AC4379 80445 Borough of Southwark ANNUAL REPORT (Medical Officer of health YEAR 192 3. Horace Wilson. M.D., B.S.Lond., D.P.H., L.R.C.P., M.R.C.S., Medical Officer of Health. Administrative Tuberculosis Officer, Administrative Officer for Maternity and T CORNELL & SONS, General Printers, 62 and 63, Borough Road, S.E.I. of the for the Child Welfare. LONDON : Borough of Southwark ANNUAL REPORT of the (Medical Officer of health for the YEAR 1 9 2 3. Horace Wilson, M.D., B.S.Lond., D.P.H., L.R.C.P., M.R.C.S., Medical Officer of Health. Administrative Tuberculosis Officer, Administrative Officer for Maternity and Child Welfare. LONDON : t CORNELL & sons, General Printers, 62 and 63, Borough Road, s.E.I. TABLE OF CONTENTS. page. Poblic Health Staff (a Moiety of whose salary is contributed by the Ministry of Health) 3 General Statistics 4 Population of Borough 5 Ward distributionand persons per acre 6 Births 6 Birth-rates for the last thirty years for the three divisions of the Borough 7 Births, Birth-rates, Infantile Mortality and Zymotic rates in the Wards 8 Deaths 9 Number registered 9 In outlying districts 9 Death-rates for the last thirty years for the three divisions of the Borough 10 Death-rates in the several wards for the last fifteen years 11 Deaths in public institutions in the Borough 12 Births and deaths registered in the sub-districts 13-14 Deaths from the various classes of disease in Sanitary Area for 1923 15-19 Deaths from all causes in Sanitary Area for ten years, 1914-23 20-23 Principal causes of and ages at death during 1923 24-25 Deaths of infants under one year of age during the last 29 years 26 Infantile Mortality (under 1 year) for the Borough 27 Vital statistics for separate localities (wards) 28-29 Cases of infectious diseases notified with ages and number removed, in wards 30 Deaths from principal zymotic diseases in the wards 31 Cases of infectious diseases notified weekly 32-33 Deaths in the several wards with the ages and death-rate in each ward 34 Births, Deaths and Infantile Mortality in London during 1923 35 Pulmonary Tuberculosis—Deaths (a) in own homes (b) in Hospitals 36 Public Health (Tuberculosis) Regulations, 1912, Summary of Notifications 37 Zymotic mortality, showing the localities where the deaths occurred 38 Scarlet fever—Cases notified, &c 39 Diphtheria—Cases notified, &c.39-40 Enteric fever—Cases notified, &c.40-41 Measles—Cases notified, &c.41 PAGE Diarrhæa—Cases notified,&c.42 Whooping cough 42 Influenza and Ophthalmia Neonatorum 42-43 Cerebro-Spinal Fever, Encephalitis Lethargica, Polio-Myelitis, and Encephalitis 13 Acute Primary and Influenzal Pneumonia 43 Health Work and Notification of Births Act 44 Number of visits made by Health Visitors 44 Maternity and Child Welfare Centres—Statistics for 1923 45-49 Nursing 50 Diphtheria Anti-Toxin 50 Laboratory Work 50 Municipal Nursery 50 Reception House: return of families accommodated 51-52 Disinfection After Infectious Disease 53-54 After Phthisis 53 Particulars in connection with Phthisis. 54 Cleansing of Verminous and Scabious Persons and Children 55-57 Verminous rooms and contents cleansed by Council and owners 58 Verminous bedding, &c., treated 59 Mortuaries 60 House to house inspection 61-62 Rats and Mice (Destruction) Act 63 Houses let in lodgings—Number added to and removed from Register in 1923 64 Sanitary works carried out, Visits made, &c.65-66 Ice Creams, Number of inspections of premises 67 Eating Houses, Number of inspections, &c.68 Inspections of wharves, markets, &c.69 Examination of food 70-84 Customs and Inland Revenue Act 85 Housing, Town Planning, &c., 1909 85 Water Certificates granted under Section 48 85 Water Supply in tenemented houses : Additional supplies provided 85 Housing Conditions—Statistics for the year 1923 86-87 Page. Black Smoke Nuisances—Obaervations made, &c.88 Factories and workshops 89 Home Work—Outworkers 90 Begiatered Workshops, &c. 91 Proceedings taken under the Public Health and other Acts 92-97 Summary of inspections and reinspections in wards for 1923 98-99 Summary of sanitary works completed during 1923 in wards 100-101 Ditto ditto ditto and 14 preceding years 102-103 Summary of inspections and reinspections during 1923and 15 preceding years 104 Milk and Dairiea (Amendment) Act, 1922 105-106 Milksellers 107 NoxiousTrades 107 Cowsheds 108 Bakehouses108 Butter and Margarine Factories and Stores 109 Slaughterhouses 109 Food and Drugs Acts, Number of "official" samples taken in wards 109 Summonses taken out and results 110 Informal samples taken and results of analyses 111 Public Health (Milk and Cream) Regulations 1ll Table giving number and description of samples with adulteration 112-113 Particulars of proceedings taken under the Sal# of Food and Drugs Acts 114-115 Appendix: Report of the Tuberculosis Officer 118-123 BOROUGH OF SOUTHWARK. Public Health Department, Town Hall, Walworth Eoad, S.E. Dear Sir, Ladies and Gentlemen, I beg to submit the Annual Report of the Borough of Southwark for the year 1923 dealing with the sanitary conditions and vital statistics of the Borough. The year was marked by the loss of the services of Dr. Millson who had served the Borough and its predecessors for the past thirty-five years with great ability and success. In July I was appointed as acting Medical Officer of Health, and permanently appointed by the Council, and the appointment sanctioned by the Ministry of Health in December. The Birth Rate for the Borough was 24.3 as against 24 4 for 1922, the Death Rate was 12.8 as against 15.5 in 1922. The infantile mortality rate has again considerably decreased from 79 in 1922, to 68 for the present year. During 1923 the department has also lost through death the services of Mr. R. H. Goodfellow, Sanitary Inspector for Christchurch and St. Saviour's Wards, who had been in the service of the Council for 21 years, and Miss Elliott who for 271/2 years had acted with energy and zeal as Lady Sanitary Inspector, was also compelled to retire through ill-health. At the time of going to press these vacancies have not been filled. The general health of the Borough has been good on the whole, although Measles was prevalent in a mild form during the latter part of the year, and owing to the low-lying nature of the laud and the proximity of the river there is a very heavy incidence and mortality from bronchial and chest troubles. During the small pox epidemic a number of cases were visited on request of practitioners by the Medical Officer including cases in Guy's and the Evelina Hospitals, but in each case the rash was found to be due, to chicken pox or to some other skin disease. The services of Dr. Wanklyn of the London County Council were enlisted in three cases presenting special difficulties in diagnosis. 2 Owing to the appointment of myself as acting Medical Officer of Health the Tuberculosis Dispensary service has been in charge of Dr. K. Hamilton who has carried on the work very successfully and with great benefit to the patients. A full report of this department is included as an appendix. Other noteworthy events during the year were the carrying out with increased vigour of the Eats and Mice (Destruction) Act 1919, and the working of the Milk and Dairies (Amendment) Act 1922, and orders made thereunder. The work of supervising of Houses let in Lodgings has been only partially carried out pending the issue of the expected new bye-laws which may affect the conditions of registration. The Dental Clinic was discontinued during the year as it was considered unnecessary and to involve too great expense. The Maternity and Child Welfare scheme has continued to do excellent work which is fully justified by the results in the general condition and appearance of the children and the greater interest taken in their progress on the part of their mothers. Statistics as to this work are set out on pages 48-49. I also append tables of other statistics with comments on the chief matters connected therewith. I have the honour to be, Your obedient servant, HORACE WILSON, Medical Officer of Health. * To the Mayor, Aldermen and Councillors, of the Borough of Southwark. 3 PUBLIC HEALTH OFFICERS TO WHOSE SALARY CONTRIBUTION IS MADE. Horace Wilson, M.D., B.S., M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health. Arabella C. Kirker, M.B., B.Ch., B.A.O., Assistant Medical Officer of Health, Maternity and Child Welfare. Sanitary Inspectors. * || J. Weatheritt (Senior Inspector). ‡ || G. Fisher (Food Inspector). ‡ || J. C. Nicholson (Food & Drugs Inspector. ‡ || J. A. Syms. ‡ || T. Bradshaw. || W. H. Banham. ‡ || D. H. Pickard. || J. R. Findley. || H. S. Steele. || F. Jenkinson. || F. Mayhew. ‡ || S. Bowers. || Margaret Burrows (Houses Let in Lodgings). || Cert. Sanitary Inspector. ‡ Meat and other Foods. * Cert. Surveyor. Health Visitors. † * || Jane Holland (Superintendent). † * || Hilda Johnson. * Lilian Hartley. || ‡ Annie Rogers, † * || Clare Cottrill. || Winifred Sayer. * || Florence Adair. * || Mary Freeth. † || Mary George. * || Annie Kingsmill. || Cert. Health Visitor. ‡ Cert. Sanitary Inspector * C.M.B. † Nursing. Part Time Officers. Dorothy Shepherd, M.B., Ch.B., Maternity and Child Welfare Clinic. 4 1.—GENERAL STATISTICS, 1923. Estimated population (1923) 187,464 Area (acres) 1,131 Number of inhabited houses (1923) 20,312 Number of families or separate occupiers (Census) 46,727 Eateable value £1,251,096 Sum represented by penny rate £5,120 2 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Births—Legitimate 4,376 Illegitimate 182 Total 4,558 Birth Rate, 24 3. Deaths 2,391 Death Rate, 12 8. Number of women dying in, or in consequeuce of childbirth — From sepsis 2 Other causes 7 Deaths of infants under 1 year of age per 1,000 births, 68. Legitimate 294 Illegitimate 18 Total 312 Deaths from Measles (all ages) 13 Do. Whooping Cough (all ages) 27 Do. Diarrhæa under 2 years of age 54 5 POPULATION The estimated population for 1923, as supplied by the RegistrarGeneral is 187,464 and all the rates in my report have been calculated on that figure. Overcrowding is still one of the outstanding features of of the Borough, a state of things which has existed more or less since the war. The greatest difficulty encountered in lessening this is the shortage of houses for the people. In some instances we have been able to lessen the congestion but it is universal throughout the district, and without providing additional accommodation very little can be done. New Bye-laws for the registration of Houses Let in Lodgings have been for some time under consideration by the London County Council. Our own Byelaws have to a great extent become obsolete owing to the increase of rents since the war. These new Byelaws may have the effect of abating a large amount of overcrowding by fixing the number of persons who may occupy a bouse or part of a house which is let in lodgings or occupied by members of more than one family. The population of the several divisions of the Borough at each Census since 1841, and also the estimated population for 1922 and 1923 are as follows:— Newington. St. George's. St. Saviour's and Christchureh. 