SHOR 30 REPORT on the Health and Sanitary Condition of the Metropolitan Borough of Shoreditch, IN THE COUNTY OF LONDON, FOR THE YEAR 1925, by LHWIS T. ERASER BRYETT, M.D. (Lond.) Medical Officer of Health; Diplomate in Public Health, Royal Colleges of Physicians and Surgeons; Fellow of the Incorporated Society of Aledical Officers of Health; and of the Royal Institute of Public Health, &c. [Printed by Order of the Health Committee.] LONDON: JAS. TRUSCOTT & SON, LTD., SUFFOLK LANE, LONDON, E.C.4. METROPOLITAN BOROUGH OF SHORE DITCH. Public Health Committee. Maternity and Child Welfare Committee. Ex officio—P. KELLEHER, Esq., J.P. (Mayor). Chairman—Councillor H. P. Griffiths, M.W.B. Chairman—Councillor J. E. Houseman. Vice-Chairman—Councillor A. E. Short. Vice-Chairman—Lady Cynthia Coiville. (Co-opted.) Alderman Adams, J. C. Alderman Parry, A. T., J.P. ,, Brown, T. W. „ Yarnals, G. j. Councillor Beavis. H. Councillor Bellamy, J. „ Bird, Sir H. B., J.P. „ Bickxell, C. „ Belciier, S. P. L. „ Doubleday, H. „ Bicknell, C. „ Evans, H. D. „ Dennison, J. J. „ Girling. Mrs. H., J.P. „ Doubleday, H. „ Webb, Mrs. E. „ Houseman, J. E. „ Yarrow, W. E. „ Land, C. (Co-opted) Bicknell, Mrs. „ Lock, A. F. „ Boge, Miss E. M. „ Poultney, J. „ Fairchild, Mrs. E. M. „ Wakeling, A. „ Neate, Mrs. Sanitary Inspectors. J. H. Pearson, Senior Inspector. C. J. Wright. J. H. Thomas R. A. Bishop. D. Grant. H. G. Chapman. F. C. Shaw. T. W. Girling. G. Walker. W. Sickelmorf.. J. B. Molloy. A. Stratton. Health Visitors. Miss I. M. Heward. Miss A. E. Barnes. Miss M. Morrell. Miss G. H. Williams. Miss B. C. Hunt. Miss A. M. Brotherton. Turberculosis Nurse. Rat Officer. Mrs. Grange. E. T. D. Jordan. Clerical Staff. H. P. Abbott. G. C. E. Gibbs. Miss E. Lehane. E. J. Hayes. W. L. Job E. R. Banks. W. Harris. Mrs. 1. M. Rutherford. A. W. Scott. G. H. Pratt. F. E. Sharpe. E. Crawley (Part time Enquiry Officer). Staff of Model Maternity Centre, Kingsland Road. Miss M. D. Borrow, Matron. Miss A. C. Andrews, Sister. Misses M. D. Wenham and J. Boon (Staff Nurses). Misses S. Sneyd, M. Harrup, D. M. Punter and B. Duncan (Probationers). Miss E. Riggs {Cook). Mrs. M. Calnan, Mrs. G. Marshall, Mrs. C. Jennings, and Mrs. J. McDonnell (Cleaners and Waitresses). J. P. Bear and J. E. Perry (Porters). Staff of Dining; Centre, 31, Herbert Street. Miss E. E. Thorogood (Cook). Miss M. Zemaitis (General Assistant). Mortuary Keeper. W. J. Bailey. Temporary Shelter. Mrs. Watson. Disinfecting Officers. A. Fawns. G. Kennedy. A. Flack. Physicians to Maternity and Child Welfare Centres. Mrs. Sylvia Smith, M.B., B.S. Hon. Mrs. Olivier Richards, M.D., B.S., M.R.C.P. Miss Amy Hodgson, M.D., M.R.C.P. Dentist. W. E. Dodd, L.D.S. Bacteriologist. Public Analyst. J. Andrew, M.R.C.S., L.R.C.P. H. G. Harrison, M.A., F.I.C. Tuberculosis Officer. Assistant Medical Officer of Health. A. Leitch, M.B., Ch.B. Maitland Radford, M.D. (State Med.), D.P.H. Medical Officer of Health. Lewis T. Fraser Bryett, M.D., D.P.H. iii CONTENTS. Page Acute Anterior Poliomyelitis 17 Anthrax 19 Appendicitis mortality from 5 Bacteriological examinations 21 Bakehouses 38 Births in sub-districts 2 Birth rates 2 Cancer 5 Cerebro-spinal fever 11 Condensed milk regulations 34 Cookshops and Eating-houses 34 Cow-Houses 33 Dairies, Cowsheds and Milk-shop Orders, 1885 and 1886 33 Deaths in sub-districts 3 Death rate 3 Deaths, ages at 5 Deaths, causes of 5 Deaths in public institutions 5 Deaths in outlying institutions 6 Diarrhœa 14 Diphtheria 11 Disinfection 21 Dysentery 20 Encephalitis Lethargica 18 Enteric Fever 13 Erysipelas 13 Factories and Workshops Act, 1901 26 Food and Drugs Act 35 Fried fish shops 34 Fur skin dressers 23 Glanders 19 Housing 25 Hydrophobia 19 Ice cream shops 34 Infantile mortality 4 Infectious cases, number certified 8 infectious cases, number removed to hospitals 8 Infectious diseases, age periods 7 Infectious diseases, deaths from 7 Infectious diseases, death rate 7 Infectious diseases, isolation 8 Infectious diseases, number of cases notified from schools 20 Infectious diseases, return cases 9 Influenza 15 Legal proceedings 70 Malaria 20 Marriages 2 Maternity and Welfare 27 Measles 14 Milk (Special Designations) Order, 1922 34 iv Page Milk and Cream Regulations, 1912 33 Milk and Dairies (Consolidation) Act, 1915 34 Mortuary 22 Ophthalmia neonatorum 17 Pneumonia 20 Population 1 Public Health (Meat) Regulations, 1924 32 Public Health (Preservatives, &c., in Food) Regulation, 1925 34 Public Houses 24 Puerperal fever 14 Rag and Bone Dealers 23 Rag Flock Act, 1911 23 Rats and Mice Destruction Act, 1919 25 Sanitary work 22 Scarlet fever 10 Schools, exclusions of children for infectious disease 20 Shelter 21 Slaughter-houses 33 Small pox 9 Smoke nuisances 23 Staff 39 Street markets and food 32 Tuberculosis 15 Typhus fever 15 Veneral Diseases 20 Verminous houses 24 Water supply 22 Whooping cough 15 APPENDIX. Statistical Tables:— For whole district during 1925 and previous years (Table I.) 43 Cases of Infectious disease notified during 1925 (Table II.) 44 Causes of, and ages at, death during year 1925 (Tables III. and V.) 45, 48 to 55 Infantile mortality during 1925 (Table IV.) 46 Notes to Table III. and IV. 47 Comparison of London and Shoreditch birth and death rates in 1925 (Table VI.) 56 Summary of proceedings under Public Health (London) Act, 1891 (Table VII.) 57 Summary of Tuberculosis Certificates received (Table VIII.) 66 Summary compiled from the abstracts of their work prepared by the Sanitary Inspectors for 1925 (Table IX.) 67 Housing Conditions 68 and 69 Summary of legal proceedings under the Public Health (London) Act, 1891 70 Factory and Workshop Act—Summary of work (Tables 1, 2, 3, 4, 5 and 6) 58 to 61 Return of work carried out at Tuberculosis Dispensary 62 to 65 Maternity and Child Welfare 71 to 76 Nursing List 77 Metropolitan Borough of Shoreditch. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. Town Hall, Old Street, E.C. 2, January, 1926. To the MAYOR, ALDERMEN and COUNCILLORS of the Metropolitan Borough of Shoreditch. Sir, Ladies and Gentlemen, I have the honour to submit the following report for the year ending 31st December, 1925, upon the health and sanitary condition of the Borough of Shoreditch. As far as practicable this report has been compiled on lines similar to those of previous reports, due allowance being made for the instructions of the Minister of Health as laid down in the circular issued at the end of the year under consideration. POPULATION. The Registrar-General's estimate as at 30th June, 1925, is 107,300. This figure is based upon the adjusted census population of 1921, after allowance for the natural increase of births over deaths and for migration as indicated from such sources of information as the changes in the numbers on the Electoral Register and the returns obtained by the Board of Trade. The above estimate includes the population in the Holborn Institution, numbering approximately 900, who are not regarded as belonging to Shoreditch. Excluding these, 106,400 is the number of inhabitants taken into account for the statistical purposes of this report. Further information upon the subject of the population and the principal industries of the Borough are 2 contained in Tables I. and VI. and in those relating to the administration of the Factory and Workshops Act, 1901 (see Appendix). BIRTHS. The births registered in the Borough numbered 2,361, of which 1,177 were of males and 1,184 females. The number corrected by the inclusion of the births outside Shoreditch, the parents being residents of the Borough, and the exclusion of those occurring within the Borough, the parents not being resident in Shoreditch, was 2,627, of which 1,300 were of males and 1,327 females. The distribution of the corrected births in the eight Wards of the Borough is given below:— Ward. Males. Females. Total. Moorfields 60 40 100 Church 243 227 470 Hoxton 218 214 432 Wenlock 219 187 406 Whitmore 207 251 458 Kingsland 129 138 267 Haggerston 114 155 269 Acton 110 115 225 Totals 1,300 1,327 2,627 Outside the Borough 286 births were registered, 137 of males and 149 of females, the parents being residents of Shoreditch. Eleven births, six of males, occurred within the Borough, the parents being non-resident. In the Shoreditch Institution there were 277 births, 148 of males and 129 females. In ten of these the parents were not residents of Shoreditch. The illegitimate births numbered 82, of which 45 were males and 37 females. Of these 44 (24 of males and 20 females) occurred in the Shoreditch Institution. The birth-rate for the Borough was 24.6 per 1,000 population. The birth-rates for the eight Wards of the Borough are given in Table VI. (Appendix). The birth-rate for England and Wales was 18.3 and for London 18.0 per 1,000 population. MARRIAGES. The number for the year ended 31st December, 1925, was 936, as compared with 979 in 1924, 873 in 1923, 959 in 1922, 976 in 1921 and 1,194 in 1920. The persons married were at the rate of 17.5 per 1,000 population as compared with 17.2 for the Metropolis. 3 DEATHS. The deaths during 1925 numbered 1,421, a little below the number for the ore ceding year. They were distributed in the Borough as shewn in the table below:— Ward. Males. Females. Total. Moorfields 41 28 69 Church 121 114 235 Hoxton 125 92 217 Wenlock 97 80 177 Whitmore 143 116 259 Kingsland 82 59 141 Haggerston 74 81 155 Acton 92 77 169 Totals 775 647 1,422 The deaths of males were 128 in excess of those of females, and the death-rate amongst males was approximately 28.5 per cent. higher than amongst females. The general death-rate for the Borough was 13.3 per 1,000 population. The causes of death and the death-rates for the Borough and its eight wards, together with other particulars respecting the mortality amongst the inhabitants during the year, are given in Tables I., III., IV., V. and VI. (Appendix). The death-rate averaged above the mean during the first three months of the year and again during the last three months. The rate was lowest during the month of August, when it averaged less than 9 per 1,000. The highest point touched was during the second and the last weeks of December, when the rates were 22.4 per 1,000 population. The mortality from diarrhoea had no appreciable effect upon the death-rate, but measles and diseases of the respiratory organs were largely contributory to the elevation noticeable during the last two months of the year. The deaths amongst infants under one year numbered 233, of which 116 were of males. They amounted to 16.3 per cent. of the deaths from all causes. The mortality amongst infants under one year was at the rate of 88 per 1,000 births registered during the year, as compared with 87 in 1924, 82 in 1923, 102 in 1922, 114 in 1921 and 91 in 1920. The infantile mortality amongst males was 89 as compared with 88 amongst females. This slight difference is worthy of note as for years past in Shoreditch the mortality amongst male infants under one year has always materially exceeded that of females. The chief causes of death amongst infants under a year old were: prematurity, atrophy debility and marasmus, malformations, pneumonia, bronchitis, diarrhcea and enteritis, whooping cough and measles. In Table IV. (Appendix) the causes of death amongst infants under one year A 2 4 are given together with the ages in weeks and months, and the nett deaths and births amongst legitimate and illegitimate infants. In the subjoined table the causes of death amongst infants under one year are given for each of the eight Wards of the Borough Cause of Death. Moorfields Ward. Church Ward. Hoxton Ward. Wenlock Ward. Whitmore Ward. Kingsland Ward. Haggerston Ward. Acton Ward. Totals Smallpox ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... Measles ... 3 2 3 ... 1 1 10 Scarlet Fever ... ... ... ... ... ... ... ... ... Whooping Cough ... 3 2 3 3 2 1 1 15 Diphtheria and Croup ... ... ... ... ... ... ... ... ... Erysipelas ... 1 ... ... 1 ... ... ... 2 Tuberculous Meningitis ... 1 ... ... ... 1 ... 1 3 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... 1 ... ... ... ... 1 Meningitis (not Tuberculous) ... ... ... 1 2 ... ... ... 3 Convulsions ... 1 2 1 ... ... ... ... 4 Laryngitis ... ... ... ... ... ... ... ... ... Bronchitis ... 2 3 2 5 1 1 2 16 Pneumonia (all forms) 3 6 4 5 5 6 4 6 39 Diarrhœa ... 2 1 1 1 I 1 1 8 Enteritis 1 5 3 2 4 2 4 ... 20 Gastritis ... 1 1 ... ... ... ... ... 2 Syphilis ... ... 2 ... ... ... ... ... 2 Rickets ... 1 ... ... ... ... ... ... 1 Suffocation, over-lying ... 1 1 1 ... ... ... 1 4 Injury at Birth ... ... ... ... ... ... ... ... ... Atelectasis ... 1 ... 1 ... ... ... ... 3 Congenital Malformations ... 2 2 ... 2 ... 2 3 11 Premature Birth ... 4 5 6 4 1 5 4 29 Atrophy Debility and Marasmus ... 9 5 4 7 4 4 5 38 Other causes 1 3 4 2 6 1 2 2 21 Totals 5 46 37 30 43 20 25 27 233 The infantile mortalities for the Wards of the Borough are given in Table VI. (Appendix). The rate was highest in Acton and lowest in Moorfields, being 120 and 50 per 1,000 births respectively. The infantile mortality for England and Wales was at the rate of 75, and for London it was 67 per 1,000 births registered. The deaths of children aged from one to two years numbered 71, the chief causes being measles and diseases of the respiratory organs. Of children aged from two to five years 59 died, the chief causes being measles, whooping cough, diphtheria, and diseases of the respiratory organs. Altogether 363 or 25.5 per cent. of the total number of deaths were of children under five years of age. 5 Taking the deaths at all ages the chief causes were: bronchitis, which accounted for 165; tuberculosis, which ended in death in 154 including 124 from phthisis; pneumonia which caused 140; diseases of the circulatory organs, including heart disease, 129, cancer 104, old age 103, Bright's disease 79, violence 63, apoplexy 51, atrophy debility and marasmus 35, measles 34, whooping cough 29, and prematurity which was given as the cause of 29 deaths. Of the deaths from cancer 58 were of males and 46 females; 8 were of persons aged from 20 to 45 years, 58 of persons aged from 45 to 65 years, 29 and 8 respectively were the numbers for the next two decades and there was one death in a person over 80 years. There were in addition 16 deaths attributed to malignant disease and sarcoma. Doubtless, some deaths from cancer are included amongst those attributed to malignant disease. The death-rate due to cancer was 0.98 per 1,000 population as compared with 1.1 for 1924, 1.0 for 1923, 0.82 for 1922, 0.87 for 1921, 0.91 for 1920, 0.93 for 1919, 0.95 for 1918 and 1.1 for 1917. There were 13 deaths from appendicitis, 8 of them of males, and 5 deaths were attributed to peritonitis, 4 of them of females. No deaths were directly attributed to alcoholism, but 3, two of males, were given as the result of cirrhosis of the liver, a disease due to chronic poisoning by alcohol. Of the deaths from violence 42 were of males and 21 females. Through accident or negligence 31 males and 16 females lost their lives. Fourteen of these were the result of street accidents, 11 were due to falls, mostly amongst old people, 3 were due to burns or scalds and 7 to suffocation. Three of the latter were in infants suffocated in bed. There were 16 cases of suicide, 11 amongst males and 2 of homicide. The number of infants suffocated in bed still remains low as compared with what it used to be in years gone by. There is, however, still room for improvement. DEATHS IN PUBLIC INSTITUTIONS. The number and distribution of the deaths of persons belonging and not belonging to the Borough in the public institutions situate in Shoreditch are as set out in the subjoined table:— Institution. Persons belonging to Shoreditch. Persons not belonging to Shoreditch. Total. Holborn Institution ... 156 156 St. Leonard's Hospital 502 15 517 Royal Chest Hospital 11 79 90 Home of Good Shepherd 7 ... 7 Convent Hospital 1 ... 1 Infant Welfare Centre 10 ... 10 Totals 531 250 781 6 Elsewhere than in public institutions 8 persons not belonging to Shoreditch died within the Borough. In the subjoined table are set forth the various institutions outside Shoreditcl with the number of persons belonging to the Borough dying therein :— * Asylums:— No. of Deaths. General Hospitals— continued No. of Deaths. Banstead 1 Prince of Wales, Tottenham 1 Broadmoor 1 Cane Hill 1 Queen's (Children) 35 Claybury 6 Royal Free 1 Colney Hatch 3 Royal Surrey County 1 Dartford Heath 5 St. Bartholomew s 57 Epsom 5 St. George's 1 Fountain 3 St. Thomas's 3 Hanwell 1 University College 1 Leavesden 5 Special Hospitals:— Three Counties Mental, Stotfold 1 Bethnal Green Chest 4 Tooting Bec 1 Brompton 1 Cancer 2 Hospitals for Infectious Diseases:— City of London Maternity 4 Colindale 10 Brook 4 Homoeopathic 1 Eastern 23 Infants 2 Grove 5 Mothers Hospital, Clapton 4 Joyce Green 1 Queen Charlotte's 2 London Fever 2 Queen Mary's 6 Northern 1 St. Columba's 1 North-Eastern 13 St. Luke's 2 North-Western 4 National Hospital for Diseases of Heart 1 Over Infectious Disease 1 Park 7 Hospital for Women and Children, Paddington 2 South-Eastern 5 South-Western 2 Other Institutions:— General Hospitals:— Archway House 2 Children's, Holborn 2 Bishopsbourne Invalid Home 1 East London 2 214a, Cambridge Road 1 German 9 Goldie Leigh Homes 1 Gt. Ormond Street (Children) 4 230, High Street, Homerton 4 London 9 86, High Street, Poplar 1 London Temperance 1 77a, Highgate Hill 1 Metropolitan 59 Home for Jewish Incurables 1 Middlesex 5 29, North Side, Clapham 3 Middlesex (North) 1 Little Folks' Home, Bexhill 1 Mildmay 6 Oxford Prison 1 National 2 St. George s Home 3 Poplar 1 St. Joseph's Hospice 7 Of 371 persons belonging to Shoreditch dying in public institutions beyond the limits of the Borough, 201 died in general hospitals, 33 in asylums, 68 in fever hospitals, 7 42 in hospitals for spccial diseases, and 27 in other institutions. Elsewhere than in public institutions, 10 persons belonging to Shoreditch died beyond the limits of the Borough. Altogether 902 or 63.3 per cent. of the people belonging to Shoreditch who died during the vear, died in various public institutions within or without the Borough. It may be noted that this percentage during recent years shows a marked increase on what it formerly was. INFECTIOUS DISEASES. The infectious diseases included under the headings 1 to 35 inclusive, together with 171 and 172 in Table V. (Appendix), were the cause of 306 deaths. This number is less than for 1924 and below the average, and amounted to 21.5 per cent. of the total mortality from all causes as compared with 22.3 per cent. in 1924, 20.0 in 1923, 25.7 in 1922, 26.6 in 1921, 25.0 in 1920, 28.5 in 1919, 37.7 in 1918, and 30.2 in 1917. The high percentage in 1918 was due to the heavy mortality resulting from the influenza outbreaks in that year. Tuberculosis accounted for just over 50 per cent. of the deaths from these infectious diseases during the year under consideration. The death-rate due to these diseases was 2.8 per 1,000 population as compared with 3.0 in 1924, 2.6 in 1923, 4.2 in 1922, 3.8 in 1921, 3.9 in 1920, 4.5 in 1919, 9.1 in 1918, 6.8 in 1917, and 5.6 in 1916. In the subjoined table the deaths from the infectious diseases referred to above have been grouped according to age:— Age period. Under 1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65-75 75-85 85 and upwards. No. of deaths 45 68 14 8 15 20 28 33 30 28 12 2 3 Of the total mortality from all causes of children under five years, 31.1 per cent. resulted from these infectious diseases. In infants under one year diarrhcea, measles and whooping cough accounted for most of the deaths. Amongst children aged from one to five years, measles, diphtheria, tuberculosis and whooping cough may be mentioned as the chief causes of death. Most of the mortality from infectious diseases amongst persons aged 15 years and upwards was the result of consumption, influenza and septic diseases. The deaths from the principal zymotic diseases—viz., smallpox, measles, scarlet fever, diphtheria, whooping cough, enteric fever and diarrhœa, excluding enteritis under two years—numbered 97, the death-rate being 0.9 per 1,000 population. A comparison of the zymotic death-rates of London and Shoreditch and the eight wards of the Borough is given in Table VI. (Appendix). The rate was highest in Haggerston Ward and lowest in Moorfields. The cases of scarlet fever, diphtheria, erysipelos, enteric fever and puerperal fever notified numbered 1,011 as compared with 27,629 for the whole of the Metropolis, the attack rates being 9.5 and 6.0 per 1,000 papulation respectively. Excluding tuberculosis, the following table shows the numbers of cases of infectious disease certified in the Borough for each of the four quarters of the year and the numbers and percentages of the cases removed to hospital:— Disease. First Quarter. . Second Quarter Third Quarter Fourth Ouarter. Total. Deaths. Smallpox ... ... ... ... ... ... Scarlet Fever or Scarlatina 88 123 155 113 485 5 Diphtheria and Membranous Croup 135 88 100 117 440 17 Typhus Fever ... ... ... ... ... ... Cholera ... ... ... ... ... ... Enteric Fever (Typhoid) ... ... ... 