Pop 3o Metropolitan Borough of Poplar. Annual Report for the YEAR 1924 on The Sanitary Condition and Vital Statistics of the Metropolitan Borough of Poplar, comprising the Registration Sub.districts of POPLAR, and BOW and BROMLEY, By FREDK. WM. ALEXANDER, Medical Officer of Health. V PUBLIC HEALTH AND HOUSING COMMITTEE. Councillor C. W. Key, J.P., Mayor (ex.officio). Councillor J. T. O'Callaghan (Chairman). Councillor Mrs. J. Mackay (Vice.Chairman). Councillor J. Ashley Councillor Mrs. E M. Lambert ,, T. J. Blacketer Alderman Miss M. Lester ,, H. E. Butler Councillor Mrs. J. A. March ,, A. J. R. Chidley ,, C. Petherick ,, T. J. Goodway ,, Mrs. J. Scurr, J.P. ,, C. J. Kelly, L.C.C. Alderman C. A. Tanner Councillor W. J. Whitelock. MATERNITY AND CHILD WELFARE COMMITTEE. Councillor C. W. Key, J.P., Mayor (ex.officio). Councillor Mrs. J. Scurr, J.P. (Chairman). Councillor Mrs. J. A. March (Vice.Chairman). Councillor T. J. Blacketer Councillor G. A. Newton * )> G. J. Cressall ,, J. Rogers )> Mrs. N. F. Cressall ,, W. J. Whitelock >> Mrs. E. M. Lambert Co.opted Members: Alderman Miss M. Lester Miss E. Herbert Mrs. Power vi STAFF. Medical Officer of Health: FREDERICK WILLIAM ALEXANDER, M.R.C.S., L.R.C.P. (Edin.), D.P.H. (ENG.). Public Analyst: ALBERT E. PARKES, F.I.C., F.C.S. Chief Clerk: HAROLD DYER.f Sanitarv Inspectors: (a) H. A. Tibbatts.* (a) J. Johnson.*§ (a) C. H. Brown.*! J § (a) II. J. Langley.* (a) Wm. Johnson. (a) A. J. Field.f (a) W. BoYCJJ.f (b) C. A. Grabham.*} (b) H. A. Pearce.*t§+ (b) F. A. Smith.*+ Miss M. E. Davies.*|11!! (from 2nd Feb., 1921). (a) Inspector under the Food and Drugs Acts and the Canal Boats Acts. (1>) Housing Inspector. Clerks: F. J. White. W. F. Roberts. A. Hamilton. H. C. Rodford. Miss S. Fells. H. A. Purdy. Miss E. Hamilton. Offices—Caretaker and Messenger : J. J. Jackson. * Cert. S.I.E. Board. f Cert R.S.I. J Cert. Meat and Food Inspector. § K.P.C. IF O.M.B. II H.V. Cert. (Board of Education). NOTE.—Contributions under tlie Public Health Acts or by Exchequer GranU are made towards the salaries of the Medical Officer of Health, Sanitary Inspector.', the Maternity and Child Welfare and the Tuberculosis Dispensary Stall's. vii MATERNITY AND CHILD WELFARE. Chief Health Visitor : Miss J. M. CARDozo*Htf. Health Visitors : Miss E. A. Foskett.*¶ Mrs. M. J. Edgei.l.§¶ Miss M. Mallett.* Mrs. E. K. ¶aythornthwaite.*¶ Miss G. E. Paice.*†† Miss D. A. E. Landray.*¶† (from 20th Oct., 1924). Clerk: Miss G. Hood. There are four Doctors, one Dental Surgeon and an Anaesthetist attending the Council's Clinics. Free Milk Scheme. Temporary Clerks: Miss R. Williams. Miss M. L. Thompson. Investigation and Enquiry Officer: C. A. Webster (temporary). TUBERCULOSIS DISPENSARY, 1, WELLINGTON ROAD. Tuberculosis Officer: W. C. P. Smith, B.A. (Camb.), M.R.C.S., L.R.C.P., D.P.H. (Camb.) Assistant Tuberculosis Officer: D. H. Geffen, M.D. (Lond.), B.S., D.P.H. (Resigned). C. K. Cullen, M.R.C.S., L.R.C.P. (from 13th May, 1924). Miss H. Messem. Dispenser: Mrs. A. M. Smith. Health Visitors: Miss D. Wood.‡ Miss E. S. Jones. Miss N. Roberts.** Clerks: Miss A. Rogers. Secretary to Care Committee : Miss L. Nugent (from 1st March, 1924). Nurse.Helper: Mrs. E. Tomlins (temporary). Caretaker: J. Tyler. DISINFECTING STATION, YEO STREET. Disinfectors: W. D. Quested (Chief). D. Boyce. Shelter and Cleansing Station Attendant: Mrs. A. Howe. MORTUARY. Mortuary Keeper and Caretaker of Coroner's Court: J. Brown. * C.M.B. † Cert. S.I.E.B. § Cert. Mid. Colonial Medical Association. ‡ H.V. Cert. R.S.I, and San. Insp. Cert. B.S.I. ** H.V.Cert.R.S.I. ¶ Three Years' General Nursing Certificate, †† Fully Trained at Children's Hospital. viii SUMMARY OF STATISTICS FOR 1924. Area of Borough (excluding water) 2,136 acres Population (Census, 1921) 162,618 Population, estimated to middle of 1924 167,300 Density 78.3 Number of Marriages 1,277 Number of Inhabited Houses (Census, 1921) 23,064 Number of families or separate occupiers (Census, 1921) 37,288 Rateable Value £934,062 Sum represented by a penny rate £3,735 Births—.Legitimate —Illegitimate Deaths Total 3,737 94: 2,023 M. 1,871 45 1,088 F. 1,866 49 935 Birth Rate 22.9 Death Rate 12.1 Number of women dying in, or in consequence of, childbirth from sepsis 1 from other causes 4 Deaths of Infants under one year of age, per 1,000 births :— ♦Legitimate, 70. Illegitimate, 2. Total, 72. Deaths from Measles (all ages) 37 ,, Whooping Cough (all ages) 39 ,, Diarrhoea (under 2 years of age) 29 * Legitimate (per 1,000 legitimate births) 72 Illegitimate (per 1,000 illegitimate births) 85 Metropolitan Borough of Poplar Comprising the Registration Sub.Districts of Poplar, and Bow and Bromley. 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' Order, 1922," I have pleasure in submitting my 32nd Annual Report. It refers to the year 1924. Births.—The birth.rate continues to decline, and last year reached the low figure of 22.9. Mortality.—The rate of mortality at all ages was 12.1 per 1,000 population; this is somewhat higher than the rate for 1923. The infant mortality rate was 72 per 1,000 nett births, also an increase on the figure for the preceding year (60). Deaths from cancer numbered 211 (115 male, 96 female), as against 203 (113 male, 90 female) in 1923. Deaths from tuberculosis and from diseases of the respiratory system were more numerous than in the previous year. Infectious Diseases.—Notifications of infectious diseases were in eicess of the number for 1923, due to an increase in the number of cases of scarlet fever and pneumonia. Tuberculosis.—The report of the Tuberculosis Officer is quoted in fxtenso. The number of new cases coming to the knowledge of this department shows a decrease. Three tuberculosis patients who died were not notified (1.5 per of the total deaths from tuberculosis), and twenty.one other cases *ere notified only after death. Under date 22nd December, 1924, a circular was issued by the Ministry of Health for securing stricter compliance with the Tuberculosis 2 Regulations. A copy has been sent to all medical practitioners in the Borough, and I trust there will be no cause for drastic action in this district. Trachoma.—After consultation with the London County Council Divisional Medical Officer, a number of cases were visited. It came to my notice during the year that many persons with trachoma were leaving this district for fruit and hop.picking. I communicated the facts to the Ministry of Health, who took up the matter of precautionary measures with the various local authorities. Public Analyst.—The Public Analyst's report in connection with the Sale of Food and Drugs Acts, etc., is given in full. Maternity and Child Welfare.—The mortality rate amongst infants visited was 44. Reports of the Chief Health Visitor, the Senior Medical Officer of the Royal College of St. Katherine, and the Council's Dental Surgeon will be found in the section of the report relating to Maternity and Child Welfare work. It has been necessary to revise the areas covered by the Health Visitors, and an additional appointment has been made. Artificial sunlight treatment has been administered to a number of children; the results are very encouraging. Pending permanent arrangements, temporary accommodation is being rented for more extensive treatment. An Ante.natal Clinic was commenced in October, at 134 , High Street, Poplar. Plans have been prepared and submitted to the Ministry of Health for the erection of a more commodious and up.to.date clinic at the rear of Nos. 134 and 13C, High Street, Poplar. There are also in preparation plans for Observation Wards to be erected in the grounds of No. 1, Wellington Road. Provision will be made for Maternity and Child Welfare Clinics, also a Dental Clinic, and accommodation for artificial.light treatment. Electrolytic Disinfecting Fluid.—On account of the increasing demand for the fluid, consideration is being given for the demolition of the existing wooden structure, and the erection of a more extensive solid building, and the installation of additional plant. Propaganda.—During the year, film displays on matters of public health were given at the Town Hall, Poplar, and at the Bow Baths. The display in April was for women only, and that in October for men only; other displays in February and December being open for both sexes. 3 Changes of Staff.—Early in the year, Miss A. Tattersall resigned owing to ill.health, and was succeeded by Miss M. E. Davies. Miss L. Nugent was appointed to the new post of Secretary to the Care Committee of the Tuberculosis Dispensary, and commenced her duties at the beginning of March. Dr. W. S. Patch, one of the Clinic Medical Officers, was accidentally killed while on holiday, and in her stead, Dr. E. M. Layman was appointed to the West Ferry Road Clinic. Misa D. A. E. Landray was appointed Health Visitor to take over an additional area caused by the revision of the Health Visitors' districts. ] regret to record the deaths of J. Nye, inspector's labourer, and A Taylor, disinfectant distributor, during the year. Bacteriological Examinations.—The arrangements with the Seamen's Hospital, Greenwich, for carrying out bacteriological examinations (other than Tubercle) continue to be satisfactory. I am, Sir, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. Public Health Offices, Bow Road. E. 3. February, 1925. 4 AREA AND POPULATION, The area of the Borough is 2,136 acres, and the population, estimated to the middle of the year by the Registrar.General, is 167,300, giving a density of 78.3 persons per acre. The estimated population given above has been used for calculating the various rates in the present report. The population of London is estimated at 4,576,505. BIRTHS. Early in the year 1925 the Registrar.General supplied the following information, relating to the year under review :— Registered. Inward Transfers. Outward Transfers. Nett. Total Births—Males Females • • 1,685 1,727 245 205 14 17 1,916 1,915 j 3,831 Illegitimate —Males Females • • 37 48 9 8 1 7 45 49 } 94 The birth.rate per 1,000 population was 22.9 as against 24.6, 34.1, 27.2, 26.6 and 25.6 for the years 1919.1923. During the year 3,450 notifications were received under the Notification of Births Act, 1907. MARRIAGES. During the year the marriages of 2,554 persons were registered, giving a rate of 15.3, as against 20.8, 18.7, 16.2, 15.0 and 16.1 in the five years 1919.1923. DEATHS. 2,122 deaths were registered as having occurred in the Borough. 442 deaths of non.residents must be deducted and 343 deaths of Poplar residents which occurred outside the Borough must be added, giving a nett total of 2,023 and a rate of 12.1 per 1,000 of the estimated population. 5 It should be borne in mind, when studying death rates, that comparisons should be made with those of districts the inhabitants of which live under similar conditions. See Table IV., East Districts. 1919. 1920. 1921. 1922. 1923. 1924. Deaths from all causes, rate per 1,000 population 14.4 14.7 12.7 14.3 11.3 121 Deaths under 1 year of age, rate per 1,000 nett births 83 82 83 79 60 72 Deaths over 65 years of age, rate per 1,000 total population 8.0 8.3 6.8 8.1 3.6 3 9 Zymotic diseases:— Death rate per 1,000 population 1.0 1.3 1.5 1.5 0.6 0.8 Proportion of 1,000 deaths 72.7 92.7 125.3 110.9 58.5 65.7 Tuberculosis, all forms:— Death rate per 1,000 population 1.4 1.6 1.3 1.3 1.2 1.2 Proportion of 1,000 deaths 100.3 112.2 105.7 94.4 1037 97.9 Respiratory diseases (excluding phthisis):— Death rate per 1,000 population 3.0 3.6 2.6 3.6 2.4 3.2 Proportion of 1,000 deaths 208.8 250.8 208.6 254.6 212 7 265.4 Deaths from Various Diseases. Disease. 1919. 1920. 1921. 1922. 1923. 1924. Measles 7 33 39 62 22 37 Whooping Cough 24 50 29 88 7 39 Influenza 139 53 16 86 22 48 Pneumonia, all forms 215 235 193 260 163 230 Diarrhoea and Enteritis (all ages) 82 55 112 28 41 30 'Smallpox, Measles, Scarlet Fever, Whooping Cough, Diphtheria and Mem. roup, Tylioid Fever and Diarrheal Diseases. 6 DEATHS OF PERSONS OF UNKNOWN ADDRESSES, ETC., INCLUDED IN THE MORTALITY STATISTICS. The following deaths have been included in the mortality statistics of the Borough in accordance with the Registrar.General's rules relating to ' 'Transferable Deaths.'' 1924. 6th Mar. R. Thames, off Unknown. Aberdeen Wharf. Male, 28. Found drowned. P.M. Open verdict. Inquest. 25th Apr. R. Thames, near Unknown. Morton's Wharf. Male, newly. born. Fractured skull and cerebral haemorrhage. Wilful murder by persons unknown. Inquest. 28th Apr. In street at Pekin Unknown. Street. Female, newly.born. Want of attention at birth. P.M. Open verdict. Inquest. 16th May. R. Thames, near Unknown. Fletcher 'a Dry Dock. Male, newly. born. Want of attent ion at birth. P.M. Open verdict. Inquest. 23rd May. Ducketts Canal, Unknown between Shew parentage. and Three Colt Bridges Female, newly born. Tape and rag tied round neck. Asphyxia from strangulation. P.M. Wilful murder. Inquest. 22nd July. R. Thames, off Ship's Fire. Union Dry man of Aber. Dock. deen Male, 43. Asphyxia due to drowning. P.M. Open verdict. Inquest. 21st July. R. Thames, off Unknown. Bullivant's Wharf. Male, 60. Asphyxia due to drowning. P.M. Open verdict. Inquest. 7 INFANT MORTALITY. There were 277 deaths of children under one year of age, the death. rate per 1,000 bii.ths for the past 17 years being :— Borough of Poplar. County of London. 1908 124 (104) 113 1909 130 (99) 108 1910 119 (106) 103 1911 158 (116) 129 1912 108 (90) 90 1913 113 (83) 105 1914 117 (117) 104 1915 134 (98) 112 191G 104 (78) 89 1917 95 (79) 103 19 IS 107 (68) 107 1919 83 (69) 85 1920 81 (48) 75 1921 S3 (66) 80 1922 79 (38) 74 1923 60 (44) 60 1924 72 69 Note.—The figures in brackets are the mortality rates amongst infants visited by the Health Visitors. The infants visited are, for the most part, resident in the poorest portions of the Borough. These rates are calculated upon births occurring in any particular year, and deaths in that and the following year. The causes of death of infants under one year of age are shown in Table III. 8 INQUESTS AND DEATHS FROM VIOLENCE * •The number of inquests held in the Borough was 267. From this total must be deducted 87 non.residents, and 36 added of residents who died outside the Borough, the nett total being 216. Verdict of Violence :— Railways 3 Vehicles and horses 18 Ships, boats and docks 3 Building operations 3 Conflagrations 0 Burns, scalds and explosions 4 Drowning (excluding suicides) 17 Suffocations in bed 1 Poisons and poisonous vapours 1 Other causes 23 Suicides 12 Murder 2 Total 87 Verdict of Natural Causes (including deaths from disease accelerated by accidents) 129 Total 216 For death rates from violence, and the percentage of inquest cases to total deaths, see Table V. 9 MORTUARY The number of bodies deposited in the Mortuary, Cottage Street. Poplar, during the year was 267 :— Residents. Non.Residents.* No age stated 2 0 Stillborn 0 0 Under 1 year 20 4 1 to 5 years 19 0 5 to 15 years 15 1 15 to 25 years 11 1 25 to 65 years 118 10 65 years and upwards 59 7 Totals 2 44 23 * Brought from outside the Borough for the convenience of the Coroner. 10 Deaths during 1924 in the Metropolitan Borough of Poplar, classified according to hcalities. 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 186 118 78 116 1 498 Bow and Bromley Sub.District 140 99 59 110 408 St. Andrew's Hospital 299 173 153 213 838 Poplar Institution 46 11 14 16 87 Bow Institution 41 32 27 27 127 Bromley House Institution — — — — — Poplar Hospital 29 23 28 29 109 Adelaide Buildings — — — — — Baffin ,, — — — 1 1 Council ,, — — — — — Grosvenor ,, — 2 1 4 7 Hanbury ,, — — — — — Hudson ,, — — — — — Melbourne ,, — — — — — Montreal ,, 1 — — 1 2 Ontario ,, — — — — — Ottawa ,, — — 1 — 1 Prestage ,, — 1 — — 1 Quebec ,, — — — — — Sydney ,, — — — — — Toronto ,, — — — — — Wellington ,, — — — — — Winnipeg ,, — — — — — River Thames 2 3 5 1 11 ,, Lee — — 1 — 1 Limehouse Cut 3 2 1 2 8 Bow Creek — — 1 — l Ducketts Canal — 1 — — 1 East India Docks — — — — — West India Docks 1 — — — 1 Millwall Docks 1 — — — 1 Casual Wards — — — 1 1 Highways 2 3 7 6 18 751 468 376 527 2122 Deaths occurring outside the Borough of persons belonging thereto 82 82 92 87 343 Deaths occurring within the Borough of persons not belonging thereto 132 106 98 106 442 Deaths at all ages—nett 701 444 370 508 2023 * See note to Infant Mortality table, page 7. 11 TABLE I. Vital Statistics during 1924 and Previous Fears. Poplar (Whole Bokough). Year. Population estimated to middle of each Year. Births. Total Deaths Registered in the Borough. Transferable Deaths. + Nett Deaths belonging to the Borough. Uncorrected Number. Nett. Of Non.residents registered in the Borough. Of Residents not registered in the Borough. 