1841 54,693 — — 1851 64,816 51,824 35,731 1861 82,157 55,510 36,169 1871 88,691 56,083 31,294 1881 107,831 58,652 31,628 1891 115,663 59,740 27,116 1901 121,863 60,998 23,319 1911 116,819 55,782 19,316 1921 114,987 52,114 17,303 1922 116,683 52,996 17,541 1923 117,200 52,690 17,574 6 The Ward distribution was as follows :— TABLE 1. Ward. Area in Acres Population. Persons to the Acre. Males. Females. Total. St. Mary 127 11,316 11,618 22,934 181 St. Paul 133 9,312 10,117 19,429 146 St. Peter 90 8,437 9,021 17,458 194 St. John 85 9,330 9,984 19,314 227 Trinity 109 8,135 8,274 16,409 151 All Saints 89 10,452 11,204 21,656 243 St. Michael 93 10,273 10,410 20,683 222 St. Jude 97 6,498 7,441 13,939 144 St. George 98 8,784 9,284 18,068 184 Christchurch 77 4,288 4,113 8,401 109 St. Saviour 133 4,207 4,966 9,173 69 Whole Borough 1,131 91,032 96,432 187,464 166 BIRTHS. The number of Births registered in the Borough during 1923 was 3,920, of which 2,073 were males, and 1,847 females. This represents a birth rate of 20.9 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:-Newington, 2,425; St. George the Martyr, 1,058; Christchurch and St. Saviour's, 437. Of the 3,920 births registered in the Borough 88 were transferred away, the permanent residence of the parents being outside the Borough. 726 births occurring in various lying-in and other institutions outside the Borough, but belonging to Southwark parents, were notified to me by the Registrar-General. When the 88 "outward " transfers are deducted 7 and the 726 "inward" transfers are added to the 3,920 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 4,558. This gives a corrected birth-rate of 24.3. Birth-rate for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's St. Saviour's and Christchurch. Whole Borough. 1894 35.4 34.6 28.9 — 1895 35.4 36.5 32.4 — 1896 35.2 36.9 30.9 — 1897 34.7 35.1 30.9 — 1898 33.8 35.5 30.2 — 1899 33.6 35.2 28.7 — 1900 33.3 34.6 29.8 — 1901 33.8 33. 6 30.0 33. 3 1902 34.4 32.7 29.3 33.3 1903 33.3 31.3 30.0 32.3 1904 32.3 31.2 27.6 31.5 1905 30.3 30.6 26.2 30.0 1906 29.0 30.5 25.2 29.1 1907 29.1 29.2 25.1 28.7 1908 28.7 28.6 23.2 28.1 1909 27.7 27.5 23.0 28.3 1910 28.2 28.1 24.3 27.8 1911 29.0 31.7 27.9 29.6 1912 29.0 30.7 28.0 29.4 1913 31.8 32.7 26.0 31.5 1914 29.7 31.4 25.5 29.7 1915 28.8 30.2 29.2 29.2 1916 28.4 27.1 24.4 27.6 1917 25.2 24.8 20.2 24.6 1918 21.8 21.0 18.4 21.3 1919 24.1 23.6 16. 8 23.2 1920 32.1 32.2 28.5 31.8 1921 27.7 28.7 21.3 27.3 1922 24.0 25.5 24.3 24.4 1923 23.9 25.4 23.7 24.3 8 TABLE 2. Number of Births belonging to each Ward, with the Birth-rates, also the Infantile Mortality and Zymotic Rate in the several wards for 1923. WARD. Births. Infantile Mortality. Zymotic Rates in the Wards. Males. Females. Total. Birth-rate. Cerebro Spinal Fever. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhæa. Phthisis. Influenza. Chioken Pox. E cephalitis Lethargica St. Mary 296 228 524 22.8 78 _ 0.04 0.22 0.09 0.31 1.74 0.09 St. Paul 214 194 408 21.0 56 0.05 — — 0.26 0.05 — 0.21 1.29 0.05 St. Peter 201 174 375 21.5 48 — 0.06 — 0.34 0.06 — — 0.80 — 0.06 St. John 277 236 513 26.6 72 — 0.05 0.05 0.36 0.21 — 0.52 0.99 0.21 0.05 Trinity 241 208 449 27.4 69 0.12 0.06 0.06 0.24 0.24 — 0.61 1.16 0.30 — — All Saints 283 251 534 24.7 60 — 0.05 — 0.28 0.14 — 0.14 1.06 0.05 — — St. Michael 263 259 522 25.2 90 — 0.10 — 0.15 0.19 — 0.29 1.45 0.24 0.05 0.05 St. Jude 168 173 341 24.5 67 — 0.22 — 0.29 0.14 — 0.43 1.22 0.07 St. George 255 221 476 26.3 76 — 0.17 — 0.44 0.33 0.11 0.61 1.05 0.39 — 0.06 Christchurch. 118 99 217 25.8 65 0.12 — 0.06 — — — 0.48 1.43 — — — St. Saviour 106 93 199 21.7 50 — — 0.12 0.11 — — — 1.42 — — 0.11 Borough 2,422 2,136 4,558 24.3 68 0.02 0.07 0.02 0.26 0.14 — 0.33 1.23 0.13 — 0.03 9 DEATHS. 1,792 deaths were registered in the sub-districts of the Borough during 1923. 20 of these deaths were of persons residing in other sanitary districts, but who died in our streets or on the way to hospitals. 835 deaths occurred in the Poor-Law Institutions, the various hospitals, and other public places for the treatment of the sick, found within our boundaries. These deaths in institutions comprised 384 belonging to Southwark and 451 to other sanitary districts. The number of inhabitants belonging to the Borough dying away from home—that is outside our boundaries in the various hospitals and infirmaries—was 1,070. When the 471 deaths of those persons who were non-parishioners, but who died in our Borough, have been deducted, and the 1,070 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 2,391 of which number 1,304 were males and 1,087 females. The death-rate when calculated on this "corrected" number is 12.8 per 1,000 inhabitants for the whole Borough for the year 1923, as against a rate of 15.5 for 1922. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 44.8. The principal localities in which the "outlying" deaths occurred are as follows :— Southwark Hospital 604 Mental Hospitals 98 Metropolitan Asylums Board Hospitals 64 St. Thomas's Hospital 56 Lambeth Hospital 27 Belgrave Hospital 17 King's College Hospital 15 Royal Waterloo Hospital 11 In the Street and other Institutions 178 Total 1070 10 TABLE 3. Death Rates for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's Christcburch and St. Saviour's. Whole Borough 1894 19.9 23.1 21.0 — 1895 24.0 25.4 26.5 — 1896 20.5 24.0 22.8 — 1897 21.2 23.7 24.6 — 1898 20.5 24.4 23.6 — 1899 24.0 27.7 25.1 — 1900 21.9 27.3 25.2 — 1901 20.8 22.1 22.0 21.4 1902 20.4 24.0 22.5 21.7 1903 17.6 18'6 18.6 18.1 1904 19.0 21.4 21.6 20.0 1905 17. 9 19.2 18.7 18.5 190(! 17.8 18.5 17.5 18.0 1907 17.6 19.3 16.4 18.0 1908 16.1 17.2 14.3 16.3 1909 15.8 18.6 16.6 16.7 1910 15.9 15.6 16.5 15.9 1911 17.3 19.7 21.1 18.4 1912 15.8 18.5 17.4 16.8 1913 16. 5 20.0 20.2 17.9 1914 16.5 19.6 20. 7 17.8 1915 19.3 23.4 22.0 20.8 1916 16.5 18.4 17.3 17.1 1917 17.9 19.5 17.9 18.3 1918 22.9 23.7 23.1 23.2 1919 14.6 16.1 15.5 15.1 1920 14.4 14.6 12.9 14.4 1921 14.3 14.6 13.1 14.3 1922 15.2 16. 1 15.4 15.5 1923 12.2 13.6 13.7 12.8 11 table 4. Death Bates for the various Wards for the last Fifteen Years. ward. 1909. 1910. 1911. 1912. 1913. 1914. 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. St. Mary 15.1 14.8 16.9 14.5 15.4 15.3 18.1 17.4 18.6 25.1 15.7 16.4 15.0 16.0 14.6 St. Paul 13.7 14.4 13.9 15.7 14.2 15.5 19.9 15.7 17.2 22.0 14.5 12.9 14.9 15.6 12.3 St. Peter 14.4 15.3 14.5 14.9 15.5 14.2 16.4 14.0 17.4 21.7 11.3 13.1 11.4 13.8 10.0 St. John 15.2 16.7 16. 9 17.6 15.9 16.7 18.7 17.0 18.0 21.0 14.0 14.2 14.3 16.5 12.8 Trinity 17.2 17.0 19.1 18.1 20.5 19.6 21.0 17.5 17.8 26.1 17.3 14.5 14.6 16.9 131 All Saints 18.6 17.2 23.0 14.6 18.4 18.0 22.1 17.4 16.6 21.8 15. 0 15.2 15.4 12.8 10.4 St. Michael 17.5 15.3 19.5 16.6 20.7 20.1 24.1 19.1 19.1 23.1 15.4 14.4 15.7 17.4 14.2 St. Jude 17.8 13.6 17.9 19.8 18.4 17.8 23.0 17.7 20.0 24.9 18.0 15.8 14.0 15.3 14.3 St. George 20.0 17.3 21.2 19.9 20.3 20.3 23.0 17.9 19.8 23.7 15.7 14.1 13.8 15.1 12.4 Christchurch 17.5 17.8 25.0 22.0 23.7 21.1 25.6 19.7 20.8 25.1 16.9 14.5 14.4 17.9 16.0 St. Saviour 15.7 15.2 17.4 13.0 16.8 20.2 18.5 15.2 15.2 21.1 14.1 11.3 11.9 13.0 11.7 12 TABLE 5. Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1923. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter In 4th Quarter. During Year. Newington Institution 90 51 35 59 235 Christchurch Institution — — — 2 2 Evelina Hospital 19 4 20 21 64 Guy's Hospital 134 132 122 124 512 Bethlem Hospital 4 5 4 6 19 60, Lambeth Road (Catholic Nursing Home) 1 - 1 1 3 Total 248 192 182 213 835 81 ♦ TABLE 6. Births and Deaths Registered in the Sub-Districts of the Borongh in 1923, with Ages at Death. For the First Quarter of thirteen weeks ending 31st March. Sub-Districts. Births. Deaths. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Male. Female. Male. Female. Newington, North 152 113 34 36 14 3 — — 2 3 1 7 7 11 13 8 1 Newington, South 202 190 93 99 15 4 1 — 2 2 6 8 16 23 58 40 17 St. George the Martyr, West 147 132 69 45 22 20 4 1 1 1 5 4 13 18 13 10 2 Christchurch and St. Saviour 63 56 90 72 22 6 8 2 7 8 10 25 15 32 22 5 — Totals 564 491 286 252 73 33 13 3 12 14 22 44 51 84 106 63 20 For the Second Quarter of thirteen weeks ending 30th June. Newington, North 145 130 27 28 10 6 — 2 1 2 1 4 4 5 11 7 2 Newington, South 207 178 58 60 8 4 — 1 — 1 4 5 10 16 28 28 13 St. George the Martyr, West 133 138 38 35 11 7 1 1 3 1 4 6 8 12 14 5 — Christchurch and St. Saviour 57 54 93 60 16 10 4 7 6 4 18 17 21 30 14 5 2 Totals 542 500 216 183 45 27 5 11 9 8 27 32 43 63 67 45 17 14 TABLE 6.—(contd.) Fop the Third Quarter of thirteen weeks ending 29th September. Sub-Districts. Births. Deaths. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Male. Female. Male. Female. Newington, North 133 114 22 21 10 4 1 — — — — 5 4 6 6 5 2 Newington, South 177 164 58 51 14 3 1 — 1 3 4 7 10 14 23 23 6 St. George the Martyr, West 144 131 39 40 27 7 1 1 1 1 2 5 9 10 8 7 — Christchurch and St. Saviour 67 54 84 62 14 8 2 3 7 10 13 18 19 31 13 8 — Totals 521 463 203 174 65 22 5 4 9 14 19 35 42 61 50 43 8 For the Fourth Quarter of thirteen weeks ending 29th December, 1923. Newington, North 109 117 29 31 10 7 — — — 3 5 6 6 5 10 7 1 Newington, South 169 125 89 79 22 2 1 — — 2 5 10 15 33 38 34 6 St. George the Martyr, West 119 114 55 51 19 15 3 — 2 1 4 5 15 11 17 12 2 Christchurch and St. Saviour 49 37 93 51 11 10 2 8 6 6 11 15 22 26 20 7 — Total 446 393 266 212 62 34 6 8 8 12 25 36 58 75 85 60 9 In 1st Quarter 564 491 286 252 73 33 13 3 12 14 22 44 51 84 106 63 20 In 2nd Quarter 542 500 216 183 45 27 5 11 9 8 27 32 43 63 67 45 17 In 3rd Quarter 521 463 203 174 65 22 5 4 9 14 19 35 42 61 50 43 8 In 4th Quarter 446 393 266 212 62 34 6 8 8 12 25 36 58 75 85 60 9 Total 2073 1847 971 821 245 116 29 26 38 48 93 147 194 283 308 211 54 15 TABLE 7. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1923. Causes of Death. AGES. All Ages 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- M. F. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (a) Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (h) Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (c) No statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 2 4 7 ... ... ... ... ... ... ... ... ... ... ... 5 8 Scarlet. Fever ... 1 3 ... ... ... ... ... ... ... ... ... ... ... 1 3 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza ... ... ... ... 1 1 ... 1 4 1 7 4 3 1 13 12 Whooping Cough 10 11 6 ... ... ... ... ... ... ... ... ... ... ... 17 10 Diphtheria, Membranous Croup 3 6 18 17 3 1 1 ... ... ... ... ... ... ... 18 31 Enteric Fever ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 1 Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhæa, Dysentery 13 3 ... ... ... ... ... ... ... ... ... ... ... ... 10 6 Epidemic or Zymotic Enteritis 28 4 ... ... ... ... 1 ... ... ... ... ... ... ... 24 9 Epidemic Cerebro - Spinal Fever 3 ... ... 1 ... ... ... ... ... ... ... ... ... ... 3 1 Polio Myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken Fox ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Rotheln ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Parotitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Vincent's Angina ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Goitre ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Trench Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica ... 1 ... ... ... 1 1 1 1 1 ... ... ... ... 1 5 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders, Farcy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tetanus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax, Splenic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cowpox, Accidents of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis 4 ... ... ... ... ... ... l ... 1 ... ... ... ... 3 3 Gonorrhæa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phagtedena ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... l ... ... 1 2 ... ... ... 3 1 Pyaemia, Septicaemia ... 1 ... ... ... ... ... l ... ... ... ... 1 ... 2 1 Puerperal Fever ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 Infective Endocarditis ... ... ... 1 1 ... 2 2 2 ... 1 ... ... ... 7 3 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Boils ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cellulitis 1 ... ... ... ... 1 ... ... ... 2 ... ... 1 ... 3 2 Mastoiditis ... ... 1 ... 1 ... ... 2 ... 1 ... ... ... ... 3 2 Tonsillitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malarial Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatic Fever, Rheumatism of Heart ... ... l 3 1 ... 1 1 2 ... 2 1 1 ... 5 8 16 TABLE 7.—Continued. Causes of Death. AGES. All Ages 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- M. F. Tuberculosis, total ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tubercular Disease of Brain or Meninges, Acute Hydrocephalus 1 10 5 5 ... ... 1 ... ... ... ... ... ... ... 10 12 Laryngeal & Pulmonary Phthisis 2 1 2 2 3 21 31 41 57 34 29 6 2 ... 142 89 Tabes Mesenterica, Tubercular Disease of Intestine 1 ... ... 1 2 1 ... ... ... 2 ... ... ... ... 2 ... 5 General Tuberculosis, Tubercular Disease of undefined position ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseminated Tuber 1 2 4 I ... 1 ... ... ... ... ... ... ... ... 3 6 Other Forms of Tuberculous, Scrofula ... ... 1 ... 1 ... 1 1 1 ... 3 2 ... ... 8 2 Thrush ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Actinomycosis ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Hydatid Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ptomaine Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... 1 2 Acute Alcoholism, Delirium Tremens ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... Lead Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Osteoarthritis, Rheumatoid Arthritis ... ... ... ... ... ... ... ... ... 1 1 3 ... ... 1 4 Gout ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Cancer, Malignant Disease ... ... ... ... 1 ... ... 4 22 41 73 60 19 2 102 120 Diabetes Mellitus ... ... ... ... l ... ... 1 2 ... 3 2 1 ... 5 5 Purpura Hemorrhagica 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Hrcmophilia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anæemia, Leucocythæmia ... ... ... ... ... 1 ... 1 ... 2 3 ... ... ... 4 3 Lymphadenoma, Hodgkin's Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sarcoma ... ... ... ... 2 1 1 ... 4 ... ... 1 1 ... 4 6 Enlarged Thymus Gland 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 2 ... Status Lymphaticus ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Graves' Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enlarged Thyroid Gland ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature Birth 69 ... ... ... ... ... ... ... ... ... ... ... ... ... 37 32 Debility at Birth 10 ... ... ... ... ... ... ... ... ... ... ... ... ... 7 3 Injury at Birth 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 Congenital Defects 15 1 1 ... ... ... ... ... ... ... ... ... ... ... 10 7 Want of Breast Milk Atrophy, Debility, Marasmus 56 10 2 ... ... ... ... ... ... ... ... ... ... ... 40 28 Dentition 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Rickets 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Old Age, Senile Decay ... ... ... ... ... ... ... ... ... ... 1 29 72 29 69 62 TABLE 7.—Continued. Causes of Death AGES All Ages 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- M. F. Convulsions 4 2 1 ... ... ... ... ... ... ... ... ... ... ... 3 4 Meningitis 2 ... ... 2 ... ... ... 1 ... ... ... 1 ... ... 3 3 Apoplexy 2 ... 1 ... ... ... ... ... 8 10 18 23 16 4 41 41 Softening of Brain ... ... ... ... ... ... ... ... 2 ... 1 2 1 ... 5 1 Hemiplegia, Brain Paralysis ... ... ... ... ... ... ... ... ... 1 2 6 ... ... 4 5 Cerebral Abscess, etc ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... Insanity, General Paralysis of Insane ... ... ... ... ... ... ... 1 10 9 5 ... ... ... 24 1 Other forms of Insanity ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 2 ... Cerebral Tumour ... ... ... ... ... 1 ... 2 1 2 ... ... ... ... 3 3 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epilepsy ... ... ... ... ... ... 2 2 1 ... 2 ... ... ... 1 6 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... 2 1 Paraplegia, Disease of Spinal Cord ... ... ... ... ... ... ... ... 2 1 3 2 1 ... 5 4 Peripheral Neuritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Neurasthenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sclerosis of Brain ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Progressive Muscular Atrophy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Otitis, Otorrhœa ... 1 ... ... 1 l 2 1 ... ... ... ... ... ... 4 2 Epistaxis, Diseases of Nose ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia, Disease of Eye ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... Endocarditis, Valvular Diseases of the Heart ... ... ... 1 2 4 7 5 11 26 28 21 14 5 57 67 Pericarditis ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 2 1 Hypertrophy of Heart ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Angina Pectoris ... ... ... ... ... ... ... ... ... 1 3 2 ... ... 6 ... Aneurism ... ... ... ... ... ... ... ... ... 1 ... 4 ... ... 4 1 Gangrene ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... 3 1 Embolism, Thrombosis ... ... 1 ... ... ... ... ... 1 4 2 3 3 ... 5 9 Phlebitis ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 Varicose Veins ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Fatty Degeneration of the Heart ... ... ... ... ... ... ... ... 6 7 14 22 10 1 35 25 Cardiac Dilatation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atheroma ... ... ... ... ... ... ... ... ... ... 2 2 2 ... 2 4 Other diseases Circulatory system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases Larynx and Trachea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Bronchitis 15 4 1 ... ... ... 2 ... ... 11 10 11 5 ... 38 21 Chronic Bronchitis ... 1 ... ... ... ... ... 3 8 19 49 97 68 11 117 139 Lobar, Croupous Pneumonia 5 1 ... ... 1 1 1 1 5 8 4 4 1 ... 26 6 Lobular, Broncho-Pneumonia 31 18 8 1 ... l ... 4 3 8 13 12 8 ... 57 50 Pneumonia, form not stated 6 5 4 2 1 ... 3 5 5 20 15 12 5 2 48 37 Emphysema, Asthma ... ... ... ... ... ... ... 1 ... ... ... 2 ... ... 3 ... Pleurisy, Empyema ... ... ... ... ... ... 1 ... 2 1 2 1 ... ... 4 3 Gangrene or Fibrosis of Lung ... ... ... 1 ... ... ... ... 1 ... 1 2 ... ... 3 2 Sore Throat, Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 18 TABLE! 7.—Continued. Causes of Death. AGES. All Ages 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- M. F. Diseases of Pharynx ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ,, , (Esophagus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ulcer of, Stomach and Duodenum ... ... ... ... ... ... 1 1 6 3 8 3 ... ... 17 5 Other Diseases of Stomach 2 ... 1 ... ... ... ... 1 ... 2 ... 3 1 ... 4 6 Enteritis 4 ... 1 ... ... ... ... ... 2 ... 1 1 1 ... 8 4 Appendicitis ... ... 2 3 2 2 ... 1 ... ... 2 1 ... ... 6 7 Obstruction of Intestine 1 ... 1 ... ... ... ... 1 1 3 2 2 1 ... 4 8 Other Diseases of Intestine ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Cirrhosis of Liver ... ... ... ... ... ... ... ... 3 3 3 2 2 ... 8 5 Other Diseases of Liver 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... 1 2 Peritonitis ... ... ... ... ... ... ... 1 2 2 ... ... ... 1 4 Pancreatitis ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 1 2 Hernia ... ... ... ... ... ... ... ... ... 1 1 1 1 ... 1 3 Splenic Tumour ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Gall Stones ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Myxœdema ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Mediastinal Tumour ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Lymphatic System ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Nephritis ... ... ... 1 ... 1 ... ... 2 1 4 7 2 ... 9 9 Bright's Disease, Albuminuria ... ... 1 ... ... ... 1 5 10 9 19 24 22 7 65 33 Calculus ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... Diseases of Bladder or Prostate ... ... ... ... ... ... ... ... ... 1 3 5 3 3 14 1 Pyelitis ... ... ... ... ... ... ... 1 ... ... 2 ... 1 ... 2 2 Hydronephrosis and Pyonephrosis ... ... ... ... ... ... ... 2 ... 1 3 ... ... ... 4 2 Other Diseases of the Kidneys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lardaceous Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Addison's Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour of Kidney ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Disease of Testis and Penis ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... Diseases of Vagina and External Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Ovaries, Uterus, &c ... ... ... ... ... ... 