4 Transferable Births Registered during the year 1918. At the beginning of the year 1919 the Registrar.General afforded the following information for the year ended 31st December. 1918:— Inward Transfers. Outward Transfers. Legitimate —Males 154 10 Females 141 9 Illegitimate—Males 10 7 Females 8 7 Total —Males 164 17 Females 149 16 The corrected total births for the Borough, according to the Registrar General, is:— Males. Females. Total. 1,682 1,557 3 239 giving a rate of 20.71 per 1,000 inhabitants. The number of illegitimate births belonging to the Borough, according to the Registrar General, is:— Males. Females. Total. 39 39 78 Metropolitan Borough of Poplar. Annual Report for the YEAR 1918, on The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar, comprising the Registration Sub-districts of POPLAR, BROMLEY and BOW. by FREDK. WM. ALEXANDER, Medical Officer of Health. A4325 CONTENTS. PAGE Summary of Vital Statistics v Vital Statistics 1 Population 1 Births and Transferable Births 2 Illegitimate Births 4 Birth Rate 4 Marriages 4 Marriage Rate 5 Deaths 5 Deaths of Illegitimate Children 5 Death Rate 6 Zymotic Diseases, Death Rate 6 Respiratory Diseases, Death Rate 7 Infantile Mortality—Notification of Births Act, 1907—Tables 8, 39 Ophthalmia Neonatorum, Notifications, Public Health (Ophthalmia Neonatorum) Regulations, 1914 9 Age Mortality 9 Tubercular Diseases, Deaths, Death Rate 10 Phthisis—Deaths 11 Prevention of Consumption—Notifications; Summaries of Notifications Received; Number of Notifications on Form D; List of Non-Pulmonary Cases; Actual Number of Cases on Register at end of year 1918. Bacteriological Examinations; The Borough of Poplar Dispensary for the Prevention of Consumption; Deaths, Tubercular Diseases and Phthisis Number and Rate (see pages 10 and 11); Disinfection of Rooms and Articles (see page 52) 11 Tables of Deaths 19 Deaths from Drowning, &c. 22 Deaths of Persons of Unknown Addresses, included in the Mortality Statistics 22 Vital Statistics, Tables 24 Notes on Nomenclature of Diseases 28 Tables of Deaths (Classification); Deaths 30 Tables of Deaths in Public Institutions and Certain Localities 38 Tables of Infectious Diseases 46 Zymotic Diseases, Notifications; Institutions, Errors in Diagnosis; Infectious Diseases in Milkshops and on Homeworkers' Premises 50 Disinfecting Department—Rooms and Articles (Infectious Diseases and Verminous) Disinfected ., 52 Electrolytic Disinfecting Fluid—Output of Fluid, Distribution of Fluid, Cost of Material and Electricity, Bottles, Corks and Labels, Total Quantity Manufactured since Installation of Plant, Estimate for the year ended .''1st. March, 1918, and Expenditure for year ended 31st March, 1918. Average expenditure for the three years ended March, 1918. Estimated Expenditure for the year ending 31st March, 1919, and for the year ending 31st March, 1920, Spraying and Cleansing of Floors of London County Council Schools with Electrolytic Fluid, Swimming Baths—the use therein of Electrolytic Disinfecting Fluid, Comments on Adverse Criticisms. Epidemic Influenza (see page 75) 53 Verminous Children attending School—London County Council (General Powers) Act, 1907, Children Act, 1908, Number of Verminous Children Bathed, Itch Cases 58 Cleansing of Persons Act, 1897 59 Verminous Persons in Common Lodging-Houses—London County Council (General Powers) Act. 1907, Number of Persons Cleansed from Common Lodging Houses within and without the Borough 59 Plague 60 A4325 8 iv PAGE Anthrax 60 Glanders—London (Notification of Glanders) Order, 1907 60 Hydrophobia 60 Puerperal Fever-Number of Cases, Deaths 61 Small-pox 61 Vaccination—Vaccination Returns, 1917 61 Erysipelas 62 Scarlet Fever 62 Continued and Typhus Fevers 63 Typhoid Fever—Notifications, Rate per 1,000 Persons living, Errors in Diagnosis, Bacteriological Examinations of Doubtful Cases, Deaths 63 Diphtheria (including Membranous Croup)—Notifications, Deaths, Bacteriological Examinations, Errors in Diagnosis, Isolation, Diphtheria Antitoxin (London) Order, 1910 65 Whooping Cough—Deaths 67 Influenza—Deaths, etc 67 Measles—Digest of Measles and German Measles notified by Doctors and other persons, Deaths, Outworkers 76 "Spotted Fever" (Epidemic Cerebro spinal Meningitis) 78 Acute Polio-Myelitis or Acute Polio-Encephalitis 79 Diarrhœa and Enteritis, Deaths, Notification of Zymotic Enteritis and Summer Diarrhœa 79 Inquests and Deaths from Violence 81 Mortuary—Number of Bodies Received into Council's Cottage Street Mortuary 82 Canal Boats 82 Workshops. Workplaces, Laundries and Outworkers 83 Table A—Number of Inspection of, &c., of Bakehouses, Laundries, Workshops, Workplaces, Places where Food is Prepared, Milk Premises, Cowsheds, Slaughterhouses, Offensive Businesses, Ice Cream Premises, Registered Houses Lot in Lodgings and Homeworkers' Premises 83 Table B—Lists of Trades, Workshops, &c. 84 Tables C, D, F, and F—Filled in at the request of the Secretary of State, Factories, Workshops, Laundries, Workplaces, Homework, &c. 86 Bakehouses—Inspections 89 Coffee Shops, Eating Houses, Fried Fish Shops, Hotels, Restaurants, &c., London County Council (General Powers) Act, 1908—Sanitary Regulations for Premises used for the Sale, &c., of Food for Human Consumption 90 Hairdressers' Premises 90 Milkshops—Dairies, Cowsheds and Milkshops Order, London County Council (General Powers) Act, 1908, Power to Sanitary Authority to remove from or refuse to enter on Register Names of Dairymen in Certain Circumstances 90 Smoke Nuisances 91 Ice Cream 91 Food and Drugs Acts—Results of Analyses, Legal Proceedings, Preservatives in Butter; Preservatives in Margarine 92 Houses Let in Lodgings or Occupied by Members of more than one Family—Work of the Inspector 96 Housing—Housing, Town Planning, &c., Act, 1909, Housing (Inspection of District) Regulations, 1910; Representations and Closing Orders under Section 17; Determination of Closing Orders Section 17 (6) 96 London County Council (General Powers) Act, 1904, Verminous Rooms 97 Schools—Inspection of Schools 98 Sanitary Inspectors' Work—Tabulated List of Sanitary Inspections, &c., Overcrowding, General, Legal Proceedings 99 Reports— Miss Alice E. Hall (Health Visitor) and 104 Miss N. Brocklehurst (Second Health Visitor) 111 v. SUMMARY OF VITAL STATISTICS FOR 1918. Area of Borough (excluding Water)* 2,136 acres „ Poplar Sub-District „ 1,004 „ „ Bromley „ „ 589 „ „ Bow „ „ 543 „ Population (Census 1911)—Borough 162,442 „ „ Poplar Sub-District 56,393 „ „ Bromley „ 65,226 „ „ Bow „ 40,823 „ **Estimated to Middle of 1918—Borough 139,530 156,338 „ „ „ Poplar Sub-District 48,467 54,306 „ „ „ Bromley „ 55,865 62,594 „ „ „ Bow „ 35,198 39,438 Density†—Borough 65.32 „ Poplar Sub-District 48.27 „ Bromley „ 94.84 Bow 64.82 Marriages—Borough 2,616 „ Poplar Sub-District 1,256 „ Bromley „ 858 „ Bow „ 502 Births—Borough 3,203 „ Poplar Sub-District 1,134 „ Bromley „ 1,337 „ Bow „ 732 Birth Rate—Borough 20.48 „ Poplar Sub-District 20.88 „ Bromley „ 21.35 „ Bow „ 18.56 Deaths—Borough 3,178 „ Poplar Sub-District 1,157 „ Bromley „ 1,247 „ Bow „ 774 Death Rate—-Borough ., 22.77 „ Poplar Sub-District 23.87 „ Bromley „ 22.32 „ Bow „ 21.98 Infantile Mortality—Borough 107 per 1,000 births „ Poplar Sub-District 112 „ „ „ Bromley „ 106 „ „ „ Bow „ ' 101 „ „ Inhabited Houses (Census 1911)—-Borough 22,472 „ „ Poplar Sub-District 8,201 „ „ Bromley „ 8,721 Bow „ 5,550 *Land and Inland Tidal Water Inland Water. Water only. and Foreshore. Acres. Acres. Acres. Bow 555.7 12.5 9.8 Sub-Districts Bromley 605.8 17.3 19.1 I Poplar 1166.2 161.9 296.9 Borough 2327.7 191.7 325.8 The last column "tidal water and foreshore" is not included in the first column, and therefore must not be deducted to arrive at " land " area. ** See italics end of first paragraph, page 2. † Without water. Metropolitan Borough of Poplar Comprising the Registration Sub-Districts of Poplar, Bromley and Bow. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Sir, Madam and Gentlemen, In accordance with the "Sanitary Officers' (London) Order, 1891," of the Local Government Board, dated 8th December, 1891, I have the pleasure of submitting to you my twenty-sixth Annual Report, which deals with the year 1918. The reports of the Lady Health Visitors are appended, those of the Sanitary Inspectors have not been printed this year, but the work as far as possible is shown in tabulated form, pages 99-101. VITAL STATISTICS. The population of the Borough, calculated by the Registrar General is 139,530 for the death rate and 156,338 for the birth rate ‡:— London. Poplar. Bromley. Bow. 3,954,554 † 48,467 55,865 35,198 4,430,9291† 54,306 62,594 39,438 being 59.95 per acre for the Borough of Poplar, 41.55 per acre in Poplar Sub-District, 92.21 in Bromley, and 63.33 in Bow.* These estimated populations are the figures used in calculating the various rates in the present Report for the year 1918. * These figures are calculated upon the acreage of the district including the inland water area, not tidal and foreshore, but exclusive of area covered by water they are:— 65.32 per acre for the Borough of Poplar, 48.27 for the Sub-District of Poplar, 94.84 for the Sub-district of Bromley, and 64.82 for the Sub-District of Bow. County of London 60.0 (Census 1911). † Based on the returns furnished under the National Registration Act, 1915 and under the scheme for rationing of sugar. ‡ See italics end of first paragraph, page 2. 2 The rates in Tables IV., V., VI. and VII., have been calculated upon revised estimated populations based upon the censuses of 1901 and 1911 with the exception of the populations for 1915-917, which were calculated by the Registrar General on the returns furnished under the National Registration Act, 1915. The following estimates of population have been adopted in the General Register Office, Somerset House, for the calculation of the death rate and birth rate of the Borough for the year 1981; For the death rate 139,530 ,, ,, birth ,, 156,338 During the year 1918 births took place in institutions within the Borough as follows:— Males. Females. Total. Remarks. Poplar Union Workhouse 29 14 43 All Poplar Borough births except six males and five females. Sick Asylum 7 16 23 All Poplar Borough births except five males and seven females. Bromley House Institution 13 4 All Stepney births. 31, Sturry Street 0 2 2 Not Poplar births. The number of births as per headings of Registrars' weekly returns was as follows:— Males. Females. Totals. Poplar 523 501 1,024 Bromley 630 562 1,192 Bow 349 336 685 Totals 1,502 1,399 2,901 The corrected number of births with additions and subtractions is as follows:—* Males. Females. Totals. Poplar 575 559 1,134 Bromley 710 627 1,337 Bow 378 354 732 Totals 1,663 1,540 3,203 *• See page 3. † See page -1, Transferable Births. 3 ###]]Particulars. Male*. Females. Totals *Poplar (Sub-District). Registrar's Weekly Returns 523 501 1,024 Births occurring outside the Sub-District of persons belonging thereto:— Mothers' Home, Commercial Road 09 5.0 69 138 London Hospital 1 2 Salvation Army Maternity Hospital 3 1 Maternity Home, Plaislow 2 0 City of London Lying-in Hospital 4 0 Whitechapel Infirmary 0 1 Stepney (Underwood Street) 1 1 Sick Asylum 0 0 Colney Hatch Asylum 0 2 St. Pancras Maternity Hospital 0 1 Paddington Workhouse 1 0 Outlying Districts 6 6 Births occurring within the Sub-District of persons not belonging thereto:— Poplar Union Workhouse Bromley 3 I .1 28 Bow 4 1 Others 6 5 31, Sturry Street 0 2 Births, nett 575 559 1,134 Bromley. Registrar's Weekly Returns 630 562 1,192 Births occurring outside the Sub-District of persons belonging thereto:— Mothers' Home, Commercial Road 551 86 61 78 164 Poplar union Workhouse 7 3 City of London Lying-in Hospital 2 7 London Hospital 6 2 St. Bart.'s Hospital 2 0 Salvation Army Hospital 1 1 Queen Charlotte's Hospital 1 3 East End Emergency Ward 1 0 University College Hospital 0 1 Maternity Home, Plaistow 3 0 Steyning Workhouse 1 0 Middlesex Hospital 1 0 Outlying Districts 6 0 Births occurring within the Sub-District of persons not belonging thereto:— Sick Asylum 5 6 101 13 13 Bromley House Institution 1 3J Births nett 710 627 1,337 Bow. Registrar's Weekly Returns 349 336 685 Births occurring outside the Sub-District of persons belonging thereto:— Mothers' Home, Commercial Road 91 20 2 18 1 47 Poplar Union Workhouse 4 I Sick Asylum 0 1 London Hospital 6 1 City of London Lying-in Hospital. 4 9 Stepney (Underwood Street) 0 1 Salvation Army Hospital, Hackney 2 1 Queen Charlotte's Hospital 1 0 Outlying Districts 3 2 Births, nett 378 354 732 4 Transferable Births Registered during the year 1918 At the beginning of the year 1919 the Registrar-General afforded the following information for the year ended 31st December 1918 :— Inward Transfers Outward Transfers Legitimate —Males 154 10 Females 141 9 Illegitimate—Males 10 7 Females 8 7 Total —Males 164 17 Females 149 16 The corrected total births for the Borough, according to the Registrar General, is :— Males Females Total 1,682 1,557 3,239 giving a rate of 20 71 per 1,000 inhabitants The number of illegitimate births belonging to the Borough according to the Registrar General, is :— Males Females Total 39 39 78 The annual birth rate per 1,000 living being :— Poplar Bromley Bow Borough of Poplar County of London 1914 30.19 33.99 29.15 31.45 24.3 1915 29.55 31.84 27.67 29.99 22.6 1916 26.86 27.97 25.32 26.92 21.5 1917 23.40 23.94 21.49 23.13 17.5 1918 20.88 21.35 18.56 20.48 16.1* Marriages During the year the marriages of 2,616 persons were registered in the Borough, giving an annual rate of 1673 per 1,000 of the estimated population, the rate for England and Wales being 153, and for London 194 * The rate in England and wales in 1918 was 177 per 1,000 of the estimated population, and the lowest on record 5 The annual marriage rate per 1,000 living being:—. Poplar. Bromley. Bow. Borough of Poplar. County of London. 1914 23.30 17.39 13.85 18.55 19.1 1915 34.86 24.55 2217 27 .53 25.7 1916 22.11 15.62 13.60 17.37 19 .0 1917 19.55 13.93 1145 15.25 17.5 1918 23.12 13.70 12.72 16.73 19.4 Deaths. In the 52 weeks 3,526 deaths were registered in the Borough of Poplar, 680 deaths having occurred in the Sub-District of Poplar, 2,431 in Bromley, and 415 in Bow; from the 680 deaths which took place in Poplar there must be deducted 42 deaths of non-residents, and to the remainder must be added 519 deaths which occurred in outlying institutions, making a total of 1,157 deaths of Poplar parishioners. Treating the 2,431 registered deaths in Bromley in a similar manner, viz., deducting 1,397 deaths of non-parishioners and adding 213 deaths in outlying institutions, the deaths to be assigned to this sub-district will be found to be 1,247. From the 415 Bow deaths, there must be deducted 2 nonresidents and added 361 deaths in outlying institutions, making a total of 774 deaths. In dealing separately with the sub-districts as above, it will be seen by referring to Tables I., II., and III., that in considering the deaths of non-residents and those from outlying institutions, certain additions and deductions from the sub-districts have to be made in respect of themselves, but when considering the Borough as a whole, then from the 3,526 deaths which were registered there must be deducted 896 deaths of actual non-residents, and 548 deaths in institutions entirely outlying must be added, making a total for the Borough of 3,178 upon which the death rate is calculated. The 1,157 deaths in Poplar included 11 illegitimate children, 9 male and 2 female; the 1,247 deaths in Bromley included 5 illegitimate children, 4 male and 1 female; the 774 Bow deaths included 5 illegitimate children. 3 male and 2 female, making a total for the Borough of 21 deaths of illegitimate children. Males. Females. Totals. Poplar 631 526 1,157 Bromley 618 629 1,247 Bow 419 355 774 Totals 1,668 1,510 3,178 6 The male births in the Borough exceeded those of the female by 123, and the male deaths exceeded those of the female by 158 which makes a gain of 35 females. The following figures are the death rates per 1,000 living for the past 5 years (see pace 2):— Poplar. Bromley. Bow. Borough of Poplar. County of London. 1914 17.29 17.46 16.88 17.25 14.4 1915 21.50 18.46 18.69 19.57 16.1 1916 17.07 15.91 15.77 16.27 14.3 1917 18.36 16.76 14.89 16.84 150 1918 23.87 22.32 21.98 22.77 18.9 It should be borne in mind that, in studying death rates, comparison should be made with those of districts the inhabitants of which exist under similar conditions. See Table XVII., page 43, East Districts. ZYMOTIC DISEASES. Measles, scarlet fever, pertussis, diphtheria and membranous croup, fever, diarrhoea and enteritis. Death rates per 1,000 living. Poplar. Bromley. Bow. Borough of Poplar. 1914 1.61 2.25 2.56 2.10 1915 3.39 2.09 2.43 2.63 1916 1.52 1.52 1.55 1.53 1917 1.64 2 07 1.43 1 76 1918 2.08 2.30 2.13 2.18 Proportion of deaths to 1,000 deaths from all causes. Poplar. Bromley. Bow. Borough of Poplar. 1914 93.16 128.88 151.82 122.11 1915 157.66 113 41 130.25 134.35 1916 8913 95.15 98.86 94.25 1917 89.61 123.57 96.47 104.67 1918 87.29 103.44 96.89 95.97 7 RESPIRATORY DISEASES. Bronchitis, pneumonia (all forms) and other diseases of respiratory organs. Death rates per 1,000 living. Poplar. Bromley. Bow. Borough of Poplar 1914 3.49 3.58 315 3.44 1915 4.66 505 3.72 4.58 1916 3.47 3.49 3.78 3.55 1917 3.63 4.33 312 3.78 1910 505 4.99 4.26 4.83 Proportion of deaths to 1.000 deaths from all causes. Poplar. Bromley. Bow. Borough of Poplar. 1914 201.86 205.33 186.86 199.56 1915 216.79 273.59 199.45 234.06 1916 203.26 219.62 239.86 218.61 1917 197.81 25856 209.64 224.65 1918 211.75 223.73 193.79 212.08 8 INFANT MORTALITY.* Infantile Mortality; Notification of Births Act. 1907. Infantile Mortality. There were 128 deaths of children under one year of age belonging to Poplar, 142 deaths under one year of age belonging to Bromley, and 74 deaths under one year of age belonging to Bow, making a total for the Borough of 344.† The death rates of children under one year per 1,000 births for the past 11 years being:— Borough of County of Poplar. Bromley. Bow. Poplar. London. 