 38 Ophthalmia Neonatorum 206 168 Diarrhcea 309 524 Miscellaneous 1,318 1,559 1,861 2,289 1924—INFANTS VISITED : 1,701. Method of Feeding. Breast. Artificial Mixed Number 1,525 86 90 Percentage 89.6 5.1 5.3 AGES AT FIRST VISIT. Breast. Method of Artificial. Feeding. Mixed. Totals. Weeks r0— 27 1 1 29 1- 492 20 13 525 2— 523 21 36 580 3— 238 15 10 263 Months r0— 1,280 57 60 1,397 1- 209 18 20 247 2— 16 7 5 28 3 and upwards 20 4 5 29 DIED BEFORE END OF YEAR : 48. Breast 32 Artificial 6 Mixed 10 CAUSES OF DEATH. Diarrhœal Diseases 12 Premature Birth 5 Respiratory ,, 21 Convulsions 1 Atrophy, Debility - Meningitis ... 2 Congenital Defects 1 Other Causes 6 Whooping Cough — Institution Deaths 36 (Paddington Infirmary 29). INFANTILE MORTALITY RATES. Breast 21 Artificial 70 Mixed 111 1925—INFANTS VISITED: 1,821. Breast. Method of Feeding. Mixed. Artificial Number 1,642 76 103 Percentage 90.2 4.2 5.6 AGES AT FIRST VISIT. Breast. Method of Feeding. Totals. Artificial. Mixed. Weeks 0— 31 - - 31 1— 814 19 18 851 2— 491 19 16 526 3— 166 12 25 203 Months r0— 1,502 50 59 1,611 1- 115 17 26 158 2— 8 3 11 22 3 and upwards 17 6 7 30 DIED BEFORE END OF YEAR: 64. Breast 48 Artificial 8 Mixed 8 34 CAUSES OF DEATH. Diarrhœal Diseases 11 Premature Birth 5 Respiratory Diseases 24 Convulsions 1 Atrophy, Debility 11 Meningitis — Congenital Defects 1 Whooping Cough 2 Other Causes 9 Institution Deaths 47 (Paddington Infirmary 36), INFANTILE MORTALITY RATES. Breast 29 Artificial 105 Mixed 77 Maternity and Child Welfare Centres. These are provided by the Paddington School for Mothers, which is a voluntary society financed by voluntary contributions and by grants from the Paddington Borough Council and the Ministry of Health. The following is a brief account of the activities of the Paddington School for Mothers. Headquarters: 232, Harrow Road, W. 2. Established 1910, when the Paddington Health Society was divided into two distinct bodies for dealing with Tuberculosis and Infant Welfare, the latter being the Paddington School for Mothers. The Birth Visiting was performed by the School's qualified Visitors until 1913, when, owing to the great increase in the work, for which only voluntary funds were then available, the Birth Visiting was taken over by the Borough Council, who appointed their first Health Visitor for that purpose. South Centres. 232, Harrow Road, W. 2.—Nine good rooms warmed by gas fires, bathroom and basement. Two Infant Consultations weekly.—Tuesday, 2.30. Medical Officer, Dr. Thoresby Jones. Thursday, 2.30. Medical Officer, Dr. O. Stuart Thompson. Area served:—Parts of Church, Harrow Road, Westbourne and Maida Vale Wards. One Maternity Consultation weekly (Ante- and Post-Natal).—Established January, 1918, monthly. March, 1919, weekly. Monday, 2.30. Medical Officer, Dr. Dorothy Fenwick. Area served :—All Paddington. St. David's Welsh Church Hall, St. Mary's Terrace, W. 2.—Large hall, electrically heated, and doctor's room, guarded coal fire. Established November, 1914, at Paddington Wharves' Mission Hall, Church Place, W. 2. Moved to present address, June, 1921. One Infant Consultation weekly.—Wednesday, 2.30. Medical Officer, Dr. Maude Richards. Area served —Church Ward. All Saints' Church House, Norfolk Mews South, London Street, W. 2.—Three rooms, warmed by guarded coal fires. Established November, 1918, at St. John's Boys' Club, Sovereign Mews, Burwood Place. Moved to present address, April 22nd, 1919. One Infant Consultation weekly.—Friday, 2.30. Medical Officer, Dr. Hammond. Area served :—Lancaster Gate, East and West, and Hyde Park Wards. North Centres. Congregational Institute, Third Avenue, Harrow Road, W. 10.—Large double room, doctor's room and sales room, warmed by gas radiators and hot pipes. Established 1911, at Emmanuel Hall, Harrow Road. Moved June, 1916, to St. Peter's Institute, Chippenham Mews. Moved to present address, November, 1916. Two Infant Consultations weekly.—Tuesday, 2.30. Medical Officer, Dr. Hammond. Friday, 2.30. Medical Officer, Dr. J. Thoresby Jones. Area served :—Queen's Park Ward and part of Harrow Road Ward. St. Simon's Parish Hall, Macroom Road, Saltram Crescent, W. 10.—Large hall, doctor's and weighing rooms, warmed by gas radiators and gas fires. Established December 6th, 1920. One Infant Consultation weekly. Wednesday, 2.30. Medical Officer, Dr. J. McKail. Area served :—Part of Harrow Road Ward. 35 Orphanage of Mercy, Randolph Gardens, Kilburn Park Road, N.W. 6.—Room for weighing, etc., warmed by guarded coal fire, and doctor's room, warmed by gas fire. Established February 8th, 1921. One Infant Consultation weekly.—Thursday, 2.30. Medical Officer, Dr. Hubert Hodge. Area served:—Part of Maida Vale Ward and part of Harrow Road Ward. Massage Sessions are held at 232, Harrow Road on Tuesday and Thursday mornings from 10.0 to 12.30, by Miss Gannon, C.S.M.M.G., for children referred by Medical Officers at all Paddington Centres. These children continue to attend the Centres in order that progress may be noted by the doctors. Sewing Classes are held on Wednesday afternoons at 232, Harrow Road, under the management of Voluntary Workers, who obtain materials and provide patterns. A cutter-out is paid 2s. 6d. for the afternoon. Mothers pay cost price for materials. Dental Arrangements.—The Dental Dispensary, 281, Harrow Road, and the Lissonia Dental Clinic treat mothers and children who attend Centres on special terms. Assistance, when necessary, given from Vest Fund. Lectures.—Lectures are provided from time to time, on Health topics at all Centres. Convalescent and Holiday Homes.—Mothers and children are sent to Convalescent and Holiday Homes on recommendation of Medical Officers at Centres. All arrangements made by School workers, and assistance given when necessary, by the Vest Fund. Vest Fund.—A small Association of ladies connected with the School, knit garments and woollies which are sold to the mothers at low cost at the Centres. The stock is augmented by gifts from friends, and the money realised is spent on dentures, convalescence, etc. Home Visiting. Home visiting is carried on systematically from the time of receiving the Borough Health Visitor's Birth Card, until the child goes to school. Each Health Visitor has her appointed area. Staff. The salaried staff consists of the Superintendent, Assistant Superintendent, one part-time and four whole-time Visitors. Consultation Centres. Summary of Work for the Year 1924. Harrow Road. Third Avenue. Macroom Road. St. Mary's Terrace. Randolph Gardens. London Street. Totals. Tues. Thurs. Tues. Fri. Wed. Wed. Thurs. Fri. Number of Sessions 51 52 52 51 51 51 51 50 409 Number of Attendances 2,459 2,352 2,802 2,803 2,128 1,653 1,772 1,344 17,313 Average Attendance 48.22 45.23 53.89 54.96 41.72 32.41 35.13 26.88 42.33 Seen by Doctor 969 982 1,243 1,119 909 1,154 1,020 795 8,191 Average number seen by Doctor at each Session 19 19 24 22 18 23 20 16 20 Ante-Natal Clinic. Number of Sessions 48 Number of Attendances 566 by 287 expectant mothers. Average Attendance per Session 11.79 Home Visiting. Visits to Babies 14,919 Visits to Expectant Mothers 677 Other Visits 9,518 36 Consultation Centres. Summary of Work for the Year 1925. Harrow Road. Third Avenue. Macroom Road. St. Mary's Terrace. Randolph Gardens. London Street. Totals Tues. Thurs. Tues. Fri. Wed. Wed. Thurs. Fri. Number of Sessions 50 52 50 50 50 51 52 50 405 Number of Attendances 2,321 2,648 3,223 3,051 2,373 1,993 1,710 1,222 18,541 Average Attendance ... 46.42 51.92 64.46 61.02 47.46 39.08 32.88 24.44 45.78 Seen by Doctor 965 1,064 1,268 1,277 986 1,247 1,059 724 8,590 Average number seen by Doctor at each Session 19 20 25 26 20 24 20 14 21 Ante-Natal Clinic. Number of Sessions 49 Number of Attendances 507 by 256 expectant mothers. Average Attendance per Session 10.35 Home Visiting. Visits to Babies 14,357 Visits to Expectant Mothers 560 Other Visits 8,233 Supply of Dried Milk, Etc., at Consultation Centres. 1924. 1925. £ £ Purchases of Dried Milks, etc.1,575 1,439 Sales „ „ 1,506 1,482 Grants „ ,, 25 30 Queen Charlotte's Maternity Hospital.—During the year 1925, 112 infants of mothers resident in Paddington attended the Infant Consultation Centre. The total attendances were 3,696. As regards ante-natal consultations, exact figures are not available. There were received into the Hospital for confinement 293 women from Paddington in 1924, and 248 women in 1925. These numbers would be approximately equivalent to the number of women from Paddington attending the Ante-natal Department in those years, and the average number of attendances in the Ante-natal Department in those years was times per patient. With regard to Outpatients in 1924, 400 Paddington women were delivered in their own homes by midwives from the Hospital, and 466 in 1925 ; each of these would have attended the Ante-natal Department about 2½ times on the average. St. Mary's Hospital.—There is no Infant Consultation Centre at this Hospital, but Ante-natal Consultations are held. There are no figures available as to the number of Paddington mothers who attended such consultations, but the number of Paddington mothers delivered at their own homes during 1925 was 172, and presumably all of these received ante-natal examination and advice. Maternity Nursing.