1 ... 1 ... ... 2 ... ... ... 4 Diseases of Breast ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Abortion, Miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Mania ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Placenta Prævia, Flooding ... ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... 3 Puerperal Thrombosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other and Undefined Accidents of Childbirth 1 ... ... ... ... ... 1 2 l ... ... ... ... ... 1 4 Arthritis, Ostitis, Periostitis ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Other and Undefined Diseases of Organs of Locomotion ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... Ulcer, Bedsore ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Eczema 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Pemphigus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 19 TABLE 7.—Continued. Causes of Death. AGES All Ages 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- m F. Other and Undefined Diseases of Integumentary System 2 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 2 Deaths from External causes (total) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Accident or negligence ... ... 1 1 1 ... ... ... 1 6 1 i 3 11 7 On Railways ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Vehicular Traffic ... ... 2 3 4 ... ... 1 2 3 5 4 2 ... 22 6 ,, Machinery ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... 3 ... In Building operations ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ,, Conflagrations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Burns, Scalds, Explosions ... 3 2 ... ... ... ... ... ... ... ... ... ... ... 3 2 ,, Weapons and Implements ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... Poisons or Poisonous Vapours ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... 1 2 Surgical Narcosis ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 Corrosion by Chemicals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Drowning ... ... ... 2 2 ... ... 1 ... ... 2 1 ... ... 7 1 „ Suffocation (overlaid in Bed) 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ,, Suffocation otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Falls, not specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Neglect at Birth 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Personal neglect ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Weather Agencies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Otherwise and not stated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electric Shock ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... Homicide ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Suicide, in all forms— By Poison ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... l 2 ,, Asphyxia ... ... ... ... ... ...... ... 2 2 1 2 1 ... ... 7 1 ,, Hanging and strangulation ... ... ... ... ... ... ... ... ... 4 1 ... ... ... 5 ... ,, Drowning ... ... ... ... ... 1 1 ... 1 1 ... ... ... ... ... 4 ,, Wounds—Shooting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ,, ,, other weapons ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 5 ... ,, Other methods ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 2 ... Sudden Death (cause not ascertained ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Ill-defined and Not Specified Causes ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 20 TABLE 8. Deaths belonging to the Sanitary Area with the Causes of Death at all Ages for the ten years 1914-1923. Causes or Death. 1914. 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. Small Pox ... ... ... ... ... ... ... ... ... ... (a) Vaccinated ... ... ... ... ... ... ... ... ... ... (b) Unvaccinated ... ... ... ... ... ... ... ... ... ... (c) No statement ... ... ... ... ... ... ... ... ... ... Measles 95 131 84 75 145 19 63 6 145 13 Scarlet Fever 22 12 5 7 14 4 5 13 17 4 Typhus Fever ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 29 28 30 22 589 146 52 49 92 25 Whooping Cough 59 46 44 35 129 10 27 28 62 27 Diphtheria, Membranous Croup 37 37 41 46 41 42 37 30 61 49 Enteric Fever 2 3 2 5 1 3 5 1 3 2 Asiatic Cholera ... ... ... ... ... ... ... ... ... ... Diarrhoea. Dysentery 104 95 56 46 37 62 22 8 2 16 Epidemic or Zymotic Enteritis 103 54 35 44 30 36 30 135 21 33 Epidemic Cerebro-Spinal Fever 6 16 9 12 4 5 4 3 3 4 Polio-Myelitis 3 1 ... 1 ... 1 ... ... ... ... Chicken Pox ... 1 ... ... ... 1 ... ... ... 1 Rotheln ... ... ... ... ... ... ... ... ... ... Parotitis 2 ... ... ... ... 1 ... ... ... ... Vincent's Angina 1 ... ... ... ... ... ... ... ... ... Goitre 1 2 ... ... ... 1 1 ... ... ... Trench Fever ... ... ... 1 ... ... ... ... ... ... Encephalitis Lethargica ... ... ... ... ... 3 1 6 7 6 Tetanus ... ... 1 1 ... ... 2 1 ... ... Anthrax, Splenic Fever 2 ... ... 1 ... ... 1 ... ... ... Cowpox, Accidents of Vaccination ... ... ... ... ... ... ... ... ... ... Syphilis 12 14 21 16 25 15 14 10 6 6 Gonorrhœa ... ... ... ... ... ... ... ... ... ... Phagædena ... ... ... ... ... ... ... ... ... ... Erysipelas 14 13 1 12 10 9 7 3 8 4 Pyaemia, Septicaemia 14 7 6 7 3 6 6 6 5 3 Puerperal Fever 10 6 7 1 4 6 7 5 4 2 Infective Endocarditis 4 10 4 10 3 4 7 16 10 10 Carbuncle 4 2 ... ... 1 2 ... 4 ... ... Boils ... ... 3 ... ... ... ... ... ... ... Cellulitis ... ... ... ... 1 3 8 3 4 5 Mastoiditis 2 3 3 2 2 5 5 4 3 5 Tonsillitis ... ... ... ... 1 2 ... 3 4 ... Empyema of Antrum ... ... ... ... ... 1 ... ... ... ... Malarial Fever ... ... ... ... ... ... 1 1 ... ... Rheumatic Fever, Rheumatism of Heart. 12 12 ii 11 7 16 9 13 16 13 Tuberculosis, total 427 511 487 497 452 366 292 305 303 279 Tubercular Disease of Brain or Meninges, Acute Hydrocephalus 53 71 51 54 35 29 26 25 27 22 Laryngeal and Pulmonary Phthisis 330 388 391 392 387 311 243 262 249 231 Tabes Mesenterica, Tubercular Disease of Intestine 16 16 12 19 10 7 2 4 8 7 Disseminated Tuberoulosis ... ... ... ... ... ... ... ... ... 9 Other Forms of Tuberculosis, Scrofula 19 9 8 18 4 ... 8 8 9 10 21 TABLE 8—continued. Causes of Death. 1914. 1915. 1916. 1917. 1918] 1919: 1920. 1921. 1922 1923. Thrush ... ... ... ... ... ... ... ... ... ... Actinomycosis ... 1 ... ... ... ... ... 1 ... 1 Hydatid Disease ... ... ... ... ... 1 ... ... ... ... Scurvy ... ... ... ... ... ... ... ... ... ... Ptomaine Poisoning ... ... 1 ... ... ... ... ... ... ... Chronic Alcoholism 15 14 5 1 ... ... ... 2 12 3 Acute Alcoholism, Delirium Tremens 7 5 2 1 ... 1 1 4 1 1 Lead Poisoning ... ... ... ... ... ... ... ... ... ... Osteo-arthritis, Rheumatoid Arthritis 8 4 4 4 5 5 6 1 4 5 Gout 1 2 4 1 2 ... 1 ... ... 1 Cancer, Malignant Disease 192 200 207 241 203 220 221 215 190 222 Diabetes Mellitus 13 22 12 9 14 16 12 15 8 10 Purpura Hæmorrhagica 2 1 2 1 9 1 1 1 1 2 Hæmophilia ... 2 ... ... ... ... ... ... ... ... Anæmia, Leucocythæmia 5 5 8 11 8 6 9 9 6 7 Lymphadenoma, Hodgkin's Disease 6 2 2 ... 1 ... 1 1 4 ... Sarcoma ... ... ... ... 4 4 8 11 8 10 Enlarged Thymus Gland ... 1 1 ... ... ... 2 1 1 2 Status Lymphaticus 1 ... 2 ... ... ... 4 1 4 1 Grave's Disease ... 1 ... ... ... ... 1 3 1 ... Enlarged Thyroid Gland ... ... ... 1 ... ... ... ... ... ... Premature Birth 105 116 81 74 69 79 68 74 53 69 Debility at Birth 12 7 20 11 12 27 25 19 4 10 Injury at Birth 4 4 3 10 5 2 2 6 4 5 Congenital Defects 40 43 40 30 16 22 42 30 26 15 Want of Breast Milk 3 ... 2 ... 3 1 ... ... ... ... Atrophy, Debility, Marasmus 74 89 54 49 37 42 80 72 66 56 Dentition 8 12 4 2 3 ... 2 5 ... 2 Rickets 5 8 7 2 3 1 1 1 2 1 Old Age, Senile Decay 136 159 134 118 120 109 175 188 189 131 Convulsions 21 19 13 13 13 14 15 10 13 7 Meningitis 17 25 17 14 11 12 12 12 7 6 Apoplexy 69 108 111 95 95 91 95 100 84 82 Softening of Brain 40 12 6 7 7 ... 2 2 3 6 Hemiplegia, Brain Paralysis 13 15 11 6 8 8 5 3 10 9 Cerebral Abscess, Ac 1 2 1 ... 9 1 5 3 1 1 Insanity, General Paralysis of Insane . 35 28 33 32 30 12 19 15 19 25 Other forms of Insanity 2 1 ... 1 1 3 9 2 3 2 Cerebral Tumour 4 9 2 3 6 2 5 3 8 6 Chorea 2 1 ... ... ... ... 2 ... ... ... Epilepsy 18 19 15 21 22 7 8 7 9 7 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy 3 4 5 2 4 4 3 3 6 3 Paraplegia, Disease of Spinal Cord 7 4 11 12 9 6 4 13 8 9 Peripheral Neuritis 4 4 ... 4 ... ... ... ... 2 ... Neurasthenia ... ... ... ... ... ... 1 ... ... ... Sclerosis of Brain ... 2 ... ... 9 2 1 1 ... ... Progressive Muscular Atrophy ... ... 1 ... ... ... 1 ... 1 ... Otitis, Otorrhœa 3 2 4 2 4 4 6 4 7 6 Epistaxis, Diseases of Nose ... 1 ... ... 1 ... ... ... ... ... Ophthalmia, Diseases of Eye 1 ... ... ... ... ... ... ... 1 1 Endocarditis, Valvular Diseases of the Heart 171 209 149 155 171 176 168 138 149 124 Pericarditis 5 5 3 3 3 3 4 8 3 3 Hypertrophy of Heart 4 4 2 1 4 1 2 2 1 1 22 TABLE! 8—continued. Causes or Death. 1914. 1915. 1916. 1917 1918 1919. 1920. 1921. 1922. 1923. Angina Pectoris ... 5 5 4 ... 2 ... 6 4 6 Aneurism 15 10 11 8 4 5 1 11 10 5 Gangrene 4 8 4 6 1 5 2 9 7 3 Embolism, Thrombosis 8 14 7 9 10 9 19 15 14 14 Phlebitis 1 1 ... ... 2 ... 2 ... 1 2 Varicose Veins ... ... 1 ... 2 ... ... ... ... 1 Fatty Degeneration of the Heart 43 43 45 53 39 27 33 64 55 60 Cardiac Dilatation 4 4 1 1 ... 2 6 2 1 ... Atheroma 5 2 8 15 5 1 3 5 2 6 Other Diseases of Circulatory System ... ... ... ... 6 ... 3 3 1 ... Laryngitis 3 5 3 3 1 4 1 3 2 ... Croup ... ... ... 1 ... ... ... ... ... ... Other Diseases of Larynx and Trachea ... 1 ... ... ... ... 1 ... 3 ... Acute Bronchitis 83 110 72 69 114 87 92 51 86 59 Chronic Bronchitis 289 386 254 274 314 262 193 221 278 256 Lobar, Croupous Pneumonia 55 74 69 84 81 44 30 ... 47 32 Lobular, Broncho-Pneumonia 140 228 170 188 208 149 187 161 196 107 Pneumonia, form not stated 143 146 108 72 174 89 91 97 110 85 Emphysema, Asthma 24 20 17 11 4 11 12 1 12 3 Pleurisy, Empyema 13 21 6 13 13 10 16 7 4 7 Gangrene or Fibrosis of Lung 1 ... 6 ... 1 8 4 4 3 5 Sore Throat, Quinsy 9 1 4 3 2 ... ... 1 ... ... Diseases of Pharynx 1 ... ... 1 3 ... 1 4 1 ... ,, (Esophagus ... ... ... 1 ... ... ... ... ... Ulcer of Stomach and Duodenum 21 22 12 15 10 16 19 14 15 22 Other Diseases of Stomach 1 ... ... 1 4 4 5 6 10 Enteritis 26 26 16 14 6 7 6 6 12 Appendicitis 11 11 5 5 14 18 16 10 13 Obstruction of Intestine 28 30 20 18 13 8 9 5 12 Other Diseases of Intestine 4 2 2 2 2 6 1 4 1 Cirrhosis of Liver 41 31 18 27 13 9 9 6 4 13 Other Diseases of Liver 8 2 3 1 2 4 4 3 7 3 Peritonitis 9 2 4 1 4 4 3 4 3 5 Pancreatitis ... ... 2 ... 2 ... 2 1 ... 3 Hernia ... ... ... ... 1 10 10 12 7 4 Splenic Tumour ... ... ... ... ... ... ... ... ... 