POP 26 Metropolitan Borough of Poplar. Annual Report for the YEAR 1920, 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. CONTENTS. PAGE Summary of Vital Statistics V Vital Statistics 1 Population 1 Births and Transferable Births 2 Illegitimate Births 4 Birth Rate 5 Marriages 6 Marriage Rate 5 Deaths 5 Deaths of Illegitimate Children 6 Death Rate 6 Zymotic Diseases, Death Rate 7 Respiratory Diseases, Death Rate 7 Infantile Mortality—Notification of Births Act, 1907—Tables 8, 37 Ophthalmia Neonatorum, Notifications, Public Health (Ophthalmia Neonatorum) Regulations, 1914: Results, etc., of Cases, 1014-1920 9 Age Mortality 10 Tubercular Diseases, Deaths, Death Rate 10 Phthisis—Deaths 11 Prevention of Consumption—Notifications; Summaries of Notifications Received; Number of Notifications on Form D; Actual Number of Cases on Register at end of year 1920. 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 50); Report of Tuberclosis Officer (see page 96) 11 Tables of Deaths 18 Deaths from Drowning, &c 21 Deaths of Persons of Unknown Addresses, included in the Mortality Statistics 21 Vital Statistics, Tables 23 Notes on Nomenclature of Diseases 27 Tables of Deaths (Classification); Deaths 28 Tables of Deaths in Public Institutions 36 Tables of Infectious Diseases 41 Zymotic Diseases, Notifications; Institutions, Errors in Diagnosis; Infectious Diseases in Milkshops and on Homeworkers' Premises 48 Disinfecting Department—Rooms and Articles (Infectious Diseases and Verminous) Disinfected 50 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, 1920, and Expenditure for year ended 31st March, 1920. Average expenditure for the three years ended March, 1920. Estimated Expenditure for the year ending 31st March, 1921, and for the year ending 31st March, 1922, 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 51 Verminous Children attending School—London County Council (General Powers) Act, 1907, Children Act, 1908, Number of Verminous Children Bathed, Itch Cases56 Cleansing of Persons Act, 1897 57 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 57 Plague 58 Anthrax 58 A6051 a- 2 iv. PAGE Glanders—London (Notification of Glanders) Order, 1907 58 Hydrophobia 58 Puerperal Fever—Number of Cases, Deaths 59 Small-pox 59 Vaccination—Vaccination Returns 59 Frysipelas 60 Scarlet Fever 60 Continued and Typhus Fevers 61 Typhoid Fever—Notifications, Rate per 1,000 Persons living, Errors in Diagnosis, Bacteriological Examinations of Doubtful Cases, Deaths 61 Dlphtheria (including .Membranous Croup)—Notifications, Deaths, Bacteriological Examinations, Errors in Diagnosis, Isolation, Diphtheria Antitoxin (London) Order, 1910 63 Whooping Cough—Deaths 64 Influenza Deaths 65 Measles—Deaths, Outworkers 66 "Spotted Fever" (Epidemic Cerebro-Spinal Meningitis) 67 Acute Polio-Myelitis or Acute Polio-Encephalitis and Acute Encephalitis Lethargica 67 Diarrhoea and Enteritis, Deaths, Notification of Zymotic Enteritis and Summer Diarrhoea 68 Inquests and Deaths from Violence 70 Mortuary—Number of Bodies Received into Council's Cottage Street Mortuary 71 Canal Boats 71 Workshops, Workplaces, Laundries and Outworkers 72 Table A—Number of Inspections of,&c., of Bakehouses. Laundries, 'Workshops, Workplaces, Places where Food is Prepared, Milk Premises, Cowsheds, Slaughterhouses, Offensive Businesses, Ice Cream Premises and Homeworkers' Premises 72 Table B—Lists of Trades, Workshops, &e 73 Tables C, D, E and F—Filled in at the request of the Secretary of State, Factories, Workshops, Laundries, Workplaces, Homework, &c 75—78 Bakehouses—Inspections 78 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 79 Hairdressers' Premises 79 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 79 Smoke Nuisances 80 Ice Cream 80 Food and Drugs Acts—Results of Analyses, Legal Proceedings, Preservatives in Butter; Preservatives in Margarine 81 Houses Let in Lodgings or Occupied by Members of more than one Family, Chinese Quarter 84 Housing—Housing Acts, 1890-1919; Housing (Inspection of District) Regulations, 1910; Representations to Council under the Housing of the Working Classes Act, 1890, Part II Additional Staff 84 London County Council (General Powers) Act, 1904, Verminous Rooms 85 Rats and Mice Destruction 86 Schools—Inspection of Schools 86 Rag Flock Act 86 Sanitary Inspectors' Work—Tabulated List of Sanitary Inspections, &c., Overcrowding, General, Legal Proceedings 86 Reports— Dr. W. C. P. Smith (Tuberculosis Officer) 96 Miss Alice E. Hall (Chief Health Visitor) 101 Mr. C. Hammond Williams (Clinic Dental Surgeon) 112 V. SUMMARY OF VITAL STATISTICS FOR 1920. Area of Borough (excluding Water)* 2 136 acres „ Poplar Sub-District 1,004 ,, „ Bromley 589 „ ,, Bow 543 „ Population (Census 191l)—Borough 162,442 ,, „ Poplar Sub-District 56,393 „ „ Bromley ,, 65,226 ,, ,, Bow „ 40,823 „** Estimated to Middle of 1920—Boiough 159,766 159,941 „ „ „ Poplar Sub-District 55,503 55,563 ,, „ Bromley ,, 63,970 64,0410 ,, ,, ,, Bow „ 40,293 40 337 Density—Borough 74.79 ,, Poplar Sub-District 55-28 „ Bromley „ 108.60 „ Bow „ 74.20 Marriages—Borough 2,986 ,, Poplar Sub-District 1,286 „ Bromley „ 1,172 ,, Bow „ 528 Births—Borough 5,457 ,, Poplar Sub District 1,841 ,, Bromley 2,294 ,, Bow 1,322 Birth Rate—Borough 34.11 „ Poplar Sub-District 33.13 ,, Bromley „ 35.82 ,, Bow „ 32.77 Deaths—Borough 2,352 „ Poplar Sub-District 818 ,, Bromley „ 931 ,, Bow „ 603 Death Rate—Borough 14.72 „ Poplar Sub-District 14.73 „ Bromley „ 14.55 ,, Bow „ 14.96 Infantile Mortality—Borough 81 per 1,000 births „ Poplar Sub-District 83 „ „ „ Bromley „75 „ „ ,, Bow ,, 90 „ ,, Inhabited Houses (Census 1911)—Borough 22,472 „ „ Poplar Sub-District 8,201 „ „ Bromley „ 8,721 ,, ,, Bow ,, 5,550 *Land and Inland Water. Inland Water only Tidal Water and Foreshore. Acres. Acres. Acres. Sub-Districts Bow Bromley Poplar 555.7 605.8 1166.2 12.5 17.3 161.9 9.8 19.1 296.9 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 i'alics end of first paragraph, page 2. Without water. Metropolitan Borough of Poplar. COMPRISING THE REGISTRATION SUB-DISTRICTS OF POPLAR, BROMLRY POW. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Sir, Ladies 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-eighth Annual Report, which deals with the year 1920. The reports of the Tuberculosis Officer, the Chief Health Visitor, and the Clinic Dental Surgeon are appended, but those of the Sanitary Inspectors have not been printed, the work as far as possible being shown in tabulated form. VITAL STATISTICS. The population of the Borough, calculated by the Registrar General is 159,766 for the death rate and 159,941 for the birth rate † :— London. Poplar. Bromley. Bow. 4,531,971 † 55,503 63,970 40,293 4,552,907 † 55,563 64,041 40,337 being 68.63 per acre for the Borough of Poplar, 47.59 per acre in Poplar Sub-District, 105.59 in Bromley, and 72.50 in Bow.* These estimated populations are the figures used in calculating the various rates in the present Report. * These figures are calculated upon the acreage of the district including the inlan water area, not tidal and foreshore, Exclusive of area covered by water they are :— 74.79 per acre for the Borough of Poplar, 55.28 for the Sub-District of Poplar, 108.60 for the Sub-District of Bromley, and 74.20 for the Sub-District of Bow. County of London 60.0 (Census 1911). † Based on the returns furnished under the scheme for rationing of food. † See italics end of first paragraph, page 2. 2 The rates in Tables IV, V, VI, and VII for 1915—1920, were calculated upon the populations estimated by the Registrar General. 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 1920: For the death rate 159,766 „ ,, birth „ 159,941 During the year 1920 births took place in institutions within the Borough as follows :— Males. Females. Total Remarks. Poplar Institution 25 23 48 All Poplar Borough births except one male and one female. St. Andrew's Hospital 13 27 40 All Poplar Borough births except eight females. Bromley House Institution 9 7 16 14 Stepney births, one Swanley, and one Poplar. 31, Sturry Street 0 0 0 231, Brunswick Road 12 11 23 11 Poplar Borough births remainder non-residents. The number of births as per headings of Registrars' weekly ret urns was as follows :— Males. Females. Totals. Poplar 887 790 1,677 Bromley 1,120 1,075 2,195 Bow 634 601 1,235 Totals 2,641 2,466 5,107 The corrected number of births with additions and subtractions is as follows:—* Males. Females. Totals. Poplar 955 886 1,841 Bromley 1,176 1,118 2,294 Bow 683 639 1,322 Totals'!" 2,814 2,643 5,457 * See page 3. †See Page 4, transferable Births. 3 Particulars. Males. Females. Totals. *Poplar (Sub-District). Registrar's Weekly Returns 887 790 1,677 Births occurring outside the Sub-District of persons belonging thereto :— Mothers' Home, Commercial Road 59 82 82 105 187 London Hospital 4 3 St. Bartholomew's Hospital 1 — City of London Lying-in Hospital 1 1 Stepney Borough 2 — St, Andrew's Hospital 3 5 Brunswick Road, Bromley S.D. 2 4 City of London Workhouse 1 — Bromley House Institution — 1 Queen Charlotte's Hospital 1 2 Chelsea Borough 1 1 Royal Free Hospital — 1 (Guy's Hospital 1 — Paddington Green Children's Hospital 1 2 Maternity Hospital, St. Pancras — 1 St. Marylebone Workhouse 1 — St. Marylebone Borough — 1 Islington Borough 1 — Southwark Borough 1 — Lewisham Borough 1 — Hornsey M.C 1 — Beckenham — 1 Births occurring within the Sub-District of persons not belonging thereto :-— Poplar Institution Bromley 7 14 6 9 23 Bow7 1 Others — 2 31, Sturry Street — — 1,841 Births, nett 955 886 Bromley. Registrar's Weekly Returns Births occurring outside the Sub -District of persons belonging thereto :— 1,120 1,075 2,195 Mothers' Home, Commercial Road 63 85 57 77 162 Poplar Institution 7 6 City of London Lying-in Hospital 2 5 London Hospital 4 — Lving-in Hospital, Lambeth 1 — (Salvation Army Hospital — 1 Queen Mary's Hospital 1 3 Paddington Green Children's Hospital 1 1 1 Kensington Workhouse — Hackney Borough 2 — Northampton 1 — St. Pancras Borough — 1 Stepney Borough 1 1 Teddington 1 — West Ham C.B 1 — Westminster, City of — 1 Births occurring within the Sub-District of persons not belonging thereto :— St. Andrew's Hospital 11 29 19 34 63 Bromley House Institution 9 7 231, Brunswick Road 9 8 Births, pett 1,176 1,118 2,29 4 Particulars. Males. Females. Totals. Bow. Registrar's Weekly Returns 634 601 1,235 Births occurring outside the Sub-District of persons belonging thereto : — Mothers' Home, Commercial Road 12 49 8 38 87 Poplar Institution 7 1 St. Andrew's Hospital 5 6 London Hospital 5 7 City of London Lying-in Hospital 4 6 Salvation Army Hospital, Hackney 3 1 Queen Charlotte's Hospital 1 — Elizabeth Garrett Anderson Hospital — 1 Forest Gate Sick Home 1 1 Queen Mary's Hospital, West Ham 3 1 St. Bartholomew's Hospital 1 2 Whitechapel Infirmary 1 1 Hackney Borough 2 — Hampstead Borough 1 — llford U.D.C 1 — Paddington Borough 1 — ■ Stepney Borough 1 2 Wanstead U.D.C. — 1 Births, nett 683 639 1,322 Transferable Births Registered during the year 1920. At the beginning of the year 1921 the Registrar-General afforded the following information for the year ended 31st December. 1920 :— Registered Births. Inward Transfers. Outward Transfers. Legitimate —Males 2,576 178 9 Females 2,434 181 13 Illegitimate—Males 57 14 5 Females 49 16 8 Total —Males 2,633 192 14 Females 2,483 197 21 The corrected total births for the Borough, according to the Registrar General, is :— Males. Females. Total. 2,811 2,659 5,470 giving a rate of 34.20 per 1,000 inhabitants. The number of illegitimate births belonging to the Borough, according to the Registrar General, is:— Males. Females. Total. 66 57 123 5 The annual birth rate per 1,000 living being :— Poplar. Bromley. Bow. Borough of Poplar. County of London 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 1919 .. 26-08 .. 25-49 . 21-42 .. 24-67 . 18-5 1920 .. 33-13 .. 35-82 . 32-77 .. 34-11 . 26-5* Marriages. During the year the marriages of 2,986 persons were registered in the Borough, giving an annual rate of 18-66 per 1,000 of the estimated population, the rate for England and Wales being 201, and for London 216. The annual marriage rate per 1,000 living being :— Poplar. Bromley. Bow. Borough of Poplar. County of London. 1916 . 22-11 . 15-62 . 13-60 .. 17-37 . 19-0 1917 19-55 . 1393 . 1145 .. 15-25 . . 175 1918 . 2312 . 13-70 . 12-72 .. 16-73 . . 19-4 1919 . 14-28 . 17-50 . 34-92 .. 20-78 . . 22-1 1920 . 2314 . 18-30 . 13-08 .. 18-66 . . 21-6 Deaths. During the year 2,318 deaths were registered in the Borough of Poplar, 473 deaths having occurred in the Sub-District of Poplar, 1,522 in Bromley, and 323 in Bow ; from the 473 deaths which took place in Poplar there must be deducted 31 deaths of non-residents, and to the remainder must be added 376 deaths which occurred in outlying institutions, making a total of 818 deaths of Poplar parishioners. Tieating the 1,522 registered deaths in Bromley in a similar manner, viz., deducting 763 deaths of non-parishioners and adding 172 deaths in outlying institutions, the deaths to be assigned to this sub-district will bo found to be 931. From the 323 Bow deaths, there must be deducted 2 nonresidents and added 282 deaths in outlying institutions, making a total of 603 deaths. * The rate in England and Wales in 1920 was 25-4 per 1,000 of the estimated population. 6 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 2,318 deaths which were registered there must be deducted 410 deaths of actual non-residents, and 444 deaths in institutions entirely outlying must be added, making a total for the Borough of 2,352 upon which the death rate is calculated. The 818 deaths in Poplar included 15 illegitimate children, 9 male and 6 female ; the 931 deaths in Bromley included 15 illegitimate children, 8 male and 7 female ; the 603 Bow deaths included 5 illegitimate children, 3 male and 2 female, making a total for the Borough of 35 deaths of illegitimate children, 20 male and 15 female. Males. Females. Totals. Poplar 461 357 818 Bromley 496 435 931 Bow 311 292 603 Totals 1,268 1,084 2,352 The male births in the Borough exceeded those of the female by 171, and the male deaths exceeded those of the female by 184 which makes a gain of 13 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 1916 17 .07 15.91 15.77 16.27 14.3 1917 18.36 16.76 14.89 16.84 15.0 1918 23.87 22.32 21.98 22.77 18.9 1919 15.17 14.14 13.75 14.40 13.4 1920 14.73 14.55 14.96 14.72 12.4 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 41, East Districts. 7 ZYMOTIC DISEASES. Measles, scarlet fever, pertussis, diphtheria and membranous croup, fever small-pox, diarrhoea, and enteritis. Death rates per 1,000 living. Poplar. Bromley. Bow. Borough of Poplar 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 1919 1.19 0.82 1.18 1.04 1920 1.24 1.31 1.61 1.36 Proportion of deaths to 1,000 deaths from all causes. Poplar. Bromley. Bow. Borough of Poplar. 1916 89.13 95.15 98.86 94.25 1917 89.61 123.57 96.47 104.67 1918 87.29 103.44 96.89 95.97 1919 79.01 58.62 86.30 72.75 1920 84.35 90.22 107.79 92.68 RESPIRATORY DISEASES. Bronchitis, pneumonia (all forms) and other diseases of respiratory organs Death rates per 1,000 living. Poplar. Bromley. Bow. Borough of Poplar. 1916 3.47 3.49 3.78 3.55 1917 3.63 4.33 3.12 3.78 1918 5.05 4.99 4.26 4.83 1919 2.97 3.25 2.63 3.00 1920 3.69 3.82 3.47 3.69 Proportion of deaths to 1,000 deaths from all causes. Poplar. Bromley. Bow. Borough of Poplar. 1916 203.26 219.62 239.86 218.61 1917 197.81 258.56 209.64 224.65 1918 211.75 223.73 193.79 212. 08 1919 196.29 229.88 191.36 208.31 1920 250.61 26314 232.17 250.85 8 INFANT MORTALITY.* Infantile Mortality; Notification of Births Act, 1907. Infantile Mortality. There were 153 deaths of children under one year of age belonging to Poplar, 174 deaths under one year of age belonging to Bromley, and 120 deaths under one year of age belonging to Bow, making a total for the Borough of 447.† The death rates of children under one year per 1,000 births for the past 13 years being :— Poplar. Bromley. Bow. Borough of Poplar. County of 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 1919 82.75 80.78 87.86 83.05 85 1920 83.10 75.85 90.77 8191** 75 * For Tables of Infantile Mortality, see Tables XIII, XIV, XV and XVI, pages 37.40. † The 447 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 101). Mortality rate among infants visited was 69.0 per 1,000. The infants visited are for the most part in the poorest portions of the Borough, and the rate refers to those born in 1919. 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 „ „ „ 7807 1917 „ ,, ,, 79.2 1918 „ „ 67.9 1919 ,, ,, 69.0 9 Notification of Births Act, 1907. During the year 5,049 notifications were received under the Notification of Births Act, 1907. OPHTHALMIA NEONATORUM. Notifications of Ophthalmia Neonatorum. Sixty-one cases of Ophthalmia Neonatorum were notified during the year—25, Poplar; 25, Bromley; and 11, Bow. Six cases were treated in hospitals—3, Poplar; 0, Bromley; and 3, Bow. Summary, 1920. District. Notifications. (10 Actual Cases. (2.) Midwives' Notifications.† (3.) Notified by Midwives only. (4.) Poplar 37 25 12 4 Bromley 35 25 14 9 Bow 14 11 1 1 Grand Totals 86 61 27 14* * Included in Cols. 1, 2 and 3. † Also notified by medical men. Results, etc., of Cases of Ophthalmia Neonatorum, 1914-1920. Year. Number of Cases Notified. Died while under Supervision. Removed while under Supervision. Born in Poplar Institution, not visited. Sight of One Eye— Damaged. Destroyed. Recovered. 1914 75 2 — — — — 73 1915 64 1 — — — 1* 62 1916 60 — — — — — 60 1917 39 1 — 1 I† — 36 1918 40 — — — I† — 39 1919 61 — — — — 1* 60 1920 61 1 1 — — — 59 Totals 400 5 1 1 2 2 389 * Midwife attended. † Doctor attended. 