1908 118.49 126.50 119.36 123.83 113 1909 128.92 132.86 128.32 130.40 108 1910 114.79 119.81 125.31 119.38 103 1911 157.02 158.02 161.42 158.50 129 1912 119.59 103.83 101.07 108.40 90 1913 107.97 117.56 112.11 112.90 105 1914 108.47 118.31 127.64 117.21 104 1915 137.78 120.98 152.15 133.98 112 1916 104.12 111.11 90.90 103.89 89 1917 94.61 97.19 92.27 95.13 103 1918 112.87 106.20 101.09 107.39** 107 *For Tables of Infantile Mortality, see Tables XIII., XIV., XV. and XVI., pages. † The 344 deaths of infants under one year of age include deaths in outlying institutions and allow for deductions of non-residents. ** See Health Visitor's Report (page 104). Mortality rate among infants visited was 79 2 per 1,000. The infants visited are for the most part in the poorest portions of the Borough, and the rate refers to those lorn in 1917. In 1910 and 1911 the rates were 105.69 and 115.62, because diarrhoea was prevalent in 1911. The infantile mortality rate is based on deaths occurring in any one year and births occurring in that and the preceding year. The rate of mortality amongst infants visited by Health Visitors is calculated upon births occurring in one particular year and deaths in that and the following year. The children born in 1910 and dying during 1910.11 are shown in the rate for 1910, so that the diarrhoea months June, July, August and September of 1911 affected not only the children born in 1911, but also those born in 1910 who had not yet reached one year of age, hence the higher rates amongst infants visited during the two years 1910 and 1911. 1908 Mortality rates amongst infants visited 104.19 1909 „ „ „ 98.75 1910 „ „ „ 105.69 1911 „ „ „ 115.62 1912 „ „ ., 90.10 1913 „ „ „ 83.20 1914 „ „ „ 117.00 1915 „ „ 98.20 1916 „ „ „ 78 07 1917 „ „ 79 2 9 Notification of Births Act, 1907 During the year 2,856 notifications were received under the Notification of Births Act, 1907 OPHTHALMIA NEONATORUM Notifications of Ophthalmia Neonatorum Forty cases of Ophthalmia Neonatorum were notified during the year— 23, Poplar; 8, Bromley; and 9, Bow Summary District Notifications Actual Cases Mid wives' Notifications! Notified by Midwives only (1) (2) (3) (4) Poplar 37 23 9 o Bromley 14 8 3 1 Bow 9 9 0 0 Grand Totals 60 40 12 3* * Included in Cols 1, 2 and 3 † Also notified by medical men AGE MORTALITY The number of deaths from one year to 65 years of age was 741 for Poplar, 823 for Bromley, and for Bow 494, making a total for the Borough of Poplar of 2,058 The annual death rates per 1,000 living for the past 5 years being:— Poplar Bromley Bow Borough of Poplar 1914 9.50 9.56 9.39 9.50 1915 12.12 9.99 9.74 10.66 1916 9.98 8.88 8.23 9.10 1917 11 .05 9.68 8.73 9.92 1918 15.28 14.73 14.03 14.74 10 The number of deaths over 65 years was 288 for Poplar, 282 for Bromley, and 206 for Bow, making a total of 776 for the whole Borough The annual death rates per 1,000 living for the past 5 years being:— Poplar Bromley Bow Borough of Poplar 1914 451 388 377 407 1915 530 461 474 488 1916 404 363 503 413 1917 483 449 395 447 1918 594 504 585 556 TUBERCULAR DISEASES * (Deaths at all ages) Poplar Bromley Bow Borough of Poplar 1914 132 134 80 346 1915 131 123 74 328 1916 138 120 68 326 1917 138 126 73 337 1918 140 127 89 356 * Including phthisis Death rates per 1,000 persons living Poplar Bromley Bow Borough of Poplar 1914 236 208 197 215 1915 241 196 187 209 1916 256 193 173 210 1917 276 219 201 234 1918 288 227 252 255 Proportion of deaths to 1,000 deaths from all causes Poplar Bromley Bow Borough of Poplar 1914 136.64 119.11 116.78 124.63 1915 112.25 106.49 100.40 107.22 1916 150.00 121.45 110.21 129.10 1917 150.81 130.84 135.43 138.60 1918 121.00 101.84 114.98 112.02 11 PHTHISIS. Deaths (all ages). Poplar. Bromley. Bow. Borough of Poplar.[/##] 1914 Ill 114 65 290 1915 102 104 63 269 1916 96 97 59 252 1917 113 100 63 256 1918 112 112 74 298 PREVENTION OF CONSUMPTION. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. TREATMENT OF TUBERCULOSIS. Notifications; Summaries of Notifications Received; Number of Notifications on Form "D"; List of Non-Pulmonary Cases; Actual Number of Cases on Register, end of year 1918; Bacteriological Examinations; The Borough of Poplar Dispensary for the Prevention of Consumption; Deaths, Tubercular Diseases and Phthisis—Numbers and Rates, see pages 10 and 11; Disinfection of Rooms and Articles, see page 52. A4S25 12 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 31st December, 1917, to the 28th December, 1918, in Poplar (Whole Borough). Age Periods Notifications on Form A. Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications Under 5 5 to 10 10 to 15 Total Primary Notifications Poor Law Institutions. Sanatoria. Pul monary— Males 2 11 27 14 25 2u 76 85 52 16 2 339 470 –— 3 — 3 5 45 78 Females 5 21 25 22 19 22 67 57 30 8 5 281 337 — 1 1 2 5 26 37 Non-Pulmonary— Males 4 30 45 22 4 –— 4 1 — 1 –— 111 133 — 4 2 6 11 8 2 Females 2 21 30 22 7 5 7 5 — — 1 100 118 — 4 4 8 14 4 3 Totals 13 83 127 80 55 56 154 148 82 25 8 831 1058 — 12 7 19 35 83 120 13 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 31st December, 1917; to the 28th December, 1918, in Poplar (Sub-District). Age Periods. Notifications on Form A. Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications Under 5 5 to 10 10 to 15 Total Primary Notifications poor Law Institutions. Sanatoria.[/##] Pulmonary— Males — 5 9 5 8 14 22 28 22 8 2 123 168 — — — — — 8 29 Females 2 8 8 6 6 11 25 18 10 2 — 96 110 — 1 1 2 4 11 9 Non-Pulmonary— Males 3 9 20 5 1 — 2 — — — — 40 45 — 3 1 4 8 3 1 Females — 7 9 11 1 4 3 3 — — 1 39 46 — 3 1 4 8 1 1 Totals 5 29 46 27 16 29 52 49 32 10 3 298 369 — 7 3 10 20 23 40 A4325 B 2 14 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period f'rom the 31st December, 1917, to the 28th December, 1918, in Bromley (Sub-District). Age Periods. Notifications on Form A. Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications Under 5 5 to 10 10 to 15 Total Primary Notifications Poor Law Institutions. Sanatoria. Pulmonary— Males 2 5 12 4 10 8 36 27 17 3 — 124 170 — 3 — 3 4 14 24 Females 2 11 10 12 9 7 23 19 11 3 4 111 132 — — — — — 11 16 Non Pulmonary— Males — 14 16 8 3 — 2 1 — — — 44 56 — — 1 1 1 2 1 Females 1 9 14 8 2 — 4 1 — — — 39 46 — — 2 2 3 1 1 Totals 5 39 52 32 24 15 65 4S 28 6 4 318 404 — 3 3 6 8 28 42 15 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 31st December, 1917, to the 28th December, 1918, in Bow (Sub-District) Age Periods. Notifications on Form A. Notifications on Form B. Number of Notifications on Form c. Number of Primary Notifications. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications Under 5 5 to 10 10 to 15 Total Primary Notifications Poor Law Institutions. Sanatoria. Pulmonary- Males — 1 15 5 7 7 is 30 13 5 —— 92 132 — — — — — 23 25 Females 1 2 7 4 4 4 19 20 9 3 1 74 95 — — — — 1 4 12 Non-Pulmonary— Males 1 7 9 9 — — — — — 1 — 27 32 — 1 — 1 2 3 — Females 1 5 — 3 4 1 — 1 — — — 22 26 — 1 1 2 4 2 1 Totals 3 15 29 21 15 12 37 51 22 9 1 215 285 — 2 1 3 7 32 38 1(5 Number of Notifications on Form D. (Cases Discharged from Poor Law Institutions and Sanatoria.) Poplar. Bromley. Bow. Totals. Poor Law Institutions Pulmonary M. 4 11 10 25 F. 8 6 3 17 NonPulmonary M. 2 2 2 6 F. 5 1 1 7 Sanatoria Pulmonary M. 37 29 26 92 F. 7 12 13 32 NonPulmonary M. — 1 — I F. — 4 1 5 Totals Pulmonary M. 41 40 36 117 F. 15 18 16 49 NonPulmonary M. 2 3 2 7 F. 5 5 2 12 List of Non-Pulmonary Cases (for Borough). Form A. Form B Bones and Joints Arms, legs, etc. 5 — Elbow 3 — Hip 10 3 Joints 2 1 Knee 4 1 Rib 2 1 Shoulder — 1 Spine 7 1 Tarsus 1 — Throat 1 — Wrist 1 — Glands:— Cervical 8 — Lymphatic 2 — Mesentery 1 — Neck 104 1 Oscheal 1 — Others (location not specified) 4 2 17 Form A. Form B. Various:— Abdomen 3 — Bladder 1 — Bowels 1 — Brain 3 — Dactylitis 1 — Enteritis 2 — Hilus 2 — Intestines 1 — Larynx 1 — Meninges 23 — Peritoneum 8 — Pleura 4 — Skin 3 3 Testicle 2 — Actual Number of Cases on Register. Number of cases on Register at beginning of year 1918 3,176 Add New cases during year 831 4,007 Deduct;— Died (notified cases) 288 Removed, etc. 28 Arrested or cured 64 380 Number of cases on Register beginning of 1919 3,627 Bacteriological Examinations. During the year ended 31st December, 1918, 122 samples of sputum were bacoteriologically examined free of cost at the Borough of Poplar Dispensary for the Prevention of Consumption. The Tubercle bacillus was found to be present in 28 instances (22.95 per cent.). 18 Borough of Poplar Dispensary for the Prevention of Consumption. Number of Notifications (actual cases) sent from the Borough of Poplar Dispensary for the Prevention of Consumption during the period from 1st January, 1918, to 31st December, 1918:— Poplar (Whole Borough). Notifications on Form A. Number of Notifications. Age Periods. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Notifications Pulmonary— Males — 2 20 10 17 23 55 54 9 5 — 195 Females — 9 14 12 13 14 34 34 12 7 2 151 Non-pulmonary— Males — 17 30 13 — 2 1 1 — — — 64 Females —— 6 21 13 3 — — 1 — — — 44 Totals 34 85 48 33 39 90 90 21 12 2 454 Distribution of Cases in the Borough. Insured. Uninsured. Total. Bromley. 21 67 88 Bow 64 94 158 Poplar 81 117 198 Out of District 9 1 10 175 279 454 The number of new cases who attended at the Dispensary during the year 1918 was 1,506; of these, 454 were tuberculous. There was a total of 9,430 attendances at the Dispensary. Deaths, Tubercular Diseases and Phthisis— Number and Rates see pages 10 and 11. Disinfection of Rooms and Articles see page 52. 19 TABLE I. Deaths during the year 1918 in the Poplar Sub-District of the Metropolitan Borough of Poplar, classified according to localities. Names of localities adopted for the purpose of these statistics: public institutions being shown as separate localities. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Poplar Sub-District 151 100 84 255 590 Union Workhouse 16 5 4 19 44 Baffin Buildings ... ... ... ... ... Council Buildings 1 ... ... ... 1 Grosvenor Buildings 5 3 4 7 19 Hanbury Buildings ... ... ... ... ... Hudson Buildings ... ... ... ... ... Montreal Buildings ... ... ... ... 1 Ontario Buildings ... ... ... ... ... Ottawa Buildings ... ... ... ... ... Prestage Buildings ... 1 ... ... 2 Quebec Buildings ... ... ... 2 2 Toronto Buildings ... ... ... ... ... Winnipeg Buildings ... ... ... ... ... River Thames ... 4 2 ... 7 East India Docks ... 1 ... 1 2 London Graving Dock ... ... ... ... ... West India Docks 1 ...1 ... ... 2 South-West India Docks 1 1 ... 1 3 Poplar Dock, G.W.R. ... ... ... ... ... Mill wall Docks ... 1 ... ... 1 Green's Dry Dock ... ... 1 ... 1 Limehouse Cut ... ... 1 ... 1 Highway ... 1 ... ... 1 Trinity Wharf ... ... ... ... ... Bow Creek ... 1 1 2 Police Station 1 ... ... ... 1 179 118 97 286 680 Deaths occurring outside the subdistrict among persons belonging thereto* + 115 113 99 192 519 Deaths occurring within the subdistrict among persons not belonging thereto — t 14 7 4 17 42— Deaths at all ages—nett 280 224 192 461 1157 * Including 301 deaths in the Bromley Sub-District:—Sick Asylum, 246; Poplar Hospital, 35; and Bow Institution, 16; Bromley House Institution, 2; Sub-district Bromley, 1; River Lea, Bromley, 1. 20 TABLE II. Deaths during the year 1918 in the Bromley Sub-District of the Metropolitan Borough of Poplar, classified according to localities. Names of localities adopted for the purpose of these statistics: public institutions being shown as separate localities. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Bromley Sub-District 161 120 91 255 627 Sick Asylum 322 233 191 430 1176 Bow Institution 72 73 43 134 322 Bromley House Institution 43 21 13 56 133 Poplar Hospital 41 36 35 44 156 Adelaide Buildings ... ... ... 1 1 Melbourne Buildings ... ... ... 1 1 Sydney Buildings 1 1 ... 2 4 Hawthorn Buildings ... ... ... 3 3 River Lee 1 ... ... 1 2 Limehouse Cut 1 1 ... 1 3 Highway 1 ... ... 1 2 Bow Creek ... ... ... ... ... Great Eastern Railway ... ... ... 1 1 Bromley Lock ... ... ... ... ... 643 485 373 930 2431 Deaths occurring outside the subdistrict among persons belonging thereto* + 60 38 47 68 213+ Deaths occurring within the subdistrict among persons not belonging thereto 375 288 224 510 1397- Deaths at all ages -- nett 328 235 196 488 1247 * Including 10 deaths in the Poplar Sub-District, viz.:—Union Workhouse, Poplar, 8; Poplar Police Station, 1 ; River Thames, Poplar, 1. 21 TABLE III. Deaths during the year 1918 in the Bow Sub-District of the Metropolitan Borough of Poplar, classified according to localities. Names of localities adopted for the purpose of these statistics: public institutions being show n as separate localities. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Bow Sub-District 88 62 59 202 411 Highway ... ... ... ... ... River Lee ... ... ... 1 1 Duckett's Canal ... ... ... 2 2 Midland Railway ... ... 1 ... 1 88 62 60 205 415 Deaths occurring outside the subdistrict among persons belonging thereto* + 101 84 60 116 361+ Deaths occurring within the subdistrict among persons not belonging thereto ... ... 1 1 2- Deaths at all ages-nett 189 146 119 320 774 * Including 234 deaths in other parts of the Borough (Poplar and Bromley Sub Districts), viz.:—Poplar Union Workhouse, 9: Sick Asylum, 212; and Bow lnstitution, 7 ; Bromley House Institution, 2; Poplar Hospital, 3; Highway, Bromley, 1. The following deaths have been included in the Mortality Statistics of the respective Sub-districts as there is no reason for believing that such deaths will be shown in the Mortality Tables of some other District :— Poplar (Sub-District). 30th Mar. River Thames, off Unknown. Stewart's Docks. Male, about 10 mins. Found dead. Want of attention at birth, but under what circumstances the deceased was born and died the evidence fails to prove. Inq. 17th April. S.S. War Helmet, Ship's fireman. Millwall Docks. Male, 27. Found dead. Acute, pneumonia. Nat. P.M. Inq. 13th May. West India Docks. Ship's lamp trimmer. Native of Russir. Male, 43. Found dead. Suffocation by drowning, but how he came into the water and was so drowned, the evidence fails to prove. Inq. 18th May. Claybury Asylum. Soap cutter, of Laindon Farm Colony. Male, 63. Br. pneumonia. 8 days. P.M. 20th May. Sick Asylum. Labourer of Poplar. No fixed abode. Male, 66. Cerebral apoplexy. 15th June. River Thames, off Unknown. Perry's Oil Mills. Female, about 45. Found dead. Suffocation by drowning, but how or by what means the deceased came into the water there is no evidence to show. Inq. 17th Sept. S.S. Sardinia, Ship's steward. Green's Dry A native of Dock. India. Male, 30. Found dead. Haemorrhage following perforation of an ulcer of the stomach. Nat. P.M. Inq. 2nd. Sept. River Thames, off Steward. Perry's Wharf. Male, about 40. Found dead. Suffocation by drowning but how he came into the water and was so drowned the evidence fails to prove. Inq. 22 DEATHS FROM DROWNING, ETC., AND DEATHS OF PERSONS OF UNKNOWN ADDRESSES INCLUDED IN THE MORTALITY STATISTICS. 23 Bromley (Sub-District). 15th April. Sick Asylum, found Son of unknown, in Momington Road. Male, 16 mos. Measles and whooping cough. 6 th July. Sick Asylum, of Ship deck hand. Bombay. Male, 30. Acute pneumonia. 1st July. Poplar Hospital, of 2nd Officer. Norway. Male, 22. Violent. Fractured skull and contuse d brain caused by falling through the opening into No. 5 tank, S.S. Ronald Amundsen. Acc. P ,M. Inq. Bow (Sub-District). llth April. Sick Asylum, found Son of unknown. N.L.R., Bow Station. Male, 16 mos. Measles and whooping cough. llth Oct. River Lee, off 419, Unknown parentOld Ford Road. age. Male, about 5 mins. ' Found dead. Want of attention at birth, but under what circumstances he was born and died, the evidence fails to prove. P.M. Inq. 31st Oct. Duckett's Canal, off Unknown. Parnell Road Bridge Female, about 5 mins. Found dead. Want of attention at birth, but under what circumstances it was born and died, the evidence failed to prove. P.M. Inq. 24 TABLE IV. Vital Statistics of Whole District during 1918 and Previous Years. Poplar (Whole Borough). Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Transferable Deathsf Nett Deaths belonging to the District. Uncorrected Number. Nett. Number.* Rate. of Non.residents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number.* Rate per 1000 Nett Births. Number.* Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1913 160,913 5082 5208 32.3 2588 16.0 443 544 588 112 2689 16.7 1914 160,839 4884 5059 31.4 2694 16.7 438 520 593 117 2776 17.2 1915 156,247 4585 4687 29.9 3139 20.0 587 507 628 134 3059 19.5 .1916 155,095 ‡ 4393 4543 26.9 2782 17.9 731 474 472 103 2525 16.2 168,746‡ 1917 143,443‡ 3578 3700 23.1 2812 19.6 901 506 352 95 2417 16.8 159,898‡ 1918 139,530‡ 2901 3203 20.4 3526 25.2 896 548 344 107 3178 22.7 156,33 ‡ Notes.—This Table is arranged to show the gross births and deaths in the borough and the births and deaths properly belonging to it with the corresponding rates. The rates are calculated per 1000 of the estimated gross population. * In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the borough, but excluding the deaths of soldiers and sailors that have occurred in hospitals and institutions in the district. In Column 12 are entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly corrected by subtraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. † "Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided, The deaths of persons without fixed or usual residence-e.g., casuals—are not included in Columns 8 or 9, except in certain instances under 3 (6) below. The following special cases arise as to Transferable Deaths:— (1) Persons dying in institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses and nursing homes (but not almshouses) are regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such institution to another, the death is transferable to the district of residence at the time of admission to the first institution. (2) The deaths of infants born and dying within a year of birth in an institution to which the mother was admitted for her confinement are referred to the district of fixed or usual residence of the parent. (3) Deaths from violence are referred (a) to the district of residence, under the general rule ; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. Area of District in acres Total population at all ages 162,442 At (land and inland 2327.7 Number of inhabited houses 22 472 Census water) Average number of persons per house 7.22 of 1911. Total families or separate occupiers 35,158 ‡ See italics, page 2. 25 TABLE V. Vital Statistics during 1918 and Previous Years. Poplar Sub.District. Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths! Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non.residents registered in the District. of Residents not registered in the District. Under 1 Year of Age . At all Ages. Number.