1 Gall Stones 4 ... ... ... 1 2 2 4 1 1 Myxœdema 2 5 2 ... ... ... ... ... 1 1 Mediastinal Tumonr 1 ... ... ... ... ... ... 1 3 ... Diseases of Lymphatic System 5 ... ... 3 ... 1 l ... 1 ... Acute Nephritis 12 17 14 10 13 18 10 15 20 18 Bright's Disease, Albuminuria 119 152 157 177 145 112 77 100 125 98 Calculus ... 1 1 1 ... ... 1 3 ... 1 Diseases of liladder or Prostate 12 10 14 18 14 21 15 12 12 15 Pyelitis 2 ... 3 ... ... 3 1 3 ... 4 Hydronephrosis and Pyonephrosis 1 2 2 2 2 ... ... 2 3 6 Other diseases of the Kidneys ... ... 3 ... 3 1 ... ... 3 ... Lardaceous Disease ... ... ... ... ... ... ... ... ... ... Addison's Disease 1 ... ... 2 2 ... 2 4 1 ... Tumour of Kidney 2 ... ... ... ... ... ... ... 1 ... Disease of Testis and Penis 2 5 3 ... ... ... 1 ... ... 1 Diseases of Vagina and External Organs. ... 1 ... 1 1 ... ... ... ... ... Diseases of Ovaries, Uterus, Ac 5 6 6 2 4 3 4 3 2 4 Diseases of Breast ... ... ... 1 1 ... 2 ... ... ... 23 TABLE 8—continued. Causes of Death. 1914. 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. Abortion, Miscarriage 2 4 2 2 1 1 3 3 2 ... Puerperal Mania ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions ... ... 1 1 ... ... 1 ... ... 3 Placenta Prævia, Flooding 4 4 4 2 2 1 1 2 1 3 3 Puerperal Thrombosis ... ... ... ... ... ... ... ... ... ... Other and Undefined Accidents of Childbirth 1 1 2 ... 5 3 3 2 3 5 Arthritis, Ostitis, Periostitis 5 2 3 3 7 4 3 1 ... 1 Other and Undefined Diseases of Organs of Locomotion ... ... ... ... ... ... ... 3 2 1 Ulcer, Bedsore 7 ... ... 1 2 1 1 ... 1 1 Eczema 2 ... 1 2 1 ... 1 ... ... ... Pemphigus 1 ... 1 ... ... ... 1 2 ... ... Other and Undefined Diseases of Integumentary System 2 ... l ... ... ... 1 1 ... 3 Deaths from External causes (total) 123 128 110 129 84 91 98 63 99 74 By Accident or negligence ... ... ... ... ... 1 10 16 22 18 On Railways 1 ... 6 1 1 1 3 ... ... ... By Vehicular Traffic 24 39 28 28 21 27 25 16 39 28 ,, Machinery 4 4 6 1 4 4 1 ... 3 3 In Building operations ... ... 1 ... 13 ... 1 ... 2 1 ,, Conflagrations ... ... ... ... ... ... ... ... ... ... By Burns, ScaldB, Explosions 14 17 17 31 7 13 11 9 6 5 ,, Weapons and Implements 1 ... ... 3 ... 2 ... ... 3 1 ,, Poisons or Poisonous Vapours 4 2 1 4 1 3 ... ... 2 3 Surgical Narcosis 2 ... 1 1 2 ... 5 2 ... 1 Corrosion by Chemicals ... ... ... ... ... 1 ... ... ... ... By Drowning 11 7 4 11 8 6 12 10 8 8 ,, Suffocation (overlaid in bed) 20 14 7 12 7 12 5 2 2 2 ,, ,, otherwise 2 6 6 3 2 ... ... 1 4 .... Falls, not specified 38 38 33 27 18 21 23 7 7 ... Neglect at Birth ... ... ... ... ... ... 1 ... 1 3 Personal neglect 2 1 ... 2 ... ... ... ... ... ... By Weather Agencies ... ... ... 2 ... ... ... ... ... ... Otherwise and not stated ... ... 1 1 ... ... ... ... ... ... Electric Shock ... ... ... 2 ... ... ... ... ... 1 Homicide 5 4 1 2 2 3 1 3 ... 1 Execution ... 1 ... ... 1 ... ... ... ... ... Suicide, in all forms (total) 18 8 6 9 10 12 26 ... 19 27 By Poison 8 1 ... 3 2 4 3 5 3 ,, Asphyxia ... ... ... ... 1 3 3 4 8 ,, Hanging and Strangulation 4 4 4 2 5 3 4 5 3 5 ,, Drowning 3 ... 1 2 ... 7 4 2 4 ,, Wounds—Shooting 1 ... 1 ... ... 2 1 1 ... other weapons 1 ... 1 3 2 3 3 7 3 5 „ Other methods 1 3 ... ... ... 1 3 1 1 2 Sudden Death (cause not ascertained) ... ... ... ... ... ... 1 ... ... ... Other Ill-defined and Not Specified Causes ... ... ... ... ... ... 2 1 1 1 24 25 TABLE 9. Borough of Southwark. Causes of, and Ages at Death during Year 1923. Causes of Death. Nett Deaths at the subjoined ages of " Residents" whether OCCURRING WITHIN OR WITHOUT THE DISTRICT (a). Deaths at all ages or " Residents " belonging to Localities, whether occurring in or beyond the District. Total Deaths whether of "Residents" or " NonResidents " in Public Institutions in the District. All ages. Under 1 year 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 St. Mary's Ward. St. Paul s Ward. St. Peter's District. St. John s District. Trinity Ward. All Saints' District. St. Micnael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 1 Enteric Fever 2 — — — — 1 — 1 — — — — — — — — — 2 — — 1 2 Small Pox — — — — — — — — — — — — — — — — — — — — — 3 Measles 13 2 4 7 — — — — — 1 — 1 1 1 1 2 3 3 — — — 4 Scarlet Fever 4 — 1 3 — — — — — — — — 1 1 — — — 1 1 — — 5 Whooping-cough 27 10 11 6 — — — — — 2 1 1 4 4 3 4 2 6 — — 2 6 Diphtheria and Croup 49 3 6 18 20 2 — — — 5 5 6 7 4 6 3 4 8 — 1 3 7 Influenza 25 — — — 1 3 5 8 8 2 1 — 4 5 1 5 — 7 — — 1 8 Erysipelas 9 1 — — — 2 — 5 1 — 1 1 2 1 1 1 — 1 1 — 5 9 Phthisis (Pulmonary Tuberculosis) 231 2 1 2 5 52 98 63 8 40 25 14 19 19 23 30 17 19 12 13 16 10 Tuberculous Meningitis 22 1 10 5 5 1 — — — — 2 3 6 2 2 2 2 2 1 — 13 11 Other Tuberculous diseases 26 2 2 5 5 3 2 5 2 2 1 1 — 3 3 7 3 3 — 3 18 12 Cancer, malignant disease 222 — — — 1 — 26 114 81 39 21 18 25 17 14 24 21 2 16 6 83 13 Rheumatic Fever 13 — — 1 3 2 3 2 2 3 1 1 2 1 2 1 — 1 — 1 3 14 Meningitis 6 2 — — 2 — 1 — 1 — 1 — — 1 3 — 1 — — — 5 15 Organic Heart disease 226 — — 1 3 11 24 94 93 31 16 14 22 22 27 26 22 13 23 10 55 16 Bronchitis 315 15 5 1 — 2 11 89 192 43 36 35 36 25 24 28 21 34 18 15 10 17 Pneumonia (all forms) 224 42 24 12 5 6 23 68 44 22 29 12 18 21 23 42 15 25 8 9 67 18 Other diseases of Respiratory organs 15 — — — 1 1 4 4 5 2 1 1 3 3 1 1 — 3 — — 7 19 Diarrhæa and Enteritis 61 45 9 1 — 1 2 1 2 7 4 — 10 10 3 — 6 11 4 — 22 20 Appendicitis & Typhlitis 13 — — 2 5 2 1 2 1 1 2 1 — 1 2 2 2 1 1 — 20 21 Cirrhosis of Liver 13 — — — — — 3 6 4 4 2 1 1 1 2 — 1 — 1 — 5 21 AAlcoholism 4 — — — — — 1 3 — — 1 2 — — — — — 1 — — 1 22 Nephritis and Bright's Disease 116 — — 1 1 2 17 33 62 20 13 9 11 10 10 15 14 6 6 2 59 23 Puerperal Fever 2 — — — — — 2 — — 1 — — — — — — 1 — — — 1 24 Other accidents and diseases of Pregnancy & Parturition 8 1 — — — 2 5 — — 1 1 1 1 1 1 — 2 — — — 3 25 Congenital Debility and Malformation,including Premature Birth 172 158 11 3 — — — — — 25 12 11 25 13 18 28 11 17 5 7 46 26 Violent Deaths, excluding Suicide 75 5 4 5 15 3 10 19 14 12 7 3 5 10 6 4 4 8 9 7 49 27 Suicide 27 — — — — 2 10 14 1 5 5 — 2 1 — 5 5 1 1 2 2 28 Other defined diseases 471 23 8 6 11 16 69 106 232 67 49 39 42 38 9 57 42 30 27 31 246 All causes 2391 312 96 79 83 114 317 637 753 335 237 175 247 215 225 293 199 224 134 107 835 26 DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 68 during the year 1923. The deaths under one year of age to 1,000 births for the last twentynine years were as follows:— 1895 201 1909 119 1896 192 1910 115 1897 187 1911 145 1898 190 1912 105 1899 199 1913 115 1900 192 1914 123 1901 168 1915 132 1902 166 1916 98 1903 148 1917 111 1904 174 1918 124 1905 148 1919 95 1906 144 1920 86 1907 142 1921 90 1908 131 1922 79 1923 68 The average number of Infantile deaths for the last twenty-nine years is 137. 27 TABLE 10. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1923. Nett Deaths from stated causes at various ages under 1 Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year All causes Certified 78 20 9 8 115 40 69 43 40 307 Uncertified 5 ... ... ... 5 ... ... ... ... 5 Influenza ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 1 ... 1 ... 2 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 2 3 4 10 Diphtheria and Croup ... ... ... ... ... ... ... 1 2 3 Erysipelas ... ... ... ... ... ... 1 ... ... 1 Tubercul us Meningitis ... ... ... ... ... ... ... 1 ... 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... 1 ... 1 2 4 Meningitis (not Tuberculous) ... ... ... ... ... l ... l ... 2 Cerebro-Spinal Meningitis ... 1 ... ... 1 ... 1 1 ... 3 Convulsions and Dentition 1 ... ... ... 1 l 1 2 1 6 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis 1 1 ... ... 3 1 3 4 4 15 Pneumonia, all forms 2 1 1 ... 4 2 16 9 11 42 Diarrhæa ... 1 1 ... 2 5 13 10 6 36 Enteritis ... 1 ... ... 1 1 6 ... 1 9 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... 1 ... ... 1 2 1 ... ... 4 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying ... ... ... ... ... 1 1 ... ... 2 Injury at Birth 4 ... ... ... 4 1 ... ... ... 5 Atelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Malformations 5 2 1 1 9 1 2 ... ... 12 Premature Birth 52 6 3 4 65 2 2 ... ... 69 Atrophy, Debility and Marasmus 9 3 3 2 17 18 15 7 7 64 Other causes 5 3 ... ... 8 1 5 2 1 17 83 20 9 8 120 40 69 43 40 312 Nett Births in the year Legitimate 4,376 Illegitimate 182 Nett Deaths in the year of Legitimate Infante 294 Illegitimate Infants 18 28 29 TABLE 11. Vital Statistics of Separate Localities in 1923 and previous years. BOROUGH OF SOUTHWARK Names of Localities. 1. St. Mart's Ward 2. St. Paul's Ward. 3. St. Peter's District. 4. St. John's District. 5. Trinity Ward. 6. All Saints' District. Year. Population estimated to middle of each year. Births registered. Deaths at all ages Deaths under 1 year. Population estimated to middle of each year. Births registered Deaths at all ages Deaths under 1 year. Population estimated to middle of each year. Births registered Deaths at all ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 jear. 1913 21,997 657 338 64 19,340 515 274 46 18,118 496 281 45 20,982 683 334 80 15,819 541 325 70 19,077 721 352 75 1914 22,040 583 337 58 19,377 481 300 61 18,154 552 258 56 21,023 649 352 74 15,851 499 311 60 19,114 718 345 83 1915 21,000 514 381 64 18,478 490 368 59 17,302 503 284 50 19,983 601 374 74 15,093 447 317 50 18,215 626 403 91 1916 20,735 545 362 49 18,238 449 287 41 17,087 491 240 36 19,731 585 335 69 14,904 424 261 53 17,988 610 313 46 1917 19,640 438 367 47 17,300 401 323 46 16,201 385 282 34 18,688 511 337 56 14,122 380 252 42 17,049 484 283 44 1918 18,924 376 476 39 16,692 282 368 38 15,629 369 340 34 18,008 383 379 62 13,622 322 356 48 16,441 440 359 41 1919 21,048 470 332 41 18,592 385 270 25 17,419 390 197 19 20,020 527 280 56 15,188 379 263 45 18,230 509 274 40 1920 21,892 624 358 56 19,338 524 250 45 18,112 509 237 49 20,806 738 296 63 15,792 542 229 52 18,956 758 289 58 1921 21,570 529 324 54 19,053 439 284 35 17,846 451 204 35 20,500 610 294 52 15,560 481 227 36 18,677 626 287 58 1922 22,882 448 366 47 19,362 386 302 27 17,370 408 239 35 19,218 554 317 49 16,315 456 275 35 21,536 546 275 31 Averages of Years 1913 to 1922 21,172 518 364 51 18,577 435 302 42 17,323 455 256 39 19,895 584 329 63 15,226 447 281 49 18,528 603 318 56 1923 22,934 524 335 41 19,429 408 237 23 17,458 375 175 18 19,314 513 247 37 16,409 449 215 31 21,656 534 225 32 7. St. Michael's Ward. 8. St. Jude's Ward. 9. St. George's Ward. 10. Christchurch Ward. 11. St. Saviour's Ward. 1913 22,318 721 463 99 13,395 367 246 38 18,344 678 372 103 9,391 228 223 31 9,706 268 163 26 ... ... ... ... 