—In December, 1924, the Council decided to ask the Minister of Health to sanction an arrangement with the Paddington and St. Marylebone District Nursing Association providing for the services of trained maternity nurses in connection with lying-in cases attended by the students and the Medical Officer of the Extern Midwifery Department of St. Mary's Hospital. An agreement subsequently entered into with the Association came into operation in April, 1925. During the nine months to the end of the year rather more than 100 women were attended in their homes by the nursing staff. The arrangement appears to be working satisfactorily. I propose to deal more fully with the subject in my next report. 37 DAY NURSERIES. There are two day nurseries in Paddington, situated at No. 66, Lancefield Street, Queen's Park. W. 10. and at No. 13. Hasborough Street. W. 2 Statistical Summary. Hasborough Street. Queen's Park] 1924. 1925. 1924. 1925. Days open 267 225 287 304 Attendances 3,057 3,477 4,471 5,121 New Children 29 19 52 42 Cases of Infectious Disease. Diphtheria - - 1 - Scarlet Fever - 1 4 1 Measles. 5 2 23 - Whooping Cough 1 - - 4 Chicken Pox ■- - 1 4 There were no Closures During 1924 and 1925 on Account of Infectious Disease. PROVISION OF MILK FOR NECESSITOUS MOTHERS AND CHILDREN. Milk is given in the following cases :— (a) Expectant mothers during the last three months of pregnancy. (b) Nursing mothers. (c) Children up to three years, also in exceptional cases children over three and under five years of age. The quantity of milk authorised does not exceed one pint per day except in the case of children between 3 months and 18 months where a special medical certificate is furnished, and in which case as much as 1½ pints per day may be authorised. One pound of dried milk is considered to be the equivalent of 7 pints of fresh milk. Applications are made at the Public Health Department at any time, when particulars of the circumstances of the family are obtained. Whenever, considered necessary wages, etc., are verified from the employer, and other enquiries instituted by the Investigation Officer. Close touch is also maintained with the Board of Guardians and other sources of assistance. A scale of income is appended which is used for the purpose of determining whether applicants are to be regarded as necessitous, and as to whether milk shall be supplied free or at half price. Where considered necessary, however, the Sub-Committee reserve the right to deviate from such scale. Before any case is recommended to the Committee, the Medical Officer of Health must be satisfied that the supply is necessary on grounds of health. A special medical certificate is also required in the case of children between 3 months and 18 months where more than 1 pint per day is required or where any milk is required for children between 3 and 5 years of age. The existence and duration of pregnancy must be verified by the signature of a doctor or midwife. Applications for grants are considered in detail by the full Maternity and Child Welfare Committee sitting as a "Grants" Sub-Committee, meetings being held practically every fortnight. Pending the sitting of the Sub-Committee the Chairman may authorise emergency grants. Grants take one or other of the following forms :— (a) Fresh milk to Expectant or Nursing Mother or a child under 5 years of age (see first paragraph) on an order issued on the usual dairyman supplying family; (b) Dried Mill?—supplied at the Welfare Centre attended by the infant; and (c) Dinners (cut from joint, two vegetables and "sweet") to expectant or nursing mothers partaken at approved restaurants. The necessary orders are despatched on the evening of the day on which the Sub-Committee sits, one copy to the tradesmen and one to the grantee. On the latter the following conditions are printed :—Milk supplied under this order is to be used only for the mother or child to whom the milk has been granted. It is not to be given to other members of the family. The Medical Officer of Health should be informed at once if there be:— (1) Any rise of wages of any Member of the family ; (2) Any increase of pension ; or (3) Any assistance received from the Relieving Officer. 38 During the years 1924 and 1925 the following quantities of milk were issued to necessitous mothers:— 1924. 1925. Fresh Milk 7,960 quarts. 9,996 quarts. Dried Milk 374 lbs. 398 lbs. The approximate cost of milk given in this way was £239 16s., in 1924, and £292 17s. 9d. in 1925 Free. Half-Price. Number of family. Total Income less Rent. Total Income less Rent. 1 15/- 18/- 2 20/— 24/— 3 25/6 27/— 4 30/- 34/- 5 32/6 37/6 6 36/- 42/- 7 40/— 47/6 8 44/- 51/6 9 48/- 55/6 10 52/- 60/- 11 56/- 65/- 12 60/- 70/- Particulars of Milk Grants. 1924. Number of New Applications. Granted. Refused or referred to Guardians. Fresh Milk 312 211 101 Dried Milk 23 20 3 Dinners 2 2 - 337 233 104 1925. Number of New Applications. Granted. Refused or referred to Guardians Fresh Milk 384 259 125 Dried Milk 27 25 2 Dinners 1 1 412 284 128 1924. 1925. Number of Orders for Milk 786 1,037 At Total Cost 741 977 At Half Cost 45 60 Number of Quarts at Total Cost 7,428 9,267 „ „ Half Cost 532J 729 Total Number of Quarts 7,960½ 9,996 £ s. d. £ s. d. Cost of Milk at Total Cost 207 2 11 253 10 11 „ „ Half Cost 7 10 7½ 9 15 9 £214 13 6½ £263 6 8 Number of Orders for Dried Milk 101 98 At Total Cost 93 98 At Half Cost 8 - Total Cost of Dried Milk £25 2 5½ £29 11 1 Number of Orders for Dinners 9 Number of Dinners supplied at Total Cost 154 - Total Cost of Dinners £9 12 6 - 39 Convalescent Homes. 1924.—One application for admission of a child to a Convalescent Home was made and acceded to. 1925.—One nursing mother and her baby were admitted to St. Mary's Convalescent Home, Birchington, for three weeks, the cost being defrayed by the Committee. ADMINISTRATION. GENERAL. Staff of the Department.—Dr. R. Dudfield who-had been Medical Officer of Health of Paddington since 1894, died on the 19th April, 1925. Dr. A. B. Porteous was appointed Acting Medical Officer of Health, and held office until September 25th, 1925, when the duties of Medical Officer of Health were taken over by Dr. G. E. Oates. Mr. H. J. Heeley, a Tenement-house Inspector, resigned from the Council's service in December, 1924, and Mr. R. A. Jones, a District Inspector, in January, 1925. Mr. C. G. Heron and Mr. C. Binding were appointed in March, 1925, to fill the vacancies. In April, 1925, Mr. V. L. Ronchetti was appointed as an additional Inspector and, after a re-arrangement of the work of the District Inspectors, was placed in charge of a district. Prevention of Infectious Disease.—Visits of inquiry after notification of infectious disease numbered 9,493 in the year 1924, and 7,756 in the year 1925. These figures exclude visits in connection with tuberculosis, which are recorded elsewhere in the report. The removals to hospitals and other institutions for various diseases other than tuberculosis numbered 1,159 in 1924, and 1,034 in 1925. In connection with the arrangement made by the Council with the Paddington and St. Marylebone District Nursing Association, 237 patients (comprising 156 cases of measles, 75 of pneumonia, 3 of whooping cough and 3 of ophthalmia neonatorum) were visited in their homes by the nurses of the Association during 1924, and 139 patients (comprising 56 cases of measles, 74 of pneumonia, 6 of whooping cough and 3 of ophthalmia neonatorum) during 1925. The visits paid to these patients numbered 3,927 in 1924, and 2,782 in 1925. Disinfection.—The rooms disinfected after infectious disease numbered 3,764 in 1924, and 2,785 in 1925. These totals include 247 rooms disinfected after tuberculosis in 1924, and 254 in 1925. The weight of bedding, etc., removed for disinfection amounted to 20¼ tons in 1924, and 22¼ tons in 1925. Two hundred and ten library books were disinfected during 1924, and 121 during 1925. At the end of the year 1923, Messrs. Armfield and Sons, Ltd., who had for many years carried out under contract the disinfection of bedding, clothing, etc., for the Council, ceased to perform this work. From January 1st to March 31st, 1924, the necessary steam disinfection was carried out by the Kensington Borough Council at their Wood Lane Disinfecting Station at a charge of 15 shillings per cwt. of articles disinfected. The total weight dealt with during this time was 5 tons, 4 cwt. odd, and £78 13s. 2d. was paid for the services rendered. As the above arrangement was found to be satisfactory and economical a contract was entered into with the Kensington Borough Council as from April 1st, 1924. Bedding, clothing, etc., are disinfected at the Wood Lane Disinfecting Station by exposure to steam under a pressure varying from 15 to 20 lbs. above atmospheric pressure for 15 minutes. Schools.—During 1924, 6,056 notices relating to the occurrence of infectious disease were sent to the Head Teachers of the various schools attended by patients or their " contacts," the corresponding figure for 1925 being 3,627. Of the notices sent during 1924, 5,437, and of those sent during 1925, 2,875, related to cases of measles, whooping cough and chicken-pox. In addition 355 reports were sent during 1924, and 292 during 1925, to the Medical Officers of Health of other boroughs in connection with cases attending outlying schools. Bacteriological Work.