2 2 1 Continued Fever 1 ... ... ... 1 ... Relapsing Fever ... ... ... ... ... ... Puerperal Fever 4 2 6 1 13 2 Erysipelas 16 11 20 21 71 11 Plague ... ... ... ... ... ... Cerebro-Spinal Fever 1 1 ... ... 2 3 Glanders ... ... ... ... ... ... Anthrax ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... Anterior Polio-myelitis ... ... ... 2 2 ... Encephalitis Lethargica 3 2 5 3 13 3 Ophthalmia Neonatorum 15 12 11 7 45 ... Acute Primary Pneumonia 68 49 11 99 257 40 Acute Influenzal Pneumonia 12 2 1 17 32 3 Malaria ... ... ... ... ... ... Dysentery ... ... ... ... ... ... Trench Fever ... ... ... ... ... ... Totals 343 299 339 382 1,363 85 N umbers and percentages of cases removed to hospitals. 298 267 311 329 1,205 ... 86.9% 89.3% 93.l% 80.1% 88.4% ... As compared with the figures for 1924, there is an, increase in the number of cases of diphtheria and scarlet fever, and a decrease in the amount of pneumonia. ISOLATION OF INFECTIOUS CASES. The hospitals of the Metropolitan Asylums Board receive cases of scarlet fever, smallpox, diphtheria, including membranous croup, enteric, typhus, and continued 9 fevers, relapsing fever, anterior polio-myelitis, encephalitis lethargica, cerebrospinal fever, together with certain cases of measles, whooping cough, puerperal fever, trench fever, malaria and dysentery. The cases of diphtheria, scarlet fever, enteric fever, continued fever, puerperal fever and cerebro-spinal fever, polio-myelitis and encephalitis lethargica certified, numbered 958 (Table II., Appendix), and the number removed to hospital, mainly to the hospitals of the Metropolitan Asylums Board, was 934 or approximately 98 per cent. RETURN CASES. The following came under observation during the year:— (1) Charlotte B—, aged five years, of 18, E—Street, was taken ill on January 13th, and Elsie B—, aged two-and-a-half years, on the following day ; they were certified as cases of diphtheria, and removed to hospital on January 13th and 14th respectively. These children returned home on February 12th, and three days later their mother, aged 24, was taken ill, and was removed to hospital on February 17th as a case of diphtheria. The diagnosis, however, was not confirmed by the hospital authorities. (2) Amelia S—, aged two years, of 17, D—, was removed to hospital as a case of diphtheria on January 8th, returning home on February 7th; Muriel R—, aged four-and-a-half years, of the same address, fell ill on February 10th, and was ten days later removed to hospital with diphtheria. As Amelia had a suspicious nasal discharge she was again certified and removed to hospital. (3) Albert R—, aged four, of 24, N—Road, was certified and removed to hospital as a case of scarlet fever on June 4th, returning home on August 29th. On his return he had a discharge from nose and ears. Madge R—, aged three, was certified to have scarlet fever on September 9th, and removed to hospital, and the following day Walter R—, age six, was removed from the same address, and Joan H—, aged three-and-a-half years—a contact—from 14, B—Street. At the date these cases came under observation the discharge mentioned in the case of Albert had to a large extent cleared up. It was not thought necessary for the child to be again removed to hospital, but precautions were taken as regards the child's nose and ears, and there were no further cases. SMALLPOX. No cases were certified in Shoreditch. Some fifteen were certified elsewhere in London, and there was one death. In connection with some of these cases there were a number of contacts resident in the Borough, who had to be kept under observation. None of them, however, developed the disease. 10 SCARLET FEVER. The cases certified numbered 185, of which 57, or 11.7 per cent., were subsequently not regarded as scarlet lever. This percentage, although less than that for 1924, is nevertheless, greatly above the average. The distribution of the cases certified, and the deaths amongst males and females in the Borough and its eight Wards during the year were as shown in the subjoined table:— Wards. SCARLET FEVER. Notifications. Fatal Cases. Male. Female. Total. Male. Female. Total. Moorfields 7 8 15 ... 1 1 Church 43 45 88 1 ... 1 Hoxton 37 40 77 1 ... 1 Wenlock 31 36 67 ... ... ... Whitmore 37 52 89 1 ... 1 Kingsland 35 30 65 ... ... ... Haggerston 22 21 43 ... ::: ... Acton 18 23 41 1 ... l Totals for Borough 230 255 485 4 1 5 The cases are grouped according to ages in Table II. (Appendix). Of the cases certified 471, or 97.1 per cent., were removed to hospital. The cases certified were at the rate of 4.5 per 1,000 inhabitants, being above the average for the previous 10 years. The attack-rate per 1,000 population in the Borough was lowest in Moorfields, and highest in Kingsland Ward, being 3.2 in the former, as compared with 6.1 in the latter. The deaths were at the rate of 0.04 per 1,000 population. The case-mortality was at the rate of a shade over 1 per cent., which is somewhat below the average for the previous ten years. Amongst children under five years there were 221 cases with a case-mortality allowing for errors in diagnosis, of 2.1 per cent. Amongst persons over five years the case-mortality was only 0.4 per cent., allowing for errors in diagnosis. The cases certified as scarlet fever in London numbered 12,296, being at the rate of 2.7 per 1,000 population. The deaths numbered 100, being at the rate of 0.03 per 1,000 population, as estimated for the middle of the year 1924. Taking the cases notified, the case-mortality for the metropolis was considerably under 1 per cent. Compared with the mortality from scarlet fever of 60 years ago that of the present day can only be described as insignificant. 11 DIPHTHERIA (INCLUDING MEMBRANOUS CROUP). The cases certified numbered 440, of which 101, or 22.9 per cent., were subsequently not regarded as being diphtheria. This percentage, although somewhat less than that for 1924, is still greatly above the average for previous years. The number of cases and the deaths amongst males and females in the Borough and its eight Wards are given in the subjoined table:— Ward. DIPHTHERIA (including Membranous Croup). Cases Certified. Fatal Cases. Male. Female. Total. Male Female. Total. Moorfields 10 6 16 ... ... ... Church 21 48 69 1 2 3 Hoxton 19 31 50 1 4 5 Wenlock 33 33 66 1 1 2 Whitmore 37 61 98 ... 3 3 Kingsland 25 22 47 ... ... ... Haggerston 24 37 61 1 2 3 Acton 13 20 33 ... 1 1 Totals for Borough 182 258 440 4 13 17 The cases are grouped according to ages in Table II. (Appendix). Of the cases certified 434, or 98.6 per cent., were removed to hospital. The cases were certified at the rate of 4.1 per 1,000 inhabitants, the rate being highest in Haggerston Ward and lowest in Acton, 5.4 and 2.6 per 1,000 respectively. The deaths numbered 17, being at the rate of 0.16 per 1,000 population. The rate was highest in Hoxton Ward, where it amounted to 0.30 per 1,000. There were no deaths in Moorfields and Kingsland Wards. Of the cases certified 3.8 per cent. terminated fatally. Twelve of the deaths were of children under five years, the mortality being at the rate of 6.3 per cent. of the cases certified amongst children of that age period. Allowing for the cases not regarded as diphtheria at the hospitals of the Metropolitan Asylums Board, this mortality is increased to 8.1 per cent. Amongst persons over five years the mortality was a shade over 2 per cent., or, allowing for errors in diagnosis, 2.6 per cent, of the cases. During the year some 68,000 units of antitoxin supplied by the Sanitary Authority were used in ten cases of diphtheria before their removal to hospital. The usual enquiries were made as to the circumstances attending the occurrence of diphtheria in the Borough. With respect to the cases investigated during 12 the year, they were distributed amongst males and females at certain age periods as set out in the subjoined table:— Age Period. Male. Female. Total. Under 1 year 9 7 16 From 1 to 2 years 12 12 24 ,, 2 to 3 years 28 24 52 ,, 3 to 4 years 24 23 47 ,, 4 to 5 years 21 30 51 ,, 5 to 10 years 52 58 110 ,, 10 to 13 years 7 21 28 Over 13 years 34 59 93 Totals 187 234 421 In 196 of the cases the patients were children attending school, and in 149 of these they were at school within a week of being certified as having the disease. As noted in previous years, there were instances in which the children were at school whilst suffering from diphtheria before the nature of their illness was recognised. In 196 other cases, although the patients themselves were not schoolgoing children, there were other children in the houses who were. In 34 instances the histories showed that there had been cases of " sore throat " amongst the inmates of the houses in which the patients resided. In 37 instances there was evidence pointing to infection from previous cases in the Borough. In 315 instances the houses were occupied by members of more than one family, in 74 by single families, and in 32 instances the cases occurred in artisans' dwellings of the block type. With regard to the sanitary condition of the dwellings, in 277 this was satisfactory, in 58 fairly so, and in 86 it was unsatisfactory, but these figures must not be taken as an indication that a satisfactory condition is favourable to the occurrence of diphtheria in houses ; their significance has been referred to in previous reports. It may be added that during the years 1902 to 1924 inclusive, as the result of investigation into some 5,324 cases, 3,211 occurred in houses which were reported satisfactory from a sanitary point of view—i.e., there were no serious sanitary defects as regards drainage, light, ventilation, cleanliness and the surroundings generally, whilst 2,113 were in houses more or less unsatisfactory. There seems to be nothing therefore pointing to the incidence of diphtheria in the Borough being dependent upon insanitary conditions of the houses invaded. The cases certified as diphtheria in the Metropolis numbered 12,608, the attack rate being 2.7 per 1,000. The deaths numbered 481 and the death-rate was 0.07 per 1,000 population, the case-mortality being 3.8 per cent. 13 ENTERIC FEVER. Two cases were certified and removed to hospital, but after being under observation they turned out not to be cases as certified. There was a death due to enteric fever credited to Shoreditch, but this occurred in an asylum away from the Borough, and there is no reason for believing that, so far as infection was concerned, the case was in any way connected with Shoreditch. A case was certified as one of continued fever early in the year, but there was no reason for suspecting enteric fever. The absence of cases during the year is a fact worth noting. The past records of the Borough would be searched in vain to find a year without the occurrence of enteric fever. Thirty years ago the yearly average of cases certified was about 120 ; during the past five years the average has not exceeded three. The decrease in the prevalence of enteric fever in the Borough began to manifest itself about the year 1903. This decrease is general in London and throughout the country, and the indications would seem to point to the disease in the course of time becoming very rare, and this perhaps in the not far distant future. The cases certified in London numbered 432, being at the rate of 0.9 per 1,000 inhabitants. The deaths numbered 48, the death rate being 0.01 per 1,000 population, and the case-mortality 11.1 per cent. of the cases certified. ERYSIPELAS. The cases certified as erysipelas numbered 71, with eleven deaths. The cases and deaths amongst males and females in the Borough and its eight ards were distributed as set out below:— Ward. ERYSIPELAS. Cases Certified. Fatal Cases. Male. Female. Total. Male. Female. Total. Moorfields 1 5 6 ... ... ... Church 7 3 10 2 1 3 Hoxton 7 7 ... 1 ] Wenlock 4 5 9 ... 1 1 Whitmore 10 10 20 1 1 2 Kingsland 4 4 8 ... 1 1 Haggerston 3 ... 3 1 ... 1 Acton 4 4 8 1 1 2 Totals for Borough 33 38 71 5 6 11 14 The deaths from erysipelas were at the rate of 0.10 per 1,000 inhabitants, and 15.5 per cent. of the cases certified terminated fatally. Pyaemia and septicaemia, generally known as blood poisoning, caused the death of 2 males and 3 females, and infective endocarditis caused the death of 2 males. PUERPERAL FEVER. Thirteen cases were certified, two of which terminated fatally. They were all removed to hospital The cases certified were at the rate of 4.9 per 1,000 births as compared with 3.9 in 1921; 2.5 in 1923, 3.1 in 1922, 2.0 in 1921, 2.9 in 1920 and 1.3 in 1919. Included amongst the cases are five which occurred in St. Leonard's Hospital. These developed temperatures during the lying-in period and they were certified as " fever during puerperium." There was some doubt as to whether these cases were actually cases which should be included under the designation of Puerperal fever. The cases certified in the Metropolis numbered 324 and were at the rate of 3.9 per 1,000 births. The deaths were at the rate of 1.3 per 1,000 births in the Metropolis as compared with 0.8 for Shoreditch. DIARRHOEA. Eleven deaths were attributed to diarrhoea and 27 to enteritis. Nearly all the deaths from diarrhoea occurred during the last five months of the year, and 8 of them were in infants under one year. Of the deaths from enteritis 21 were in infants under one year and the remainder were of children aged from one to two years. Excluding deaths from enteritis, the death-rate was 0.10 per 1,000 population, including deaths from enteritis in children under two years, the rate was 0.35 per 1,000 population. The deaths from diarrhoea amongst infants under one year were at the rate of 3.0 per 1,000 births; including deaths from enteritis under one year the rate was 11.0 per 1,000 births. The usual enquiries were made with a view to the prevention of infection, but the cases were comparatively few, the prevalence of the disease being again below the average. The deaths from diarrhoea and enteritis in children under two years in the Metropolis numbered 875, the death rate being 0.22 per 1,000 inhabitants. The mortality from diarrhoea and enteritis amongst infants under one year was at the rate of 9,5 per 1,000 births. MEASLES. The deaths numbered 34 as compared with 58 in 1924, 23 in 1923, 84 in 1922, 18 in 1921, 50 in 1920, 12 in 1919, 72 in 1918, 139 in 1917, 33 in 1916 and 67 in 1915, being considerably below the average for recent years. Of the deaths, 14 were amongst males and 20 females. With one exception they were all amongst children under five years of age, 15 The death-rate was 0.32 per 1,000 as compared with 0.55 in 1924, 0-21 in 1923, 0.81 in 1922, 0.17 in 1921, 0.19 in 1920, 0.12 in 1919, 0.82 in 1918, 1.57 in 1917 and 0.33 in 1916. Most of the deaths occurred during the last two months of the year. The deaths were relatively most numerous in Haggerston. There were none in Moorfields Ward. Some 26 cases were nursed under the Borough Council's arrangement with the Local District Nursing Association, in connection with which 426 visits were made by the Association's nurses. The .deaths from measles in the Metropolis numbered 337 as compared with 1,335 in 1924, 367 in 1923, 1,559 in 1922, 241 in 1921, 1,026 in 1920, and 1,359 in 1919. The death-rate was 0.13 per 1,000 inhabitants. WHOOPING COUGH. The deaths numbered 29, all of children under five years, as compared with 28 in 1924, 10 in 1923, 27 in 1922, 19 in 1921, 12 in 1920, 2 in 1919, 93 in 1918, 20 in 1917 and 35 in 1916. As in the case of measles, pneumonia and bronchitis are the common complications which so often prove fatal in this disease. The death-rate was 0.27 per 1,000 population. The deaths in the Metropolis numbered 855, the rate being 0.15 per 1,000 inhabitants. INFLUENZA. Nineteen deaths, 12 amongst males, were attributed to influenza, the death-rate being 0.18 per 1,000 inhabitants. Most of the deaths occurred during the first three months of the year. The deaths during recent years were 28 in 1924, 14 in 1923, 69 in 1922, 27 in 1921, 51 in 1920, 121 in 1919, 295 in 1918, 12 in 1917, 22 in 1916, 26 in 1915 and 25 in 1914. The deaths in the Metropolis numbered 1,055, being at the rate of 0.23 per 1,000 inhabitants. TYPHUS FEVER. No cases were certified in Shoreditch nor elsewhere in London. This disease which used to be so common some fifty or sixty years ago is now very rare. During the past thirty years or more only one case has been certified in Shoreditch. TUBERCULOSIS. Tuberculosis (Appendix, Table V., Nos. 29 to 34 inclusive) resulted in 154 deaths as compared with 145 in 1924, 161 in 1923, 182 in 1922, 172 in 1921, 166 in 1920, 209 in 1919, 255 in 1918,302 in 1917,302 in 1916 and 328 in 1915. It accounted for 11 per cent, approximately of the total mortality for the year. The decrease shown by the figures given above were commented on in the report for 1924. The 16 deaths during 1925 include those of 20 persons who were not certified under the Tuberculosis Regulations in Shorcditch. The mortality was at the rate of 1.4 per 1,000 inhabitants, being highest in Kingsland and lowest in Action Ward, 1.87 and 1.14 per 1,000 respectively. The deaths from tuberculosis of the lungs or consumption numbered 124, the same as for 1924. The great majority of the deaths were amongst persons aged between 15 and 65 years. The deaths amongst males numbered 78 as compared with 46 amongst females. The death-rate was 1.1 per J ,000 population, being highest in Kingsland and lowest in Hoxton Ward, 1.5 and 0.8 per 1,000 respectively. The deaths from tuberculosis in the Metropolis numbered 4,932, the death-rate being 1.0 per 1,000 population. The deaths attributed to tuberculosis of the lungs numbered 4,181, giving a death-rate of 0.8 per 1,000 persons. A summary of the notifications received under the regulations during the year is contained in Table VIII., and the distribution of the cases according to age periods and localities is shown in Table II. (Appendix). The cases of tuberculosis certified numbered 303, being at the rate of 2.9 per 1,000 persons in the Borough as compared with 2.4 in 1924, 2.4 in 1923, 2.7 in 1922, 2.5 in 1921, 3.0 in 1920 and 5.1 in 1919. The cases certified were most numerous in proportion to the population in Kingsland and least in Acton Ward, being at the rate of 4.3 per 1,000 in the former as compared with 1.9 in the latter. The cases certified as pulmonary tuberculosis numbered 243, and were at the rate of 2.2 per 1,000 as compared with 2.0 in 1924, 2.1 in 1923, 2.1 in 1922, 2.1 in 1921, 2.8 for 1920 and 4.0 for 1919. The notifications for pulmonary tuberculosis were proportionately most numerous in Kingsland and least in Acton Ward, 3.5 and 1.5 per 1,000 respectively. At the close of the year the Tuberculosis Register contained the names of 1,709 persons of whom 928 were males. The report of the Tuberculosis Officer which summarises the work carried out for Shoreditch at the Tuberculosis Dispensary during the year under consideration is appended (pp. 62 to 65). The