10 AGE MORTALITY. The numbers of deaths from one year to 65 years of age was 468 for Poplar, 531 for Bromley, and for Bow 327, making a total for the Borough of Poplar of 1,326. The annual death rates per 1,000 living for the past 5 years being :— Poplar. Bromley. Bow. Borough on Poplar 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 1919 8.69 7.93 7.32 8.04 1920 8.43 8.30 8.11 8.29 The numbers of deaths over 65 years was 197 for Poplar, 226 for Bromley, and 156 for Bow, making a total of 579 for the whole Borough. The annual death rates per 1,000 living for the past 5 years being: — Poplar. Bromley. Bow. Borough of Poplar. 1916 4.04 3.63 5.03 4.13 1917 4.83 4.49 3.95 4.47 1918 5.94 5.04 5.85 5.56 1919 4.23 4.06 4.46 4.22 1920 3.54 3.53 3.87 3.62 TUBERCULAR DISEASES.* (Deaths at all ages.) Poplar. Bromley. Bow. Borough of Poplar. 1916 138 120 68 326 1917 138 126 73 337 1918 140 127 89 356 1919 84 86 52 222 1920 99 101 64 264 * Including phthisis. Death rates per 1,000 persons living. Poplar. Bromley. Bow. Borough of Poplar. 1916 2.56 1.93 1.73 2.10 1917 2.76 2.19 2.01 2.34 1918 2.88 2.27 2.52 2.55 1919 1.57 1.39 1.34 1.44 1920 1.78 1.57 1.58 1.65 11 Proportion of deaths to 1,000 deaths from all causes. Poplar. Bromley. Bow. Borough of Poplar. 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 1919 103.70 98.85 97.56 100.31 1920 121.02 108.48 106.13 112.24 PHTHISIS. Deaths (all ages). Poplar. Bromley. Bow. Borough of Poplar. 1916 96 97 59 252 1917 113 100 63 256 1918 112 112 74 298 1919 74 74 47 195 1920 84 85 54 223 PREVENTION OF CONSUMPTION. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. TREATMENT OF TUBERCULOSIS. Notifications ; Summaries of Notifications Received ; Number of Notifications on Form " D " ; Actual Number of Cases on Register, end of year 1920; 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 50; Report of Tuberculosis Officer, see page 96. A6051 B 12 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications received during the period from the 4th January, 1920, to the 1st January, 1921, 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. Pulmonary—Males 2 13 27 14 20 20 48 57 43 22 4 270 348 2 3 5 5 6 127 Females 2 7 19 14 30 25 55 40 27 8 1 228 290 — 1 — 1 2 7 58 Non-Pulmonary— Males 2 17 27 10 3 1 1 4 1 2 68 83 1 3 2 6 10 2 6 Females 4 15 24 21 10 3 5 3 1 1 1 88 97 1 4 3 8 12 2 10 Totals 10 52 97 59 63 49 109 104 72 33 6 654 818 2 10 8 20 29 17 201 81 Age Periods. Notifications on Form B. Number of Notifications on Form c. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. 0 to 1 1 to 5 5 to 10 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 2 7 12 20 23 19 8 2 102 132 2 2 4 4 4 44 Females 2 3 5 4 13 19 9 3 — 74 95 — 1 — 1 2 1 22 Non-Pulmonary— Males 2 6 12 5 — — 2 — — — 28 34 1 2 1 4 7 1 1 Females 2 5 7 1 — 2 1 1 — 32 38 — — — — 2 1 3 Totals 7 16 31 17 33 46 29 12 2 236 299 1 5 3 9 15 7 70 A6051 B 2 14 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications received during the period from the 4th January, 1920, to the 1st January, 1921, in Bromley (Sub-District). Ago 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 8 6 6 10 4 17 25 18 8 1 104 136 1 1 1 1 51 Females — 4 7 5 13 10 24 15 7 2 1 88 115 — — — — — 3 19 Non-Pulmonary— Males 7 8 2 1 1 1 1 1 22 28 1 1 2 3 1 4 Females — 8 10 10 5 1 1 1 — — — 36 37 1 4 3 8 10 — 5 Totals 1 27 31 23 29 16 42 42 26 11 2 250 316 1 5 5 11 14 5 79 15 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. • Summary of Notifications received during the period from the 4th January, 1920, to the 1st January, 1921, 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 5to 10 10 to 15 Total Primary Notifications Poor Law Institutions. Sanatoria Pulmonary— Males - 3 14 4 6 4 11 9 6 6 1 64 80 — — — 1 32 Females — — 7 2 8 11 18 6 11 3 — 66 80 — — — — 3 17 Non-Pulmonary— Males 4 7 3 1 1 1 — 1 18 21 — Females 2 2 7 1 2 1 4 — — — 1 20 22 — — — — — 1 2 Totals 2 9 35 10 17 16 34 16 17 10 2 168 203 — — — — — 5 52 16 Number of Notifications on Form D. (Cases Discharged from Poor Law Institutions and Sanatoria.) Poor Law Institutions Pulmonary Poplar. Bromley. Bow. Totals. M 4 4 2 10 F 2 3. 1 6 NonPulmonary M 1 — 1 2 Sanatoria F — 1 — 1 Pulmonary M 41 44 28 113 F 21 18 12 51 NonPulmonary M 1 3 3 7 F 5 — 2 7 Pulmonary M 45 48 30 123 Totals F 23 21 13 57 NonPulmonary M 2 3 4 9 F 5 1 2 8 Actual Number of Cases on Register. Corrected number of cases on Register at beginning of year 1920 4,903 Add New cases during year 683 5,586 Deduct:— Died (notified cases only) 247 326 Removed, etc. 7 Arrested or cured 72 Number of cases on Register beginning of 1921 5,260 Bacteriological Examinations. During the year ended 31st December, 1920, 156 samples of sputum were bacteriologically examined at the Tuberculosis Dispensary. The Tubercle bacillus was found to be present in 36 instances (23.0 per cent.) 17 Borough of Poplar Dispensary for the Prevention of Consumption. This institution was taken over by the Poplar Borough Council 1st April, 1920. Number of Notifications received during the year 1st January, to 31st December, 1920 :— 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 — 10 14 10 10 6 34 30 13 6 — 133 Females — 4 13 9 17 19 40 33 13 7 — 155 Non-pulmonary— Males 15 13 7 1 — 2 1 — — — 39 Females — 12 13 9 — 1 1 1 — — — 37 Totals — 41 53 35 28 26 77 65 26 13 — 364 Distribution of Cases in the Borough, etc. Insured. Uninsured. Total. Bromley 34 73 107 Bow 45 65 110 Poplar 46 101 147 Out of District 5 1 6 130 240 370 The number of new cases who attended at the Dispensary during the year 1920 was 2,017 ; of these, 370 were tuberculous. There was a total of 7,919 attendances at the Dispensary. Deaths, Tubercular Diseases and Phthisis— Number and Rates see pages 10 and 11. Disinfection of Rooms and Articles see page 50. Report of Tuberculosis Officer, see page 96. 18 TABLE I. Deaths during the year 1920 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 130 101 62 97 390 Poplar Institution 14 10 5 6 35 Baffin Buildings ... ... 1 ... I Council Buildings ... ... ... ... ... Grosvenor Buildings 8 4 2 2 16 Hanbury Buildings ... ... ... ... ... Hudson Buildings ... ... ... ... ... Montreal Buildings 3 ... ... ... 3 Ontario Buildings ... 2 ... ... 2 Ottawa Buildings ... ... ... ... ... Prestage Buildings ... ... ... ... ... Quebec Buildings ... ... ... ... ... Toronto Buildings ... ... ... ... ... Winnipeg Buildings ... ... 1 ... 1 River Thames 2 4 2 3 11 East India Docks 2 1 1 1 5 West India Docks 3 ... 1 ... 4 South-West India Docks ... ... ... ... ... Poplar Dock, G.W.R. ... ... ... ... ... Millwall Docks 1 1 1 ... 3 Orchard House Dry Dock ... ... ... ... ... Limehouse Cut ... ... ... ... ... Highway ... 1 ... 1 2 Trinity Wharf ... ... ... ... ... Bow Creek ... ... ... ... ... Police Station ... ... ... ... ... 163 124 76 110 473 Deaths occurring outside the subdistrict among persons belonging thereto* + 87 98 94 97 376+ Deaths occurring within the subdistrict among persons not belonging thereto — 8 10 4 9 31— Deaths at all ages—nett 242 212 166 198 818 * Including 211 deaths in the Bromley Sub-District:—St. Andrew's Hospital, 172 ; Poplar Hospital, 37; and Bromley Sub-District, 2. 19 TABLE II. Deaths during the year 1920 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 164 95 85 102 446 St. Andrew's Hospital 218 221 155 199 793 Bow Institution 22 19 22 28 91 Bromley House Institution 8 7 6 9 30 Poplar Hospital 40 32 47 40 159 Adelaide Buildings ... ... ... ... ... Melbourne Buildings ... ... ... ... ... Sydney Buildings ... 1 ... 1 2 River Lee ... ... ... ... ... Limehouse Cut ... ... ... ... ... Highway ... ... ... 1 1 Bow Creek ... ... ... ... ... 452 375 315 380 1522 Deaths occurring outside the subdistrict among persons belonging thereto* + 50 33 27 62 172+ Deaths occurring within the subdistrict among persons not belonging thereto – 204 198 .170 191 763— Deaths at all ages—nett 298 210 172 251 931 * Including 7 deaths in the Poplar Sub-District, viz.:—Poplar Institution, 5; and East India Docks, 2. 20 TABLE III. Deaths during the year 1920 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 shown as separate localities. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Bow Sub-District 133 80 33 74 320 Highway ... ... 1 ... 1 River Lee ... ... 1 ... 1 Duckett's Canal ... ... ... ... ... Bow Station, N. L. Ry. 1 ... ... ... 1 134 80 35 74 323 Deaths occurring outside the subdistrict among persons belonging thereto* + 61 74 67 80 282 + Deaths occurring within the subdistrict among persons not belonging thereto – ... 1 1 2 Deaths at all ages—nett 195 153 101 154 603 * Including 168 deaths in other parts of the Borough (Poplar and Bromley SubDistricts), viz.:—Poplar Institution, 7; St. Andrew's Hospital, 155; Poplar Hospital, 4 ; Highway, Poplar, 1 ; and Highway, Bromley, 1. 21 DEATHS FROM DROWNING, ETC., AND DEATHS OF PERSONS OF UNKNOWN ADDRESSES INCLUDED IN THE MORTALITY STATISTICS. 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 any other District:— Poplar (Sub-District). 25th Feb. s.s. Ulm, West India Dock. Deck hand. of Calcutta. Male, 41. Found dead. Pneumonia. Natural. Inquest. 6th Mar. Millwall Docks. Unknown. Male, 35. Found dead. Suffocation by drowning, but how deceased got into the water and was so drowned evidence fails to prove. Inquest. 9th Mar. River Thames, off Maconochies' Wharf Unknown. Female, about 5 minutes Violent. Hemorrhage from umbilical cord due to the cord not having been tied, and want of attention at birth, but under what circumstances evidence fails to prove. Inquest. 15th April. River Thames, off Blackwall Stairs. Unknown. Male, about 5 minutes. Found dead. Want of attention at birth, but under what circumstances the said male child was born and died evidence fails to prove. Inquest. 28th May. East Ferry Road. Unknown. Male. halfhour. Violent. Asphyxia by strangulation. Murder. Inquest. 29th Aug. Millwall Docks. Fireman, s.s. Noelle, Ireland. Male, 23. Violent. Suffocation by drowning caused by falling overboard while trying to sit on the rail while under the influence of alcohol. Inquest. 6th Dec. River Thames, off Morton's Wharf. Unknown. Female, 5 minutes. Found dead. Lack of attention at birth. Inquest. 22 Bromley (Sub-District). 29th Mar. Poplar Hospital. Fireman, s,s. Roon, of Calcutta. Male, 23. Influenza. Bronchopneumonia 1st June. Poplar Hospital. Unknown. Male, 60. Found dead. Angina pectoris. Natural. P.M. Inquest. 26th June. Bromley House Institution. Ship's Carpenter, of Rotterdam. Male, 64. Chronic Bronchitis, Asthma, and Syncope. 27th Dec. Poplar Hospital. Mess-room boy s.s. Ville dv Havre Male, 23. Violent. Asphyxia by drowning, the deceased having fallen into the water in the East India Dock whilst attempting to go ashore from the ship. Accidental. P.M. Inquest. 23 TABLE IV. Vital Statistics of Whole District during 1920 and Previous Years. Poplar (Whole Borough). 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. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 22.7 156,338‡ 1919 153,64‡ 3671 3949 24.6 2337 15.2 549 425 328 83 2213 14.4 160,051‡ 1920 159,766‡ 5107 5457 34.1 2318 14.5 410 444 447 81 2352 14.7 159,941‡ 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 tho 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 (land and inland water) 2327.7 Total population at all ages 162,442 Number of inhabited houses 22,472 Average number of persons per house 7.22 At Census of 1911 Total families or separate occupiers 35,158 ‡ See italics, page 2. 24 TABLE V. Vital Statistics during 1920 awl 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. 1 2 3 4 5 6 7 8. 9 10 11 12 13 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‡ 1919 53,371‡ 1347 1450 26.0 451 8.45 34 393 120 82 810 15.17 55,596‡ 1920 55,503‡ 1677 1841 33.1 473 8.52 31 376 153 83 818 14.7 55,563‡ Area of Sub-District in acres (land and inland water) 1166.2 Total population at all ages 56,393 Number of inhabited houses 8,201 Average number of persons per house 6.87 At Census, of 1911. Total families or separate occupiers 12,044. *† See notes, page 23. ‡ See italics, page 2. 25 TABLE VI. Vital Statistics during 1920 and Previous Years. Bromley 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 ox 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 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‡ 1919 61,516‡ 1514 1634 25.4 1609 26.1 902 163 132 80 870 14.14 64,083‡ 1920 63,970‡ 2195 2294 35.8 1522 23.7 763 172 174' 75 931 14.55 64,041‡ Area of Sub-District in acres (land and inland water) 605.8 Total population at all ages 65,226 Number of inhabited houses 8,721 Average number of persons per house 7.47 At Census of 1911. Total families or separate occupiers 14,256. *† See notes, page 23. ‡ See italics, page 2. 26 TABLE VII. Vital Statistics during 1920 and Previous Years. Bow 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. 1 2 3 4 5 6 7 8 9 10 n 12 13 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 39,438‡ 1919 38,757‡ 810 865 21.4 277 7.14 4 260 76 87 533 13.75 40,372‡ 1920 40,293‡ 1235 1322 32.7 323 8.01 2 282 120 90 603 14.96 40,337‡ Area of Sub-District in acres (land and inland water) 555.7 Total population at all ages 40,823 Number of inhabited houses 5,550 Average number of persons per house 735 At Census of 1911. Total families or separate occupiers 8,858. †See notes, page 23. ‡ See italics, page 2. 27 NOTES TO TABLES VIII., IX., X., XI., XII., XIII., XIV., XV. & XVI. Nomenclature of Diseases. All "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 entered 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 all 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 from 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), Gastro-enteritis, Gastro-intestinal catarrh, Muco-enteritis, Colitis, &c. Deaths from diarrhoea secondary to some other well-defined disease are included under the latter. 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 such 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 marasmus of infants, and want of breast-milk, but not from Atelectasis. A6051 c 28 29 TABLE VIII METROPOLITAN BOROUGH OF POPLAR. The Borough. Causes of, and Ages at, Death during the Year 1920. Causes of Death (see page 27). 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 Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 All causes Certified 2352 447 113 124 101 117 341 530 579 32 591 1 3 85 19 444 1175 Uncertified 1 Enteric Fever 4 ... ... ... 3 ... ... 1 ... ... 2 ... ... 1 ... 1 4 2 Small Pox 3 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... 3 3 3 Measles 33 5 12 15 1 ... ... ... ... ... 9 ... ... ... ... 1 10 4 Scarlet Fever 14 2 1 6 5 ...... ... ... ... ... ... ... ... ... ... 13 13 5 Whooping Cough 50 17 20 12 1 ... ... ... ... ... 19 ... ... ... ... 1 20 6 Diphtheria and Croup 59 4 9 26 19 1 ... ... ... ... a 2 ... ... 2 ... b 49 53 7 Influenza 53 1 ...... 4 1 7 23 12 5 ... 5 ... ... 2 ... 4 11 8 Erysipelas 9 2 ... ... ... ... 3 1 3 ... 4 ... ... ... ... ... 4 9 Phthisis (Pulmonary Tuberculosis) 223 7 2 2 9 35 102 60 6 ... 45 ... ... 2 ...... 62 109 10 Tuberculous Meningitis 26 7 4 8 4 2 ... 1 ... ... 6 ... ... 6 ... 5 17 11 Other Tuberculous Diseases 15 1 ... 4 5 3 ... ... 2 ... 7 ... ... 1 ... 4 12 12 Cancer, malignant disease 187 ... ... ... 1 3 17 86 80 1 76 ... ... 4 ... 18 99 13 Rheumatic Fever 6 ... ... ... 2 3 1 ... ... ... 1 ... ... 2 ... 2 5 14 Meningitis 17 6 ... 1 6 1 2 ... ... ... 3 ... ... 1 ... 8 12 15 Organic Heart Disease 159 ... ... 1 6 13 32 65 42 2 44 1 ... 5 **2 25 79 16 Bronchitis ... 326 44 13 3 ... 3 24 94 145 9 110 ... 1 ... ... 8 128 17 Pneumonia (all forms) 235 61 40 28 9 11 31 37 18 1 48 ... ... 14 *1 36 100 18 Other diseases of respiratory organs 29 2 1 1 1 3 5 12 4 ... 8 ... ... 1 ... 6 15 19 Diarrhoea and Enteritis ... 55 42 2 2 1 2 ... 1 5 2 7 ... 1 2 ‡2 15 29 20 Appendicitis and Typhlitis 7 1 ... ... 3 ... ... 2 1 ... 1 ... ... 3 ... 3 7 21 Cirrhosis of Liver 9 ... ... ... 1 ... 2 4 2 ... 1 ... ... ... ... 2 3 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease . 38 ... ... 1 1 ... 8 17 11 ... 11 ... ... 2 ... 13 26 23 Puerperal Fever 7 ... ... ... ... 1 6 ... ... ... 2 ... ... ... ... 5 7 24 Other accidents and diseases of Preenancv & Parturition 12 ... ... ... ... 2 10 ... ... ... 4 ... ... ... ... 1 5 2o Congenital Debility and Malformation, including Premature Birth 191 188 ... 2 ... 1 ... ... ... 3 31 ... ... 4 ... 18 56 26 Violent Deaths excluding Suicide 100 11 2 4 9 14 22 18 20 1 25 ... ...... 17 ¶12 29 84 27 Suicide 13 ... ... ... ... ... 3 8 2 2 1 ... ... ... ... 2 5 470 46 7 4 13 12 49 107 232 10 119 ... 1 16 §1 110 257 29 Diseases ill-defined or unknown ... 2 ... ... ... ... ... ... 1 1 1 ... ... ... ... †1 ... 2 Total Deaths ... ... ... ^ 2352 447 113 124 101 117 341 530 579 32 591 1 3 85 19 444 Sub-entries (included in above figures). 14 Cerebro-spinal Meningitis ... 8 2 ... ... 4 1 1 ... ... ... 1 ... ... ... ... 4 5 28 Encephalitis Lethargica 2 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 2 17 Pneumonia ... I 100 9 5 5 3 8 26 2 12 1 31 ... ... 3 ... 19 54 28 Dysentery ... 2 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 2 28 Tetanus 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 26 Murder 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 28 Actinomycosis 2 ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... 1 2 c 2 A6051 ** Highway, Bromley, 1 ; Highway. Bow, 1. * S.S. Vim, West India Dock, Poplar, 1. ‡ Bromley Sub-District, 2. ¶ River Thames, Poplar, 6 ; Millwall Docks, Poplar, 3 ; East India Docks, Poplar, 1 ; Highway, Poplar, 2. § River Thames, Poplar, 1. † S.S. Braemar Castle, East India Docks, Poplar, 1. (a) One Laryngeal Croup not notified as Diphtheria. b) One not notified. 30 31 TABLE IX. METROPOLITAN BOROUGH OF POPLAR. Sub-District of Poplar. Causes of, and Ages at, Death during the Year 1920. Causes of Death (see page 27). 