* Rate. Number. Rate. Number.* Rate per 1000 Nett Births. Number.* Rate. l 2 3 4 5 6 7 8 9 10 11 12 13 1913 55,885 1796 1843 32.9 622 111 44 420 199 107 998 17.8 1914 55,869 1634 1687 30.1 555 8.9 40 451 183 108 966 17.2 1915 54,274 1579 1604 29.5 708 13.0 64 523 221 137 1167 21.5 1916 53,874‡ 1509 1575 26.8 543 10.0 57 434 164 104 920 17.0 58,616‡ 1917 49,826‡ 1267 1300 23.4 517 10.3 66 464 123 95 915 18.3 55,543‡ 1918 48,467‡ 1024 1134 20.8 680 14.0 42 519 128 112 1157 23.87 54,306‡ Area of Sub.District in Total population at all ages 56,393 At acres (land and inland 1166.2 Number of inhabited houses 8,201 . Census, water) Average number of persons per house 6.87 of 1911. Total families or separate occupiers 12,044. See notes, page 24. ‡ See italics page 2 26 TABLE VI. Vital Statistics during 1918 and Previous Years. Bromley Sub.District. Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Transferable Deathsf Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non.residents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number.* Rate. Number. Rate. Number.* ' Rate per 1000 Nett Births. Number.* Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1913 64,485 2104 2152 33.3 1622 25.1 779 224 253 117 1067 16.5 1914 64,397 2093 2189 33.9 1784 27.7 882 223 259 118 1125 17.4 1915 62,558 1937 1992 31.8 2052 32.8 1084 187 241 121 1155 18.4 1916 62,097 ‡ 1846 1890 27.9 1941 31.2 1146 193 210 111 988 15.9 67,562‡ 1917 57,432‡ 1488 1533 23.9 2030 35.3 1278 211 149 97 963 16.7 64,019‡ 1918 55,865‡ 1192 1337 21.3 2431 43.5 1397 213 142 106 1247 22.3 62,594‡ Area of Sub.District in Total population at all ages 65,226 At acres (land and inland 605.8 Number of inhabited houses 8,721 . Census water) Average number of persons per house 7.47 1911. Total families or separate occupiers 14,256. See notes, page 24. ‡See italics, page 2. Vital Statistics during 1918 and Previous Years. Bow Sub.District. Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Transferable Deathsf Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non.residents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number.* Rate. Number. Rate. Number.* Rate per 1000 Nett Births. Number.* Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1913 40,543 1182 1213 29.9 344 8.4 4 284 136 112 624 15.3 1914 40,573 1157 1183 29.1 355 8.7 4 334 151 127 685 16.8 1915 39,415 1069 1091 27.6 379 9.6 3 361 166 152 737 18.6 1916 39,124‡ 1038 1078 25.3 298 7.6 2 321 98 90 617 15.7 42.568‡ 1917 36,185‡ 823 867 21.4 265 7.3 4 278 80 92 539 14.8 40,336‡ 1918 35,198‡ 685 732 18.5 415 11.7 2 361 74 101 774 21..9 39,4381‡ Area of Sub-District in Total population at all ages 40,8231 At acres (land and inland 555.7 Number of inhabited houses 5,550. Census water) Average number of persons per house 7.35 of l911. Total families or separate occupiers 8,858. Sec notes, page 24. ‡See italics, page 2. 4325 27 TABLE VII. 28 NOTES TO TABLES VIII., IX., X., XI., XII., XIII., XIV., XV. & XVI. Nomenclature of Diseases Ail "Transferable Deaths" of residents, i.e., of persons resident in the district who have died outside it, are included with the other deaths in columns 2-10, Tables VIII., IX., X. and XI., and Infantile Mortality Tables XIII., XIV., XV., and XVI. Transferable deaths of nonresidents, i.e., of persons resident elsewhere in England and Wales, who have died in the district, are in like manner excluded from these columns. For the precise meaning of the term "transferable deaths" see footnote to Table IV. All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are entersd in Table XII. All deaths certified by registered medical practitioners and all inquest cases are classed as "Certified"; all other deaths are to be regarded as "Uncertified" Under the heading of "Diphtheria" and "Croup " are included nil deaths from Croup except those certified as due to " spasmodic," " stridulous," "catarrhal" or "false" croup. Under the heading of "Tuberculous Meningitis" are included deaths from Acute Hydrocephalus. Under the heading of "Cancer" are included deaths under such \ headings as Carcinoma, Scirrhus, Epithelioma, Rodent ulcer, Sarcoma, Cancer, and Malignant disease. Under the heading of "Diarrhoea" and "Enteritis" are included deaths registered as due to Epidemic diarrhoea, Epidemic enteritis, Infective enteritis, Zymotic enteritis, Summer diarrhoea, Choleraic diarrhoea, Cholera (other than Asiatic), Castro-enteritis, Gastro-intestinal catarrh, Muco-enteritis, Colitis, &c. Deaths from diarrhoea secondary to some other well-defined diseases are included under the latter. 29 Under the heading of "Alcoholism" are included deaths from Delirium tremens, acute and chronic alcoholism. Under the heading of "Puerperal Fever" are included deaths under euch headings as Pyaemia, Septicaemia, Sapraemia, Pelvic peritonitis, Peri and Endo-metritis occurring in the Puerperium. Under the heading of "Congenital Debility and Malformation, including Premature birth," are included deaths from Atrophy and niarsamus of infants, and want of breast-milk, but not from Atelictasis 4325 TABLE VIII METROPOLITAN BOROUGH OF POPLAR, The Borough. Causes of, and Ages at, Death during the Year 1918. Causes of Death (see page 28). Nett Deaths in whole Borough at subjoined Ages. Nett Deaths in Public Institutions and certain localities within and outside Borough (at all ages) belonging thereto. Nett Total Deaths in Public Institutions, &c. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Poplar Union Workhouse. Sick Asylum. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 All causes Certified 3177 344 239 259 190 234 500 636 775 32 792 40 6 83 22 547 1522 Uncertified 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 1 Enteric Fever 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 2 Small Pox ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... 3 Measles 151 15 64 6l 11 ... ... ... ... ... 25 ... ... ... ... 8 33 4 Scarlet Fever 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 2 2 5 Whooping Cough 61 18 21 19 3 ... ... ... ... ... 24 ... ... ... ... 6 30 6 Diphtheria and Croup 31 2 9 11 9 ... ... ... ... ... ... ... ... 5 ... 23 28 7 Influenza 524 9 28 42 54 86 164 96 45 6 94 2 1 3 ... 42 148 8 Erysipelas 3 1 ... ... ... ... 1 1 ... ... 2 ... ... ••• ... ... 2 9 Phthisis (Pulmonary Tuberculosis) 298 4 7 2 19 54 124 75 13 ... 76 1 1 4 *1 94 177 10 Tuberculous Meningitis 32 5 3 14 7 3 ... ... ... ... ... ...... ... 4 ... 10 14 11 Other Tuberculous Diseases 26 2 6 5 3 3 5 2 ... 1 3 ... ... ... ... ... ... 12 Cancer, malignant disease 146 ... ... ... ...... ... 8 81 57 1 52 4 ... ... 1 21 79 30 13 Rheumatic Fever 7 ... ... 1 1 2 1 1 1 ... ... ... ... ... ... 2 2 14 Meningitis 20 2 4 5 6 3 ... ... ... 1 2 ... ... 2 ... 7 12 15 Organic Heart Disease 232 ... ... ... 8 13 41 72 98 1 82 14 2 3 ‡1 31 134 16 Bronchitis 274 24 19 5 2 1 11 71 141 12 69 9 1 ... ... 7 98 17 Pneumonia (all forms) 377 61 51 59 33 29 58 57 29 5 75 2 ... 15 §4 53 151 18 Other diseases of respiratory organs 23 1 ... 2 ... 2 3 9 6 ... 8 1 ... ... ... 3 12 19 Diarrhoea and Enteritis 58 36 11 7 ... ... ... 1 3 ... 10 ... ... 2 ... 16 28 20 Appendicitis and Typhlitis ]1 ... ... ... 5 3 1 2 ... ... 4 ... ... 3 ... 3 10 21 Cirrhosis of Liver 7 ... ... ... ... ... ... 4 3 ... 1 ... 1 ... ... 1 3 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 32 ... 1 ... ... 1 5 12 13 ... 6 1 ... 1 ... 10 18 23 Puerperal Fever 6 ... ... ... ... 1 5 ... ... ... 4 ... ... ... ... 1 5 24 Other accidents and diseases of Pregnancy & Parturition 7 ... ... ... ... 4 3 ... ... ... 2 ... ... ... ... 4 6 25 Congenital Debility and Malformation, including Premature Birth 115 108 4 3 ... ... ... ... ... ... 21 ... ... ... ... 19 40 26 Violent Deaths excluding Suicide 123 14 1 11 17 10 12 29 29 2 28 ... ... 33 **] 2 22 97 27 Suicide 10 1 3 p 1 2 2 ††2 1 7 28 Other Defined Diseases 595 38 10 12 10 16 55 117 337 3 203 6 ... 6 ... 153 371 29 Diseases ill-defined or unknown 6 4 ... ... ... 1 ... 1 ... ... 1 ... ... ... .‡‡1 ... 2 Total Deaths 3178 344 239 259 190 234 500 636 776 32 791 40 6 83 22 548 1522 Sub-entries (included in above figures.) 14 Cerebro-spinal Meningitis 6 2 1 ... 2 1 ... ... ... ... ... ... ... ... ... 3 3 28a Poliomyelitis 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Pneumonia 196 9 10 22 22 32 ...40 42 19 5 53 ... ... 3 1 20 82 28 Dysentery 12 ... ... ... ... ... 4 5 3 ... ... ... ... 3 ... 6 6 28 Botulism 1 ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... w H-1 *River Thames, Poplar, 1 †Highway, Bromloy, 1. ‡Highway, Poplar, 1. §Millwall Doeks, Poplar, 1; Bromley Sub-District, 1; Poplar Police Station, 1; Highway, Bow, 1. **River Thames. Poplar, 3; East India Docks, Poplar, 1; West India Docks, Poplar, 1; Bow Creel:, Poplar, 1; Limohouso Out, Poplar, 1; Iiimehouse Cut, Bromley, 3; River Lee, Bromley, 1; Highway, Bromloy, 1.††Bow Creek, Poplar, 1; Duckett's Canal, Bow, 1.‡‡ River Lee, Bow, 1. 32 co co 11 Other Tuberculous Diseases 13 ... 4 3 1 3 2 ... ... 2 ... ... ... ... 6 8 12 Cancer, malignant disease 47 ... ... ... ... ... 1 29 17 ... 12 1 ... ... ... 9 22 13 Rheumatic Fever 1 ... ... • • • 1 ... ... ... ... ... ... ... ... ... ... 1 1 14 Meningitis 3 ... ... 1 1 1 ... ... ... 1 ... ... 1 ... ... ... ... 1 15 Organic Heart Disease 98 ... ... ... 4 5 16 31 42 ... 30 7 1 1 ‡l 14 54 16 Bronchitis 87 5 8 l ... • • • 4 28 41 8 27 3 ... ... ... 2 40 17 Pneumonia (all forms) 150 23 22 26 12 7 26 22 12 3 11 1 ... 7 §2 23 47 18 Other diseases of respiratory organs 8 1 ... ... ... 1 1 2 3 ... 4 1 ... ... ... ... 5 19 Diarrhoea and Enteritis 21 16 2 3 ... ... ... ... ... ... 1 ... ... ... ... 10 11 20 Appendicitis and Typhlitis 1 ... • •• ... ... 1 "" ... ... ... 1 ... ... ... ... ... 1 21 Cirrhosis of Liver 3 ... ... ... ... ... ... 2 1 ... ... ... 1 ... ... ... 1 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 13 ... ... ... ... 1 2 5 5 ... 3 1 ... ... ... 4 8 23 Puerperal Fever 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 24 Other accidents and diseases of Pregnancy & Parturition 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 2 25 Congenital Debility and Malformation, including Premature Birth 41 37 1 3 ... ... ... ... ... ... 4 ... ... ... 6 10 26 Violent Deaths, excluding Suicide 58 9 ... 7 6 4 7 16 9 1 10 ... ... 16 **7 9 43 27 Suicide 4 ... ... ... ... 1 1 2 ... ... ... ... ... 1 †† 1 ... 2 28 Other Defined Diseases 223 12 2 3 3 7 22 40 134 1 75 1 ... 3 ... 58 138 29 Diseases ill-defined or unknown 2 1 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 Total Deaths 1157 128 83 91 58 83 181 245 288 15 246 16 2 35 12 218 544 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 28a Poliomyelitis 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Pneumonia 71 3 2 10 7 10 16 16 7 4 7 ... ... 2 ... 10 23 28 Dysentery 5 ... ... ... ... ... 3 2 ... ... ... ... ... ... ... 3 3 * River Thames, Poplar, 1. ‡Highway, Poplar, 1.§Brorley Sub-District, 1; Millwall Dock, Poplar. 1. **River Thames, Poplar, 2 ; East India Docks, Poplar, 1; West India Docks, Poplar, 1; Bow Creek, Poplar, 1; Limehonse Cut Poplar, 1; River Lee, Bromley, 1. ††Bow Creok, Poplar 1. TABLE IX. METROPOLITAN BOROUGH OF POPLAR. Sub-District of Poplar. Causes of, and Ages at, Death during the Year 1918. Causes of Death (see page 28). Nett Deaths in whole Sub-District at subjoined Ages. Nett Deaths in Public Institutions and certain localities within and outside Sub-District (at all ages) belonging thereto. Nett Total Deaths in Public Institutions, &c. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Poplar Union Workhouse. Sick Asylum. Bow Institution Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 Certified 1156 128 83 91 58 83 181 245 287 15 246 16 2 35 12 217 543 All causes Uncertifled 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 1 Enteric Fever 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 2 Small Pox ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 Measles 35 7 13 12 3 ... ... ... ... ... ... ... ... ... ... 2 3 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ......... ... ... ... ... ... ... ... 5 Whooping Cough 35 9 11 13 2 ... ... ... ... ... 13 ... ... ... ... 3 16 6 Diphtheria and Croup 8 2 3 2 1 ... ... ... ... ... ... ... ... 2 ... 5 7 7 Influenza 175 3 11 10 18 25 53 37 18 1 28 ... ... 1 ... 19 49 8 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Phthisis (Pulmonary Thberculosis) 112 1 3 1 3 24 44 30 6 ... 23 1 ... 1 *1 38 64 10 Tuberculous Meningitis 15 2 3 6 1 ... ... ... ... ... ... 3 ... 5 8 34 35 TABLE X. METROPOLITAN BOROUGH OF POPLAR. Sub-District of Bromley. Causes of, and Ages at, Death during the Year 1918. Causes of Death (see page 28). Nett Deaths in whole Sub-District at subjoined Ages. Nett Deaths in Public Institutions and certain localities within and outside Sub-District (at all ages) belonging thereto. Nett Total Deaths in Public Institutions, &c. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. • 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Poplar Onion Workhouse. Sick Asylum. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 Certified All causes Uncertified 1247 142 100 107 90 101 233 222 282 8 334 17 2 45 6 203 615 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Measles 79 4 36 31 8 ... ... ... ... ... 16 ... ... ... ... 5 21 4 Scarlet Fever 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 2 2 5 Whooping Cough 14 3 5 6 ... ... ... ... ... ... 4 ... ... ... ... 1 5 6 Diphtheria and Croup 16 ... 5 7 4 ... ... ... ... ... ... ... ... 3 ... 12 15 7 Influenza 218 2 9 16 28 41 72 29 21 3 49 2 1 ... ... 14 71 8 Erysipelas 2 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 1 9 Phthisis (Pulmonary Tuberculosis) 112 2 4 1 7 20 51 23 4 ... 29 ... 1 1 36 68 10 Tuberculous Meningitis 12 2 ... 6 3 1 ... ... ... ... ... ... ... ... ... 2 3 11 Other Tuberculous Diseases 3 ... ... 1 1 ... 1 ... ... ... 1 ... ... ... ... 1 2 12 Cancer, malignant disease 54 ... ... ... ... ... 4 29 21 ... 21 2 ... ... ... 9 32 13 Rheumatic Fever 3 ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... 1 1 14 Meningitis 10 2 3 2 2 1 ... ... ... ... 1 ... ... 2 ... 5 8 15 Organic Heart Disease 88 ... ... ... 3 7 17 27 34 ... 32 6 ... 2 ... 8 48 16 Bronchitis 115 12 8 3 2 1 3 27 59 2 29 5 ... ... ... 3 39 17 Pneumonia (all forms) 155 27 15 22 16 14 24 25 12 1 43 1 ... 8 §1 19 3 18 Other diseases of respiratory organs 9 ... ... 2 ... 1 1 4 1 ... 2 ... ... ... ... 3 5 19 Diarrhoea and Enteritis 18 10 6 1 ... ... ... ... 1 ... 3 ... ... 2 ... 4 9 20 Appendicitis and Typhlitis 7 ... ... .. 3 2 1 1 ... ... 2 ... ... 3 ... 2 7 21 Cirrhosis of Liver 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 10 ... 1 ... ... 1 3 5 ... ... ... ... 1 ... 3 4 23 Puerperal Fever 3 ... ... ... ... ... 3 ... ... ... 3 ... ... ... ... ... 3 24 Other accidents and diseases of Pregnancy & Parturition 3 ... ... ... 2 1 ... ... ... 1 ... ... ... ... 1 2 25 Congenital Debility and Malformation, including Premature Birth 55 54 1 ... ... ... ... ... ... ... 11 ... ... ... ... 11 22 26 Violent Deaths, excluding Suicide 47 5 1 4 8 4 3 10 12 1 9 ... ... 16 **5 7 38 27 Suicide 2 ... ... ... ... ... 1 1 ... ... 1 ... ... 1 ... ... 2 28 Other Defined Diseases 207 17 6 4 3 5 18 42 112 1 74 1 ... 2 ... 54 132 29 Diseases ill-defined or unknown 2 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Total Deaths 1247 142 100 107 90 101 203 222 282 8 333 17 2 45 6 203 614 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis 4 2 1 ... 1 ... ... ... ... ... ... ... ... ... ... 2 2 28a Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Pneumonia 89 6 4 10 11 13 19 18 8 ... 32 ... ... 1 1 7 41 28 Dysentery 4 ... ... ... ... ... ... 2 2 ... ... ... ... ... ... 1 1 28 Botulism 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... §Poplar Police Station, 1. **Limehouse Cut, Bromley, 3; River Thame , Poplar, 1; Highway, Bromley, 1. 36 TABLE XI METROPOLITAN BOROUGH OF POPLAR. Sub-District of Bow. Causes of, and Ages at, Death during the Year 1918. Causes of Death (see page 28). Nett Deaths in Sub-District at subjoined Ages. Nett Deaths in Public Institutions and certain localities within and outside Sub-Districts(at all ages) belonging thereto. Nett Total Deaths in Public Institutions, &c. AU Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Poplar Union Workhouse. Sick Asylum. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions 1 2 3 4 5 6 7 8 9 10 Certified All causes , Uncertified 774 74 56 61 42 50 116 161 206 9 212 7 2 3 127 364 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Small Pox ... ... ... ... ... ... ... ... ... ... ••• ... ... ... ... ... ... 3 Measles 37 4 15 18 ... ... ... ... ... ... 8 ... ... ... ... ... ... 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Whooping Cough 12 6 5 ... 1 ... ... ... ... ... 7 ... ... ... ... 2 9 6 Diphtheria and Croup 7 ... 1 2 4 ... ... ... ... ... ... ... ... ... ... 6 7 Influenza 131 4 8 10 8 20 39... 30 6 2 17 ... ... ... ... 9 28 8 Erysipelas 1 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 9 Phthisis (Pulmonary Tuberculosis) 74 1 ... ... 9 10 29 22 3 ... 24 ... ... 1 ... 20 45 10 Tuberculous Meningitis 5 1 ... 2 1 1 ... ... ... ... ... ... ... ... ... 1 1 11 Other Tuberculous Diseases 10 2 2 1 1 ... 2 2 1 ... ... ... ... ... 3 4 12 Cancer, malignant disease 45 ... ... ... ... ... 3 23 18 1 19 1 ... ... †1 3 25 13 Rheumatic Fever 3 ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... 14 Meningitis 7 ... 1 2 3 1 1 2 3 15 Organic Heart Disease 46 ... ... ... 1 1 8 14 22 1 20 1 1 ... ... 9 32 16 Bronchitis 72 7 3 1 ... ... 4 16 41 2 13 1 1 ... ... 2 19 17 Pneumonia (all forms) 72 11 14 11 5 8 8 10 S 1 18 ... ... ... §1 11 31 18 Other diseases of respiratory organs 6 ... ... ... ... ... 1 3 2 ... 2 ... ... ... ... ... 2 19 Diarrhoea and Enteritis 19 10 3 3 ... ... ... 1 2 ... 6 ... ... ... ... 2 8 20 Appendicitis and Typhlitis 3 ... ... ... 2 ... ... 1 ... ... 1 ... ... ... ... 1 2 21 Cirrhosis of Liver 3 ... ... ... ... ... ... 1 2 ... ... ... ... ... ... 1 1 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Blight's Disease 9 ... ... ... ... ... 2 4 3 ... 3 ... ... ... ... 3 6 23 Puerperal Fever 2 ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... 1 24 Other accidents and diseases of Pregnancy & Parturition 2 ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... 1 2 25 Congenital Debility and Malformation, including Premature 19 17 2 ... ... ... ... ... ... ... 