Tuberculosis Care Committee met on 17 occasions during the year and dealt with 318 cases. Of these 126 were admitted to institutions and some 48 terminated fatally. The removals to hospitals, sanatoria and other institutions are given in Table II. (Appendix). Of the deaths from consumption belonging to Shoreditch approximately 65 per cent, occurred in institutions within and without the Borough, 31 per cent, of them in St. Leonard's Hospital, 17 OPHTHALMIA NEONATORUM. The certificates received numbered 53, relating to 45 cases, a marked decrease on the figures for 1924. There were besides some 75 other cases of inflamed eyes in infants which were brought to our notice through the Medical Officer of Health, London County Council, but not formally notified. The usual supervision was exercised through the Health Visitors for ensuring proper treatment. Of the cases certified two were of a severe type. All recovered without impairment of vision. Two of the infants died whilst suffering from the disease. Most of the cases received hospital treatment at the Moorfields Eye Hospital, the Queen's Hospital for Children, and the City of London Maternity Hospital. Four of the patients were removed to hospital for treatment therein, three of them to St. Margaret's Hospital, an institution of the Metropolitan Asylums Board provided especially for the treatment of this disease, mothers as well as their infants being admitted when necessary. Six of the cases were dealt with under nurses from the Local District Nursing Association, who made an average of 24 visits a case. The certified cases were at the rate of 17.1 per 1,000 births, as compared with 8.6 for London as a whole. The figure for Shoreditch shows a marked reduction on that for 1924, but it remains still twice as heavy as that for the Metropolis. EPIDEMIC CEREBRO-SPINAL MENINGITIS. Two cases were certified, one in a female infant three months old, who fell ill about February 5th with vomiting and diarrhoea, and was admitted to the Queen's Hospital on February 9th, where it died on the 16th,'the case being notified the following day. There was no post-mortem examination. The second case was a little boy a year old. He was taken ill about March 9th, when he was admitted to the Queen's Hospital. He was discharged on the 19th, and re-admitted on the 26th. The case was certified on April 21st, and terminated fatally a few days later. ACUTE ANTERIOR POLIOMYELITIS. The following cases of the above disease, which is more generally known as infantile paralysis, came under observation during the year :— (1) A schoolgirl, aged 13 years, of 106, S-Street, was taken ill about September 22nd, with a " cold," sneezing and a "sore-throat" being noted. Subsequently paralysis of the right leg was noticed. The case was certified on October 9th, about 17 days after the onset of symptoms. The sanitary condition of the house, which was occupied by one family, was satisfactory, and there was nothing amiss as regards the health of the other inmates. The case was at home when certified. (2) A little boy, aged nearly three years, of 93, B-Street, was taken ill with vomiting and diarrhoea about December 4th. He was admitted to St. Leonard's Hospital on 9th, when paralysis of the right leg was noticed. The sanitary condition °f the house was unsatisfactory, and the health of the patient's family had not been good prior to the occurrence of the case. 18 ENCEPHALITIS LETHARGICA. The following are brief particulars respecting the cases of the above disease, sometimes termed sleepy sickness, which were certified during the year under consideration:— (1) A woman, aged 55, of 57, C-Street, was taken ill with headache and pain in her back on December 15th, 924. She was admitted to St. Leonard's Hospital on December 30th, and her case was certified on January 5th, 1925. She was feverish and lethargic, and there was-drooping of the upper eyelids. The sphincters were paralysed and the knee jerks were sluggish. Her mental condition was fair. During the last few days of her illness her speech was affected. The case terminated fatally on January 4th. There was no history of any recent illness. The number of persons in the family to which the patient belonged was six, and there were altogether ten persons in the house, the sanitary condition of which was satisfactory. (2) A young woman, aged 22, a boxmaker, of 33, T Street, was last at work on June 5th. Her illness, however, was stated to have begun some time about the middle of 1924. The case was certified on August 10th, 1925. The initial symptoms were mild coryzal attacks. On May 17th, 1925, she had an attack of what was believed to be influenza, and on June 6th she had to take to her bed with another attack, which was more severe. On getting about again vague nerve symptoms began to develop—twitchings and tingling pains in the limbs, with drowsiness. On June 13th she went to a convalescent home at Guildford, and on her return at the end of the month became an out-patient at the West End Hospital for Nervous Diseases. On July 12th she was stated to be convalescent. The case was treated at home. "There was a history of influenza in the house. The number of persons in the family was 5, and there were altogether 11 persons in the house, which was unsatisfactory from a sanitary point of view. There was no overcrowding, but the patient's bedroom was dirty and verminous. The outstanding feature in this case at the end of the year was mental depression with frequent attacks of weeping. She was said to sleep well at night. (3) A young woman, aged 18, of 47, T-Street, employed as a packer, was last at work on August 11th. Her case was certified on the 19th. During the early part of August the patient was depressed and languid. Drowsiness was noticed on 11th. She complained of pain in her head and down one side. Later, muscular twitchings were noted. On August 26th she was up and about, but was dull and lethargic, disinclined to go out of doors, taking no interest in her personal appearance or surroundings, and sitting for hours rubbing her hands. The case was treated at home. There were 10 persons in the family, and altogether 14 in the house, which was in a fair sanitary condition. At the end of the year this patient was said to be improving; she was still depressed, and not nearly so lively as before her illness, but her temper was improving, and she was more sociable and taking a greater interest in her surroundings. 19 (4) A youth, aged 16, apprenticed to an upholsterer, of 50, H — Street, was take ill towards the end of March or the beginning of April. He was last at work in the latter month. He was admitted to the London Hospital on May 2nd, where the remained lor five weeks. Drowsiness, sleepiness during day, restlessness at night and double vision were amongst the early symptoms noticed. The case was certified on September 28th, when he was attending the hospital as an out-patient. Restless nights and day-time drowsiness were still apparent, but he was said to be improving. There was no history of recent illness in the house which was occupied only by the family of" the patient, consisting of seven persons, and was in a satisfactory sanitary condition. At the end of the year he was under treatment at the German Hospital. He was not sleeping well, although at times he had prolonged spells. His intelligence was, poor, his conduct fair ; he complained of pain in his back and loss of power. (5) A voting man, aged 10, a packer, of 31, W-Terrace, was taken ill on December 21st, and was certified nine days later. The initial symptoms were severe headache, paroxysmal dizziness, extreme drowsiness, and sleepiness day and night. Subsequently abdominal pains were complained of. Five days after the case was notified the patient was stated to be greatly improved, only a slight headache being noted. There were 7 persons in the patient's family, and altogether 12 in the house, which was in a satisfactory sanitary condition, and there was no history of recent illines-. In addition to the foregoing, seven other cases were certified and removed to hospital, but these subsequently were not regarded as having been cases of encephalitis lethargica. With regard to the cases coming under observation during the year, Nos. (2) (3) were in the same street, and it is possible there may have been some connection between them, as the patients were acquainted with each other although they did not associate. The number of persons belonging to the families in which the cases occurred was 35, and in addition there were some 10 other persons resident in like houses invaded. There was nothing especially noted as regards suspicious illness in the houses, and four out of the five were satisfactory from a sanitary point of view. At the end of the year 1925 enquiries were made with respect to 18 of the cases testified during 1924, with the result that in 7 recovery was affirmed, 4 were under treatment in institutions, in six there was no improvement, and in one instance the police had committed suicide. GLANDERS, ANTHRAX AND HYDROPHOBIA. No cases of the above were certified in Shoreditch, and there were but three case of anthrax notified during the year in the Metropolis. B 2 20 PNEUMONIA, MALARIA AND DYSENTRY. In accordance with the Regulations of 1919 some 257 cases of acute primary pneumonia and 32 of influenzal pneumonia were certified during the year. Of the cases of pneumonia investigated 208 were treated in St. Leonard's Hospital, 7 in St. Bartholomew's Hospital, and 7 in other institutions. Some 51 were nursed at home by relatives, nine of them with the help of the District Nursing Association. Some 56 other cases of pneumonia also received the nursing assistance of the Association. Altogether 892 visits were made by the nurses of the District Association in connection with pneumonia cases. Evidence of infection was obtained in 30 of the cases investigated. In 102 instances the dwellings occupied were, satisfactory as regards air space, light and ventilation; in 58 they were fairly so,and in 113 they were unsatisfactory. There were no cases of malaria, dysentery or trench fever certified. VENEREAL DISEASES. During the year under consideration the Health Committee, in co-operation with the Propaganda Committee of the Shoreditch Public Welfare Association, affiliated with the British Social Hygiene Council, made arrangements for public lectures on the subject of the above diseases. The first of these was delivered at the Town Hall on September 22nd to an audience of about 600, when E. B. Turner, Esq., F.R.C.S., gave a most interesting address and explanation of a film entitled, The Gift of Life," the same being highly appreciated by those attending. INFECTIOUS DISEASES AND SCHOOLS. The numbers of children belonging to Shoreditch who were suffering from infectious diseases, or were resident in houses in which infectious diseases existed, concerning whom intimations of exclusion from school were received from head teachers in accordance with the requirements of the school management code of the London County Council, were as follows:—Two for enteric fever, 1 for encephalitis lethargica, 2 erysipelas, 615 for diphtheria, 778 for scarlet fever, 1,306 measles, 906 chicken-pox, 380 whooping cough, 339 mumps, and 257 for other infectious ailments. The exclusions altogether numbered 4,586 and related to 39 schools. The scheme referred to in the report for 1924 drawn up by the School Medical Officer for the more effective control of measles in public elementary schools was put into operation in connection with the infants' departments of the following schools : In the month of January, Hoxton House ; in the month of November, Hoxton House, Wenlock Road, St. Johns Road, Curtain Road, Canal Road and Shap Street; and in the last month of the year, Trinity Place, Maidstone Street, Laburnum Street, Catherine Street, Gopsall Street, Napier Street, Chatham Gardens, and Scawfell Street. 21 A number of intimations were received as to investigations by the School Medical Authorities in consequence of the occurrence of cases of scarlet fever and diphtheria amongst children attending some of the schools in the Borough. In only a few instances was it found necessary to exclude any of the children. Information was also received from the School Medical Officer relative to the exclusions from school of 21 children on account of the presence of diphtheria bacilli in their noses or throats. The families, residents in some thirteen houses, to which the children belonged, were kept under observation, but no cases of diphtheria were subsequently notified amongst the members thereof nor is there any evidence that such cases occurred. BACTERIOLOGICAL EXAMINATIONS. During the year some 898 examinations were made by Dr. J. Andrew, the pathologist at the Metropolitan Hospital. Of these 576 were for suspected diphtheria, 4 for enteric fever, 297 for tuberculosis and 2 for gonorrhoea. Eleven Wassermann tests were made, three samples of urine were examined, one specimen of cerebrospinal fluid, one specimen of discharge from eye, two specimens for organisms and one for thread worms were also examined. Positive results were obtained in 84 of the examinations for diphtheria organisms, 67 of those for tubercle bacilli and in three of the Wassermann tests. In addition to the above some 687 bacteriological examinations were made at the Royal Chest Hospital in connection with the work at the Tuberculosis Dispensary. DISINFECTION. The premises disinfected numbered 1,231; the articles removed to the Borough reinfecting Station to be there disinfected totalled 19,165, and included 1,123 beds, 1.201 mattresses, 2,520 pillows, 771 bolsters and some 13,547 other articles such as sheets, blankets, quilts, curtains, carpets, clothing and the like. It was necessary to destroy two beds and two pairs of mattresses which were so dilapidated and contaminated as to render it inadvisable to return them. These were replaced with new. disinfection for trade purposes was stopped by the Council about the middle tue year. During the early part of the year, 41,455 blankets and 90,873 pieces of we aring apparel were dealt with. THE SHELTER. The he accommodation provided under Section 60 (4) of the Public Health (London) Act. 1891, was not in use during the year under consideration. 22 PUBLIC MORTUARY. The bodies of 140 persons were deposited in the Mortuary, and the inquests held numbered 134, in connection with which 131 post mortem examinations were made, 79 in the post mortem room attached to the Mortuary. No infectious bodies were removed to the Mortuary by the Sanitary Authority during the year. WATER SUPPLY. The Meteorological Table for London, deduced from observations at Greenwich under the Astronomer Royal, issued by the Registrar-General for 1925, shows that the rainfall for the year amounted to 23.379 inches, which is slightly below the average. July was the wettest and June the driest month of the year. In accordance with section 49 of the Public Health (London) Act, 1891, communications were received from the Metropolitan Water Board as to water supplies being cut off in respect to 15 premises, all of them in the Northern District. The grounds for withdrawing the supplies were :—On account of defective water pipes in 3 instances, waste on empty premises 4 and premises demolished in 8 instances. Water was also laid on to 60 new premises in the Borough and in 3 instances additional taps were provided in tenement houses. No complaints were received as to the quality of the water, nor was there any reason for suspecting the occurrence of any illness due to consumption of the water. SANITARY WORK. Intimations as to insanitary conditions were served in respect to 5,573 premises. In 560 instances they were dealt with by Inspector Wright, in 537 by Inspector Chapman, 504 Inspector Sickelmore, 485 Inspector Thomas, 367 Inspector Shaw, 563 Inspector Molloy, 702 Inspector Bishop, 439 Inspector Girling, 504 Inspector Stratton, 445 Inspector Grant and 467 under the supervision of Inspector Walker. In connection with the work of the Sanitary Inspectors 1,656 letters were written to owners and others concerned. Some 51,949 visits of inspection were made by the Inspectors in connection with some 12,037 premises, which included 9,701 dwellings, 1,498 workshops, besides factories, laundries, bakehouses, cowsheds and milk vendors' premises, ice cream shops, slaughterhouses, places where food is prepared and sold, and other premises. Some 1,192 visits of inspection made in connection with the street markets, food exposed for sale, stables and stable yards, are included in the total given above. The inspection of 3,270 of the dwellings was the result of a house-to-house visitation which was in progress during the year by order of the Sanitary Authority. 23 In Table IX. (Appendix) a summary is given of the particulars of the work carried out for the abatement of nuisances and for the improvement of the dwellings of the people in the Borough. This has been compiled by the Senior Inspector from information supplied by the Sanitary Inspectors. The work done in compliance with the provisions of the Factory and Workshops Act, 1901, and also in connection with the drains and sanitary arrangements of new buildings is included. Most of it was done to comply with requirements indicated on the written intimatiqns given by the Sanitary Inspectors. Statutory Notices under the Public Health (London) Act, 1891, were served by order of the Sanitary Authority upon parties responsible for the abatement of nuisances and for otherwise infringing the Act in 1,049 instances. For non-compliance with Statutory Notices and other breaches of the law relating to public health, proceedings were taken before the magistrate in 58 instances. The results of these proceedings are shown on page 70 (Appendix). SMOKE NUISANCES. Only one communication referring to the emission of black smoke was received from the London County Council and this was duly brought to the notice of the party responsible. Some 45 observations were made by the Sanitary Inspectors and in one case an intimation was served. This was effective and there was no necessity for further action on the part of the Sanitary Authority. FUR SKIN DRESSERS. At the end of the year there were four premises on the Register. They were regularly inspected and some 15 visits were made in connection with them. In one instance it was necessary to serve a Statutory Notice on account of an offensive accumulation which was duly complied with. RAG FLOCK ACT, 1911. Under the above Act eight samples were taken and analysed. Seven complied with the requirements of the law, in none was the 30 parts per 100,000 of soluble chlorine allowed exceeded. The remaining sample contained 23.9 parts per 100,000 in excess. Police court proceedings were instituted and the defendant was ordered to pay two guineas costs. RAG AND BONE DEALERS. Some 22 premises to which the byelaws under Section 9 of the London County Council (General Powers) Act, 1908, are applicable were on the register at the end of the year, four having been added. The visits of inspection made in connection with them numbered 68, and in two instances it was necessary to direct the attention of the proprietors of the businesses to the need for proper attention to cleanliness. 