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 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 Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 All causes Certified Uncertified 818 153 42 31 36 48 112 199 197 20 172 ... ... 37 14 165 408 1 Enteric Fever 3 ... ... ... ... 3 ... ... ... ... 2 ... ... 1 ... ... 3 2 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Measles 3 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Scarlet Fever 6 1 ... 2 3 ... ... ... ... ... ... ... ... ... ... 6 6 5 Whooping Cough 17 4 10 3 ... ... ... ... ... ... 9 ... ... ... ... ... 10 6 Diphtheria and Croup 17 ... 4 3 10 ... ... ... ... ... ... ... ... ... ... 13 13 7 Influenza 14 ... ... 3 1 2 4 4 ... ... ... ... ... ... ... 1 1 8 Erysipelas 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Phthisis (Pulmonary Tuberculosis) 84 3 1 1 ... 2 36 27 3 ... 16 ... ... 1 ... 22 39 10 Tuberculous Meningitis 10 3 1 3 2 1 ... ... ... ... ... ... ... 5 ... 2 7 11 Other Tuberculous Diseases 5 1 ... 1 3 ... ... ... ... ... 2 ... ... ... ... 2 4 12 Cancer, malignant disease 60 ... ... ... ... 2 6 31 21 1 25 ... ... 1 ... 7 34 13 Rheumatic Fever ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 ... 1 2 14 Meningitis 4 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... 3 3 15 Organic Heart Disease 46 ... ... ... 1 7 10 17 11 1 8 ... ... 1 ... 12 22 16 Bronchitis 114 13 7 1 ... ... 6 38 49 4 33 ... ... ... ... 3 40 17 Pneumonia (all forms) 79 19 14 9 3 4 13 12 5 ... 10 ... ... 8 *1 19 38 18 Other diseases of respiratory organs 1 2 1 ... ... ... 1 ... 8 2 ... 4 ... ... ... ... 2 6 19 Diarrhœa and Enteritis 23 17 1 ... 1 2 ... 1 1 1 2 ... ... 1 ‡2 6 12 20 Appendicitis and Typhlitis 2 ... ... ... 1 ... ... 1 ... ... 1 ... ... 1 ... ... 2 21 Cirrhosis of Liver 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 1 21a Alcoholism ... ... ... ••• ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 14 ... ... 1 ... ... 2 7 4 ... 4 ... ... 1 ... 3 8 23 Puerperal Fever 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 2 24 Other accidents and diseases of Pregnancy & Parturition 2 ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... 1 25 Congenital Debility and Malformation, including Premature Birth 69 67 ... 1 ... 1 ... ... ... 3 10 ... ... 3 ... 7 23 26 Violent Deaths, excluding Suicide 46 5 1 1 2 7 11 11 8 1 10 ... ... 8 ¶10 9 38 27 Suicide 7 ... ... ... ... ... 1 4 2 2 1 ... ... ... ... 1 4 28 Other Defined Diseases 174 15 3 1 3 6 20 3o 91 7 34 ... ... 5 §1 42 89 29 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total Deaths 818 153 42 31 30 48 112 199 197 20 172 ... ... 37 14 165 408 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis 3 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 2 28a Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Pneumonia 28 1 3 1 ... 1 10 10 2 ... 6 ... ... ... ... 12 19 28 Tetanus 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 1 26 Murder 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 28 Actinomycosis 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 * S.S. Vim, West India Docks, 1. ¶ River Thames, Poplar, 6; Millwall Docks, 3; Highway, Poplar, 1. ‡ Bromley Sub-District, 2. § River Thames, Poplar, 1. 32 33 table x. metropolitan borough of poplar. Sub-District of Bromley. Causes of, and Ages at, Death during the Year 1920. Causes of Death (see page 27). 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 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 Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 All causes Certified 931 174 40 59 42 39 141 210 226 5 261 1 3 44 165 484 Uncertified 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Small Pox 3 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... 3 3 3 Measles 12 1 5 6 ... ... ... ... ... ... 6 ... ... ... ... 1 7 4 Scarlet Fever 6 1 1 2 2 ... ... ... ... ... ... ... ... ... ... 5 5 5 Whooping Cough 17 6 6 4 1 ... ... ... ... ... 8 ... ... ... ... ... 8 6 Diphtheria and Croup 30 4 3 17 6 ... ... ... ... ... a 2 ... ... 2 ... b24 28 7 Influenza 20 ... ... 1 ... 1 10 5 3 ... 4 ... ... 2 ... 2 8 8 Erysipelas 5 1 ... ... ... ... 1 ... 3 ... 3 ... ... ... ... ... 3 9 Phthisis (Pulmonary Tuberculosis) 85 4 ... 2 5 13 44 15 2 ... 18 ... ... 1 ... 25 44 10 Tuberculous Meningitis 10 2 1 4 1 1 ... 1 ... ... 4 ... ... 1 ... 1 6 11 Other Tuberculous Diseases 6 ... ... 2 2 1 ... ... 1 ... 3 ... ... 1 ... 1 5 12 Cancer, malignant disease 79 ... ... ... 1 1 3 34 37 ... 30 ... ... 3 ... 6 39 13 Rheumatic Fever 3 ... ... ... ... 2 1 ... ... ... ... ... ... 1 ... 1 2 14 Meningitis 8 2 ... 1 3 1 1 ... ... ... 2 ... ... 1 ... 2 5 15 Organic Heart Disease 65 ... ... ... 4 4 15 28 14 1 25 1 ... 3 ... 9 39 16 Bronchitis 134 8 3 2 ... 2 12 38 59 1 52 ... 1 ... ... 2 56 17 Pneumonia (all forms) 98 26 17 9 3 4 14 18 7 1 23 ... ... 6 ... 11 41 18 Other diseases of respiratory organs 13 1 1 1 1 2 4 2 1 ... 4 ... ... 1 ... 4 9 19 Diarrhoea and Enteritis 16 12 ... 2 ... ... ... ... 2 ... 3 ... ... 1 ... 4 9 20 Appendicitis and Typhlitis 4 ... ... ... 2 ... ... 1 1 ... ... ... ... 2 ... 2 4 21 Cirrhosis of Liver 6 ... ... ... 1 ... 1 2 2 ... 1 ... ... ... ... 1 2 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 18 ... ... ... 1 ... 4 7 6 ... 5 ... 1 1 ... 6 12 23 Puerperal Fever 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 24 Other accidents and diseases of Preenancv & Parturition 7 ... ... ... ... ... 7 ... ... ... 1 ... ... ... ... 1 2 25 Congenital Debility and Malformation, including Premature Birth 72 ... ... ... ... ... ... ... ... ... 14 ... ... 1 ... 6 21 26 Violent Deaths, excluding Suicide 34 72 1 3 ... 4 5 7 5 ... 11 ... ... 6 ¶1 11 29 27 Suicide 3 ... ... 5 ... 1 2 ... ... ... ... ... ... ... 1 1 28 Other Defined Diseases 175 20 2 3 ... 3 16 44 83 2 45 ... 1 11 ... 35 94 29 Diseases ill-defined or unknown 1 ... ... ... 4 ... ... 1 ... ... ... ... ... ... †1 ... 1 Total Deaths 931 174 40 59 42 39 141 210 226 5 264 1 3 44 2 165 484 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis 2 ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 1 17 Pneumonia 48 7 ... 2 ... 4 13 16 6 1 16 ... ... 2 ... 5 24 28a Poliomyelitis ... ...7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28 Dysentery 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 28 Actinomycosis 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 28 Encephalitis Lethargica 2 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 2 ¶ East India Docks, Poplar, 1. (a) One Laryngeal Croup not notified as Diphtheria. † S.S. Braemar Casile, East India Docks, Poplar, 1. (6) One not notified. 34 35 TABLE XI. METROPOLITAN BOROUGH OF POPLAR. Sub-District of Bow. Causes of, and Ages at, Death, during the Year 1920. Causes of Death (see page 27). 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 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 Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. See Footnotes. Outlying Institutions. 1 2 3 4 5 6 7 8 9 10 All causes Certified 603 120 31 34 23 30 88 121 15f 7 155 4 3 1J 4 283 Uncertified 1 Enteric Fever 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 2 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Measles 18 3 7 7 1 ... ... ... ... ... 3 ... ... ... ... ... 3 4 Scarlet Fever 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 2 5 Whooping Cough 16 7 4 5 ... ... ... ... ... ... 2 ... ... ... ... ... 2 6 Diphtheria and Croup 12 ... 2 6 3 1 ... ... ... ... ... ... ... ... ... 12 12 7 Influenza 19 1 ... ... ... 4 9 3 2 ... 1 ... ... ... ... 1 2 8 Erysipelas 3 ... ... ... ... ... 2 1 ... ... 1 ... ... ... ... ... 1 9 Phthisis (Pulmonary Tuberculosis) 54 ... 1 ... 2 10 22 18 1 ... 11 ... ... ... ... 15 26 10 Tuberculous Meningitis 6| 2 2 1 1 ... ... ... ... ... 2 ... ... ... ... 2 4 11 Other Tuberculous Diseases 4 ... ... 1 ... 2 ... ... ... ... 2 ... ... ... ... 1 3 12 Cancer, malignant disease 48 ... ... ... ... ... 8 18 22 ... 21 ... ... ... ... 5 26 13 Rheumatic Fever 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 14 Meningitis 5 2 ... ... 3 ... ... ... ... ... 1 ... ... ... ... 3 4 15 Organic Heart Disease 48 ... ... 1 1 2 3 20 17 ... 11 ... ... 1 **2 4 IS 16 Bronchitis 78 13 3 ... ... 1 6 18 37 4 25 ... ... ... ... 3 32 17 Pneumonia (all forms) 58 16 9 10 3 3 4 7 6 ... 15 ... ... ... ... 6 21 18 Other diseases of respiratory organs 4 ... ... ... ... ... 1 2 1 ... ... ... ... ... ... ... ... 19 Diarrhoea and Enteritis 16 13 1 ... ... ... ... ... 2 1 2 ... ... ... ... 5 8 20 Appendicitis and Typhlitis 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 21 Cirrhosis of Liver 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 21a Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Nephritis and Bright's Disease 6 ... ... ... ... ... 2 3 1 ... 2 ... ... ... ... 4 6 23 Puerperal Fever 4 ... ... ... ... ... 4 ... ... ... 2 ... ... ... ... 2 4 24 Other accidents and diseases of Pregnancy & Parturition 3 ... ... ... ... 1 2 ... ... ... 2 ... ... ... ... ... 2 25 Congenital Debility and Malformation, including Premature Birth 50 49 ... 1 ... ... ... ... ... ... 7 ... ... ... ... 5 12 26 Violent Deaths, excluding Suicide 20 2 ... ... 2 3 6 ... 7 ... 4 ... ... 3 ¶ 1 9 17 27 Suicide 3 ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... 28 Other Defined Diseases 121 11 2 ... 6 3 13 28 58 1 40 ... ... ... ... 33 74 29 Diseases ill-defined or unknown 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 Total Deaths 603 120 31 34 23 30 88 121 156 7 155 ... ... 4 3 114 283 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis 3 ... ... ... 3 ... ... ... ... ... 1 ... ... ... ... 1 2 17 Pneumonia 24 1 2 2 3 3 3 6 4 ... 9 ... ... ... ... 2 11 ?8 Dysentery 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 28a Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ** Highway, Bromley, 1; Highway, Bow, 1. ¶ Highway, Poplar, 1. 36 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 27). Poplar Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. Total deaths in Public Institutions within the Borough. All causes Certified 35 793 91 30 159 1108 Uncertified ... ... ... ... ... ... 1 Enteric Fever ... 3 1 4 2 Small Fox ... ... ... ... ... ... 3 Measles ... 13 ... ... ... 13 4 Scarlet Fever ... ... ... ... ... ... 5 Whooping Cough ... 25 ... ... ... 25 6 Diphtheria and Croup ... 2 ... ... 2 4 7 Influenza ... 8 ... ... 4 12 8 Erysipelas ... 4 ... ... ... 4 9 Phthisis (Pulmonary Tuberculosis) ... 61 ... ... 4 65 10 Tuberculous Meningitis ... 7 ... ... 7 14 11 Other Tuberculous Diseases ... 8 ... ... 1 9 12 Cancer, malignant disease 1 105 9 2 8 125 13 Rheumatic Fever ... 1 1 1 2 5 14 Meningitis ... 3 ... ... 1 4 15 Organic Heart Disease 2 52 49 4 6 113 16 Bronchitis 10 146 13 1 ... 170 17 Pneumonia (all forms) 1 62 2 2 20 87 18 Other diseases of respiratory organs ... 9 1 ... 1 11 19 Diarrhoea and Enteritis 3 10 ... 1 4 18 20 Appendicitis and Typhlitis ... 2 ... ... 7 9 21 Cirrhosis of Liver ... 1 ... ... 1 2 21a Alcoholism ... ... ... ... ... 22 Nephritis and Bright's Disease ... 16 ... ... 2 18 23 Puerperal Fever ... 3 ... 1 ... 4 24 Other accidents and diseases of Pregnancy and Parturition ... 5 ... ... ... 5 25 Congenital Debility and Malformation, including Premature Birth 3 43 ... ... 5 51 26 Violent Deaths, excluding Suicide 2 33 ... ... 46 81 27 Suicide 2 1 ... ... ... 3 28 Other Defined Diseases 10 170 16 18 37 251 29 Diseases ill-defined or unknown 1 ... ... ... 1 Total Deaths 35 793 91 30 159 1108 Sub-Entries (included in above figures). 14 Cerebro-spinal Meningitis ... 1 ... ... 1 2 28a Poliomyelitis ... ... ... ... ... ... 17 Pneumonia ... 45 2 6 53 37 TABLE XIII. METROPOLITAN BOROUGH OF POPLAR. Whole Borough. Infantile Mortality during the Year 1920. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 27). 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 104 17 25 19 165 93 81 57 51 447 Uncertified ... ... ... ... ... ... ... ... ... ... Small Fox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 3 2 5 Scarlet Fever ... ... ... ... ... ... ... ... 2 2 Whooping Cough ... ... 1 ... 1 3 1 5 7 17 Diphtheria and Croup ... ... ... ... ... ... 1 ... 3 4 Erysipelas ... ... ... ... ... 2 ... ... ... 2 Tuberculous Meningitis ... ... ... ... ... ... 2 1 4 7 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... 4 1 3 8 Meningitis (not Tuberculous) ... ... ... 1 1 ... 2 2 1 6 Convulsions 4 ... 3 1 8 1 4 ... ... 13 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 3 3 2 8 11 11 8 6 44 Pneumonia (all forms) ... 1 2 1 4 12 16 18 11 61 Diarrhoea ... ... ... ... ... 4 7 5 16 Enteritis ... ... ... 1 1 8 10 5 2 26 Gastritis ... ... ... ... ... 2 1 1 ... 4 Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 1 ... ... ... 1 1 ... ... ... 2 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis 7 7 7 Congenital Malformations 4 2 3 1 10 7 3 ... 1 21 Premature birth 62 8 9 7 86 13 ... ... ... 99 Atrophy, Debility and Marasmus 18 3 4 3 28 21 14 3 2 68 Other Causes 8 ... ... 2 10 7 5 5 6 33 Total Deaths 104 17 25 19 165 93 81 57 51 447 Nett Births in the year Legitimate 5,347* Illegitimate 123* Nett Deaths in the year of Legitimate infants 412 Illegitimate infants 35 Medical Officer of Health's figures—Legitimate, 5,323; Illegitimate, 134; total, 5,457. * Registrar-General. 38 TABLE XIV. METROPOLITAN BOROUGH OF POPLAR. Poplar Sub-District Infantile Mortality during the Year 1920. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 27). 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 39 5 9 7 60 37 21 14 21 153 Uncertified Small Fox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 1 ... 1 Scarlet Fever ... ... ... ... ... ... ... ... 1 1 Whooping Cough ... ... 1 ... 1 1 ... ... 2 4 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... ......... ... ... 3 3 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... 1 1 2 4 Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... 1 2 Convulsions ... ... 2 1 3 1 1 ... ... 5 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 1 1 1 3 4 1 3 2 13 Pneumonia (all forms) ... ... ... ... ... 4 4 5 6 19 Diarrhoea ... ... ... ... ... ... 2 3 ... 5 Enteritis ... ... ... ... ... 5 4 1 ... 12 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at birth ... ... ... ... ... ... ... ... ... Atelectasis 3 ... ... ... 3 ... ... ... ... 3 Congenital Malformations 1 ... ... ... 1 6 1 ... ... 8 Premature birth 19 2 3 2 26 5 ... ... ... 31 Atrophy, Debility and Marasmus 10 2 2 2 16 7 5 ... ... 28 Other Causes 6 ... ... 1 7 3 1 ... 2 13 Total Deaths 39 5 9 7 60 37 21 14 21 153 Nett Births in the year Legitimate 1,774 Illegitimate 67 Nett Deaths in the year of Legitimate infants 138 Illegitimate infants 15 39 TABLE XV. METROPOLITAN BOROUGH OF POPLAR. Bromley Sub-District. Infantile Mortality during the Year 1920. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 27). 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 37 8 9 8 62 32 40 23 17 174 Uncertified Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... 1 1 Whooping Cough ... ... ... ... ... 1 ... 2 3 6 Diphtheria and Croup ... ... ... ... ... ... 1 ... 3 4 Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... ... 1 ... 1 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... 3 ... 1 4 Meningitis (not Tuberculous) ... ... ... 1 1 ... 1 ... ... 2 Convulsions 3 ... 1 ... 4 ... 2 ... ... 6 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 2 1 ... 3 3 8 3 1 18 Pneumonia (all forms) ... 1 1 1 3 4 6 10 ... 26 Diarrhoea ... ... ... ... ... 2 3 2 ... 7 Enteritis ... ... ... ... ... 2 3 ... ... 5 Gastritis ... ... ... ... ... 2 1 1 ... 4 Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying ... ... ... ... ... 1 ... ... ... 1 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations 1 1 1 1 4 ... 1 ... ... 5 Premature birth 27 4 5 3 39 7 ... ... ... 46 Atrophy, Debility and Marasmus 4 ... ... 1 5 6 7 2 1 21 Other Causes 1 ... ... 1 2 3 3 3 1 12 Total Deaths 37 8 9 8 62 32 40 23 17 174 Nett Births in the year Legitimate 2,244 Illegitimate 50 Nett Deaths in the year of Legitimate infants 159 Illegitimate infants 15 40 TABLE XVI. METROPOLITAN BOROUGH OF POPLAR. Bow Sub-District. Infantile Mortality during the Year 1920. Nett Deaths from stated Causes in Weeks and Months under One Year of Age. Causes of Death (see page 27). Under I 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 28 4 7 4 43 24 20 20 13 120 Uncertified Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ••• ... Measles ... ... ... ... ... ... ... 2 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ••• ... Whooping Cough ... ... ... ... ... 1 1 3 2 7 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 1 ... 2 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... 2 ... 2 Convulsions 1 ... ... ... ... ... 1 ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... 1 1 2 4 2 2 3 13 Pneumonia (all forms) ... ... 1 ... 1 4 6 3 2 16 Diarrhoea ... ... ... ... ... 2 2 ... ... 4 Enteritis ... ... ... 1 1 1 3 4 ... 9 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 1 ... ... ... 1 ... ... ... ... 1 Injury at birth ... ... ... ... ... ... ... ... ... ... Atelectasis 3 ... ... ... 3 ... ... ... ... 3 Congenital Malformations 2 1 2 ... 5 1 1 ... 1 8 Premature birth 16 2 1 2 21 1 ... ... ... 22 Atrophy, Debility and Marasmus 4 1 2 ... 7 8 2 1 1 19 Other Causes 1 ... ... ... 1 1 1 2 3 8 Total Deaths 28 4 7 4 43 24 20 20 13 120 Nett Births in the year Legitimate 1305 Illegitimate 17 Nett Deaths in the year Legitimate infants 115 Illegitimate infants 5 41 TABLE XVII. (1920). Cities and Boroughs. Estimated population to the middle of 1919. Notifications. Annual rate per 1,000 persons living. Births. Annual rate per 1,000 persons living. Zymotic Deaths. Annual rate per 1,000 persons living. Deathrate per 1,000 living. Deaths of Infants under one year to 1,000 births. LONDON 4,531,971 . 26.5 0.9* 12.4 75 West Districts. Paddington 149,673 . 22.7 . 