6 ... ... ... ... 2 8 26 Violent Deaths, excluding Suicide 18 ... ... ... 3 2 2 3 8 ... 9 ... ... 1 ... 6 16 27 Suicide 4 ... ... ... ... ... 1 2 1 ... 1 ... ... ... ††1 1 3 28 Other Defined Diseases 165 9 2 5 4 4 15 35 91 1 54 4 ... 1 ... 41 101 29 Diseases ill-defined or unknown 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ‡‡1 ... 1 Total Deaths 774 74 56 61 42 50 116 169 206 9 212 7 2 3 4 127 364 Sub-Entries (inc'uded in above figures). 14 Cerebro-spinal Meningitis 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 28a Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Pneumonia 36 ... 4 2 4 9 5 8 4 1 14 ... ... ... ... 3 18 28 Dysentery 3 ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 2 2 co -1 † Highway. Broralcv, 1. §Highway, Bow, 1. ††Duckett's Canal, Bow, 1. ‡‡ River Lee, Bow, 1. 38 TABLE XII. METROPOLITAN BOROUGH OF POPLAR, Total Deaths (at all ages) in Public Institutions within the Borough. (Resident and Non-Resident included.) Causes of Death (see page 28). Poplar Union Workhouse Sick Asylum. Bow Institution. Bromley House Institution. Poplar Hospital. Nett total deaths in Public Institutions within the Borough. All causes Certified Uncertified 44 1176 322 133 ,156 1831 1 Enteric Fever ... 1 ... ... ... 1 2 Small Pox ... ... ... ... ... ... 3 Measles ... 41 ... ... 1 42 4 Scarlet Fever ... ... ... ... ... ... 5 Whooping Cough ... 42 ... ... ... 42 6 Diphtheria and Croup ... 1 ... ... 3 4 7 Influenza 7 140 20 23 11 201 8 Erysipelas ... 4 ... 1 ... 5 9 Phthisis (Pulmonary Tuberculosis) ... 138 24 7 5 174 10 Tuberculous Meningitis ... 2 ... ... 4 6 11 Other Tuberculous Diseases 1 7 1 1 ... 10 12 Cancer, malignant disease 1 86 27 6 3 123 13 Rheumatic Fever ... 3 ... ... ... 3 14 Meningitis 1 2 ... ... 2 5 15 Organic Heart Disease 1 109 94 31 4 239 16 Bronchitis 16 96 73 24 ... 209 17 Pneumonia (all forms) 5 112 13 9 19 158 18 Other diseases of respiratory organs ... 8 6 3 ... 17 19 Diarrhoea and Enteritis ... 19 ... ... 4 23 20 Appendicitis and Typhlitis ... 4 ... ... 6 10 21 Cirrhosis of Liver ... 1 ... 2 ... 3 21a Alcoholism 1 ... ... ... ... 1 22 Nephritis and Bright's Disease 1 11 4 3 1 20 23 Puerperal Fever ... 4 ... ... ... 4 24 Other accidents and diseases of Pregnancy and Parturition ... 2 ... ... ... 2 25 Congenital Debility and Malformation, including Premature Birth ... 33 ... ... ... 33 26 Violent Deaths, excluding Suicide 4 35 6 ... 78 123 27 Suicide ... 2 1 ... 4 7 28 Other Defined Diseases 6 272 53 23 11 365 29 Diseases ill-defined or unknown ... 1 ... ... ... 1 Total Deaths 44 1176 322 133 156 1831 Sub-Entries (included in above figures). - 14 Cerebro-spinal Meningitis ... ... ... ... ... ... 28a Poliomyelitis ... ... ... ... ... ... 17 Pneumonia 4 79 1 8 5 97 39 TABLE XIII. .METROPOLITAN BOROUGH OF POPLAR. Whole Borough. Infantile Mortality during the Year 1918. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 28). Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Nett total Deaths under 1 year. All causes Certified 66 13 11 16 106 51 69 64 54 344 Uncertified ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 6 8 15 8carlet Fever ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 2 4 5 7 18 Diphtheria and Croup ... ... ... ... ... ... ... ... 2 2 Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... 2 1 2 ... 5 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculoids Diseases ... ... ... ... ... 1 2 1 2 6 Meningitis (not Tuberculous) ... ... ... ... ... 1 1 ... ... 2 Convulsions 2 1 1 ... ... 3 1 1 ... 9 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 1 2 ... 4 5 9 4 2 24 Pneumonia (all forms) ... ... ... 1 1 9 13 15 23 61 Diarrhoea ... 1 1 ... 2 3 5 7 1 18 Enteritis ... ... ... 2 2 2 5 8 1 18 Gastritis ... ... ... ... ... ... ... 1 ... 1 Syphilis 1 ... ... ... 1 1 ... 1 ... 3 Rickets ... ... ... ... ... ... 1 ... 1 2 Suffocation, overlying 3 ... 1 ... 4 4 2 ... ... 10 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... 6 ... 1 ... 7 ... ... ... ... 7 Congenital Malformations 3 1 ... 1 5 2 2 ... ... 9 Premature birth 30 7 4 4 45 3 ... ... 1 49 Atrophy, Debility and Marasmus 13 1 1 8 23 11 9 4 3 50 Other Causes 7 1 ... ... 8 1 13 9 3 34 Total Deaths 66 13 11 16 106 51 69 64 54 344 Nett Births Legitimate 3,161* Nett Deaths Legitimate infante 323 in the year Illegitimate 78* in the year of Illegitimate infants 21 * Registrar-General. 40 TABLE XIV. METROPOLITAN BOROUGH OF POPLAR. Poplar Sub-District Infantile Mortality during the Year 1918. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 24). Under 1 week. 1-2 weeks. 2-3 weeks. 3^4 weeks. Total under 1 month. 1-3 months 3-6 months. 6-9 months. 9-12 months Nett total Deaths under 1 year. All causes Certified 24 8 5 2 39 17 23 28 21 128 Uncertified ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 3 4 7 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 2 2 4 9 Diphtheria and Croup ... ... ... ... ... ... ... ... 2 2 Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... 1 1 ... ... 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... 1 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... 1 ... ... 1 2 ... ... ... 3 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... 1 ... 1 1 2 1 ... 5 Pneumonia (all forms) ... ... 1 ... 1 3 4 7 8 23 Diarrhoea ... ... ... ... ... 1 3 3 1 8 Enteritis ... ... ... ... ... ... 2 6 ... 8 Gastritis ... ... ... ... ... ... ... 1 ... 1 Syphilis 1 ... ... ... 1 ... ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 2 ... 1 ... 3 2 1 ... ... 6 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... 2 ... ... ... 2 ... ... ... ... 2 Congenital Malformations 1 1 ... ... 2 1 2 ... ... 5 Premature birth 12 4 2 ... 18 1 ... ... ... 19 Atrophy, Debility and Marasmus 4 1 1 1 7 4 1 1 ... 13 Other Causes 2 1 ... ... 3 ... 5 4 1 13 Total Deaths 24 8 5 2 39 17 23 28 21 128 Nett Births Legitimate ...1,095 Nett Deaths Legitimate infants ...117 in the year Illegitimate ... 39 in the year of Illegitimate infants ... 11 41 TABLE XV. METROPOLITAN BOROUGH OF POPLAR. Bromley Sub-District. Infantile Mortality during the Year 1918. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 28). Under 1 week. 1-2 weeks. 2-3 weeks. 3—4 weeks. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Nett total Deaths under 1 year. All causes Certified 29 4 3 9 45 27 28 19 23 142 Uncertified ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 1 2 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... 1 1 1 3 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... 1 ... 1 ... 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... 1 ... 1 2 Meningitis (not Tuberculous) ... ... ... ... ... 1 l ... ... 2 Convulsions ... ... 1 ... 1 l l 1 ... 4 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 1 1 ... ... 2 2 5 2 1 12 Pneumonia (all forms) ... ... ... ... ... 5 6 5 11 27 Diarrhoea ... ... ... ... ... 2 1 2 ... 5 Enteritis ... ... ... ... ... 1 2 1 1 5 Gastritis ... ... ... ... ... ......... ... ... ... ... Syphilis ... ... ... ... ... 1 ... 1 ... 2 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 1 ... ... ... 1 2 1 ... ... 4 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis 4 ... 1 ... 5 ... ... ... ... 5 Congenital Malformations 1 ... ... 1 2 1 ... ... ... 3 Premature birth 13 ... 1 4 21 1 ... ... ... 22 Atrophy, Debility and Marasmus 7 ... ... 4 11 7 5 3 3 29 Other Causes 2 ... ... ... 2 1 3 1 2 9 Total Deaths 29 4 3 9 45 27 28 19 23 142 Nett Births Legitimate 1,319 Nett Deaths Legitimate infants 137 in the year Illegitimate 18 in the year of Illegitimate infants 5 42 TABLE XVI. METROPOLITAN BOROUGH OF POPLAR. Bow Sub-District. Infantile Mortality during the Year 1918. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 28). Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 2-6 months. 6-9 months. 9-12 months. Nett total Deaths under 1 year. All causes Certified 13 1 3 5 22 7 18 17 10 74 Uncertified ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 2 2 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 1 2 2 6 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... 1 ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 1 1 ... 3 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions 2 ... ... ... 2 ... ... ... ... 2 Laryngitis ... ... ... ... ... ...•... ... ... ... ... Bronchitis ... ... ... 1 ... 1 2 2 1 1 ... Pneumonia (all forms) ... ... ... ... ... 1 3 3 4 11 Diarrhoea ... 1 1 ... 2 ... 1 2 ... 5 Enteritis ... ... ... 2 2 1 i 1 ... 5 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... 1 ... ... 1 Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations 1 ... ... ... 1 ... ... ... ... 1 Premature birth 5 ... 1 ... 6 1 ... ... 1 8 Atrophy, Debility and Marasmus 2 ... ... 3 5 ... 3 ... ... 8 Other Causes 3 ... ... ... 3 ... 5 4 ... 12 Total Deaths 13 1 3 5 22 7 18 17 10 74 Nett Births Legitimate 717 Nett Death Legitimate infants 69 in the year Illegitimate 15 in the year lllegitimate infants 5 43 TABLE XVII (1918). Cities and Boroughs. Estimated populatioi to the middle of 1918. Notifica tions. Annual rate per 1,000 persons living. Births. Annual rate per 1,000 persons living. Zymoti( 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 4,026,901* |... 16.1 ... 18.9 107 West Districts. Paddington 117,517 ... 15.3 4.2 19.1 116 Kensington 154,814 ... 13.3 0.8 17.8 97 Hammersmith 115,833 ... 15.5 1.0 17.1 104 Fulham 143,211 ... 16.7 1.3 17.4 107 Chelsea 56,741 ... 12.4 0.7 19.6 91 City of Westminster 126,215 ... 10.3 0.6 16.3 100 North Districts. St. Marylebone 98,126 ... 12.4 3.2 18.5 110 Hampstead 71,815 ... 111 0.3 13.4 69 St. Pancras 175,716 ... 16.8 1.5 22.2 102 Islington 286,400 ... 16.2 1.3 20.4 110 Stoke Newington 44,195 ... 13.4 0.9 17.2 87 Hackney 193,104 ... 15.7 18.9 105 Central Districts. Holborn 36,769 ... 13.8 0.9 22.3 124 Finsbury 66,492 ... 17.1 1.9 23.7 no City of London 13,900 ... 7.3 0.5 20.9 148 East Districts. ... Shoreditch 87,645 .... 17.5 2.7 24.3 166 Bethaal Green 103,403 ...• 19.2 3.7 24.1 130 Stepney 250,899 ...• 16.5 1.5 18.9 115 Poplar 139,530 ... 20.7 2.1 22.7 106 South* Districts. Southwark 161,968 ... 21.3 2.3 23.2 124 Bermondsey 108,406 ... 19.1 1.1 22.0 138 Lambeth 262,275 ... 21.7 1.3 18.9 89 Battersea 149,951 ... 16.0 1.2 18.4 98 Wandsworth 292,408 ... 14.2 0.8 15.0 89 Camberwell 233,833 ... 15.8 ... 20.1 101 Deptford 102,036 ... 18.3 108 17.9 97 Greenwich 89,939 ... 17.5 1.3 19.0 118 Lewisham ... ... ... ... ... ... Woolwich 146,503 ... 16.5 0.7 14.3 104 i j Port of London — — — — — — * Estimated population, 1917, rates calculated upon population estimated to middle of 1918. A4325 D 44 The following death rates for the year 1918 are interesting when compared with one another:— Annual Rate per 1,000 persons living. Deaths of Children under one year of age to 1,000 Births. Poplar Borough 22.77 107† Poplar (Sub-District) 23.87 112 Bromley 22.32 106 Bow 21.98 101 England and Wales 17.6 97 96 Great Towns‡ 18.2 106 148 Smaller Towns 16.1 94 London 18.9 107 Liverpool 21.6 124 Manchester 18.3 106 Edinburgh 15.2 94 Glasgow 16.5 113 Dublin (City) 23.6 149 Belfast 22.7 144 † See Footnote ** page 8. ‡ Including London. 45 TABLE XVIII. Birth Rate, Death Rate, and Analysis of Mortality Dcring the Year 1918. Birthrate per 1,000 Total Population. Annual Death.rate per 1,000 Civilian Population. Rate per 1,000 Births. Percentage oe Total Deaths.* All Causes Enteric Fever. Small.pox. Measles. Scarlet Fever. Whooping. cough . Diphtheria. Violence. Diarrhoea and Enteritis (under 2 years). Total Deaths under One Year. Deaths in Public Institutions. Certified Causes. Inquest Cases. Uncertified Causes of Death. England and Wales 17.7 17.6 0.03 0.00 0.28 0.03 0.29 014 0.49 10.99 97 24.3 93.3 5.4 1.3 96 Great Towns including London (Census Populations exceeding 50,000) 17.6 18.2 0.02 0 00 0.36 0.04 0.34 015 0.49 14.46 106 28.4 93.4 5.8 0.8 148 Smaller Towns (Census Populations 20,000.50,000) 17.9 16.1 0.03 — 0.25 0.02 0.25 0 14 0.38 9.73 94 15.4 94.5 3.9 1.6 London 16.1 18.9 0.02 . 0.42 0.03 0.43 017 0.56 15.67 107 45.0 92.5 7.3 0.2 Poplar Borough ... 20.4 22.7 0.00 — 1.08 0.01 0.43 0.22 0.95 14.67 107 47.2 — 10.5 — Poplar Sub.District 20.8 23.8 0.02 — 0.72 0.00 0.72 016 1.27 15.87 112 45.9 — 10.8 — Bromley ... 21.3 22.3 0.00 — 1.41 0.03 0.25 0.28 0.87 11.96 106 48.8 — 10.5 — Bow 185 21.9 0.00 . 1.05 0.00 0.34 0 19 0.62 17.75 101 46.5 — 9.9 — * Non.civilians are included in these figures for England and Wales but not for other areas. 46 TABLE XIX. METROPOLITAN BOROUGH OF POPLAR. Borough of Poplar. Cases of Infectious Disease notified during the Year 1918. Notifiable Disease. Cases Notified in Whole Borough. Total Cases notified in each SubDistrict. No. of Cases removed to Hospital from each Sub-District. At all Ages. At Ages-Years. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards, Poplar. Bromley. Bow. Total. Poplar. Bromley. Bow. Total Cases Removed. Small-pox 2 ... ... 1 ... ... 1 ... ... 1 1 2 ... 1 1 2 Cholera (C), Plague (P) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 305 8 150 133 9 5 ... ... 124 137 44 305 * 111 *115 *39 *265 Erysipelas 94 2 4 17 2 24 30 15 29 38 27 94 †10 †6 †10 †26 Scarlet Fever 231 3 74 137 11 6 ... ... 97 82 52 231 ‡87 ‡71 ‡41 ‡199 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 12 ... ... 3 3 5 1 ... 8 3 1 12 ¶5 ¶3 ¶1 ¶9 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 12 ... ... ... 2 10 ... ... 2 5 5 12 §1 §4 §4 §9 Cerebro-Spinal Meningitis 9 2 2 3 2 ... ... ... 3 4 2 9 **3 **4 **2 **9 Poliomyelitis 4 3 1 ... ... ... ... ... 2 ... 2 4 ††2 ... ††1 ††3 Ophthalmia Neonatorum 36 36 ... ... ... ... ... ... 21 7 8 36 ... ... ... ... Pulmonary Tuberculosis ... 625 7 32 93 95 285 106 7 221 238 166 625 ... ... ... ... Other forms of Tuberculosis 225 6 51 133 16 17 1 1 87 86 52 225 ... ... ... ... Zymotic Enteritis 786 134 301 66 54 90 73 18 217 414 105 736 ... ... ... ... Chicken Pox || || 44 8 73 61 2 ... ... ... 57 63 £4 144 ‡‡3 ‡‡4 ‡3 ‡10 Totals 2435 209 688 647 196 442 212 41 868 1078489 2435 222 208 102 532 * See page 65. † See page 62. ‡ See page 62. ¶ See page 63. § See page 61. ** See page 78. †† See page 79. || || Notifiable from March 27th to June 30th. ‡‡ Five cases to Sick Asylum (3 Poplar, 2 Bow), 5 cases Cleveland Street Infirmary (4 Bromley, 1 Bow.) 47 TABLE XX. METROPOLITAN BOROUGH OF POPLAR. Poplar Sub-District. Cases of Infectious Disease notified during the Year 1918. Notifiable Disease. Cases Notified in whole Sub-District. No. of Cases removed to Hospital from Sub-District. At all Ages. At Ages—Years. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards Small-pox ... ... ... ... ... ... ... ... ... Cholera, Plague ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 124 4 63 53 1 3 ... ... *111 Erysipelas 29 ... 2 6 1 5 9 6 †10 Scarlet Fever 97 3 34 58 ... 2 ... ... ‡87 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 8 ... ... 3 2 2 1 ... ¶5 Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 2 ... ... ... 1 1 ... ... §1 Cerebro-Spinal Meningitis 3 ... 1 ... 2 ... ... ... **3 Poliomyelitis 2 1 1 ... ... ... ... ... ††2 Ophthalmia Neonatorum 21 21 ... ... ... ... ... ... ... Pulmonary Tuberculosis 221 2 13 30 39 93 42 2 ... Other forms of Tuberculosis 87 3 16 53 6 8 ... 1 ... Zymotic Enteritis 217 50 92 22 15 19 17 2 ... Chicken Pox || || 57 3 37 16 1 ... ... ... ‡‡3 Totals 868 87 259 241 68 133 69 11 222 * See page 65. † See page 62, ‡ See page 62. ¶ See page 63. § See page 61. ** See page 78. †† See page 79. || || Notifiable from March 27th to June 30th. ‡‡Sick Asylum. 48 TABLE XXI. METROPOLITAN BOROUGH OF POPLAR. Bromley Sub-District. Cases of Infectious Disease notified during the Year 1918. Notifiable Disease. Cases Notified in whole Sub-District. No. of Cases removed to Hospital from Sub-District. At all Ages. At Ages-Years. Under 1. 1 to ,6. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and u p wards. Small-pox 1 ... ... ... ... ... 1 ... 1 Cholera, Plague ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 137 4 70 55 7 1 ... ... *115 Erysipelas 38 2 1 10 ... 9 13 3 †6 Scarlet Fever 82 ... 22 51 7 2 ... ... ‡71 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... ... 1 2 ... ... ¶3 Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 5 ... ... ... ... 5 ... ... §4 Cerebro-Spinal Meningitis 4 2 1 1 ... ... ... ... **4 Poliomyelitis ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 7 7 ... ... ... ... ... ... ... Pulmonary Tuberculosis 238 4 16 41 34 105 34 4 ... Other forms of Tuberculosis 86 1 23 49 5 8 ... ... ... Zymotic Enteritis 414 64 143 35 39 68 52 13 ... Chicken Pox || || 63 3 27 33 ... ... ... ... ‡‡4 Totals 1078 87 303 275 93 200 100 20 208 * See page 65. † See page 62. ‡ See page 62. 1, ¶ See page 63. § See page 61. ** See page 78. || || Notifiable from March 27th to June 30th. ‡‡ Cleveland Street Infirmary. TABLE XXII. METROPOLITAN BOROUGH OP POPLAR. Bow Sub-District. Cases of Infectious Disease notified during the Year 1918. Notifiable Disease. Cases Notified in whole Sub-District. No. of Cases removed to Hospital from Sub-District. At all Ages. At Ages—Years. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox 1 ... ... 1 ... ... ... ... 1 Cholera, Plague ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 44 .. 17 25 1 1 .. ... *39 Erysipelas 27 ... 1 1 1 10 1 6 †10 Scarlet Fever 52 ... 18 28 4 2 ... ... ‡41 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 1 ... ... ... ... 1 ... ... ¶1 Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 5 ... ... ... 1 4 ... ... §4 Cerebro-Spinal Meningitis 2 ... ... 2 ... ... ... ... **2 Poliomyelitis 2 2 ... ... ... ... ... ... ††l Ophthalmia Neonatorum 8 8 ... ... ... ... ... ... ... Pulmonary Tuberculosis 166 1 3 22 22 87 30 1 ... Other forms of Tuberculosis 52 2 12 31 5 1 1 ... ... Zymotic Enteritis 105 20 66 9 ... 3 4 3 ... Chicken Pox 24 2 9 12 1 ... ... ... ‡‡3 Totals 489 35 126 131 35 109 43 10 102 * See page 65. † See page 62. ‡ See page 62. ¶ See page 63. § See page 61. ** See page 78. †† See page 79. || || Notifiable from March 27th to June 30th. ‡‡ Two to Sick Asylum and one to Cleveland Street Infirmary. 49 50 ZYMOTIC DISEASES.* Notifications ; Institutions ; Errors in Diagnosis ; Infectious Diseases in Milk Shofs and on Homeworkers' Premises. Notifications. There were 265 notifications of infectious diseases in Poplar, 270 in Bromley, and 134 in Bow, making a total of 669 for the Borough of Poplar ; these do not include 29 second notifications. In the above figures no deductions have been made for cases removed to the Metropolitan Asylums Board's hospitals, which were certified as not having a notifiable disease. The notification rate per 1,000 living being:— Poplar. Bromley. Bow. Borough of Poplar. 