24 PUBLIC HOUSES. During the year a special inspection was made in respect to the sanitary accommodation provided at the licensed houses in the Borough. Altogether some 199 premises were inspected. They were found satisfactory except in two instances. At the end of the year steps were being taken to remedy the unsatisfactory conditions existing. VERMINOUS HOUSES. The houses in which it was necessary to take measures on account of the presence of vermin numbered 329, and some 573 rooms were dealt with during the year. Sanitary notices were served where necessary and the usual steps were taken. In an appreciable proportion the cases came under our notice through intimations from the School Authorities. During the year the homes of some 58 children, 24 boys and 34 girls, notified as verminous by the School Medical Officer, were reported with a view to the homes and bedding, where necessary, being dealt with by the Sanitary Authority on the children being cleansed and their clothing disinfected at the cleansing stations of the London County Council in the neighbourhood. Intimations were received that 20 boys and 17 girls had been given the opportunity of being cleansed at the cleansing stations, that in the cases of 4 boys and 9 girls statutory notices had been served upon the parents to cleanse the children within 24 hours under Section 122 of the Children's Act, 1908, and that in the cases of 8 girls legal proceedings were pending for non-compliance with the requirements of Statutory Notices under the Act mentioned. In a few instances the same children figured more than once upon the notices and their homes had to be visited and dealt with accordingly. In practically all the cases reported the homes were visited by the Sanitary Inspectors, and the following summarises the results obtained :—In 48 the rooms occupied were satisfactory, varying from fairly clean to very clean, in 9 they were dirty and in 1 buggy. In 52 the bedding was clean, or fairly so, in 2 it was dirty, and in 4 bugs were noticed. In two of the houses evidence of poverty was marked. No evidence of lice was found in connection with any of the cases investigated. Arising out of the visits of the Sanitary Inspectors in connection with the cases reported by the School Medical Officer some 9 sanitary notices were served upon owners and one upon the occupier of verminous dwellings, mostly for general cleansing and repairs. The children reported by the School Authorities as suffering from scabies numbered 59, of whom 27 were males and 32 females. As a result of the enquiries made by the Sanitary Officers one other case came under observation. As far as practicable steps were taken to prevent the spread of infection. 25 RATS AND MICE DESTRUCTION ACT, 1919. The following is a summary indicating the work done by the Rat Officer with a view to giving effect to the provisions of the above-mentioned Act Number of complaints (rats) 295 „ „ (mice) 46 „ visits and revisits 4,849 „ rats caught in traps or killed by dogs 1,280 „ rats found dead through poisoning 280 ,, premises cleared of rats 287 ,, premises cleared of mice 31 „ pavements taken up, fronting houses 44 ,, drains reconstructed and repaired 27 ,, drains tested by Sanitary Inspectors 50 „ floors of kitchens, sculleries, passages and coal cellars concreted 55 The poisons used included 1,759 packets of Ratquit, which provided some 35,180 baits, 27 lbs. of Londovus, and 1,153 tins of Rodine. Experience shows that variation in the poisoned baits used is very frequently necessary. The rat-infested localities in the Borough did not differ materially from those of the previous year. HOUSING. The special house-to-house inspection of dwelling-houses is referred to on page 22, and further particulars as regards housing are contained in the Appendix (pp. 68 and 69). The work on the area included in the London County Council Ware Street housing scheme was in progress throughout the year, and the erection of some 39 tenements was completed, and of 30 others was commenced. In addition, the erection of a block of 20 tenements in Pritchards Road was completed by the Borough Council during the year. As the result of a special inspection made by order of the Sanitary Authority material improvement was effected as regards the artificial lighting of the common stairs of a number of blocks of artisans dwellings. The houses let in lodgings or occupied by members of more than one family on the register at the end of the year numbered 307, five having been added and three removed. Some 1,625 visits of inspection were made in connection with these houses. In 315 instances intimations relating to various matters requiring attention were served upon the persons responsible for dealing with the same, and in 175 instances statutory notices followed. In six instances proceedings before the magistrate became necessary. 26 During the year five applications for certificates were made under the provisions of the Rent and Mortgage Interest (Restrictions) Acts, 1920-1923, as to the insanitary condition of dwellings, i.e., that they were not in all respects reasonably fit for human habitation. In all cases the certificates were granted. FACTORY AND WORKSHOP ACT, 1901. The number of workshops, exclusive of bakehouses, on the register at the end of the year was 1,498. Of these 177 had been added, 126 having been removed. A classification of the workshops registered is contained in the summary of proceedings under the Act which is appended. Some 3,078 visits of inspection were made in connection with workshops and 716 to factories. Three communications were received from the factory inspectors relative to the establishment of 90 new workshops in the Borough. As the result of inspection 73 were found in a satisfactory condition, and five were not in use. With regard to the remainder sanitary notices were necessary ; in five instances for cleansing, four for the provision of proper and separate w.c. accommodation, one on account of defective w.c., one for defective roof, and one for various defects. Thirty-eight written intimations were received from the factory inspector relating to insanitary conditions and infringements of the law as to public health in connection with 25 factories and 14 workshops. The chief insanitary conditions to which the factory inspector directed attention were : dirty conditions of walls and ceilings in 17, defective and insufficient w.c. accommodation in 16, w.c.'s not properly screened in two, absence of proper ventilation in three, and in one instance there was an accumulation of refuse. Including those brought under the notice of the department by the factory inspector 429 workshops were dealt with, 439 sanitary notices being served upon the parties responsible for their proper sanitary upkeep. The following is an abstract of the sanitary work carried out to comply with these notices :— Premises cleansed throughout 128 partially 64 Number of rooms cleansed 226 Walls, floors, sashes, etc., repaired 54 Light and ventilation improved 4 Roofs, guttering, etc., repaired 101 Overcrowding abated 1 Water reinstated or improved 2 Drains newly constructed „ reconstructed 2 „ repaired, etc. 23 „ obstructions removed 18 Urinals cleansed, etc 4 Soil and vent pipes dealt with 3 Water-closets newly constructed 106 repaired, etc. 191 ,, obstructions removed 16 Sinks, etc., cleansed and repaired 6 Sink traps provided 2 Sculleries, yards, etc., paving repaired 11 Sculleries, yards, etc., cleansed or limewashed 79 Dust receptacles provided 16 Foul accumulations removed 57 27 The number of factories under observation for insanitary conditions during the year was 65, and in connection with them some 65 sanitary notices were served. The work carried out to comply with these notices included the cleansing and repairing of water-closets in 36 instances, the construction of 99 new water-closets, the removal of obstructions from drains and water-closets in 9 instances, besides several other matters. Limewashing of factories can only legally be dealt with by the Factory Inspector, but defects in connection with the sanitary arrangements in factories are matters within the province of the sanitary authority. During the year 60 lists of out-workers were received from employers in the Borough, 30 in the first and 30 in the second half-year. Those for the first halfyear are due in February, for the second in August. These lists contained the names of 897 out-workers, of whom 654 were not residents in Shoreditch. The addresses of those non-resident were forwarded to the sanitary authorities of the districts to which they belonged. Communications were received from various sanitary authorities relating to some 1,601 out-workers, and of these 13 were residents in other Boroughs, and their addresses were duly forwarded to the authorities concerned. A table is given in the Appendix showing the numbers of addresses of out-workers received from the sanitary authorities referred to during 1925. The number of out-workers reported was 2,498 and of these some 1,831 were residents in Shoreditch. These figures are again below the average for the past five years, but they show an increase as compared with those for 1924. As pointed out in previous reports, in numerous instances names and addresses of out-workers are duplicated owing to lists being sent in twice a year, and in some cases the same out-workers are employed by more than one firm, so that the numbers given above must not be taken as representing the actual numbers of individual out-workers. Tables are appended showing the distribution of out-workers as regards trades in the Borough. Most of them are engaged in work connected with the making of wearing apparel, artificial flowers, paper bags and boxes, and brushes. Some 1,137 visits of inspection were made to places where home-work was being carried on, and in connection with these 97 sanitary notices were served. The cases of notifiable infectious disease occurring at out-workers' premises numbered 32 and included 11 of scarlet fever, 17 diphtheria and 4 pneumonia. The usual steps were taken in connection with them by the officers of the sanitary authority. MATERNITY AND CHILD WELFARE. The notified births numbered 2,287, and there were in addition some 44 still births. Of the notifications, 1,639 were received from registered midwives practising in the Borough. In addition, 183 births occurring in institutions outside Shoreditch were notified on forms sent in weekly by the London County Council. Including 28 these, the live births notified during the year were approximately 94 per cent. of the number registered during the year as compared with 98 per cent. in 1924, 88 in 1923, 88 in 1922, 98 in 1921, 85 in 1920, and 95 in 1919. A summary of the work of the doctors and health visitors is appended (pp. 71 to 75). It follows on the general lines of previous years. Subjoined are brief particulars as to the staff employed and the work carried on at the Model Centre, 210, Kingsland Road, during the year under consideration :— The staff comprises a matron (Miss Borrow), a sister, two staff nurses, four probationers and a cook, who are resident in the institution. Staff nurses Wenham and Boon were appointed in April and June respectively to fill vacancies caused by resignations. The appointments of probationers are for one year only, but the Maternity and Child Welfare Committee may permit an extension of this time if such extension be considered desirable in the interest of the work. Probationers Harrop, Punter and Duncan were appointed during the year. Towards the end of 1924, the Committee decided to reverse the previous arrangement and to engage a resident cook and to replace the two maids by non-resident workers. In pursuance of this arrangement, Miss Riggs was appointed cook, and commenced duty early in January. The non-resident members of the staff are the Assistant Medical Officer of Health (Dr. Radford), who is in charge of the observation wards, an emergency Medical Officer (Dr. Hamilton), who also acts as occasional anaesthetist for dental purposes, a dentist (Mr. Dodd), who attends on Wednesday mornings, an anaesthetist (Dr. Carswell) for the dental clinic, and for consultations the staff is as under Infant Welfare „ „ „ „ it „ „ Ante-Natal Dr. Richards Dr. Hodgson Dr. Richards Dr. Radford Dr. Smith Dr. Smith Monday afternoons. Tuesday afternoons. Wednesday afternoons. Thursday afternoons. Friday afternoons. Friday mornings. In accordance with a scheme laid down, six health visitors, together with two lady clerks, are in attendance at the consultations. As explained below, an additional health visitor was appointed in March. A sewing class is conducted by the health visitors on Wednesday afternoons. With a view to economy, a reduction was made in the cleaning staff during the year. A death vacancy was not filled and the services of one waitress and cleaner were dispensed with, the staff now consisting of two porters (male), a cook-help and cleaner, a cleaner, a baby-minder cleaner and waitress, and a cleaner and laundress, six in all, who are non-resident. At the weekly ante-natal clinic on Fridays, the average attendance has been ten expectant mothers per session. The occasional post-natal cases seen are included. 29 Although mothers may come to the centre from all parts of the Borough, they are mostly from close by. On the west side of the Borough they go to the Shoreditch School for Mothers. The observation wards are for the use of the whole of the Borough. During the year attendances at the Infant Welfare consultations held at this centre averaged 270 per week. From Monday to Friday, inclusive, a mid-day dinner was supplied to nursing and expectant mothers, who averaged approximately 28 per day on which dinners were served. There is another dining centre for the western part of the Borough which is in use mainly for the area of the Shoreditch School for Mothers. At this centre, the average attendance for the year was about 20 per day. All arrangements as regards the supply of milk are made at the administrative centre at the Town Hall in accordance with a scheme settled by the Maternity and Child Welfare Committee. Dried milk only is distributed at the centre as is done in the cases of the other consultation centres. In cases where cows' milk is required for infants in the wards, certified milk is used. During the year 55 babies and 7 mothers were admitted to the observation wards. It is satisfactory to be able to record the admission of 7 mothers with their babies for the establishment of breast-feeding, as considerable difficulty was experienced in the preceding year in arranging the admission of these cases. In the cases of 10 of the infants admitted there were fatal terminations. Brief particulars regarding these are contained in the Table at the end of the Appendix. The children discharged were in nearly all cases greatly benefited by their stay in the institution. The cases admitted to the observation wards (see Statistical Summary, pp. 75 and 76 Appendix) were those suffering from disorders of digestion, marasmus, debility, prematurity, and the like. For the most part treatment in the wards means careful attention to general management and to diet. As more than 18 months had elapsed since the completion of the Centre, the Committee decided to have it painted, and this work was accordingly put in hand in September. This necessitated emptying the wards for four weeks. By the kind permission of the Management several of the babies were transferred to the wards of the Harman Street Mission. At the Infant Welfare consultations advice is given as regards the care of infants and children. Beyond such simple remedies as aperients, treatment is not undertaken. Cases requiring to be under medical supervision are referred to medical practitioners or hospitals in the neighbourhood. At the ante-natal consultations mothers are advised as regards their general health. Any requiring special treatment are referred to the City of London Maternity Hospital, City Road, there being special facilities for this under an agreement between the Borough Council and the Hospital Authorities. Mothers, however, are not bound by this, and it is open to them to select any other hospital they may desire. 30 The Dental Clinic has been continued throughout the year, one session being held weekly on Wednesday mornings. The average attendance is about 8 per session. The dentist, Mr. Ridout, resigned in April, his place being taken by Mr. Dodd. Dr. Davie, the anæsthetist, resigned in May, his place being taken by Dr. Carswell. From what has been stated, it may be gathered that the Kingsland Road Centre is a most important adjunct in connection with the Maternity and Child Welfare work carried on in the Borough, which may be briefly outlined as follows :— The Administrative Centre is at the Town Hall, where the requisite medical, together with the health visiting and clerical staffs, attend daily. The Consultation Centres were held as set out below :— Town Hall Infant Welfare Consultation— Mondays. Model Centre „ „ Mondays. Hoxton Hall „ „ Tuesdays. Model Centre „ „ Tuesdays. Model Centre „ „ Wednesdays. Model Centre Dental Clinic Wednesdays. Model Centre Infant Welfare Consultation Thursdays. Model Centre „ „ Fridays. Model Centre Ante-Natal Consultation Fridays. Harbour Lights also Infant Welfare Consultation (two Doctors) Fridays. School for Mothers Infant Welfare Consultation Tuesdays. School for Mothers „ „ Thursdays. School for Mothers Ante-Natal Consultation Thursdays. In order to provide for the increasing numbers attending the Centres, it was suggested by the Ministry of Health that a doctor should be appointed to attend the Centre at 210, Kingsland Road, on Tuesday afternoons, which had previously been a Weighing Centre only, and also that a second Doctor should be appointed to the Harbour Lights Clinic on Friday afternoons, so that there should be one doctor for each of the Health Visitors' Districts attending that Centre. In accordance with these suggestions, Miss Amy Hodgson, M.D., M.R.C.P., was appointed to take both these consultations. She commenced duty at the Kingsland Road Centre in January, and at Harbour Lights in March. As the result of a further recommendation of the Ministry of Health, an additional Health Visitor, Miss Brotherton, was appointed, and commenced duty during March. A re-division of the Borough into seven Health Visiting Districts was made, Miss Brotherton taking that in the South of the Borough. During the year the health visitors attended the consultations referred to above, and they were assisted by two lady clerks. Two whole-time health visitors are 31 employed by the Shoreditch School for Mothers, a voluntary institution situate at 28, Herbert Street, and operating in a district in the western part of the Borough (vide No. 7 Summary on pp. 71 to 74). At the end of the year, therefore, eight health visitors were at work in Shoreditch. With regard to health visiting during the year 1925, the following deductions from the appended summary (page 71) are of interest. The total number of children under five years of age is estimated at approximately 12,000, of whom about 2,600 are under one year, and 9,400 between the ages of one and five years. Of these two groups, the infants under one year received approximately three visits each, whilst of the children aged between one and five years, approximately 2,000 received on an average from four to five visits each. The attendances at the Centres show a considerable increase over those of previous years, the average per week being 574, as compared with 495 in the previous year. The average attendance per session was 57, as compared with 50 last year. Approximately 58 per cent. of all infants under one year in the Borough have attended the Centres, and these have made on an average 11 visits each. Slightly under 6 per cent. of the children between one and five years living in the Borough attended the Centres, the actual number being 537. Each of these children made an average of slightly under 15 visits each. With the object of obtaining reliable knowledge as to the health of children before they attend school, a special enquiry, instituted by the Chief Medical Officer of the Ministry of Health, is being carried out under the general supervision of Dame Janet Campbell. With a view to assisting in the enquiry, a small advisory Committee of Medical Officers has been formed, of which Dr. Maitland Radford is a member. Shoreditch being one of the districts chosen for the purpose, the necessary investigations are now being carried out by Drs. Olivier Richards and Hodgson concurrently with their work at the Centres. Dinners have been served as in previous years to nursing and expectant mothers at the Model Welfare Centre, 210, Kingsland Road, and at the Council's Dining Centre, 28, Herbert Street. With a view to economy it was decided in the early part of the year to dispense with the services of the two non-resident members of the staff at the latter Centre, and to appoint one resident assistant in their place. In pursuance of this plan, Miss Zamaitis was appointed temporarily at the beginning of April. During 1925, according to the information supplied by the Hospital Authorities, some 427 cases from Shoreditch were dealt with at the Ante-Natal and Consultative Maternity Centre of the City of London Maternity Hospital. Of these 126 were examined by the Obstetric Surgeon attached to the Centre, some 269 examinations being made. In all cases the urine was tested. In 301 cases the sister attached to 32 the department saw and advised cases upon various aspects of their pregnancy. Seventeen cases were referred to this Centre by the Council's Medical Officers under the agreement between the Borough Council and the Hospital, six for diagnoses, and eleven for their confinements in the institution. Special features noted during the vear were : Version in, 2 ; contracted pelvis, 20; past history, 24; breech, 8; breech version, 10; albuminuria, 10; post maturity, 5; and varicose veins, 3. The great majority of the cases were normal before admission, and practically all who were treated ante-natally had normal confinements. The number of cases admitted to the hospital was 180, and 214 were attended during their confinements in their own homes. The cases nursed under the District Nursing Association numbered some 395, of which 291 were amongst children under the age of five years. Of some 4,235 visits to patients of all ages, 2,667 were made to children under the age mentioned. The various ailments dealt with were fairly numerous, but pneumonia, measles, influenza, threadworms, tonsils and adenoids, otorrhoea, opthalmia neonatorum, post partem troubles and miscarriage furnished the majority of the cases nursed. Further particulars are given in the Appendix (p. 77). STREET MARKETS AND FOOD. The usual supervision was exercised by the Sanitary Officers as regards food exposed for sale in the market streets, and generally throughout the Borough. The following were surrendered or seized and destroyed as unfit for the food of man : 42 lbs. of meat, 9 half-pound jars of lunch tongues, 65 eggs, 42 lbs. of cods' roes, 12 boxes of kippers, 25 boxes of kippered mackerel, 112 lbs. of skate cuttings, 1½ cwt. sprags, 18 boxes of apples, 28 lbs. of cherries, half a sieve of gooseberries, one truckload and 4 tons 9 cwt. of greens, 16 boxes and 283 oranges, 2 tons 19 cwt. of savoys one tub of strawberries and three bundles of boxes of tomatoes. In the case of the eggs legal proceedings were taken against the person upon whose premises they were deposited for the purpose of preparation for human food. The offender was fined £2 and ordered to pay 2 guineas costs. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The above regulations made by the Minister of Health, December 20th, 1924, under the Public Health (Regulations as to Food) Act, 1907, came into operation April 1st, 1925. They contain provision for the regulation of slaughterhouses and slaughtering, for the inspection and marking of meat found free from disease, and for securing cleanliness in the handling, storage and transport of meat, there being special provisions for the prevention of contamination of meat exposed on stalls or in shops or during storage or whilst it is being conveyed from place to place in vehicles or carried about in markets or other places where it is sold wholesale. 33 All premises upon which meat and edible offal is sold, including the stalls, were under inspection during the year by the sanitary inspectors. It was found that some 81 shops and stalls came within the scope of the regulations, viz., 49 butchers' shops, 23 butchers' stalls, 5 offal shops and 4 offal stalls. Copies of the regulations were distributed amongst the butchers and offal dealers, and they were duly instructed as to the steps necessary to give effect to the requirements of the regulations. SLAUGHTERHOUSES. The two slaughterhouses in use in the Borough were subject to the usual inspection, and the attention of the proprietors was directed to the requirements of the Public Health (Meat) Regulations, 1924. Some 21 visits were made in connection with them. Their general sanitary condition may be reported as satisfactory. There was no evidence of recent use when they were inspected during the autumn. COWHOUSES. Some 19 visits of inspection were made to the two cowhouses in the Borough. Their sanitary condition may be reported as satisfactory. On September 30th there were 27 cows kept in the Borough. The number of dairymen and milk purveyors on the register at the end of the year was 264, 18 having been added and 10 removed. In 30 instances there were changes in the names of the persons registered. The premises were under observation throughout the year, and some 1,683 visits of inspection were made in connection with them. In 12 instances sanitary notices were served mainly for general cleansing, defective roofs and defective water-closets. Three cases of scarlet fever, two of diphtheria and one of tuberculosis were certified on milk vendors' premises during the year. The usual steps were taken for safeguarding the milk. It may be noted with regard to tuberculosis of the lungs, occurring on premises where milk is dealt with, that the Public Health (Prevention of Tuberculosis) Regulations, 1925, prohibit a person suffering from tuberculosis of the respiratory tract from following any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk. DAIRIES, COWSHEDS AND MILK-SHOPS ORDERS, 1885 AND 1886. During the year one person was summoned for selling milk without being registered, contrary to the provisions of the above order. A fine of 5 shillings was inflicted. MILK AND CREAM REGULATIONS, 1912. None of the samples of milk submitted for analysis were reported to contain any preservative. Two samples of cream were also analysed, but were free from Preservative. c 34 CONDENSED MILK REGULATIONS. No samples were submitted for analysis. MILK AND DAIRIES (CONSOLIDATION) ACT, 1915. The above Act, which became operative, under an Order of the Ministry of Health, on September 1st, 1925, may be briefly referred to. It deals, amongst others, with milk and dairies orders and the powers for enforcing the same, tuberculosis in respect to milk, giving powers for stopping supplies and making the inspection of dairies in certain cases obligatory. It also amends the Sale of Food and Drugs Acts, 1875-1907, with reference to sampling milk. Power is also given to Sanitary Authorities with the approval of the Ministry of Health to establish and maintain depots for the sale at not less than cost price of milk specially prepared for consumption by infants under two years old. For a breach of Section 6 of the Act, namely, selling milk in a public place without having his name and address inscribed on the barrow a person was ordered to pay 10s. 6d. costs. MILK (SPECIAL DESIGNATIONS) ORDER, 1922. During the year licenses were issued to sell " certified " milk in accordance with the above Order at 73, Kingsland Road, 193, Kingsland Road, 60, Shepherdess Walk and 13/15, Sun Street. COOK-SHOPS AND EATING-HOUSES. Including the kitchens of public-houses, where food is prepared for customers, 174 were under inspection during the year, and some 567 visits were made in connection with them. Sanitary notices were served to the number of 54, and included 44 which were mainly for cleansing. FRIED-FISH SHOPS. Some 55 were under inspection, and 289 visits were made in connection with them. The sanitary notices required numbered 25, mainly on account of general cleansing. ICE CREAM SHOPS. There were 135 under observation during the year, and 306 visits of inspection were made in connection with them. 21 sanitary notices were served, mostly for general cleansing. PUBLIC HEALTH (PRESERVATIVES, &c., IN FOOD) REGULATION, 1925. The above Regulations come into operation generally on January 1st, 1927, but in certain specified cases they do not become operative until later dates. The 35 only preservatives allowed under these Regulations are sulphur dioxide (SO2), including sulphites and benzoic acid (C6 H5 COOH), including benzoates. The First Schedule to the Regulations gives a list of articles of food which may contain preservatives and the nature and proportion of preservative allowed in each case. SALE OF FOODS AND DRUGS ACTS. The reports of the Public Analyst, Mr. H. G. Harrison, M.A., show that 1,073 samples were submitted to him during the year. This number is at the rate of 100 per 1,000 inhabitants, and is above the average for recent years. The results of the year's work are summarised in the following Table:— Quarter of 1924. Number of Samples taken. Number of Samples. Adulterated. Percentage Adulterated. Number of Prosecutions Instituted. Prosecutions withdrawn because of Warranties, &C. Prosecutions Proceeded with Number of Successful Prosecutions. Fines and Costs. Amount paid to Analyst for Samples Analysed. 1st 234 13 5.5% 7 v 7 2 £ 23 s. 18 d. 6 £ 146 s. 5 d 0 2nd 252 12 4.7% 2 — 2 0 8 0 157 10 0 3rd 181 6 3.3% 3 — 3 3 6 2 0 113 2 6 4 th 406 24 5.9% 4 o 2 0 2 6 0 253 15 0 Totals for Year. 1,073 55 5.1% 16 2 14 5 32 14 6 670 12 6 The samples taken included 521 of milk, 65 cocoa, 62 vinegar, 55 butter, 42 pepper, 40 margarine, 24 tea (2 informal), 20 non-alcoholic wines, 14 coffee, 11 dripping, 9 baking powder, 9 ground ginger, 8 ground almonds, 8 sausage, 7 arrowroot, 7 camphorated oil, 7 self-raising flour, 7 rice, 7 sago, 7 malt vinegar, 7 linseed oil, 7 pure turpentine, 6 glycerine, 6 custard powder, 6 crushed linseed, 6 mixed spice, 6 dried full cream milk (informal), 5 olive oil, 5 whiskey, 4 boric acid ointment, 4 honey, 4 tapioca, 4 tartaric acid, 4 turpentine (1 informal), 4 zinc ointment, 3 pure borax, 3 borax honey, 3 ground cinnamon, 3 oil of eucalyptus, 3 ground rice, 3 wine, 3 ammoniated tincture of quinine, 2 cream (1 informal), 2 madeira cake, 2 spirit of camphor, 2 lard, 2 linseed, 2 medicine (1 informal), 2 jam, 2 mustard condiment, 2 mustard, 2 oatmeal, 2 starch powder, 2 soda water (1 informal), 1 each of ammonium chloride, rum, apples (informal), boracic acid, boracic ointment, queen cakes, sultana cake, citric acid, coffee and chicory, cheese, lemonade, compound mustard, flaked rice, fish, paste, salmon and shrimp paste, sugar, tinned rhubarb in syrup (informal), compound of liquorice powder, sauce and starch. Of the samples of milk, 19 or 3.6 per cent., were found to be below the standard fixed by the Board of Agriculture. The proportion of milk samples returned as adulterated during 1925 was again greatly below the average, C 2 36 In the subjoined table are shown the numbers of samples of milk taken during the four quarters of the year, with the numbers and percentages of those not found to be genuine:— Quarter of the year. Number of Samples. Number not genuine. Percentage adulterated. 1st 123 6 4.8 2nd 121 7 5.7 3rd 124 5 4.0 4th 153 1 0.6 In four of the samples water was certified to have been added ; in all of these it was less than 5 per cent. In 15, the samples showed deficiencies in milk fat; in two of these it was deficient to the extent of 5 per cent., and in nine it was less and in the other four it was more than 5 per cent., taking the standard of the Board of Agriculture. Legal proceedings were instituted in 8 or 42.1 per cent, of the cases in which samples of milk were below standard. In two instances, the summonses were dismissed, warranties being proved. In four instances, the defendants were fined, and in three of these costs were also allowed the Council. In two instances costs only were allowed the Council. No legal proceedings were considered advisable as regards the remainder of the samples of milk below standard. Of the adulterated samples of milk it was not thought advisable to institute legal proceedings in 57.9 per cent. In the four cases in which convictions were obtained the aggregate of fines and costs amounted to £7 2s. 0d., and the average amount paid by the defendants was £1 15s. 6d. The fines amounted to 3.5 per cent, of the maximum which might have been inflicted. 55 samples of butter were taken, 54 of which were returned as genuine, 41 were reported as containing boric acid not exceeding 0.5 per cent, in each. In one instance water was present in excess of the amount allowed by law. The vendor was summoned, 12s. 6d. costs being allowed by the Court. 40 samples of margarine were taken, all of which were returned as genuine. Boric acid was pros nt in 34, but not exceeding 0.5 per cent, in any case. Of the 62 samples of vinegar taken, two contained 2 per cent, excessive water, No proceedings were taken, 37 One sample of borax contained arsenic 15 parts per million in excess of the B.P. limit for purified borax. Legal proceedings were instituted, and the vendor was ordered to pay 23s. Od. costs. Two samples of sago were, on analysis, found to be tapioca. A warning letter was sent to each vendor. The sample of boracic ointment was 12 per cent, deficient in boric acid according to the B.P. standard for boric agid ointment. The vendor was ordered to pay 23s. 0d. costs. One sample of starch powder contained crystallised borax 21.1 per cent. No action was taken. Two samples sold as turpentine (one informal) contained liquid petroleum derivatives giving no indication of the presence of turpentine to the extent of 100 per cent. Legal proceedings were taken, and the vendor was fined £20. One sample of turpentine contained a liquid distilling below 156° C. to an amount of 15 per cent. No action was taken. One sample of whiskey contained excessive water 16.1 per cent. No action was taken. The two samples of linseed contained foreign seeds and other foreign matters to the extent of 1.5 per cent, and 2.8 per cent, respectively. No action was taken in either case. The informal sample of tinned rhubarb in syrup contained tin 2.1 grains per pound. One sample of coffee contained 50 per cent, chicory. No action was taken, there being a disclosure on the tin. One sample of madeira cake contained boric acid 7.3 grains per pound. No action was taken. The sample of sultana cake contained boric acid 5 3 grains per pound. No action was taken. The sample of queen cakes contained boric acid 1.5 grains per pound. No action was taken. Twelve samples of non-alcoholic wines contained salicylic acid, ranging from 0.4 to 24 grains per pint. No proceedings were taken. One sample of non-alcoholic wine contained alcohol 16.04 per cent, by volume, one 11.84 per cent., one 9.91 per cent., and another 11.04 per cent. The summonses 38 respecting the first two were withdrawn. The latter two were dismissed under the Probation of Offenders Act, 23s. 0d. costs, being allowed the Council in each case. One of the informal samples of tea contained iron filings 0.07 per cent. The subjoined table gives a comparison of the results of the work under the Sale of Food and Drugs Acts for the years 1902 1905 inclusive:— Year. Number of Samples. Number of persons in the Borough to each Sample. Number of Samples adulterated. Percentage of Samples adulterated. Number of prosecutions instituted Summonses wuhdrawn on account of wrtmititios Prosecutions proceeded with. Number of successful prosecutions. Fines and Costs. Amount paid to Public Analyst. £ s. d. £ s. d. 1902 281 420 71 25.3 54 2 52 48 117 9 0 140 10 0 1903 707 166 112 15.8 60 5 55 51 173 11 6 353 10 0 1904 612 189 110 17.9 56 6 50 46 128 5 0 306 0 0 1905 536 215 98 18.2 57 2 51 47 233 18 0 267 0 0 1906 520 224 122 23.4 44 2 42 34 106 12 6 260 0 0 1907 519 223 99 19.0 36 4 32 27 67 14 0 259 10 0 1908 580 200 92 15.8 45 ... 45 39 117 10 0 290 0 0 1909 570 200 92 16.1 76 2 74 69 255 18 6 276 5 0 1910 578 200 133 23.0 65 ...... 60 49 93 17 6 279 5 0 1911 577 200 149 25.8 64 ... 62 58 180 0 6 278 17 6 1912 584 190 100 17.1 48 1 48 45 172 11 0 281 10 0 1913 768 144 132 17.1 47 ... 47 42 94 2 6 350 10 0 1914 768 143 132 17.1 36 ... 36 21 74 6 0 350 10 0 1915 768 135 130 17.8 43 ... 43 30 63 16 0 350 10 0 1916 768 130 144 18.7 50 ... 49 36 134 18 0 350 10 0 1917 770 129 154 20.0 65 ... 65 41 99 12 0 351 5 0 1918 724 134 137 1 7 .5 54 1 53 37 284 13 0 340 12 6 1919 632 155 72 11.3 32 1 31 17 137 3 0 316 0 0 1920 934 109 69 7.4 25 1 24 14 38 3 6 700 10 0 1921 1077 98 58 5.4 25 ... 25 20 94 14 0 807 15 0 1922 1068 97 58 5.4 20 ... 20 14 31 5 0 700 15 0 1923 1049 101 51 4.9 19 ... 19 10 24 18 6 655 12 6 1924 1051 101 37 3.5 17 ... 17 11 49 9 0 656 17 6 1925 1073 100 55 5.1 16 2 14 5 32 14 6 670 12 6 The percentage of samples found adulterated was again markedly below the average for past years. With reference to the convictions in 1925, in 2 instances the defendants had been previously convicted once. The remaining 3 were first convictions under the Sale of Food and Drugs Acts. BAKEHOUSES. The bakehouses were subject to the usual inspection during the year, and some 278 visits were made in connection with them. The number on the register in the 39 month of November was 61, of which 36 were underground and 25 above ground. Their general condition may be described as satisfactory. Two, viz., the one at 91, Leonard Street and the one at 271, Hoxton Street, both underground, were found, when visited on the 7th and 17th of September, not to be in use as bakehouses. In 26 electric power is used in connection with bread-making. In 15 instances limewashing was required, and sanitary notices were served accordingly. There were, besides, a few other minor sanitary defects. The notices served were all complied with, and it was not necessary to report any of them for action on the part of the Sanitary Authority. STAFF. Mr. Shaw, Sanitary Inspector, was absent on account of illness from the middle of December, 1924, to March 12th, 1925, and again from April 9th to May 4th, and Mr. Thomas, Sanitary Inspector, was away from the end of June until the end of September through an accident whilst in the execution of his duty. Mr. Goodwin, who had for several years rendered satisfactory service as a Clerk in the department, left to take up an appointment as Sanitary Inspector at Sheerness. The vacancy was filled by the promotion of Mr. Gibbs, whose place was taken by Mr. W. L. Job, appointed on probation as Junior Clerk. He commenced his duties about the middle of July. Owing to the suspension of the three disinfectors, Messrs. Fawns, Kennedy and Flack were appointed temporarily to take over the duties of disinfection in June, and they continued to be so employed at the close of the year. The staff employed in maternity and child welfare work during 1925 have already been dealt with generally in the section relating thereto (pp. 27 to 32). Miss Amy Hodgson, M.D., M.R.C.P., was appointed physician to take charge of the infant welfare consultations on Tuesdays at the Kingsland Road Centre, and on Fridays at the Harbour Lights. At the former Centre her duties commenced on January 6th, and at the latter on March 27th. Nurses Paterson and Smith resigned during the year, and Nurses Wenham and Boon were appointed to fill the vacancies. Mrs. Levi, a former health visitor, was temporarily employed as such from the end of June to the end of October during the absence of Miss Barnes on account of illness. Mrs. Lewis, who was employed for over five years taking care of the children in the creche at the Centre in Kingsland Road, died in September. She was a good worker, and devoted to her charges, and her loss was much regretted by all associated with her. A brief note may be made as to the work of the clerical staff. In connection with the work under the Health Committee some 22,996 communications, written and printed, were despatched from the office during the year. These included 7.562 notices and summonses, 4,784 letters, cards and other communications under tlhe Public Health and Sale of Food and Drugs Acts, 166 in connection with the work Under the Factory and Workshops Acts, 8,274 on various matters connected with 40 infectious disease, verminous cases and disinfection, and 2,210 agendas and reports relative to the work carried out. In connection with the work under the Maternity and Child Welfare Committee, some 25,508 communications were despatched, including 12,204 Milk forms, books and cards, 8,026 other forms and letters, and 4,676 agendas, reports and other documents. Generally, it may be stated that the staff discharged their duties satisfactorily, and my thanks are due to them for the assistance they have given me. Both Dr. Radford and Mr. Pearson have rendered valuable help in the work of safeguarding the health of the people of Shoreditch, which I cordially appreciate. In conclusion, I desire to thank the Mayor and the Chairman and members respectively of the Health and Maternity and Child Welfare Committees, and the members of the Borough Council generally, for their kind consideration and help in connection with the work carried out during the year. I have the honour to be, Sir, Ladies and Genctlemen, Your obedient Servant, LEWIS T. FRASER BRYETT, Medical Officer of Health. 