1914 22,364 665 449 103 13,420 343 239 42 17,844 675 363 97 9,409 261 199 32 9,725 227 197 31 ... ... ... ... 1915 21,324 614 514 104 12,803 314 294 52 16,992 617 391 81 8,980 230 230 34 9,254 303 171 27 ... ... ... ... 1916 21,059 532 403 63 12,639 299 224 32 16,778 537 301 64 8.8S7 170 174 16 9,140 270 139 33 ... ... ... ... 1917 19,964 461 381 60 12,013 277 240 49 15,892 452 315 47 8,397 156 175 16 8,670 190 132 13 ... ... ... ... 1918 19,248 384 445 53 11,585 184 289 36 15,320 405 364 40 8,113 118 204 17 8,386 187 177 21 ... ... ... ... 1919 21,372 466 329 48 12,816 240 231 35 16,997 502 268 48 9,008 136 153 22 9,281 172 131 17 ... ... ... ... 1920 22,223 648 321 56 13,326 384 210 35 17,673 685 250 63 9,368 261 136 18 9,656 281 109 17 ... ... ... ... 1921 21,895 541 342 53 13,130 335 184 34 17,413 627 241 52 9,230 189 133 21 9,514 210 113 21 ... ... ... ... 1922 20,795 517 362 40 14,012 273 215 27 18,189 562 275 40 8,389 184 150 9 9,152 242 119 23 ... ... ... ... Averages of Years 1913 to 1922 21,256 554 400 67 12,913 301 237 38 17,144 574 314 63 8,915 193 177 21 9,248 235 145 22 ... ... ... ... 1923 20,683 522 293 47 13,939 341 199 23 18,068 476 224 36 8,401 217 134 14 9,173 199 107 10 ... ... ... ... TABLE 12. Gases of Infectious Diseases notified during the Year 1923. Disease Cases notified in whole District. Total Cases notified in each locality. Number of cases removed to Hospital from each locality. At ages—Years. Sex. St. Mary's Ward. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. All Saints' Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. St. Mary's Ward. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. All Saint's Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. 0- 1- 5- 10- 15- 20- 25- 35- 45- 56- 65- 75- 85- Male. Female. At all ages. Ophthalmia Neonatorum 36 ... ... ... ... ... ... ... ... ... ... ... ... 20 16 36 1 1 6 8 3 5 5 2 3 1 1 ... ... 4 1 1 ... 1 1 2 1 ... 11 Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 4 156 141 63 22 11 12 ... ... ... ... ... ... 181 228 409 48 35 54 30 32 37 57 35 41 10 30 48 33 52 30 30 37 56 35 41 10 30 402 Enteric Fever ... 2 5 5 3 1 2 ... 1 1 ... ... ... 7 11 18 2 3 ... ... 3 1 4 ... 3 ... 2 2 3 ... ... 3 1 4 ... 3 ... 2 18 Diphtheria 15 286 253 124 31 21 28 7 2 ... ... ... ... 324 443 767 101 45 104 104 48 88 73 76 79 11 38 100 45 104 104 48 87 72 76 79 11 37 763 Memb. Croup 1 2 ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... 3 Erysipelas 4 4 3 8 7 6 11 11 16 8 7 4 ... 43 46 89 8 6 12 9 12 10 11 5 7 4 5 ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... 1 5 4 7 ... ... ... ... ... ... 17 17 2 I 1 2 2 3 ... 3 3 ... ... 2 1 1 2 2 3 ... 3 3 ... ... 17 Csrebro-Spinal Fever 3 ... 1 ... ... ... ... ... ... ... ... ... ... 3 1 4 ... 1 ... ... 2 ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... 1 ... 3 Phthisis 2 2 15 10 36 47 90 83 77 49 12 1 ... 266 158 424 59 35 40 39 37 35 50 44 36 27 22 ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis 5 28 23 21 13 7 9 5 5 3 1 ... ... 71 49 120 15 11 11 14 8 13 12 9 14 4 9 ... ... ... ... ... ... ... ... ... ... ... ... Measles 59 566 282 16 1 4 3 3 454 480 934 188 112 •220 66 45 110 77 37 51 18 10 Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Polio-Myelitis ... 4 ... ... ... ... ... ... ... ... ... ... ... 1 3 4 ... ... ... ... 1 ... ... ... 2 1 ... ... ... ... ... ... ... ... ... 2 1 ... 3 Polio-Encepha litis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhæa 13 8 ... ... ... ... ... ... ... ... ... ... ... 15 6 21 2 3 4 1 5 1 3 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fncph. Lethal ... ... ... ... 2 1 1 1 1 ... ... ... ... 1 5 6 ... ... 1 ... 1 ... 1 ... 2 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 14 46 29 14 17 13 18 20 25 7 3 2 1 139 70 209 13 13 8 18 27 13 42 11 36 9 19 11 10 8 16 20 11 32 10 29 7 13 167 Malaria ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 156 1105 750 261 133 116 178 137 127 68 23 7 1 1529 1533 3062 439 266 461 294 226 317 335 223 278 86 137 163 92 169 155 106 140 165 125 159 31 82 1387 31 TABLE 13. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various wards for 1923. WARD. Cerebro Spinal Fever. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhæa. Phthisis. Pneumonia & Bronchitis. Heart Disease. Influenza. Chicken Pox. Encephalitis Lethargica. St. Mary — 1 — 5 2 — 7 40 67 31 2 — — St. Paul 1 — — 5 1 — 4 25 66 16 1 — — St. Peter — 1 — 6 1 — — 14 48 14 — — 1 St. John — 1 1 7 4 — 10 19 57 22 4 — 1 Trinity 2 1 1 4 4 — 10 19 49 22 5 — — All Saints — 1 — 6 3 — 3 23 48 27 1 — — St. Michael — 2 — 3 4 — 6 30 71 26 5 1 1 St. Jude — 3 — 4 2 — 6 17 36 22 — — 1 St. George — 3 1 8 6 2 11 19 62 13 7 — 1 Christchurch 1 — 1 — — — 4 12 26 23 — — — St. Saviour — — — 1 — — — 13 24 10 — — 1 Borough 4 13 4 49 27 2 61 231 554 226 25 1 6 32 33 TABLE 14. Cases of Infectious Disease. Notified to the Medical Officer of Health for Southwark, during each week of the year 1923. Week Ending. Scarlet Fever. Diphtheria. Membranous Croup. Enteric Fever. Cerebrospinal Fever. SmallPox. Erysipelas. Puerperal Fever. Anthrax. Ophthalmia Neonatorum Phthisis. Other forms of Tuberculosis. Measles. Encephalitis Lethargica. Epidemic Diarrhæa. Pneumonia. PolioMyelitie Malaria. Dysentery. Total. 1923 Jan. 6 13 14 ... ... ... ... ... ... ... ... 8 l 3 ... ... 5 ... ... ... 44 „ 13 5 21 ... ... ... ... 1 ... ... ... 13 2 3 ... ... 6 ... 1 ... 51 „ 20 9 36 ... ... ... ... ... ... ... ... 11 1 2 1 ... 1 ... ... ... 62 „ 27 5 26 ... ... ... ... 1 ... ... 1 5 ... 2 1 ... 2 ... ... ... 43 Feb. 3 13 31 ... 1 ... ... 1 ... ... ... 14 3 4 ... ... 5 ... ... ... 72 „ 10 12 18 ... 3 ... ... 1 ... ... ... 14 2 ... 1 ... 2 ... ... ... 53 „ 17 6 19 ... ... ... ... 4 ... ... 3 5 3 2 ... ... 5 ... ... ... 47 „ 24 8 19 ... 1 ... ... ... ... ... ... 7 2 2 ... ... 3 1 ... ... 43 March 3 11 20 1 1 ... ... 1 1 ... ... 7 3 5 ... ... 5 ... ... ... 55 „ 10 10 15 ... 1 ... ... ... ... ... 1 12 4 5 1 ... 7 ... ... ... 56 „ 17 7 12 ... ... ... ... 1 ... ... 1 15 3 ... ... ... 5 ... ... ... 44 „ 24 19 16 ... 1 1 ... 3 ... ... 2 8 3 2 ... ... 4 ... ... ... 59 „ 31 8 17 ... 2 ... ... 4 1 ... 1 7 5 9 ... ... 4 ... ... ... 58 April 7 9 17 ... 3 1 ... 2 ... ... ... 2 2 4 ... ... 6 ... ... ... 46 „ 14 13 14 ... 1 ... ... 2 ... ... ... 8 1 4 ... ... 6 ... ... ... 49 „ 21 7 15 ... ... ... ... 1 1 ... ... 9 4 1 ... ... 3 ... ... ... 41 „ 28 6 8 ... ... 1 ... 3 1 ... 1 9 3 3 ... ... 5 ... ... ... 41 May 5 6 16 ... 1 ... ... 2 ... ... ... 11 4 11 ... ... 4 1 ... ... 56 „ 12 11 19 1 1 ... ... 1 ... ... ... 7 4 6 ... ... 4 ... ... ... 53 „ 19 4 16 ... ... ... ... 1 ... ... 1 8 7 10 ... ... 2 ... ... ... 49 „ 26 4 7 ... ... ... ... 2 ... ... 1 4 2 10 ... ... 4 1 ... ... 35 June 2 9 8 ... ... ... ... 1 1 ... 1 5 3 12 1 ... 8 ... ... ... 49 „ 9 8 12 ... ... ... ... 1 ... ... 1 4 5 11 ... ... 3 A ... ... ... 45 „ 16 10 17 ... ... ... ... 1 ... ... 10 1 13 ... ... 4 ... ... ... 56 „ 23 4 14 ... ... ... ... 1 1 ... ... 5 ... 16 ... ... 4 ... ... ... 45 „ 30 9 8 ... ... ... ... 6 1 ... 10 1 10 ... ... 10 ... ... ... 55 July 7 15 9 1 ... ... ... 2 1 ... 2 7 5 17 ... ... 5 ... ... ... 64 „ 14 8 12 ... ... ... ... 1 1 ... 1 14 2 18 ... 1 4 ... ... ... 62 „ 21 7 10 ... ... ... ... 1 ... ... 8 2 21 ... 2 6 ... ... ... 57 „ 28 3 10 ... ... ... ... 1 3 ... 2 7 1 8 ... ... 6 ... ... ... 41 Aug. 4 6 6 ... ... ... ... ... ... ... 1 12 1 12 ... 1 3 ... ... ... 42 „ 11 9 14 ... ... ... ... 2 ... ... 1 11 1 10 ... 1 ... ... ... ... 49 „ 18 3 6 ... ... ... ... 1 ... ... 3 12 3 6 ... 2 ... ... ... ... 36 „ 25 11 8 ... 1 ... ... 3 ... ... ... 7 1 12 ... 2 2 ... ... ... 47 Sept. 1 6 7 ... ... ... ... 1 ... ... 1 7 2 6 ... 10 1 ... ... ... 41 „ 8 1 10 ... ... ... ... 1 1 ... 1 10 4 6 ... ... 3 ... ... ... 37 „ 15 8 15 ... ... ... ... ... ... ... 2 4 3 11 ... ... 2 ... ... ... 45 „ 22 13 17 ... ... ... ... 2 1 ... ... 5 ... 6 ... 1 8 ... ... ... 53 „ 29 4 13 ... ... ... ... 2 ... ...... ... 4 1 15 ... 1 1 ... .... ... 41 Oct. 6 7 9 ... ... ... ... 2 ... ... 1 6 ... 19 ... ... 3 ... ... ... 47 „ 13 10 8 ... ... ... ... 4 ... ... ... 10 4 26 1 ... 5 ... ... ... 68 „ 20 4 11 ... ... ... ... 3 ... ... 1 4 1 20 ... ... 2 ... ... ... 46 „ 27 11 9 ... ... ... ... 1 ... ... 1 5 1 25 ... ... 1 ... ... ... 54 Nov. 3 7 17 ... l ... ... 4 1 ... ... 10 3 31 ... ... 4 1 ... ... 79 „ 10 4 20 ... ... ... ... 2 ... ... 2 4 2 33 ... ... 3 ... ... ... 70 „ 17 9 18 ... ... ... ... 3 ... ... 1 15 2 41 ... ... 4 ... ... ... 93 „ 24 6 18 ... ... ... ... 3 ... ... ... 11 3 69 ... ... 4 ... ... ... 114 Dec. 1 3 14 ... ... ... ... 2 ... ... ... 8 2 59 ... ... 3 ... ... ... 91 „ 8 4 20 ... ... ... ... 2 ... ... 1 7 2 72 ... ... 6 ... ... ... 114 „ 15 9 16 ... ... 1 ... 2 ... ... ... 6 3 83 ... ... 6 ... ... ... 126 „ 22 6 16 ... ... ... ... 2 1 ... 1 8 2 80 ... ... 4 ... ... ... 120 „ 29 9 19 ... ... ... ... 2 ... ... ... 4 ... 78 ... ... 6 ... ... ... 118 Year 409 767 3 18 4 ... 89 17 ... 36 424 120 934 6 21 209 4 1 ... 3062 34 table 15. The total number of Deaths in the Sanitary Area, with the Ages apportioned to the several wards, and the Death-rate in each ward for 1923. WARD. Males Females. Total. Rate per 1000. AGES—YEARS. 0- 1. 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- St. Mary 202 133 335 14.6 41 10 8 2 2 4 10 36 57 59 43 45 13 St. Paul 126 111 237 12.2 23 10 7 2 3 7 15 22 23 46 50 23 6 St. Peter 85 90 175 10.0 18 11 4 — 3 8 6 12 13 26 43 23 8 St. John 129 118 247 12.8 37 27 5 4 4 7 11 27 21 28 41 25 10 Trinity 124 91 215 13.1 31 21 5 3 3 8 7 17 28 30 36 21 5 All Saints 134 91 225 10.4 32 14 6 4 4 8 9 25 20 41 30 27 5 St. Michael 148 145 293 14.2 47 27 2 7 6 3 9 19 38 40 51 35 4 St. Jude 102 97 199 14.3 23 15 8 1 3 2 16 14 21 28 33 29 6 St. George 132 92 224 12.4 36 29 5 4 11 8 9 20 26 36 25 11 4 Christchurch 77 57 134 16.0 14 3 — 1 — 5 7 13 9 24 30 28 — St. Saviour 45 62 107 11.7 10 8 2 3 8 2 7 6 9 14 21 13 4 Whole Borough 1304 1087 2391 12.8 312 175 52 31 47 67 106 211 265 372 408 280 65 35 TABLE 16. London and the Metropolitan Boroughs. Births, Deaths, and Infantile Mortality. Boroughs. Estimated Population, 1922. Births. Deaths from Death rate per 1,000 births infants under 1 year. All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhæa and Enteritis (under 2 years). Influenza. LONDON 4,534230 91,662 50,743 39 1 367 112 425 602 936 752 60 West. Paddington 145,300 2,617 1,666 1 ... 3 2 22 14 22 30 68 Kensington 179,100 3,121 2,141 2 ... 15 2 23 13 47 47 71 Hammersmith 134,400 2,701 1,445 2 ... 6 3 10 20 25 19 63 Fulham 159,500 3,123 1,669 ... ... 23 5 15 20 23 26 63 Chelsea 03,920 1,015 770 ... ... ... 