1914 8.21 8.64 9.16 8.62 1915 7.77 8.77 10.27 8.80 1916 5.92 5. 37 6.87 5.94 1917 6.38 5.46 4.33 5.50 1918 5.46 483 3.80 4.79 * Exclusive of Zymotic Enteritis. 51 Institutions. Notifications of parishioners from Institutions (excluding cases which had been notified before admission) within the sub-districts of Poplar and Bromley were as follows:— Total Cases. Notifications. Removals. Zymotic Enteritis. Chicken-pox. Ophthalmia Neonatorum. Scarlatina. Diphtheria. Typhoid Fever. Puerperal Fever. Erysipelas. Zymotic Enteritis. Chicken-pox. Scarlatina. Diphtheria. Typhoid Fever. Puerperal Fever. Erysipelas. Poplar Union Workhouse 6 .. 1 .. .. 1 .. .. 4 .. *1 .. *1 .. .. *4 Sick Asylum 5 .. 1 ||3 §1 .. .. .. .. †1 ||3 §1 .. .. •• Bow Institution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bromley House Institution 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Langley House, 54, East India Dock Road 3 .. 2 .. .. 1 .. .. .. .. *2 .. ** 1 .. .. .. Poplar Hospital 1 .. .. .. .. 1 .. .. .. .. .. .. ‡1 .. .. .. * Admitted into Sick Asylum. † Admitted to Cleveland Street Infirmary. § Staff. Admitted to M.A.B. Hospit&l. || Two cases members of Staff admitted to M.A.B. Hospitals, 1 other case admitted to Cleveland Street Infirmary. ‡ Admitted to London Fever Hospital. ** Admitted to M.A.B. Hospital. Of the 265 patients notified in Poplar, 219 were removed to hospitals and institutions ; of the 270 in Bromley 204 were isolated, and of the 134 in Bow 99 were removed, so that of a total of 669 notifiable diseases in the Borough 520 patients had been removed from their homes.* Errors in Diagnosis. The corrected number of notifications would be— Poplar 265 — 9 = 256 or 5.28 per 1000 living. Bromley 270 — 8 = 262 or 4.68 „ Bow 134 — 1 = 133 or 3.77 Borough of Poplar 669 — 18 = 651 or 4.66 „ * See Tables XIX.—XXII., pages 46-49. 52 Infectious Diseases in Milkshops and Homeworkers' Premises. Three cases of infectious disease were connected with milkshops in the Borough : 0 in Poplar ; 3 in Bromley ; and 0 in Bow. The sale of milk was stopped until after the premises and utensils had been disinfected. Twenty-nine premises with outworkers were connected with infectious cases notified : 6 in Poplar, 9 in Bromley, and 14 in Bow- 19 measles and 10 other infectious diseases. No notices were served under the Factory and Workshop Act, 1901, Sections 108 and 110, but, where there was any risk of infection the work was discontinued, and any work found on the premises was disinfected before being returned. Nineteen cases of measles were connected with out-workers' premises : 5 Poplar, 8 Bromley, and 6 Bow. DISINFECTING DEPARTMENT. Rooms and Articles (Infectious and Verminous) Disinfected. The following figures give the number of rooms and articles disinfected:— Sub-District, &c. Rooms. Beds Mattresses and Palliasses Pillows. Bolsters. Various. Totals. Poplar 306 273 192 862 294 3,425 5,046 Bromley 299 299 183 895 322 3,682 5,381 Bow 164 164 77 473 168 1.923 2,810 Totals 769 736 452 2,230 784 9,035 13,237 Miscellaneous 192 239 31 526 167 2,913 3,876 Totals 961 975 483 2,756 951 . 11,948 17,113 Pulmonary Tuberculosis 162 87 8 275 87 995 1,452 Totals 1,123 1062 491 3,031 1,038 12,943 13,565 Other articles also passed through the Council's apparatus, from the Shelter, Glaucus Street, disinfector's clothing, overalls, drop-sheets, etc., to the number of 22,721 and 65,740 articles of clothing from verminous persons were disinfected. Making a total of 107,026 articles. 53 ELECTROLYTIC DISINFECTING FLUID. Output of Fluid ; Distribution of Fluid ; Cost of Material and Electricity ; Bottles, Corks and Labels : Total Quantity Manufactured Since Installation of Plant ; Estimate for the Year ended 31st March, 1918, and Expenditure for Year ended 31st March, 1918, Average Expenditure for Three Years ended 31st March, 1918, Estimate for Year ended 31st March, 1919, and for Year ending 31st March, 1920; Spraying and Cleansing Floors of London County Council Schools with Electrolytic Disinfecting Fluid ; Swimming Baths, the use therein of the Electrolytic Fluid ; Comments on Adverse Criticisms; Epidemic Influenza, see Page 75. Output of Fluid. At the seven depots the electrolytic fluid was still in great demand by the public. The output of fluid during each month of the year 1913 was as follows:— Manufactured Gallons. Broken down to Gallons and Distributed. January 825 1,650 February 1,350 2,700 March 1,875 3,750 April 2,205 4,410 May 2,685 5,370 June 3,330 6,660 July 3,855 7,710 August 4,035 8,070 September 2,760 5,520 October 3,180 6,360 November 2,835 5,670 December 1,815 3,630 Total 30,750 61,500 Since the beginning of August, 1914, the fluid has been manufactured of greater strength, being afterwards broken down to half strength for distribution. 54 Distribution of Fluid. The fluid was distributed as follows:— 1. Violet Road Depot 27,824 ½ gallons 2. Bickmore Street Depot 5,745 ,, 3. Old Ford Road Depot 3,624 „ 4. Ford Road Depot 2,940 ,, 5. Trego Road Depot 2,505 ,, 6. Stebondale Street Depot 3,480 ,, 7. Millwall Depot 780 „ 8. Public Health Offices 108 ,, 9. Poplar Baths 3,085 ,, 10. Bow Baths 4,042 ,, 11. Millwall Baths 97 „ 12. Poplar Town Hall 84 ,, 13. Bromley Public Hall 42 „ 14. Works Department 976 ,, 15. Guardians' Offices 285 „ 16. Poplar Union Workhouse 921 ,, 17. Langley House 147 ,, 18. Poplar Training School, Hutton 4½ „ 19. Public Libraries 90 „ 20. Used at Council's Shelter in baths of verminous persons 622 ,, 21. London County Council Schools 1,536 ,, 22. Mortuary, High Street, Poplar 696 ,, 23. Borough of Poplar Dispensary 40 „ 24. Military Guard Posts, etc. 74 „ 25. Private Firms in Borough 1,395 ,, 26. Bow Church Institute 51 „ 27. Council Offices, Poplar 72 ,, 28. East London Federation of Suffragettes 204 ,, 29. Kingsley Hall 18 ,, 30. Wellington Road Air Raid Shelter 12 ,, Total 61,500 ,, 55 Cost of Material and Electricity. The cost of material in manufacturing 30,750 (strong) gallons of the electrolytic fluid was as follows:— £ s. d. Electricity, 7,438 units at 1½d. (with 10 per cent. advance) per unit 51 2 8 *Chloride of Magnesium, 4 tons 10 cwts. 58 10 0 *Salt, 6 tons 10 cwts. 22 8 6 *Caustic Soda, 10 cwts. 1 qr. 4 lbs .. 30 16 0 Water 2 11 3 Total cost of materials to produce 30,750 gallons (strong) broken down to 61,500 gallons £165 8 5 Electric motor for stirring : 91 units .. 0 12 6 Bottles, Corks and Labels. Bottles 39 13 6 Corks 490 Labels (no labels ordered) — £44 2 6 Total Quantity Manufactured since Installation of Plant. Since the installation of the plant, a period of 13 years, 504,219 gallons of fluid have been manufactured (see footnote page 56) at a cost for eleotricity of £586 8s. 4½,d., and materials of £645 9s. 3d., about ½d. per gallon (previous to the war the cost was under ½d. per gallon, but even with the strong fluid which at present is being made and is broken down the cost is still about ½d. per gallon when the gallons are reckoned in bulk)f. * On account of the war the price of these materials was increased. † See "Comments on Adverse Criticism," Annual Report, 1911. 56 Material, Chloride of Year. Output, Magnesium, Electricity. Total, gallons. Salt, Caustic Soda and Water. Cost. £ s. d. £ s. d. £ •. d. 1906 17,000 17 12 5 15 17 10 33 10 3 1907 15,586 14 16 9 14 13 2 29 9 11 1908 28,280 27 14 7 28 7 10 56 2 5 1909 27,216 23 4 7 29 17 79 53 2 2½ 1910 50,726 47 11 10 50 10 6 98 2 4 1911 53,063 50 17 9 56 16 7½ 107 j4 4½ 1912 54,388 41 7 10 59 14 4½ 101 2 2½ 1913 66,740 62 7 3 71 0 10½ 133 8 l½ 1914 68,795f 59 16 ll† 75 0 3 0134† 134 17 2† 1915 36,985†4 35 19 3† 48 12 0† 84 11 3† 1916 26,790† 74 4 0f 40 3 1f 114 7 1† 1917 27,900t 75 10 4† 44 11 6½† 120 1 10½† 1918 30,7504 114 5 94 51 2 8† 165 8 5† Total 504,219 £645 9 3 £586 8 . 4½ £1,231 17 7½ The Public Health Department is not only furnished with the disinfectant and the various institutions of the Council (the pubbc baths, etc.), but the institutions of the Managers of the Sick Asylum and of the Board of Guardians (within and without the Borough) are supplied with an unlimited quantity free if required. For the Fluid supplied to the Works Department a charge of Id per gallon is made ; the Public Health Department is credited with this amount although no actual monetary transaction takes place. As applicants now usually bring their own receptacles to the depots, there is also a very appreciable saving in the expense on bottles alone. From October, 1915, for Electrolytic Disinfectant supplied to manufacturers and trading concerns, a charge of 8d. per gallon is to be made through the Electricity Department, the Electricity Undertaking being allowed an amount of 10 per cent, for establishment charges. * See " Comments on Adverse Criticism," Annual Report, 1911. † On page 53 it will be seen that the fluid is made of greater strength and afterwards broken down to half strength for distribution, more electrical current being used. Gallons distributed:— 1914 88,425 1915 73,970 1916 53,580 1917 55,800 191 8 61,500 The diminution is due to not such a lavish distribution on account of increased prices and difficulty of obtaining materials. 57 Estimate for the Year ended 3lst March. 1918, and Expenditure for year ended 31st March, 1918, average Expenditure for Three Years ended 31st March, 1918, Estimate for Year ended 31st March, 1919, and for Year ending 31st March, 1920. Electrolytic Disinfectant. Estimate for year ended 31st March, 1918. Expenditure for year ended 31st March, 1918. Average Expenditure for 3 years ended 31st March, 1918. Estimate for year ending 31st March, 1919. Estima'.e for year ending 31st March, 1920. No. £ £ £ £ £ £ £ £ £ £ 1 Wages & War Bonuses (Manufacturing, bottling & delivery to Depots, Guardians' Institutions,and Sick Asylums) 330 327 298 450a 500 1 2 Rent, Rates and Insurance—Main Depot ... 75 63 63 80 80 2 3 Supervision of Plant 15 15 15 15 15 3 4 Electricity and Water 90 61 59 90 90 4 5 Materials (Chemicals) 100 100 80 100 100 5 6 Bottles, Corks, Wax, Labels and Paste 53 9 23 24 20 6 7 Sundries (including Testing Apparatus and Carboys) 32 16 19 32 32 7 8 Repairs—Depot 40 34 50 40 50 8 735 625 607 831 887 9 Issuing—Wages and War Bonuses—(Old Ford Road. Trego Road, Ford Road, Bickmore Street, West Ferry Road, and Stebondale Street Depots) 295 335 288 408b 470 9 10 Issuing—Cartage 34 28 25 50 30 10 11 Rent—Issuing Depots (Ford Road, Trego Road and Stebondale Street) 32 31 31 32 32 11 12 Sundries and Petty Expenses 16 9 6 8 10 12 377 403 350 498 542 1,112 1,028 957 1,329 1,429 13 Less—Sale of Fluid 50 41 35 60 60 13 1,062 987 922 1.269 1,369 Item No. 1 (A)—Includes Supplementary Estimate £50. Item No 9 (B)—Includes Supplementary Estimate £38. 58 Spraying and Cleansing Floors of London County Council Schools with Electrolytic Disinfecting Fluid. 1,536 gallons were supplied to four London County Council Public Elementary Schools for spraying and cleansing floors of class rooms. Swimming Baths, the use therein of the Electrolytic Fluid. The fluid continues to be added to the water in the swimming baths in the same quantity and strength as mentioned in the Annual Report for the year 1909, viz., 1 part of Chlorine to 2,000,000 parts of water. 3,085 gallons were supplied to the Poplar Baths, 4,042 gallons to the Bow Baths, and 97 gallons to the Island Baths, making a total of 7,224 gallons. Comments on Adverse Criticisms respecting the Process. See Annual Report, 1911. In spite of adverse criticisms, the process has been a success for thirteen years. VERMINOUS CHILDREN ATTENDING SCHOOLS. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1907, CHILDREN ACT, 1908. Number of Verminous Children Bathed ; Itch Cases. Number of Verminous Children Bathed Quarter. Total number of Cleansings. Amount. 1918. £ s. d. March 1,527 76 7 0 June 1,085 54 5 0 September 694 34 14 0 December 1,151 57 11 0 Totals 4,457 £222 17 0 4,064 children (1.904 boys and 2,160 girls) belonging to the Borough and 365 children (173 boys and 192 girls) outside the Borough were bathed and their clothes disinfested. Miss Tattersall made 94 visits in connection with verminous (not itch) school children—38 Poplar, 40 Bromley, and 16 Bow. Cleansing of Verminous Rooms, see page 97. Itch Cases. The itch cases are included in the verminous cases. Miss Tattersall made 530 visits in connection with children suffering from itch—148 Poplar, 244 Bromley, and 138 Bow. CLEANSING OF PERSONS ACT, 1897. During the year 159 persons (123 men and 36 women) (including 79 from Common Lodging Houses—see below) had applied for baths and for their clothes to be disinfested. Since the notices were posted throughout the Borough, a total of 6.148 persons, exclusive of nonresidents, had applied for baths, etc., as mentioned above. VERMINOUS PERSONS IN COMMON LODGING HOUSES, LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1907. Number of Persons Cleansed Within and Without Borough from Common Lodging Houses. The following number of persons from Common Lodging Houses within and without the Borough of Poplar were cleansed at the Council's A4325 59 60 Cleansing Station, Glaucus Street, during the year ended 31st December, 1918. Common Lodging House, etc. Male. Female Total. Bow Chambers, 193-7, Bow Road 54 - 54 St. James' Chambers, 217, High Street, Poplar 25 - 25 79 — 79 From Common Lodging Houses without Borough of Poplar— Whitechapel — 8 8 8 8 PLAGUE. No case of this disease was notified during the year. ANTHRAX, GLANDERS, AND HYDROPHOBIA IN MAN. Anthrax ; London Notification of Glanders Order, 1907 ; Hydrophobia. Anthrax. No case was notified. London Notification of Glanders Order, 1907. In accordance with the London (Notification of Glanders) Order, 1907, one notice was received from the Veterinary Inspector of the London County Council of the existence of Glanders at premises in the Borough. Hydrophobia. No case of this disease was notified during the year. 61 PUERPERAL FEVER.* * See page 29 as to what diseases are included under Puerperal Fever. Number of Cases. Twelve cases of puerperal fever were notified—2 Poplar, 5 Bromley, and 5 Bow. Removals. Poplar (London Hospital, 1) ; Bromley (Sick Asy'um, 4); Bow (Sick Asylum, 3, London Temperance Hospital, 1); so that nine patients out of twelve notified were removed. Deaths. Six patients died—1 Poplar, 3 Bromley, and 2 Bow. SMALL-POX. Two cases of small-pox were notified during the year—0 Poplar, 1 Bromley, 1 Bow. No deaths occurred. VACCINATION. Vaccination Return, 1917. The Vaccination Officer, Mr. Ryan, has kindly furnished me with the following statistics, which are the latest Local Government Board's Vaccination Return for the year 1917. 1917 1st January to 31st December, Births notified. Successful Vaccinations. Insusce ptible. Dead. Poplar 1,271 331 1 101 Bromley 1,500 325 — 116 Bow 826 157 — 60 Totals 3,597 813 1 277 - - - - A4325 E 2 62 ERYSIPELAS. 94 cases of erysipelas were notified during the year : 29 Poplar, 38 Bromley, and 27 Bow. 26 patients were isolated as follows:— Poplar Sub-District. Sick Asylum 10 Bromley Sub-District. Sick Asylum 6 Bow Sub-District. Sick Asylum 10 Three deaths occurred—0 Poplar, 2 Bromley, and 1 Bow. SCARLET FEVER. The number of Scarlet Fever cases notified for the three sub-districts and the deaths which occurred for the past five years were as follows:— Poplar. Bromley. Bow. Borough of Poplar. 1914 Cases notified 233 243 187 663 Deaths 1 6 3 10 1915 Cases notified 168 169 142 479 Deaths 4 4 — 8 1916 Cases notified 114 103 91 308 Deaths 0 5 2 7 1917 Cases notified 81 74 50 205 Deaths 1 1 2 4 1918 Cases notified 97 82 52 231 Deaths 0 2 0 2 87 cases in Poplar (Sub-District) were removed to the Metropolitan Asylums Board's Hospitals. 70 in Bromley and 41 mBow, and 1 Bromley case to the London Fever Hospital. So that 199 patients out of 231 notified cases in the Borough were isolated. 63 CONTINUED AND TYPHUS FEVER. No cases of continued and typhus fever were notified. TYPHOID FEVER. Notifications ; Rate per 1,000 Living ; Errors in Diagnosis ; Bacteriological Examinations of Doubtful and Convalescent Cases ; Deaths. Notifications, The Typhoid Fever cases notified were:— Poplar. Bromley. Bow. Borough of Poplar. 1914 15 13 6 34 1915 10 7 1 18 1916 7 7 5 19 1917 19 16 4 39 1918 8 3 1 12* 1st quarter. 2nd quarter. 3rd quarter. 4th quarter. Total. Poplar 5 — 1 2 8 Bromley . 1 — — 2 3 Bow — — 1 — 1 6 — 2 4 12 * The lowest number of cases recorded. Notifications per 1,000 living:— Poplar. Bromley. Bow. Borough of Poplar. 1914 0.26 0.20 0.14 0.21 1915 0.18 0.11 0.02 0.11 1916 0.12 0.11 0.12 0.12 1917 0.38 0.27 0.11 0.27 1918 0.16 0.05 0.02 0.08 64 Isolation. Five cases in Poplar, three in Bromley and one in Bow were removed to various hospitals, as follows:— POPLAR (Sub-District). Metropolitan Asylums Board's Hospitals 5 BROMLEY. Metropolitan Asylums Board's Hospitals 2 Sick Asylum 1 3 BOW. Metropolitan Asylums Board's Hospital 1 Errors of Diagnosis. Two cases sent to Metropolitan Asylums Board Hospitals from Poplar were certified as not suffering from typhoid fever Bacteriological Examinations of Doubtful Cases. Twelve specimens of blood from doubtful cases of typhoid fever were forwarded to the Lister Institute of Preventive Medicine. Jn two instances (16.6 per cent.) the typhoid (Widal) reaction was obtained. Deaths. One Poplar patient died from typhoid fever, making a total of one death in 10 (corrected) cases. 65 DIPHTHERIA, INCLUDING MEMBRANOUS CROUP. Notifications ; Deaths ; Bacteriological Examinations ; Errors in Diagnosis ; Isolation ; The Diphtheria Anti-toxin (London) Order, 1910, Notifications. One hundred and twenty four cases of diphtheria were notified in Poplar, 137 cases were notified in Bromley and 44 cases were notified in Bow, making a total of 305 cases for the whole Borough. Cases notified:— Poplar. Bromley Bow. Borough of Poplar. 1914 89 154 109 352 1915 86 120 104 310 1916 104 124 111 339 1917 148 150 68 366 1918 124 137 44 305 Notifications per 1,000 living:— Poplar. Bromley. Bow. Borough of Poplar. 1914 1.59 2.39 2.68 2.18 1915 1.58 1.91 2.63 1.98 1916 1.93 1.99 2.83 2.18 1917 2.97 2.61 1.87 2.55 1918 2.55 2.45 1.25 2.18 Deaths. Number of deaths for the past five years was as follows :— Poplar. Bromley. Bow. Borough of Poplar Mortality per 100 eases notified. 