41 Metropolitan Borough of Shoreditch. APPENDIX TO THE REPORT OF THE Medical officer of Health, CONTAINING Statistical Tables and Summaries of Proceedings under the Public Health and Factory and Workshops Act during the Year 1925, copy of the Report of the Tuberculosis Officer, and a Summary of Notifications under the Public Health (Tuberculosis) Regulations, 1912, a Summary compiled from the Abstracts of the Work of the Sanitary Inspectors by the Senior Inspector, Statistical Information relating to Housing( a Summary showing the Results of Police Court Proceedings taken during the Year, together with a Summary of the Work of the Medical Officers and Health Visitors in connection with Maternity and Child Welfare, a Summary relating to the Infants admitted to the Wards at 210, Kingsland Road, during the Year prepared by the Assistant Medical Officer of Health, and Particulars as to Cases Nursed by the District Nursing Association on behalf of the Shoreditch Borough Council during the Year 1925. 43 TABLE I. Vital Statistics of the Borough of Shoreditch during 1925 and previous years. Year. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Population estimated to middle of each year. Uncorrected Number. Nett. Number. Rate. of Nonresidents registered in the District. of residents not registered in the District. Under 1 year of Age. At all Apes. Number. Rate. Number. Rate per 1,000 nett Births. N umber. Rate. 1 2 3 4 5 6 7 8 !) 10 11 12 13 1916 99932 2833 2983 30.3* 1687 16.2 290 444 369 124 1841 18.7 1917 89675 2056 2225 22.2 1789 19.9 260 461 352 158 1990 22.5 1918 87645 1514 1719 17.5 1990 22.7 317 435 286 166 2108 24.2 1919 98134 2136 2286 22.3 1362 13.8 224 399 251 110 1537 15.7 1920 102044 3546 3731 36.9 1450 14.2 245 378 340 91 1583 15.6 1921 105200 2798 2975 28.5 1393 13.3 264 369 341 114 1498 14.4 1922 105800 2645 2926 27.9 1508 14.2 204 408 301 102 1712 16.3 1923 106200 2552 2832 26.9 1191 11.2 191 370 232 82 1370 13.0 1924 106500 2336 2528 23.9 1309 12.3 232 367 221 87 1444 13.7 1925 107300 2361 2627 24.6 1298 12.1 258 381 233 88 1421 13.3 Note.—The above 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 1,000 of the estimated gross population. For columns 5 and 13 the population of the Holborn Institution, estimated at 900, has been deducted in calculating the rates. In column 6 are included the whole of the deaths except those of soldiers and sailors in public institutions, which were registered during the year as having actually occurred within the Borough. In column 12 is entered the number in column 6 corrected by subtraction of the number in column 8 and by the addition of the number in column 9. Deaths in column 10 have been similarly corrected by subtraction of the deaths under one year included in the number given in column 8 and by addition of the deaths under one year included in the number given in column 9. "Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. Area of Borough in acres (exclusive of area covered by water). 642.5 Total population at all ages 104,308 Number of inhabitated houses 11,889 Average number of persons per house 8.8 At Census of 1921. * The birth rate for 1916, based upon the Registrar-General's estimate of the population for 1916, was 27.4 per thousand inhabitants. 44 TABLE II. Cases of infectious disease notified during the Year 1925 in the Borough of Shoreditch. Notifiable Disease. Number of Cases Notified. Totai. Cases Notified in each Ward of the Borough. Total Cases Removed to Hospital. At all Ages. At Ages — Years. 1 3 i 7 8 Moor- fields. | Church. Hoxton. Wen lock. Whit- more. Kingsland. Baggerston. Acton. Under 1. 1 to 5. 5 to 15. 15 to 25. ! 25 to 45. 15 to 65. 65 and upwards. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera (C), Plague (P) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous croup) 440 18 173 171 53 20 5 ... 16 69 50 66 98 47 61 33 434 Erysipelas 71 2 2 7 11 13 23 13 6 10 7 9 20 8 3 8 42 Scarlet fever 485 5 216 231 27 5 1 ... 15 88 77 67 89 60 43 41 471 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 2 ... 1 1 ... ... ... ... ... ... 2 ... ... ... ... ... 9 Relapsing fever (R), Continued fever (C) (lc) ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 4 Puerperal fever 13 ... ... ... 7 6 ... ... ... 2 1 1 5 3 ... 1 13 Cerebro-spinal meningitis 2 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... Poliomyelitis 2 ... 1 1 ... ... ... ... ... ... ... ... ... ... 2 ... 1 Encephalitis lethargica 13 ... ... 1 10 1 1 ... ... 3 ... 4 1 1 3 1 10 Pulmonary tuberculosis 243 ... 1 17 58 93 67 7 12 44 41 28 34† 38 27 19 212‡ Other forms of tuberculosis 60 3 20 23 12 1 1 ... 2 14 9 7 6 8 9 5 53‡ Ophthalmia neonatorum 45 45 ... ... ... ... ... ... ... 19 8 3 4 8 3 2 4 Acute primary pneumonia 257 47 104 24 23 37 17 5 1 52 35 46 57 10 30 17 215‡ Acute influenzal pneumonia 32 2 10 2 3 11 3 1 ... 4 3 15 ... ... 10 ... 10‡ Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Trench fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 1,666 123 529 478 204 188 118 26 52 305 233 246 315 197 192 128 1,470 * This Number includes the cases of consumption notified from the Holborn Institution. Highgale, † This includes the ca?es of consumption in the St. Leonard's Hospital. ‡ Removed to St. Leonard's and other Hospitals or Sanatoria. It is to be noted ihat the cases of tuberculosis removed during the year included cases certified in previous years as well as cases certified in 1925. 45. TABLE III. Causes of, and ages at, death during the Year 1925 in the Borough of Shorcditch. CAUSES OF DEATH. Nett Deaths at the subjoined Ages ok " Residents" whether occurring within or without the District (a). Total Deaths whether of "Residents ' or " NonResidents" in Institutions in the District (b), All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45 45 and under 65. 65 and upwards. I 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 1422 233 71 59 57 59 165 317 431 781 Uncertified ... ... ... ... ... ... ... ... ... ... 1 Enteric fever 1 ... ... ... ... 1 ... ... ... ... 2 Smallpox ... ... ... ... ... ... ... ... ... ... 3 Measles 34 10 18 5 1 ... ... ... ... 6 4 Scarlet fever 5 ... 1 3 1 ... ... ... ... ... 5 Whooping cough 29 15 7 7 ... ... ... ... 2 6 Diphtheria and Croup 17 ... ... 12 5 ... ... ... ... ... 7 Influenza 19 ... ... ... ... ... 3 9 7 ... 8 Erysipelas 11 2 ... ... ... 1 4 1 3 10 9 Phthisis (pulmonary tuberculosis) 124 ... ... ... 5 27 46 41 5 96 10 Tuberculous meningitis 15 5 3 2 3 2 ... ... ... 5 11 Other tuberculous diseases 15 ... 3 4 1 4 ... 3 ... 12 12 Cancer, malignant disease 120 1 ... ... 1 3 9 66 40 47 13 Rheumatic fever 2 ... ... ... ... ... 1 1 ... ... 14 Meningitis (see note (d) ) 7 2 1 l 1 1 ... 1 ... ... 15 Organic heart disease 40 ... ... ... 4 5 9 19 3 31 16 Bronchitis 175 16 4 1 ... 1 12 60 81 100 17 Pneumonia (all forms) 146 39 21 9 8 2 23 21 23 59 18 Other diseases of respiratory organs 8 ... ... 2 ... ... 2 1 3 3 19 Diarrhcea and Enteritis (see note (e) ) 38 29 7 1 ... ... ... 1 ... 19 20 Appendicitis and Typhlitis 13 ... ... 2 4 1 2 3 1 3 21 Cirrhosis of liver 3 ... ... ... ... ... 1 ... 2 2 21aAlcoholism ... ... ... ... ... ... ... ... ... 1 22 Nephritis and Bright's disease 79 ... ... ... 1 ... 9 22 47 54 23 Puerpural fever 2 2 24 Other accidents and diseases of pregnancy and parturition 6 ... ... ... ... ... 5 1 ... 3 25 Congenital Debility and malformation, including premature birth 81 78 1 1 1 ... ... ... ... 41 26 Violent deaths, excluding suicide 47 11 ... 2 7 4 6 9 8 14 27 Suicides 16 ... ... ... ... ... 5 8 3 3 28 Other defined diseases 366 22 5 7 14 7 26 80 205 270 29 Diseases ill-defined or unknown 3 3 ... ... ... ... ... ... ... ... 1422 233 71 59 57 59 165 347 431 781 46 TABLE IV. INFANTILE MORTALITY IN THE BOROUGH OF SHOREDITCH DURING THE YEAR 1925. Nett deaths from stated causes at various ages under One Year of Age (see Note (a)). CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 1 2—3 Weeks. 3—4 Weeks. Total under 1 .Month 1—3 Months. 3—6 Months. 6—9 Months. 9—12 Months. Total Deaths under I Year. All causes Certified 36 12 13 3 64 45 52 39 3.3 233 Uncertified ... ... ... ... ... ... ... ... ... ... Smallpox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 3 6 10 Scarlet fever ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... 5 4 4 2 15 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... 2 ... ... ... 2 Tuberculous meningitis ... ... ... ... ... ... 1 ... 2 3 Abdominal tuberculosis (b) ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... ... ... 1 1 Meningitis (not tuberculous) ... ... ... ... ... 1 1 1 ... 3 Convulsions 1 ... ... ... 2 1 1 ... ... 4 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... 1 1 7 3 2 3 16 Pneumonia (all forms) ... ... 2 ... 2 6 10 11 10 39 Diarrhoea ... ... ... ... ... ... 4 3 1 8 Enteritis ... ... ... ... ... 4 8 5 4 21 Gastritis ... ... ... ... ... ... ... 2 ... 2 Syphilis ... 1 ... ... 1 1 ... ... ... 2 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying 2 2 ... ... 4 ... ... ... ... 4 Injury at birth ... ... ... ... ... ... ... ... ... Atelectasis 3 ... ... ... 3 ... ... ... ... 3 Congenital malformations (c) 3 2 2 ... 7 2 2 ... ... 11 Premature birth 19 3 5 ... 27 1 1 ... ... 29 Atrophy, Debility and Marasmus 2 1 2 1 6 13 11 6 2 38 Other causes 6 2 2 1 11 2 5 2 1 21 36 12 13 3 64 45 52 39 33 233 Nett Births in the year.—Legitimate, 2,545 ; illegitimate, 82. Nett Deaths in the year of legitimate infants, 223 ; illegitimate infants, 10, 47 NOTES TO TABLE III. The classification and numbering of Causes of Death are those of the " Short List on page xxv. of the Manual of the International List of Causes of Death." (a) All " Transferable Deaths " of residents, i.e., of persons resident in the district who have died outside it, have been included with the other deaths in columns 2-10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England or Wales who have died in the district, have been in like manner excluded from these columns. For the precise meaning of the term " Transferable Deaths," see footnote to Table I. (b) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, have been entered in the last column of Table III. (c) All deaths certified by registered medical practitioners and all inquest cases have been classified as " Certified " ; all other deaths being regarded as " Uncertified." (d) Exclusive of " Tuberculous Meningitis " (10), but inclusive of cerebrospinal meningitis. (e) Title 19 has been used for deaths from diarrhoea and enteritis at all ages. (In the " Short List " deaths from diarrhoea and enteritis under 2 years are included under 19 ; those at 2 years and over being placed under title 28.) NOTES TO TABLE IV. (a) The total in the last column of Table IV equals the total of column 10 of Table I and in column 3 of Table III. (b) Under abdominal tuberculosis have been included deaths from culous peritonitis and enteritis, and from tabes mesenterica. (c) The total deaths from congenital malformation, premature birth, atrophy, debility and marasmus equal the total in Table III under the headings congenital debility and malformation, atelectasis and premature birth. Want of breast milk has been included under atrophy and debility. (d) For references to the meaning of any other headings, see Notes to Table III. /*9 TABLE v. DEATHS FROM ALL CAUSES IN THE BOROUGH OF SHOREDITCH, AND IN EACH WARD DURING THE YEAR ENDING 31st DECEMBER, 1925. Note.—The deaths of persons not belonging to Shorcditch occurring in hospitals and other institutions in the Borough are excluded ; deaths of persons belonging to Shoreditch occurring in public institutions in London beyond the limits of the Borough are included. causes oF death. ages. DEATHS IN EACH WARD. sex. Total. Under 1. 1 to 2. 2 lo 5. 5 to 10. 10 to 15. 15 t o 20. 2U to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65 to 75. 75 to 80. 85 and upwards. Moorfields Church. Hoxton. Wenlock. Whitmore Kingslnnd. Haggerston. Acton. Male. Female 1 Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Measles 10 18 5 1 ... ... ... ... ... ... ... ... ... ... 5 6 2 7 4 6 4 14 20 34 3 Scarlet fever ... 1 3 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... 4 1 5 4 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Epidemic influenza ... ... ... ... ... ... ... 2 i 2 7 4 ... ... ... ... ... 7 ... ... ... 1 12 7 19 6 Whooping cough 15 7 7 ... ... ... ... ... ... ... ... ... ... ... ... 4 3 6 ... 2 4 5 13 16 2!) 7 Diphtheria, membranous croup ... ... 12 4 1 ... ... ... ... ... ... ... ... ... ... 3 5 2 ... ... 3 1 4 13 17 8 Enteric fever ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... . 1 ... ... ... 1 1 9 Asiatic cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Diarrhoea, dysentery 5 ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 1 1 2 1 ... 3 4 7 11 Epidemic or zymotic enteritis 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... 1 4 ... 4 12 Other allied diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Glanders, farcy ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Tetanus... ... ... ... ... I ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 16 Anthrax, splenic fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Cow-pox, accidents of vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Syphilis 2 ... ... ... ... ... ... ... 1 1 ... 1 ... ... ... ... 3 2 ... ... ... ... ... 1 5 19 Gonorrhoea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 Phagedoena, hospital gangrene ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21 Erysipelas 2 ... ... ... ... ... 1 1 3 1 ... 1 1 1 ... 3 1 1 2 1 1 2 5 6 11 22 Puerperal fever ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 2 23 Pyaemia, septicaemia 1 ... ... 2 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... 3 1 ... ... 2 3 5 24 Infective endocarditis ... 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 ... ... 1 ... ... ... 2 ... 2 25 Other allied diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 Malarial fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 Rheumatic fever ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... 1 ... ... ... ... 1 1 2 28 Rheumatism of the heart ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 2 Tuberculosis :— 29 Brain or meninges, acute hydrocephalus 5 3 2 2 I I 1 ... ... ... ... ... ... ... ... 3 3 3 1 2 1 2 7 8 15 30 Larynx ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 Lungs ... ... ... 2 3 11 16 23 23 23 18 5 ... ... 6 20 14 14 26 16 16 12 78 46 124 32 Intestines, tabes mesenterica ... 2 2 ... ... 1 ... ... ... ... ... ... ... ... ... 2 1 ... 1 1 ... ... 5 ... 5 33 General, position undefined ... 1 1 ... ... i ... ... ... 2 ... ... ... ... ... ... ... ... 2 ... 3 ... 3 2 5 34 Other forms, scrofula ... ... 1 1 ... i 1 ... ... 1 ... ... ... ... 2 ... 1 1 ... 1 ... ... 1 4 5 35 Other infective diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 36 Thrush ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 37 Actinomycosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 38 Hydatid diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 39 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 40 Other diseases due to altered food ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 41 Acute alcoholism, delirium tremens ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... D 50 51 CAUSES OF DEATH. AGES. DEATHS IN EACH WARD. SEX. Total. Under 1. 1 to 2. 2 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 to 75. 75 to 85. 85 and upwards. Moorfields. Church. Hoxton. Wenlock. Whitmore. Kingsland. Haggerston. Acton. Male. Female. 12 Chronic alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Chronic industrial poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... ... 14 Other chronic poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Osteo-arthritis, rheumatoid arthritis ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 47 Cancer ... ... ... ... ... ... 1 2 5 30 28 29 8 1 9 12 21 15 12 12 8 15 58 | 46 104 48 Diabetes mellitus ... ... ... ... ... ... ... 1 | 1 1 3 1 ... ... 1 ... 1 ... 1 1 ... 3 5 2 7 49 Purpura haemorrhagica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 50 Haemophilia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 51 Anaemia, leucocythaemia ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 2 2 52 Lymphadenoma, Hodgkin's disease ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 0 ... 2 53 Premature birth 29 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5 6 4 1 5 4 14 15 29 54 Injury at birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 55 Debility at birth 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 3 ... ... ... 4 1 5 56 Atelectasis 3 ... ... ... ... ... ... , ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... ... ... 3 3 57 Congenital defects 11 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 2 ... 2 1 2 3 7 5 12 58 Want of breast milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 59 Atrophy, debility, marasmus 33 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 9 3 4 5 4 4 5 21 14 35 60 Dentition 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 61 Rickets 1 2 1 ... ... ... ... ... ... ... ... ... ... 2 1 ... 1 ... ... ... 3 1 1 62 Old age, senile decay ... ... ... ... ... ... ... ... ... ... 4 28 49 22 6 15 20 10 14 8 i'2 18 53 50 103 63 Convulsions 4 I 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 1 1 ... ... 4 2 0 64 Meningitis 2 1 1 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ••• 1 2 1 1 2 3 4 7 65 Encephalitis ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 66 Apoplexy ... ... ... ... ... ... ... ... 2 4 13 19 13 ... ... 12 15 3 9 1 1 6 21 30 51 67 Softening of brain ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 68 Hemiplegia, brain paralysis ... ... ... ... ... ... ... ... ... ... 1 2 1 ... ... 1 ... 2 1 ... ... ... 1 3 4 69 General paralysis of insane ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... 1 2 ... ... ... 3 ... 3 70 Other forms of insanity ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 71 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 72 Cerebral tumour ... ... l ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 4 73 Epilepsy ... ... ... ... 1 ... 1 ... 2 ... ... 1 ... ... ... ... 1 1 ... 1 1 1 ... 5 5 74 Laryngismus stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 75 Locomotor ataxy ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 1 ... ... 1 1 2 76 Paraplegia, diseases of spinal cord ... ... ... ... ... ... 1 ... ... 1 ... 1 ... ... ... ... ... 2 ... 1 ... ... 2 1 3 77 Other diseases of brain or nervous system ... ... 1 1 ... ... ... 1 1 ... ... ... ... i ... ... 2 ... 3 ... ... ... 3 2 5 78 Otitis, otorrhcea ... ... ... 1 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... 2 1 1 ... 2 2 4 79 Diseases of nose, epistaxis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 80 Diseases of eye, ophthalmia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 81 Pericarditis ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 1 2 82 Endocarditis, valvular diseases of the heart ... ... ... 