1 5 10 8 15 55 City of Westminster 139,390 1,752 1,460 1 ... 1 ... 7 5 6 24 46 North. St. Marylebone 105,200 1,657 1,207 ... ... ... 3 20 2 15 23 68 Hampstead 86,920 1.238 895 1 ... 2 1 3 7 10 17 42 St. Pancras 212,500 4,367 2,544 3 ... 5 3 28 21 51 22 63 Islington 333,900 7,117 3,853 ... ... 16 13 38 21 102 63 66 Stoke Newington 52,620 960 556 1 ... ... ... 2 4 5 13 48 Hackney 225,400 4,433 2,374 4 ... 16 6 16 30 30 53 58 Central. Holborn 42,850 593 516 ... ... 3 3 5 4 8 1 76 Finsbury 76,840 1,845 1,006 ... ... 11 2 7 8 29 13 60 City of London 13,363 111 153 ... ... 1 ... 1 1 ... ... 81 East. Shoreditch 105.800 2,864 1,361 1 ... 21 5 10 14 34 14 80 Bethnal Green 118,400 2,880 1,335 ... ... 32 5 21 20 38 16 69 Stepney 252,170 5,913 2.929 ... ... 65 7 18 30 87 39 63 Poplar 165,700 4,256 1,852 3 ... 22 4 8 29 35 24 59 South. Southwark 187,220 4,558 2,391 2 ... 13 4 27 49 54 25 68 Bermondsey 121,100 3,020 1,456 2 ... 12 3 11 31 50 13 73 Lambeth 307,000 6,242 3,498 1 ... 22 12 14 48 59 41 58 Battersea 169,200 3,434 1,808 2 1 20 6 16 33 27 30 48 Wandsworth 334,900 5,474 3,375 1 ... 11 2 30 26 45 56 52 Camberwell 270,300 5,657 2,960 3 ... 35 6 32 71 51 39 56 Deptford 114,100 2,428 1,239 2 ... 8 2 13 32 19 20 58 Greenwich 102,000 2,119 1,102 6 ... 2 2 13 11 19 15 62 Lewisham 176.600 3,297 1,813 1 ... 2 7 6 26 27 30 45 Woolwich 138,250 2,867 1,368 ... ... ... 3 4 2 10 24 43 36 DEATHS FROM PULMONARY TUBERCULOSIS. table 17. Shewing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions. 1923. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- All Ages. Males Females Total Number of patients who died at home ... ... 1 1 7 14 20 21 10 9 3 ... ... 57 29 86 Number of patients who died in hospitals, &c. 2 3 1 2 14 17 21 36 24 20 3 2 ... 85 60 145 2 3 2 3 21 31 41 57 34 29 6 2 ... 142 89 231 Of the total number of deaths from Pulmonary Tuberculosis 62.8 per cent. occurred in hospitals or other institutions. 37 TABLE 18. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 31st December, 1922, to the 29th December, 1923, in the Metropolitan Borough of Southwark. Age-periods Notifications on Form A. Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form A. Number of Primary Notifications. Total Notifications on Form B. Poor Law Institutions. Sanatoria. 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 & upwards Total Primary Notifications. Under 5 5-10 10-15 Total. Primary Notifications. Pulmonary Males — — 5 3 21 21 53 55 62 38 7 265 296 — — 1 l 1 105 155 „ Females 2 2 10 6 15 26 37 28 15 11 6 158 168 — — — — 1 59 61 Non-Pulmonary Males 2 21 14 8 8 4 5 5 2 2 — 71 73 — — — — — 12 29 „ Females 3 7 8 12 5 3 4 — 3 1 1 47 50 — 1 1 2 3 8 18 38 TABLE 19. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1923. Showing the localities where the deaths occurred. Locality. Encephalitis Lethargica. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhea. Cerebrospinal Fever. Influenza. Chicken Pox. Total. The Borough 1 10 ... ... 15 ... 16 1 21 ... 64 Southwark Hospital 3 1 ... 1 4 ... 19 ... 3 1 32 Met. Asylums Board Hospitals ... 2 4 44 7 2 ... ... ... ... 59 St. Thomas's Hospital ... ... ... ... ... ... ... 3 1 ... ... 4 Evelina Hospital ... ... ... 2 ... ... 4 ... ... ... 6 Guy's Hospital 1 ... ... 1 ... ... 6 2 ... ... 10 City of London Maternity Hospital ... ... ... ... ... ... 1 ... ... ... 1 Royal Waterloo Hospital ... ... ... ... ... ... 2 ... ... ... 2 Belgrave Hospital ... ... ... ... ... ... 5 ... ... ... 5 Infants' Hospital ... ... ... ... ... ... 1 ... ... ... 1 Children's Hospital ... ... ... ... ... ... ... ... ... ... 1 Lambeth Hospital ... ... ... ... ... ... 1 ... ... ... 1 King's College Hospital ... ... ... 1 ... ... 1 ... ... ... 2 Westminster Hospital ... ... ... ... ... ... ... ... 1 ... 1 39, Riggindale Road, Streatham ... ... ... ... ... ... 2 ... ... ... 2 48a, Lower Road, Rotherhithe 1 ... ... ... ... ... ... ... ... ... 1 Total 6 13 4 49 27 2 61 4 25 1 192 39 SCARLET FEYER. During the year under consideration 409 cases were notified, as against 802 cases in 1922. The number of deaths from this disease was 4. This is the lowest number of cases notified since 1917, and the deaths the lowest recorded since 1919. The number of cases notified, as compared witli London, during the last ten years was:— In Southwark. In London. In Southwark, In London. 1914 1,448 25,015 1919 799 12,931 1915 467 17,104 1920 893 22,713 1916 301 8,766 1921 1,266 32,738 1917 276 6,110 1922 802 17,225 1918 653 6,811 1923 409 10,082 Number of deaths from Scarlet Fever during the last ten years:— In Southwark. In London. In Southwark. In London. 1914 22 316 1919 4 145 1915 12 332 1920 5 207 1916 5 146 1921 13 290 1917 7 85 1922 17 299 1918 14 118 1923 4 112 Of the 409 cases notified in the present year, as many as 402 were removed to hospital, i.e., 98.3 per cent., as against 99 0 per cent. for last year. The deaths in the 402 cases sent to hospital numbered 4, a mortality of 10 per cent. In regard to the 7 cases nursed at home, they all recovered. The annual rate of mortality was 0 02. DIPHTHERIA. There is still an upward tendency in regard to the number of cases of Diphtheria notified during the year under consideration, although the 40 deaths from this disease are lower in number than in 1922. The total notifications numbered 770 and the deaths 49 for the year. The increase in both notifications and deaths may probably be accounted for by the increase in the number of throat swabs taken by practitioners and forwarded for examination, as no doubt many cases otherwise classed as doubtful are discovered to be carrying the bacillus. This again reacts on the death return as many deaths now known to have been due to the Diphtheria bacillus would formerly have been returned as due to some other cause. The percentage of deaths to the cases notified was 6.4. The annual mortality per 1,000 inhabitants was 0.26. The number of cases notified as compared with London, during the last ten years was:— In Southwark. In London. In Southwark. In London 1914 338 9,118 1919 505 9,479 1915 387 9,166 1920 457 13,784 1916 442 8,754 1921 537 16,319 1917 580 8,300 1922 749 15,272 1918 504 8,174 1923 770 10,353 Number of deaths from Diphtheria during the last ten years:— In Southwark. In London. In Southwark. In London 1914 37 706 1919 42 777 1915 37 699 1920 37 1,009 1916 41 604 1921 30 1,054 1917 46 580 1922 61 1,137 1918 41 654 1923 49 602 Of the 770 cases notified 766, or 99 5 per cent. were removed to hospital with 49 deaths, a mortality of 6.4 per cent. In regard to the 4 cases nursed at home, they all recovered. ENTERIC FEYER. Two death from Enteric Fever occurred during the year, a mortality of 11.1 per cent. as against 3, 1 and 5, in the three preceding years. The total number of cases notified was 18 for the present year, and 3, 7 and 8, for the three preceding years. 41 This is the highest number notified since 1915. Of the above eighteen cases nine were patients or nurses in the Evelina Hospital for Children. The ages of the two fatal cases were 15 and 45 respectively. All the cases were removed to hospital for treatment. The number of cases notified and the number of deaths for the last ten years:— Notified. Deaths. Notified. Deaths 1914 24 2 1919 12 3 1915 23 3 1920 8 5 1916 13 2 1921 7 1 1917 10 5 1922 3 3 1918 8 1 1923 18 2 MEASLES. This is still by special order a notifiable disease in Southwark. During the latter part of the year there was an epidemic of Measles of a mild type, and the number of deaths was very few. There were 931 cases notified with 13 deaths. The whole of these deaths occurred in children under the age of 5 years. The percentage of deaths to the number of cases at all ages being 1.4 as against 2.3 during the last epidemic. Each case was visited by a health visitor, no special Measles nurse was employed. In all cases where deaths have occurred the room, clothing and bedding has been disinfected. Deaths from Measles during the last ten years:— 1914 95 1919 19 1915 131 1920 63 1916 94 1921 6 1917 75 1922 145 1918 145 1923 1 42 DIARRÆA The deaths from Diarrhaea and enteritis numbered 61. 21 notifications were received during the months of July, August and September The number of deaths in infants under 2 years of age was 54. This shows a slight rise in the deaths from Diarrhaea in spite of the facts that the summer was on the whole a cool one and no great number of flies was noticeable compared with the previous year. Deaths from Diarrhæa during the last ten years:— 1914 207 1919 104 1915 148 1920 59 1916 107 1921 149 1917 108 1922 29 1918 81 1923 61 WHOOPING COUGH. The deaths from this disease were 27 for the year. The annual death-rate per 1,000 living was 0.14. Deaths from Whooping Cough for the last ten years:— 1914 59 1919 10 1915 46 1920 27 1916 44 1921 28 1917 35 1922 62 1918 129 1923 27 INFLUENZA. The deaths from this disease were 25 for the year. The annual death rate per 1,000 living was 0.13. It will be seen from the subjoined table that there was a considerable fall in the deaths from Influenza. The type of disease was not so fatal as in preceding years. Deaths from Influenza during the last ten years:— 1914 29 1919 146 1915 28 1920 52 1916 30 1921 49 1917 22 1922 92 1918 589 1923 25 43 OPHTHALMIA NEONATORUM. 36 cases of this disease were notified during the year. An analysis of the total cases will be found hereunder:— 29 cases completely recovered with no permanent injury to eyesight. 1 case death. 4 cases born in Institutions and treated there. 1 case parents refused admission. (No report obtainable). 1 case still under treatment in hospital. 36 cases. Of these 36 cases 29 were treated in or at the various hospitals and 7 cases treated at home. CEREBRO SPINAL FEYER, ENCEPHALITIS LETHARGICA AND POLIO MYELITIS. 4 cases of Certbro-Spinal Fever were notified during the year, all of which died. 6 cases of Encephalitis Lethargica were notified all of which died. 4 cases of Polio Myelitis were notified, the present condition of the patients is as follows:— (a) Left arm at first useless, can now lift it above his head, arm still in splints. Still being massaged four times weekly. (b) Still in hospital, progressing well. (c) Right arm useless, attends hospital for Paralysis and Epilepsy. (d) Practically normal. Had bilateral Paralysis, but can now walk quite well. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. 209 cases were notified during the year, 167 of these were removed to the hospital or infirmary. There were 37 deaths of these notified cases. 