—The Council have an arrangement with the Lister Institute of Preventive Medicine, Chelsea Gardens, S.W. 1, for the bacteriological examination, at the expense of the Council, of specimens sent by medical practitioners of Paddington patients suspected to be suffering from diphtheria, tuberculosis of the lungs or typhoid fever. All specimens are collected at the Town Hall and transmitted to the Lister Institute by special messenger the same evening. The results are generally available the next morning, and are telephoned to the medical practitioner concerned. 40 During 1924 the examinations were as follow:— Disease suspected. Number of Number of Examinations. Positive Results. Diphtheria 469 52 Tuberculosis 391 . 74 Typhoid Fever 5 None During 1925 the examinations were as follow :— Disease suspected. Number of Number of Examinations. Positive Results. Diphtheria 1,158 145 Tuberculosis 668 93 Typhoid Fever 7 None House Drainage: ' 1924 1925 Existing drains tested and found watertight 76 157 Drains reconstructed ... ... ... ... ... ... ... 124 123 Drains made sound by"process" 5 5 Reconstruction Plans.-—The plans deposited numbered 285 in 1924, and 294 in 1925. In connection therewith 691 letters were despatched in the former, and 719 in the latter year. Summonses for failure to supply plans were taken out in six instances in 1924, and in one instance in 1925. Combined Drainage.—Orders were made under Section 74 of the Metropolis Management Act 1855, with respect to new drainage systems to which the following groups of houses were to be connected :— 1924. Edgware Road, Nos. 229 and 231. Hyde Park Terrace, No. 7, and Albion Mews East, No. 11. Harrow Road, Nos. 507, 509 and 511. Lancaster Gate, Nos. 100 and 101. Poplar Place, Nos. 16, 17 and 18. Titchborne Row, Nos. 7 to 11 (consecutive). Great Western Road, Nos. 40, 42 and 44. Shirland Mews, Nos. 9 and 11. 1925. Cambridge Mews, Nos. 8 and 9. Queensborough Terrace, Nos. 5 and 6. Harrow Road, Nos. 217, 219, 221 and St. Paul's Parish Hall. Porchester Terrace, Nos. 6 and 8. Harrow Road, Nos. 159, 161, 163 and 165. Five lock-up shops on the east side of Ladbroke Grove within the curtilage of and including No. 597, Harrow Road. Garage on a site with a frontage to Market Street and at the rear of the properties between 43, Praed Street and Junction Place, and entered from 49, Praed Street. Queen's Road, Nos. 24, 26 and 28 (Beardmore Petrol Garage). Edgware Road, Nos. 227, 229 and 231. Queen's Road, Nos. 7 and 9. Porchester Gardens, Nos. 14, 16 and 18. Queen's Road, Nos. 157 and 159. Lauderdale Mansions, Nos. 2-12. Market Street, 3-3a. Two new garages situate on the West side of Bark Place within the curtilage of No. 3, Orme Square, and at the rear of Nos. 2 and 3, Orme Square and portions of the two latter premises. Ashworth Road, Nos. 17, 19, 21 and 23, and garage of No. 23. Monmouth Road, Nos. 38 and 40. Lancaster Gate, Nos. 10 and 11. Queen's Road, Nos. 158 to 164 (even). Edgware Road, Nos. 45, 47 and 49 (Kenvon Court). Edgware Road, Nos. 207 to 217 (odd). 41 Westbourne Grove, Nos. 53 and 55. Harrow Road, Nos. 504 and 506, and Ashmore Road, No. 1. The Council recognised as sewers and reconstructed combined systems serving 1924—Lanark Place, Nos. 5a to 8. 1925—Blomfield Road, Nos. 41 and 42, and Nos. 43 and 44. Sewer Connections.—In 1924 118 were reconstructed, either partially or wholly, 42 after Orders under Section 85 of the Metropolis Management Act, 1855, and 76 on the initiative of the owners of the properties concerned. In 1925 the figures were :—Constructed under Orders, 12; constructed voluntarily, 63. Water Supply.—Certificates under Section 48 of the Public Health (London) Act were issued with respect to 13 premises during 1924 and 3 premises during 1925. The Metropolitan Water Board reported 15 cases of discontinuance of water supply in 1924, and 11 in 1925. In one instance (in 1925) the supply was disconnected in consequence of defective fittings, the reason given in all other instances being non-payment of water rate. Four of the premises (2 in each year) were found on inspection to be unoccupied. The water supply was restored to the remaining premises after intervals varying from 1 day to 27 days. In 11 instances (9 in 1924 and 2 in 1925) notices were served, but no legal proceedings were necessary. During 1925 a further case was reported in which the supply of water had been cut off by the owner of the premises. The supply was reinstated after the issue of a summons, at the hearing of which the defendant was ordered to pay £1 1s. costs. Mortuary.—The bodies deposited at the Mortuary numbered 292 in 1924, and 309 in 1925. Inquests were held in 216 instances in the former year, and in 213 instances in the latter year. In 1924 76 bodies (3 infectious) were deposited pending burial, and in 1925 96 (all non-infectious). Trade Nuisances.—Sixteen complaints of smells were received during 1924, and 10 during 1925, those relating to accumulations of manure numbering 10 and 3 in the respective years. Rag and Bone Dealers.—The term rag and bone dealer as defined in the London County Council (General Powers) Act, 1908, means any person selling or buying for the purpose of re-sale or otherwise dealing in rags (other than tailors' or dressmakers' cuttings), bones, rabbit-skins, fat or other like article. The bye-laws applicable to this trade came into force on September 26th, 1923, except as regards certain structural requirements which did not take effect until a year later. In 1924 there were 29 rag and bone dealers in the borough, but 10 closed down during 1925, leaving 20 at the end of that year. Ten of these deal in rags only, 9 deal in fat, bones, rags and skins, and 1 deals exclusively in skins. Careful attention was given to the enforcement of any structural alterations under the bye-laws. In premises where the inner surfaces of the walls were found to be lined with wood matching in good condition, such woodwork was allowed to remain. All the premises had the requisite window openings for lighting purposes, though none of them had permanent openings for ventilation of adequate area. Where the floors were of wood and found to be in good condition, they were not disturbed. Galvanized iron receptacles with covers and tarred bags have been provided at each store. Smoke Control.—During 1924 twenty-six trade premises were kept under observation for the detection of black smoke. These premises were watched on 144 occasions, occupying 87¾ hours. Smoke of all descriptions was noted during 37J hours, the duration of "black" smoke being only 3¼ hours. Fifteen complaints relating to the emission of smoke were received during the year. During 1925 twelve trade premises were kept under observation for the detection of black smoke. These premises were watched on 155 occasions, occupying 98¾ hours. Smoke of all descriptions was noted during 431/3 hours, the duration of " black " smoke being only 3¾ hours. Seven complaints relating to the emission of smoke were received during the year. FOULING OF PUBLIC FOOTWAYS BY DOGS. The following bye-law was made by the Council on the 29th July, 1924, for the good rule and government of the borough:— No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway. Any person offending against this bye-law shall be liable to a penalty not exceeding 40 sh illirgs 42 This bye-law shall cease to be in force after the first day of August, 1926, unless a bye-law confirming and continuing its provisions has been duly made and come into force before that date. This bye-law is enforced by the Medical Officer of Health and his staff. During 1924 and 1925 no prosecutions were instigated, but numerous verbal warnings to offenders were given. The publicity which has been given to the bye-law has had good effect in causing many dog-owners to be more careful. One minor difficulty in enforcing the bye-law is that an offender cannot be compelled to divulge his identity, and cannot be given in charge as the police do not enforce the bye-law. Notices concerning the bye-law were twice posted on shingle-bins throughout the borough, and twice enclosed with rate demand notes. CANAL BOATS ACTS, 1877 AND 1884. By virtue of the Local Government Board Regulations of May 17th, 1878, the Paddington Borough Council is one of the Registration Authorities for the Regent's and Grand Junction Canals. The Medical Officer of Health is the Examining Officer for the purpose of the Regulations, and Mr. E. J. Potter is Inspector of Canal Boats. On June 9th, 1925, the Canal Boats Amendment Regulations, 1925, came into force. These regulations amend the Canal Boats Regulations of 1878 by definitely placing on the owner of a canal boat the obligation of maintaining it in the condition required for registration, and in case of default the suspension or cancellation of the registration may be ordered by a Court. The obligation on the owner of a boat to notify the name of a newly-appointed master to the registration authority is also abrogated by the new order. In practice such notification was unnecessary and had fallen into disuse. At the Easter clean-up of the Paddington Basin there were in 1924, 377½ tons of mud removed, 723 square yards of concreting laid, 60 cubic feet of brickwork repaired and 49 square yards of pointing done by the Grand Junction Canal Company. In 1925 the figures were, 711½ tons of mud, 697 square yards of concreting, 247½ cubic feet of brickwork and 6 square yards of pointing, in addition to 169 feet of concrete coping done. The following reports were made to the Council by the Medical Officer of Health and were adopted by the Council as their statutory reports to the Ministry as required by the Canal Boats Act, 1884. Report for 1924.