11.4 78 Kensington 164,177 • 24.3 0.9 13.4 81 Hammersmith 136,200 • 24.3 0.8 11.4 66 Fulham 158,621 • 27.3 0.8 11.5 74 Chelsea 68,500 . 20.3 0.04 11.3 52 City of Westminster 132,615 . 16.1 0.4 11.8 73 North Districts. St. Marylebone 101,856 . 21.5 0.5 12.7 65 Hampstead 91,519 17.1 0.2 9.4 48 St. Pancras 228,178 • 25.4 0.9 12.4 73 Islington 335,907 28.1 1.0 13.3 72 Stoke Newington 52,984 • 23.1 0.7 12.4 80 Hackney 225,372 26.6 1.0 12.7 80 Central Districts. Holborn 39,676 . 20.8 0.6 15.2 65 Finsbury 78,291 • 32.4 0.9 14.7 74 City of London 12,200 . 14.9 0.4 15.6 60 East Districts. Shoreditch 101,000 36.9 1.4 15.6 91 Bethnal Green 114,471 . 33.7 1.9 14.9 94 Stepney 270,000 27.2 0.9 12.8 90 Poplar 159,766 • 34.1 1.3 14.7 81 South Districts. Southwark 187,142 31.8 • 14.4 86 Bermondsey 129,189 31..2 1.3 12.7 83 Lambeth 293,572 27.5 0.9 12.9 63 Battersea 165,664 28.1 1.1 12.5 82 Wandsworth 342,808 31.0 0.6 10.3 64 Camberwell . . . Deptford 115,636 28.3 0.8 12.2 79 Greenwich 104,453 24.6 0.9 11.7 75 Lewisham 174,438 22.8 0.4 10.7 62 Woolwich 141,666 24.7 0.5 10.5 61 * This figure was furnished by the Lancet, the remainder of the rates for London being supplied by the Registrar-General. 42 The following death rates for the year 1920 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 14.72 811 Poplar (Sub-District) 14.73 83 Bromley 14.55 75 Bow ... 14.96 90 England and Wales 12.4 80 96 Great Towns‡ 12.5 85 148 Smaller Towns 11.3 80 London 12.4 75 Liverpool 16.4 113 Manchester 13.2 97 Edinburgh 13.3 89 Glasgow 15.3 105 Dublin (City) 39.1 137 Belfast 17.5 132 † See Footnote ** page 8. ‡ Including London. 43 A6651 D TABLE XVIII. Birth-rate, Death-rate, and Analysis of Mortality During the Year 1920. — Birthrate per 1,000 Total Population. Annual Death-rate per 1,000 Civilian Population. Rate per 1,000 Births. Percentage of Total Deaths.* All Causes Enteric Fever. Small-pox. Measles. Scarlet . Fever. Whoopingcough. Diphtheria. Influenza. Violence. Diarrhœa 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 25.4 12.4 0.01 0.00 0.19 0.04 0.11 0.15 0.28 0.48 8.3 80 24.3 92.2 6.6 1.2 96 Great Towns, including London (Census Populations exceeding 50,000) 26.2 12.5 0.01 0.00 0.22 0.04 0.14 0.16 0.31 0.43 10.4 85 31.3 92.2 7.1 0.7 148 Smaller Towns (Census Populations 20,00050,000) 24.9 11.3 0.02 0.00 0.19 0.03 0.10 0.14 0.27 0.38 7.8 80 16.5 93.2 5.3 1.5 London 26.5 12.4 0.01 0.00 0.22 0.05 0.17 0.22 0.30 0.47 13.5 75 46.8 91.2 8.6 0.2 Poplar Borough 34.1 14.7 0.02 0.01 0.20 0.08 0.31 0.36 0.33 0.70 8.0 81 49.1 86.9 13.1 0.0 Poplar Sub-District 33.1 14.7 0.05 0.00 0.05 0.10 0.30 0.30 0.25 0.95 9.7 83 48.1 85.2 14.80 0.0 Bromley 35.8 14.5 0.00 0.04 0.18 0.09 0.26 0.46 0.31 0.57 5.2 75 51.7 87.1 12.9 0.0 Bow 32.7 14.9 0.02 0.00 0.44 0.04 0.39 0.29 0.47 0 .57 10.5 90 46.4 88.7 11.3 0.0 * Non-civilians are included in these figures for England and Wales but not for other areas. 44 TABLE XIX. METROPOLITAN BOROUGH OF POPLAR. Borough of Poplar. Cases of Infectious Disease notified during the Year 1920. 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 11 ... 1 ... 2 3 5 ... 5 6 ... 11 5 6 ... 11 Cholera (C), Plague (P) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 698 21 226 393 38 16 4 ... 250 253 195 698 237 243 191 *671 Erysipelas 84 5 ... 8 6 32 24 9 26 32 26 84 10 15 6 †31 Scarlet Fever 1400 20 291 961 103 24 1 ... 486 610 304 1400 455 579 291 ‡ 1325 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 17 ... ... 4 4 5 4 ... 9 5 3 17 7 3 2 ¶ 12 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 24 ... ... ... 6 16 2 ... 10 8 6 24 9 8 6 §23 Cerebro-Spinal Meningitis 11 2 ... 5 2 2 ... ... 4 3 4 11 4 1 3 **8 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Encephalitis Lethargica 4 ... ... ... 1 1 2 ... ... 3 1 4 ... 3 1 ††4 Ophthalmia Neonatorum 61 61 ... ... ... ... ... ... 25 25 11 61 3 ... 3 6 Pulmonary Tuberculosis 504 4 20 80 95 200 100 5 181 193 130 504 ... ... ... ... Other forms of Tuberculosis 170 6 34 94 17 13 5 1 64 68 38 170 ... ... ... ... Zymotic Enteritis 128 58 53 14 2 1 ... ... 55 55 18 128 ... ... ... ... Anthrax 2 ... ... ... ... 1 1 ... 1 ... 1 2 1 ... 1 ||2 Trench Fever 1 ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... Pneumonia (all forms) 512 91 139 57 53 94 57 21 182 211 119 512 ... ... ... ... Malaria 10 ... ... ... 1 9 ... ... 1 6 3 10 ... 2 ... 2 Dysentery 1 ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... ... Totals 3638 268 764 1616 330 419 205 36 1301 1478 859 3038 731 860 504 2095 * See page 64.† See page 60. ‡ See page 60. ¶ See page 62. § See page 59. ** See page 67. †† See page 68. || See page 58. 45 TABLE XX. METROPOLITAN BOROUGH OF POPLAR. Poplar Sub-District. Cases of Infectious Disease notified during the Year 1920. Notifiaiile Disease. Cases Notified in Sub-District. No. of Cases removed to Hospital from. 1 Sub D istrict. 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 5 ... 1 ... 1 1 2 ... 5 Cholera, Plague ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 250 4 75 153 13 3 2 ... 237* Erysipelas 26 1 ... 1 1 8 11 4 10† Scarlet Fever 486 9 110 327 32 8 ... ... 455 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 9 ... ... 3 2 1 3 7¶ Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 10 ... ... ... 3 6 1 ... 9§ Cerebro-Spinal Meningitis 4 2 ... ... 1 1 ... ... 4** Poliomyelitis ... ... ... ... ... ... ... ... ... Acute Encephalitis Lethargica ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 25 25 ... ... ... ... ... ... 3 Pulmonary Tuberculosis 181 3 5 28 29 75 39 2 ... Other forms of Tuberculosis 64 4 12 37 5 4 2 ... ... Zymotic Enteritis 55 25 23 7 ... ... ... ... ... Anthrax 1 ... ... ... ... ... 1 ... 1|| Trench Fever 1 ... ... ... ... 1 ... ... ... Pneumonia (all forms) 182 36 50 20 18' 30 20 8 ... Malaria 1 ... ... ... 1 ... ... ... ... Dysentery 1 ... ... ... ... 1 ... ... ... Totals 1,301 109 276 576 106 139 81 14 731 * See page 64. † See page 60. ‡ See page 60. ¶ See page 62 § See page 59. ** See page 67. || See page 58. A6051 D 2 46 TABLE XXI. METROPOLITAN BOROUGH OF POPLAR. Bromley Sub-District. Cases of Infectious Disease notified during the Year 1920. Notifiable Disease. Cases Notified in 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 6 ... ... ... 1 2 3 ... 6 Cholera, Plague ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 253 12 93 129 12 6 1 ... 243* Erysijelas 32 1 ... 2 3 15 8 3 15† Scarlet Fever 610 7 122 414 54 12 1 579‡ Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 5 ... ... 1 1 3 ... ... 31¶ Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Faerperal Fever 8 ... ... ... 3 4 1 ... 8§ Cerebro-Spinal Meningitis 3 ... ... 1 1 1 ... ... 1** Acute Encephalitis Lethargica 3 ... ... ... 1 ... 2 ... 3†† Ophthalmia Neonatorum 25 25 ... ... ... ... ... ... ... Pulmonary Tuberculosis 193 1 12 25 37 81 35 2 ... Other forms of Tuberculosis 68 ... 16 39 8 3 2 ... ... Zymotic Enteritis 55 21 25 7 2 ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... Pneumonia (all forms) 211 31 53 26 24 44 27 6 ... Malaria 6 ... ... ... ... 6 ... ... 2 Dysentery ... ... ... ... ... ... ... ... ... Totals 1,478 98 321 644 147 177 80 11 860 * See cage 64. † See Page 60. † See page 60. ¶ See page 62. § See page 59. ** See page 67. ft See page 68. 47 TABLE XXII. METROPOLITAN BOROUGH OF POPLAR. Bow Sub-District. Cases of Infectious Disease notified during the Year 1920. Notifiable Disease. Cases Notified in 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) 195 5 58 111 13 7 1 ... 191 Erysipelas 26 3 ... 5 2 9 5 2 †6 Scarlet Fever 304 4 59 220 17 4 ... ... ‡291 Typhus Fever ... ... ... ... ... ... ... ... ... Enteric Fever 3 ... ... ... 1 1 1 ¶2 Relapsing Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Puerperal Fever 6 ... ... ... ... 6 ... ... §G Cerebro-Spinal Meningitis 4 ... ... 4 ... ... ... ... **3 Acute Encephalitis Lethargica 1 ... ... ... ... 1 ... ... ††1 Ophthalmia Neonatorum 11 11 ... ... ... ... ... ... 3 Pulmonary Tuberculosis 130 ... 3 27 29 44 26 1 ... Other forms of Tuberculosis 38 2 6 18 4 6 1 1 ... Zymotic Enteritis 18 12 5 ... ... 1 ... ... ... Anthrax 1 ... ... ... ... 1 ... ... ||1 German Measles ... ... ... ... ... ... ... ... ... Pneumonia (all forms) 119 24 36 11 11 20 10 7 ... Malaria 3 ... ... ... ... 3 ... ... ... Dysentery ... ... ... ... ... ... ... ... ... Totals 859 61 167 396 77 103 44 11 504 * See page 64. †See page 00. ‡See page 60. ** See page 67. ††See page 68. ¶ See page 62. § See page 59. || See page 58. 48 ZYMOTIC DISEASES.* Notifications; Institutions; Errors in Diagnosis; Infectious Diseases in Milk SHors and on Homeworkers' Premises. Notifications. There were 791 notifications of infectious diseases in Poplar, 920 in Bromley, and 540 in Bow, making a total of 2,251 for the Borough of Popiar ; these do not include 59 second notifications. In the above figures no deductions have been made for cases removed to the Metropolitan Asylums Board's hospitals, which were afterwards certified as not having a notifiable disease. The uncorrected notification rate per 1,000 living being :— Poplar. Bromley. Bow. Borough of Poplar 1916 592 5 37 6.87 5.94 1917 6.38 5.46 4.33 5.50 1918 5.46 4.83 3.80 4.79 1919 5.07 594 6.39 5.76 1920 14.25 14.38 13.40 .. 14.08 Corrected number of notifications and rates— Poplar 791 — 14 = 777 or 13-99 per 1000 living. Bromley 920 — 18 = 902 or 14 10 „ Bow540 — 11 = 529 or 13 12 „ Borough of Poplar 2.251 — 43 =2,208 or 13.82 „ * Exclusive of Zymotic Enteritis, Pneumonia, Dysentery, Tren'h Fever, Malaria, Ophthalmia Neonatorum. 40 Of the 791 patients notified in Poplar, 728 were removed to hospitals and institutions ; of the 920 in Bromley 858 were isolated, and of the 540 in Bow 501 were removed, so that of a total of 2,251 notifiable diseases in the Borough 2,087 patients (exclusive of ophthalmia neonatorum) had been removed from their homes.* 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. Diphtheria. Erysipelas. Scarlet Fever. Enteric Fever. Puerperal Fever. Ophthalmia Neonatorum. Zymotic Enteritis. Pneumonia (all forms'. Diphtheria. Erysipelas. Scarlet Fever. Enteric Fever. Puerperal Fever. Zymotic Enteritis. Pni-umonia (all forms). Poplar Institution 7 .. 3 1 .. 1 .. .. 2 .. 3* 1** .. 1* 2* St. Andrew's Hospital 4 1§ 2§ .. .. .. .. §i 1* 2** .. .. .. 1* Bow Institution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bromley House Institution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Langley House, 54, East India Dock Road 12 .. .. 12 .. .. .. .. .. .. .. 12** .. .. .. .. Poplar Hospital 2 .. .. 1§ .. .. .. .. 1‡ .. .. 1† .. .. .. 1‡ * Admitted into St. Andrew's Hospital. ** Removed to M.A.B. Hospitals. § Staff. ‡ Homeless, treated in Poplar Hospital, † Removed to London Fever Hospital. * See Tables XIX.—XXII., pages 44-47. 50 Infectious Diseases in Milk hops and Homeworkers' Premises. Three cases of infectious disease (scarlet fever) 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. Nineteen premises with outworkers were connected with infectious cases notified : 5 (scarlet fever) in Poplar, 6 (5 scarlet fever and 1 diphtheria) in Bromley, and 8 (5 scarlet fever, 2 diphtheria, and 1 erysipelas) in Bow. 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. No cases of measles were connected with outworkers' premises. 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 656 668 509 1,999 777 8,188 12,141 Bromley 826 836 629 2,741 1,001 10,372 15,579 Bow 458 470 301 1,401 542 5,703 8,417 Totals 1,940 1,874 1,439 6,141 2,320 24,263 36,137 Miscellaneous 174 167 63 477 175 2,220 3,102 Totals 2,114 2,141 1,502 6,618 2,495 26,483 39,239 Pulmonary Tuberculosis 263 27 8 71 21 211 338 Totals 2,377 2,168 1,510 6,689 2,516 26,694 39,577 Other articles also passed through the Council's apparatus, from the Shelter, Glaucus Street, disinfectors' clothing, overalls, drop-sheets, etc., to the number of 22,291 and 69,905 articles of clothing from verminous persons were disinfected Making a total of 131,773 articles 51 ELECTROLYTIC DISINFECTING FLUID. Output of Fluid ; Distribution of Fluid ; Cost of Material and Electricity ; Bottles, Corks and Laeels : Total Quantity Manufactured Since Installation of Plant ; Estimate for the Year ended 31st March, 1920, and Expenditure for Year ended 31st March, 1920, Average Expenditure for Three Years ended 31st March, 1920, Estimate for Year ending 31st March, 1921, and for Year ending 31st March, 1922; Spraying and Cleansing Floors of London County Council Schools with Electrolytic Disinfecting Fluid ; Swimming Baths, the use therein of the Electrolytic Fluid ; Comments cn Adverse Criticisms. 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 1920 was as follows:— Manufactured Gallons. Broken down to Gallons and Distributed. January 1,725 3,450 February 2,265 4,530 March 2,940 5,880 April 3,480 6,960 May 3,915 7,830 June 4,410 8,820 July 4,335 8,670 August 4,290 8,580 September 3,870 7,740 October 3,465 6,930 November 2,580 5,160 December 1,980 3,960 Total 39,255 78,510 Since the beginning of August, 1914, the fluid has been manufactured of greater strength, being afterwards broken down to half strength for distribution. 52 Distribution of Fluid. The fluid was distributed as follows:— 1. Violet Road Depot 35,1051/2 gallons 2. Bickmore Street Depot 8,150 „ 3. Old Ford Road Depot 6,568 „ 4. Ford Road Depot 3,624 „ 5. Trego Road Depot 3,815 „ 6. Stebondale Street Depot 4,035 „ '7. Millwall Depot 744 „ 8. Public Health Offices 165 „ 9. Poplar Baths 4,066 „ 10. Bow Baths 3,841 „ 11. Island Baths 1,016 „ 12. Poplar Town Hall 129 „ 13. Bromley Public Hall 66 „ 14. Works Department 684 „ 15. Guardians' Offices 302 „ 16. Poplar Union Workhouse 1,278 „ 17. Langley House 114 „ 18. Poplar Training School, Hutton 111/2 „ 19. Public Libraries 180 „ 20. Used at Council's Shelter in baths of verminous persons 644 „ 21. London County Council Schools 1,707 „ 22. Mortuary, High Street, Poplar 540 „ 23. Borough of Poplar Dispensary 48 „ 24. Royal College of St. Katharine 312 „ 25. Private Firms in Borough 846 „ 26. Council Offices, Poplar 204 „ 27. East London Federation of Suffragettes 24 „ 28. Kingsley Hall 114 „ 29. Bow War Pensions Office 132 „ 30. North Poplar Clinic, Shirbutt Street 18 „ 31. St. Gabriel's Settlement 27 „ Total 78,510 „ 53 Cost of Material and Electricity. The cost of material in manufacturing 39,255 (strong) gallons of the electrolytic fluid was as follows:— £ s. d. Electricity, 9,529 units at 11/2d. (with 65-85 per cent, advance) per unit 105 7 3 *Chloride of Magnesium, 7 tons 9 cwt. 3 qrs 100 15 6 *Salt, 4 tons 17 cwt. 2 qrs. 23 17 6 *Caustic Soda, 10 cwt. 1 qr. 4 lb 26 2 11 Water 2 15 5 Total cost of materials to produce 39,255 gallons (strong) broken down to 78,510 gallons £258 18 7 Electric motor for stirring : 233 units 2 11 6 Bottles, Corks and Labels, Bottles 87 0 2 Corks 4 13 0 Labels — £91 13 2 Total Quantity Manufactured since Installation of Plant. Since the installation of the plant, a period of 15 years, 576,759 gallons of fluid have been manufactured (see footnote page 54) at a cost for electricity of £769 3s. 41/2d., and materials of £938 4s. 7d., less than 1d. per gallon (previous to the war the cost was under 1/2d. per gallon, but even with the strong fluid which at present is being made and is broken down the cost is still about 1/2d. per gallon when the gallons are reckoned in bulk)†. * The price of these materials has considerably increased in recent years. † See "Comments on Adverse Criticism," Annual Report, 1911. 54 Year. Output, gallons. Material, Chloride of Magnesium, Salt, Caustic Soda and Water. Cost. Electricity Total £ s. d. £ s. d. £ s. 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 71/2 53 2 21/2 1910 50,726 47 11 10 50 10 6 98 2 4 1911 53,063 50 17 9 56 16 71/2 107 14 41/2 1912 54,388 41 7 10 59 14 41/2 101 2 21/2 1913 66,740 62 7 3 71 0 101/2 133 8 11/2 1914 68,795† 59 16 11† 75 0 3† 134 17 2† 1915 36,985† 35 19 3† 48 12 0† 84 11 3† 1916 26,790† 74 4 0† 40 3 1† 114 7 1† 1917 27,900† 75 10 4† 44 11 61/2 120 1 101/2† 1918 30,750† 114 5 9† 51 2 8† 165 8 5† 1919 33,285† 139 4 0† 77 7 9† 216 11 9† 1920 39,255† 153 11 4† 105 7 3† 258 18 7† Total 576,759 £938 4 7 £769 3 £1,707 7 111/2 The Public Health Department is not only furnished with the disinfectant and the various institutions of the Council (the public baths, etc.), but the institutions of the Managers of St. Andrew's Hospital 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 1d. 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. For Electrolytic Disinfectant supplied to manufacturers and trading concerns, a charge of 8d. per gallon is made through the Electricity Department, the Electricity Undertaking being allowed an amount of 10 per cent. for establishment charges. † On page 51 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 1918 61,500 1919 66,570 1920 78,510 The diminution is due to not such a lavish distribution on account of increased prices and difficulty of obtaining materials 55 Estimate for the Year ended 31st March. 1920, and Expenditure for year ended 31st March, 1920, average Expenditure for Three Years ended 31st March, 1920, Estimate for Year ended 31st March, 1921, and for Year ending 31st March, 1922. Electrolytic Disinfectant. Estimate for year ended 31st March, 1920. Expenditure for year ended 31st March, 1920. Average Expenditure for 3 years ended 31st March, 1920. Estimate for year ending 31st March, 1921. Estimate for year ending 31st March, 1922. No. 1 Wages (Manufacturing, bottling & delivery to Depots. Guardians' Institutions) £ £ £ £ £ £ £ £ £ £ 513 018 474 695 650 1 2 Rent Rates and Insurance—Main Depot 80 73 68 80 80 2 3 Supervision of Plant 15 15 15 15 15 3 4 Electricity and Water 90 108 84 90 120 4 5 Materials (Chemicals) 100 127 106 145 145 5 6 Bottles, Corks, Wax, Labels and Paste 20 16 24 50 50 6 7 Sundries (including Testing Apparatus and Carboys) 32 54, 43 60 60 7 8 Repairs—Depot 50 166 82 100 160 8 900 1177 896 1235 1220 9 Issuing—Wages and War Bonuses —(Old Ford Road, Trego Road, Ford Road, Bickmore Street, West Ferry Road, and Stebondale Street Depots) 483 477 414 568 624 9 10 Issuing—Cartage 30 49 40 60 60 10 11 Rent—Issuing Depots (Ford Road, Trego Road and Stebondale Street) 32 31 31 32 32 11 12 Sundries and Petty Expenses 10 33 20 10 38 12 555 590 505 680 754 - - - - 1,455 1,767 1,401 1,915 1,974 13 Less—Sale of Fluid 60 33 41 60 40 13 1,395 1,734 - 1,360 - 1,855 - 1,934 56 Spraying and Cleansing Floors of London County Council Schools with Electrolytic Disinfecting Fluid. 