2 1 l 3 6 3 10 9 2 1 ... 5 8 7 4 6 4 2 2 17 21 38 83 Hypertrophy of heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 84 Angina pectoris ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 1 ... ... ... 1 2 1 ... 85 Aneurism ... . . . ... ... ... ... ... ... ... 2 1 . . . 1 ... ... ... 2 ... ... ... ... 2 2 2 4 86 Senile gangrene ... ... ... : ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 87 Embolism, thrombosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 88 Phlebitis ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 89 Varicose veins ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... • •• 90 Other and ill-defined diseases of heart and circulatory system, including heart disease not stated to be valvular ... ... ... ... 1 1 ... 2 2 5 15 33 18 3 2 16 17 9 14 8 6 8 44 36 i | 80 52 53 CAUSES OF DEATH. AGES. DEATHS IN EACH WARD. I SEX. Total. Under I. 1 to 2. 2 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 to 75. 75 to 85. 85 and upwards. Moorfields. Church. Hoxton. Wen lock. Whit more Kingsland. Hagger:, ton Acton Male. Female. — — , 91 Laryngitis ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 92 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 93 Other diseases of larynx and trachea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 94 Acute bronchitis 16 4 1 ... ... ... ... 2 ... 5 5 2 3 ... ... 6 5 6 8 2 3 8 18 20 38 95 Chronic bronchitis ... ... ... ... ... ... ... ... ... 10 17 33 46 26 4 6 29 17 8 28 18 16 15 88 49 137 96 Lobar croupous pneumonia... 1 2 ... 1 ... ... ... 5 10 4 5 7 1 1 ... 5 2 9 10 4 2 4 20 16 36 97 Lobular broncho-pneumonia 36 17 7 4 ... ... ... ... 2 3 3 8 1 1 5 14 7 16 8 11 11 13 43 42 85 98 Pneumonia, form not stated 2 2 2 1 ... ... ... 2 4 4 2 2 2 ... 3 4 4 2 5 3 2 2 14 11 25 99 Emphysema, asthma ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... 1 100 Pleurisy ... ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... 1 1 ... ... ... ... 1 2 1 3 101 Other and ill-defined diseases of respiratory system ... ... 1 ... ... ... ... 1 ... ... 1 1 ... ... ... ... ... 1 ... ... . 2 l 3 1 4 102 Diseases of mouth and annexa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 103 Diseases of pharynx ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 104 Diseases of oesophagus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 105 Ulcer of stomach and duodenum ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... 1 ... 1 ... ... ... 2 ... 3 ... 3 106 Other diseases of stomach ... 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 ... 1 ... ... ... 3 ... 3 107 Enteritis 21 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 8 3 2 3 I 2 6 2 11 16 27 108 Appendicitis ... ... ... 2 ... 3 ... ... 1 1 2 1 1 ... ... ... ... ... 1 7 1 1 3 8 5 13 109 Obstruction of intestine ... ... ... ... 1 ... ... ... 1 2 1 2 ... l ... 3 1 2 ... 1 1 ... 3 5 8 110 Other diseases of intestine ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ill Cirrhosis of liver ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... 1 ... ... 1 | 1 ... ... 2 1 3 112 Other diseases of liver ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 ... 1 ... ... 1 1 2 113 Peritonitis ... ... 1 ... 1 ... ... ... 1 ... 1 1 ... ... 2 2 1 ... ... ... ... ... 2 3 5 114 Other and ill-defined diseases of digestive system ... 2 ... ... ... ... ... ... ... 2 1 ... ... ... ... ... 1 1 ... 1 ... 1 2 1 4 5 115 Diseases of lymphatic system and ductless glands... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... 1 1 116 Acute nephritis ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... 1 1 2 117 Bright's disease ... ... ... ... ... ... ... ... 5 ... 13 26 19 2 5 9 12 9 17 6 12 7 .. 44 33 77 118 Calculus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 119 Diseases of bladder and prostate ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... 1 1 ... ... 1 3 ... 3 120 Other and ill-defined diseases of urinary system ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 1 ... ... ... ... 1 2 1 3 121 Diseases of testes and penis... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 122 Diseases of ovaries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 123 Diseases of uterus and appendages ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 124 Diseases of vagina and external genital organs ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 l 125 Diseases of breast ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 126 Abortion, miscarriage ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 l 127 Puerperal mania ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 128 Puerperal convulsions ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 l 129 Placenta praevia, flooding ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 130 Puerperal thrombosis ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 l 131 Other and ill-defined accidents and diseases of pregnancy and childbirth ... ... ... ... ... ... ... 2 1 ... ... ... ... 2 ... ... ... ... 1 ... ... 3 3 132 Arthritis, ostitis, periostitis... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... 1 ... 2 ... ... ... 2 1 3 133 Other and ill-defined diseases r.f osseous system ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... 2 ... ... ... ... 2 ... 2 54 55 CAUSES OF DEATH. AGES. ! DEATHS IN EACH WARD. | SEX. Total, Under 1. 1 to 2. 2 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 to 75. 75 to 85. 85 and upwards. Moorfields. Church. Hoxton. Wenlock. Whitmore. Kingsland. ITaggerston. Acton. Male. Female. 134 Ulcer, bedsore ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 135 Eczema ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 136 Pemphigus 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 2 ... 2 137 Other and til-defined diseases of integumentary system ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... I ... ... ... ... ... ... 1 1 By Accident or Negligence : 138 In mines and quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 139 In vehicular traffic ... ... ... 3 ... I ... 2 ... 1 I 2 1 ... 1 2 3 2 ... 2 I ... 12 2 14 140 On railways ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 141 On vessels and docks, excluding drowning ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 142 In building operations ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 143 By machinery ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... 1 2 ... 2 144 By weapons and implements ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 145 Burns and scalds 1 ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 2 3 146 Poisons, poisonous vapours ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 147 Surgical narcosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 148 Effects of electric shock ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 149 Corrosion by chemicals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 150 Drowning 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 2 151 Suffocation, overlaid in bed 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... 3 3 152 Suffocation otherwise 3 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 1 ... ... ... ... ... 1 3 4 153 Falls, not specified ... ... ... 1 ... l ... 1 ... 1 4 2 ... 1 ... 2 1 1 ... 1 ... 1 10 1 11 154 Weather agencies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 155 Otherwise, and not stated 2 ... ... ... ... ... i ... ... 1 ... ... ... ... ... ... ... 2 ... ... 1 1 2 2 4 156 Homicide 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 1 2 Suicides, all forms :— 157 By poison ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... 1 ... ... ... 1 1 ... 2 1 3 158 By asphyxia ... ... ... ... ... ... ... ... ... 1 2 2 ... ... 1 ... ... ... 2 ... I 1 3 2 5 159 By hanging and strangulation ... ... ... ... ... ... ... ... 1 2 ... 1 ... ... ... ... 2 ... ... 1 I ... 4 ... 4 160 By drowning ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 161 By shooting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 162 By cut or stab ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... ... ... ... ... 1 1 2 163 By precipitation from elevated places ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 164 By crushing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 165 By other and unspecified methods ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 166 Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 167 Sudden death ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 168 Other ill-defined and not specified causes 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... 1 9 3 169 Malignant disease 1 ... ... 1 ... 1 1 2 ... 3 5 2 ... ... I 2 2 2 3 2 4 ... 8 8 16 170 Abscess 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... 2 171 Cerebro-spinal fever 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 2 1 3 172 Encephalitis Lethargica ... ... ... ... I ... ... ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... 1 ... 3 3 Totals 233 71 59 35 22 26 33 68 97 151 196 241 149 41 69 235 217 177 259 141 155 169 775 647 1422 oG TABLE VI.—ANALYSIS AND COMPARISON OF LONDON AND SHOREDITCH BIRTH AND DEATH RATES FOR THE YEAR ENDING 31ST DECEMBER, 1925. DISTRICTS. Estimated Population 1925. ANNUAL RATE PER 1,000 PERSONS LIVING. Deaths under 1 year ii> 1,000 Births. PERCENTAGE TO TOTAL DEATHS. BIRTHS. DEATHS DURING THE YEARS: DEATHS DURING 1925 FROM Inquest Cases. Deaths in Public i 1 nstitutions. Uncertified Causes of Death. Principal Zymotic Diseases. Smallpox. | Measles. Scarlet Fever. Diphtheria. Whooping Cough. *Fever. +Diarrhcpa. Tuberculous Disease. Violence. 1922. 1923. 1924. 1925. London 4,576,505 18.0 13.4 11.2 12.1 11.7 06 ... 0.13 0.03 0.07 0.15 0.01 0.22 Yo 0.46 67 8.9 ... 0.0 Shoreditch + 106,400 24.6 16.3 13.0 13.7 13.3 1.2 ... 0.32 0.04 0.16 0.27 o.oo 0.35 1.4 0.59 88 9.1 63.4 ... Wards. Moorfields 4,558 21.9 16.2 11.7 11.5 15.1 0.4 ... ... 0.22 ... ... ... 0.22 1.75 0'65 50 7.2 55'1 ... Church 18,650 25.2 18.7 13.1 14.6 12.5 1.2 ... 0.27 0.05 0.16 0.21 ... 0.54 1.34 0.64 96 10.2 64.2 ... Hoxton 16,250 26.6 17.9 14.1 15.3 13.3 1.2 ... 0.37 0.06 0.30 0.18 ... 0.30 1.17 0.61 85 12.0 60.8 ... Wenlock + 13,873 29.2 16.2 13.3 15.1 12.7 0.9 ... 0.14 0.14 0.43 ... 0.21 1.29 0.50 74 6.2 60'5 ... Whitmore §18,930 24.2 16.0 13.0 13.2 13.6 M ... 0.37 0 05 0.16 0.26 ... 0.26 1.59 0.52 94 9.3 55'6 ... Kingsland 10,645 25.0 13.2 12.8 13.2 13.2 1.0 ... 0.37 ... ... 0.18 0.09 0.37 1.87 0.75 75 10.6 78'0 ... Haggerston 11,232 23.9 14.1 13.1 12.7 13.8 1.8 ... 0 53 ... 0.26 0.36 ... 0.62 1.77 0.71 93 7.7 76'7 ... Acton 12,262 18.3 16.1 11.8 11.2 13.8 1.1 ... 0.32 0 '08 0.08 0.40 ... 0.24 1.14 0.40 120 7.1 59.8 ... * Fever includes typhus, typhoid and continued fevers. + Diarrhoea in this table includes enteritis in children under two years. + The inhabitants of the Holborn Institution, which is situate in Wenlock Ward, estimated at 900, and the deaths occurring in that institution are excluded. § The Shoreditch Institution is situate in this Ward. In the cases of some of the deaths in outlying institutions, the Shoreditch Institution is the last known place of residence. This Ward is therefore probably credited with some deaths belonging to other Wards. Note.—Where the deaths under any heading are too few to express as a rate per 1,000 within two places of decimals, 0*00 is inserted ; where no deaths have occurred,, dots are placed in the space under the heading. The London population is adjusted to the middle of 1924. 57 PUBLIC HEALTH (LONDON) ACT, 1891. SUMMARY OF PROCEEDINGS DURING 1925. TABLE VII. PREMISES. NUMBER OF PLACES— Number of inspections, 1925. Number of notices, 1925. Number of prosecutions, 1925. On register at end of 1924. Added in 1925. Removed in 1925. On register at end of 192.1. Milk premises 256 18 10 264 1,683 12 ... Cowsheds 2 ... ... 2 19 ... ... Slaughterhouses 2 ... ... 2 21 ... ... Other offensive trade premises 22 5 27 83 7 ... Ice Cream premises 127 24 16 135 306 21 ... Registered houses let in lodgings 305 5 3 307 1,625 315 6 Number of intimation notices served for all purposes 5,573 Overcrowding :— Number of dwelling rooms overcrowded 58 Number remedied 39 Number of prosecutions 1 Number of premises dealt with under Section 20 of the London County Council (General Powers) Act, 1904 329 Underground rooms :— Number dealt with during year 2 Insanitary houses :— Number closed under the Public Health (London) Act, 1891 — Shelter provided under Section 60 (4) of the Public Health (London) Act, 1891 :— Number of persons accommodated during the year — Customs and Inland Revenue Acts Number of dwellings for which applications were received during the year — Number of prosecutions under Bye-laws under Public Health (London) Act, 1891 With respect to water closets, earth closets, houses let in lodgings, &c. 9 Mortuary :— Total number of bodies removed 140 Total number of infectious bodies removed — 58 BOROUGH OF SHOREDITCH. Administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK DURING THE YEAR 1925. 1.—Inspection. Inspections made by Sanitary Inspectors. Premises. (1) Inspections. (2) Number of Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries) 716 65 1 Workshops (Including Workshop Laundries and Bakehouses) 3,356 405 3 Workplaces (Excluding Outworkers' premises dealt with in Table III.) 1,162 100 ... Totals 5,234 570 4 2.—Defects Found. Particulars, (1) Number of Defects. Number of Prosecutions (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (-4). Nuisances under the Public Health Acts :* Want of cleanliness 30 305 ... ... Want of ventilation 4 4 ... ... Overcrowding 1 1 ... ... Want of drainage of floors ... ... Other nuisances 229 229 ... 2 Sanitary accommodation 'insufficient 95 95 ... ... unsuitable or defective 207 207 ... 1 not separate for sexes 11 11 ... ... Offences under the Factory and Workshop Act: ... ... ... ... Illegal occupation of underground bakehouse (Section 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (Sections 97 to 100) ... ... ... ... Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) ... ... ... ... Totals 852 852 ... 3 * Including those specified in Sections 2, 3, 7 and S of the Factory and Wurkshop Act as remediable under the Public Health Acts. 59 3.—Home Work—1925. NATURE OF WORK. (1) OUTWORKERS- LISTS, SECTION 107. Outwork in unwholesome premises. Section 108. Outwork in infected premises, Sections 10i) and 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending Lists. (8) Prosecutions. Instances. (Ill Notices served. (12) Prosecutions. (131 Instances. (14) Orders made. (S. 109.) | (15) Prosecutions. (S. 100, 110.1 (16) Twice in the Year. Once in the Year. Failing to keep or permit inspection of Lists. 19) Failing to send Lists. (10) Lists. (2) Outworkers. Lists. (5) Outworkers. Contractors. (3) Workmen. (4) Contractors. Workmen. (7) Wearing apparel:— (1) Making, &c. 32 22 555 7 4 34 ... ... ... 49 49 ... 25 1 ... (2) Cleaning and washing... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial flowers ... ... ... 2 ... 43 ... ... ... 4 4 ... 4 ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas ... ... ... ... ... ... ... ... ... 4 4 ... 1 ... ... Paper bags and boxes 18 ... 236 1 ... 3 ... ... ... 37 37 ... 2 ... ... Brush making... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... ... Wire Netting ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Totals 50 22 791 10 4 80 ... ... ... 97 97 ... 32 ... ... (a) There were no names and addresses of outworkers received in respect to the following classes of work :—Sacks, basket making, mats other than wire nets, racquet and tennis balls, stuffed toys, file making, electro plate, cables and chains, anchors and grapnels, cart gear, locks, latches and keys, pea picking, household linen, lace, lace curtains and nets, curtains and furniture hangings, brass and brass articles, tents, feather sorting, and carding, &c., of buttons. (b) The figures in columns 2, 3 and 4 are the total number of lists received from employers who sent them both for February and August, and of the entries of names of outworkers in those lists. They are therefore double the number of employers and approximately double the number of individual workers whose names are given, since in the February and August lists of the same employers, the same outworker's name will often be repeated. 60 4.—Registered Workshops—1925. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) (1) Furniture, woodwork, fitting and other branches of the furniture trades ... 1,017 (a) Cabinet making ... 600 (b) French polishing 127 (c) Upholstery ... '... 66 (d) Other workers 224 (2) Dress 173 (a) Tailoring ... ... 69 (e) Shirt making (b) Mantles ... ... 9 (f) Boot and shoe trades 27 (c) Dress... ... ... 32 (g) Artificial flowers 3 (d) Millinery ... ... 6 (h) Other workers 27 (3) Skin, leather, hair and feather trades... 60 (a) Furriers ... ... 17 (b) Saddlery and Harness 12 (c) Feathers ... ... 2 (d) Other workers 29 (4) Paper, printing, book, stationery and fancy goods trades ... 57 (a) Box and bag makers 47 (b) Other workers 10 (5) Laundry and washing 6 (6) Food 13 (7) Metals, machines, implements and conveyances 34 (8) Precious metals, jewels, &c. 2 (9) Other trades than those mentioned above 136 Total number of workshops on Register 1,498 Note.—A separate register is kept for bakehouses, the number of which in use at the end of the year was 61, including 26 factory bakehouses. 5.—Other Matters. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshops Act (s. 133). 5 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshops Act (s. 5.) Notified by H.M. Inspector 38 referring to 25 factories and 14 workshops. Reports (of action taken) sent to H.M. Inspector. referring to 5 25 factories and 14 workshops. Other 10 Underground Bakehouses (s. 101) :— Certificates granted during the year Nil. In use at the end of the year 36 61 6.—Showing the Numbers of Outworkers Received from other Districts during 1925. districts. Making Wearing Apparel. Confectionery Packing. Artificial Flowers. Furniture and Upholstery. Fur Pulling. Feather Sorting. Umbrellas, &c. Paper Bags and Boxes. Brush Making. Fancy Leather Goods. Crackers and Toys. Totals. Feb. Aug. Feb. Aur, Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Feb Aug. Feb. Aug. Feb. Aug. Feb. Aug Feb. Aug. Battersea 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Bethnal Green 36 38 ... ... ... ... ... ... ... ... ... ... ... ... 55 59 10 11 ... ... ... ... 209 Camberwell 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 City of London 252 253 ... ... 9 15 ... ... ... 7 ... ... 28 ... ... 1 ... ... 1 2 ... ... 607 Chelsea 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Enfield 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Finsbury 43 55 ... ... 10 15 l 1 ... 8 ... ... 3 ... 24 45 ... ... 15 ... ... 2 233 Hackney 118 106 ... ... 7 5 4 4 ... 1 ... ... ... ... 15 18 ... ... 3 ... ... 3 296 Hampstead ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 Hertford ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... ... ... 4 Holborn 9 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Hornsey 4 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Islington 26 29 ... ... 4 7 ... ... ... ... ... ... ... ... 9 21 4 2 ... ... 4 1 107 Southwark 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 9 St. Marylebone 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Stepney 12 15 ... ... 1 ... ... ... ... ... ... ... ... ... 9 8 ... ... ... ... ... ... 