—The Inspector reports that 103 canal boats were inspected during the the year, following infringements of the Acts being discovered:— Without certificate 4 Marking or numbering illegible or incorrect 6 Unregistered boats 2 Painting required 10 Registration number incorrect 2 Cabins leaky 4 Stove pipe defective 3 On no occasion was admission to a boat refused and no legal proceedings were necessary against either the owner or occupier of any boat. Seventeen (17) notices were served and twenty-two (22) letters sent to various persons relating to registration of boats, etc. There were four (4) cases of infectious disease notified during the year, three of Measles (females, 11, 9 and 11) and one of Diphtheria (male 4). Three deaths occurred during the year among the boat population, two from Bronchial Pneumonia and one from Heart Disease. Three boats were registered, one new and two owing to change of ownership. There were no registrations of boats propelled by steam or motor power. One hundred and six (106) children were found to be living on boats, fifty-seven (57) being of school age. The total number of boats on the Register at the end of 1924 was two hundred and forty-three (243), one being a motor boat. Only one hundred and thirty-one (131) of this total can be traced. Several of the boats have been temporarily dismantled by having some of the fittings removed. Efforts have been made by the Inspector to get the dismantled canal boats with dilapidated cabins put in repair, or the cabins removed and the boat taken off the Register of Canal Boats, but without much success. The Inspector has devoted on an average one day a week during the year to inspecting canal boats. 43 Report for 1925.—Mr. E. J. Potter continues to act as Canal Boats Inspector, he having been appointed in November, 1909. The Inspector reports that 96 canal boats were inspected during the year, the following infringements of the Acts being discovered :— Cabins leaky 2 Floor of cabin decayed 1 Unregistered boat 1 Painting of cabin required 7 Stove pipes defective 2 Lettering, marking and numbering illegible 6 Without certificates 1 On no occasion was admission to a boat refused and no legal proceedings were necessary against either the owner or occupier of any boat. Fourteen (14) notices were served and ten (10) letters sent to various persons relating to registration of boats, etc. There were six (6) cases of infectious disease notified during the year, one of Whooping Cough (female 3) and five of Chicken-Pox (males 8 months and 15 years, and females 6, 13, and 12). One death from heart disease occurred during the year among the boat population. Three boats were registered, two new and one owing to change of ownership. There were no registrations of boats propelled by steam or motor power. One hundred and twelve (112) children were found to be living on the boats, sixty-four (64) being of school age. The total number of boats on the Register at the end of 1925 was two hundred and forty-one (241), one being a motor-boat; only about half of this, total can be traced. There are several boats temporarily dismantled by the removal of some of the fittings. The Registration of four (4) canal bpats registered by this Authority has been cancelled during the past year owing to the boats having been broken up or registered with other Authorities. HOUSING. Conversions.—Orders of the Court having been obtained by the owners of the undermentioned houses, as provided for by Section 27 of the Housing, Town Planning, etc., Act, 1919, the said premises were converted during the years 1924 and 1925 into the number of flats or tenements mentioned. 7, Palace Court : 5 flats or tenements. 22, Palace Court : 5 flats or tenements. 25, Palace Court : 4 flats or tenements. The Special Housing Committee gave due consideration to the plans of work proposed to be carried out and granted the approvals necessary for the purpose of obtaining the Orders of the Court. Approval was also given during 1924 to plans, etc., deposited relative to the conversion of fortyone (41) premises into some 134 flats, and during 1925 to plans for converting thirty-five (35) premises into 109 flats. These deposits of plans pursuant to the Bye-laws under Section 202 of the Metropolis Management Act, 1855, do not necessarily comprise all " conversions " as in many cases interference with the existing drainage and sanitary arrangements does not take place. Compulsory Repairs.—On account of the difficulties which had arisen in previous years in the application of the provisions of the Housing Acts, no notices requiring the execution of repairs were served under those Acts during 1924 and 1925. In a large number of instances, however, defects which could not be dealt with under the Public Health (London) Act or bye-laws were remedied as the result of special letters which were forwarded to the owners of the houses. Houses Unfit for Habitation.—A Closing Order under Section 11 (1) of the Housing Act, 1925, was made by the Council in December, 1925, with respect to premises at No. 7a, Windsor Place which were unfit for occupation as a dwelling. The premises were vacated and converted into a workshop. Undergrourul Rooms.—During 1924 two Orders were made by the Council with respect to underground rooms used as sleeping places in contravention of the Regulations made by the Council under Section 17 (7) of the 1909 Act. The use of the rooms for sleeping purposes was given up. In one instance in each year basement rooms were dealt with under Section 96 of the Public Health (London) Act, 1891, and the illegal occupation discontinued. Tenement Houses.-—During the two years the number of houses on the Register (viz., 1,404) remained unaltered. The inspections made by the two Special Inspectors totalled 6,041 in 1924 and 5,773 in 1925. Particulars of the defects, etc., discovered and remedied are shown in the table on page 45. Overcrowding.—Seventeen tenements were reported to be overcrowded in 1924, and 9 in 1925. Owing to the impossibility of obtaining other accommodation, 3 cases in 1924 and 8 cases in 1925 were allowed to remain in abeyance. 44 Annual Cleansing.—The houses inspected for this purpose numbered 1,007 in 1924, and 951 in 1925. The practice followed in previous years of inspecting certain streets annually and others every two years was continued, it being impossible for the two Inspectors engaged on this work to carry out a complete inspection each year of all the houses on the Register. Common Lodging Houses.—There are 5 houses in Kilburn Lane accommodating 128 men and 37 women. These houses are licensed by the London County Council, whose officers carry out routine inspection. Each year, however, at the time of application for licences, an inspection is made by the Sanitary Inspector of the district. Among the occupants of these houses one case of pneumonia and 10 deaths from various causes occurred in 1924, and 8 deaths in 1925. Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. Section 2 (2). Rent and Mortgage Interest Restrictions Act, 1923. Section 23. Certificates of Medical Officer of Health: 1924. 1925. Applications made 11 11 Certificates issued 6* 4 Certificates refused 4 7 Cases deferred 1 - *A rescinding Certificate under Section 5(2) of the 1923 Act was issued with regard to one case in March, 1925. Housing on London County Council Estates. The London County Council in November, 1924, initiated a scheme whereby "15 per 1,000 houses available for letting during the year" were apportioned amongst residents of the borough recommended by the Medical Officer of Health for preferential treatment on account of overcrowding or other special hardship. Some four to five hundred persons applied for the assistance of the Council in the course of 1925 in obtaining better housing accommodation, but as is to be expected the great majority required " rooms " in the borough, the breadwinner's work being in the vicinity. Out of the applications made to the Department during 1924 the undermentioned matured for the said recommendation of the Medical Officer of Health:— Estate. Number of Applications. Applications abandoned. Accommodation offered and refused. Refused by L.C.C. Waiting. Housed. Becontree 25 12 5 2 2 4 Downham 1 — — — — 1 Old Oak Common 1 — — — — 1 27 12 5 2 2 6 The figures for 1925 are as follow:— Estate. Number of Applications. Applications abandoned. Accommodation offered and refused. Refused by L.C.C. Waiting. Housed. Becontree 58 6 8 3 19 22 *Downham (Lewisham) 12 — — — 10* 2 *Roehampton 5 — — — 4* 1 *Tottenham 1 — — — 1* — Old Oak Common 1 — — 1† — — 77 6 8 4 34 25 * Few houses were available on these estates, hence the high proportion on "waiting" list. †Nothing available on Old Oak Common Estate. The above figures should not be taken as the total for the Borough, it being known that some families obtained accommodation on the various Estates by direct application to the County Council. 45 Housing Acts: Rent Books.—During 1924 seven (7) Rent Books in the possession of tenants of various premises in the borough were found by the staff to be without the particulars required, and during 1925 two (2) similar offences were reported. In every case a cautionary letter was addressed to the landlord. Sanitary Defects Remedied in Tenement Houses. 