1,707 gallons were supplied to seven 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. 4,066 gallons were supplied to the Poplar Baths, 3,841 gallons to the Bow Baths, and 1,016 gallons to the Island Baths, making a total of 8,923 gallons. Comments on Adverse Criticism respecting the Process. See Annual Report, 1911. In spite of adverse criticism, the process has been a success for fifteen 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. 1 Total number of Cleansings. Amount. 1920. £ a. d. March 1,389 69 9 0 June 1,289 64 9 0 September 757 37 17 0 December 886 44 6 0 Totals 4,321 £216 1 0 57 3,722 children (1,784 boys and 1,938 girls) belonging to the Borough and 583 children (275 boys and 308 girls) outside the Borough were bathed and their clothes disinfested. Miss Tattersall made 116 visits in connection with verminous school children—13 Poplar, 30 Bromley, and 73 Bow. Cleansing of Verminous Rooms, see page 85. Itch Cases. The itch cases treated at the cleansing station are included in the verminous cases above. Miss Tattersall made 418 visits in connection with children suffering from itch—138 Poplar, 153 Bromley, and 127 Bow. CLEANSING OF PERSONS ACT, 1897. During the year 174 persons (114 men and 60 women) (including 35 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 6,279 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 58 Cleansing Station, Glaucus Street, daring the year ended 31st December, 1920. Common Lodging House, etc. Male. Female. Total. Bow Chambers, 193-7, Bow Road 31 — 31 St. James' Chambers, 217, High Street, PoDlar 17 — 17 48 — 48 From Common Lodging Houses without Borough of Poplar— Whitechapel 35 35 — 35 35 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. Two cases were notified : one Poplar and one Bow. The Poplar case was treated in Poplar Hospital and the Bow case in the London Hospital. Both cases recovered. 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. 59 PUERPERAL FEVER.* * See page 27 as to what diseases are included under Puerperal Fever. Number of Cases. Twenty-four cases of puerperal fever were notified :—10 Poplar, 8 Bromley, and 6 Bow. Removals. Poplar. Bromley. Bow. Totals. M.A.B. Hospitals 5 7 1 13 St. Andrew's Hospital 4 — 4 8 London Hospital — 1 — 1 Holborn Institution — — 1 1 9 8 6 23 Deaths. Seven patients died—2 Poplar, 1 Bromley, and 4 Bow. SMALL-POX. Eleven cases of small-pox were notified and removed to M.A.B. Hospitals during the year—5 Poplar, 6 Bromley, 0 Bow. Three patients belonging to Bromley Sub-District died. One case included above was certified, after removal, to be not suffering from small-pox, leaving 10 true cases. VACCINATION. Vaccination Return, 1919 and 1920. The Vaccination Officer, Mr. Ryan, has kindly furnished me with the following statistics. Approximate Figures, 1920. Births notified. Deaths registered under 12 months. Poplar 1,681 95 Bromley 2,198 243 Bow 1,235 75 Totals 5,114 413 Vaccination certificates received of all ages, 1,385 A6051 60 ERYSIPELAS. 84 cases of erysipelas were notified during the year : 26 Poplar 32 Bromley, and 26 Bow. 31 patients were isolated as follows:— Poplar. Bromley. Bow. Totals. M.A.B. Hospital 1* — — 1* St. Andrew's Hospital. 9 15 6 30 10 15 6 31 * Admitted with scarlet fever. Nine deaths occurred—1 Poplar, 5 Bromley, and 3 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. 1916 Cases notified 114 103 91 308 Deaths 0 5 2 1 1917 Cases notified 81 74 50 203 Deaths 1 1 2 4 1918 Cases notified 97 82 52 231 Deaths 0 2 0 2 1919 Cases notified 112 162 95 370 Deaths — 4 — 4 1920 Cases notified 486 610 301 1,400 Deaths 6 6 2 14 455 cases in Poplar (Sub-District) were removed to the Metropolitan Asylums Board's Hospitals, 578 in Bromley and 291 in Bow. One Bromley patient was treated in the London Fever Hospital (Poplar Hospital staff). So that 1,325 patients out of 1,400 notified cases in the Borough were isolated. 61 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. 1916 7 7 5 19 1917 19 16 4 39 1918 8 3 1 12* 1919 11 6 6 23 1920 9 5 3 17 * The lowest number of cases recorded. 1st quarter. 2nd quarter. 3rd quarter. 4th quarter. Total. Poplar 2 3 3 1 9 Bromley 2 — 2 1 5 Bow — 1 1 1 3 4 4 6 3 17 Notifications per 1,000 living:— Poplar. Bromley. Bow. Borough of Poplar 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 1919 0.20 0.09 0.15 0.14 1920 0.16 0.07 0.07 0.10 A6051 E 2 62 Isolation. Seven cases in Poplar, three in Bromley and two in Bow were removed to various hospitals, as follows Poplar. Bromley. Bow. Borough. Metropolitan Asylums Board's Hospitals 3 1 2 6 St. Andrew's Hospital 3 — — 3 Poplar Hospital 1 — — 1 London Hospital — 1 — 1 Seamen's Hospital — 1 — 1 7 3 2 12 Errors of Diagnosis. No cases removed to Metropolitan Asylums Board Hospitals were certified to be not suffering from typhoid fever. Deaths. Four patients died from typhoid fever, out of 17 cases (3 Poplar, and 1 Bow). Bacteriological Examinations of Doubtful Cases. Three specimens of blood from doubtful cases of typhoid fever were forwarded to the Lister Institute of Preventive Medicine. In one instance (33.3 per cent.) the typhoid (Widal) reaction was obtained. 63 DIPHTHERIA, INCLUDING MEMBRANOUS CROUP. Notifications ; Deaths ; Bacteriological Examinations ; Errors in Diagnosis ; Isolation ; The Diphtheria Anti-toxin (London) Order, 1910. Notifications. 250 cases of diphtheria were notified in Poplar, 253 cases were notified in Bromley, and 195 cases were notified in Bow, making a total of 698 cases for the whole Borough. Cases notified :— Poplar. Bromley. Bow. Borough of Poplar. 1916 104 124 11 339 1917 148 150 68 366 1918 124 137 44 365 1919 93 128 99 320 1920 250 253 195 698 Notifications per 1,000 living:— Poplar. Bromley. Bow. Borough of Poplar 1916 1.93 1.99 2.83 2.18 1917 2.97 261 1.87 2 .55 1918 2.55 2 45 1.25 2.18 1919 1.74 2.08 2.55 2.08 1920 4.50 3.95 4.83 4 36 Deaths; Number of deaths for the past five years was as follows:— [##3]Poplar. Bromley. Bow. Borough of Poplar Mortality per 100 eases notified. 1916 11 8 9 28 8.25 1917 6 13 4 23 6.28 1918 8 16 7 31 10.16 1919 11 13 14 38 11.87 1920 17 30 12 59 8.45 For death rates from diphtheria, also see Table XVIII., page 43. 64 Bacteriological Examinations. 442 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 126 instances (28.5 per cent.). Errors in Diagnosis. Eighteen cases of diphtheria admitted into Metropolitan Asylums Board's hospitals were certified as not having the complaint, 7 Poplar, 5 Bromley and 6 Bow. No deductions have been made in respect of these patients. Isolation. 237 cases in Poplar, 243 in Bromley, and 191 in Bow were removed to various hospitals for treatment, as follows:— Poplar. Bromley. Bow. Total. Metropolitan Asylums Board's Hospitals 236 239 191 666 St, Andrew's Hospital 1 3 — 4 Poplar Hospital — 1 — 1 237 243 191 671 The Diphtheria Anti-Toxin (London) Order, 1910. Eighty-eight thousand units of diphtheria anti-toxin were supplied to medical practitioners during the year. WHOOPING COUGH. Deaths. Poplar. Bromley. Bow. Borough of Poplar. 1916 6 21 16 43 1917 4 24 3 31 1918 35 14 12 61 1919 12 12 — 24 1920 17 17 16 50 65 INFLUENZA. Deaths. Poplar. Bromley Bow. Borough of Poplar. 1916 1 7 2 10 1917 7 9 1 17 1918 175 218 131 524 1919 51 50 38 139 1920 14 20 19 53 Poplar (Whole Borough). Influenza Deaths during the Year 1920. 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 28 - - 2 - 4 11 9 2 Females 25 1 - 2 1 3 12 3 3 Totals 53 1 - 4 1 7 23 12 5 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 7 — — 2 — 1 2 9 — Females 7 — — 1 1 1 2 2 — Totals 14 — — 3 1 2 4 4 — 66 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 11 — — — — 1 5 4 1 Females 9 — — 1 — — 5 1 2 Totals 20 — — 1 — 1 10 5 3 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 10 — — — — 2 4 3 1 Females 9 1 — — — 2 5 — 1 Totals 19 1 — — — 4 9 3 2 MEASLES. Deaths. The following figures are the deaths from Measles for the past five Years:- Poplar. Bromley. Bow. Borough of Poplar. 1916 21 19 8 48 1917 29 47 15 91 1918 35 79 37 151 1919 6 — 1 7 1920 3 12 18 33 Thirteen deaths (9 of which belonged to the Borough of Poplar) occurred in St. Andrew's Hospital. For death rates see Table XVIII., page 43. Respecting outworkers see page 50. 67 . SPOTTED FEVER. EPIDEMIC CEREBRO-SPINAL MENINGITIS.* Number of Cases. Eleven cases occurred within the Borough—4 Poplar, 3 Bromley, and 4 Bow. Isolation. Poplar. Bromley. Bow Totals. Metropolitan Asylums Board's Hospitals 1 — — 1 St. Andrew's Hospital . — — 1 1 Mild may Medical Mission Hospital — — 1 1 London Hospital 2 — 1 3 Poplar Hospital — 1 — 1 Children's Hospital, Great Osmond Street 1 — — 1 4 1 3 8 Eight patients died from Cerebro-Spinal Meningitis—3 Poplar, 2 Bromley and 3 Bow. In one other notified case the cause of death was given as " Cerebral Haemorrhage. P.M." ACUTE POLIO-MYELITIS, OR ACUTE POLIOENCEPHALITIS, AND ACUTE ENCEPHALITIS LETHARGICA, No cases of Polio-myelitis were notified. Three cases of Encephalitis Lethargiea occurred in Bromley and one in Bow. * Posterior basal meningitis is included in the term " cerebro-spinal fever," which does not include meningitis due to tuberculosis, syphilis, middle ear disease, or injury. 68 Removals. Poplar Bromley Pow Total. St. Andrew's Hospital — 1 — 1 London Hospital — 2 1 3 3 1 4 Deaths Two deaths of Bromley patients occurred, in one notified case the cause of death being given as " Sarcoma of brain." DIARRHOEA AND ENTERITIS. Diarrhcea and Enteritis—Deaths ; Notification of Zymotic Enteritis and Summer Diarrhœa. Under this heading are included deaths registered as due to epidemic diarrhoea, epidemic enteritis, infective enteritis, zymotic enteritis, summer diarrhœa, choleraic diarrhoea, gastro-enteritis, gastro-intestinal catarrh, muco-enteritis, colitis, etc. Deaths from dysentery are not included. See Tables VIII.—XI., XIII — XVI. Deaths—All Ages. Poplar. Bromley. Bow. Borough of Poplar. London. 1916 43 41 23 107 1,598* 1917 39 32 28 99 1,506* 1918 21 18 19 58 1,112* 1919 33 22 27 82 1,372* 1920 23 16 16 55 1,141* DIARRŒHA,† UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1916 13 18 9 40 1917 13 16 7 36 1918 8 5 5 18 1919 8 3 8 19 1920 5 7 4 16 * U nder two years for London only. † Under the heading of " Diarrhœa " are included deaths registered as due to epidemic diarrhoea, epidemic enteritis, infective enteritis, zymotic enteritis, summer diarrhœa, choleraic diarrhoea and cholera (other than Asiatic or epidemic). 69 ENTERITIS* UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1916 13 12 8 33 1917 7 5 9 21 1918 8 5 5 18 1919 17 13 9 39 1920 12 5 9 26 DIARRHŒA- AND ENTERITIS, UNDER ONE YEAR. Poplar. Bromley. Bow. Borough 1916 26 30 17 73 1917 20 21 16 57 1918 16 10 10 36 1919 25 16 17 58 1920 17 12 13 42 Notification of Zymotic Enteritis (Summer Diarrhœa). Notifiable from 1st June to 30th September. Age periods. Years. Number of notifications. Total Number of deaths. Total. Poplar Bromley. Bow. Poplar. Bromley. Bow. Under 1 25 21 12 58 17 12 13 42 1—5 23 25 5 53 1 2 1 4 5—15 7 7 — 14 1 — — 1 15—25 — 2 — 2 2 — — 2 25—45 — — 1 1 — — — — 45—65 — — — — 1 — — 1 65 and upwards — — — — 1 2 2 5 All ages—totals 55 55 18 128 23 16 16 55 *Under the heading of "Enteritis" are included deaths registered as due to enteritis, muco-enteritis, gastro-onteritis, and gastro-intestinal catarrh. 70 INQUESTS AND DEATHS FROM VIOLENCE. Inquests and Deaths from violence during the year 1920, 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 88 20 53 121 53 68 Bromley 230 125 15 120 37 83 Bow 30 1 33 68 23 45 Totals 354 146 101 309 113 196 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 43. 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 ... 2 ... 2 1 1 By Vehicles and Horses 2 19 ... 1 2 5 Ships, Boats and Docks (exclusive of drowning) ... 6 ... ... ... ... Building Operations ... 3 ... 1 ... ... Conflagrations ... ... ... ... ... ... Burns, Scalds and Explosions 6 11 ... ... 1 ... Drowning (accidental not suicidal) 15 2 ... 2 1 1 Suffocation in Bed ... 1 1 ... ... ... Poisons or Poisonous Vapours ... 3 1 ... ... ... Other and not stated Causes 10 41 4 2 5 2 Homicide ... ... ... ... ... ... Suicide 5 3 4 1 1 ... Murder 2 ... ... ... ... ... Anthrax ... ... ... ... ... ... Food Poisoning ... 1 ... ... ... ... Total 40 92 10 9 11 9 71 MORTUARY. Number of Bodies Received into Council's Mortuary, Cottage Street. The following is the number of bodies received into the Council's .Mortuary, Cottage Street, Poplar, classified according to the ages of the deceased:— No age stated 1 Stillborn 4 Under 1 53 1 to 5 15 5 to 15 10 15 to 25 22 25 to 65 157 65 and upward 73 Total 335 CANAL BOATS. For the year ended 31st December, 1920, the inspections and reports of the Inspectors respecting registered canal boats and non-registered cinal boats were as follows:— Registered. NonRegistered. †Mr. H. A. Tibbatts, East Combined Division — — ‡ Mr. J. Johnson, West Combined Division — — †Mr. C. H. Brown, Poplar South Division — — Mr. H. J. Langley, Bromley North Division — — Mr. Wm. Johnson, Bromley Central Division _ _ *Mr. A. J. Field, Bow East Division 5 7 Mr. W. Boyce, Bow West Division — 43 5 50 †No canal in Sub-division ; deputises when necessary for other Inspectors. * Mr. Field reported that one registered boat was visited twice, ‡ Mr. J.Johnson reported no canal boats were inspected in West Combined Division during the year. 72 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, and Homeworkers' premises. Premises. On Register during year 1920. Number of Inspections. Number of Intimations. Numl er of Notices. Number of Final Notices. Number of Prosecutions. Male. Female. Total. Bakehouses (Factories) 24 .. 24 70 8 1 .. .. Bakehouses( Workshops) 49 .. 49 238 24 3 .. .. Bakehouses (Domestic Workshops) 15 .. 15 70 12 .. .. .. Factories (Laundries and Miscellaneous Factories) ‡ ‡ + 4- £8 6 4 Laundries (Workshops) 1 5 6 25 2 .. .. .. Laundries (Domestic Workshops) .. 3 3 13 2 .. .. .. Workshops 159 H8|| 277|| 514 50 28 7 .. Workshops (Domestic) 10 15 25 41 5 3 Workplaces 201 .. 201 251 32 7 1 .. Workplaces (Domestic) 31 ;; 31 41 7 3 2 Places where food is sold or prepared 311§ .. 311§ 926* 109 28 5 .. Milk Premises 194** .. 194** 209 2 .. .. .. Cowsheds 10 .. 10 23 .. .. .. .. Slaughterhouses 9 .. 9 78 1 .. .. .. Other offensive trade promises 5§§ .. 5§§ 18 .. .. .. .. Ice Cream premises .. 83 83 44 3 1 .. .. Homeworkers' premises 66 839 895 1619 2 1 • • .. ‡ No Register is kept of Factories. Figures are from Journals and Card Index. || Including 9 workshops where both men and women are employed. § Power is used in 22 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. 73 TABLE B. Workshops on Register (Male), 1920. 27 Bootmakers 1 Oar maker 2 Barge builders 1 Oil refiner 2 Boat builders 1 Organ builder 1 Basket maker 1 Packing maker 1 Bellows maker 2 Printers 1 Bottle maker 1 Paint store 2 Brush makers 2 Paint can cleaners 2 Builders 2 Picture frame makers 2 Cycle makers 1 Painter's fitter 1 Cigar maker 1 Pickle works 4 Cork cutters 3 Plumbers 1 Comb maker I Rope and twine maker 1 Chemical works 2 Rag sorters 3 Confectioners 1 Rubber wash-house works 1 Coach builder 1 Rat poisons 1 Cardboard box maker 1 Solder works 1 Composition works 1 Sack and Tarpaulin maker 1 Cooperage 1 Stonemason 6 Cabinet makers 6 Tailors 1 Clay pipe maker 4 Tarpaulin works 1 Draught board maker 1 Sheet metal worker 2 Engineers 1 Skin dresser 1 Egg store 1 Tile and earthenware 1 Electrical engineer 2 Tinsmiths 1 Flag maker 1 Tea stores 16 Farriers 3 Upholsterers 1 Frilling maker 3 Undertakers I Glass bender 1 Varnish works 5 Harness makers 1 Van works 1 Leather goods 1 Vinegar works 1 Machinery dealer 2 Wheelwrights 1 Medicine maker 1 Wood chopper 3 Motor garage works 2 Wire workers 1 Mattress maker 1 Walking stick maker 2 Metal works 2 Zinc workers 1 Mineral water As per List Table A Workshops on Register, page 72. 74 TABLE B—continued. Workshops on Register (Men and Women Employed) 1 Cork cutter 1 Clay pipe maker 1 Tailor 1 Brush maker 2 Confectioners 1 Skin Dresser 2 Upholsterers Domestic Workshops on Register (where Men are Employed) ti Bootmakers 1 Blacksmith 1 Tailor 1 Wood chopper 1 Confectioner Home Workers on Register (Male) 51 Bootmakers 1 Toy maker 2 Tailors 1 Brush maker 1 Furrier? 1 Workshops and Domestic Workshops on Register (Females).* 50 Tailors 4 Confectioners 8 Laundresses 1 Dressing gown maker 6 Boot upper makers 1 Packer 13 Dressmakers 1 Pickle maker 1 Upholsterer 3 Glass blowers 2 Cork cutters 3 Mantle makers 4 Skirt and blouse makers 5 Paper and rag sorters 1 Waterproof garment maker 2 Woodchoppers ] Sack and bag maker 1 Shirt front and collar maker 2 Shirt and pyjama makers 2 Trimming makers 2 Furriers 1 Corset maker 2 Underclothing makers 1 Artificial flower maker 1 Seal stamper 1 Horse hair sorter i4 Milliners 2 Toymakers 5 Tiemakers 1 Canewcrker. *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 72. 75 TABLE C.* See footnote, page 74. Factories, Workshops, Laundries, Workplaces and Homeworkers. 1 —INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Intimation. Statutory. Final. Factories (Including Factory Laundries.) 