1914 7 17 15 39 11.07 1915 17 10 10 37 11.93 1916 11 8 9 28 8.25 1917 6 13 4 23 6.28 1918 8 16 7 31 10.16 For death rates from diphtheria, also see Table XVII., page 45. 66 Bacteriological Examinations. 193 swabbings from throats of doubtful cases of diphtheria were forwarded for bacteriological examination to the Lister Institute of Preventive Medicine. The bacillus diphtheriæ was isolated in 57 instances(29.5 per cent.). Errors in Diagnosis. Twelve cases of diphtheria admitted into Metropolitan Asylums Board's hospitals were certified as not having the complaint, 4 Poplar, 7 Bromley and 1 Bow. No deductions have been made in respect of these patients. Isolation. 1ll cases in Poplar, 115 in Bromley, and 39 in Bow were removed to various hospitals for treatment as follows:— Poplar (Sub-District). Metropolitan Asylums Board's Hospitals 109 Sick Asylum 1 Poplar Hospital 1 111 Bromley. Metropolitan Asylums Board's Hospitals 115 Bow. Metropolitan Asylu ms Board's Hospitals 37 Hackney Infirmary 1 Bethnal Green Military Hospital 1 39 The Diphtheria Anti-Toxin (London) Order, 1910. Ten thousand units of diphtheria anti-toxin were supplied to medical practitioners during the year. 67 WHOOPING COUGH. Deaths. Poplar. Bromley. Bow. Borough of Poplar. 1914 8 9 8 25 1915 26 21 25 72 1916 6 21 16 43 1917 4 24 3 31 1918 35 14 12 61 INFLUENZA. Deaths. Poplar. Bromley. Bow. Borough of Poplar. 1914 4 7 6 17 1915 8 11 3 22 1916 1 7 2 10 1917 7 9 1 17 1918 175 218 131 524 Poplar (Whole Borough). Influenza Deaths (Lining the Ycar 1918. Age Periods. All Ages. Under 1. 1 and under 2. J 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and uuder 65. 65 and upwards. Males 224 5 15 19 21 27 67 43 27 Females 300 4 13 23 33 59 97 53 18 Totals 524 9 28 42 54 86 164 96 4.5 68 Poplar (Sub-District). Age Periods. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Males 76 2 7 5 6 4 25 17 10 Females 99 1 4 5 12 21 28 20 8 Totals 175 3 11 10 18 25 53 37 18 Bromley (Sub-District). Age Periods. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Males 83 2 5 6 9 13 25 10 13 Females 135 — 4 10 19 28 47 19 8 Totals 218 2 9 16 28 41 72 29 21 Bow (Sub-District). Age Periods. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards: Males 65 1 3 8 6 10 17 16 4 Females 66 3 5 8 2 10 22 14 2 Totals 131 4 8 16 8 20 39 30 6 69 During the epidemic in the middle of November, while the facts were fresh in the memories of the practitioners, a circular letter was addressed to them asking for certain information, and the following are the questions submitted and answers received from a number of the medical men who have very large practices within the Borough, the residents of which are for the most part of the working classes. The letters preceding the replies are simply to separate them, and do not indicate the same practitioner's reply under each heading. Question 1. Date of first appearance of the epidemic in your practice (Poplar District) and of its cessation. Replies. (а) 11.10.1918 to 16.12.1918. (b) Appeared early in October, say, about second week. (c) About October 14th to first week in December. Previous outbreak, last week in June—duration about five wceks. (d) End of September. I do not consider the summer epidemic to have been influenza. (e) Middle of October. (f) Middle of October, 1918. (g) About October 19th, 1918. (h) October 10th, 1918, to November 13th, 1918. (i) Week commencing October 7th, 1918. (j) October 14th, 1918. Question 2. -The results of any local pathological examinations able to be obtained, including bacteriological examinations of sputa. Replies None made in any case. Question 3.—Have you any evidence throwing light on the means of introduction of the disease ? 70 Replies. (а) In some cases—after people suffering from disease had visited them. In other cases could not find any definite cause. (b) No. Only theories (c) Air passages get affected in bulk of cases. (d) No positive evidence. (e) In such a widespread infection it is very hard to get good evidence, but 1 had one woman—an invalid—who lived alone with her husband in the house, who escaped infection. She went for a walk with her husband one day, and developed symptoms within twenty-four hours. Qucstion 4.—Duration of incubation period ? Replies. (a) A few hours. (b) Ten days. Others, very short time ; few hours, say, twelve. (c) Short. One to two days. (d) About forty-eight hours. (e) Very brief. In many cases only an hour or two. (f) Two days. (g) Prom two to seven days. (h) Three or four days. (i) As far as I know—in a few cases very short, 24 hours. (j) No real evidence. I should say, short. Question 5.—Duration of infectivity ? Replies. (а) Apparently very short. (b) Query. (c) About seven days. 71 (d) Most infectious during early stage, but probably remains infectious as long as bronchial and catarrhal symptoms persist. (e) Variable. (f) Query. (g) Seven to fourteen days. (h) No real evidence. I should say short. Question 6.—Methods of spreading. Replies. (a) Contact. Sneezing. Coughing. (b) Air borne. People affected visited others before well. (c) Public gatherings. Most fresh cases on Monday. Personal contact. (d) Common methods. Coughing and sneezing. (e) By air. (f) Cannot toll. (g) Crowded sleeping apartments. Crowded buses and trams. (h) Probably from person to person by breath, or by coughing and sneezing. (i) Various—chiefly by direct contact. Question 7.—Evidence of possible protection by a previous attack. Replies. (а) Slight, if any. (b) None. (c) Previous attack often afforded some protection. Many of the cases in this epidemic were not treated in the July outbreak, and many treated in July did not get attack in recent epidemic. (d) None. 72 (e) Very few affected who wore affected in last attack. (f) Does not protect. (g) I believe an attack gives protection. (h) Should think there is no protection. (i) As a rule, those in our practice who were ill with influenza in.June did not suffer in this epidemic. (j) No protection. (k) None whatever—rather the reverse. Question 8.—Frequency of occurrence of second attacks in 1918 ? Replies. (a) Fairly frequent. (b) None. (c) Quite frequent, and "relapses" of this "influenza maligna" quite frequent, also suffered two or three months before from the "Spanish 'Flu." (d) Several cases of second attacks—probably 10 per cent. to 15 per cent. (e) I do not consider the summer epidemic to have been influenza. No cases. (f) Not frequent. (g) Cannot give numbers, but quite common. (h) Very few. Not 2 per cent. (i) Rare. As a rule, those who were ill with influenza in June did not suffer in this epidemic. (j) Frequent. Question 9.- Any special clinical features of the outbreak. Replies. (a) Severe epistaxis. Persistent anæmia. Extreme constipation. In one case, severe jaundice. (b) Backache. Headache. Lassitude. Depression (marked). Cough almost constant. (c) Specially liable to develop pneumonia, especially where high temperature, and if much pharyngitis. Liability of hæmorrhage both from nose, pharvnx and from lungs in several of the pneumonia cases. 73 (d) Various haemorrhages. Pharyngeal and laryngeal symptoms. Irregular type of pneumonia. (e) Stomatitis of frequent occurrence. (f) No. (g) Several cases of meningitic symptoms and frequent pneumonia and bronchitis. (h) In nearly all cases of respiratory type with bronchial catarrh, bronchitis or pneumonia. (i) Frequent pneumonia. (j) The clinical features have embraced every variety of influenza. Question 10.—Have you found any special incidence on particular occupations on the Poplar District ? Replies. (a) No. (b) None whatever. Whole families affected-all types—men, women children and infants. (c) No, but women have suffered more than men in my practice. (d) Housewives and children seem to suffer most. General Remarks. (а) There was a slight decrease in the number of cases about the beginning of December, followed by a recurrence of apparently a milder type ; mortality less, fewer complications and recovery quicker. (b) Only one fatal case in July epidemic, though temperatures were as high as second epidemic. Young adult females had greatest mortality, especially amongst those who work in the City. The second epidemic much more fatal than first. Many of the elderly pneumonia cases and most of the cases in children have recovered. Fatal cases had usually very acute pneumonia, with almost complete absence of breath sounds over a large area of lungs. (c) Have used inoculation as preventive m a few cases, and so far none of the inoculated have taken it. 74 (d) It is worthy of note that if a fatal case of pneumonia following influenza occurred in one house, another member of the same family contracted influenza followed by pneumonia, and in many cases both cases were fatal; whereas, as a rule, if one case of influenza and pneumonia recovered in a house, any second case did so—query-pointing to infection with a strain of bacteria of some virulence. The number of cases of pneumonia was high —in many cases the pneumonia was of a mild type, and might have passed unsuspected without examination of chest. The present epidemic has been of a much severer type than that earlier in the year. Where the vast majority had no complications and were soon back at work, in nearly every case in the present epidemic nearly all have had some bronchitis, if not pneumonia, and patients have been in bed for several days. I should say that those who suffered from the milder type earlier in the year obtained immunity, and that this is the same disease, but with a much more virulent bacteria, whether originating in this country or brought from abroad. (e) I should like to remark that the mortality seems high, but is it any higher proportionately to the attacks? Broncho-pneumonia following influenza has always been a fatal disease, but as we are having an enormous number of influenza cases, we must naturally expect more broncho-pneumonia. (f) During the past three or four weeks (December 10th) there has been:- 1. A slight recrudescence of the more severe type of influenza, but this is now lessening in extent. 2. When lobar pneumonia has occurred as a complication in this recrudescence it has, in my experience, not been of such a fatal type as that of three months ago. 3. Prevalence of the usual "Seasonal Influenzal Colds." Regarding this latter affection (clinically, Catarrh of the Air Passages) I have noticed this season a very marked "immediate infection" amongst those coming much together when one of them is already suffering from this illness. Dr. C. Spurrell. Medical Superintendent of the Poplar and Stepney Sick Asylum. Began on September 12th, with the admission of six Asiatics, from the S.S. Palma, R.A. Docks. The chef characteristics of the present outbreak which I have noticed are the following:— Sore throat—Almost universal, consisting of a laryngitis sometimes, but more often of an inflammatory condition of the lower part of the pharynx and upper part of the œsophagus, with nothing visible on ordinary examination of the throat. Some cases, however, have had well-marked follicular tonsilitis. 75 Pneumonia—Very prevalent, and seemed to have a tendency to begin deeply, the symptoms being unmistakable for forty-eight hours before the appearance of definite physical signs. Meningism—I have had three cases (in children of 16, 7 and 7) showing all the symptoms of meningitis, irritability followed by profound unconsciousness, with rigidity of the neck, slight optic neuritis in two cases. All three recovered totally. Disuria—I have had two cases of serious disuria in patients, aged between twenty and thirty, accompanied by a swollen condition of the vulva and inner sides of the thighs where they touched the inflamed parts. Both cases fatal. Albuminuria—Almost universal—generally slight. Rash—A punctate, scarlatiniform rash very common, with an "oral ring," but not followed by desquamation, and not accompanied by any injection of the fauces or "strawberry tongue." I believe the fatal issue in so many cases has been largely due to "keeping about" too long. This is largely due, I think, to the unusually prosperous condition of my patients, just now, the high wages tempting them to remain at work when, if their wages were at the normal figure, they would prefer to remain at home or go into some institution instead of working. I think the fortunate immunity from deaths which we have experienced amongst the staff here is due to their being very carefully watched, and sent off duty directly they appeared to be in the least ill. In this way we have had many nurses fretting in the sick room with nothing the matter with them, but although we have had many severe cases of influenza, we have had no single case of pneumonia. Prevention of Influenza. The district was posted and handbills distributed advising use of the Council's Electrolytic Disinfecting Fluid, obtainable at the seven distributing depots. To commence with, add two or three teaspoonsful of the Council's Electrolytic Disinfecting Fluid to a tumblerful of lukewarm water, rinse the mouth well and gargle the throat two or three times a day or more frequently ; also douche the inside of the nose with the diluted solution by pouring some of it into the palm of the hand, draw up through the nostrils and expel through the mouth. FOR ADULTS the gargle may be used stronger if desired to the benefit of the user. Of course, the gargle, like all other gargles, should not be swallowed. A4325 F 76 77 MEAS Digest of Measles and German Measles Notified by Notification of Measles and German Measles LES. Doctors and other Persons, Deaths—Outworkers For the Year ended 31st December, 1918. District. Under 3 months. 3—6 months. 6—9 months. 9—12 months. Total under 1 year 1—2 years. 2—3 years. 3—4 years. 4—5 years. 5—10 years. 10—15 years. 15—25 years. 25—45 years. 45 years and upwards Totals. District. Measles, by doctors. Poplar 1 8 14 34 57 136 88 76 94 47 3 — 1 — 502 Poplar. Measles, by doctors. Bromley 1 8 25 56 90 182 134 112 100 58 3 2 4 — 685 Bromley. Bow 1 2 14 27 44 100 79 77 84 68 2 2 — 1 457 Bow. Borough 3 18 53 117 191 418 301 265 278 173 8 4 5 1 1,644 Borough. Measles, by "other persons." Poplar — 2 8 10 20 33 26 16 18 17 — — — — 130 Poplar. Measles, by "other persons." Bromley — 1 1 10 12 45 24 26 21 13 1 - — — 142 Bromley Bow — — — 8 8 18 23 13 11 17 — — — — 90 Bow. Borough 0 3 9 28 40 96 73 55 50 47 1 0 0 0 362 Borough. German measles. Poplar — — 2 3 5 7 3 2 4 3 1 1 1 — 27 Poplar. German measles. Bromley — — 1 1 2 3 5 3 4 4 2 1 — — 24 Bromley. Bow 1 — — 1 2 2 1 2 1 1 — — 1 — 10 Bow. Borough 1 0 3 5 9 12 9 7 9 8 3 2 2 0 61 Borough. Totals 5 21 65 150 240 526 383 327 337 228 12 6 7 1 2,067 Totals. A4325 F2 78 Deaths. The following figures are the deaths from Measles for the past five years:— Poplar. Bromley. Bow. Borough of Poplar. 1914 15 28 20 63 1915 61 44 9 114 1916 21 19 8 48 1917 29 47 15 91 1918 35 79 37 151 Forty-one deaths (25 of which belonged to the Borough of Poplar)' occurred in the Sick Asylum. For death rates see Table XVIII., page 45. Respecting outworkers see page 52. SPOTTED FEVER. EPIDEMIC CEREBRO-SPINAL MENINGITIS.* Number of Cases. Nine cases occurred within the Borough—3 Poplar, 4 Bromley, and 2 Bow, as follows:— Removals. Poplar (Sub-District). Metropolitan Asylums Board's Hospitals 3 \ Bromley. London Hospital 2 Children's Hospital, Shadwell 2 4 Bow. Metropolitan Asylums Board's Hospitals 2 *Posterior basal meningitis is included in the term "cerebro-spinal fever," which does not include meningitis due to tuberculosis, syphilis, middle ear disease, and injury. 79 Six patients died from Cerebro-Spinal Meningitis—1 Poplar, 4 Bromley, and 1 Bow, and in two other fatal cases (Poplar Sub-District) which had been notified as Cerebro-Spinal Meningitis the causes of death were given as "Tuberculous Meningitis "and "Miliary Tuberculosis" respectively. ACUTE POLIO-MYELITIS, OR ACUTE POLIOENCEPHALITIS. Number of Cases. Four cases were notified—2 Poplar, 0 Bromley, and 2 Bow. Removals. Two Poplar cases were treated in Children's Hospital, Shadwell, and a Bcw case in London Hospital. Deaths. Two Poplar patients died. DIARRHCEA AND ENTERITIS. Diarrhcea and EnteriIts -Deaths; Notification of Zymotic Enteritis and Summer Diarrhcea. Under this heading are included deaths registered as due to epidemic diarrhcea, epidemic enteritis, infective enteritis, zymotic enteritis, summer diarrhoea, choleraic diarrhoea, gastro-enteritis, gastro-intestinal catarrh, muco-enteritis, colitis, etc. See Tables VIII.—XI., XIII.—XVI. Deaths from dysentery are not included, but tabulated separately, and 12 fatal cases from this disease occurred in the Borough—5 Poplar, 4 Bromley and 3 Bow. See Tables VIII.—XI. Borough Poplar. Bromley. Bow. of Poplar. London. 1914 55 82 58 195 3,031* 1915 73 49 52 174 2,542* 1916 43 41 23 107 1,598* 1917 39 32 28 99 1,506* 1918 21 18 19 58 1,112* *Under two years for London only. 80 DIARRHŒA,* UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1914 34 43 23 100 1915 43 27 18 88 1916 13 18 9 40 1917 13 16 7 36 1918 8 5 5 18 ENTERITIS,†UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1914 8 17 25 50 1915 8 11 15 34 1916 13 12 8 33 1917 7 5 9 21 1918 8 5 5 18 DIARRHCEA AND ENTERITIS, UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1914 42 60 48 150 1915 51 38 33 122 1916 26 30 17 73 1917 20 21 16 57 1918 16 10 10 36 Notification of Zymotic Enteritis (Summer DiarrhŒa). Notifiable from 1st June to 30th September. Age periods. Years. Number of notifications Number of deaths. Total. Poplar. Bromley. Bow. total. Poplar. Bromley. Bow. Under 1 50 64 20 134 16 10 10 36 1—5 92 143 66 301 2 6 3 11 5—15 22 35 9 66 3 1 3 7 15—25 15 39 — 54 — — — — 25-45 19 68 3 90 — — — — 45—65 17 52 4 73 — — 1 1 65 and upwards 2 13 3 18 — 1 2 3 All ages—totals 217 414 105 736 21 18 19 58 *Under the heading of "Diarrhœa" are included deaths registered as due to epidemic diarrhœa, epidemic enteritis, infective enteritis, zymotic enteritis, summer diarrhœa, choleraic diarrhœa and cholera (other than Asiatic or epidemic). †Under the heading of "Enteritis" are included deaths registered as due to enteritis, muco-enteritis, gastro-enteritis, gastric catarrh and gastro-intestinal catarrh. Gastritis is not included, except under two years. 