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 1919 153,644 160,051 3671 3949 24.6 2337 15.2 549 425 328 83 2213 14.4 1920 159,766 159,941 5107 5457 34.1 2318 14.5 410 444 447 81 2352 14.7 1921 164,100 4117 4478 27.2 2107 12.8 431 414 374 83 2090 12.7 1922 165,700 3990 4417 26.6 2396 14.4 480 456 349 79 2372 14.3 1923 166,400 3842 4256 25 6 1928 11.6 418 370 255 60 1880 11.3 1924 167,300 3412 3831 22.9 2122 12.7 442 343 277 72 2023 12.1 Notes.—This Table is arranged to show the gross births and deaths in the borough and the births and deaths properly belonging to it with the corresponding rates. The rates are calculated per 1000 of the estimated gross population. "In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the borough, but excluding the deaths of soldiers and sailors that have occurred in hospitals and institutions in the district. In Column 12 are entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly corrected by subtraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. t "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 Arra of District in acres (land and inland water) 2327.7 Total population at all ages 162,618 Number of inhabited houses 23,064 Average number of persons per house 7.05 At Census of 1921. Total families or separate occupiers 37,288 to TABLE II. METROPOLITAN BOROUGH OF POPLAR. The Borough. Causes of and Ages at, Death during the year 1924 Total Deaths. Sex. All Ages. Nett Deaths at Subjoined Ages. Districts. outside Borough (at all ages) belonging thereto. Nett Deaths in Public Institu tions, etc. Causes of Death Under 1 year. 1 to 2 years. 2 to 3 years. 3 to 4 years. 1 4 to 5 years. 5 to 10 years. ; 10 to 15 years. r 15 to 20 years. 1 20 to 35 years. t 35 to 45 years. £ 45 to 65 years. 65 years and over Poplar. Bow and Bromley. Poplar Institution. St. Andrew's Hospital. Bow Institution. lironuey no use Institution. Poplar Hospital. See Footnotes. outlying Institutions. 2 3 4 5 6 7 8 9 10 11 12 13 14 All causes Certified 2023 2023 277 100 49 26 24 30 38 33 151 138 508 647 1101 75 623 .. .. 47 24 339 1108 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 Enteric Fever 1 M .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. F 1 .. .. .. .. .. .. .. .. 1 .. .. .. 2 Small-pox 5 M .. .. .. .. .. .. .. .. .. .. .. .. .. 21 16 .. 10 .. .. .. .. 6 16 f .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Measles 37 M 22 2 13 4 1 2 .. .. .. .. .. .. .. 2 4 .. .. .. .. .. .. 6 6 F 15 2 8 2 1 2 .. .. .. .. .. .. .. 4 Scarlet Fever 6 M 3 1 .. .. .. .. .. .. .. .. .. .. .. 27 12 .. 11 .. .. .. .. 7 18 F 3 .. 1 .. .. .. .. .. .. .. .. .. .. 5 Whooping Cough 39 M 20 10 5 4 .. 1 .. .. .. .. .. .. .. 13 7 .. 2 .. .. .. .. 16 18 F 19 8 4 3 1 2 1 .. .. .. .. .. .. 8 Diphtheria 20 M 10 2 1 3 1 2 .. 1 .. .. .. .. 28 20 7 3 .. .. 1 .. 4 15 F 10 2 .. 1 1 3 2 .. .. 1 .. .. .. 7 Influenza 48 M 21 1 .. .. 1 .. .. .. .. .. .. 9 10 3 3 .. 3 .. .. 1 .. 1 5 F 27 I .. .. .. .. .. 1 .. 4 .. 8 .. 8 Encephalitis lethargica 6 M 2 .. .. .. .. .. .. 1 .. .. .. 1 .. 3 .. .. .. .. .. 1 .. 2 3 F 4 .. .. .. .. .. .. 1 .. 1 .. 2 .. 9 Meningococcal Meningitis 3 M 1 1 .. .. .. .. .. .. .. .. .. .. .. 92 78 .. 54 .. .. 1 .. 42 97 F 2 2 .. .. .. .. .. .. .. .. .. .. .. 10 Tuberculosis o( respiratory sys tern) 170 M 101 1 1 1 1 1 1 1 4 25 29 32 4 14 14 2 4 .. 1 .. 12 19 F 69 .. 1 1 .. 1 2 4 4 27 10 16 3 11 Other Tuberculous Diseases 28 M 20 3 .. 5 1 3 2 2 1 .. 1 1 1 107 104 2 76 .. .. 4 .. 34 116 F 8 1 1 1 1 .. .. 1 .. 1 .. 1 1 12 Cancer, Malignant disease 211 M 115 .. .. .. .. .. .. 1 .. 5 6 60 433 3 5 .. 1 .. .. 1 .. 3 5 F 96 .. .. .. .. .. .. .. .. 3 11 45 37 13. Rheumavtle Fever 8 M 4 1 " 1 1 t | F 4 .. .. .. .. 1 .. 1 1 .. .. .. 14 Diabetes 13 M 5 .. .. .. .. .. .. .. .. .. .. 2 3 7 6 1 5 .. .. .. .. .. 6 !•' * .. .. .. .. .. .. .. .. 1 .. 5 2 15 Cerebral haemorrhage, etc. 57 M 27 .. .. .. .. .. .. .. .. .. 2 9 16 37 20 3 23 .. .. 1 .. 1 28 F 30 .. .. .. .. .. .. .. .. .. 12 18 16 Heart Disease 214 M 112 .. .. .. .. .. 4 .. 2 5 7 42 52 108 106 17 55 .. .. 2 1 (a) 18 93 M 102 .. .. .. .. .. .. 1 3 13 3 34 48 17 Arterio-sclcrosis 74 M 36 .. .. .. .. .. .. .. .. .. .. 9 27 45 29 8 36 .. .. .. .. 13 93 F 38 .. .. .. .. .. .. .. .. .. .. 9 29 18 Bronchitis 291 M 142 11 7 2 .. .. 1 .. .. 3 2 49 67 152 139 15 106 .. 1 .. 6 128 F 149 14 8 1 1 .. .. .. .. 1 6 23 95 19 Pneumonia (all forms) 230 M 127 25 23 8 .. 1 1 2 3 8 9 28 19 117 113 12 78 .. .. 3 .. 21 114 F 103 32 20 8 8 1 2 .. 3 3 4 7 15 20 Other Respiratory Diseases 16 M 7 1 .. .. .. .. .. .. .. 1 1 2 2 11 5 .. 8 .. .. 1 .. 3 12 F 9 1 .. 2 .. .. 1 2 .. 1 1 1 .. 21 Ulccr of Stomach or Duodenur 18 M 15 .. .. .. .. .. .. .. .. 1 2 8 .. 9 9 .. 6 .. .. 1 .. 6 13 F 3 .. .. .. .. .. .. .. .. 1 1 1 22 Diarrhoea, etc. 30 M 19 17 2 .. .. .. .. .. .. .. .. .. .. 14 16 .. 8 ..••.. .. .. 1 13 22 F 11 10 .. .. .. .. .. .. .. .. .. .. 1 23 Appendicitis and Typhlitis 14 M 7 .. .. .. .. .. 2 1 2 1 1 .. .. 3 11 .. 6 .. .. 2 .. 6 14 F' 7 .. .. .. .1 .. 1 .. 1 .. .. 3 1 24 Cirrhosis of Liver 2 M 2 .. .. .. .. .. .. .. .. .. 1 1 1 1 1 .. 1 .. .. .. 2.. 1 2 F .. .. .. .. .. .. .. .. .. .. .. .. .. 25 Acute and Chronic Nephritis 50 M 20 .. .. .. .. .. .. .. 1 2 .. 13 .. 29 21 3 17 .. .. 1 .. 1 2 F 30 2 13 4 26 Puerperal Sepsis 1 M .. .. .. .. .. .. .. .. .. .. .. .. 10 .. 1 .. 1 .. .. .. .. .. 1 F 1 .. .. .. .. .. .. .. .. 1 .. .. .. 27 Other accidents and diseases of pregnancy and parturition 4 M .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 .. 3 .. .. .. .. 1 4 F 4 .. .. .. .. .. .. .. .. 3 1 .. .. 28 Congenital Debility and ma formation, premature birth 100 M 54 54 .. .. .. .. .. .. .. .. .. .. .. 55 45 2 16 .. .. 2 .. 15 35 F 46 45 1 .. .. .. .. .. .. .. .. .. .. 29 Suicide 12 M 8 .. .. .. .. .. .. .. .. 1 .. .. .. 8 4 .. .. .. .. .. 3 (c) 2 5 F 4 .. .. .. .. .. .. .. .. .. 2 3 .. 30 Other Deaths from Violence 75 M 53 2 .. .. 1 1 4 5 4 9 2 1 1 47 3 (<) 2 5 F 22 1 9 5 11 11 i 31 Other Defined Diseases %. . 245 ) M 135 '' 2 2 11 i I 19 9 16 OO 28 73 F 110 13 2 io 14 30 50 1 32 Causes ill-defined or unknown . • - { M 4 1 15 12 13 47 i .1 14 3 « 65 155 P :: 1 Deaths from All Caises 2023 j M 1088 145 54 27 ii —--— F 935 132 46 22 15 11 13 20 13 <2 79 54 312 196 313 ( 334 ( Totals (a) Highway. Bow and Bromlov- s 2023 277 100 49 | 26 24 32 38 33 151 138 508 647 1101 922 75 623 47 24 339 1108 „ ...., —- u .i'. i. (c) Kiver Lee, How and Bromley S.D. 2 ; Wcct India Docks, Poplar, S.D. 1. v) jvi>ui xnames, ropiar s.D. G: Hirer Lee, Poplar S.D. 1; -River Lee, Bow and Bromley S.D. 1; Bow and Bromley S.D. 1; Highway, Poplar S.D. 2. Limehouse Cut, Poplar S.D. 1; Duck tt's Canal, Bo;v and Bromley S.D. 1 ; Highway, Bow and Bromley S.D. 1; Limehousc Cut, Bow and Bromley S.D. 1. and Highway, Poplar S.D. I. (p) Highway, Poplar S.D. 1; Highway, Bow and Bromley S.D. I; and Itiver Thames, Poplar S.D. I. CO 14 TABLE III. METROPOLITAN BOROUGH OF POPLAR. The Borough. Infantile Mortality during the Year 1924. Nett Deaths from stated Causes in Weeks and Months tinder One Year of Age. Causes of Death 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. Poplar. Bow and Bromley Whole Borough All causes Certified 65 10 13 15 103 30 43 44 57 145 132 277 Uncertified — — — — — — — — — — — — Small Pox — — — — — — — — — — — — Chicken Pox — — — — — — — — — — — — — — — — — — — 1 3 9 2 4 — — — — — — — — 1 1 — 1 Whooping Cough — — — 1 1 1 6 4 6 10 8 18 Diphtheria and Croup — — — 1 1 — 1 1 1 2 2 4 Erysipelas — — — — — — — — — — — — Tuberculous Meningitis — — — — — — 2 1 1 2 2 4 Abdominal Tuberculosis — — — — — — — — — — — — Other Tuberculous Diseases — — — — — — 1 — — — 1 1 Meningitis (not Tuberculous) — — — — — 1 1 1 3 3 Convulsions — — — — — — 2 — — — 2 — Laryngitis — — — — — — — — — — — — Bronchitis — 2 — 1 3 4 5 4 9 7 18 25 Pneumonia (all forms) — — 3 2 5 6 10 12 24 31 26 57 Diarrhoea — — — — — 1 2 I 1 1 4 5 Enteritis — — 1 1 2 3 5 7 5 12 10 22 Gastritis — — — — — 1 — — — 1 — 1 Syphilid — — — 1 1 1 — — — 1 1 2 Rickets — — — — — — — — — — — — Suffocation, overlying 1 — — — 1 — — — — 1 — 1 Injury at birth 1 — — — 1 — — — — 1 — 1 Atelectasis 1 1 — — 2 1 — — — — 3 3 Congenital Malformations 2 1 3 6 2 1 4 1 8 6 14 Premature birth 50 6 6 4 66 6 1 — — 39 34 73 Atrophy, Debility and Marasmus 3 — 1 1 5 3 3 1 — 8 4 12 Other Causes 7 — 2 — 9 1 3 7 4 15 9 24 Total Deaths 65 10 13 15 103 30 43 44 57 145 132 277 Nett Births Legitimate 3,737 in the year IIIegitimate 94 Nett Deaths Legitimate infants 269 in the year of .Illegitimate infants 8 15 TABLE IV. (1924). Cities and Boroughs. Estimated population to the middle of 1924. 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. Death. rate per 1,000 living. Deaths of Infants under one year to 1,000 births. LONDON 4,576,505 .. ] 8.7* ? 121* 69* West Districts. Paddington 146,400 . . 17.1 0.9 131 78 Kensington 178,700 . . 16.2 0.64 130 75 Hammersmith 134,200 . . 17.9 0.7 12.4 72 Fulham 163,100 . . 18.2 0.5 111 72 Chelsea 64,580 . . 14.4 0.8 13.2 63.5 City of Westminster .. 143,000 . . 11.6 0 4 12.1 59 North Districts. St. Marylebone 105,300 . . 14.5 101 13.6 78 Hampstead 87,600 . . 13.5 0.09 11.7 56 St. Pancras 214,300 . . 18.8 1.0 130 74 Islington 3(7,400 . . 19.8 0.66 12.3 66 Stoke Newington 52,920 . . 16.6 0.7 11.3 58 Hackney 226,900 . . 18.5 0.45 11.4 60 Central Districts. Holborn 43,250 . . 13.36 0.57 12.2 81 Finsbury 77,180 . . 21.5 1.27 141 75 City of London 13,330 . . 7.1 0.14 11.3 117 East Districts. Shoreditch 106,500 . . 23.7 1.2 13.7 87 Bethnal Green 119,200 . . 22.1 11 12.4 78 Stepney.. .. .. 2.54,340 . . 21.4 0.78 12.2 74 Poplar 167,300 . . 22 9 0 8 121 72 South Districts. Southwark 187,714 . . 22.5 1.5 14.2 71 Berrnondsey 122,100 . . 23.8 — 13.6 78 Lambeth 309,300 . . 25.5 0.6 12.5 50.05 Battersea 171,000 . . 18.4 0 7 11.7 62 Wandsworth 338!200 . . 14.57 0.47 11.03 57 Camberwell 273,700 . . 18.8 0.7 11.4 70 Deptford 115!200 . . 20.6 0.7 12.0 76 Greenwich 102,470 . . 20.09 0.69 11.47 73 Lewisham 184,900 . . 16.3 0.3 10.4 47 Woolwich 139,980 . . 18.5 0.5 11.0 65 'These provisional figures are taken from a table furnished by the Registrar. general. Other figures supplied by Medical Officer of Health of borough concerned. 16 The following death rates for the year 1924 are interesting when compared with one another:— Annual Rate per 1,000 persons living. Deaths of Children under one year of age to 1,C00 Births. Poplar Borough 12.1 72 *England and Wales 12.2 75 *105 Great Towns J 12.3 80 *157 Smaller Towns .. 11.2 71 *London 12.1 69 Liverpool 13.6 103 Manchester 13.9 100 Edinburgh 14.8 89 Glasgow 16.1 119 Dublin 15.8 113 *Belfast 14.3 107 * Provisional figures furnished by the Registrar.General. ‡ Including London. TABLE V. Birth.rate, Death.rate, and Analysis of Mortality During the Year 1924. – 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. Smallpox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhtea and Enteritis (under 2 years). Total Deaths under One Year. Causes of Death Certified by Ketristered Med ical Practitioners. Inquest Cases. Uncertified Causes of Death. England and Walesf 18.8 12.2 0.01 0.00 0.12 0.02 0.10 0.06 0.49 0.44 7.3 75 92.3 6.6 1.1 105 County Boroughs and Great Towns, including London† 19.4 12.3 0.01 0.00 0.18 0.03 0.12 0.08 0.45 0.40 9.2 80 92.5 6.9 0.6 157 Smaller Towns (adjusted Populations 20,000.50,000) t 18.9 11.2 0.01 0.00 0.08 0.02 0.09 0.06 0.50 0.36 6.2 71 93.3 5.5 1.2 Londonf 18.7 121 0.01 — 0.29 0.03 0.11 0.12 0.36 0.44 8.4 69 91.3 8.6 0.1 Poplar Borough.. 22 9 121 0.06 — 0.22 0.03 0.23 012 0 29 052 7.6 72 89 3 10.7 0.0 17 * Non.civilians are included in these figures for England and Wales, but not for other areas. f Provisional figures for England and Wales, 105 Great Towns, 157 Smaller Towns and London. The rates for England and Wales and for Poplar have been calculated on a population estimated to the middle of 1924, while those for the towns have been calculated on populations estimated to the middle of 1923. 18 TABLE V . METROPOLITAN BOROUGH OF POPLAR. Total Deaths {at all ages) in Public Institutions within the Borough. (Residents and Non-Residents included.) Causes of Death. Sex. Poplar Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. Total deaths in Public Institutions within the Borough- All causes Certified M 50 474 94 67 685 F 37 364 33 42 476 Uncertified M — F — — — — — 1. Enteric Fever M — — — — — F — 1 — 1 2. Small-pox M F — — 3. Measles M 7 — — 7 F 8 — — 8 4. Scailet Fever M — — — — F — — — — — 5. Whooping Cough M — 10 — — 10 F — 7 — — 7 6. Diphtheria M — — — — F 1 1 7. Influenza M 6 — 1 CLOSED. — 7 F 2 4 2 1 9 8. Encephalitis Lethargica M — 1 — 2 3 F — 3 — — 3 9. Meningococcal Meningitis M F 1 1 10. Tuberculosis of respiratory system M — 54 4 58 F — 28 1 1 30 11. Other Tuberculous Diseases M 1 7 — 2 10 F 1 — — 2 3 12. Cancer, malignant disease M 2 59 4 7 72 F 1 40 3 2 46 13. Rheumatic Fever M 2 — 1 3 F 1 — — 1 14. Diabetes M — 7 — 7 F ] 2 1 4 15. Cerebral hemorrhage, etc. M 2 12 3 2 19 F 2 14 2 18 16. Heart Disease M 10 42 44 3 99 F 8 32 13 2 55 19 TABLE VI. (continued). METROPOLITAN BOROUGH OF POPLAR. Total Deaths (at all ages) in Public Institutions within the Borough. (Residents and Non-Residents included.) Causes of Death. Sex. Poplar Institution. St. Andrew's Hospital. Bow Institution. Bromley House Institution. Poplar Hospital. Total deaths in Public Institutions within the Borough. 17. Arterio-sclerosis M 6 22 4 CLOSED. – 32 F 5 22 1 28 18. Bronchitis M 9 79 15 1 104 F 9 67 4 1 81 19. Pneumonia (all forms) M 7 59 4 3 73 F 4 49 2 4 59 20. Other Respiratory Diseases M 1 6 — — 7 F — 3 — 1 4 21. Ulcer of Stomach or Duodenum M — 7 — 3 10 F — — 1 — 1 22. Diarrhea, etc. M — 8 — — 8 F — 3 — — 3 23. Appendicitis and Typhlitis M — 3 — 2 5 F 1 4 — 3 8 24. Cirrhosis of Liver M — — 2 1 3 F — — 25. Acute and Chronic Nephritis M 2 8 4 14 F 2 13 2 1 18 26. Puerperal Sepsis M — — — — — F — 1 — — 1 27. Other accidents and diseases of pregnancy and parturition M — — — — — F — 5 — — 5 28. Congenital Debility and malformation, premature birth M 2 12 — 1 15 F — 8 — 1 9 29. Suicide M — — — — F — — — 2 2 30. Other Deaths from Violence M 1 13 1 28 43 F — 11 — 6 17 31. Other Defined Diseases M 1 56 8 11 76 F 1 37 3 12 53 32. Causes ill-defined or unknown M — — — — — F — — — — — All causes M 50 474 94 67 685 F 37 364 33 42 476 Totals .. 87 838 127 109 1161 20 TABLE VII. METROPOLITAN BOROUGH OF POPLAR. The Borough. Cases of Infectious Disease notified during the Year 1924. Notifiable Disease. Cases Notified in Whole Borough. Total cases notified in each Sub-District. No. of Cases removed to Hospital lrom each Sub-District. At all Ages. At Ages—Years. Under 1. 1 to 2. 2 to 3. 3 to 4. 4 to 5. 5 to 10, 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 65 and upwards. Poplar. Bow and Bromley. Poplar. Bow and Bromley. Total Cases Removed. Cholera (C), Plague (P) — — — — — — — — — — — — — — — — — Diphtheria (including Membranous Croup) 348 11 15 32 41 45 110 47 11 24 3 3 — 208 140 206 136 342 Erysipelas 57 2 1 — 1 2 3 1 0 9 11 l(i 5 20 31 4 10 14 Scarlet Fever 400 3 26 49 55 57 170 58 14 24 2 2 — 200 200 195 258 453 Typhus Fever — — — — — — — — — — — — — — — Enteric Fever 8 — — — — 1 — 1 1 2 2 1 — 3 5 3 3 6 Relapsing Fever — — — — — — — — — — — — — — — — — — Continued Fever — — — — — — — — — — — — — — — — — Puerperal Fever 8 — — — — — — — 1 0 1 — — 2 6 1 5 0 Cerebro-Spinal Meningitis — — — — — — — — — — — — — 3 2 2 Acute Poliomyelitis and Acute Polioencephalitis.. 4 1 — — — 1 2 — — — — — — 4 1 1 Acute Encephalitis Lethargica 14 2 2 2 2 2 4 — 9 5 7 3 10 Ophthalmia Neonatorum 40 40 — — — — — — — — — — — 34 12 5 3 8 Pulmonary Tuberculosis 258 — — 3 2 3 8 11 20 97 49 60 5 187 171 — — — Other forms of Tuberculosis 160 3 4 9 7 0 24 14 10 14 4 3 2 Zymotic Enteritis 07 18 11 7 3 1 3 — 4 4 0 10 20 47 Anthrax 1 1 — — 1 1 1 Trench Fever — — — — — — — — — — — — — _ Pneumonia (all forms) 017 91 101 58 42 30 48 14 25 49 38 71 50 360 257 124 122 246 Malaria 3 — — — — — — 3 — — 2 1 Dysentery l — — — — — — — — 1 — — — 1 1 — 1 Totals 1995 178 158 158 151 146 376 148 94 235 119 170 62 1060 935 550 540 1090 N.. P...,. "not .udTing," etc., ,.r<. t.d.drf from the a.bovo tabic. 21 INFECTIOUS DISEASES. Notifications. There were 1,637 notifications of cases of infectious diseases, excluding 62 second notifications and 96 cases in which diagnosis was not confirmed. The notification rate was 9.8 as against 5.7, 13.8, 12.9, 6.6 and 9.2 for the preceding five years. Number of Cases Occurring in Institutions. Notifications of parishioners from Institutions (excluding cases which had been notified before admission) within the Borough were as follows:— Total Cases. Notifications. Removals. Diphtheria. ! Erysipelas. Scarlet Fever. Smallpox. Puerperal Fever. Ophthalmia Neonatorum. Zymotic Enteritis. Pneumonia (all forms). Diphtheria. Erysipelas. Scarlet Fever. Smallpox. Puerperal Fever. Zymotic Enteritis. Pneumonia (all forms). Poplar Institution 13 .. .. 5 .. .. .. .. 