1921. 1922. 1923. 1924. 1925. Drain defective 3 3 25 4 15 „ choked 24 18 15 5 14 „ unventilated or improperly ventilated 9 — 1 3 3 Manhole cover defective 22 17 10 15 20 Gulley choked 12 9 6 10 23 Ventilating pipe improperly constructed 1 1 — 16 20 Soil pipe defective — 9 7 8 10 Water-closet choked 50 33 27 18 38 „ defective 272 271 130 82 59 ,, insufficiently flushed 13 8 19 7 21 ,, flushing apparatus defective 76 78 48 44 65 ,, without water supply 32 29 12 18 16 „ foul 41 45 55 46 40 ,, accommodation insufficient 2 9 4 6 10 ,, without door 1 — — 157 44 ,, without external light or ventilation — 1 3 — 1 Rainwater pipe not disconnected from drain or soil pipe 1 — — — 1 ,, ,, defective 55 50 34 27 74 „ „ choked 5 14 6 18 21 Wastepipe defective 21 21 22 13 40 ,, choked 7 11 2 5 11 „ not provided — 1 — 1 o Other drainage defects 10 34 10 18 51 Cistern defective 4 1 3 3 11 „ dirty 17 13 16 13 14 „ without proper cover 12 2 5 1 2 „ cover defective 23 15 12 7 4 Dustbin defective 228 147 86 90 91 „ not provided 36 10 9 16 18 „ insufficient 5 31 15 16 46 ,, disused and not abolished 3 4 3 5 3 Paving defective in area or yard 192 220 113 93 114 ,, ,, washhouse 138 110 77 89 99 Guttering defective 39 50 12 30 47 Premises damp 41 62 53 31 31 Rooms, etc., dirty 3,275 1,638 3,202 3,546 2,809 ,, verminous 344 204 162 201 97 Roof defective 251 387 272 256 214 Accumulation of refuse 5 5 11 22 19 Animals improperly kept 32 16 10 31 9 Water supply to premises insufficient 5 18 10 9 — Other defects or nuisances 957 1,531 2,494 1,438 1,103 Overcrowding. Tenements overcrowded 2 8 4 17 9 Rooms overcrowded 2 8 5 17 9 Occupants, total 12 43 24 93 53 Under 10 7 23 11 41 28 10 and upwards 5 20 13 52 25 Overcrowding abated— By re-arrangement 1 — — — — By voluntary removal — 2 1 4 1 Under notice 1 5 3 10 Cases held over — 1* — 3 8 Notices Issued. Written Intimations 518 735 553 659 605 Statutory Notices 142 240 154 162 178 Bye-law „ 2,369 2,309 1,771 1,972 1,718 Notices under L.C.C. (G.P.) Acts— Verminous rooms 204 244 125 162 134 Additional taps 4 18 8 9 — Abolition of old dustbins 5 4 1 4 3 *This case resulted in a summons, which was adjourned five times, finally sine die. 46 HOUSING. (MINISTRY OF HEALTH TABLE.) Unfit Dwelling Houses. 1921. 1922. 1923. 1924. 1925. I.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910— (a) Houses inspected on complaint or after illness 2,332 2,020 2,074 2,108 2,373 (b) Registered tenement houses inspected 997 915 793 1,007 951 (c) Houses inspected under Housing Acts 63 2 2 2 1 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation *8 — *1 •2 1 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 55 2 2 — — *Underground rooms only. II.—Remedy of Defects without Service of Notice. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers No record. III.—Action under Statutory Powers. (A) Proceedings under Section 28 of the Housing, Town Planning, &c., Act, 1919— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 55 2 2 — — (21 Number of dwelline-houses which were rendered fit— (a) by owners 87 45 27 — — (b) by Local Authority in default of owners 9 — 1 — — (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — — — — — (B) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied— (a) Number of notices under Public Health (London) Act, 1891, and London County Council (General Powers) Acts 1,892 2,198 1,861 2,040 2,177 (6) Number of bye-law notices served 2,570 2,572 1,942 2,110 1,967 (2) Number of dwelling-houses in which defects were remedied— (a) by owners Not available. (6) by Local Authority in default of owners — — — — — (C) Proceedings under Sections 17 and 18 of the Housing, Town Planning, &c., Act, 1909, and Section 11 Housing Act, 1925— (1) Number of representations made with a view to the making of Closing Orders 8 — 2 2 1 (2) Number of dwelling-houses in respect of which Closing Orders were made 8 — 2 2 1 (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwellinghouses having been rendered fit 4 — — — — (4) Number of dwelling-houses in respect of which Demolition Orders were made — — — — — (5) Number of dwelling-houses demolished in pursuance of Demolition Orders — — — — — 47 FACTORIES AND WORKSHOPS. 1924. Inspection of Factories, Workshops and Workplaces. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 620 3 — Workshops (including Workshop Laundries) 1,662 10 — Workplaces (other than Outworkers' Premises) 26 — — Total... 2,308 13 — Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts— Want of cleanliness 157 157 — — Want of ventilation 3 3 — — Overcrowding 2 2 — — Want of drainage of floors — — — — Other nuisances ... — — — — Sanitary accommodation insufficient 4 3 — — „ „ unsuitable or defective 35 34 — — „ „ not separate for sexes 3 3 — — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouse (s. 101) — — — — Other offences 6 5 — — Total 210 207 — — At the end of 1923, 1,150 premises were on the Register of the Department as compared with 1,446 at the end of 1914. During 1924, 37 premises were removed from the Register and 70 added, making the total at the end of the year 1,183. The Department reported the opening of 26 workshops to the Home Office, and received from that Office notice of 39, 27 of which were already known to the Department. Homework (Outworkers).—Local employers of outworkers sent in 38 lists in February, and the like number in August. These lists contained 471 names and addresses, of which 365 were forwarded to other districts. From other districts 333 addresses within the borough were received. As usual the majority of the lists of addresses were received from the City of London, Kensington and Westminster. Supervision.—There were during the year 2,308 inspections, including 620 of factories, 1,662 of workshops and 26 of workplaces. The inspector reported the existence of 210 nuisances or defects on registered premises, 207 oi which were remedied during the year, the majority on his verbal request. He served 13 notices during the year. The defects found comprised— Want of cleanliness. 157 Want of ventilation 3 Overcrowding 2 Sanitary accommodation—Insufficient 4 Unsuitable or defective 35 Not separate for sexes 3 Other offences 6 The Home Office forwarded 10 complaints, 2 of which were withdrawn. The complaints comprised— Defective water-closet apparatus 5 Dirty conditions of rooms 3 Insufficient water-closet accommodation 1 Inadequate ventilation 1 48 Bakehouses.—During the year one "level" bakehouse was opened and one "underground" bakehouse was closed, the total number on the register at the end of the year being 67, of which 44 were Factory Bakehouses. The number of "level" bakehouses was 20 (13 being factories), and of "underground" 47 (31 being factories). The number of persons working in bakehouses was 328, including 15 women and 28 individuals under the age of 18. The bakehouses were inspected on 680 occasions during the year. Duplicate certificates under Section 101 of the Factory and Workshop Act, 1901, were issued with respect to the following underground bakehouses, which were found on inspection to comply with the requirements laid down with respect to underground bakehouses : Kilburn Park Road, No. 37 ; Harrow Road, No. 292. 1925. Inspection of Factories, Workshops and Workplaces. Premises. Number of Occupiers prosecuted. Inspections. Written Notices. Factories (including Factory Laundries) 853 — — Workshops (including Workshop Laundries) 1,781 14 — Workplaces (other than Outworkers' Premises) 37 — — Total... 2,671 14 — Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect to which Prosecutions were instituted. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts— Want of cleanliness 129 123 — — Want of ventilation 6 6 — — Overcrowding 3 3 — — Want of drainage of floors — — — — Other nuisances 31 31 — — Sanitary accommodation insufficient — — — — ,, ,, unsuitable or defective 32 32 — — ,, ,, not separate for sexes 2 2 — — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouse (s. 101) — — — — Other offences — — — — Total 203 197 — — At the end of 1924, 1,183 premises were on the Register. During the year 115 premises were removed from the Register and 77 added, making the total at the end of the year 1,145. The Department reported the opening of 22 workshops to the Home Office, and received from that Office notice of 14, 10 of which were already known to the Department. Homework (Outworkers).—Local employers of outworkers sent in 33 lists in February, and 34 lists in August. These lists contained 433 names and addresses, of which 341 were forwarded to other districts. From other districts 352 addresses within the borough were received. Supervision.—There were during the year 2,671 inspections, including 853 of factories, 1,781 of workshops and 37 of workplaces. The Inspector reported the existence of 203 niusances or defects on registered premises, 197 of which were remedied during the year, the majority at his verbal request. He served 14 notices during the year. The defects found comprised— Want of cleanliness... 129 Want of ventilation 6 Overcrowding 3 Sanitary accommodation—Insufficient — „ „ Unsuitable or defective 32 „ „ Not separate for sexes 2 Other offences 31 49 The Home Office forwarded 5 complaints, which comprised— Overcrowding 2 Inadequate ventilation 1 Insufficient water-closet accommodation 1 Sanitary conveniences not properly screened 1 Bakehouses.