46 St. Pancras 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Stoke Newington 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Tottenham 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Westminster 18 19 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 37 Willesden 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Totals 541 538 4 31 42 5 5 8 16 l 2 31 36 113 158 20 19 19 2 4 6 1,601 1,079 4 73 10 24 3 67 271 39 21 10 62 SHOREDITCH TUBERCULOSIS DISPENSARY. REPORT FOR 1923. by Alfred Leitch, M.B., Ch.B., Tuberculosis Officer. To the Medical Officer of Health, Town Hall, Shored itch. Sir, I have much pleasure in'submit ting my report for the year 192"):— The total number of attendances during the year was 5,718, and the total number of persons attending was 1,162 ; of these 433 were suffering from some form of tuberculosis. New persons examined for the first time numbered 610, and 129 were found to be tuberculous ; many of these have been sent to Residential Institutions. The Local War Pensions Authority continues to send a large number of pensioners for examination. In the past year 540 examinations were made, and the same number of reports sent to the Authority concerned. During the year 236 patients were recommended to the London County Council for residential treatment. With a few exceptions all were admitted eventually, either to hospital or sanatorium. The staff of the Dispensary have been of the greatest assistance to me, and have carried out their duties to my satisfaction. Statistical Report, 1925. 1925. 1924. Total attendances 5,718 6,088 Total new patients examined for the first time 610 657 Renewed cases 552 546 Sisters' visits 2,984 2,816 Medical Officers' visits 258 258 All New Persons Examined. Tuberculous. Suspects. NonTuberculous. Totals. Contacts 46 14 278 338 Other new cases 83 15 174 272 Totals 129 29 452 610 63 The New Persons examined, the examinations and the attendances each month were as follows:— New Persons Examined. Examinations. Attendances. Ins. NonIns. Totals. Ins. NonIns. Totals. Ins. NonIns. Totals. January 22 25 47 93 80 173 280 224 504 February 24 35 59 79 91 169 267 214 481 March 21 33 54 104 100 204 304 228 532 April 23 30 53 101 72 173 284 191 475 May 17 31 48 83 82 165 263 201 464 June 19 18 37 87 59 146 243 165 408 July 20 3J 51 89 68 157 262 175 437 August 18 20 38 77 51 128 252 150 402 September 14 31 45 78 89 167 273 197 470 October 27 38 65 94 99 193 287 213 500 November 27 45 72 106 115 221 303 235 538 December 17 24 41 99 86 185 299 208 507 Totals 249 361 610 1,089 992 2,081 3,317 2,401 5,718 Detailed Analysis of all New Persons examined. Non-Insured. Totals Insured. Under 15 years. Over 15 years. M. F. M. F. M. F. Total new persons 147 102 115 116 52 78 610 Pulmonary Tuberculosis 56 20 19 20 115 Non-Pulmonary Tuberculosis 4 7 3 14 Suspects 9 6 5 4 1 4 29 Non-Tuberculous 78 76 103 109 32 54 452 64 Analysis of all Persons attending this Dispensary during 1925. Under 15 years. Over 15 years. Totals Ins. Non-Ins. Males 182 311 110 603 Females 187 184 188 559 Totals 369 495 298 1,162 Tuberculous. Males 25 195 64 284 Females 15 67 67 149 Totals 40 262 131 433 SPECIAL SESSION FOR SCHOOL CHILDREN. The number of attendances and examinations made each month are shown in the following table:— Attendances. Examinations. Attendances. Examinations. January 23 9 July 17 12 February 35 18 August 11 6 March 35 18 September 22 15 April 26 15 October 15 8 May 30 15 November 33 26 June 12 6 December 14 5 Total Attendances 273 Total Examinations 153 Total number of persons attending during the year 1925:— Insured 495 Non-insured 667 Total 1,162 65 Of Registered New Persons, including "Contacts," there were:— Insured 219 Non-insured 361 Total 610 In addition to the foregoing, the following information may also be given:— Total number of— Bacteriological examinations 687 X-Ray examinations 35 Examinations made and reports sent to the Local War Pensions Authority 540 Persons recommended to the London County Council for Institutional Treatment 236 Progress reports sent to the London County Council 161 Patients sent bv Doctors 130 Alfred Leitch, Tuberculosis Officer. 66 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Table VIII.—Summary of Notifications duking the Period from the 4th January, 1925, to the 2nd January, 1926, in the Metropolitan Borough of Shoreditch. Age-periods. Notifications on Form A. Notifications on Form b. Number of Notifications on Form C. Number of Primary Notifications. Number of Primary Notifications. 0 to 1. 1 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 25 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 and upwards. Total Primary Notifications. Total Notifications on Form A. Under 5 5 to 10. 10 to 15. Total Primary Notifications. Total Notifications on Form 13. Poor Law Institu- tions. Sanatoria. Pulmonary, Males ... ... 2 l 13 20 27 31 26 23 6 149 247 ... ... ... ... ... 67 112 „ Females ... l 6 8 15 10 21 14 10 8 1 94 150 ... ... ... ... ... 26 55 Non-pulmonary, Males 2 11 5 8 3 9 ... 1 ... ... ... 32 42 ... ... ... ... ... 8 20 ,, Females 1 9 8 2 5 2 ... ... 1 ... ... 28 36 ... ... ... ... ... 9 16 Cols. (1) (2) (3) (4) (5) (G) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) Patients notified as suffering from both pulmonary and non-pulmonary disease are included in the "pulmonary" returns. Primary Notifications relate to patients who have not previously been notified in this or former years, either on Form A or ' on Form B, in Shoreditch. A School Medical Inspector is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have been previously notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A, and which have never previously been notified in Shoreditch, either on Form A or on Form B, are included in these returns. Col. 14. All notifications on Form A, whether duplicate or not, are included in this column. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B, and which have never previously been notified in Shoreditch, either on Form A or on Form B, are included in these columns. Col. 19. All notifications which have been made during the year on Form B, whether the cases have previously been notified in the area or not, either on Form A or on Form B, are included in this column. Col. 21. Only notifications on Form C, made by the medical officers of sanatoria, as defined in the Tuberculosis Regulations, are included in this column. 67 TABLE IX. Summary compiled from the Abstracts of the work or the Sanitary Inspectors by the Senior Inspector. for the Year 1920. InspWright. Insp. Chapman. Insp. Sickelmore. Insp. Thomas. Insp. Shaw. Insp. Molloy. Insp. Bishop. Insp. Girling. Insp. Stratton I nsp. Grant. Insp. Walker Totals. Premises cleansed throughout 95 28 16 29 14 31 51 54 45 46 5 414 ,, ,, partially 160 299 196 297 198 271 352 197 261 263 259 2,753 ,, ,, total rooms 491 1100 552 851 518 865 905 532 915 675 942 8,346 verminous rooms 14 24 25 80 6 26 170 49 61 20 98 573 Premises generally repaired—Walls, floors, sashes, &c. 146 194 310 238 243 222 425 210 383 339 239 2,949 Light and ventilation improved 2 7 2 3 1 2 7 2 3 1 1 31 Roofs, guttering, rain water pipes improved or repaired 106 291 343 200 160 165 336 180 282 190 292 2,545 Overcrowding dealt with 1 1 2 9 5 4 7 9 2 5 13 58 Water reinstated or improved 3 18 3 2 1 4 1 4 5 12 53 Drains newly constructed 3 5 4 ... 3 10 3 4 3 6 1 42 ,, re-constructed 6 6 2 ... 6 4 9 2 4 13 3 55 ,, improved or repaired 14 15 32 17 13 13 43 13 12 13 25 210 ,, obstructions removed 26 36 36 24 28 26 29 13 35 12 24 289 Soil and vent pipes—Improved or repaired 6 ... 3 7 ... 1 15 4 2 1 2 41 Water closets—newly constructed 102 53 9 ... ... 12 4 21 12 7 19 239 „ improved or repaired 112 85 69 111 42 171 141 68 91 75 109 1,074 ,, obstructions removed 7 17 32 34 10 34 48 24 15 10 20 251 Sinks, etc., improved, cleansed or repaired 23 15 13 27 10 30 25 12 14 8 12 189 Sinks, etc., traps provided 6 1 4 12 3 2 5 2 1 5 41 Outdoor premises— Floors or paving repaired 10 26 32 33 17 44 69 10 49 27 24 341 Cleansed or limewashed 53 113 88 81 69 3 268 33 122 131 97 1,058 Improved or repaired ... ... ... ... 1 ... ... 13 1 ... ... 15 Ash-pits—Dust-bins provided 34 83 93 45 63 58 82 67 76 45 111 757 ,, Improved or repaired 2 ... 1 4 ... ... ... ... ... 2 1 10 ,, Abolished ... ... 1 ... ... ... 8 2 2 2 1 16 Accumulations removed 27 2 24 11 9 46 34 2 8 7 23 193 Urinals cleansed or repaired 5 ... ... ... 4 6 11 ... 1 26 1 54 Animals removed 4 1 ... 1 2 ... 1 2 ... 3 2 16 68 METROPOLITAN BOROUGH OF SHOREDITCH. HOUSING CONDITIONS. Statistics. Year ended 31st December, 1925. 1.—General. (1) Estimated population 107,300 (2) General death-rate 13.3 (3) Death-rate from tuberculosis 1.4 (4) Infantile mortality 88 (5) Number of dwelling-houses of all classes 14,000 (Estimated) (6) Number of working-class dwelling-houses 13,000 (Estimated) (7) Number of new working-class houses erected 59 2.—Unfit Dwelling-houses. I.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 9,701 (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 (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 II.—Remedy of Defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers III.—Action under Statutory Powers. A. Proceedings under Section 28 of the Housing, Town Planning, &c., Act, 1919. Nil. (1) Number of dwelling-houses in respect of which notices were served requiring repairs ... (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 69 B. Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 4,994 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 4,994 (b) by Local Authority in default of owners — C. Proceedings under Sections 17 and 18 of the Housing, Town Planning, &c., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders Nil. (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 dwellinghouses 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 3.—Unhealthy Areas. Areas represented to the Local Authority with a view to Improvement Schemes under (a), Part I, or (b). Part II, of the Act of 1890 :—- (1) Name of area Nil. (2) Acreage (3) Number of working-class houses in area (4) Number of working-class persons to be displaced 4.—Number of houses not complying with the building bye-laws erected with consent of Local Authority under Section 25 of the Housing, Town Planning, &c., Act, 1919 Nil. 5.—Staff engaged on housing work, with, briefly, the duties of each officer:— So much of the time of the Medical Officer of Health, Senior Inspector, eleven Sanitary Inspectors and five Clerks as may be necessary. The duties are as required under the various Acts relating to the Health and Housing. In addition, it may be mentioned that the services of the Borough Surveyor and his staff, together with those of one Superintendent, a Caretaker, an Assistant Caretaker, and eight workmen, with the necessary clerical assistance, are required in connection with some 394 dwellings for the working class, which are now the property of the Borough Council. 70 SUMMARY OF LEGAL PROCEEDINGS DURING 1925. PUBLIC HEALTH (LONDON) ACT, 1891, AND THE METROPOLITAN PAVING ACT, 1817. In six instances summonses were withdrawn on the work being done. Costs amounting to £2 14s. 6d. were allowed to the Borough Council. Nuisance orders were made in 11 instances, costs amounting to £8 18s. 6d. being ordered to be paid to the Council. In 24 instances the Statutory Notices were complied with before the cases came on for hearing, £17 0s. Od. being ordered to be paid to the Council. In six instances, for non-compliance with a Statutory Notice, the defendants were fined £8 10s. 6d. and ordered to pay £5 5s. costs. In one instance, for non-compliance with the Magistrate's order, the defendant was fined £1 10s. Od. and ordered to pay 10s. 6d. costs. In one instance, for being in possession of unsound food deposited for the purpose of preparation for sale, the vendor was fined £2 and ordered to pay £2 2s. Od. costs. BREACHES OF LONDON COUNTY COUNCIL BYE-LAWS. In one instance the defendant was fined £5 and ordered to pay £2 2s. Od. costs to the Borough Council, in two instances the defendants were fined £2 and 7s. 6d. respectively; in four instances the defendants were ordered to pay £2 2s. Od., 10s. 6d. 10s. Od. and 4s. Od. respectively; in one, the case was dismissed under the Probation, of Offenders Act, and one case was dismissed. METROPOLITAN PAVING ACT, 1817, SECTION 65. One defendant was fined 5s. Od. for refusal to remove his stall from the public highway. 71 METROPOLITAN BOROUGH OF SHOREDITCH. MATERNITY AND CHILD WELFARE. Summary of Work for the Year 1925 by Dr. Maitland Radford. Health Visitors' Districts. 1. 2. 3. 4. 5. 6. 7. Total. No. of 1st visits to infants 298 311 281 406 400 257 540 2,493 No. of re-visits to infants 650 725 479 630 652 674 1,404 5,214 No. of 1st visits to children aged 1 to 5 years (irrespective of whether visited previously as an infant) 121 179 167 195 190 356 803 2,011 No. of re-visits to children aged 1 to 5 years 894 945 587 1,217 1,058 536 2,077 7,314 No. of 1st visits to expectant mothers 51 66 42 70 102 45 188 564 No. of re-visits to expectant mothers 30 90 50 48 66 16 157 463 No. of futile visits 210 165 111 196 185 312 681 1,860 No. of interviews in connection with work 226 167 337 353 96 120 834 2,133 No. of 1st visits to infants with diarrhœa ... ... ... ... ... 1 ... 1 *No. of 1st visits to cases of ophthalmia neonatorum 4 8 2 11 9 4 38 *No. of re-visits to cases of ophthalmia neonatorum ... 11 3 11 16 4 ... 45 No. of 1st vists to cases of puerperal fever 4 3 ... ... ... 1 ... 8 No. of re-visits to cases of puerperal fever ... 6 ... 2 ... ... ... 8 No. of Health Visitors' attendances at Clinics: (a) Town Hall Centre 33 ... ... 12 24 36 ... 105 (b) Hoxton Hall Centre 8 ... 38 50 2 11 ... 109 (c) Maternity Centre 107 166 120 129 124 96 ... 742 (d) Harbour Lights Centre 37 42 46 ... 22 ... 1 148 (e) School for Mothers Centre ... ... ... ... ... ... 323 323 * These visits are also included above. 72 NUMBER OF FIRST ATTENDANCES OF INFANTS AND CHILDREN AT WELFARE CLINICS. Health Visitors' Districts. 1. 2. 3. 4. 5. 6. 7. Total. (a) Town Hall: (Mon.) under 1 yr. 24 ... ... ... ... 109 ... 133 over 1 yr. 8 ... ... ... ... 46 ... 54 (b) Hoxton Hall: (Tues.) under 1 yr. ... ... ... 138 ... ... ... 138 over 1 yr. ... ... ... 24 ... ... ... 24 (c) Maternity Centre: (Mon.) under 1 yr. ... 133 ... ... ... ... ... 133 over 1 yr. ... 84 ... ... ... ... ... 84 (Tues.) under 1 yr. 52 91 ... ... ... ... ... 143 over 1 yr. 25 36 ... ... ... ... ... 61 (Wed.) under 1 yr. ... ... 80 9 ... ... ... 89 over 1 yr. ... ... 28 3 ... ... ... 31 (Thur.) under 1 yr. ... ... ... ... 177 ... ... 177 over 1 yr. ... ... ... ... 73 ... ... 73 (Fri.) under 1 yr. 27 ... ... 92 ... 59 ... 178 over 1 yr. 10 ... ... 12 ... 12 ... 34 (d) Harbour Lights: (Fri.) under 1 yr. 38 ... 83 ... 5 ... ... 126 over 1 yr. 23 ... 27 ... 4 ... ... 54 (e) School for Mothers: (Tues.) under 1 yr. ... ... ... ... ... ... 182 182 over 1 yr. ... ... ... ... ... ... 51 51 (Thur.) under 1 yr. ... ... ... ... ... ... 215 215 over 1 yr. ... ... ... ... ... ... 71 71 73 TOTAL ATTENDANCES OF INFANTS AND CHILDREN AT WELFARE CLINICS. Health Visitors' Districts. 1. 2. 3. 4. 5. 6. 7. Total (a) Town Hall: (Mon.) Infants 213 ... ... ... ... 763 ... 976 Children 112 ... ... ... ... 587 ... 699 Mothers without children 101 ... ... ... ... 260 ... 361 (b) Hoxton Hall: (Tues.) Infants ... 113 ... 1,832 ... ... ... 1,945 Children ... 31 ... 975 ... ... ... 1,606 Mothers without children ... 35 ... 463 ... ... ... 498 (c) Maternity Centre: (Mon.) Infants ... 1,466 ... ... ... ... ... 1,466 Children ... 607 ... ... ... ... ... 607 Mothers without children ... 446 ... ... ... ... ... 446 (Tues.) Infants 691 1,032 ... ... ... ... ... 1,723 Children 413 338 ... ... ... ... ... 751 Mothers without children 362 316 ... ... ... ... ... 678 (Wed.) Infants ... ... 1,478 133 ... ... ... 1,611 Children ... ... 505 38 ... ... ... 543 Mothers without children ... ... 475 15 ... ... ... 490 (Thur.) Infants ... ... ... ... 1,855 ... ... 1,855 Children ... ... ... ... 682 ... ... 682 Mothers without children ... ... ... ... 520 ... ... 520 (Fri.) Infants 185 ... ... 772 ... 504 ... 1,461 Children 64 ... ... 656 ... 158 ... 878 Mothers without children 26 ... ... 206 ... 115 ... 347 74 TOTAL ATTENDANCES OF INFANTS AND CHILDREN AT WELFARE CLINICS—Continued Health Visitor's Districts. 1. 2 3. 4. 5. 6. 7. Total. Harbour Lights : (Fri.) Infants 613 ... 1,443 ... 89 ... ... 2,175 Children 394 ... 472 ... 47 ... ... 913 Mothers without children 468 ... 582 ... 63 ... ... 1,113 School for Mothers: (Tues.) Infants ... ... ... ... ... ... 1,626 1,626 Children ... ... ... ... ... ... 859 859 Mothers without children ... ... ... ... ... ... 49 49 (Thur.) Infants ... ... ... ... ... ... 1,986 1,986 Children ... ... ... ... ... ... 1,042 1,042 Mothers without children ... ... ... ... ... ... 97 97 75 CHILD WELFARE CONSULTATIONS. Health Visitors' District No. Infants seen by Doctor. Children (1-5 yrs.) seen by Doctor. Maternity Centre. Dr. Richards (Mon.) For 1st time. Total No. For 1st time. Total No. 1 9 57 3 13 2 117 669 48 316 Dr. Hodgson (Tue.) 1 64 371 27 137 2 71 502 29 181 Dr. Richards (Wed.) 3 84 787 40 289 Dr. Radford (Thu.) 5 117 764 86 210 Dr. Smith (Fri.) 1 21 150 6 47 4 78 835 21 317 6 58 414 9 117 Town Hall. Dr. Radford (Mon.) 1 29 129 10 49 6 104 424 38 181 Hoxton Hall. Dr. Radford (Tue.) 4 132 662 20 210 Harbour Lights. Dr. Radford (Fri.) 1 0 12 0 2 3 110 639 41 191 5 1 6 0 9 Dr. Hodgson (Fri.) 1 41 343 23 86 5 2 14 2 11 School for Mothers. Dr. Pratt (Tue.) 7 180 1,116 51 649 Dr. Pratt (Thu.) 7 217 1,343 75 822 MODEL WELFARE CENTRE. The following is a statistical Summary relating to Infants admitted to the Municipal Model Welfare Centre, 210, Kingsland Road, for the year 1925 :— (1) Number of cases in the wards on 1st January, 1925 : 10 babies and 2 mothers. (2) Number of cases admitted : 55 babies and 7 mothers. 76 (3) Average duration of stay : 6 weeks. (4) Reasons for admission and the number of cases under certain specified heads :— Marasmus 21 Rickets 4 Vomiting 5 Dyspepsia 12 Enteritis 1 To establish breast feeding (mother and baby) 7 Prematurity 5 (5) Number of cases discharged during the year:— (a) In good health 20 (b) Improved 19 (6) There was one case of acute diarrhoea which was transferred to one of the Metropolitan Asylums Board's Hospitals. (7) Number of deaths : 10, particulars as under :— Date of death. Cause of death. Period of residence. 29/ 4/ 25 Debility, status 1ymphaticus... 1 month, 9 days. 31/5/25 Gastric irritability ; Acute enteritis 25 days. 13/6/ 25 Debility, Heart failure 7 days. 18/6/25 Prematurity 28 days. 19/6/ 25 Prematurity 1 day. 8/7/25 Bronchitis ; Broncho pneumonia 23 days. 28/7/25 Enteritis 23 days. 13/8/25 Enteritis ; Broncho pneumonia 14 days. 4/11/ 25 Marasmus ; Broncho pneumonia 12 days. 14/11/25 Marasmus ; Enteritis 3½ months. (8) The discharges on account of illness, infectious or otherwise, were as follows:— Two for light treatment. Result : good in one case ; second, child readmitted ; died, 29/4/25. Two were transferred to other institutions for empyema, but the diagnosis was not confirmed. Two cases of acute enteritis were transferred, one to the South-Western Hospital, M.A.B., and one to the Mildmay Hospital. 77 NURSING LIST. Subjoined is a list of cases nursed for the Shoreditch Borough Council by the Shoreditch and Bethnal Green District Nursing Association during the year 1925. Disease Under 5. Visits. Disease. Over 5. Visits. Whooping cough 6 57 Pneumonia 30 464 Measles 24 407 Miscarriage 22 287 Ophthalmia Mammary Abscess 4 95 Neonatorum 6 144 Post-Partum 30 539 Otorrhoea 14 257 Influenza 11 118 Threadworms 76 566 Parturition 1 6 Tonsils & Adenoids 91 364 Measles 2 19 Pneumonia 35 428 Ante-natal 2 21 Pyrexia 5 65 Abortion 2 19 Bronchitis 5 69 Tubercular glands 1 7 Abscess 2 10 Sickness 1 7 Tapeworm 1 3 Hypospadias 1 6 Burns 1 27 Septic nose 1 3 Corneal ulcer 2 60 Impetigo 2 20 Marasmus 2 16 Scabies 1 12 Mastoid Abscess 1 22 Tuberculous hip 1 12 Discharge from eyes 2 22 Intestinal 1 2 Septic throat 3 13 Ulcerated mouth 2 10 Tonsillitis 1 4 Stomatitis 1 11 Ophthalmia 2 32 Strabismus 1 11 Total 291 cases 2,667 visits Total 104 cases 1,568 visits The total number of cases at all ages was 395, in connection with which 4,235 visits were made by the Nurses of the Association. Amongst persons over five years there were one death from Influenza and four from pneumonia, and amongst the children under five, three died from pneumonia, one from bronchitis and one from marasmus.