8 .. .. 5** .. .. .. .. St. Andrew's Hospital 6 3 .. 3+ .. .. .. .. .. 3** .. 3** .. .. .. .. Bow Institution 3 .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. Bromley House Institution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Langley House, 54, East India Dock Road 3 1 .. .. .. .. .. .. 2 1** .. .. .. .. .. 2* Poplar Hospital 2 1+ .. 1+ .. .. .. .. .. 1* .. 1** .. .. .. .. Admitted into St. Andrew's Hospital. ** Removed to M.A.B. Hospitals, t Staft. II Kemoved to London Fever Hospital. Infectious Diseases in Milkshops and Homeworkers' Premises. Two cases of infectious disease (1 scarlet fever and 1 measles) were connected with milkshops. Eight premises with outworkers were connected with infectious cases: 2 diphtheria, 5 scarlet fever and 1 measles. 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. Removal of Cases of Notifiable Diseases to Hospital. Disease. M.A.B. Hospitals Poor Law Institutions General Hospitals etc. Total Removals Percentage of cases notified. Diphtheria 340 1 1 342 98.3 Erysipelas — 13 1 14 24.6 Scarlet Fever 453 — — 453 98.5 Enteric fever 3 1 2 6 75.0 Puerperal Fever — 4 2 6 75.0 Cerebro-spinal Fever — — 2 2 66.6 Encephalitis Lethargica 6 4 10 71.4 Ophthalmia Neonatorum 6 2 8 17.4 Pneumonia — 243 3 246 39.9 Dysentery — 1 — 1 100. Anthrax — — 1 1 100. Acute Poliomyelitis, etc. — — 1 1 25.0 N.B.—Cases reported to be "not suffering" have been excluded from above table. 23 Comparative Mortality. Diphtheria Scarlet fever Enteric fever Cases notified 320 370 23 1919 Deaths 38 4 6 Mortality rate per cent. 11.9 1.1 26.1 Cases notified 698 1,400 17 1920 Deaths 59 14 4 Mortality rate per cent 8.4 1.0 23.5 Cases notified 648 1423 16 1921 Deaths 64 13 5 Mortality rate per cent. 9.9 0.9 31.2 Cases notified 626 415 10 1922 Deaths .. .. .. 62 7 0 Mortality rate per cent... 9.9 1.7 0.0 Cases notified 303 263 8 1923 Deaths 32 5 3 Mortality rate per cent. 10.6 1.9 37.5 Cases notified 348 460 8 1924 Deaths 2 6 1 Mortality rate per cent. 5.7 1.3 12.5 BACTERIOLOGICAL EXAMINATIONS. 1,011 swabbings from doubtful cases of Diphtheria were examined. Of these 116 gave positive results (11.5 per cent). 8 blood specimens from doubtful cases of Enteric Fever were examined, positive result being obtained in one case (12.5 per cent.). DIPHTHERIA ANTI-TOXIN. 128,000 units of Diphtheria anti-toxin were issued to medical practitioners during the year. 24 TUBERCULOSIS. Report of Dr. VV. C. P. Smith, Tuberculosis Officer and Assistant Medical Officer of Health for Tuberculosis Purposes. Information required by Ministry of Health. (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 Medical Officers and the number of other officers should be given. (1) (a) Tuberculosis Dispensary.—1, Wellington Road, Bow. The new premises have now been in use for a full year and have fulfilled expectations in all important respects. The comparative quietude of the house and surroundings is specially appreciated after the turmoil of the main road. (b) The question of a branch dispensary in High Street, Poplar, to meet the requirements of the southern part of the borough, is still in abeyanoe, and in the meantime the fares of patients living south of the East India Dock Road who attend at Wellington Road continue, in suitable cases, to be refunded to them. (2) Staff. Tuberculosis Officer : W. C. P. Smith. Assistant Tuberculosis Officer : C. K. Cullen—from 13/5/24— vice D. H. Geflen. 3 Health Visitors. 1 Dispenser. 1 Care Secretary—from 1/3/24. 1 Clerk. 1 Assistant Clerk. 1 Part-time helper. 1 Caretaker. (3) Residential Institutions :— (a) Sanatoria—hospitals and homes available under the L.C.C. scheme (which now includes all classes of patients, whether insured, uninsured, or ex-Service men). (b) The Poor Law Infirmary. 25 (c) A few In-patient letters for Victoria Park or other hospitals when obtainable. (ii.) In the case of administrative counties, precise particulars of arrangements for co-operation with Sanitary Authorities and their officers. The L.C.C. is the Administrative authority. (iii.) The nature and extent of co-operation with general and special hospitals, school clinics, and other institutions. General Hospitals.—Under an agreement between the Council and the London Hospital, cases of surgical tuberculosis and certain other cases are referred to this hospital for opinion or treatment. Also under the L.C.C. scheme, the dispensary is "linked" to the London Hospital for purposes of consultation in special cases. Cases of lupus are, on the recommendation of the Tuberculosis Officer, given Finsen Light treatment at the London Hospital, the cost being defrayed by the Borough Council. A charge of 5s. per application of the treatment is made, and if more than twelve applications are required in any case a further authorisation from the Tuberculosis Officer is necessary. During the year nine new cases were sent for treatment, while eight old cases were carried over from the previous year. These seventeen cases received a total of 440 applications. Special Hospitals.—By arrangement with the Management Committee of St. Andrew's Hospital the Tuberculosis Officer has been appointed visiting physician to the tuberculosis wards of the hospital— with a view to co-ordinating the tuberculosis work of the Poor Law Authority with that of the Council. Cases in which an artificial pneumothorax has been induced attend at Brompton Hospital for refills. A charge of 10s. per refill is made to the Council. Cases of pulmonary disease considered to be not tuberculous are generally referred by card or out-patient letter to Victoria Park Hospital, or, in the case of children, to the East London Hospital, Shadwell, or to the Queen's Hospital, Hackney Road. School Clinics.—Co-operation with the school medical service has been continued on the same lines as in 1923. In the three categories. viz.: (1) " unsatisfactory children," (2) " apparently healthy contacts," 26 and (3) " unexamined contacts" *270 children have been referred to the Divisional School Medical Officer to be kept under observation. At the end of a period, usually six months, the cards referring to these children are returned to the Tuberculosis Officer with the School Medical Officer's notes and a record of the child's weight and general progress. This enables the Tuberculosis Officer to pick out for attendance and reexamination at the Dispensary those cases in which a suspicion of tuberculosis appears to call for further investigation. (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. The Tuberculosis Officer communicates with every local practitioner who notifies a case of tuberculosis, offering to confer as to the best means of dealing with the case. The practitioner is also invited to avail himself of the services of the care committee for any case occurring in his private practice in which he thinks they will prove helpful. Local practitioners have referred a number of patients, both insured and uninsured, to the dispensary for investigation and diagnosis. In each case, usually after a short period of observation, a report has been sent to the practitioner by the Tuberculosis Officer. 791 reports of this kind have been sent during the year. The new, or rather, revised scheme of co-operation between the Tuberculosis Officer and Insurance Practitioners in respect of insured patients came into use on 1/1/24. By the interchange of numerous forms and progress reports, the Tuberculosis Officer is kept informed of the condition and progress of all insured tuberculosis patients and conversely sends to each Panel Practitioner information concerning those patients on his panel list. All these patients fall into one or other of five groups, viz. : (1) " Dispensary Observation " (for investigation before diagnosis, or with a view to possible sanatorium treatment), (2) " Sanatorium Treatment," (3) " Domiciliary Treatment " (by the panel doctor), (4) " Dispensary Treatment," (5) " General Supervision (cases in whom the disease is quiescent and no active treatment is required). All cases are considered to be under the immediate care of the Tuberculosis Officer except those in group (3), for whose welfare the Panel Practitioner is directly, and the Tuberculosis Officer only indirectly responsible The scheme entails a considerable amount of " form filling " on the part of the practitioner and the Tuberculosis Officer. It appears, however, to have worked fairly well during the first year and to have brought about some improvement with regard to the 27 exchange of information, as evidenced by the increased number of reports received from Panel Practitioners, viz. : 162 as against only 13 during 1923. (v.) The arrangements for following up patients in cases where the diagnosis is doubtful. Cases in which the diagnosis is doubtful are kept under observation at the dispensary—attending weekly as a rule. If, after a reasonable period, a definite decision cannot be arrived at, the case may be referred to the London Hospital for a further opinion, or be recommended to the London County Council for admission to either Brompton or Victoria Park Hospitals for further investigation. If, however, there is no urgency, as regards treatment or otherwise, the patient is asked to attend again after a lapse of three or six months for further examination. In due course, the patient is written to, or a Health Visitor calls to remind him of the appointment, and there is usually little difficulty in securing the desired attendance. Similar cases among children of school age are, as already explained, recommended to be kept under observation by the School Medical Officer, and are referred back to the dispensary in due course. (vi.) The arrangements for securing the examination ancl systematic mpervision of "home contacts." Home contacts of definite cases are examined at the dispensary as soon as possible after the discovery of the original case. Arrangementsfor their attendance are made by the Health Visitor for the appropriate district, who thereafter has the household under her supervision. Child contacts of school age, whether examined at the dispensary or not, are referred to the School Medical Officer to be kept under observation, the result of this being reported to the Tuberculosis Officer after a lapse of six months—or earlier if necessity arises. The number of contacts examined during the year was 629. (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. The X-ray installation has continued in use for diagnostic purposes. No other special methods either for diagnosis or treatment have been employed. (viii.) The results of local experience as to the relative value of each form of treatment. See (vii.) above. 28 (ix.) The nature and extent of any dental treatment provided by the Council for tuberculous patients. A special session for tuberculous patients has been held weekly at the Council's Dental Clinic, at the Old Ford Wesleyan Mission Hall, to which all tuberculous patients in need of dental treatment, and for whom such treatment is not available otherwise, have been sent. Every new case of tuberculosis coming to the knowledge of the Tuberculosis Officer, in which dental treatment is required, is, so far as it is possible to do so, referred to the Clinic. It would appear that some disappointment has been felt with regard to the number of patients sent to the Clinic, and with their subsequent attendances. In this respect, one or two points must be borne in mind. In the first place, until the establishment of the Council's Clinic there was no special provision for the dental treatment of tuberculous patients, so that there was in the Borough a certain accumulation of such cases requiring treatment, with the result that the number of patients sent to the earlier sessions of the Clinic was above that which could reasonably be expected to be maintained. Again, in a large proportion of the cases sent to the Clinic, the first and most important consideration is to get the patient admitted to sanatorium as soon as possible, and it is seldom desirable to delay this until the completion of the dental treatment. It is also probably true that tuberculosis cases do not attend so willingly as others. A person suffering from active tuberculosis already feels sufficiently ill, and even when persuaded of the need for it, is apt to regard dental treatment as a gratuitous addition to his other discomforts. Cases requiring new dentures are referred to the Care Committee for arrangements to be made for defraying the cost of these, and for assessment of the proportion of the cost to be found by the patient. (x.) Any arrangements for the provision of nursing or of extra nourishment for patients living at home. The Council has power to provide nursing where required for children up to 10 years of age. For older children and adults no special provision is made, but where such assistance is required the matter can be brought before the Care Committee, who will probably be able to arrange for the services of a district or other nurse. 29 Extra nourishment in the form of dried milk, eggs, glyco-lecithin and extract of red bone marrow, has been supplied to suitable cases on the terms laid down by the Ministry of Health, which allows an expenditure for this purpose of £2 per 1,000 of the population. Under this scheme 79 patients have been in receipt of nourishment for varying periods during the year. Other cases have been recommended for nourishment to the Red Cross Society, the Ministry of Pensions or the Guardians, and have usually been provided with what is required. (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 requiring residential treatment are recommended for this to the London County Council or, in certain instances, to the Guardians. Cases which can be suitably dealt with as out-patients are sent to the London Hospital under the agreement already referred to. Cases of lupus are also sent to the London Hospital for Finsen Light treatment. Surgical apparatus is obtained through hospital almoners, the Invalid Children's Aid Association, the Charity Organisation Society, Surgical Aid Society letters or other charitable organisations, through the medium of the Care Committee. (xii.) The arrangements for "care" and "after care" and their working. The arrangements for care and after care are in the hands of the Tuberculosis Care Committee which meets fortnightly at the dispensary. The Committee, which is appointed by the Borough Council, is composed of representatives of the Council, with the addition of representatives from practically all the public or voluntary organisations engaged "i social work in the borough, from the London Insurance Committee and the local panel practitioners, the appropriate officers of the Borough Council being ex-officio members. lhe services of the Committee are available for any case of tuberculosis in the borough, provided the patient is willing to have his case brought before it. 30 An addition has been made to ihe dispensary staS by the appointment of a Care Secretary, to act specially as secretary to the Care Committee and to undertake generally the duties arising in connection 'with the care and after care of patients and their families. Miss Nugent, who was appointed on 24/1/24, commenced her duties on 1/3/24. Twenty-three meetings of the Care Committee were held during 1924, and 482 cases were deajt with. 175 recommendations in connection with assessment for residential treatment were forwarded to the London County Council. The Committee has worked in close touch with the Invalid Children's Aid Association, the Poplar Board of Guardians, the Ked Cross Society, the United Services Fund, and other societies. Assistance in the form of the provision of dentures free of charge (one case), the loan of beds and bedding (two cases), and the provision of a shelter has been given by the Borough Council on the Committee's recommendation. The Poplar Guardians have provided dentures in 11 cases, and beds and bedding in 6 cases recommended by the Committee. They have also given general assistance and extra nourishment in the many cases referred to them. The Red Cross Society has given valuable help in connection with tuberculous ex-Servicemen (including financial assistance, beds, dentures, clothing, etc.), and has also undertaken, for the Committee, all investigations regarding pensions. The United Services Fund has given assistance to ex-Service men s families. The Invalid Children's Aid Association has undertaken all the visiting for the Committee in connection with tuberculous children, and also the children's convalescence. The finding of employment for ex-sanatorium patients is, perhaps, the most difficult aspect of the Committee's work. Employment w'as found for three cases through the Committee's efforts during 1924. 