—During the year one "level" bakehouse and one "underground" one were closed, the total number at the end of the year being 65, of which 43 were Factory Bakehouses. The number of "level" bakehouses was 18 (13 being factories, and of "underground" 47 (30 being factories). The number of persons working in bakehouses was 320, including 13 women and 26 individuals under the age of 18 years. The bakehouses were inspected on 818 occasions during the year. FOOD SUPERVISION. Slaughterhouses.—There were four slaughterhouses in the borough at the beginning of 1924, but the licence of one of them, that at 6, Upper Brook Mews, lapsed during 1924 owing to non-user, and was not renewed by the London County Council. There were 138 inspections in 1924, and 133 in 1925. The animals slaughtered, so far as is known, were 421 head in 1924, comprising 45 bullocks and 376 sheep, and 558 head in 1925, comprising 34 bullocks, 515 sheep and 9 pigs. In 1924, 2 sheeps' livers were destroyed as unsound and in 1925, 2 bullocks' livers and 2 pigs' heads (tuberculous). Public Health (Meat) Regulations, 1924. These Regulations came into force on April 1st, 1925, and deal with the inspection and marking of meat and its protection from contamination. The Regulations are divided into six parts. Part 1.—Contains definitions. Part 2.—This provides for proper notice being given of any slaughtering by the occupier of a slaughterhouse, and prohibits certain practices whereby the meat in a slaughterhouse may become contaminated. There are now only three slaughterhouses in Paddington, and the amount of slaughtering is not great. The new arrangements for giving notice of slaughtering to the local authority have worked smoothly. Part 3.—Deals with the marking of meat and does not affect this borough at present. Part 4.—Deals with the protection from contamination of meat on a stall. Meat was sold from two coster's stalls at the beginning of 1925, but during the year the use of one stall was discontinued, and the other stall was adapted to comply with the regulations by having its top and three sides enclosed. This stall stands in Kilburn Lane on Saturdays. At the beginning of the year meat was sold from two stalls situated on the footway opposite to butchers' shops. Both these stalls have been discontinued. The definition of a "stall" in the Regulations appears to be insufficient, and does not apparently include the case where meat is exposed in a street on a piece of sacking. I have in the past observed this practice in London (not in Paddington), ox-tails being exposed for sale by a hawker in this manner. Part 5.—Deals with the protection of meat in shops, stores, etc. An important section in this part states that the occupier of a room in which meat is on sale shall take all such steps as may be reasonably necessary to guard against the contamination of the meat therein by flies and shall cause the meat to be so placed as to prevent mud, filth, or other contaminating substance being splashed or blown thereon. Considerable discussion has taken place as to what the steps are which are reasonably necessary in an ordinary butcher's shop to protect the meat from contamination. This aspect has not presented any difficulty in Paddington where, in common with the West End of London, the arrangement and cleanliness of butchers' shops show a high standard as compared with other parts of the country. There are some 80 butchers' shops in Paddington, 69 of which are provided with glass fronts, 2 are partly closed in this way, whilst 9 are open in front. The amount of meat exposed outside the shops is not great, and as a result of the new regulations a great improvement in this respect was effected, notably by the fixing of sun and side blinds. 50 The practice of handling meat by the prospective purchaser is not forbidden by the regulations, and although notices asking customers not to do this are exhibited in some shops, the practice largely continues. Part 6.—Deals with the handling of meat in markets and the transport of meat in vehicles. In the case of vehicles transporting meat through the streets of Paddington the conditions found were in conformity with the regulations. During the year an abstract of the regulations was left at each butcher's premises, and any necessary explanations and helpful suggestions given. No legal action was found necessary. Poultry Slaughtering.—This business is regulated by special bye-laws which came into full effect on December 22nd, 1925. The only poultry-slaughterhouse in the borough is situated at No. 51, Shirland Road. During last year this slaughterhouse was entirely reconstructed, and now consists of a small building with brick walls cemented inside. The roof is of corrugated iron, with an open skylight. Ventilation is provided by two air-bricks and open louvres. The floor is concreted and cemented with a fall to a gully outside. The blood receptacle is a cemented pit, the full width of the house, and about two feet deep. Food Purveyors.—At the end of 1925 there were 453 purveyors of food in the borough. There are 7 premises where fish-curing is carried on, and 33 premises where fish-frying is carried on. The food inspector made 1,130 inspections in 1924, and 1,137 in 1925. Cowsheds.—There is one licensed cowhouse in the borough, situated at the rear of No. 39 Star Street. Nineteen visits were paid during 1924 and 1925. Dairies and Milk Shops.—At the end of 1923 there were 96 names on the register. During the year 1924 one shop was closed and five new ones opened, making 100 on the register at the end of the year. Eight businesses were transferred to new proprietors. At the end of 1925 there were 100 names on the register. There were 340 inspections in 1924, and 349 in 1925. Milk (Special Designations) Order, 1923. 1924. 1925. Licences issued for sale of— " Certified " Milk 33 34 " Grade A (Tuberculin Tested)" Milk 9 12 "Pasteurised" Milk 1 19 Samples taken and submitted to bacteriological examination. "Certified" Milk 33 26 "Grade A (Tuberculin Tested)" Milk 3 6 "Pasteurised" Milk — 1 Ice Cream.—At the beginning of 1924 there were 160 effective entries on the register, and 163 at the beginning of the year 1925. In addition to the 160 shops of various descriptions at which this commodity was sold, there were 34 barrow-men known, 8 with pitches in the borough, and 26 with pitches outside the borough. Two hundred and fifty-three inspections of premises were made in 1924, and 224 in 1925. Food destroyed.—Excluding the meat dealt with at the time of slaughter, the weight of food stuffs surrendered for destruction was about 11 tons in 1924, and about 3 tons in 1925. SALE OF FOOD AND DRUGS ACTS, 1875-1907. Of the 600 samples taken in each of the years 1924 and 1925, 39 (6.5 per cent.) in 1924, and 31 (5.1 per cent.) were found to be not " of the nature, substance and quality demanded." This compares with a proportion of 9.3 per cent. in each of the years 1922 and 1923. In 1924, 102 milk samples were taken on Sundays or Bank Holidays, only one of which was adulterated. In 1925, 86 milk samples were taken at these times and only one found to be adulterated. Summaries of the results of analyses made by the Public Analyst during each year are given on page 51. 51 1924.—Samples Submitted to Public Analyst. Total Found adulterated. Percentage adulterated. Milk 288 14 4.8 Dried Milk 1 — — Condensed Milk 6 — — Cream 17 1 5.8 Butter 30 — — Margarine 15 1 6.6 Lard 16 — — Bread 16 — — Flour 15 — — Cake 4 2 50.0 Mincemeat 4 — — Lemon Cheese 2 1 50.0 Cheese 5 — — Jam 16 — — Cocoa 9 — — Coffee 9 — — Rice 8 — — Tapioca 3 — — Sago 3 — — Mustard 5 — — Pepper 5 — — Vinegar 23 5 21-7 Beans 1 1 100.0 Peas 1 1 100.0 Brawn 4 — — Sausages 21 6 28.5 Dripping 10 — — Fish Paste 3 — — Soda Water 7 4 57.1 Lemon Squash 2 2 100.0 Olive Oil 9 — — Ammoniated Tincture of Quinine 3 — — Glycerine 6 — — Chicory 3 — — Herring Roes 4 — — Ground Ginger 5 — — Tinned Beef 1 — — Tinned Tomatoes 1 1 100.0 Whiskey 1 — — Semolina 5 — — Liquid Coffee 4 — — Marmalade 2 — — Tripe 3 — — Walnuts 4 — 600 39 6.5 1925.—Samples Submitted to Public Analyst. Total. Found adulterated. Percentage adulterated. Milk 284 16 5.6 Dried Milk 5 — — Tinned Milk 6 — — Cream 30 5 16.6 Butter 32 — — Margarine 13 — — Lard 13 — — Dripping 8 — — Bread 16 — — Cake 3 — — Flour 16 — — Rice 6 — — Tapioca 3 — — Sago 2 — — Semolina 3 — — Cocoa 11 — — Coffee 13 — — Chicory 2 — — Liquid Coffee 1 — — Jam 20 — — Soup 1 — — Mincemeat 6 — — Pepper 4 — — Mustard 4 — — Vinegar 25 1 4.0 Ground Ginger 3 — — Sausages 29 3 10.3 Brawn 3 — — Tinned Peas 1 1 100.0 Tinned Beef 1 — — Lime Juice 3 1 33.3 Soda Water 3 2 66.6 Apples 3 2 66.6 Honey 2 — — Pickles 1 — — Cheese 7 — — Ammoniated Tincture of Quinine 3 — — Glycerine 4 — — Camphorated Oil 2 — — Olive Oil 6 — — Castor Oil 2 — — 600 31 5.1 52 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 AND 1917. Milk.—Two hundred and eighty-eight (288) samples of milk were submitted to the Public Analyst during 1924 and 284 during 1925. All were reported to be free from preservative. Cream.