81 INQUESTS AND DEATHS FROM VIOLENCE. Inquests and Deaths from violence during the year 1918, were as follows:— SubDistricts. Number of Inquests held in the SubDistricts. Deduct Inquests held on nonparishioners. Add Inquests held on parishioners from outlying districts. Total Inquests belonging to each SubDistrict. Verdict from Violence. Verdict from Natural Causes. Poplar 106 22 42 126 62 64 Bromley 290 172 13 131 49 82 Bow 34 2 45 77 22 55 Totals 430 196 100 334 133 201 For annual rates of deaths from violence per 1,000 persons living and the percentages of inquest cases to total deaths, see Table XVIII page 45. Violent deaths which actually occurred in Poplar, Bromley and Bow, not deducting non-residents, were as follows:— Deaths occurring entirely outside the Borough, but belonging thereto. Poplar. Bromley. Bow. Poplar. Bromley. Bow. By Railway ... 6 ... 1 ... ... By Vehicles and Horses 1 30 ... 2 2 2 Ships, Boats and Docks (exelusive of drowning) 1 9 ... ... ... ... Building Operations ... 4 ... ... ... ... Conflagrations ... ... ... ... ... ... Burns, Scalds and Explosions ... 19 ... 1 ... 2 Drowning (accidental not suicidal) 14 4 2 1 1 Suffocation in Bed 6 4 ... ... ... ... Poisons or Poisonous Vapours 2 1 ... 1 ... ... Other and not stated Causes 12 65 2 4 3 Homicide ... ... ... ... ... ... Suicide 4 9 ... ... ... 1 Manslaughter ... ... ... ... ... ... Murder ... ... ... ... ... ... Execution ... ... ... ... ... ... Total 40 151 8 9 7 9 82 MORTUARY. Number of Bodies Received into Council's Mortuary, Cottage Street. The following is a list of the number of bodies received into the Council's Mortuary, Cottage Street, Poplar, classified according to the ages of the deceased:— No age stated — Stillborn 7 Under 1 46 1 to 5 70 5 to 15 29 15 to 25 25 25 to 65 179 65 and upward 113 Total 469 CANAL BOATS. For the year ended 31st December, 1918, the inspections and reports of the Inspectors respecting registered canal boats and non-registered canal boats were as follows:— Registered. Non-Registered. †Mr. J. Bullock, East Combined Division *Mr. J. Johnson, West Combined Division †Mr. C. Foad, Poplar South Division Mr. H. J. Langley, Bromley North Division Mr. Wm. Johnson, Bromley Central Division — Mr. A. J. Field, Bow East Division 5 10 Mr. W. Boyce, Bow West Division — 26 5 36 *Mr. J. Johnson reported that on each occasion when passing the portion of canal in his district, no canal boats have been observed. †No canal in Sub-division; deputises when necessary for other Inspectors. 83 WORKSHOPS, WORKPLACES, LAUNDRIES AND OUTWORKERS. TABLE A. Table giving number of, and inspections, etc., of Bakehouses, Laundries, Workshops, Workplaces, Places where food is prepared, Milk premises, Cowsheds, Slaughter-houses, Offensive Businesses, Ice Cream premises, Registered Houses Let in Lodgings, and Homeworkers' premises. Premises. On Register during year 1918. Number of Inspections. Number of Intimations. Number of Notices. Number of Final Notices. Number of Prosecutions. Male. Female. Total. Bakehouses (Factories) 16† .. 16† 90 1 3 1 .. Bakehouses (Workshops) 58† .. 58† 392 21 6 2 .. Bakehouses (Domestic Workshops) 17† .. 17† 93 4 4 1 .. Factories (Laundries and Miscellaneous Factories) ‡ ‡ t 33 12 3 .. .. Laundries (Workshops) I 6 7 23 1 .. .. Laundries (Domestic Workshops) .. 2 2 5 .. .. .. .. Workshops 148 132|| 280|| 320 28 17 .. .. Workshops (Domestic) 7 15 22 25 .. .. .. .. Workplaces 150 .. 150 124 6 1 .. .. Workplaces (Domestic) 20 .. 20 15 1 .. .. .. Places where food is sold or prepared 285§ .. 285§ 901¶ 40 26 3 .. Milk Premises 247** .. 247** 623 .. .. .. .. Cowsheds 10 .. 10 14 .. .. .. .. Slaughterhouses 10 .. 10 62 1 1 .. .. Other offensive trade premises 5§§ .. 5§§ 56 1 1 .. .. Ice Cream premises 68 .. 68 18 .. .. .. .. Registered houses-letin-lodgings .. 1,442 4632†† 449‡‡ 399|||| 51 .. Homeworkers' premises 38 857 895 1805 .. .. •• .. †12 Bakehouses were disused at the date of the last inspection. See page 89. ‡No Register is kept of Factories. Figures are from Journals and Card Index. ||Including 7 workshops vhere both men and women are employed. §Power is used in 26 of these premises where sausages are made. ¶Including inspections of all factories where food is prepared. **Including 10 cowsheds. §§5 registered premises, by the London County Council, ††See page 96. ‡‡41 intimations were for 75 verminous rooms. ||||Including 186 for cleansing and 14 for overcrowding. 64 TABLE B. Workshops on Register (Male), 1918. 19 Bootmakers 2 Metal workers 2 Barge builders 1 Mineral water 3 Boat builders 1 Oar maker 1 Basket maker 1 Oil refiner 1 Bellows maker 1 Organ builder 1 Bottle maker 1 Packing maker 3 Brush making 2 Printers 2 Builders 1 Paint can cleaner 2 Cycle makers 2 Picture frame makers 4 Cork cutters 1 Painter's fitter 1 Comb maker 1 Pickle works 1 Chemical maker 2 Plumbers 3 Confectioners 2 Rope and twine maker 1 Coach builder 2 Rag sorters 1 Cardboard box maker 1 Rubber works 1 Composition works 1 Rat poisons 1 Cooperage 1 Solder works 6 Cabinet makers 1 Sack and Tarpaulin makers 1 Cigar maker 1 Sheet metal worker 1 Clay pipe maker 1 Stonemason 1 Draught board maker 7 Tailors 1 Electrical engineer 2 Tarpaulin works 1 Engineer 1 Tile and earthenware 15 Farriers 2 Tinsmiths 1 Frilling maker 3 Upholsterers 1 Glass bender 3 Undertakers 5 Harness makers 1 Varnish works 1 Keg and drum maker 1 Ventilator maker 1 Laundry 1 Vinegar works 1 Milliner 2 Wheelwrights 1 Machinery dealer 2 Wood choppers 1 Munition works 2 Wire workers 2 Motor garage works 1 Walking stick maker 1 Metal marine stores 1 Van works 2 Marine store dealers 2 Zinc workers 1 Mattress maker As per List Table A Workshops on Register —83 85 TABLE B —continued. Workshops on Register (Men and Women Employed). 1 Cork cutter 1 Upholsterer 2 Tailors 1 Clay pipe maker 1 Confectioner 1 Brush maker Domestic Workshops on Register (where Men are Employed). 6 Bootmakers 1 Confectioner Home Workers on Register (Male) 34 Bootmakers 1 Fur. 3 Tailors Workshops and Domestic Workshops on Register (Females).* 46 Tailors 8 Laundresses 5 Boot upper makers 15 Dressmakers 1 Upholsterer 2 Cork cutters 4 Skirt and blouse makers 4 Waterproof garment makers 3 Sack and bag makers 2 Shirt and pyjama maker 3 Furriers 4 Underclothing makers 1 Seal stamper 19 Milliners 3 Tiemakers 3 Confectioners 1 Dressing gown maker 1 Medical sundries 2 Packers 1 Pickle maker 2 Glass blowers 5 Mantle makers 3 Paper and rag sorters 3 Woodchoppers 1 Bracemaker 2 Shirt front and collar makers 1 Rubber balloons 1 Trimming maker 1 Corset maker 1 Artificial flower maker 1 Horse hair sorter 2 Toymakers 1 Boxmaker 3 Rope sling makers. *It is very difficult to separate Workshops and Domestic Workshops, as these premises are sometimes one and sometimes the other, according to the pressure of work. See Table A, page 83. 86 TABLE C* See footnote, page 85. Factories, Workshops, Laundries, Workplaces and Homeworkers. 1.—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Intimation. Statutory. Final. Factories 123 13 6 1 ... (Including Factory Laundries.) Workshops† 735 50 23 3 ... (Including Workshop Laundries.) Domestic Workshops‡ 123 4 4 1 ... Workplaces (Males) 124 6 1 ... ... Domestic Workplaces (Males) 15 1 ... ... ... Places where food is sold or prepared || 901 40 26 3 ... Homeworkers' Premises 1,805 ... ... ... ... Total 3,826 114 60 8 ... *Tables C, D, E and F are filled in at the request of the Secretary of State †Including Workshop Bakehouses. See Table A, page 83. ‡Including Domestic Bakehouses and Laundries. See Table A, page 83. ||The inspections of all factories where food is prepared are included. Power is used to chop meat for sausages, etc., in 26 of the premises. 2.—DEFECTS FOUND * Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Act: Want of cleanliness 251 251 Want of ventilation 3 3 Overcrowding 1 1 Want of drainage of floors ... Other nuisances 92 92 Sanitary accommodation. insufficient ... ... unsuitable or defective 9 8 not separate for . sexes ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) Other offences ... (Excluding offences relating to outwork which are included in Table D of this Report.) Total 356 355 * These defects refer to premises as mentioned above under table of Inspection. Nature of Work. (1) Outworkers' List, Section 107. Outwork in unwholesome premises, Section 108.* Outwork in infected premises,* Sections 109,110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances.† * Orders made (S. 110). Prosecutions (Sections 109, 110). Twice in the year. Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Outworkers. Contractors. "Workmen. Lists. Contractors. Workmen. (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— „ Making, &c. 102 107 1297 6 ... 33 ,, Cleaning & Washing Household Linen Lace, lace curtains & nets Curtains and furniture hangings TABLE D-—Home Work. Furniture and Upholstery Electro-plate File Making Brass and Brass articles Fur pulling Cables and Chains Anchors and Grapnels ... Cart Gear Locks, Latches and Keys Umbrellas, &c. Artificial Flowers Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 8 400 1 ... 3 Brush Making Pea Picking Feather Sorting Carding,&c.,of buttons,&c Stuffed Toys Basket Making Chocolates & Sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c. Textile Weaving Total 110 107 1,697 7 ... 36 87 *For Infectious Diseases see page 52. 88 LIST OF OUTWORKERS, FACTORY AND WORKSHOP ACT, 1901 (S. 107).* Class of Homework. 1918. Number of Lists received. Number of Addresses of Outworkers. Due Feb. 1st. Due Aug. 1st. Forwarded to other Authorities. Received from other Authorities. No. of Lists. No. of Outworkers. No. of Lists. No. of Outworkers. Due Feb. L Due Aug. 1. Due Feb. 1. Due Aug. 1. Total 58 863 59 971 462 481 516 514 Tailoring 37 309 41 397 Shirtmaking 3 97 3 89 Miscellaneous 9 226 7 258 Shoemakers 4 32† 4 26‡ Boxes 5 199 4 201 *See page 87. †18 Males and 14 Females. ‡17 Males and 9 Females. TABLE E. Registered Workshops and Workplaces. Workshops and Workplaces, etc., on the Register (s. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop bakehouses may be enumerated here. (Bakehouse Workshops 58 Bakehouse Domestic Workshops 17 Laundries Workshops 7 Laundries Domestic Workshops 2 Workshops 280* Domestic Workshops 22 Workplaces 150 Workplaces Domestic 20 Places where food is sold or prepared 285† Total number of workshops and workplaces, etc., on Register 841‡ *7 where men and women are employed. †Power is used in 26 of these premises. ‡See Tables A and B, and pages 83 and 84. 89 TABLE F Other Matters. • Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 3 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 10 Reports (of action taken) sent to H.M. Inspector 10 Other (Communications) 4 Underground Bakehouses (s. 101):— Certificates granted during the year ... In use at the end of the year 21 BAKEHOUSES. Inspections. The Bakehouses throughout the Borough were inspected at least twice during the year. There are 79 Bakehouses in the Borough of Poplar, 24 Poplar (including 5 factory bakehouses), 32 Bromley (includng 14 factory bakehouses), 23 Bow (including 4 factory bakehouses). See Table A, page 83, number made up to end of year. * There are 21 underground bakehouses in the Borough, 1 Poplar, 10 Bromley, and 10 Bow. Cleansing was necessary in the various bakehouses on 120 occasions. Two other nuisances were found. 90 COFFEE SHOPS, EATING HOUSES, FRIED-FISH SHOPS,* HOTELS AND RESTAURANTS, ETC.† London County Council (General Powers) Act, 1908.—Sanitary Regulations For Premises used for Sale, etc., of Food for Human Consumption. The number of premises in the Borough where food is sold or prepared for sale is 285: 156 Poplar, 74 Bromley, and 55 Bow. (See Table A, page 83.) London County Council (General Powers) Act, 1908. 901 visits were paid to these premises during the year and the Sanitary Regulations under the London County Council (General Powers) Act, 1908, Section 8, were enforced. Want of cleanliness was found in 71 instances, and 57 other defects existed. 40 intimations were served, which in 26 cases were followed up by Statutory notices and three final notices were served. A register of these premises is kept. HAIRDRESSERS' PREMISES. The hairdressers' premises were inspected during the year. MILKSHOPS. Dairies, Cowsheds and Milkshops Order. London County Council (General Powers) Act, 1908.—Power to Sanitary Authorities to remove from or refuse to enter on Register Names of Dairymen in certain circumstances. Dairies, Cowsheds and Milkshops Order. At the end of the year there were in the Borough 242 registered premises (including 10 cow-houses, 1 Poplar, 4 Bromley and 5 Bow) where milk is sold, 79 Poplar, 101 Bromley and 62 Bow. These milk shops were kept under observation. *Bye Laws. †See Tables A and C, pages 83 and 86. 91 Cleansing of premises was necessary in five instances. No other defects were found. 2 milkshops had been placed on the register during the year, 0 Poplar, 1 Bromley, and 1 Bow. 9 premises were on account of change of occupiers re-registered as milkshops, 2 Poplar, 4 Bromley and 3 Bow. The sale of milk was discontinued on 36 premises— 9 Poplar, 25 Bromley and 2 Bow. For milkshops connected with infectious diseases, see page 52. London County Council (General Powers) Act, 1908. Part II. Sanitary Provisions. Power to Sanitary Authorities to remove from or refuse to enter on Register Names of Dairymen in certain Circumstances. No circumstances arose during the year calling for the enforcement of the power given to the Sanitary Authority under the London County Council (General Powers) Act, 1908, Section (5). SMOKE NUISANCES. 4 smoke nuisances were dealt with during the year:— 0 Bow East, 0 Bow West, 0 Bromley North, 4 Bromley Central, 0 East Combined, 0 West Combined, and 0 Poplar South. ICE CREAM. London County Council (General Powers) Act, 1902, Sec. 43. Twice annually and as often as may be necessary all the known premises within the Borough where ice-creams are manufactured are inspected. There are 68 such premises within the Borough, 29 Poplar, 33 Bromley, and 6 Bow. (See Table A, page 83.) Cleansing of premises was necessary in no instance. No nuisance existed. a4325 g 92 FOOD AND DRUGS ACTS. Results of Analyses. Legal Proceedings. Preservatives in Butter, Preservatives in Margarine. The results of the analyses of 691 samples were reported to the Committee during the year 1918, the samples being as follows:— Sample. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter Total. Milk 108 100 103 96 407‡ Butter 1 — 7 12 20 Margarine — — 17 31 48 Lard — — 19 18 37 Chocolate 1 - - - 1 Cheese - - - - - Coffee 6 8 7 2 23 Cocoa 8 7 7 3 25 Cream - - - - - Baking Powder — — - - Pepper 5 9 4 18 Condensed Milk 4 - - - 4 Rice - - - - - Arrowroot 4 4 2 1 11 Glycerine — — — - - Saffron — — 1 - 1 Olive Oil - - - - - Cod Liver Oil 2 - - - 2 Ammoniated Tincture of Quinine ... — 1 2 1 4 Crushed Linseed 3 2 3 1 9 Almond Oil 1 - - - 1 Camphorated Oil — - 1 2 3 Seidlitz Powder — - - - - Lime Water - - 1 1 2 Cream of Tartar — 3 1 4 Ground Rice 2 6 2 2 12 Pearl Barley — — 1 - 1 Powdered Cinnamon — — - - - Dripping 3 1 - 4 8 Self-Raising Flour — — - - Oatmeal 1 4 3 - 8 Tea — — 1 - 1 Vinegar 7 6 4 2 19 Honey 1 1 — 2 Mustard 4 8 1 1 14 Fish Pie 2 — - - 2 Brawn — - 1 - 1 Sweet Spirit of Nitre — 1 - - 1 Sausage — — 1 - 1 Liquid Magnesia - 1 — - 1 Totals 163 162 189 177 691 93 ‡Of the 407 samples of milk. 68 samples were procured on Sundays from itinerant vendors and 82 from itinerant vendors on weekdays. Four Sunday samples were not in accordance with the standard and legal proceedings were instituted. Four week-day samples were not genuine legal proceedings were instituted in three cases and the fourth vendor was cautioned. Thirty-one samples were taken on delivery, viz., 7 Poplar Union Workhouse, 8 Sick Asylum, 5 Out-relief Stores, North Street, and 11 at Railway Stations. All the samples taken at the Institutions were genuine: Results of Analyses. Of these 691 samples legal proceedings were instituted in 25 cases and letters of caution were sent in three instances. Milk 18 Condensed Milk 1 Vinegar 2* Scotch Whisky 4† Administrative Action regarding Articles reported to be not Genuine. Quarter ended 31st March, 1918. Article. No. Result of Analysis. Proceedings. Milk 4 Deficient in fat 8.8 per cent... £10 penalty, £1 Is. costs. Condensed Milk 5 Sold in a tin which was not clearly marked "Skimmed Milk" in large letters. Adjourned sine die. Milk 289 Deficient in fat and solids, not fat, 24 per cent. and 28.4 per cent. respectively. £2 penalty, £1 costs. Milk 277 Deficient in solids not fat 8.5 per cent. Letter of caution sent. Milk 291 Deficient in fat and solids not fat 3.3 per cent. and 10.3 per cent. respectively. Cautioned by Committee. *1 adulterated with 35.5 per cent. added water and 1 with 46 per cent. water. †2 found to Le foreign brandy 50 degrees under proof and 2 found to be Spanish brandy. A4325 G 2 94 Quarter ended 30th June, 1918. Article. No. Result of Analysis. Proceedings. Milk 339 Deficient in fat and solids not fat 40 per cent. and 34.4 per cent. Dismissed on warranty. Milk 21f Deficient in fat 29.3 per cent. £8 penalty, £2 2s. costs. Milk 304 Deficient in fat and solids not fat 8.3 per cent. and 4.7 per cent. Dismissed on warranty. Milk 303 Deficient in fat and solids not fat 4 per cent. and 5 per cent. £3 penalty, £2 2s. costs. Milk 27f Deficient in fat 12.3 per cent. £1 penalty, £1 Is. costs. Milk 309 Deficient in solids not fat 12.9 per cent. Dismissed on warranty. Milk 307 Deficient in fat and solids not fat 7.3 per cent. and 10 per cent. Dismissed on warranty. Milk Sold in Bow Road from a can which did not have conspicuously inscribed thereon name and address. Dismissed. Milk 346 Deficient in fat and solids not fat 6 per cent. and 12.5 per cent. £1 fine, to include costs. Milk — Gave a false warranty for milk £20 penalty, £5 5s. costs. Milk 44 Deficient in solids not fat 4.7 per cent. Letter of caution sent to vendor. Milk 35F Deficient in fat and solids not fat 19 per cent. and 14.1 per cent. Bound over for 12 months, £1 Is. costs. Milk 322 Deficient in fat and solids not fat 36.6 per cent. and 18 per cent. 10s. penalty, £1 Is. costs. Milk 49 Deficient in fat 15 per cent. Summons dismissed, £2 2s. costs, to be paid by defendant. 95 Quarter ended 30th September, 1918. Quarter ended 30th September, 1918. Article. No. Result of Analysis. Proceedings. Vinegar 44 f Adulterated with 35.5 per cent. water. 