31 (xiii.) Particulars as to any local arrangements for finding employment for patients. There are no local arrangements outside the Employment Exchanges, which, hitherto, have not proved to be of much value to the tuberculous seeker for work, who usually requires, more or less, special consideration. In three instances the Care Committee has been able to place patients; but this has been fortuitous only, and not due to any existing "arrangement." (xiv.) Statement as to the supply and supervision of shelters at the homes of patients. Two shelters are on loan to patients : the Health Visitors for the districts, who have the households under their supervision, see that they are properly used. One new shelter has been obtained and lent during 1924. (xv.) Any special points noted locally as to the incidence of tuberculosis (i.e., occupation). No special occupational incidence has been noted. (xvi.) Any special methods adopted or proposed for the prevention of tuberculosis. No special measures have been in use. The provision of spit cups or flasks and of disinfectant, the arrangement, where possible, of separate sleeping accommodation, advice on general hygiene, the removal of infectious cases or of contacts from close association with them, the reference of ailing and delicate children to other agencies for treatment or convalescence, and where possible the improvement of housing conditions are all of them routine measures of a preventive kind. (xvii.) Special difficulties encountered. The difficulty of finding light employment or light hours of employ'nent for patients who return from sanatorium fit for something short full time work. The difficulty of improving adverse home conditions consequent upon the shortage of houses. STATISTICS FOR 1924. Attendances at Dispensary (Insured, 1,873; Uninsured, 4,313 6,186 New patients examined 1,611 Contacts examined 629 Notifications by Tuberculosis Officer :— Pulmonary, 176; Non-pulmonary, 48 224 Patients sent away for Sanatorium Treatment, during 1924 278 Patients away in institutions on 31/12/24 115 Patients receiving Dispensary Treatment on 31/12/24 106 Patients receiving Domiciliary Treatment on 31/12/24 224 Under observation pending diagnosis on 31/12/24 22 In receipt of extra nourishment during the year 79 In receipt of extra nourishment on 31/12/24 26 Health Visitors' visits 8,869 Doctors' visits 313 Sputum examinations made (Dispensary, 1,444; Public Health Department, 224) 1,668 Reports sent (to Practitioners, 791; to Public Authorities, 1,618) 2,409 11th February, 1925. W. C. P. SMITH, Tuberculosis Officer. 33 REPORT OF DENTAL SURGEON. The Medical Officer of Health, Borough of Poplar. Sir, I beg to submit my Annual Report of Dental Work at the Tuberculosis Dental Clinic for the year 1924. Though the amount of work is not as great as we should like, our figures, herewith, show a steady increase. The number of attendances is not very great, but during the last few months it has shown a decided growth. I account for the low attendance in two ways. Firstly, the health and condition of the patients is such that, and varies so that, though they attend on one occasion it is all too likely that they will be unable to attend the next. Secondly, there appears to be a certain amount of overlapping between sanatorium treatment and dental treatment. It happens very frequently that patients are sent to sanatoria before their dental treatment is completed, and in many instances have to wait till their return home. The arrangement, I conjecture, reduces the benefit of both forms of treatment, and, as far as I can see, can only be obviated by the provision of dental treatment at sanatoria. Authority to supply dentures is sought where the need of them is found, and dentures are supplied at the same scale as that in force in the Maternity and Child Welfare Dental Clinic. The condition of the majority of the patients necessitates more careful handling than the treatment of those in normal health, and I have found that some signs of shock are noticeable if too much work is carried out at one sitting. To prevent this, treatment ihas been modified to a certain extent, and great care is taken lest a bad impression is left on the mind of the patient. I wish to express my thanks for the help and assistance I have always received in my work at the Tuberculosis Dental Clinic, and beg to remain, Sir, Your obedient Servant, C. HAMMOND WILLIAMS, L.D.S., R.C.S., Eng. 34 TUBERCULOSIS DENTAL CLINIC. Annual Summary, 1924. Sessions Attendances New Patients Extractions Fillings Scalings 52 232 61 359 97 75 Dressings, etc. Dentures, repairs, etc. C. HAMMOND WILLIAMS. 35 PUBLIC HLALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications received during the period 30th December, 1923, to 3rd January, 1925. The Borough. Age Periods. Notifications on Form A. Notifications on Form B. Number of Notifications on Forms c and d. Number of Primary Notifications. Total Notifications on Form a. Number of Primary Notifications. Total Notifications on Form B. Form c. Form D. 0 to 1 1 to 5 5 to 10 10 to 15 15 20|25:35 to to to to 20 25 35 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications. Under 5 5 to 10 10 to 15 Total Primary Notifications. PoorLaw Institutions. Sanatoria. PoorLaw Institutions. Sanatoria. Pulmonary— Males 5 6 4 4 15 28 2fi 32 14 3 137 247 2 12 137 16 132 Females .. — 3 2 6 16 21 33 23 11 3 2 120 214 — — 1 1 1 6 72 17 55 Non-Pulmonary— Hales 3 17 16 5 5 2 4 3 2 1 58 76 1 1 2 7 15 14 8 8 Females — 9 7 7 5 4 4 1 1 — 1 39 64 — — 1 1 2 5 11 5 16 Totals 3 34 31 22 30 42 69 53 46 17 7 354 601 — 1 3 4 12 38 234 46 211 36 New cases of Tuberculosis coming to the knowledge of the Mcdic.al Officer of Health, during the period 30th December, 1923, to 3rd January, 1925, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. 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 cases. Pulmonary— Males — — — — — — — — — 1 1 Females – – – – – – – – – – – – Non-pulmonary— Males – — 2 — — — — — — — — 2 Females .. – – – – – – – – – – – – From Registrars' Returns of Deaths. 37 Actual Number of Cases on Register. Number of cases on Register at beginning of year 1924 3,639 Add new cases during year 358 Cases returned to Register 409 4,406 Deduct :— Died (notified cases only) 192 Removed, etc. 43 Arrested or cured Removed from Register 235 Number of cases on Register beginning of 19*25 4,171 SMALLPOX. No cases of smallpox were notified during the year under review. VACCINATION. The Vaccination Officer, Mr. P. Ryan, has kindly furnished me with the following :— Total number of certificates of successful primary vaccinations in respect of persons of all ages received was 969. PLAGUE. No case of this disease was notified during the year. ANTHRAX, GLANDERS, AND HYDROPHOBIA IN MAN. Anthrax. One case of this disease occurred. London Notification of Glanders Order, 1907. No 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. ERYSIPELAS. 57 cases of erysipelas were notified during the year. Two deaths occurred. 38 PUERPERAL FEVER. Number op Cases. Eight cases of puerperal fever were notified. One patient died. CONTINUED AND TYPHUS FEVERS. No cases of continued fever occurred. No case of typhus fever occurred. SPOTTED FEVER. EPIDEMIC CEREBRO-SPINAL MENINGITIS.* Three cases occurred. All terminated fatally. ACUTE POLIO -MYELITIS, OR ACUTE POLIO -ENCEPHALITIS. AND ACUTE ENCEPHALITIS LETHARGICA. Four cases of Acute Polio-myelitis and Poli-encephalitis were notified. One patient died. Fourteen cases of Encephalitis Lethargica occurred. Six patients died. One other patient died from Cerebral Abscess (gumma). OPHTHALMIA NEONATORUM. Notifications of Ophthalmia Neonatorum. Forty-six cases of Ophthalmia Neonatorum were notified during the year :—35 notified by doctors only, 5 by midwives only, and 6 by both doctors and midwives. The total notifications received numbered 55. Year. Cases Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified. Treated At home. In hospital. 1914 75 70 5 73 2 1915 64 62 2 62 1 1 1916 60 60 60 — 1917 39** 37 1 36 1 1 1918 40 38 2 39 1 — 1919 61 51 10 60 1 — 1920 61 51 10 59 — 2 1921 47 41 6 42 2 1 2 1922 36 33 3 34 1 1 1923 38 30 8 35 — 3 1924 46 38 8 46 — — — Totals .. 567 511 55 546 7 1 12 * Posterior basal meningitis is included in theterm " cerebro spinal fever," which does not include meningitis due to tuberculosis, syphilis, middle ear disease, or injury. ** 1 born in Institution—not visited, no information available. 39 MATERNITY AND CHILD WELFARE. Report to Medical Officer of Health of Miss J. M. Cardozo, Chief Health Visitor. Public Health Offices. Bow Road, E. 3. January, 1925. Sir. I submit herewith my second Annual Report, as Chief Health Visitor, upon the work of the Maternity and Child Welfare Department relating to the year 1924. In January, Dr. Cameron, one of the Medical Officers of the Ministry of Health, made an inquiry into this work. She inspected the Clinics, and upon her report a letter was received from the Minister of Health statins that he was "glad to observe that the work is being continued along satisfactory lines and that increased use is being made of the facilities provided at the Council's Ante-Natal and Dental Clinics." The Millwall Centre has lost a valued Doctor and friend through the death of Dr. Winifred Patch, who had been Medical Officer to the Centre for 6 years. We welcome Dr. Marian Layman as her successor. Additional Health Visitor.—Owing to the congested condition of the North Poplar Area and the large attendance at the Clinics, the three districts, including the Isle of Dogs, have been divided into four and an additional Health Visitor has been appointed. A much more satisfactory arrangement. infant Consultations.—The attendance at all the Clinics has increased, Poplar being the highest with an average attendance of 6-1.4 per session. The Clinic is very overcrowded, but this will be relieved when the new building is ready in the gardens of 134 and 136, High Street, Poplar. Ante-Natal Clinic.—A special effort has been made by the Staff to develop this branch of the work, with good results, particularly at Bow, where the attendances have increased from 169 in 1923 to 367 in 1924. 40 A monthly Ante-Natal Clinic was started at Poplar last Octobei. 1 hope this will be successful. Dental Clinic.—The attendances have been excellent. The mothers are most appreciative of the treatment and advice which they obtain. Sewing Class.—A fortnightly Sewing Class has been started at Millwall, and we have held small Jumble Sales both here and at Poplar. Infantile Mortality.—The rate for the Borough, 72 per 1,000 births, is higher than last year, due chiefly to the prevalence of respiratory diseases. There has been a large number of Whooping Cough cases. In the overcrowded homes it is impossible for a mother to isolate an infectious child, babies of 3 weeks dying from the result of Whooping Cough. Toddlers.—We have endeavoured to keep the toddlers under closer supervision and have impressed upon the Mothers the importance of bringing them to the Clinic when possible. Artificial Sunlight.—In allowing the use of your office, a number of children have received Artificial Sunlight treatment, with the most beneficial results. We have a long waiting list and hope soon to have all-day sessions in our new quarters. Educational Health Films.—Tickets were distributed at the Clinics for the Health Films which were shown at Poplar and Bow. They were in great demand, the mothers and fathers attending well. The Mothers' and Babies' Christmas Party, given by the Clinic Staff and their friends, took place on January 5th and 6th, 1925. We had the pleasure of entertaining 1,200 guests. I am sorry that Mrs. March has found it necessary to discontinue her visits to the Clinics and wish to offer her our sincere thanks for the valuable help she has given during the last 17 years. Our thanks are also due to the following Voluntary Workers :—Mrs. Waters, Mrs. Radcliffe, Miss Edwards, Miss Kean. 41 Statistical Summary for 1924. Public Health Department. The Royal College of St. Katharine. Total. Ante-natal:— Visits 621 550 1,171 Re-Visits 532 911 1,443 Post-natal:— Visits 1,491 1,797 3,288 Removed before Visit 25 41 66 Died before Visit 33 40 73 Stillbirths 39 30 69 Re-visits:— Under 1 6,653 14,392 21,045 1—5 15,068 30,935 46,003 Removed 237 489 726 Died 117 182 299 Ophthalmia Neonatorum:—* Visits 46 nil. 46 Re-visits 94 nil. 94 Zymotic Enteritis:— Visits 17 28 45 Re-visits 27 27 54 Dead 1 — 1 Measles:— Visits 264 334 598 Re-visits 90 113 203 Dead 3 7 10 Miscellaneous 40 7,310 7,350 Total Visits Paid 25,398 57,186 82,584 * All infants with this disease are notified to the Medical Officer of Health, and We immediately visited by the Health Visitors of the Public Health Department. 42 Stillbirths. Number of stillbirths 72 Delivered by Doctors 17 ,, by Midwives 20 in Institutions 21 B.B.A. 6 No information available 2 Premature births 22 First pregnancies 18 Mothers who had had previous stillbirths:— One. Two. Three. Four. Five. 6 5 1 0 1 Nursing. Ophth. Neon. Measles. Pneumonia. Cases. Visits. Cases. Vis ts. Case !s. Visits. Under 5 5-10 Under 5 5-10 Under 5 5-10 Under 5 5-10 East London Nunrng Society 9 168 8 1 124 23 12 1 194 13 St. John Divine ] 15 — — — — 1 — 44 — Total 10 183 8 1 124 23 13 1 238 13 ATTENDANCES AT CLINICS. Old Ford. West Ferry Road. Christchurch. North Poplar. Royal College of St. Katharine. First attendances 700 117 207 390 933 Infant consultations 12,548 2,038 4,383 6,704 11,836 Average per session 62-4 40-7 42-5 64-4 49 9 Average attendances of each child 10-0 8-0 8-7 10-2 — Dental Clinic 627 — — — 762 Expectant mothers 367 — — 143 428 Sewing Class — 163 — 164 572 43 Total attendances at all Clinics:—Public Health Dppartment. 27,137; Royal College of St. Katharine, 13,598. Money Taken. £ s. d. For Dried Milk (12,0221bs.) 845 7 2 ,, Medical sundries 63 5 9 ,, Dentures 39 8 0 Materials at Sewing Class 40 19 0 .. Convalescent Treatment 3 18 0 ,, Virol 10 15 8 Oil and Malt .. 52 17 1 Total money taken £1,056 10 8 Free issue.—4,415lbs. Dried Milk. 5,875 vouchers for cod liver oil, malt, etc., were also issued. Grants in Aid. Convalescent Treatment (13 children; 6 mothers and babies) 19 cases. Attendance of midwife 34 „ Loan of maternity bag 4 „ Zymotic Enteritis. Died before notification received 1 Not traced 2 Visited 37 Under 1 year (see feeding below) 17 1 to 2 years 15 (1 died). 2 to 3 years 4 3 to 4 years 1 4 to 5 years 0 Feeding. Age period. Breast. Mixed feeding. Hand fed Not stated. Under 1 year 6 1 10 — Died. — — — — 44 Ophthalmia Neonatorum. Number of notifications received 46 Died whilst under supervision — Sight of one eye damaged — Recovered 46 Occurred in Institutions 2 Occurred in the practice of medical practitioners 12 Occurred in the practice of midwives 32 Admitted to hospital as in-patients 6 Treated as hospital out-patients 5 Treated privately 33 Visited by nurse 10 Vital Statistics, 1923. All births, including those occurring in outlying districts, but belonging to the Borough 4,345 Attended by doctors 950 Attended by midwives 2,658 Delivered in institutions 680 Not stated 57 Stillborn 110 Died before visit 97 Not requiring or desiring visits 406 Visited 3,796 Removed and not traced 232 Died during visitation 163 Remaining under supervision end of first year 3,337 Stillbirths per 1,000 births 25.3 Mortality per 1,000 births, died before visit 22.3 Mortality per 1,000 visited 43.6 The feeding of infants during the first six months of life was as follows:— 1. Those alive at end of completed year (December, 1924)— Breast-fed 78.5 Mixed feeding 17.0 Hand-fed 4.5 2. Those who died— Breast-fed 54.9 Mixed feeding 32.5 Hand-fed 13.5 45 5. Comparison of rates of mortality between infants Breast-fed 3.2 Mixed feeding 8.5 Hand-fed 13.0 Year of Birth. 1919 1920 1921 1922 Remaining under supervision:— End of first year — — — 3,462 ,, ,, second „ — — 3,338 — ,, „ third ,, — 3,814 — — ,, ,, fourth ,, 2,915 — — — Found 17 25 16 118 Given up 1 1 3 2 Removed and not traced 79 119 106 156 Died 8 22 25 95 Remaining under supervision: End of second year — — — 3,327 ,, „ third „ — — 3,250 — ,, ,, fourth ,, — 3,697 — — ,, ,, fifth „ 2,844 — — — Mortality per 1,000 visited:— Second Year — — — 26.5 (18.5) Third — — 7.4 (11.2) — Fourth ,, — 5.7 (7.3) — — Fifth ,, 2.7 (5.6) — — — The figures in brackets are the rates for the previous years. I am, Sir, Your obedient Servant, J. M. CARDOZO, Chief Health Visitor. 