—During 1924 14 samples of fresh cream and 3 samples of preserved cream were submitted for analysis. One of the samples of " fresh " cream was found to contain boric acid. It being an informal sample no action was taken. In the case of the preserved cream all provisions of the Regulations were complied with. The number of samples of fresh cream analysed during 1925 was 23, and of preserved cream 7. Two official and 3 informal samples of " fresh " cream contained boric acid. After consideration of the explanations furnished by the vendors of the official samples, it was decided not to institute proceedings. All samples of preserved cream complied with the Regulations. PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923. These Regulations came into operation on 1st May, 1924. "Dried Milk" is therein described as "milk, partly skimmed milk, or skimmed milk, which has been concentrated to the form of powder or solid by the removal of water." Article 4 requires dried milk to be sold in a tin or other receptacle labelled in the manner prescribed by the Regulations, and provides that it must contain not less than the following percentages of milk fat, namely:— (i.) In the case of milk described as " dried full cream milk," not less than 26 per cent. (ii.) In the case of milk described as " dried three-quarter cream milk," not less than 20 per cent. (iii.) In the case of milk described as " dried half cream milk," not less than 14 per cent.; and (iv.) In the case of milk described as " dried quarter cream milk," not less than 8 per cent. The labels prescribed are to indicate clearly that (i.) is "Dried Full Cream Milk," and must state what is the equivalent of the contents in milk; and that (ii.) - (iv.) are "Dried Partly Skimmed Milk (¾, ½ or ¼ Cream)." These latter labels must also state that the contents of the tin " Should not be used for babies except on medical advice," and must indicate what is the equivalent of the contents in pints of ¾, ½ or ¼ cream milk. In the case of skimmed milk, that is to say, dried milk containing less than 8 per cent. of milk fat, the label must state that the contents are "Dried Machine-Skimmed Milk (or Dried Skimmed Milk) " ; are " Unfit for babies," and must indicate what is the equivalent of the contents in pints of skimmed milk. For the purpose of these Rules the terms "Milk," "¾-cream milk," "½-cream milk," and "¼-cream milk" mean milk containing not less than the following percentages of milk fat and milk solids, that is to say:— Milk Fat. Milk Solids (including fat). Milk 3.6 12.4 ¾ cream milk 2.7 11.6 ½ cream milk 1.8 10.8 ¼ cream milk 0.9 9.9 and " Skimmed Milk " means milk which contains not less than 9 per cent, of milk solids other than milk fat. During the year 5 samples of Dried Milk were taken, all of which complied with the Regulations. RATS AND MICE (DESTRUCTION) ACT, 1919. 1924. 1925. Number of complaints received of rat-infestation of premises 69* 76 Number of complaints of mice-infestation 2 - *(In three cases the complaint referred to a stray rat only and full action was therefore unnecessary.) Action taken. Sewer connections and frontages examined In all cases of houses complained of and premises adjacent. Frontages re-constructed or repaired 30 16 House drains re-constructed or repaired 6 19 Notices served under the Act 4 3 Rat Week.—The weeks 3rd to 9th November, 1924, and 2nd to 8th November, 1925, were fixed by the Ministry of Agriculture and Fisheries for intensive action against rats. The usual circular letter was sent to all the principal wharfingers, railway companies, shopkeepers, etc., in the borough. 53 asking that special steps be taken during those weeks, and the Borough Engineer and Surveyor took the usual action in connection with the sewers in the borough. He reported as follows:— 1924. 1925. Number of positions in which bait was laid 393 478 Number of baits laid 5,290 7,593 Number of baits untouched — — Number of rats found dead 123 162 Total cost of labour and materials... £35 17 4 £39 1 6 The rats found dead probably formed only a small proportion of the number actually killed. Rat Infestation : Chippenham Mews Area.—In July, 1924, following receipt of numerous complaints of rat infestation of the premises on the north side of the Mews between Marylands and Chippenham Roads, known as Nos. 1 to 39 (odd) Chippenham Mews and No. 6a, Marylands Road, the services of an expert were engaged and the properties effectually cleared. Certain rat-proofing was carried out at the suggestion of the expert, the whole of the cost of clearing and proofing being borne by the occupiers or owners of the premises concerned. Despite the fact that all the properties were declared by the tenants to be free of rats after thecarrying out of the aforesaid works, in the following September complaints of fresh invasions of rats were received in the Public Health Department, the source of which was obviously the premises on the other side of the Mews and in the immediate neighbourhood. It was therefore decided to adopt a comprehensive scheme for dealing with the whole of the block of properties comprising Nos. 1 to 5, Chippenham Road, Nos. 2 to 6, Marylands Road, Nos. 362 to 414, Harrow Road and Nos. 5 to 39 (odd) and 2a and 2 to 42 (even) Chippenham Mews. The services of the expert were again requisitioned, and an estimate of £297 obtained for disinfestation and proofing (where necessary) of the whole of the premises. This work was carried out by the expert's employees in conjunction with the District Sanitary Inspector (Mr. R. A. Jones), in the following November, the means of destroying and clearing used being dogs, ferrets, pistols and raticides. Sewer connections were examined and, where necessary, repaired. In a few places the paving stones opposite infested premises were lifted and rat-runs abolished. During 1925 the drainage of each of the premises in the Mews was tested and, where found unsound, was repaired or reconstructed. Having regard to the fact that very few complaints have been received since the scheme was carried out, the disinfestation can be considered practically effectual. VERMINOUS CONDITIONS. Cleansing of Verminous Persons.—Twenty-one (21) persons in 1924 and twelve (12) in 1925 were referred by the Department to the Kensington Medicinal Baths for treatment, in accordance with the scheme arranged between the Kensington and Paddington Borough Councils. Cleansing of Verminous Rooms.—During 1924, 400 rooms in 272 premises were dealt with by the service of notices under Section 10 of the London County Council (General Powers) Act, 1922, the corresponding figures for 1925 being 206 and 147. Considerable use was made by owners of the facilities first offered by the Council in 1923 in regard to the spraying of infested rooms with a special vermicidal solution. One hundred and twentythree rooms in 94 houses were treated in this manner during 1924, and 133 rooms in 79 houses during 1925, at a charge to the owners of 7s. 6d. per room. 54 LEGAL PROCEEDINGS. The results of the summonses taken out during the two years are summarised in the following tables:— Legal Proceedings—1924. Premises. Offence. Fines. Costs. £ s. d. £ s. d. PUBLIC HEALTH (LONDON) ACT, 1891. Section 4. 22, Brindley Street Insufficient water supply Order made 90, Kensal Road Sink waste pipe choked ; window glass broken Work done Summons withdrawn 227, Shirland Road Roof leaky, rooms, etc., dirty Order made 1 1 0 1b, Maida Vale Mansions Rooms and passage damp Work done 2 12 6 Summons withdrawn 59, Hereford Road Failing to comply with Magistrate's Order to amend drain 1 10 0 42, Torquay Street Failing to comply with Magistrate's Order to remedy dampness of rooms 1 0 0 15, Cambridge Terrace Water-closet not suitably enclosed, etc. Order made 1 1 0 52, Warrington Crescent Walls damp „ 1 1 0 124, Kensal Road Drain stopped 0 5 0 2, Desborough Street Rooms, etc., dirty, washhouse paving defective Work done 0 10 6 12, Alfred Road Rooms dirty 0 10 6 5, Windsor Gardens Roofs defective 1 1 0 22, Brindley Street Failing to comply with Magistrate's Order to provide additional water supply 1 0 0 59, Hereford Road Drain defective, etc Order made 5 0 0 20, Clarendon Street Addition roof defective and without gutter, window glass broken Work done 3 3 0 Includes cost on summonses under By-laws 64, Woodchester Street Parts of premises dirty „ 1 1 0 Section 37. 90, Kensal Road Premises with insufficient dustbin Order made 1 1 0 Section 96. 10, James Street Failing to vacate underground room Room vacated Summons withdrawn By-Laws. 22, Brindley Street Failing to carry out annual cleansing Work done Summons withdrawn 90, Kensal Road „ „ „ Order made 1 1 0 43, Woodchester Street „ „ „ Work done 1 1 0 20, Clarendon Street „ „ „ se above 28, Campbell Street „ „ „ 3 5 0 1 1 0 41, Cirencester Street „ „ „ Work done Summons withdrawn 2. Dartington Terrace Soil pipe defective 2 0 0 1 1 0 2, Dartington Terrace (Second Summons) Soil pipe defective Work done 1 1 0 162, Kensal Road Room overcrowded Overcrowding partly abated. Summons adjourned sine die. 115, Westbourne Grove Failing to deposit plans of drainage works Plans deposited. Summons withdrawn 0 10 6 11, Richmond Road „ „ „ „ „ Plans deposited 0 10 6 2, 3, 4 & 5, Lanark Mews Failing to deposit plans and notices in respect of drainage works 2 0 0 2 2 0 12, Alfred Road Yard paving defective Work don< 0 10 6 90, Kensal Road Window sash cords defective „ Summons withdrawn LOND ON COUNTY COUNCIL (GENERAL POWERS) A CT, 1922. Section 10. 