123 14 5 ... ... Workshops † (Including Workshop Laundries.) 777 76 31 7 2 Domestic Workshops‡ 124 19 3 ... ... Workplaces (Males) 251 32 7 1 ... Domestic Workplaces (Males) 41 7 3 2 ... Places where food is sold or prepared || 926 109 28 5 ... Homeworkers' Premises 1,649 2 1 ... Total 3,896 259 78 15 2 *Tables C, D, E and F are filled in at the request of the Secretary of State, †Including Workshop Bakehouses. See Table A, page 72. ‡ Including Domestic Bakehouses and Laundries. See Table A. page 72. || The inspections of all factories where food is prepared are included. Power is used to chop meat for sausages, etc., in 22 of the premises. 2.—DEFECTS FOUND * Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Act: Want of cleanliness 473 473 ... ... Want of ventilation 4 4 ... ... Overcrowding ... ... ... ... Want of drainage of floors Other nuisances 305 305 ... 2 Sanitary accommodation. insufficient ... ... ... ... unsuitable or defective 1 1 ... ... 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 783 783 2 *These defects refer to premises as mentioned above under table of Inspection. A6051 f 76 Nature of Work. Outworkers' List, Section 107. Outwork in unwholesome premises, Section 108.* Outwork in infected premises,* Sections 109, 110. TABLE D.—Home Work. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances.* Orders made (8. 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. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— ,, Making, &c. 80 162 915 10 2 49 ,, Cleaning & Washing Household Linen Lace, lace curtains & nets Curtains and furniture hangings 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 6 ... 467 ... ... ... 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 86 162 1,382 10 2 49 77 LIST OF OUTWORKERS, FACTORY AND WORKSHOP ACT, 1901 (S. 107).* Class of Homework. 1920 Number o£ 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. 1. Due Aug. 1. Due Feb. 1. Due Aug. 1. Total 49 805 47 790 382 389 530 492 Tailoring 36 417 35 488 Shirt making 2 65 9 55 Miscellaneous ... 5 34 5 22 Shoemakers 3 26† 2 21‡ Boxes 3 263 3 204 * See page 76. †17 Males and 9 Females. ‡10 Males and 11 Females. TABLE E. Registered Workshops and Workplaces. [Workshops and Workplaces, etc., on the Register (s. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses may be enumerated here. Bakehouse Workshops 49 Bakehouse Domestic Workshops 15 Laundries Workshops 6 Laundries Domestic Workshops 3 Workshops 277* Domestic Workshops 25 Workplaces 201 Workplaces Domestic 31 Places where food is sold or prepared 3 l1† Total number of workshops and workplaces, etc., on Register 918‡ * 9 where men and women are employed, † Power is used in 22 of these premises. ‡See Tables A and B, pages 72 and 73. A6051 f 2 78 TABLE F. Other Matters Class. Number. (1) (19) Matters notified to H.M. Inspector of Factories: Failure to affix Abstract of the Factory and Workshop Act (s. 133) 5 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 19 Reports (of action taken) sent to H.M. Inspector 19 Other (Communications) 5 Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 28 BAKEHOUSES. Inspections. The Bakehouses throughout the Borough were inspected at least twice during the year. There are 92 Bakehouses in the Borough of Poplar, 28 Poplar (including 7 factory bakehouses), 41 Bromley (including 11 factory bakehouses), 23 Bow (including 6 factory bakehouses). See Table A, page 72, number made up to end of year. There are 28 underground bakehouses in the Borough, 4 Poplar, 14 Bromley, and 10 Bow. Cleansing was necessary in the various bakehouses on 144 occasions. Eighteen other nuisances were found. Four bakehouses were disused at time of visit. 79 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 311: 183 Poplar, 68 Bromley, and 60 Bow. (See Table A, page 72.) London County Council (General Powers) Act, 1908. 926 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 186 instances, and 105 other defects existed. 109 intimations were served, which in 28 cases were followed up by Statutory notices and five 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 194 registered premises (including 10 cow-houses, 1 Poplar, 4 Bromley and 5 Bow) where milk is sold, 53 Poplar, 80 Bromley and 61 Bow. These milk shops were kept under observation. *Bye Laws. †See Tables A and C, pages 72 and 75. 80 Cleansing of premises was necessary in sixteen instances. Ten other defects were found. 1 milkshop has been placed on the register during the year, 0 Poplar, 0 Bromley, and 1 Bow. 2 premises were on account of change of occupiers re-registered as milkshops, 0 Poplar, 0 Bromley and 2 Bow. The sale of milk was discontinued on 2 premises—0 Poplar, 1 Bromley and 1 Bow. For milkshops connected with infectious diseases, see page 50. 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. 75 smoke nuisances were dealt with during the year:—43 Bow East, 0 Bow West, 9 Bromley North, 10 Bromley Central, 0 East Combined, 8 West Combined, and 5 Poplar South. Four summonses were issued, see pages 91-93. 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 83 such premises within the Borough, 44 Poplar, 33 Bromley, and 6 Bow. (See Table A, page 72.) Cleansing of premises was necessary in 4 instances. Seven other nuisances existed. 81 FOOD AND DRUGS ACTS. Results of Analyses. Legal Proceedings. Preservatives in Butter, Preservatives in Margarine. The results of the analyses of 730 samples were reported to the Committee during the year 1920, the samples being as follows:— Sample. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter Total. Milk 120 107 114 98 439‡ Butter — 2 12 3 17 Margarine 14 5 7 1 27 Lard 7 6 4 — 17 Coffee 1 — 3 — 4 Cocoa 5 — 6 -— 11 Pepper 4 3 2 — 9 Arrowroot 1 1 1 — 3 Glycerine — — 2 1 3 Aramoniated Tincture of Quinine — — — 1 1 Crushed Linseed — — 2 — 2 Camphorated Oil — 2 — 2 4 Calomel Ointment — — — 2 2 Ground Rice — _ 1 1 2 Ground Ginger — — — 1 1 Vinegar 18 16 12 11 57 Sweet Spirit of Nitre — 1 — — 1 Mustard 4 3 5 1 13 Baking Powder — — — 1 1 Magnesium Carbonate — — — 1 1 Heavy Magnesia — — 1 — 1 Prescriptions — 2 — — 2 Gin — 1 — 3 4 Whisky 1 5 — 10 16 Spirits — 11 — 2 13 Malt Liquors — 38 — 33 71 Condensed Milk — 8 — — 8 Totals 175 211 172 172 730 Note.—The samples of Beer and Spirits were procured under Food Control Orders. ‡Of the 439 samples of milk, 72 samples were procured on Sundays from itinerant vendors and 95 from itinerant vendors on weekdays. All the Sunday samples were in accordance with the standard and no legal proceedings were instituted. Three week-day samples were not genuine, legal proceedings were instituted in two cases, and one vendor was 82 cautioned. Samples were taken on delivery, viz., 7 Poplar Institution. 4 Out Relief Stores, 4 St. Andrew's Hospital, 5 at Railway Stations, 1 at a L.C.C. School, and 2 at the canteen of a firm in the Borough. All the samples were genuine. The Guardians were communicated with in regard to the samples procured at the Poplar Institution and OutRelief Stores, and the Managers of St. Andrew's Hospital were informed of the results of analyses of samples taken at their institutions. Results of Analyses. Legal proceedings were instituted in 4 cases and letters of caution were sent in three instances. In two cases no action was taken. Milk 3 Vinegar 1 Administrative Action regarding Articles reported to be not Genuine. Quarter ended March, 1920. Sample. No. Result of Analysis. Result of Proceedings. Milk 510 Deficient in fat and solids not fat to the extent of 10.3 and 17.8 per cent, respectively Warranty proved; summons dismissed. Vinegar 312 Adulterated with at least 10 per cent, of water. No action. Resolution of Public Health and Housing Committer. Quarter ended June, 1920. Sample. No. Result of Analysis. Result of Proceedings. Vinegar 129 Adulterated with 34.5 per cent, of water. £2 penalty; £2 2s. costs. Milk 556 Deficient in solids not fat to the extent of 3.4 per cent. Letter of caution to Vendor. 83 Quarter ended September, 1920. Sample. No. Result of Analysis. Result of Proceedings. Milk 561 Deficient in solids-not-fat 4.3 cent. Letter of caution to vendor. Heavy Magnesia 46 Sample consisted of Heavy Magnesia Carbonate. Letter of caution to vendor. Milk 58 Deficient in fat, 6 3 per cent. Dismissed; warranty proved. Milk 565 Deficient in fat, 16 3 per cent. Withdrawn on payment of £2 2s. costs. Quarter ended December, 1920. Sample. No. Result of Analysis. Result of Proceedings. Milk no Deficient in fat, 79.6 per cent. No action milk sold as "separated milk." Legal proceedings were also taken in a number of cases where infringements of various Food Control Orders and Regulations had occurred. Particulars were forwarded to the Ministry of Food and the Local Food Control Committee as well as to the Ministry of Health. Preservatives in Butter. Of the 17 samples of butter, 8 contained percentages of boric acid as follows:— 3 samples contained 0.05 per cent. 5 „ 01 „ Preservatives in Margarine Of the 27 samples of margarine, 21 contained percentages of boric acid as follows:— 11 samples contained 01 per cent. 9 „ 0.2 1 ,, 0.3 84 Margarine Act, 1887, Sale of Food and Drugs Act, 1899, and the Butter and Margarine Act, 1907. No application was received to register premises for the carrying on of businesses of wholesale dealers in margarine and milk blended butter. The following is the number of premises in each Sub-District of the Borough registered and in use under the above-mentioned Acts, up to and including 31st December, 1923, viz.:— Margarine. Butter. Sub-District. Wholesale Dealer. Manufacturer. Factory. Wholesale Dealer in Milk-blended. Poplar 3 ... ... ... Bromley 4 ... 1 ... Bow 4 ... ... ... Totals 11 ... 1 ... HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. At the end of the year there were 1,450 houses on the register, including 95 premises occupied by Chinese, which latter premises are under constant supervision. HOUSING ACTS, 1890-1919. Housing (Inspection of District) Regulations, 1910. Representations to Council under Housing Working Classes Act, 1890. Part II., Additional Staff. Housing (Inspection of District) Regulations, 1910. No premises were inspected with a view to closing under Section 17 (1) of the Housing and Town Planning, etc., Act, 1909. 85 Representations to the Council under Housing of the Working Classes Act, 1890—Part II. The following areas were represented to the Council under Part II. of the above Act:— Area. No. of houses, etc. Population. Sophia Street 11 houses and sites 57 Lower North Street 53 houses and sites 257 The Ministry of Health enquiry was held 2nd December, 1920. Report awaited. Additional Staff. Three additional Inspectors were appointed early in the year, for house-to-house inspection. For summary of report, see page 89. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1904. Verminous 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. †For the Cleansing of Verminous Persons, see pages 56-57. 86 During the year 1,024 Intimation Notices were served in respect of verminous rooms, and the verminous rooms cleansed were:— East Combined Division 114 West Combined Division 67 Popiar South Division 16 Bromley North Division 14 Bromley Central Division 46 Bow East Division 71 Bow West Division — Housing Inspectors— Poplar 77 Bromley 190 Bow 112 707 No summonses were applied for. _ RATS AND MICE DESTRUCTION. During the organised "Rat Weeks" a large quantity of barium carbonate paste was distributed to applicants, the results being highly satisfactory. Lithographic varnish traps were also used with success. The number of complaints of the presence of rats and mice has greatly diminished. It must be added that every week is a "rat week" in Poplar, and the work of destruction proceeds, principally by the use of barium carbonate paste which is still being distributed to tenants of houses, where necessary, and is recommended for use in factories, etc. Where rats are still persistent after the use of poison the ground is opened and the drain examined as a matter of routine. Accumulations of refuse are also directed to be removed. SCHOOLS. Inspection of Schools. A special report re inspection of schools was issued to all members of the Council early in 1921. RAG FLOCK ACT, 1911. No samples of rag flock were able to be procured during the year 1920. SANITARY INSPECTORS' WORK. etc. Tabulated Lists of Sanitary Inspections, etc. Legal Proceedings, Overcrowding. General. 87 Tabulated Statement of Inspections, of Insanitary Condition found existing, and of Re-inspections during the Period from 1st January, 1920, to 31st December, 1920. East combined. West combined. Poplar Soitth. Bromley North. Bromley Central. Bow East. Bow W est. Totals. Inspections:— 947 1,649 1,416 1,408 976 1,105 1,508 9,009 On Complaints of Nuisances, etc. 333 I,004 853 728 569 656 1,026 5,169 On notification o{ infectious diseases 495 645 557 661 371 439 482 3.650 House to house visitation 119 — 6 19 36 10 — 190 Houses found in good condition 237 812 523 953 212 672 854 4,263 Do. requiring amendment 710 837 893 455 764 433 654 4,746 Details of Insanitary Conditions. Walls and ceilings requiring cleansing throughout 41 21 23 68 18 19 16 206 Do. do. partially 331 439 411 221 359 209 472 2,442 Yards and areas insufficiently paved 81 86 281 51 170 1 67 737 Do. imperfectly drained 44 38 9 28 — 59 3 181 Inlets to drains not properly trapped 3 9 3 2 — 2 3 22 Drains proved defective by smoke drain test 7 32 40 14 1 29 31 154 Smoke drain test applied with negative results 120 8 239 14 297 98 93 869 Drains obstructed 50 139 116 51 14 56 70 502 Sink waste pipes directly connected with drains — 9 — 1 —. 1 1 12 Rain water pipes do. do. — 11 4 — 1 16 Soil pans of w.c.s without suitable water supply 100 21 91 45 43 1 52 353 Do. broken or unsuitable 10 11 20 15 12 19 7 94 Do. in foul condition 55 20 94 1 28 31 26 255 Do. untrapped 1 — 2 — 6 — — 9 88 East combined. W est combined. Poplar South. Bromley North. Bromley Central. Bow East. Bow Vest. Totals. Roof guttering and rainwater pipes defective 168 155 276 129 171 69 72 1,040 Roofs not watertight 236 184 296 164 279 126 194 1,479 Water supplies to premises cut off (notified by Metropolitan Water Board) 1 2 9 4 1 6 23 Water service fittings defective, causing waste of water 17 17 26 28 23 13 19 143 Drinking Water improperly stored 1 1 — — — — — 2 W.C.s badly ventilated 4 1 — 2 15 2 — 24 Do. badly situated 1 1 — — — 1 — 3 Dampness 225 105 170 35 143 116 117 911 Inundations — 5 — 2 — 2 — 9 Overcrowding 6 2 5 — — I — 14 Accumulations of dung or refuse 18 33 9 30 — 3 10 103 Foul p.h. urinals 13 9 4 17 10 — 1 54 Other nuisances, dilapidations, want of ventilations, etc. 216 228 1,007 216 450 339 628 3,084 Breaches of London County Council By laws 78 5 — — 65 77 2 227 Breaches of Council's By laws 91 6 — — — 63 3 163 Intimations served 710 759 893 466 740 433 654 4,6c 5 Notices served 277 580 261 257 536 216 477 2,604 Final notices served 94 86 82 54 131 17 41 505 Summonses applied for 4 13 2 2 — 6 — 27 Passengers from Continental Ports— Visited 11 13 I 2 — 4 5 36 Undiscovered, — 7 — — — 7 Re-Iuspections 4,638 2,917 4,484 2,180 2,666 1,691 1,891 20,467 Intimations served in respect of verminous rooms, whether in conjunction with, or separate from, other defects 95 97 152 14 141 63 83 645 89 Tabulated statement of Inspections of Insanitary Conditions found existing, and of Re-inspections, &c., during the twelve months ended 31st December, 1920 (Miss Alice Tattersall—Lady Inspector). Poplar. Bromley. Bow. Total. Workshops, Workplaces, Laundries, &c., Number of, on the Register 25 53 63 141 Workshops, Number of Workrooms there in 39 77 94 210 „ Number of Inspections of 48 82 84 214 „ Number of Re-inspections of 36 70 78 184 „ Found to be overcrowded — — — „ &c., newly discovered and registered — 6 1 7 „ Workrooms therein measured 5 4 5 14 „ Reported to H.M. Inspector on discovery — 4 1 5 Houses visited for enquiry at which no female hands were employed 205 588 806 1,599 Written intimations issued 9 13 15 37 Statutory Notices 2 11 9 22 Final Notices 1 1 2 4 Works carried out under supervision:— (a) Rooms cleansed and whitewashed 8 2 25 35 (b) Yards, roofs, &c., repaired 1 4 4 9 Additional means of ventilation provided 1 2 1 4 Sanitary Conveniences Constructed 4 4 Overcrowding of Workrooms, cases of, abated — — — — Visits re Scabies 138 153 127 418 „ Suspected infectious disease 80 209 44 333 „ Outworkers' Lists 22 21 26 69 „ Inspection cf Schools 21 21 7 49 „ Verminous School Children 13 30 73 116 Miscellaneous Inspections 36 56 24 116 Reports of Housing Inspectors. Summary, 1920. Poplar. Bomley. Bow. Totals. House-to-house Inspections 462 694 447 1,603 Re-inspections 2,835 3,370 2,384 8,589 Number of Intimations served— Public Health (London) Act 655 737 572 1,964 P.B.C. By-laws 298 447 291 1,036 L.C.C. (General Powers) Act, re verminous rooms 77 190 112 379 Number of Notices served— Public Health (London) Act ... ... ... 314 380 249 943 P.B.C. By-laws 194 239 182 615 For cleansing 167 186 126 479 Number of Final Notices served— For cleansing 57 59 60 176 Others 51 121 — 172 Number of drains tested— Chemical test 296 608 447 1,351 Smoke test 1 5 6 12 Water test 6 33 13 52 90 Police Court Proceedings No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Decision. Result. Name of Officer. 303, Manchester-road Various defects 1920. 2nd March Adjourned sine die. Reinstated ; owner ordered to do work and pay £2 2s. costs Brown, C. H. 140, Armagh-road Roofs of workshops defective 1st March Work done ; £2 4s. costs Tattersall,Miss A. 337, St: Leonard's Road Various defects 4th March £2 8s. costs ; 14 days' abatement order Johnson, Wm. 65, Bromley Hall Road Ditto 11th March £3 3s. costs ; 7 days' abatement order Ditto. 