46 ROYAL COLLEGE OF ST. KATHARINE, POPLAR. Report of the Senior Medical Officer for the year ended 31st December, 1924. Routine work at an Infant Welfare Centre affords interesting opportunities of observing the babies' individual reactions to the difficulties which beset them in the early months of life. The weight curve of the first two or three years reflects this struggle very vividly. It is depressed by illness or by environmental disadvantages, wavers, declines and recovers as one obstacle after another is met and overcome. Welfare Centres could, with profit, make collections of such charts showing graphically some of the difficulties, successes and failures of their attendants. Such collections would enhance the records of statistics which tell merely the number of babies weighed or visited per annum. A chart shown for the purposes of this report illustrates one aspect of the work which has always been claimed as important by enthusiasts, though it is sometimes belittled by those who regard the educative side of Infant Welfare work as of only slight importance. There are many cases of failures of nutrition dependent on a child's individual peculiarities; others are more simple instances of faulty dietetics. Another group contains those whose nutrition is more closely dependent on the general hygiene, the mother's skill in handling and training, on clothing and ventilation, sleep and so forth. The infants in this class should profit especially by the supervision which a Welfare Centre supplies through the medium of its clinics and health visitors. A physician practising from a consulting room or hospital out-patient department can seldom review more than a few of the influences at work; at the best he can but guess what is the manner of the infant's upbringing at home. If management is seriously at fault no real or lasting improvement can take place until it is remedied. To remove the baby to an institution teaches the parent nothing, for the mother can seldom participate in the treatment; and the conditions in which an improvement is achieved there are too unlike those at home to be helpful. Moreover in institutional treatment the important element of "mothering" may have to be reduced to a dangerous minimum, in any, that is to say, in which the staff of nurses is not so numerous as to be almost prohibitively costly. The special danger of acute infections in wards containing a number of ailing babies adds to the drawback of taking an infant away from its home. The infant, whose weight chart is reproduced, had had a varied career before he first attended the welfare centre. It may be felt that to quote an isolated example of this type and one which appears to flatter theCentre's methods is unfair to those who had previously tried to improve 47 the baby's condition. No criticism of their skill is implied. Reference to the chart shows that in the stage (15-22 weeks) when the child was in hospital its condition improved rapidly. Unhappily a change of management became necessary and the child was transferred to another institution where the improvement was lost. This is exactly the kind of disappointment which so often occurs in the career of a delicate infant. Perchance this child suddenly had to give place to some other more urgently ill; and this at the moment when, possibly, the exactly right understanding between him and his nurse had been achieved, the feeds correctly estimated and his digestion suited. And perhaps again, he entered his next "home" with a slightly exaggerated reputation for robust progress and failed to fulfil it. At any rate, there is good reason to believe the diet on which the child ultimately throve differed very little from what he had been having while his weight was fluctuating or declining. The case of this infant is chosen rather as being very typical of a fairly numerous class which seldom thrives while attending the out-patient department of hospital, because, from the outset, attention needs directing to the mother and the home conditions as much as or even more than, to the infant. The Health Visitor, equipped with the appropriate knowledge and the ability to teach, is the most fitted person, it is maintained, to ensure a steady and lasting improvement. The dietetics of this child proved to be a simple matter, though when he first attended the clinic he was formidably wasted, and his power of fat digestion was low. A dilute feed of cows milk, citrated and with a high percentage of added sugar, was well taken. Later this was modified to one of more normal proportions. The Health Visitor's training and encouragement of the distracted mother furnished the essence of the child 's recovery. By one means or another she achieved a better state of affairs in the house; taught the woman how to handle the child, how to soothe it when fractious, when to stimulate it to take exercise and when to insist that it should rest. Faults of clothing and ventilation were altered, and the day was so ordered that several hours were regularly spent in the open air. By degrees the mother acquired an air of confidence and optimism that was of almost as great importance to her baby as the proper diet. The weight rises rapidly and steadily. An interesting fact remains to be mentioned, it was obtained when inquiry was made at the various hospitals where the child had been treated. The confinement took place in a lying-in hospital and the baby's birth weight was registered at 91b.; the following day the weight was found to be 81b. 3oz., and on the seventh day 71b. 140oz. The birth weight was therefore suspected to have been wrongly calculated, and there was some speculation as to whether it should have been 81b. rather 48 than 91b. The mother knew of this uncertainty and left the hospital in doubt whether she was nourishing or starving her baby. One is perhaps entitled to wish that she had been given a letter recommending her attendance at the Welfare Centre on her discharge from hospital. For, as it was situated close to her home, the yield of milk could have been investigated and home visiting started at once. Instead, she took her baby to a children's hospital several miles from her locality. Breast feeding was replaced by artificial feeding at about a month of age. It would be interesting to calculate the cost incurred by these long journeys taken regularly once a week, and sometimes twice, the expense of the drugs administered, and, finally, of the 19 weeks during which the baby was maintained away from home. This incident of the unreliable birth weight serves to show the great importance of accuracy. Occasional mistakes must occur, especially where large numbers are dealt with, and even when, as in lying-in hospitals, accurate scales are used. A much more serious source of errcr arises from the common custom of mid wives, who weigh the new-born wrapped in a towel and suspended from the hook of a cheap spring balance. Contrasting these reported records with those registered on a beam balance a few weeks later at the Welfare Centres, one wishes the custom could be dropped. Were the babies weighed in the same towel at, say the end of the first week, one could see its object. But this scarcely ever seems to be done. The results of inaccurate weighing affect adversely our work at the clinic in two ways. A child said to have weighed 101b. at birth frequently turns the scale at only 8½lb. or 91b. when brought at three or four weeks of age. It is not to be wondered if the mother is perturbed by the discovery, even though her baby shows every sign of thriving. If it be restless or prone to attacks of screaming, it will require all one's powers of persuasion to induce her to persist with breast feeding until a series of weekly weights prove the baby is growing satisfactorily and suggests the original was placed some 2lb. too high, or until she is content to forget the suspected fall in face of the record of steady progress. Not a few, however, cannot stand the suspense and augment the supposed lack of breast milk with bottle feeds. As these may well produce dyspepsia and screaming, the breast milk is further suspect and is abandoned. The other example where erroneous weights cause confusion is when a small or premature baby is found to weigh, say 61b. at three weeks of age, when it first attends the clinic. The mother mentions the birth weight was 2½lb.; she readily calculates that the growth has been exceedingly rapid. It is a source of great disappointment to find that nothing like this rate is maintained subsequently. The deduction is made that either the child has derived harm from visiting the clinic, or that the mother's 49 milk, originally abundant and nourishing, is failing in quality or quantity. The truth is that the original weight was much under-estimated. Why well-nourished babies are commonly recorded as weighing much more than they do weigh, and small ones much less, is an interesting problem. There is perhaps some subtle flattery implied in the exaggerations. There is at any rate no doubt that the errors are too common to be accidental. As with records of a feverish patient's temperature, unreliable data are worse than none. H. K. WALLER. REPORT ON MATERNITY AND CHILD WELFARE DENTAL CLINIC FOR THE YEAR 1924. The Medical Officer of Health, Borough of Poplar. Sir, I beg to submit my Annual Report of Dental Work at the Maternity and Child Welfare Dental Clinic for the year 1924. On reference to the summary herewith, a considerable growth in all branches of the work is apparent. The number of attendances per session has increased so much that the two hours allotted is seldom sufficient to do all one would like. In fact, it is becoming the rule for the session to extend fifteen to thirty minutes over the scheduled time. There can be little doubt that the work is being appreciated by those attending; in fact, the number of patients attending for preventive treatment, i.e., before actual pain is experienced, is increasing noticeably. Dentures are being supplied at a very moderate cost, though just recently some cases have been held up, and the work somewhat protracted. This has been due to the fact that sickness among the staff has somewhat handicapped the running of my workshops. May I again take the opportunity of thanking all those with whom I come in contact for their help and assistance in the efficient working of the Clinic. I have the honour Sir, to remain, Your obedient Servant, C. HAMMOND WILLIAMS, L.D.S., R.C.S., Eng. 50 MATERNITY AND CHILD WELFARE DENTAL CLINIC. Annual Summary, 1924. Sessions Attendances New Patients Extractions Fillings Scalings 52 627 255 1069 161 106 Dressings, etc. Dentures, repairs, etc. C. HAMMOND WILLIAMS. Free Milk Scheme. Mr. Dyer, Chief Clerk, reported:— During the 12 months ended 27th December, 1924, 14,828 applications for free milk were received, of which 13,597 were granted (compared with 15,537 applications and 14,086 grants for 1923). Orders for 487,074 pints of fresh, and 4,902 lbs. of dried milk were issued, the total commitments amounting to approximately £6,150. Personal inquiry was made into 2,922 cases by the Inquiry and Investigation Officer. Fourteen cases were reported to the Maternity Committee as unsatisfactory. 10 cases applicants had commenced work and received an income which rendered them over-scale while receiving free milk without notifying the fact; 1 case notification was not given that the child had been sent away, and 3 cases the whole of the income had not been declared. The Committee addressed letters of caution in 6 cases, and the remaining 8 were instructed to refund the value of milk supplied. During the year the sum of £7 was repaid on account of milk supplied upon incorrect information, making a total sum of £306 repaid to December, 1924. Several complaints of short measure have been dealt with during the year. The Council has suggested to all milk suppliers that by supplying milk in sealed bottles the giving of short measure on delivery would be obviated. By arrangement with the Dairymen's Association, since April 1st, 1923, the Council has been paying 4d. per gallon below the ruling retail price. The price of milk per pint to the Council varied during the year as follows:—1st January, 3id., 2nd March, 3d., 30th March, 2½d., 1st October, 3d. 51 Tabulated statement of Inspections, of Insanitary Conditions found existing, and of Re inspections, &c., during the eleven months ended 27th December, 1924. (Miss M. E. Davies, Lady Inspector). Poplar. Bow and Bromley. Totals. Workshops, Workplaces, Laundries, &c., Number of on the Register 56 109 165 Workshops, Number of Workrooms therein 85 156 241 ,, Number of Inspections of 86 163 249 ,, Number of Re-inspections of 23 91 114 Workrooms, Number of Inspections of 128 229 357 ,, found to be overcrowded 7 3 10 ,, found to be insufficiently ventilated — 3 3 ,, found to be in dirty condition 15 15 30 Workshops, etc., newly discovered and registered 5 12 17 ,, Workrooms therein measured 8 15 23 ,, Reported to H.M. Inspector on discovery 5 12 17 Factories, Number visited 106 209 315 ,, W.C.'s dirty, &c. 19 13 32 Outworkers' premises visited 247 796 1,043 Written Intimations served 74 145 219 Statutory Notices served 6 18 24 Final Notices served — — — Works carried out under supervision:— (a) Additional means of ventilation provided — 3 3 (b) Rooms cleansed and whitewashed 18 39 57 (c) Yards, floors, roofs, &c., repaired 7 7 14 (d) Sanitary conveniences constructed, cleansed or repaired 15 27 42 Overcrowding of Workrooms, Cases abated 1 3 4 Miscellaneous Visits 110 50 160 Visits re Verminous Children 79 51 130 ,, Scabies 41 16 57 ,, Outworkers' Lists 17 17 34 ,, Suspected Infectious Disease 123 78 201 ,, Eye trouble 87 30 117 Visits to Schools 47 36 83 Reports of housing inspectors. Summary, 1924. Poplar. Bromley. Bow. Totals. House-to-house Inspections 236 277 299 812 Re-inspections 3,917 4,420 3,870 12,207 Number of Intimations served— Public Health (London) Act 440 601 316 1,357 P.B.C. By-laws 184 194 193 571 L.C.C. (General Powers) Act, re verminous rooms 16 68 22 106 Number of Notices served— Public Health (London) Act 148 305 117 570 P.B.C. By-laws 63 115 92 270 For cleansing 34 51 22 107 Number of Final Notices served— For cleansing and other matters 19 111 28 158 Number of drains tested— Chemical test 206 291 287 784 Smoke test 82 161 113 356 Water test 11 12 23 46 Number of drains defeetive 4 10 16 30 „ „ obstructed 6 3 7 16 52 SANITARY INSPECTORS' WORK, Etc. (See also Tables on preceding page.) Tabulated Statement of Inspections, Insanitary Conditions found existing, and Re-inspections during the year 1924. East Combined Division. West Combined Division. Poplar South Division, Bromley North Division. Bromley Central Division. Bow East Division. Bow West Division. Totals Total Inspections:— 1,073 1,378 1,219 1,443 1,122 1,160 1,341 8,736 On complaints of nuisances, etc. 383 577 465 751 609 635 538 3,938 On notification of infectious diseases 363 596 203 562 286 323 250 2,583 House-to-House — — — — 58 56 — 114 Bakehouses 43 41 18 21 17 7 69 216 Slaughterhouses 5 — 2 5 — 3 56 71 Cowhouses 7 3 — 9 — 12 16 47 Milkshops 48 37 12 23 14 53 97 284 Ice cream vendors' premises 27 35 32 1 31 12 7 145 Workshops, workplaces, etc. 217 89 487 71 107 59 308 1,338 Premises found in fair condition 513 664 578 978 385 487 708 4,313 Do. requiring amendment 560 714 641 465 737 673 633 4,423 Details of Insanitary Conditions, etc. Walls and ceilings dirty 317 272 473 230 280 262 310 2,144 Yards, forecourts and areas insufficiently paved or drained 90 58 63 52 109 54 27 453 Inlets to drains not properly trapped 2 4 7 1 — — — 14 Number of drains tested 172 119 168 106 158 119 133 975 Do. do. defective 38 63 53 68 6 29 26 283 Do. do. obstructed 42 95 113 141 26 42 48 507 Sink waste pipes not trapped or otherwise defective 51 2 18 1 108 26 9 215 Sink waste pipes directly connected to drains — 1 — 1 — — — 2 53  East Combined Division. West Combined Division. Poplar South Division. Bromley North Division. Bromley Central Division. Bow East Division. Bow West Division. s Soil pans of w.c.'s without suitable water supply 38 23 62 28 39 4 31 225 Do. do. broken or unsuitable 28 16 6 7 11 20 7 95 Do. do. in foul condition 33 4 19 6 10 21 16 109 Do. do. untrapped 2 — — — 2 — 1 5 Hoofs, guttering and rainwater pipes defective 189 215 302 300 301 196 226 1,729 Water supplies to premises cut off (notified by Metropolitan Water Board) — — — 3 1 — 4 Water service fittings defective, causing waste of water 12 11 29 5 5 13 8 83 Drinking Water improperly stored 2 2 — 1 — — — 5 Dampness 170 69 108 28 129 85 97 686 Inundations 1 — 1 6 — 7 — 15 Overcrowding 6 — — 3 4 1 — 14 No proper receptacle for house refuse 37 18 50 39 64 24 55 287 Accumulations of dung or refuse 28 18 7 7 8 4 5 77 Foul P.H. urinals — 2 4 2 8 — 1 17 Other nuisances, dilapidations, want of ventilation, etc. 120 273 731 204 323 596 528 2,775 Breaches of London County Council's By-laws 94 — 12 1 99 41 28 275 Breaches of Council's By-laws 82 — 82 1 10 56 31 262 Intimations served 559 645 641 465 607 673 633 4,223 Notices served 213 400 161 263 340 233 374 1,984 Final Notices served 63 36 42 91 89 48 38 407 Summonses applied for (except Food and Drugs) 2 6 — 5 13 7 — 33 Passengers from Continental Ports:— Visited — 2 — — — 1 — 3 Undiscovered — — — — — — — — Intimations served in respect of verminous rooms 29 28 54 33 80 30 36 290 Verminous rooms cleansed 37 31 — 47 76 33 — 224 Re-inspections 2,666 2,303 2,407 2,125 1,817 2,173 1,390 14,881 54 HOUSING ACTS, 1890-1923. Housing (Inspection of District) Regulations, 1910. Representations to Council under Housing, Town Planning, Etc., Act, 1909. No premises were inspected with a view to closing under Section 17 (1) of the Housing and Town Planning, Etc. Act, 1909. Increase of Rent and Mortgage Interest (Restrictions) Acts. No certificates were issued under the above Acts. HOUSING CONDITIONS. Statistics. Year Ended December, 1924. 