22, Brindley Street Room verminous Vermin destroyed 0 5 0 41, Cirencester Street „ „ Work done Summons withdrawn DAIRIES, COWSHEDS & MILKSHOPS ORDER 1885. Milk & Dairies (Amendment) Act, 1922. 9, Marylands Road Selling milk without being registered Summons dismissed with £3 3s. costs against Council 55 Summary of Legal Proceedings Under Sale of Food and Drugs Acts, 1875-1907. Fines. Costs. £ s. d. £ 8. d. Milk.—8% deficient in fat 40 0 0 3 3 0 ,,6% „ „ Summonses ,,9% „ „ Dismissed ,, 25% „ „ 4 0 0 ,,4% added water and a trace of annatto 1 10 0 ,,containing traces of annatto 0 10 0 4 4 0 ,, ,, ,, ,, 0 10 0 ,, ,, ,, ,, 0 10 o coloured with annatto 1 0 0 Vinegar 7½% added water 1 0 0 „14% „ „ 1 0 0 8% „ „ 1 0 0 4¾% „ „ 1 0 0 MILK & DAIRIES (AMENDMENT) ACT, 1922. Adding water to Milk (five summonses) 10 0 0 3 3 0 Legal Proceedings.—1925. Premises. Offence. Fines. Costs. £ s. d. £ s. a. PUBLIC HEALTH (LONDON) ACT, 1891. Section 4. 59, Hereford Road Failing to comply with Magistrate's Order to amend drain 10 0 0 Summons withdrawn 7, Clarendon Street Drain choked Work done 80, Cirencester Street Rain-water pipe defective ,, 1 1 0 8, Orsett Mews Premises without proper water supply Supply reinstated 1 1 0 7, Woodfield Gardens Skylight and roof leaky Work done 1 1 0 Section 37. Summons withdrawn 16, Walterton Road Premises without a proper dustbin ,, 19, Clarendon Street ,, ,, ,, ,, ,,1 0 0 By-Laws. 8, Netley Street Failing to carry out annual cleansing Work done 1 1 0 25, Clarendon Street ,, ,, ,, ,, ,, 1 1 0 21, Woodfield Place ,, ,, ,, ,, 2 0 0 1 1 0 10, Torquay Street ,, ,, ,, ,, Work done 1 1 0 28, Campbell Street ,, ,, ,, ,, 1 0 0 1 1 0 ,, ,, ,, ,, ,, Convicted same offence 28/11/24 45, Star Street ,, ,, ,, ,, Work done 1 1 0 ,, Yard paving defective ,, 1 1 0 ,, Flushing cistern defective ,, 1 1 0 5, Elcom Street Failing to carry out annual cleansing ,, 1 1 0 ,, Sashcords defective ,, 1 1 0 80, Cirencester Street Failing to carry out annual cleansing 2 0 0 1 1 0 ,, Window sashcords defective Work done 1 1 0 95, Cirencester Street Failing to carry out annual cleansing 0 10 0 1 1 0 ,, Window sashcords defective 0 10 0 ,, Water-closet door defective 0 10 0 19, Clarendon Street Failing to carry out annual cleansing Work done 1 0 0 ,, Window sashcords defective ,, Summons withdrawn ,, Yard paving defective ,, 1 0 0 14, Netley Street Copper defective 1 1 0 ,, Sashcords defective ,, ,, Fresh air inlet to drain defective ,, 3, Bradiston Road Executing sanitary work without notice, 1 1 0 ,, and contrary to the by-laws 1 1 0 46, Kensal Road Yard paving defective Work done 1 1 0 263, Edgware Road Failing to deposit drainage plans Deposited 1 1 0 21, Campbell Street Water-closet defective Work done Summons withdrawn 2, Modena Street Water-closet defective 2 0 0 1 1 0 DAIRIES, COWSHEDS & MILKSHOPS ORDER, 1 885. Milk & Dairies (Amendment) Act, 1922. Street Vendor Selling milk without being registered 0 2 0 Summary of Legal Proceedings Under Sale of Food and Drugs Acts, 1875-1907. Fines. Costs. £ s. d. £ s. d.[/##] Milk 4½% added water. Warranty proved Summons Dismissed „ 7% less than the proper proportion of fat 6 0 0 1 1 0 Selling from a hand can not bearing vendor's name and address Summons withdrawn Summons Vinegar 16% added water Warrantyproved Dismissed Margarine—For sale in unstamped wrapper 0 10 0 1 1 0 56 Report of the Work of the District Inspectors, 1920-1925. To Regulate Keeping of Animals. Improperly kept, Removed. 2 — 3 — — 5 Accumulations Removed. 19 11 12 51 13 41 Manure Receptacles Reconstructed, &c. 3 2 1 13 4 — Sanitary Works completed in Dwelling Houses. Miscellaneous. Roofs Repaired. 107 137 180 107 134 145 | Yards and Areas Paved and Drained. 21 19 34 15 25 19 Cellar Dwellings Closed. 4 1 2 — 6 — Cases of Overcrowding Abated. 5 3 1 — 1 2 Houses or Rooms Cleansed, Whitewashed, &c. 136 265 619 197 175 517 Drains Cleared, Flushed, &c. 66 86 90 85 59 87 Dust Receptacles Repaired, &c. 12 6 5 2 6 6 New, Provided. 54 74 111 51 62 128 Water Supply. Cisterns, Cleansed, Repaired, &c. 21 17 36 17 14 46 Cisterns, New, Provided. — 2 — 4 — 27 Supplies Reinstated. 5 19 9 6 11 9 Services Separated. 9 6 8 — 1 2 Drainage, &c. Soil Pipes Ventilated. 48 38 28 22 18 34 Soil Pipes Repaired. 11 13 26 31 20 31 Soil Pipes, New, Provided. 8 7 66 51 62 103 W.C.'s, New, Provided, Repaired, &c. 360 350 449 465 429 495 Rain-water Pipes Disconnected. 31 37 52 31 27 41 New Waste Pipes Provided. 368 450 410 704 717 1008 Waste Pipes Disconnected. 38 40 11 13 4 60 Drains Repaired and made Sound. 26 28 49 22 13 46 Drains Relaid, Trapped or Ventilated. 55 51 52 41 87 88 Entire Reconstruction. 35 36 58 35 31 38 Inspection of Dwelling Houses. Re-Inspection of all kinds. 10,035 10,467 10,875 11,127 11,017 12,232 Cellar Dwellings. 15 — — — — — On Complaint or after Illness. 2,243 2,332 2,020 2,074 2,108 2,373 " House-to-House." — — — — — 49 Number of Complaints received. 1,328 1,401 1,139 1,029 1,114 1,044 YEARS. 1920 1921 1922 1923 1924 1925 57 Prevention of Infectious Disease. 1924. 1925. All Diseases, Enquiries by— District Inspectors 1,475 1,391 Women Inspectors and Health Visitors 9,796 8,661 Tuberculosis—Included in above— Women Inspectors 1,778 2,296 Patients removed to Hospital—All Diseases (excluding Tuberculosis) 1,159 1,034 Rooms disinfected after— Tuberculosis 247 254 Other Diseases 3,517 2,501 Weight of Bedding, etc., disinfected (tons) 20¼ 22¼ School Notices issued— Measles, Whooping Cough, Chicken Pox 5,437 2,875 Other Diseases 619 752 Bacteriological Examinations for— Diphtheria 469 1,158 Typhoid Fever 5 7 Tuberculosis 391 668 Sanitary Work—Cutting-off of Water Supplies. Notices received 15 11 Referring to Inhabited Premises 10 7 Empty „ 2 2 Other ,, 3 2 Reasons for—Rates unpaid 15 10 Defective fittings — 1 Mortuary. Bodies deposited, total 292 309 „ „ for inquests 216 213 >( „ pending burial, infectious 3 — „ „ „ other 73 96 P.M. examinations made 121 120 Trade Nuisances. Offensive Smells—Complaints 16 10 Accumulations of Manure 10 3 Smoke—Complaints 15 7 ,, Premises watched 26 12 „ „ „ Hours of observation 87¾ 98¾ Duration of smoke (hours), including 37¾ 462/3 M „ black smoke 3 1/3 31/3 Canal Boats. On Register at end of year 243 241 Known to be using Canal Basin 131 120 (about) Inspections made 103 96 Infringements of Acts discovered 31 20 Notices served 17 14 Children found on boats 106 112 Office (Clerical) Work. Letters received 6,700 5,619 „ despatched 6,884 5,834 Entries in Postage Book 14,370 11,674 Certificates dealt with relating to Infectious Disease (including Tuberculosis) 4,776 4,192 Notices sent re above 7,002 9,681 Entries in Birth Register 2,542 2,450 Complaints received 1,346 1,044 Plans dealt with 285 294 New openings in Journals 295 226 Disinfection Orders 3,529 2,781 Notices to abate nuisances, etc. 1,404 1,109 58 CLINICS AND TREATMENT CENTRES. Maternity and Child Welfare. A ddress. By whom provided. Ante-natal Consultation Centres 232, Harrow Road St. Mary's Hospital, Cambridge Place Paddington School for Mothers. St. Mary's Hospital. Infant Consultation Centres *232, Harrow Road St. David's Church Hall, St. Mary's Terrace All Saints' Church House, Norfolk Mews South *Congregational Institute, Third Avenue Orphanage of Mercy, Randolph Gardens St. Simon's Hall, Macroom Road *Two sessions weekly. Paddington School for Mothers. Day Nurseries West House, 13, Hasborough Street Paddington Day Nursery. 66, Lancefield Street Queen's Park Day Nursery. Tuberculosis. Dispensaries 20, Talbot Road Paddington Tuberculosis Dispensary St. Mary's Hospital, Cambridge Place St. Mary's Hospital. Venereal Diseases. Clinics Lock Hospital, 283, Harrow Road (Women and Children) London County Council. St. Mary's Hospital, Cambridge Place (Male and Female) do. PUBLIC HEALTH STAFF. (W.T. Whole-time appointments. P.T. = Part-time appointments. See footnote for explanation of figures in parentheses.) Medical Officer of Health, Administrative Tuberculosis Officer, W.T. G. E. Oates, M.D., M.R.C.P., D.P.H., Barrister-at-Law. Assistant Medical Officers of Health, P.T. R. S. Walker, M.R.C.P., L.R.C.S.Ed., L.R.F.P.S.Glas., D.P.H., Tuberculosis Officer, Paddington Tuberculosis Dispensary. A. B. Porteous, M.D., D.P.H., Tuberculosis Officer, St. Mary's Hospital Tuberculosis Dispensary. Public Analyst, P.T. Sir William R. Smith, M.D., D.Sc., F.I.C. Chief Sanitary Inspector and Canal Boats Inspector, W.T. E. J. Potter (1), (4). District Sanitary Inspectors, W.T. J. W. Webster (1). T. Mitchell (1), (3), (4), (5). G. J. Miners (1), (4). C. Binding (1), (2). (3), (4). V. L. Ronchetti (2), (3), (5). Meat and Food Inspector, W.T. E. J. Grivell (1), (3), (4), (5). Women Sanitary Inspectors, W.T. F. M. Nicolas (2), (6), (7). L. M. O'Kell (1), (7). Workshops Inspector, W.T. C. S. Wansbrough (1), (4), (5). Tenement Houses Inspectors, W.T. C. Lawrence (1), (3), (4), (5). C. G. Heron (2), (3). Health Visitors, W.T. D. A. M. Newhall (1), (2), (8), (9). E. A. S. Davies (8), (9). (1) Sanitary Inspector's Certificate, Royal Sanitary Institute. (2) ,, ,, ,, Sanitary Inspectors' Examination Board. (3) Meat and other Foods Certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (4) Building Construction Certificates. (5) Plumbing Certificates. (6) Diploma, National Health Society. (7) Tuberculosis Certificate, National Health Society. (8) Central Midwives Board Certificate. (9) Nursing Training Certificates.