22, Marner Street W.C. cistern defective 11th March £1 Is. penalty ; £3 3s. costs ... Ditto. 25, Portree Street Various defects 11th March £3 3s. costs ; 7 days' abatement order Ditto. 60, Merchant Street W.C. without water supply 25th March £1 penalty; £1 Is. costs Tattersall,Miss A. 66, Donald Street Various defects 8th April £5 penalty ; £2 8s. costs ; 7 days' abatement order Johnson, Wm. 17, Garford Street Ditto 7th April £5 5s. costs; 7 (lays' abatement order Johnson,- J. 49, Pennyfields Woodwork back of sink defective 15th April Summons withdrawn Grabham.C. A. 51, Pennyfields Various defects 15th April Ditto Ditto 49, Pennyfields Failed to comply with notice re cleansing 15th April Ditto Ditto. 91 A605I No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Decision. Result. Name of Officer 51, Pennyfields Owner failed to comply with notice re cleansing 15th April Summons withdrawn Grabham.C. A. 7, Weston Street W.C. and main drain choked 29th April £2 8s. costs; 7 days' abatement order Langley, H. J. Engert and Rolfe, Barchester Street Smoke nuisance 4th May £10 penalty ; £5 5s. costs Johnson, J. 154, Brunswick Road Failed to comply with notice to cleanse, alter, and amend the drains 27th May £1 penalty; £2 2s. costs Johnson, Wm. 156, Brunswick Road Ditto 27th May £1 penalty; £1 Is. costs Ditto. 248, St. Leonard's Road Various defects 17th June £2 penalty; £2 8s. costs; 14 days' abatement order Ditto. 260, St. Leonard's Road Ditto 17th June £2 penalty; £2 8s. costs; 14 days' abatement order Ditto. 63, Devas Street W.C. trap defective 21st June £2 4s. costs; summons withdrawn H. A. Pearce. 8, Weston Street 9, Weston Street Various defects Ditto 10th July | 20th July £5 5s. costs; 60 days' abatement order Ditto. Ditto. 59, Rothbury Road Yard not properly paved and sloped 23rd July £1 penalty; £1 Is. costs Smith, F. A. Ditto 1 Various defects 23rd July £2 8s. costs; 14 days' abatement order Ditto. 19, Broomfield Street Ditto 28th July £2 2s. costs; 28 days' abatement order Johnson, J. 92 Police Court Proceedings—continued. No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Decision. Result. Name of Officer. 40, Rothbury Road Various defects 27th August | £2 8s. costs ; 14 days' Smith, F. A. 38, Rothbury Road Ditto 27th August ) ment order Ditto. 40, Rothbury Road Yard not properly paved and sloped 27th August 5s. penalty Ditto. Achille Serre and Co., Ltd., Whitepost Lane Smoke nuisance 3rd September £3 3s. costs Field, A. J. 13, Hawthorn Buildings Various defects 17th September £5 penalty; £1 Is. costs; 7 days' abatement order Pearce, H. A. Ditto W.C. without water supply 17th September £1 Is. costs; 7 days' abatement order Ditto. 8, Tomlin's Grove Various defects 20th September 6s. costs; 21 days' abatement order Langley, H. J. 36, Cardigan Road Failed to comply with notice to cleanse, alter and amend the drains 5th October £1 Is. costs. System held to be a "drain"* Boyce, W. 34, Cardigan Road Ditto 5th October £1 Is. costs. Ditto. Passage way, Cardigan Road Ditto 5th October £2 2s. costs. Ditto. 8, Harley Street Various defects 23rd September £2 8s. costs; 7 days' abatement order Field, A. J. 19, Broomfield-street Failed to comply with Magistrates' Order to abate nuisance 8th October £5 penalty; £2 8s. costs Johnson, J. * During reconstruction found to be a " sewer." Costs refunded. 93 A6051 No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Decision. Result. Name of Officer. 13, Hawthorn Buildings Failed to comply with order to abate the nuisance 13th October £2 penalty; £2 2s. costs Pearce, H. A. Ditto Failed to comply with Magistrate's Order under Section 12 Public Health (London) Act, 1891 13th October £2 penalty; £2 2s. costs Ditto. 14, Ricardo Street Various defects 13th October £2 8s. costs ; 28 days' abatement order Johnson, J. Bryant and May, Ltd., Bow Smoke nuisance 1st November £2 penalty; £5 5s. costs Field, A. J. 62, Guildford Road Various defects 1st November £2 88. costs; 28 days' abatement order Johnson, J. Achille Serre and Co., Ltd., Whitepost Lane Smoke nuisance 3rd November & 12th January, 1921 £10 costs; abatement order made Field, A. J. 47, Monier Road Failed to comply with notice to cleanse, alter, and amend the drains 2nd November £3 3s. costs; system held to be a "drain" Ditto. Chrisp Street (stall) 10 tins of condensed milk exposed for sale which were unfit for food of man 28th October Condemnation order made Johnson, J. 3, Marner Street Various defects 10th November £5 penalty; £3 3s. costs Johnson, Wm. 5. Marner Street Ditto 10th November £5 penalty; £3 3s. costs Ditto. 7, Marner Street Ditto 10th November £5 penalty; £3 3s. costs Ditto. 9, Marner Street Ditto 10th November £5 penalty; £3 3s. costs Ditto. Chrisp Street (stall) 10 tins of condensed milk exposed for sale which were unfit for food of man 11th November £25 penalty; £5 5s. costs or 6 weeks' imprisonment Johnson. J. 94 Police Court Proceedings—continued. No. of Street or Name of Premises or Locality, &c. Nature of Complaint. Date of Decision. Result. Name of Officer. 8, Weston Street Failed to comply with Magistrate's Order to abate nuisance 23rd November £1 penalty; £3 3s. costs Pearce. H. A 9, Weston Street Ditto 23rd November £1 penalty; £3 3s. costs Ditto. 20, Hawthorn Buildings Various defects ... 30th November f5 penalty; £2 8s. costs; 14 days' abatement order Ditto. 14, Ellerthorpe Street Ditto 29th November £3 3s. costs; 14 days' abatement order Johnson, J. 30, Pekin Street Ditto 29th November £3 3s. costs; 14 days' abatement order Ditto. 16, Clutton Street Failed to comply with by-laws re yard paving 8th December £2 2s. costs; (work done) Johnson, Wm. 14. Ricardo Street Failed to comply with Magistrate's order to abate nuisance 21st December (Adjourned to 18th January, 1921) £5 penalty; £5 5s. costs Johnson, J. HOUSING, TOWN PLANNING, ETC., ACT, 1919. 49 and 51, Pennyfields Demanded rent, name of Medical Officer of Health not on rent books 29th April £4 8s. costs (2 summonses) ... Grabbam,C. A. Ditto Collected rent, name of Medical Officer of Health not on rent books 29th April £4 8s. costs (2 summonses) Ditto. Ditto Demanded rent, amount of rates payable by owner not on rent book 29th April £1 8s. costs (2 summonses) Ditto. 51, Allanmouth Road Demanded rent, name of Medical Officer of Health not on rent book 29th April £1 1s. costs Smith, F. A. Ditto Collected rent, name of Medical Officer of Health not on rent book 29th April £1 1s. costs Ditto. Ditto Demanded rent, amount of rates payable by owner not on rent book 29th April £1 1s. costs Ditto. Note.—For proceedings under Food and Drugs Acts, see pages 82 and 83. 95 Overcrowding. Fourteen cases of overcrowding were abated. No cases of overcrowding were found in workshops. General. 6,311 communications were received, and 2,188 complaints (including 69 smoke) as to nuisances were made. 5,018 communications were despatched. It is with deep regret I have to record the death, early in 1920, of Mr. C. Foad, sanitary inspector for the Poplar South Division. Mr. Foad was an unwearying, most painstaking and highly conscientious officer, a very popular colleague, and his death was greatly deplored by the members of the Public Health Department. I am, Sir, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. Metropolitan Borough of Poplar, Public Health Offices, Bow Road, E. April, 1921. 9(5 Report of Tuberculosis Officer. In the "Memorandum as to contents and arrangement of the Annual Reports of Medical Officers of Health for 1920," the Ministry of Health require to be included in the annual report the following particulars relating to the administration of the Council's Tuberculosis Scheme. The information below has been furnished by the Tuberculosis Officer, Dr. W. C. P. Smith. (i.) A list of dispensaries, specifying also branch dispensaries and visiting stations; a list of the Tuberculosis Officers employed; a statement of the numbers of other officers employed in dispensary work; a list of residential institutions, specifying for each the number of beds normally available for patients from the area of the Local Authority, and the type of case for which these beds are used. In the case of residential institutions belonging to the Local Authority, the names of the Medical Officers and the number of other officers should be given. Tuberculosis. (1) (a) Tuberculosis Dispensary.—Alexandra House, 135, Bow Road, E. Premises unsuitable, owing to noise, being situated on the main road—which is paved with granite setts and ever which the traffic is heavy. At the back the noise is even more troublesome—owing to the recent extension of a neighbouring engineering works—in such a way as to practically surround the dispensary at close quarters. The Council are negotiating for other premises in Wellington Road. This is a comparatively quiet site, and far better suited for the purposes of a dispensary. (b) Proposed Branch Dispensary. — No. 116, High Street, Poplar, has been acquired for the purposes of a Branch Dispensary, to serve the southern part of the Borough. This branch will be opened so soon as possession of the premises—which are at present occupied—can be obtained. Tuberculosis Officer : W. C. P. Smith. Assistant Tuberculosis Officer : F. N. Moos. Other Officers :— 3 Health Visitors. 1 Dispenser. 1 Clerk. 1 Assistant Clerk. 1 Part-time Helper (female). 1 Caretaker. 97 Residential Institutions:— (a) Sanatoria—hospitals and homes available through the medium of the London Insurance Committee for insured cases and ex-service men. (b) Similar institutions available for uninsured cases, through the medium of the London County Council. (c) The Poor-Law Infirmary. (d) In a few cases in-patient letters for Victoria Park and other hospitals are made use of. (ii.) In the case of administrative counties, precise particulars of arrangements for co-operation with Sanitary Authorities and their officers. Nil. (iii.) The nature and extent of co-operation with general and special hospitals, school clinics, and other institutions. General Hospitals:— Under an agreement made between the Borough Council and the London Hospital, cases of surgical tuberculosis may be referred to the latter institution for opinion or treatment. A fair number of cases are dealt with in this way. Other patients are sent for dental treatment, or the removal of tonsils and adenoids. Special Hospitals:— No special arrangements exist, but cases, for the most part nontuberculous, are referred to Victoria Park Hospital; sometimes they are given an out-patient's letter. Other cases are referred to the Children's Hospitals, either at Shadwell or Hackney Road. School Clinics, etc. :— A large number of children are sent to the school clinics for the treatment of enlarged tonsils and adenoids, others for dental or aural treatment. Co-operation with the School Medical Officers is in course of development. A number of children come up to the dispensary on the recommendation of the School Medical Officer. In these cases—and in the cases of other school children examined at the dispensary—where there is definite or suspected tubercle, full particulars of the case are entered on a special card, which is sent to the Divisional School Medical Officer for his information, and which may contain a recommendation for the provision of milk or meals for the child at school. When further attendance of the child at the dispensary, for either treatment or observation is considered unnecessary, a request that the child shall come up again for re-examination after a stated interval is entered on the card, which now passes into the keeping of the Divisional School Medical Officer, 98 who undertakes to keep the patient under supervision, and arrange for his or her re-attendance at the dispensary in due course. This method of co-operation has only recently been started. It is hoped that it will lead to a better supervision of definite and especially of doubtful cases, that it will relieve the congestion at the dispensary due to unnecessary re-attendances and prevent a good deal of overlapping. (iv.) Any special arrangements made to secure the co-operation of medical practitioners and the working of the arrangements for periodical reports on insured patients under domiciliary treatment. Patients, both insured and uninsured, are constantly being sent up to the dispensary by local practitioners, for examination. In all cases a report is sent to the doctor, giving the result of physical, sputum, and frequently X-ray examinations, and suggestions as to the best method of dealing with tho case. The resources of the dispensary are at all times at the service of the private practitioner. The arrangements for the collection of periodical reports on domiciliary cases have worked fairly well. In the majority of cases the required report is obtained, though not always at the appointed time. (v.) The arrangements for following up patients in cases where the diagnosis is doubtful. The method of dealing with doubtful eases depends to some extent upon the class of case. If it is a legitimate dispensary case (viz., uninsured, with no other provision for medical attention) the patient may be kept attending the dispensary under treatment with a view to further examination and re-examination, until a definite opinion can be formed. In practice, however, it has been found almost impossible to find opportunities for re-examining these cases as desired, owing to the number of other patients who have to be seen. This quickly leads to an accumulation of undiagnosed cases, which hampers the working of the dispensary, so that, except in very suspicious cases, the patient is not kept attending, but an appointment is made for re-examination after a stated interval. If the case has been sent up by a panel or private doctor, it is referred back to him with a request that he will keep it under observation, and send it up for re-examination later. Insured cases in which there is considerable suspicion may be recommended to hospital for observation. Suspicious cases among school children are dealt with, as already explained, by arrangement with the School Medical Department. (vi.) The arrangements for securing the examination and systematic supervision of " home contacts." Home contacts are for the most part examined at the dispensary, it being the duty of the health visitor to arrange for their attendance at 99 a convenient time. In this way it has been found that practically all the children and a considerable number of the women contacts can be dealt with. Those contacts who are insured and other adult contacts are being asked to attend at the special evening clinic. It is too early yet to form an opinion as to the efficacy of this arrangement. (vii.) Information as to special methods of diagnosis and treatment in use and the number of persons to whom these special methods have been applied. An X-ray apparatus is in constant use for diagnostic purposes. For the most part it is used for screen work only ; lack of time and of facilities for the development of plates preventing the making of radiographs, except in a few cases. No special record of the number of cases examined in this way has been kept. A moderate estimate for 1920 would be 50 per cent, of the new cases. (viii.) The results of local experience as to the relative value of each form of treatment. No special form of treatment is at present in use. (ix.) The nature and extent of any dental treatment provided by the council for tuberculous patients. Nil at present. A proposed dental clinic has for some time been awaiting the approval of the Ministry of Health. (x.) Any arrangements for the provision of nursing or of extra nourishment for patients living at home. No special arrangements for the provision of nursing for adults and children over 10 years of age exist, but it is frequently possible to obtain such assistance in the person of a district nurse or from local nursing associations. The Borough Council undertake the nursing of children up to 10 years of age. There is no provision for extra nourishment except such as can be obtained from the War Pensions Committee, for ex-service men, by application to the Poor-Law Guardians. (xi.) The arrangements for treating non-pulmonary tuberculosis, especially tuberculosis of bones and joints in adults and in children, and for the provision of surgical apparatus, etc. Non-pulmonary cases, including especially cases of bone and joint disease, requiring residential institutional treatment, are referred to either the London Insurance Committee or the London County Council, according as they are or are not insured. Those cases requiring out-patient treatment only are generally sent to the London Hospital, as are also cases of Lupus, for Finsen Light treatment. 100 Any necessary surgical apparatus is usually obtained through the hospital Almoners' Department, the Invalid Children Aid Association, the Charity Organisation Society, or other charitable bodies. (xii.) The arrangements for "care" and "after care" and their working. Care and after care are in the hands of the Care Committee, which meets fortnightly. Most of the organisations engaged in social work in the Borough are represented on the Committee, and many of the cases which come up for consideration are already known to one or other of them. The Committee is doing excellent work in several directions, notably in arranging for the care of children during the absence of the parents, especially the mother, in sanatorium or hospital. (xiii.) Particulars as to any local arrangements for finding employment for patients. No arrangements exist for finding employment for patients, except the Labour Bureaux, which are of little or no value to the tuberculosis patient, who usually requires a light occupation. (xiv.) Statement as to the supply and supervision of shelters at the homes of patients. Three shelters are at present out on loan. (xv.) Any special points noted locally as to the incidence of tuberculosis (i.e., occupation). The "occupation" tables over several years show a marked preponderance of cases amongst general labourers. This is probably more a question of the regularity or otherwise of the occupation than of its character. Next in order come clerks, and then machinists. Apart from these, the figures for any particular occupation are too small to draw any conclusions from. (xvi.) Any special methods adopted or proposed for the prevention of tuberculosis. No special method outside the general scheme. An open-air school would be a very useful aid. (xvii.) Special difficulties encountered. The difficulty of finding suitable work, within the capacity of the tuberculous case, especially for the unskilled worker. There is still considerable difficulty in finding adequate institutional accommodation for advanced cases, apart from the Poor-Law Infirmary. The difficulty of finding other and better accommodation for cases, where the home conditions are adverse. 