1.—General. (1) Estimated population 167,300 (2) General death rate 12.1 (3) Death rate from tuberculosis (all forms) 1.2 (4) Infantile mortality 72 (5) Number of dwelling-houses of all classes (Census 1921) 23,248 (6) Number of working-class dwelling-houses Practically all (7) Number of new working-class houses erected during 1924 61 houses. (In course of erection, 43.) 2.—Unfit Dwelling-houses. I.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or other Acts) 8,550 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 36 55 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 4,876 II.—Remedy of defects without Service of Formal (Statutory) Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,650 III.— Action under Statutory Powers. A. Proceedings under Section 28 of the Housing, Town Planning, Etc., Act, 1919 — (1) Number of dwelling-houses in respect of which notices were served requiring repairs 4* (2) Number of dwelling-houses which were rendered fit— (a) by owners — (b) by Local Authority in default of owners — (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — B. Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,938 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 2,922 (b) by Local Authority in default of owners — (c) by Local Authority and owner jointly — * Ministry of Health inquiry held early in 1925 with a view to the Council acquiring the site. 56 Proceedings under Sections 17 and 18 of the Housing, Town Planning, Etc., Act, 1909— (1) Number of representations made with a view to the making of Closing Orders — (2) Number of dwelling-houses in respect of which Closing Orders were made — (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit — (4) Number of dwelling-houses in respect of which Demolition Orders were made — (5) Number of dwelling-houses demolished in pursuance of Demolition Orders — 6 houses were subjects of Closing Orders made by Magistrates under the Public Health (London) Act, 1891. 5 of the Closing Orders were camelled early in 1925. 7 premises were represented under Part II of the Housing Acts, 1890 and 1923, Nos. 97 and 99 Brunswick Road, and 8, 9, 10, 11 and 12, Andrew Street. 57 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 1924. Number of Inspections. Number of Intimations. Number of Notices. Number of Final Notices. Number of Prosecutions. Male. Female. Total. Bakehouses (Factories) 32 — 32 130 33 1 1 Bakehouses (Workshops) 53 — 53 177 43 1 — — Bakehouses (Domestic Workshops) 1 — 1 7 3 1 — — Factories (Laundries and Miscellaneous Factories) 32 118 150 301 41 7 — — Laundries (Workshops) — 4 4 12 2 1 — — Laundries (Domestic Workshops) — 3 3 6 — — — — Workshops 121 1515 3728 523 51 20 2 2 Workshops (Domestic) 14 — 14 28 4 2 — — Workplaces 167 — 167 369 64 11 2 — Workplaces (Domestic) 41 — 41 109 13 2 — — Places where food is sold or prepared 316r — 316r 1001¶ 133 15 1 — Milk Premises 167 — 167 385 4 2 — — Cowsheds 10 — 10 37 — — — — Slaughterhouses 9 — 9 62 — — — — Other offensive trade premises 2rr — 2rr 4 — — — — Ice Cream premises 94 — 94 165 17 5 1 — Homeworkers' premises 56 918 974 1106 67 8 — 1 8 Including 26 workshops where both men and women are employed and 2 laundry receiving offices. r Power is used in 31 of these premises. ¶ Including inspections of all factories where food is prepared, rr 2 registered by the London County Council. 58 TABLE B. Workshops on Register (Male), 1924 9 Bootmaking. 2 Paint making. 2 Barge building. 1 Paper sorting, etc. 2 Boat building. 2 Plumbing. 1 Brush making. 1 Poultry food mixing. 1 Building, etc. 1 Rag sorting. 7 Cabinet making. 1 Sawyer. 1 Chemical Works. 10 Tailoring. 1 Cigar making. 3 Tarpaulin works. 1 Clay pipe making. 1 Sackmaking. 3 Cork cutting. 2 Skin dressing. 7 Confectionery making. 1 Stonemasonry. 4 Cooperages. 1 Tinsmith. 2 Electrical Engineering and Winding. 1 Tin toy making. 5 Upholstering. 5 Engineering. 3 Undertaking. 12 Farriers. 2 Van building, etc. 3 French polishing. 2 Vinegar making. 1 Frilling making. 1 Waterproof working. 1 Gas works. 1 Wax refining. 4 Harness making. 1 Welding. 1 Joinery. 1 Wheelwright. 2 Motor garage works. 2 Wire working. 2 Metal works. 1 Walking stick making. 2 Oil stores. 1 Zinc working. As per List, Table A Workshops on Register, page 57. Workshops on Register (Men and Women Employed). 2 Cork cutting. 1 Upholstering. 15 Tailoring. 3 Bootmaking. 3 Confectionery making. 1 Clay pipe making. 1 Cap making. 59 Domestic Workshops on Register (where Men are Emploted).* 2 Tailoring. 1 Keg and drum repairing. 2 Blacksmiths. 1 Decorated earthenware making 3 Boot repairing. 1 Plumbing. 1 Picture frame making. 1 Blind making. 2 Cycle repairing. Home Workers on Register (Male). 36 Bootmaking. 2 Brush making. 15 Tailoring. 1 Waterproof garment making. 1 Mantle making. 1 Clothing making. Workshops and Domestic Workshops on Register (Females).* 54 Tailoring. 2 Woollen garment making. 9 Laundries. 8 Confectionery making. 10 Boot upper making. 1 Packing. 12 Dressmaking. 1 Glass blowing. 4 Upholstering. 1 Tinned goods labelling and sorting. 2 Cork cutting. 2 Skirt and blouse making. 1 Paper and rag sorting. 3 Waterproof garment making. 1 Wood chopping. 2 Trimming making. 2 Sack and bag making. 1 Corset making. 1 Shirt and pyjama making 1 Artificial flower making. 5 Furriers. 1 Horse hair sorting. 1 Seal stamping. 3 Toymaking. 10 Milliners. 1 Bedding making. 11 Mantle making. 2 Underwear making. 1 Leather sorting. 2 Tarpaulin works. 3 Tiemaking. * 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 57. 60 Factories on Register (Female). 35 Tailoring. 5 Dressmaking. 1 Blouse making. 4 Mantle making. 1 Trimming making. 1 Flute making. 3 Bedding manufacturing. 4 Sack making. 1 Corset making. 4 Confectionery making. 2 Shirt making. 1 Rug making. 1 Brush making. 1 Cigarette paper making. 1 Rice starch making. 2 Rubber goods making. 1 Tortoiseshell goods making. 1 Fibre, hemp and jute making. 2 Wood chopping. 2 Christmas cracker making. 2 Perambulator builders. 1 Bunting and flag making. 2 Cleaners and dyers. 1 Laundry. 1 Match making. 2 Toy balloon making. 2 Boot making. 1 Toy making. 2 Waterproof making. 1 Woollen garment making. 1 Whalebone works. 2 Mineral water manufacturers. 1 Shroud making. 1 Cork cutting. 1 Type founder. 2 Overall making. 1 Wallpaper manufacturer. 1 Dog biscuit manufacturer. 1 Butter mixing factory. 1 Boiler packing. 4 Varnish and paint works. 1 Glass works. 8 Box making. 4 Rope works. 1 Pianoforte manufacturer. 61 TABLE C.* See footnote, page 59. Factories, Workshops, Laundries, Workplaces and Homeworkers. 1 .—INSPECTION. Premises. Number of Inspections. Written Notices. Prosecutions. Intimation. Statutory. Final. Factories (Including Factory Laundries.) 431 74 8 1 Workshops† (Including Workshop Laundries.) 712 96 22 2 2 Domestic Workshops‡ 41 7 3 Workplaces (Males) 369 64 11 2 Domestic Workplaces (Males) 109 13 2 Places where food is sold or prepared§ 1001 133 15 1 Homeworkers' Premises 1106 67 8 1 Total 3769 454 69 6 3 * Tables (J, D, E and F are tilled in at the request of the Secretary of State, † Including Workshop Bakehouses. See Table A, page 57 . ‡ Including Domestic Bakehouses and Laundries. See Table A, page 57. § The inspections of all factories where food is prepared are included. Power is used in 31 of the nremises. 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 375 375 .. 1 Want of ventilation 4 4 .. .. Overcrowding 3 3 .. .. Want of drainage of floors .. .. .. .. Other nuisances 293 293 .. .. Sanitary accommodation insufficient 7 7 .. .. unsuitable or defective 56 56 .. 1 not separate for sexes 6 6 .. 1 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 744 744 .. 3 These defects refer to premises as mentioned above under table of Inspection. 62 Nature of Work. Outworkers' List, (Section 107). Outwork in unwholesome premises. (Section 108). Outwork in infected premises, (Sections 139, 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 (S. 110). Prosecutions (Sections 109, 110). Twice in the year. Once in the year. hailing to keep or permit inspection of list. 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, etc. 82 135 810 5 5 18 29 .. .. 62 5 1 8* Cleaning and Washing Household Linen Lace, lace curtains and nets Curtains and furniture hangings Furniture and Upholstery 2 .. 18 Electro-plate File Making Brass and Brass Articles Fur pulling Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, etc. Artificial Flowers Nets, other than wire nets Tents Sacks Racquet and Tennis Balls Paper, etc., Boxes, Paper Bags 2 167 Brush Making Pea Picking Feather Sorting Carding,etc. ,of buttons,etc. Stuffed Toys Basket Making Chocolates and Sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, etc. .. .. .. 2 .. 12 1 Textile Weaving Total 86 135 995 7 5 30 30 62 5 1 8* * For Infectious Diseases sec page 22 . 63 LIST OF OUTWORKERS, FACTORY AND WORKSHOP ACT, 1901 (S. 107).* Class of Homework. 1924 Number of Lists received. Number of Addresses of Outworkers. Due Feb. 1st. Due Aug. 1st. Forwarded to other Authorities. Received from other Authorities. No. of Lists. No. of Outworkers. No. of Li sts. No. of Outworkers. Due Feb. 1. Due Aug. 1. Due Feb. 1. Due Aug. 1. Total 51 599 42 566 234 168 404 405 Tailoring 44 471 35 433 Shirtmaking 1 8 1 5 Miscellaneous 1 13 2 8 Shoemakers 4 30 3 30 Boxes 1 77 1 90 * See page 62. 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 53 Bakehouse Domestic Workshops 1 Laundries Workshops 4 Laundries Domestic Workshops 3 Workshops 372* Domestic Workshops 14 Workplaces 167 Workplaces Domestic 41 Places where food is sold or prepared 316† Total number of workshops and workplaces, etc., on Register 971‡ * 20 where men and women are employed, † Power is used in 31 of these premises. ‡ See Tables A and B, pages 57 and 58. TABLE F. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 12 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 22 Reports (of action taken) sent to H.M. Inspector 19 Other (Communications) 11 Underground Bakehouses (s. 101):— Certificates granted during the year .. In use at the end of the year 24 64 COFFEE SHOPS, EATING HOUSES, FRIED-FISH SHOPS, HOTELS & RESTAURANTS, ETC.† London County Council (General Powers) Act, 1908.—Sanitary Provisions 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 316. London County Council (General Powers) Act, 1908. 1,001 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 126 instances, and 125 other defects existed. 133 intimations were served, which in 15 cases were followed up by Statutory notices, and one final notice was served. MILK SHOPS. At the end of the year there were in the Borough 177 registered premises (including 10 cow-houses) where milk is sold. These milk shops were kept under observation. Cleansing of premises was necessary in seven instances. Nineteen other defects were found. Thirty-four milkshops have been placed on the register during the year. Twenty-one premises were on account of change of occupiers reregistered as milkshops. Forty persons were registered for the sale of sterilised milk only in bottles. The sale of milk was discontinued on five premises. For milkshops connected with infectious diseases, see page 21. † See Tables A and C, pages 57 and 61. 65 The Milk (Special Designations), Order, 1923. The above Order revoked previous regulations and came into operation on the 1st July, 1923. One application was made for a dealer's licence for Grade A (Tuberculin Tested) milk. The premises, 179, Bow Road, are used as a bottling establishment (licensee, D. J. Williams). For analysis of samples, see Report of Public Analyst, page 78. ICE CREAM. London County Council (General Powers) Act, 1902, Sec. 43. There are 94 premises where ice creams are manufactured within the Borough, on the register. 165 inspections (including 13 inspections of itinerant vendors' utensils) were made during the year. Cleansing of premises was necessary in 11 instances. 38 other nuisances existed. HAIRDRESSERS' PREMISES. The hairdressers' premises were inspected during the year. RAG AND BONE DEALERS. Legal proceedings were taken in one instance for non-compliance with the L.C.C. Bye-laws.—(See legal proceedings, page 87.) SMOKE NUISANCES. 55 smoke nuisances were dealt with during the year:—11 Bow East, 1 Bow West, 11 Bromley North, 8 Bromley Central, 6 East Combined, 15 West Combined, and 3 Poplar South. One summons was issued, see page 88. BAKEHOUSES. Inspections. The Bakehouses throughout the Borough were inspected at least twice during the year. There are 86 bakehouses in use, of which 24 are underground. In 32 bakehouses machinery is used. See Table A, page 57, number made up to end of year. 66 Cleansing was necessary in the various bakehouses on 88 occasions. Twenty-five other nuisances were found (including 1 defective or unsuitable w.c. accommodation). SLAUGHTERHOUSES. No action was taken under the bye-law made by the London County Council for regulating the conduct of a business of a slaughterer of cattle, which came into operation on 8th March, 1924. SLAUGHTERER OF POULTRY. No action was taken under the bye-laws made by the London County Council respecting the business of a slaughterer of poultry, allowed by the Minister of Health on the 22nd December, 1923. CANAL BOATS. For the year ended 31st December, 1924, the inspections and reports of the Inspectors respecting registered and non-registered canal 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 4 2 **Mr. A.J. Field, Bow East Division 5 6 Mr. W. Boyce, Bow West Division 2 20 11 28 † There is no canal in the East Combined and Poplar South Divisions, the Inspectors deputise, when necessary, for other Inspectors. ‡ Mr. J. Johnson reported, "There have been no canal boats in my part of canal at times of visits during 1924." * Mr. W. Johnson reported that in one case the Master was unable to produce certificate. A letter was sent to the owners. ** Mr. A.J. Field reported that one registered boat was visited twice. 67 DISINFECTING DEPARTMENT. Rooms and Articles (Infectious and Verminous) Disinfected. The following figures give the number of rooms and articles disinfected:— Rooms. Beds. Mattresses and Palliasses. Pillows. Bolsters. Various. Totals. Infectious Disease 868 881 472 2612 1066 11199 16230 Miscellaneous 113 140 53 275 98 1447 2013 Totals 981 1021 525 2887 1164 12646 18243 Pulmonary Tuberculosis 339 31 12 86 37 404 570 Totals 1320 1052 537 2973 1201 13050 18813 Other articles also passed through the Council's apparatus, from the Shelter, Glaucus Street, disinfectors' clothing, overalls, drop-sheets, etc., to the number of 9,407, and 25,245 articles of clothing from verminous persons were disinfected, making a total of 53,465 articles. Three articles were destroyed at the Council's apparatus from premises where cases of cancer had occurred. 78 articles were destroyed at the request of a Relieving Officer and one for a private individual. ELECTROLYTIC DISINFECTANT FLUID. At the seven depots the electrolytic fluid was still in great demand by the public. During the year 1924, 70,350 gallons were manufactured and broken down to 140,700 gallons for distribution. 