10s. penalty. Scotch Whisky - Found to be foreign brandy 50 degrees under proof. £2 2s. costs. Scotch Whisky - Found to be foreign brandy 50 degrees under proof. £2 2s. costs. Quarter ended 31st December, 1918. Article. No. Result of Analysis. Proceedings. Vinegar 72 Adulterated with 46 per cent. water. 2s. costs. Scotch Whisky — Found to be Spanish brandy (proprietor). £10 penalty, £3 3s. costs. Scotch Whisky — Found to be Spanish brandy (barmaid). 10s. penalty. Milk 671 Deficient in fat 16.6 per cent. £2 28. costs. Milk 87f Deficient in fat and solids not fat 2 per cent. and 4.9 per cent. £2 2s. costs. Milk 116 Deficient in fat and solids not fat 11.6 and 17.5 per cent. Dismissed on warranty. Preservatives in Butter. Of the '_0 samples of butter, 8 contained percentages of boric acid as follows:— 6 samples contained 0.1 per cent. 2 „ 0.2 Preservatives in Margarine. Of the 48 samples of margarine, 29 contained percentages of boric acid as follows:— 15 samples contained 0.1 per cent. 9 „ 0.2 5 „ 0.3 96 HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. Work of the Inspector and Inspection of Chinese Quarter. At the end of the year there were 1,442 houses on the register. See Table A, page 83. There are 95 premises occupied by Chinese on the Register and these premises are under constant supervision. HOUSING, TOWN PLANNING, ETC., ACT, 1909. Housing (Inspection of District) Regulations, 1910. Representations and Closing Orders under Section 17; Determination of Closing Orders, Section 17 (6). Housing (Inspection of District) Regulations, 1910. Representations and Closing Orders Under Section 17 (2). Thirty-nine premises were inspected under Section 17 (1) of the Housing and Town Planning, etc., Act, 1909, and in the first place, as a rule, intimations and statutory notices were served upon owners under the Public Health (London) Act, 1891, in order that the defects might be remedied and thereby prevent "Representations" under the Housing, Town Planning, etc., Act., 1909, which would be followed by the Council making "Closing Orders." The following is a list of dwelling-houses inspected, and the work executed; but in seven cases "Representations" were made followed by "Closing Orders ":— Premises Inspected. Bird-in-Hand Court, *Nos. 1, 2, 3, 4, 5, 6 All work done Bird-in-Hand Yard, Nos. 4a and 5a All work done. Chadbourne Street, Nos. 17 and 18 Closing Orders made 16th January, 1919. Premises now empty. 97 Stewart Cottages,*Nos. 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13 Owners interviewed by Committee 11/6/18. Stewart Cottages,*Nos. 14, 15,16, 17, 18,19, 20 Work done at these premises. Stewarts Buildings,*Nos. 1, 2, 3, 4, 5, 6, 7, Owners interviewed by Committee 11/6/18. West Ferry Road,† No. 321 Closing Order made 16/1/19 West Ferry Road,† No. 327 Closing Order made 16/1/19. Determination of Closing Orders. Closing Orders made by the Council in respect of No. 23, Pennyfields, and Nos. 1 and 2, Elizabeth Cottages on the 21st June, 1918, were determined, as the premises were made fit for human habitation. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1904. V erminous Rooms.‡ Licensed Premises' Urinals. Verminous Rooms. Verminous rooms are still brought to the notice of owners upon the "Intimations" which are followed, if necessary, by "Statutory Notices," more especially as there are generally other defects upon the premises, and certainly verminous premises are "in such a state as to be a nuisance to health," and owners, if they do not already know, are informed when defects are being dealt with under the Public Health (London) Act, 1891, that the vermin must be got rid of, otherwise the London County Council (General Powers) Act, 1904, will be brought into operation. When a notice is served for cleansing under the bye-laws for houses let in lodgings or occupied by members of more than one family, should the premises be verminous a special intimation to that effect is enclosed. *Since taken over by London County Council to be demolished for erection of new School. †Both since demolished. †For the Cleansing of Verminous Persons, see pages 59 and 60. 98 During the year 173 Intimation Notices were served in respect of verminous rooms, and the verminous rooms cleansed were:- Poplar South Division 4 West Combined Division 25 East Combined Division 15 Bromley Central Division 23 Bromley North Division 40 Bow West Division 28 Bow East Division 10 Houses Let in Lodgings 75 No summonses were applied for. SCHOOLS. Inspection of Schools. The Schools of the Borough were inspected and the sanitary conveniences and water supplies were found in a satisfactory condition. SANITARY INSPECTORS' WORK. etc. Tabulated Lists of Sanitary Inspections, etc. Legal Proceedings Overcrowding. General. 99 Tabulated Statement of Inspections, of Insanitary Condition found existing, and of Re-inspections diking the Period from 1st January, 1918, to 31st December, 1918. East combined. Mr. Bullock Wat combined. Mr. Johnson. Poplar South. Mr. Foad. Bromley nrth. Mr. Langley. Bromley Central. Mr. W. Johnson. Bow East. Mr. Field. Bow West. Mr. Boyce. Totals. Inspections:— 1,638 1,171 1,255 1,320 548 1,189 1,368 8,489 On Complaints of Nuisances, etc. 1,314 830 731 790 319 793 837 5,614 On notification of infectious diseases 324 326 524 • 492 212 396 531 2,80" House to house visitation 15 38 17 70 Houses found in good condition 1,265 679 943 1.091 192 901 966 6,037 Do. requiring amendment 373 492 312 229 356 288 402 2,452 Details of Insanitary Conditions. Walls and ceilings requiring cleansing throughout 26 26 10 47 6 6 11 132 Do. do. partially 182 206 96 30 87 44 130 775 Yards and areas insufficiently paved 57 47 13 4 26 1 11 159 Do. imperfectly drained 34 39 1 35 — 2 1 112 Inlets to drains not properly trapped 8 16 2 1 - - — 27 Drains proved defective by smoke drain test 10 32 20 6 - 19 25 112 Smoke drain test applied with negative results 135 26 168 7 2 46 56 440 Drains obstructed 39 80 114 62 113 29 31 468 Sink waste pipes directly connected with drains - 11 — - 19 - — 30 Rain water pipes do. do. - 1 - - - - 1 2 Soil pans of w.c.s without suitable water supply 39 29 46 49 21 6 27 217 Do. broken or unsuitable 15 26 10 8 12 6 14 91 Do. in foul condition 23 29 7 4 9 7 6 85 Do. untrapped 10 3 3 — — — — 16 100  East combined Mr. Bullock West combined. Mr. Johnson. Poplar South. Mr. Road. Bromley North. Mr. Langley. Bromley Central. Mr. W. Johnson. Bow East. Mr. Field. Bow West. Mr. Boyce. Totals. Roof guttering and rainwater pipes defective 80 95 103 90 39 19 51 477 Roofs not watertight 135 118 138 91 84 79 161 806 Water supplies to premises cut off (notified by Metropolitan Water Board) 14 56 6 10 11 — 3 100 Water service fittings defective, causing waste of water 31 30 21 20 14 12 12 140 Drinking Water improperly stored 1 25 2 1 — — — ee W.C.s badly ventilated 5 — 1 — 1 — — 7 Do. badly situated — 1 1 — — — — 2 Dampness 72 68 59 2 20 51 71 343 Inundations 4 32 — 3 — 28 8 75 Overcrowding 4 14 1 — 1 1 1 22 Accumulations of dung or refuse 21 54 8 3 1 5 12 104 Foul p.h. urinals 31 12 5 — 5 1 1 55 Other nuisances, dilapidations, want of ventilations, etc. 353 234 233 123 153 97 158 1,351 Breaches of London County Council By-laws 9 28 — — 25 36 — 98 Broaches of Council's By-laws — 19 — — — 5 — 24 Intimations served 367 407 295 229 299 288 402 2,287 934 Notices served 120 221 60 64 217 56 196 Final notices served 41 33 23 17 55 1 14 184 Summonses applied for — — — — — 1 — I Passengers from Continental Ports— Visited 2 39 — 9 — 9 — 59 Undiscovered 9 5 — — — — — 14 Re-Inspections 3,741 1,822 2,044 1,805 2,784 1,838 921 14,955 Intimations served in respect of verminous rooms, whether in conjunction with, or separate from, other defects 15 17 4 40 23 5 28 132 101 Tabulated statement of Inspections of Insanitary Conditions found existing, and of Re-inspections, &c., during the twelve months ended 31 st December, 1918 (Miss Alice Tattersall— Lady Inspector). Poplar. Bromley. Bow. Total. Workshops, Workplaces, Laundries, &c., Number of, on the Register 28 52 75 155 Workshops, Number of Workrooms therein 47 81 104 234 „ Number of Inspections of 39 57 79 175 „ Number of Re-inspections of 30 47 59 136 „ Found to be overcrowded — 1 — 1 ,, Insufficiently ventilated 1 1 — 2 „ &c., newly discovered and registered — 1 2 3 „ Workrooms therein measured — 1 3 4 „ Reported to H.M. Inspector on discovery — 1 2 3 Houses visited for enquiry at which no female hands were employed 243 551 963 1,759 Written intimations issued 9 10 11 30 Statutory Notices 3 6 8 17 Final Notices — — 1 1 Works carried out under supervision :—- (a) Rooms cleansed and whitewashed — 3 5 8 (b) Yards, roofs, &c., repaired 2 2 2 6 Sanitary Conveniences Constructed — 10 5 15 Overcrowding of Workrooms, cases of, abated — 1 — 1 Visits re Scabies 148 244 138 530 „ Phthisis — — — — „ Outworkers' Lists 31 24 35 90 „ Inspection of Schools 20 16 9 45 ,, Verminous School Children 38 40 16 94 Miscellaneous Inspections 62 54 22 138 102 Police Court Proceedings No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Attendance at Police Court. Result. Name of Officer. 8, East Ferry Road No water supply for sanitary, domestic and drinking purposes. 1918 12th August £1 1s. costs, £1 penalty Field, A. J. 103 Overcrowding. Twenty-two cases of overcrowding were abated. One case of overcrowding was found in a workshop ; 49 cases of overcrowding were also abated in connection with houses let in lodgings, or occupied by members of more than one family. General. 7,428 communications were received, and 959 complaints (including 4 smoke) as to nuisances were made. 3,696 communications were despatched. I am, Sir, Madam and Gentlemen, Your obedient Servant, Medical Officer of Health. Metropolitan Borough of Poplar, Public Health Offices, Bow Road, E. June, 1919. 104 Public Health Department, Bow Road, E. 3, January lst, 1919. Sir, I beg to present the eleventh Annual Report of my work, the fourth under the Local Government Board's extended scheme for the Prevention of Infantile Mortality. Arrangements are now in working order for (1) the payment of Nurses for visiting cases of Ophthalmia Neonatorum, Zymotic Enteritis and Measles when required ; (2) Sale of dried milk and a galactagogue at cost price. Payment of doctor's fees when called to assist a midwife in the delivery of a necessitous mother, is now undertaken by the London County Council. The visiting areas remain as before:— Poplar Infant Welfart Association. Undertake all the work south of the first bridges. The Royal College of St. Katharine. Undertake all the work between the first bridges and Bow Road The Public Health Department. Undertake all the work north of Bow Road. The working arrangement between the above bodies and this department has been slightly altered, each submit their own figures for the monthly report, saving labour both to themselves and this Department. The new arrangement is working smoothly. 105 Visiting. Miss Ha 1. Miss Brocklehurst. Poplar Infant Care Assocn. The Royal College of St. Katharine. Total. Ante-Natal 43 — 55 633 731 Post-Natal— Visits 237 298 339 1,873 2,747 Removed before visit — o 3 11 16 Died before visit 10 15 54 79 Still-born 66 11 — 16 93 Revisits— Under one 629 1,004 2,438 17,750 21,821 One—five 1,426 2,370 2,784 34,884 41,464 Removed 83 114 110 752 1,059 Died 26 61 64 338 489 Zymotic Enteritis— Visits 51 26 46 289 412 Revisits 42 4 40 517 603 Died 1 2 4 5 12 Measles Visits 172 176 249 799 1,396 Revisits 81 90 326 1,352 1,852 Died 4 14 13 47 78 Ophthalmia Neonatorum— Visits 28 4 — — 32 Revisits 58 6 — — 64 Miscellaneous 267 104 — 676 1,017 Total Visits paid 72,262 Medical Aid. Fifty visits have been paid to cases in which the midwife has had to call in the assistance of a doctor for difficult delivery of necessitous mothers. 106 Stillbirths. Number of stillbirths 97 Delivered in Institutions—No information available 22 Premature births 28 Fœtus macerated 20 First pregnancies 14 Mothers who worked during pregnancy 18 Instrumental deliveries (forceps) 8 Craniotomy 1 Transverse presentations 2 Prolapse of cord 3 Prolapse of uterus 4 Breech presentations 17 Ante-partum hœmorrhage 8 Eclampsia 1 Mothers who had had previous stillbirth: One. Two. Three. Four. Five. Eight. 7 4 111 1 Seven have had 1 mis-carriage and one—two miscarriages. Ten attributed the fact that the child was stillborn to "shock," six to "accidents" or "overwork," and two to "ill-health." Nursing. Ophth. Neon. Measles. Zy. Enteritis. Influenza. Cases. Visits. Cases. Visits. Cases. Visits. Cases . Visits. East London Nursing Society 4 164 30 505 2 17 — - St. John Divine „ 3 126 18 189 4 18 — - Millwall & Cubitt Town ,, 2 37 19 199 1 10 — - The Ranyard „ 5 74 1 4 2 12 5 37 Total 14 401 68 897 9 57 5 37 107 Bow Maternity Centre. The Maternity Centre has undergone many changes during the past year. The baths were taken for the use of a National Kitchen and we had a very unhappy time during the alterations. Comfortable quarters for the mothers were found at the Bow Wesleyan Mission, Old Ford Road, and we moved in during April. Dr. Dobson resumed Military duties in May, Dr. Kidd acting in her absence, and in September we started two sessions weekly. However, with all the changes, the attendances have increased. Attendances :— Expectant mothers 2 Infants (first attendance) 330 Infants (total attendances) 2,506 Infants weekly attendance (average) 49 Infants average attendance (each child) 6.4 Priority cards issued :— Cows' milk 144 Condensed milk 86 Vouchers issued (cod liver oil, etc.) 1,325 Galactagogue 25 pkts. Sugar 27¾ lbs. Dried milk 3,184 lbs. Average amount dried milk issued, per each mother attending 1.2 lbs, (1st quarter. 0.67 lbs.; 4th quarter, 1.77 lbs.). Money taken £269 3 3½ Free issue £24 0 11¾ Ophthalmia Neonatorum. Number of notifications received, 40. Sight of one eye damaged 1 Recovered 39 Occurred in the practice of medical practitioners 10 Occurred in the practice of midwives 30 Admitted to hospital as in-patient 2 Treated as hospital out-patients 8 Treated privately 30 Visited by a nurse A4325 108 Zymotic Enteritis. The information given on the Case Sheets, re any "special condition" was practically nil. The percentage of cases visited by myself, in which the mothers were working was 49 per cent. This figure might be taken as representing the whole. Special foods mentioned as being given to infants under two years of age were : Cows' Milk, Glaxo, Nestle's, Cow and Gate, Ridge's, Allenbury's, Mellin's, and Garman's. Visited 417 Failed to trace 5 Under 1 year 126 1 to two years 175 2 to 3 years 62 3 to 4 years 33 4 to 5 years 16 Feeding. Age period. Breast. Mixed feeding. Hand fed. Not stated. Under 1 year 21 25 64 16 1 to 2 years 12 32 118 13 Medical Advice Obtained. Same day 87 1 day 115 2 days 46 3 days 20 4 days 22 5 days 10 6 days 6 7 days 13 No information or too doubtful to use 93 Vital Statistics, 1917. I have included in this year's statistics the number of cases notified by doctors, midwives, etc., as the information was required last year by the L.G.B. 109 All births, including those occurring in out-lying districts but belonging to the Borough and still births 3,706 Notified by doctors 520 ,, midwives 2,162 „ parents and other persons 895 Stillborn 91 Died before visit 83 Not requiring or not desiring visits 369 Visited 3,163 Removed and not traced 450 Died during visitation 215 Remaining under supervision end of first year of birth 2,498 Mortality per 1,000 births 106.5 Still births per 1,000 births 24.5 Mortality per 1,000 visited 79.2 ,, „ delivered in Institutions 1141 „ ,, „ by doctors 74.4 ,, ,, ,, midwives 79.9 Percentage of still births delivered in institutions 6.3 „ „ „ by doctors 3.3 „ „ „ by midwives 1.6 The feeding of the infants visited during the first fix months of life was as follows:— (1) Those alive at end of completed year (December, 1917):— Breast-fed 76.9 per cent. Mixed feeding 18.3 „ Hand-fed 1.9 „ (2) Those who died:— Breast-fed 60.0 per cent Mixed feeding 34.4 „ Hand-fed 5.5 „ (3) Comparison of Rates of Mortality between infants:— Breast-fed 6.0 per cent. Mixed feeding 13.9 „ Hand-fed 20.0 110 Vital Statistics, 1916. Remaining under supervision end of their first year of birth 3,082 Found 18 Not desiring or requiring further visits 10 Removed and not traced 384 Died 152 Remaining under supervision end of second year of birth 2,554 Mortality per 1,000 visited, second year 56.1 Vital Statistics, 1915. Remaining under supervision end of second year of birth 2,737 Not desiring or requiring further visits 10 Removed and not traced 292 Died 71 Remaining under supervision end of third year of birth 2,364 Mortality per 1,000 visited third year 29.1 Vital Statistics, 1914. Remaining under supervision end of third year of birth 1,704 Removed and not traced 88 Died 17 Remaining under supervision end of fourth year of birth 1,599 Mortality per 1,000 visited, fourth year 10.5 I remain, Sir, Your obedient Servant, ALICE E HALL. 1ll Public Health Offices, Bow Road, E. 3. April 28th, 1919 To the Medical Officer of Health. Sir, I respectfully beg to present my Second Annual Report. Twice each week I have attended the Bow Maternity Centre, Old Ford —during my absence on holiday one of the West Ham Health Visitors attended. Patterns of infant clothes have been given to the mothers and in some cases the garments have been cut at the Centre. The Annual Baby Show was held in July and was successful. All sanitary defects found on my district have been reported to the Medical Officer of Health. All particulars of my work are given below in the tabulated form. Children under supervision at the end of December, 1918—1,288. Visits. Visits 289 Died before visit 10 Removed before visit 2 Stillbirths 11 Visits not wished for 4 Re-visits. Re-visits paid to children under one year 1,031 Re-visits paid to children over one year 2,370 Died aged one year and over 61 Removed, aged one year and over 114 Ophthalmia Neonatorum. Visits 4 Re-visits 6 Sight injured 0 112 Zymotic Enteritis. Visits 26 Re-visits 4 Recovered 24 Died 2 Measles. Visits 176 Re-visits 90 Died 14 Maternity Centre Infants weighed 2,506 Miscellaneous. Visits 115 The Borough Council provided free of charge the following :— No. of cases Cow's milk 3 Dried milk 8 Lactogol 2 Malt extract 4 Virol 2 This help has been much appreciated by the mothers, and has only been given in necessitous cases, upon the recommendation of Dr. Kidd. I am, Sir, Your obedient servant, NELLIE BROCKLEHURST.