101 Report to Medical Officer of Health of Miss A. E. Hall, Chief Health Visitor. Public Health Offices, Bow Road, E. 3. January 3rd, 1921. Sir, I beg to present the thirteenth Annual Report of the work of the Maternity and Child Welfare Department—quite the most strenuousyear we have known. In January, an additional Health Visitor was appointed for the Bow District, and you approved the introduction of new " Daily Diaries " for Health Visitors. In April, a Dental Clinic was opened at Old Ford, sessions every Wednesday, 10—12 a.m., and a Clinic at Allanmouth Road, sessions every Monday 11 a.m.—1 p.m. (infant consultations); 2—4 p.m. (treatment minor ailments and ante-natal). In that month the Council also accepted responsibility for the work previously undertaken by the Poplar Infant Welfare Association, i.e., home visiting south of the first bridges, with Clinics at Christ Church Schools, sessions every Thursday and Friday 2—4 p.m. (infant consultations), and at 54, West Ferry Road, sessions every Wednesday 2—4 p.m. (infant consultations), first Monday in the month 2—4 p.m. (ante-natal), and a Sewing Class every Monday 2—4 p.m. The Sewing Class at Old Ford was reopened in September. Later the Royal College of St. Katharine intimated that they were unable to continue the work south of East India Dock Road. The Council appointed an additional Health Visitor ; the home visiting was taken over on October 1st, and a Clinic opened at St. Joseph's Institute, Shirbutt Street, December 1st, sessions every Wednesday 2—4 p.m. (infant consultations). The visiting areas now are:— The Royal College of St. Katharine. All the work between East India Dock Road and Bow Road. The Poplar Borough Council. All the work north of Bow Road, and south of East India Dock Road. The abnormal increase in the attendances at Old Ford (6,645, as against 3,443) was entirely due to the Clinic being used as a distributing centre for free milk ; the attendance is now normal. It is possible that the attendances at other Clinics were also affected, but in a smaller degree, as the figures given are only for nine months. 102 The Clinic at Allanmouth Road is not a success—there may be other causes operating, but the chief one is the cold, miserable atmosphere of the weighing room. The Ante-natal Clinics also are not a success, at least, as far as ante-natal work is concerned. The attendance of expectant mothers at all clinics would not make one decent session. The inquiries in the milk cases were not test cases, all the statements as to wages were doubtful. The usual Baby Show was organised in connection with the Mayor's Garden Party. Our very grateful thanks are due to Midwife Hulett for the loan of a sewing machine. We now have one of our own, presented by the Mayor's Garden Party Committee, to whom our very hearty thanks are also due. Visiting. Public Health Dept. Royal College of St. Katharine. Total. Ante-Natal 594 1,234 1,828 Post-Natal— Visits 1,714 3,318 5,032 Removed before visit 28 34 62 Died before visit 35 68 103 Still-born 112 20 132 Revisits— Under one 5,021 19,561 24,582 One—five 7,935 32,341 40,276 Removed 197 140 337 Died 155 173 328 Zymotic Enteritis— Visits 20 82 102 Revisits 44 48 92 Died 1 1 Measles— Visits 76 133 209 Revisits 60 38 98 Died 2 4 6 Ophthalmia Neonatorum— Visits 58 — 58 Revisits 86 — 86 Miscellaneous 193 2,574 2,767 Total Visits paid 75,130 103 Stillbirths. Number of stillbirths 144 Delivered in institutions and no information available 20 Premature births 43 Foetus macerated 30 First pregnancies 24 Mothers who worked during pregnancy 13 Instrumental deliveries (forceps) 8 Induction (one (?) hydramnios, one mother def.) 2 Transverse presentations 2 Prolapse of cord 3 One of triplets 1 One of twins 4 Breech presentations 16 Ante-partum hæmorrhage 11 Malformation (child) 1 Cord round neck 2 Five mothers died too. Mothers who had had previous stillbirths :— Miscarriages:— One. Two. Three. Four. Five. 12 1 3 — — 12 5 2 — 1 Eight attributed the fact that the child was stillborn to " shock," ten to "accident," fourteen to "ill-health" (two tumours, one epileptic, two epistaxis, one diabetes, one septic poisoning, one anaemia, five influenza and pneumonia, one severe bilious attack), two to " blows in street fight," one "excitement" (was sailing for Africa, taken ill in shipping office), and one to-" efforts in early months to get rid of it." Nursing. Ophth. Neon. Measles. Zy. Enteritis. Influenza. Cases. Visits. Cases Visits. Cases Visits. Cases. Visits. East London Nursing Society 12 343 32 421 — — 4 54 St. John Divine 6 174 — — — — — — Millwall & Cubitt Town 4 158 1 25 — — — — The Ranyard Nursas 1 26 9 158 — — — — Total 23 701 42 604 — — 4 54 104 Zymotic Enteritis. Visited 99 Failed to trace 3 Under 1 year 45 1 to 2 years 27 2 to 3 years 16 3 to 4 years 5 4 to 5 years 2 Died before notification received 1 Feeding. Age period. Breast. Mixed feeding. Hand fed. Not stated. Under 1 year 22 6 17 — 1 to 2 years 1 7 18 1 (Fresh milk eight, dried milk seven, condensed milk two.) Medical Advice Obtained. Same day 13 1 day 22 2 days 24 3 days 2 4 days 7 5 days 1 6 days 6 No information or too doubtful to use 24 Ophthalmia Neonatorum. Number of notifications received 61 Died whilst under supervision 1 Removed whilst under supervision 1 Remaining in hospital end of year 2 Recovered 57 Occurred in institutions 2 Occurred in the practice of medical practitioners 11 Occurred in the practice of midwives 48 Admitted to hospital as in-patients 8 Treated as hospital out-patients 18 Treated privately 33 Visited by nurse 25 105 Old Ford Clinics. Dental Clinic (April, 1920.) Number of attendances 244 Fillings Permanent 31 Temporary 1 Local anaesthetics, extractions:— Permanent 125 Temporary 20 N.,0 extractions:— Permanent 174 Temporary 37 Scalings 31 Dressings 4 Other operations 82 Average attendance—6.4. Ante-Natal. Expectant mothers First attendances 44 Total attendances 103 Average attendance each session 1.9 Potential mothers:— First attendances 105 Total attendances 426 Average attendance each session 8.1 Infant Consultations. First attendances 899 Total attendances 6,645 Average attendance each session 63.7 Treatment Minor Ailments. First attendances 469 Total attendances 1,192 Average attendance each session 22.9 Eye Clinic. First attendances 50 Total attendances 91 Average attendance each session 8.2 Sewing Class. Total attendances 168 Average attendance each session 9.8 106 Allanmouth Road Clinic. (April, 1920.) Ante-Natal. Expectant mothers:— First attendances 7 Total attendances 21 Average attendance each session 0.6 Potential mothers:— First attendances 35 Total attendances 91 Average attendance each session 2.6 Infant Consultations. First attendances 98 Total attendances 892 Average attendance each session 25.4 Treatment Minor Ailments. First attendances 96 Total attendances 228 Average attendance each session 6.5 West Ferry Road Clinic. (April, 1920.) Infant Consultations. First attendances 218 Total attendances 1,345 Average attendance each session 35.3 Ante-Natal. Expectant mothers:— First attendances 19 Total attendances 19 Average attendance each session 2.3 Sewing Class. Total attendances 353 Average attendance each session 10.8 Christ Church Schools. (April, 1920.) Infant Consultations. First attendances 355 Total attendances 2,563 Average attendance each session 34.6 107 Shirbutt Street (North Poplar) Clinic. (December, 1920.) Infant Consultations. First attendances 56 Total attendances 109 Average attendance each session 21.8 Money Taken. £ s. d. For Dried milk (4,249 lbs.) 466 19 3 ,, Fresh milk 1 5 6 „ Sugar (258½ lbs.) 9 18 3 ,, Medical sundries 49 10 0½ ,, Dentures 21 9 6 ,, Spectacles (31 pairs) 9 2 1 ,, Materials at sewing class 38 10 2½ Total money taken £596 14 10 3,385 vouchers for cod liver oil, malt, etc., were also issued. Grants. Free vouchers 3 cases " Grants in aid " spectacles 2 „ Free dentures 1 ,, Free convalescent treatment (one mother, two children) 3 ,, Free attendance of midwife 1 „ Loan of maternity bag 1 „ Milk (Mothers' and Children's Order). Qualifications. January 1st Expectant and nursing mothers, and children under five, where income does not exceed 12s. 6d. per head less rent, income based on earnings of husband and contributions of children. „ 9th Part payment could be made if income found to be more than above. ,, 13th To be given to all, without enquiry. (a.m.) ,, 13th To keep three lists—(1) Under 12s. 6d. per head less (p.m.) rent, free. (2) Over 12s. 6d., part payment. (3) Well over 12s. 6d., pay for their own. A6051 H 108 February 16th Over 12s. 6d. less rent, on medical certificate. Between 10s. and 12s. 6d., half price. Under 10s., free. Expectant mothers to produce a certificate of seven months' pregnancy from doctor or midwife. No application to be considered where the income per head less rent is over 12s. 6d. March 1st Between 10s. and 12s. Gd., on medical certificate. Under 10s., free. Total earnings of family to be taken as basis. May 3rd Families of four and under, 12s. 6d. per head less rent. Applications. January The Royal College of St. Katharine, and the Poplar Infant Welfare Association, to receive and deal with their own applications, forwarding a list of applications granted to this department each month. Applications to be received at every session of the maternity clinics throughout the Borough. April Poplar Infant Welfare Association taken over by Council. Applications received:—West Ferry Road, Wednesday; Christ Church, Thursday; Allanmouth Road, Monday; Old Ford, Thursday and Friday. September 13th All applications to be made at the Public Health Offices on printed forms. December 13th Whole organisation transferred to Public Health Department. Enquiries. January None. February 12th Stated income to be compared with Trade Union rates. If obviously inaccurate, and husband's permission obtained, Borough Council to verify. Milk to be granted pending enquiry. February 18th Committee to verify in doubtful or inaccurate cases (without husband's permission). September 13th (Introduction of printed forms.) Enquiries in doubtful cases made before milk granted. Quantity Allowed. January As per Ministry of Health's scale—Children under 18 months, not more than 1½ pints daily; over 18 months, not more than 1 pint. Expectant mothers, as specified by Medical Officer. Allowed for 28 days. 109 May Not more than three pints to one family. Dried or condensed milk (in proportion to fresh) on certificate from doctor. Orders to be given on dairymen named by applicant,if trade conducted on Trade Union lines, and milk supplied at 2d. per gallon less than current retail prices. Number of enquiries made 315 Statements found to be untrue 211 Statements found to be true 54 No reply 50 Number of Sub-Committee meetings held and attended 33 Number of applications granted 17,095 Cow's milk 109,198¼ gallons. Dried milk (free) 3,454 lbs. Dried milk (at cost price) 4,249 lbs. Condensed milk 49 tins. Vital Statistics, 1919. All births, including those occurring in out-lying districts, but belonging to the Borough 4,417 Attended by doctors 853 Attended by midwives 3,245 Delivered in institutions 198 Not stated 121 Stillborn 103 Died before visit 117 Not requiring or not desiring visits 397 Visited 3,800 Removed and not traced 280 Died during visitation 243 Remaining under supervision end of first year 3,277 Stillbirths per 1,000 births 23.3 Mortality per 1,000 births, died before visit 27.1 Mortality per 1,000 visited 69.0 The feeding of the infants during the first six months of life was as follows:— 1. Those alive at end of completed year (December, 1920)— Breast fed 75.3 per cent. Mixed feeding 21.0 Hand-fed 3.6 „ 110 2. Those who died— Breast fed per cent. Mixed feeding 32.9 „ Hand-fed 11.5 „ 3. Comparison of rates of mortality between infants— Breast-fed 5.1 per cent. Mixed feeding 10.4 Hand-fed 19.1 „ Vital Statistics, 1918. Remaining under supervision end of first year 2,372 Found 9 Given up 9 Removed and not traced 68 Died 85 Remaining under supervision end of second year 2,219 Mortality per 1,000 visited, second year 36.8 (51.6) Vital Statistics, 1917. Remaining under supervision end of second year 2,221 Found 32 Removed and not traced 81 Remaining under supervision end of third year 2,129 Mortality per 1,000 visited, third year 19.7 (24.1) Vital Statistics, 1916. Remaining under supervision end of third year 2,348 Found 51 Given up 3 Removed and not traced 83 Died 28 Remaining under supervision end of fourth year 2,285 Mortality per 1,000 visited, fourth year 12.1 (18.1) 111 Vital Statistics, 1915. Remaining under supervision end of fourth year 2,221 Found 43 Given up 2 Died 47 Remaining under supervision end of fifth year 2,201 Mortality per 1,000 visited, fifth year 6.3 (8.4) The figures in brackets are the rates for the previous year. As will he seen, the mortality during each period shows a marked decrease. I remain, Sir, Your obedient Servant, ALICE E. HALL. 112 Annual Report of Clinic Dental Surgeon. To the Medical Officer of Health. Sir, The Dental Clinic in connection with the Old Ford Maternity and Child Welfare Centre has now been in operation for one year ; the first session was held on April 7th, 1920, and thereafter once weekly till March 30th, 1921. I beg to submit a report on our progress:— I.—From the records kept we find that— 53 Sessions have been held, two hours each, representing 106 hours. 114 Patients have been treated and finished, with the exception of a few current cases. 365 Attendances have been made at the clinic. 532 Teeth have been extracted. 63 Teeth have been filled. 23 Dentures have been fitted. II.—From these figures we may deduce the following information in averages- Average number of patients dealt with at each session... 6.80 Average number of attendances per patient ... ... 3.20 Average number of patients treated and finished per session *2.15 III.—Treatment.—Extraction, so far, is the largest heading under which treatment falls, with subsequent fitting of artificial dentures-. Scaling is found to be of the greatest importance (with which is included various forms of gum treatment). Fillings, at present, are possibly the smallest item. I am of opinion that the order of importance should be reversed, to reach the ideal , but the following facts must be remembered. We have a condition of affairs in which dental treatment has been absent till quite recently. The results are mouths in which dental disease is of very long standing. We are therefore only treating the urgent cases which come for relief from pain and discomfort now. These have passed the conservative stage. It is to be anticipated, therefore, that in time the urgent cases will have been worked off to a great extent, and we shall then be able, through the education and enlightenment of the people, to treat cases in the first stages of dental disease instead of the last. * From a knowledge of the foul and neglected mouths of the majority of patients, this average number is surprising. 113 IV.—Staff.—Consists of a nurse in attendance besides myself. On anaesthetic days we have the services of an anaesthetist, of course, and those of a health visitor in the recovery room. It will, therefore, be seen that we have no clerical help, though it is usual to have a clerk in most clinics. This means a more considerable item than is often realised. However, time spent on clerical work is made up by the use of up-to-date appliances and methods, and, further, the emoluments required by a clerk help to defray the cost of the up-to-date appliances. Unless the work at the clinic grows out of all proportion, I think we can dispense with outside clerical help for some time to come. I desire to take this opportunity of thanking those connected with me in the work for their valuable help and co-operation. V.—Premises.—Not much need be said about our premises ; it is too obvious that they are not faultless, but this fact is considerably counterbalanced by our modern appointments. I have no hesitation in saying that, given decent premises, the clinic would rank amongst the first in London. VI.—General observations.—Considering the usual distrust and prejudice with regard to dentistry by the working classes, I think our first year's progress is highly gratifying. The actual results in figures show great promise, and from my own observations, I think our efforts are very much appreciated. The amount of work to be got through before the ideal is reached, however, is stupendous. The fact that we can undercut the unqualified in denture work, as has been proved, will be a great point for us. I have the honour to remain, Sir, Yours faithfully, C. HAMMOND WILLIAMS, L.D.S., R.C.S. (Eng.).