68 Distribution of Fluid. The fluid was distributed as follows:— galls. Violet Road Depot 77,008 Bickmore Street Depot 12,345 Old Ford Road Depot 8,568 Ford Road Depot 4,404 Trego Road Depot 5,130 Stebondale Street Depot 5,265 Millwall Depot 972 Public Health Offices 105 Poplar Baths 5,574 Bow Baths 4,807 Island Baths 2,110 Violet Road Baths 258 Wick Lane Baths 317 Empson Street Baths 711 Open Air Bath 572 Poplar Town Hall 150 Bromley Public Hall 312 Works Department 309 Guardians'Offices 464 Poplar Union Workhouse 3,776 Langley House 267 Poplar Training School, Hutton 191 Public Libraries 360 Used at Council's Shelter in baths of verminous persons 625 London County Council Schools 3,252 Mortuary, High Street, Poplar 432 Borough of Poplar Dispensary 24 Royal College of St. Katharine 204 Private Firms in Borough 1,285 Council Offices. Poplar 291 69 Finance Department Offices 75 Kingsley Hall 60 Bow War Pensions Office 69 North Poplar Clinic 63 Howrah House Convent 231 Bow Relief Offices 84 Children's House 30 Total 140,700 Cost of Materials and Electricity. The cost of materials and electricity for manufacturing the electrolytic fluid was as follows:— £ s. d. Electricity, 14,520 units at lid. per unit (with 50 per cent. advance) 136 2 5 Chloride of Magnesium, 10 tons 0 cwts. 2 qr. 16 lbs. 43 0 11 Salt, 14 tons, 0 cwt. 0 qrs. 56 0 0 Caustic Soda, 19 cwt. 0 qrs. 16 lbs. 29 8 0 Water (70,350 gallons) 3 18 3 Total cost of materials and electricity to produce 70,350 gallons (strong); broken down to 140,700 gallons 268 9 7 Electric motor for stirring: 412 units 3 17 3 Bottles, Corks and Labels. Bottles 43 3 11 Corks 12 10 0 Labels 6 0 0 £61 13 11 Total quantity of water used for all purposes, 255.000 gallons, cost £13 19s. 11d. 70 Total Quantity Manufactured since Installation of Plant Since the installation of the plant, a period of 19 years, 819,699 gallons of fluid have been manufactured (see footnote) at a cost for electricity of £1,283 9s. 5½d., and materials of £1.575 0s. 3d. Year. Output, gallons. Materials, Chloride of Magnesium, Salt, Caustic Soda and Water. Cost. Electricity. Total. £ 8. d. £ s. d. £ a. 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 7½ 53 2 2½ 1910 50,726 47 11 10 50 10 6 98 2 4 1911 53,063 50 17 9 56 16 7½ 107 14 1912 54,388 41 7 10 59 14 4½ 101 2 2½ 1913 66,740 62 7 3 71 0 10½ 133 8 1½ 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 6½ 120 1 10½ 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 1921 51,330† 220 7 10 134 18 8 355 6 6 1922 56,520† 166 0 1 119 13 9 285 13 10 1923 64,740† 118 0 7 123 11 3 241 11 10 1924 70,350† 132 7 2 136 2 5 268 9 7 Total 819,699 £1,575 0 3 £1,283 9 5½ £2,858 9 8½ Not only are the Public Health Department and other buildings of the Council (the public baths, etc.) furnished with the disinfectant, 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, as required. As applicants now usually bring their own receptacles to the depots, there is a very appreciable saving in the expense on bottles. † Since 1914 the fluid has been made of greater strength than originally, and afterwards broken down to half strength for distribution. Quantity distributed:— 1914 88,425 gallons. 1915 73,970 ,, 1916 53,580 ,, 1917 55,800 ,, 1918 61,500 ,, 1919 66,570 ,, 1920 78,510 ,, 1921 102,660 ,, 1922 113,040 ,, 1923 129,480 ,, 1924 140,700 ,, 71 Electrolytic Disinfectant. Estimate for year ended 31st March, 1924. Expenditure for year ended 31st March, 1924. Average Expenditure for 3 years ended 31st March, 1924. Estimate for year ending 31st March, 1925. Estimate for year ending 31st March, 1926. No. £ £ £ £ £ £ £ £ £ £ 1 Wages (Manufacturing, bottling and delivery to Depots, Guardians' Institutions and Sick Asylums) 888 919 919 890 900 1 2 Rent. Rates and Insurance—Main Depot 85 99 96 85 90 2 3 Supervision of Plant 15 15 15 15 15 3 4 Electricity and Water 130 146 147 140 140 4 5 Materials (Chemicals) 200 119 152 150 150 5 6 Bottles, Corks, Wax, Labels and Paste 50 62 50 50 50 6 7 Sundries (including Testing Apparatus and Carboys) 60 52 85 60 60 7 8 Repairs—Depot 150 67 112 100 20 8 9 Repairs—Plant 20 — — 20 20 9 —1598 —1479 —1576 —1510 —1445 10 Issuing—Wages—(Old Ford Road, Trego Road, Ford Road, Bickmore Street, West Ferry Road, and Stebondale Street Depots) 644 655 665 648 654 10 11 Issuing—Cartage 112 137 126 112 120 11 12 Rent —Issuing Depots (Ford Road, Trego Road and Stebondale Street) 32 34 30 32 32 12 13 Sundries and Petty Expenses 22 13 17 20 20 13 —810 —839 —838 —812 — 826 14 Less—Sale of Fluid 2408 2318 2414 2322 2271 30 2378 29 2289 34 2380 30 2292 30 2241 14 72 Spraying and Cleansing Floors of London County Council Schools with Electrolytic Disinfecting Fluid. 3,252 gallons were supplied to eight London County Council Public Elementary Schools for spraying and cleansing floors of classrooms. 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. 5,574 gallons were supplied to the Poplar Baths, 4,807 gallons to the Bow Baths, 2,110 gallons to the Island Baths, and 572 gallons to the openair swimming bath, making a total of 13,063 gallons. VERMINOUS CHILDREN ATTENDING SCHOOLS. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1907. CHILDREN ACT, 1908. Number of Verminous Children Bathed; Itch Cases. Number of Verminous Children Bathed. Quarter. Total number of Cleansings. Amount. 1924. £ s. d. March 479 41 11 0 June 440 41 16 0 September 354 34 0 0 December 415 36 15 0 Totals 1,688 £154 0 73 1,237 verminous school children (104 boys and 1,133 girls) belonging to the Borough, and 200 school children (34 boys and 166 girls) residing outside the Borough were bathed, and their clothes were disinfested. 243 children (146 boys and 97 girls) and 47 adults (40 male and 7 female) suffering from scabies were similarly dealt with. Miss Davies made 130 visits in connection with verminous school chlidren—79 Poplar and 51 Bow and Bromley. Cleansing of Verminous Rooms, see pages 51 and 52. Itch Cases. Miss Davies made 57 visits in connection with children suffering from itch—41 Poplar, and 16 Bow and Bromley. CLEANSING OF PERSONS ACT, 1897. During the year, 89 persons (59 men and 30 women—including 31 (10 men and 21 women) from Common Lodging Houses—see below) had applied for baths and for their clothes to be disinfested. 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. The number of persons from Common Lodging Houses within and without the Borough of Poplar, cleansed at the Council's Cleansing Station, Glaucus Street, during the year ended 31st December, 1924 was: Common Lodging House, etc. Male. Female. Total. 215, Bow Road .. 4 4 St. James's Chambers, 217, High Street, Poplar 3 — 3 65, Bow Lane — — — 378, Old Ford Road 3 — 3 10 – 10 From Common Lodging Houses without the Borough of Poplar— Whitechapel — 21 21 — 21 21 74 SHELTER AND CLEANSING STATION. During the year one person was accommodated at the shelter—a suspected smallpox patient. The case was diagnosed as chickenpox. LONDON COUNTY COUNCIL (GENERAL POWERS) ACTS 1904 AND 1922. †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. 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) Acts, will be brought into operation. A fluid insecticide is given and sprayers loaned to tenants in order to rid rooms and contents of bugs. Two hundred and twenty gallons were distributed during the year. 17 p.h. urinals were found to be in foul condition, and were subsequently cleansed. HOUSES LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. During the year three houses were registered, giving a total of 1,453, which includes a number of premises occupied by Chinese. The latter premises have been under constant supervision. WATER CERTIFICATES. One certificate was issued under sec. 48 of the Public Health (London) Act, 1891. CUSTOMS AND INLAND REVENUE ACTS, 1890-1891, AND REVENUE ACT 1903. No applications for certificates for exemption under the Customs and Inland Revenue Act, 1890-1891, and the Revenue Act, 1903, were made during the year. † For the Cleansing of Verminous Rooms, see Tabulated Statements, pages 51 & 52. 75 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, by the use of barium carbonate paste, and the red squill preparation recommended by the Ministry of Agriculture, which are distributed to tenants of houses, where necessary, and 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. The public elementary schools were inspected during the year. A few minor defects were discovered and remedied. RAG FLOCK ACT, 1911 Two samples of rag flock were procured during the year 1924. (See Public Analyst's report, page 78.) OVERCROWDING. A number of cases of overcrowding were reported, but on account cf lack of housing accommodation remained unabated. 10 Cases of over- crowding were found in workshops. GENERAL. 2,470 Complaints (including 31 smoke) as to nuisances were made. 4,225 communications on general matters were despatched, and 3,880 in connection with the supply of milk. EXPORT OF MEAT PRODUCTS. 178 certificates were issued in connection with 114 consignments of foodstuffs: Canada (68 certificates), Australia (78), Philippine Islands (16), Venezuela (9), others (7). Two firms applied for certification under the Australian Customs Proclamation No. 83. 76 PUBLIC ANALYST,S ANNUAL REPORT, 1924. During the year 1924, 764 samples were examined under the Sale of Food and Drugs Acts, of which 28 samples, or 3.7 per cent., were found to be adulterated. The amount of adulteration is identical with that of the previous year. In addition, 61 samples, or 8.0 per cent., were reported as of poor quality or doubtful purity. The figures for the past five years are as follows :— Year. Samples Examined. Percentage of Adulteration. 1924 764 3.7 1923 762 3.7 1922 738 2.2 1921 710 0.8 1920 730 1.2 Average 741 2.3 The average adulteration for the whole of London in 1923 was 4.6 per cent., and for the whole of the country 6.1 per cent. The number of samples examined was in the ratio of 4.7 per 1,000 of the population, as compared with 8.5 per 1,000 for the whole of London, and 3.0 per 1,000 for the whole of the country. Twenty-one out of the 764 samples were purchased informally, two samples were submitted by the public, and one sample was submitted by the police. Three unofficial samples were adulterated. Preservatives. The Departmental Committee appointed to enquire into the use of preservatives and colouring matters in food issued their final report during the year. After careful consideration of the subject from all sides, they decided to recommend that some of the commonly used preservatives like boracic acid, borax, formalin and salicylic acid should be prohibited, and the permitted preservatives be restricted to two kinds only, the comparatively harmless sulphur-dioxide and benzoic acid, within definite limits. Moreover, they decided that the variety of foods to which these preservatives may be added should be also definitely restricted to those which it would be difficult to keep sound otherwise. A further useful recommendation made was that wherever possible the presence of preservatives should be declared on the label. 77 If these recommendations are carried into force, it will mean that manufacturers, who are to be allowed two years' grace, will have to pay strict attention to careful manufacture of prepared foods, and the use of sound materials, and probably have to improve the quality of some of their goods. All this will, no doubt, be to the benefit of the health of the consumer in the long run. The following samples examined during the year were found to contain preservatives:— Food. No. Examined. Preserved. Percentage Preserved. Butter 55 18 32.8 Margarine 49 27 55.1 Meat pies 2 2 100.0 Cake 6 2 33.3 Lime juice cordial 2 2 100.0 Lemon squash 4 1 25.0 Sauce 2 1 50.0 Total 120 53 44.1 Ice-cream. During the summer months some attention was paid to the question of ice-cream. It was found that vendors advertised their products under various names, some as "ices," and others as "ice-cream," or "creamices." In the latter case it was found, after examination, that the article was generally devoid of cream, and consisted of frozen starch custard. To vend such a product as "ice-cream" should be regarded as a similar offence to other forms of adulteration. Heated Milk. A large number of the milks examined during the year were found to have been heated, i.e., raised to a temperature of 180°F, or over. A considerable trade has quite recently grown up in the Borough in so called "Sterilised Milk," and no objection is taken to its sale as such. It is subject to the same control as ordinary milk by the Officers of the Department, and it must reach the usual milk standards for quality. 78 It appears probable, however, that this sterilised milk is sometimes served to a purchaser who expects fresh milk. Legally this is an offence under the Sale of Food and Drugs Acts, as the milk is not of the nature and substance demanded, and not in its natural condition. Although much might be said in favour of a supply of sterilised milk, the business requires careful watching and investigation in case it should be used to hide an unhealthy or unclean supply. Fresh milk bacteriologically clean is a more wholesome product than milk of doubtful purity which has been sterilised. In the latter six months of the year 176 samples of milk were found to give definite reactions one way or the other; 62 samples, or 35.2 per cent. had been heated, and 114 samples were fresh unheated milk. There were also many doubtful cases, which may have been mixed milks, but these are not included in these numbers. Grade "A" Milk. Six samples of Grade "A" milk were examined bacteriologically. They were all from the same vendor. Grade "A" milk should not contain more than 200,000 organisms per 1 cc. The samples examined were all well within this limit, in fact the numbers found were approximately only about one-tenth of this number, showing that the standard is a very liberal one and apparently easily obtained. None of these samples showed evidence of having been heated to obtain the desired results. Prescribed Medicines. Ten Prescribed Medicines were examined for the National Health Insurance Committee. Three of the samples were found to have been dispensed in an unsatisfactory manner. Rag Flock Act. Two samples of Rag Flock were examined. They were found to be not up to the required standard of cleanliness, and legal proceedings were taken in one case. (See p. 93.) ALBERT E. PARKES, F.I.C., F.C.S., Public Analyst. 24ih February, 1925. 79 FOOD AND DRUGS ACTS. The results of the analyses of 764 samples were reported to the Committee during the year:— Sample. Number examined. Doubtful purity and inferior quality. Adulterated. Legal Proceedings. Milk 430 36 15 6 ,, Separated 1 — — — ,, Sterilized 3 — — — ,, Condensed 8 — 4 1 ,, Dried 5 — — — Butter 55 3 — — Margarine 49 4 3 — Cheese 6 — — — Dripping 7 2 2 — Lard 9 — — — Suet — — — — Shredded Suet 4 1 — — Mustard 6 1 — — Pepper 9 — — — Vinegar 16 — 1 1 Sauce 2 — — — Cocoa 9 6 — — Coffee 8 — — — Coffee Essence 2 — — — Coffee Mixture 2 — — — Coffee & Chicory Extract 1 — — — Cornflour 2 — — — Rice 3 — — — Ground Rice 3 — — — Arrowroot 1 — — — Pearl Barley 3 — — — Sago 2 — — — Oatmeal 3 — — — Flour 5 — — — Self-raising Flour 5 — — — Ground Ginger 3 1 — — Baking Powder 6 — — — Egg Powder 4 — — — Custard Powder 3 — — — Curry Powder 1 — — — Bread 1 — — — Cake 8 1 — — Cake Mixture 3 — — — Jam 5 1 — — Marmalade 4 — — — Jelly Crystals 1 — — — Golden Syrup 4 — 1 1 Honey 2 — — — Borax 2 — — — Bicarbonate of Soda 1 — — — Cream of Tartar 1 – – – Carried forward 708 56 26 9 80 Sample. Number examined. Doubtful purity and inferior quality. Adulterated . Legal Proceedings. Brought forward 708 56 26 9 Epsom Salts 1 — — — Glauber Salts 2 — — — Flowers of Sulphur 1 — — — Lime Water 1 — — — Prescriptions (N.H.I.) 10 2 1 * Camphorated Oil 1 1 — — Lime Juice Cordial 2 — — — Lemon Squash 4 — 3 1 Lemonade 2 — — — Sarsaparilla Wine 1 — — — Spirits 7 — 1 — Mincemeat, Fruit 3 — — — Meat Pie 2 — — — Food Preservative 1 — — — Brawn 4 — — — Sausage 11 — — — Ice Cream 3 2 — — Totals 764 61 31 10 Of the 430 samples of milk, 94 were procured on Sundays from itinerant vendors and 123 from itinerant vendors on weekdays. Eight samples purchased from itinerant vendors were not in accordance with the legal standard and proceedings were instituted in three cases, letters of caution being sent in the remaining five. Samples were taken on delivery as follows:—Poplar Institution, 7; and St. Andrew's Hospital, 6. * Results of analyses reported to the London Insurance Committee. 81 Administrative Action taken with regard to Samples reported to be not genuine, etc. March Quarter, 11)24. Sample. No. Result of Analysis, etc. Result of Legal Proceedings, or action taken. Golden Syrup 2 Contained at least 90 per cent. of glucose or starch syrup £1 penalty; £2 2s. costs. Camphorated Oil 710 Not made with Olive Oil Letter of caution. Margarine 265 Contained 0.2 per cent. excess of water Letter of caution. Margarine 714 Contained 1.2 per cent. excess of water Letter of caution. Pure Cocoa 275 Contained 2.5 per cent. added alkali Letter of caution. Margarine 14 Contained 0.9 per cent. excess of water Letter of caution. Ministry of Agriculture informed. Dripping 927 Contained 1.4 per cent. of water and at least 2.3 per cent. excess free fatty acids Letter of caution. Dripping 21 Contained 2 per cent. of water Letter of caution. 82 June Quarter, 1924. Sample. No. Result of Analysis, etc. Result of Legal Proceedings, or action taken. Skimmed Milk Informal Not properly labelled Vendor cautioned. Cake Mixture Informal Chemically pure but musty and useless Vendor cautioned. Pure Cocoa 744 Contained 3 per cent. added alkali Vendor cautioned. Milk 252 Deficient in non-fatty solids 0.2 per cent., equivalent to the addition of 2.3 per cent. of water Vendor cautioned. Milk 251 Deficient in non-fatty solids 0.2 per cent., equivalent to the addition of 2.3 per cent. water Vendor cautioned. Meat Pie 742 Contained boric acid 5 grains per lb. Mouldy condition Letter to Vendor. Skimmed Milk Informal Not correctly labelled Letter to Vendor. Cake 260 Contained boracic acid 3.5 grains per lb. Letter to Vendor. 83 September Quarter, 1924. Sample. No. Result of Analysis, etc. Result of Legal Proceedings, or action taken. Milk 758 Deficient in non-fatty solids 0.5 per cent. Summons dismissed; £1 1s. costs. Margarine 58 Contained 16.5 per cent. of water Letter of caution. Ministry of Agriculture informed. Milk 546 Deficient in milk fat 3.3 per cent. Letter of caution. Margarine 53 Contained 1.1 per cent. excess of water Letter of caution. Ministry of Agriculture informed. Milk Deficient in non-fatty solids 0.5 per cent. £3 penalty: £1 Is. costs. Lime Juice Cordial .. 973 Contained salicylic acid 1 grain per pint Letter to vendor. Milk 57 Deficient in milk fat 3.3 per cent. Letter of caution. Ground Ginger 327 Contained 3 per cent. of chalk Letter of caution. Milk 278 Deficient in non-fatty solids 0.3 per cent. Letter to vendors. Milk 281 Deficient in non-fatty solids 0.2 per cent. Letter to vendors. Condensed milk 776 Deficient in fat 2.2 per cent. Further sample taken; see No. 784, next report (December quarter). Pure Cocoa 566 Contained 2.5 per cent. added alkali Letter to vendor. Milk 69 Deficient in non-fatty solids 0.3 per cent. Letter of caution. 84 December Quarter, 1924. Sample. No. Result of Analysis, etc. Result of Legal Proceedings, or action taken. Vinegar 573 Deficient in acetic acid 1.1 per cent. £2 4s. costs. Milk 332 Deficient in non-fatty solids 0.4 per cent. £2 4s. costs. Milk 77 Deficient in non-fatty solids 0.2 per cent. Third portion to Somerset House; too decomposed for analysis. Summons withdrawn. Lemon Squash 78 A solution of sugar and water, coloured and flavoured, to which a false trade description was then applied. (Merchandise Marks Act.) Defendant pleaded guilty and ordered to pay £3 5s. costs. Condensed Milk 784 Contained less than the appropriate percentage of fat Summons dismissed owing to conflicting evidence of analysts. Milk 346 Deficient in non-fatty solids 1.9 per cent. £10 penalty; £2 2s. costs. Shredded Suet 338 Contained 12 per cent. starch Letter to Ministry of Health. Mincemeat 88 Contained salicylic acid ¾ grain per lb. Letter to vendors. Pure Cocoa 81 Contained 2.5 per cent. added alkali Letter to vendors. Pure Cocoa 84 Contained 2.5 per cent. added alkali Letter to vendors. . Butter 997 Contained 16.7 per cent. water Letter to vendors and to Ministry of Agriculture, etc. Margarine 356 Contained 16.5 per cent. water Letter to vendors and to Ministry of Agriculture, etc. Plum Jam 351 Contained 13.6 per cent. of stones Letter to vendors and to Ministry of Health, etc. Margarine 96 Not labelled in bulk or served in stamped wrapper Letter of caution. Pure Cocoa 314 Contained 2.5 per cent. added alkali Letter of caution. Milk 990 Deficient in milk fat 23 per cent. £2 4s. costs. Milk 9 Deficient in non-fatty solids 0.3 per cent. Letter of caution. -{ Margarine 593 Contained 2.5 per cent. excess of water Letter to Ministry Agriculture, etc. Cake 813 Contained boracic acid 10 grains per lb. Letter of caution. Prescription 80 Lotio Zinci Co. Short measure 8 per cent. Reported to London Insurance Committee. Prescription 77 Plumbi c. Opii. Stale solution Reported to London Insurance Committee. Prescription 82 Mist. Pot. Brom. Made up from old solution Reported to London Insurance Committee. 85 Public Health (Milk and Cream) Regulations, 1912 and 1917. 1. — MILK; AND CREAM NOT SOLD AS PRESERVED CREAM. (a) Number of Samples examined for the presence of preservative. (b) Number in which preservative was reported to be present, and percentage of preservative found in each case. Milk 434* Nil. Cream Nil. Nil. * Including 1 separated milk and 3 sterilized. 2.—CREAM SOLD AS PRESERVED CREAM. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the label as to preservatives were correct. (i.) Correct statements made (ii.) Statements incorrect (iii.) Percentage of preservative found in each sample Percentage stated on statutory label. No samples of Preserved Cream were taken. (b) Determinations made of milk fat in cream sold as preserved cream. (i.) Above 35 per cent. Nil. (ii.) Below 35 per cent. Nil. (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V. (2) of the Regulations have not been observed.—Nil. (d) Particulars of each case in which the Regulations have not been complied with, and action taken.—Nil. 3. Thickening Substances.—Any evidence of their addition to cream or preserved cream, action taken where found.—Nil. 86 4. Other Observations, if any.—There is very little demand for cream or preserved cream in this Borough and shopkeepers do not, as a rule, stock these articles. Margarine Act, 1887, Sale of Food and Drugs Act, 1899, and the Butter and Margarine Act, 1907. One application was received to register premises for the carrying on of business of wholesale dealer in margarine. The following is the number of premises in each Sub-District of the Borough registered under the above-mentioned Acts, up to and including 31st December, 1924, viz.:— Sub-District. Margarine. Butter. Wholesale Dealer. Manufacturer. Factory. Wholesale Dealer in Milk-blended. Poplar 6 .. •• •• Bow and Bromley 8 .. 2 2 Totals 14 .. 2 2 87 LEGAL PROCEEDINGS. (Public Health Act, Metropolis Management Acts, etc.). No. of Street, etc. Nature of Complaint. Date of Decision. Result. Name of Officer. 96, Knapp Road Failed to amend the drains 1924. 17th Jan. 10s. penalty; £2 2s. costs Pearce, H. A. 41 and 43, Devas Street Failed to comply with L.C.C. Bye-laws re Rag sorting 16th Jan. Adjourned sine die Johnson, W. 8, Harley Street Failed to comply with Magistrate's order 6th Feb. £24 10s. penalty; £3 3s. costs Field, A. J. 26, Augusta Street Various defects 6th Feb. 10s. penalty; £3 3s. costs Johnson,J. 12, Andrew Street Ditto 15th Feb. 28 days' order; £2 8s. costs Johnson, W. 68, Broomfield Street Ditto 20th Feb 14 days' order; £2 8s. costs Grabham, C. A. 22, Perring Street Ditto 25th Feb. 14 days' order; £5 penalty £2 8s. costs Pearce, H. A. 19, ditto Failed to comply with Magistrate's order 25th Feb. £10 penalty; £2 2s. costs Ditto 21, ditto Various defects .. 25th Feb. 14 days' order; £5 penalty: £2 8s. costs Ditto 14, Ford Street Failed to amend the drains 11th Mar. £4 penalty; £2 4s. costs Smith, F. A. 283, Brunswick Road Roof defective 3rd Mar. 14 days' order; £2 8s. costs Johnson, W. 33, Ettrick Street Various defects 3rd Mar. 14 days' order; £2 8s. costs Ditto 205, St. Leonard's Road Main and wash-house roofs defective 10th Mar. £3 penalty; £2 2s. costs Ditto 12, Andrew Street Failed to comply with Magistrate's order 23rd April Adjourned sine die (see below) Ditto 88 No. of Street, etc. Nature of Complaint. Date of Decision. Result. Name- of Officer. 66, Quickett Street Various defects 1924. 8th April 28 days' order; £1 penalty; £2 8s. costs Pearce, H. A. 70, ditto Ditto 8th April 28 days' order; £1 penalty; £2 8s. costs Ditto 72, ditto Failed to amend the drains 8th April £2 penalty; £2 2s. costs Ditto 8, Andrew Street Various defects 23rdApril Closing order made; £2 8s. costs Johnson, W. 9, ditto Ditto 23rd April Closing order made; £2 8s. costs Ditto 10, ditto Ditto 23rd April Closing order made; £2 8s. costs Ditto 11, ditto Ditto 23rd April Closing order made; £2 8s. costs Ditto The Kmithfields Animal Products Co.. Ltl., Marshgate Lane, West Ham Failed to comply with Magistrate's Prohibition order re smoke nuisance 4th June Adjourned sine die-, £3 3s. costs Field, A.J. 90, Knapp Road Failed to amend the drains 2nd May 2s. (id. penalty; £2 2s. costs.. Pearce, H. A. 12, Andrew Street Various defects 12th May Closing order made; £2 8s. costs Johnson, W. 20, Whitethorn Street Water-closet trap broken 7th May Work done; £2 4s. costs Pearce, H. A. 18, Flint Street Various defects 124th June Adjourned to 10/7/24; £2 4s. costs Johnson, J. 1 10th July £1 penalty Ditto 89 No. of Street, etc. Nature of complaint. Date of Decision. Result. Name of Officer. 34, Broomfield Street Guttering very defective 1924. 7th May Work done; £2 4s. costs Grabham, C. A. 78, Barchester Street Roof defective 7th May Work done; £2 4s. costs Ditto 2, Jodrell Road Various defects 14th May 21 days' order; £2 8s. costs Smith, F. A. 48, Fern Street Roof defective 27th May 14 days' order; £2 8s. costs Langley, H. J. 76, Quickett Street Various defects 21st May 21 days' order; £2 8s. costs Pearce, H. A. 72, ditto Failed to amend the drains 21st May £2 penalty; £2 2s. costs Ditto 18, Tibbatts Road Various defects 26th May 14 days' order; £2 8s. costs Ditto 22, ditto Ditto 26th May 14 days' order; £2 8s. costs Ditto 16, ditto Ditto 26th May 14 days' order; £2 8s. costs Ditto 95, St. Stephen's Road Failed to amend the drains 17th June £3 3s. costs Smith, F. A. 30, Broomfield Street Guttering, rainwater pipe and rainwater heads defective 16th June Work done; £2 8s. costs Grabham, C. A. 78, Barchester Street Roof defective 16th June Work done; £2 8s. costs Ditto 114, ditto Various defects 16th June Work done; £2 8s. costs Ditto 50, ditto Roof, etc., defective 16th June Work done; £2 8s. costs Ditto 766, Old Ford Road Various defects 25th June Closing order made; £2 8s. costs Field, A. J. 90 No. of Street, etc. Nature of Complaint. Date of Decision. Result. Name of Officer. 27, Harley Street Soil pan broken 1924. 25th June 7 days' order; £2 8s. costs Field, A.J. 23, Joshua Street Various defects 2nd July £2 penalty; £2 8s. costs (*) Johnson, W. 18, Jodrell Road Failed to amend the drains 8th July £5 5s. costs Smith, F. A. 116, St. Stephen's Road Various defects 8th July 14 days' order; £2 8s. costs Ditto 46, Jodrell Road Ditto 15th July Work done; £3 penalty Ditto 48, ditto Ditto \ 15th July Work done; £3 penalty Ditto 39, Wyke Road Various defects 22nd July 7 days' order; £2 7s. costs Field, A. J. 48, Fern Street Failed to comply with Magistrate's order 7th Aug. £3 penalty; £2 2s. costs Langley, H.J. 6, Priscilla Road Roof, etc., defective 13th Aug. Work done; £2 4s. costs Ditto 31, Fern Street Various defects 12th Sept. £1 penalty; £2 2s. costs Pearce, H. A. 228, Devons Road Ditto 1st Oct. 28 days' order; £2 8s. costs Langley, H.J. 202, ditto Ditto 8th Oct. 14 days' order; £2 8s. costs Pearce, H. A. 78, Quickett Street Ditto 1st Oct. 21 days' order; £5 penalty (including costs) Ditto 144, Fairfoot Road Ditto 3rd Oct. 7 days' order; £2 8s. costs Davits, Miss M. E. 22, Parnell Road Soil pipe defective 14th Oct. 7 days' order; £2 7s. costs Ditto (*) Defendant went to prison in default of payment. 91 No. of Street, eto. Nature of Complaint. Date of Decision. Result. Name of Officer. 41, Market Street Main roof defective 1924. 8th Oct. £5 penalty; £2 2s. costs Johnson, J. 52, Barchester Street Ditto 8th Oct. £5 penalty; £2 2s. costs Ditto 47, ditto Roof, etc., defective 8th Oct. £2 4s. costs Grabham, C. A. 15, Southill Street Various defects 8th Oct. £5 penalty; £2 2s. costs Ditto 54, Barchester Street Main roof defective 8th Oct. £2 4s. costs Ditto 52, Broomfield Street Guttering defective 8th Oct. £2 4s. costs Ditto 54, ditto Various defects 8th Oct. £2 4s. costs Ditto 30, Ranwell Street Drain repaired so as to be a nuisance 14th Oct. 10s. penalty; £2 2s. costs Smith, F. A. 30, ditto W.C. fitted and fixed without notice being given 14th Oct. 10s. penalty Ditto 22, Tibbatts Road Failed to comply with Magistrate's order 27th Oct. £3 3s. penalty; £2 2s. costs Pearce, H. A. 18, ditto Ditto 27th Oct. £3 3s. penalty; £2 2s. costs Ditto 16, ditto Ditto 27th Oct. £3 3s. penalty; £2 2s. costs Ditto 30, Ranwell Street Failed to amend the drains 28th Oct. 10s. penalty; £2 2s. costs Smith, F. A. 41, Wyke Road Various defects 28th Oct. 7 days' order; £2 7s. costs Field, A. J. 140, High Street, Poplar Ditto 29th Oct. 7 days' order; £2 8s. costs Johnson, J. 92 No. of Street, etc. Nature of Complaint. Date of Decision. Result Name oi Officer. 22, Parnell Road Failed to provide proper and sufficient sanitary accommodation for both sexes 1924. 2nd Dec. £5 penalty; £15 15s.costs Davies, Miss M. E. 4, Lingen Street Roof defective 4th Nov. £2 4s. costs Johnson, W. 32. Ireton Street Various defects 11th Nov. 14 days' order; £2 8s. costs Pearce, H. A. 30, ditto Ditto 11th Nov. 14 days' order; £2 8s. costs Ditto 34, ditto Ditto 11th Nov. 14 days'order; £2 8s. ccsts Ditto 22, Parnell Road Failed to comply with Magistrate's order 18th Nov. £5 penalty; £2 2s. costs Davies, Miss M. E. 34, Brabazon Street Roof, ceiling and flank wall defective 24th Nov. £2 4s. costs Johnson,J. 123 Kerbey Street Various defects 22nd Dec. 7 days'order; £2 8s. costs Ditto 13, Ivy Cottages Eaves gutters defective 29th Dec. Work in hand. Summons with drawn on payment of £2 4s. costs Ditto 93 HOUSING, TOWN PLANNING, ETC., ACT, 1919, AND STATEMENT OF RATES ACT, 1919. No. of Street, etc. Nature of Complaint. Date of Decision. Result. Name of Officer. 66, Quickett Street Collected rent, name and address of M.O.H. and of landlord not on rent book 1924. 28th Jan. 10s. penalty; £2 4s. costs Pearce, H. A. 70, ditto Ditto ditto ditto 28tli Jan. 10s. penalty; £2 4s. costs . Ditto 23, Lower N orth Street Application for possession of premises on which a Closing order had been made 4th June Order for possession in 21 days Grabham, C. A. 17, Ranwell Street Collected rent, name and address of M.O.H. and of landlord not on rent book 21st Oct. 10s. penalty; 10s. 6d. costs. Smith, F. A. RAG FLOCK ACT. Defendant. Nature of Complaint. Date of Decision. Result. Name of Officer. Robert Graham, 201, Bow Road Unlawfully had possession of Rag Flock containing 42 parts of chlorine per 100,000 1924. 16th May Defendant satisfied the Magistrate that he had bought the flock under a warranty from J. C. Mattinson, who was ordered to pay £5 5s. costs Field, A. J. Note.—In addition to the proceedings shown above, in six cases summonses were issued for non-payment of costs, amounting to £14 2s. These have now been paid. 94 INDEX. Page Age Mortality 5 Analyst's Report 76 Anthrax 37 Antitoxin, quantity issued 23 Area and Population 4 Bacteriological Examinations 23 Bakehouses 65 Births 4 Canal Boats 60 Cerebro-spinal Meningitis 38 Cleansing of Verminous Persons, etc.72 & 73 Committees V Continued and Typhus Fevers 38 Customs and Inland Revenue Acts74 Dairies, Cowsheds, and Milkshops 64 Death Rate amongst infants visited 7 Deaths and Death Rates 4 Deaths, Classified Causes, Table 12 ,, Infantile, Table 14 Dentist's Reports 33 & 49 Diarrhoea and Enteritis, Deaths 5 Diphtheria 22 & 23 Disinfectant, Electrolytic 67 Disinfecting Department 67 Electrolytic Disinfecting Fluid 67 Encephalitis Lethargica 38 Erysipelas 37 Export of Meat Foods 75 Food and Drugs Acts, etc.76 Food, Preparation for Sale, etc.64 Free Milk Scheme 51 Glanders 37 Hairdressers'Premises 65 Health Visitor, Chief, Report of 39 Houses Let in Lodgings 74 Housing Acts 54 Housing Inspectors' Reports 51 Hydrophobia 37 IceCream65 Infantile Mortality 7 Infectious Diseases, Table of Notifications 20 Inquests and Deaths from Violence 8 Legal Proceedings 81 & 87 Marriages 4 Maternity and Child Welfare 39 Milkshops, etc. 64 Mortuary 9 Notification of Births Act 4 Notifications of Infectious Diseases, Table 20 Ophthalmia Neonatorum 38 Overorowding 75 95 Page Plague 37 Poliomyelitis, eto.38 Population 4 Puerperal Fever38 Rag and Bone Dealer, Byelaws 65 Rag Flock Act 75 Rats and Mice Destruction Act75 Reports:— Chief Health Visitor39 Dental Sujrgeon (M. & C.W.) 49 Dental Surgeon (Tuberculosis) 33 Public Analyst 76 Senior Medical Officer, Royal College of St. Katharine .46 Tuberculosis Officer 24 Sanitary Inspectors' Work, Summary 51—53 Scarlet Fever 22 & 23 Schools, Inspection of 76 ,, Use of Electrolytic Fluid in72 Slaughterer of Poultry, Byelaws 66 Slaughterhouses, Byelaws 66 Small-pox 36 Smoke Nuisances 65 "Spotted Fever"38 Staff vi. Swimming Baths, Use of Electrolytic Fluid in 72 Tables A to F (Workshops, etc.) 57—63 Tables of Deaths 10—19 ,, Infectious Diseases.20 Tuberculosis Officer's Report 24 ,, Regulations, Notifications, etc.35 Typhoid Fever 22 & 23 Vaccination 36 Verminous Children and Persons 72 & 73 Verminous Rooms 74 Vital Statistics, Summary viii. ,, ,, Tables 10—19 Water Certificates 74 Workshops, Workplaces, etc. (Tables)57—63 Zymotic Diseases, Notifications, etc.20