44 HEALTH WORK. The number of visits made by the Health Visitors and other officers of the Public Health Department to houses in connection with Births, and other Health Work during 1923. TABLE 20. Original Visits. Revisits. Visits to AnteNatal Cases. Visits to PostNatal Cases. Visits to Delicate Infants. Visits to Cases of Diarrhoea and Sick Children. Attendances at Welfare Centres and Dental Clinic. Visits where Mothers were found to be out. Special Visits, &c. Total. Births. Measles Ophthalmia Neonatorum Births. Measles. Ophthalmia Neonatorum Mrs. Holland — — — — — — — — — — 393 — — 393 Mrs. Kingsmill 538 247 — 5,002 10 — 230 — — — 100 2 1 6,136 Miss Johnson 399 98 2 3,139 19 — 94 6 — — 88 202 1 4,048 Miss Hartley 392 312 1 3,548 4 — 105 5 — 3 86 54 — 4,510 Miss Eogers 402 93 — 2,946 10 — 121 — — — 96 19 — 3,687 Miss Cottrill 424 114 — 4,116 46 — 62 13 1 — 46 18 2 4,842 Miss Sayer 349 59 — 4,318 4 — 13 3 — — 88 41 — 4,875 Miss Adair 329 29 — 4.323 — — 220 56 27 — 98 — — 5,082 Miss Freeth 601 106 2 4,740 31 — 136 36 7 13 87 60 4 5,823 Mrs. George 223 38 1 3,550 5 — 96 o 1 — 96 302 1 4,316 Mrs. Southward (to August 18th) — 85 9 — 47 2 — 66 9 — 258 5 64 545 Mrs.Newman (home help) 395 117 512 Total 3,657 1181 15 35,682 182 2 1077 188 45 16 1,831 703 190 44,769 45 MATERNITY AND CHILD WELFARE CENTRES. Superintendent Health Visitor Mrs. J. A. Holland. 1a CENTRE (Voluntary). St. John's Institute, Larcom Street. District served by Centre St. John's Ward. Sessions held every Wednesday 10.30—12.30. 2.0—4.30. Medical Officer Dr. Cogan. Superintendent Mrs. A. Parkins. 1b CENTRE (Municipal). St. Mary's Parochial Hall, Kennington Park Road. District served by Centre St. Mary's Ward. Sessions held every Tuesday 10.30—12.30. 2.0—4.30. Medical Officer Dr. Dorothy Shepherd. Health Visitor Mrs. Kingsmill. 2a CENTRE (Municipal). St. Paul's Church Parochial Hall, Lorrimore Street. District served by Centre St. Paul's Ward. Sessions held every Wednesday 10.30—12. 2.0—4.30. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss H. Johnson. 2b CENTRE (Municipal). Working Boys' Club, Villa Street. District served by Centre St. Peter's Ward. Sessions held every Wednesday 10.0 — 12. 2.0—4.30. Medical Officer Dr. A. C. Kirker. Health Visitor Miss L. F. Hartley. 46 3a CENTRE (Municipal). All Saints' Parish Room, Surrey Square. District served by Centre:—The Southern portion of All Saints' Ward and the portion of St. George's Ward between East Street'and Albany Road. Sessions held every Thursday 10.0—12. 2.0—4.30. Medical Officer Dr. A. C. Kirker. Health Visitor Miss A. Rogers. 3b CENTRE (Municipal). Lady Margaret Church Parish Room, Chatham Street. District served by Centre:—The Northern half of All Saints' Ward and the portion of St. George's Ward between East Street and New Kent Road. Sessions held every Thursday 2.0—4.30. Medical Officer Dr. A. C. Kirker. Health Visitor Miss A. C. Cottrill. 4a CENTRE (Partly Municipal and partly Voluntary). Crossways Mission Hall, New Kent Road. District served by Centre Trinity Ward. Sessions held every Wednesday 10.0—12. 2.0—1.30. Medical Officer Dr. Jackson Smith. Health Visitor Miss W. Sayer. 4b CENTRE (Municipal). Mission Hall, Lansdowne Place. District served by Centre:—The Northern half of St. George's Ward and the streets between Trinity Street and Tabard Street. Sessions held every Friday 10.0—12. 2.0—4.30. Medical Officer Dr. A. C. Kirker. Health Visitor Miss F. N. Adair. 47 5 CENTRE (Partly Municipal and partly Voluntary). 56, Lambeth Road. District served by Centre:—A part of St. Jude's and St. Michael's Wards. Sessions held every Monday and Friday, 2—4.30. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss McCurdy. 6a CENTRE (Municipal). St. George's Dispensary, Pocock Street. District served by Centre:—Christchurch Ward and a part of St. Michael and St. Jude's Wards. Sessions held every Tuesday 10.0—12. 2.0—4.30. Medical Officer Dr. A. C. Kirker. Health Visitor Miss M. Freeth. 6b CENTRE (Municipal). St. Mary's Girls' Club, Union Street. District served by Centre St. Saviour's Ward. Sessions held every Monday 10.0—12. 2.0—4 30. Medical Officer Dr. A. C. Kirker. Health Visitor Mrs. M. E. George. 6c CENTRE (Partly Municipal and partly Voluntary), St. George the Martyr Parish Room, Borough High Street. District served by Centre A part of St. Michael's Ward Sessions held every Monday 2.0—4.30. Medical Officer Dr. Vernon. Health Visitor Miss Oxley. In addition to the above, the Roman Catholic Centre, 148, New Kent Road (Voluntary), holds a session every Thursday from 2.30—4, and Salamon's Centre, 28, Newcomen Street (Voluntary), holds two sessions, Monday 2—5, and Thursday, 10—12. 48 49 MATERNITY AND CHILD WELFARE CENTRES. Showing the Attendances at the several Centres and Visits paid by Health Visitors. TABLE 21. CENTRES. • Total. la. 1b. | 2a. 2b. 3a. 3b. 4a. 4b. 5. 6a. 6b. 6c. 7. Number of Births notified during the year 527 523 407 379 389 396 367 306 336 575 222 155 45 4627 Number of individual children attending the Centre during year 325 710 453 366 369 329 382 458 474 581 359 167 69 5042 Number of Sessions held during the year 88 94 94 94 96 48 86 94 90 92 90 44 104 1114 Number of new cases attending the Centres during the year — (1) Expectant Mothers 154 24 59 45 9 11 49 57 12 60 1 992 1473 (2) Infants under 1 year 281 497 321 261 250 251 245 264 280 379 185 120 66 3400 (3) Seen by Doctor 225 376 229 191 200 175 189 236 222 314 180 60 66 2663 (4) Children 1 to 5 years 44 213 132 105 119 78 137 194 194 202 106 47 3 1574 (5) Seen by Doctor 37 107 75 76 67 46 94 169 136 139 86 18 3 1053 Method of Feeding—(a) Breast 236 409 217 199 191 240 171 225 219 304 221 81 55 2768 (b) Breast and bottle 19 37 56 30 23 21 40 15 23 36 25 14 5 344 (c) Bottle 24 58 49 30 41 17 33 26 35 34 15 25 7 395 (d) Ordinary diet 46 206 131 107 114 51 138 192 196 207 98 47 2 1535 Total number of attendances at the Centres during the year— (1) Mothers 6654 7123 4725 4626 5552 3904 3715 5315 3394 5336 5175 1754 938 58211 (2) Expectant Mothers 586 209 109 164 39 85 — 92 140 111 72 7 3020 4634 (3) Infants under 1 year 3844 4941 3078 3174 3756 2523 ■2080 3258 2165 3197 3163 1237 938 37354 (4) Children 1 to 5 years 2101 1868 1897 1469 1776 1071 1289 2415 1449 1451 1683 1001 317 19787 (1) Average number of attendances 75.6 75.8 50.3 49.2 57.8 81.3 43.2 56.5 37.7 58.0 57.5 39.9 9.0 — (2) do. do. 6.7 2.2 1.2 1.7 0.4 1.8 — 1.0 1.6 1.2 0.8 0.2 29.0 — (3) do. do. 43.7 52.6 32.7 33.8 39.1 52.6 24.2 34 7 24.1 34.7 35.1 28.1 9.0 — (4) do, do. 23.9 19.9 20.2 15'6 18.5 22.3 15.0 25.7 161 15.8 18.7 22.8 3.0 — (5) Total number of attendances of Infants seen by Doctor during the year 1008 1212 1119 1416 1464 888 1369 2400 1193 1734 1920 542 938 17203 (6) Total number of attendances of children 1 to 5 years seen by Doctor during the year 351 294 590 579 564 345 763 1200 810 744 793 422 317 7772 (7) Post.natal cases 1364 1095 1619 1085 1400 1284 1217 2631 1826 1529 1792 406 938 18186 (8) Children weighed 4332 6127 4102 3912 4569 3157 3277 4440 3378 4565 4472 2250 1254 49835 Total number of first visits paid by Health Visitors to homes of— (1) Expectant Mothers 172 153 79 104 78 62 13 220 233 127 55 17 1049 2362 (2) Infants under 1 year 536 538 399 392 402 424 349 329 335 601 223 146 45 4719 (3) Children 1 to 5 years 27 — — — 1 — — — 9 — 4 — 41 Total number of revisits paid by Health Visitors to homes of— (1) Expectant Mothers 268 77 15 1 43 — - — 326 9 41 146 1459 2385 (2) Infants under 1 year 2308 2358 1500 1513 1565 2231 1929 2368 1833 2150 1473 1321 961 23513 (3) Children 1 to 5 years 3024 2644 1639 2035 1381 1885 2389 1955 2654 2590 2077 2271 1029 27573 44 Sewing Classes were held at No. 5 Centre, with a total attendance of 598. 50 NURSING. There are now no special nurses employed by the Borough Council for the nursing of cases of measles. The Maternity and Child Welfare scheme provides a home help for rendering assistance during the absence from her home of a mother, or during her incapacity through illness. Sick nursing in the district of St. Mary, Newington, is carried out by the Benson Home Nurses, which home receives a subsidy of £400 from the Newington United Charities. In other parts of the Borough the Ranyard Nurses do much valuable sick nursing, and one or two parishes provide their own nurse. DIPHTHERIA ANTITOXIN. Diphtheria Antitoxin can be obtained any time at tbe Council's Reception House, King James Street, Lancaster Street, including Sunday and all Public Holidays, and also on ordinary week days, during the hours between 9.0 a.m. and 5.30 p.m., at the Town Hall. This is always kept in a fresh condition and a sterilised syringe is also lent if necessary to give the injection. LABORATORY WORK. During 1923 there has been a considerable increase in the use of facilities offered by the bacteriological department for the examination of throat swabs and sputa; also for the blood examination for typhoid fever, the numbers amounting to 2,259, as against 1,722 in 1922, a total increase of 537 specimens. Of these specimens 1,411 were for tubercle bacilli, and this is an important factor in our fight against consumption, and an integral part of the London County Council's scheme. MUNICIPAL NURSERY. The nursery at 63, Kennington Park Road, continues to do good work and is much appreciated by the mothers living in the borough. They go to their daily work with the knowledge that their children left in our charge will be well looked after. The staff consists of a matron and a nurse, four probationers, a cook, house cleaner and a laundrywoman. The number of attendances of children during the year was 10,120, making an average daily attendance of about 36. The charge is eightpence a day for those over nine months, and tenpence a day for those under that age. 51 TABLE 22. Return of Families Admitted into the Council's Reception House during the tear 1923. 1923. Scarlet Fever. Diphtheria. Small Pox. Other Diseases, &c. Verminous Persons. Week Ending. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. Jany. 6 — — — — — — 1 2 12 — — — — — — „ 13 — — — 1 2 6 — — — — — — — — — „ 20 — — — 2 7 21 — — — — — — — — — „ 27 — — — 4 10 34 — — — — — — — — — Feby. 3 — — — 1 2 4 — — — — — — — — — „ 10 1 3 9 — — — — — — — — — — — — „ 17 — — — — — — — — — — — — — — — „ 24 1 3 9 1 2 6 — — — 1 1 3 — — — March 3 — — — — — — — — — — — — — — — „ 10 — — — 1 4 12 — — — — — — — — — „ 17 — — — 2 10 30 — — — — — — — — — „ 24 — — — — — — — — — — — — — — — „ 31 — — — — — — — — — — — — — — — April 7 — — — 1 3 9 — — — — — — — — — „ 14 — — — — — — — — — — — — — — — „ 21 — — — 2 4 16 — — — — — — 1 1 2 „ 28 — — — — — — — — — — — — — — — May 5 — — — — — — — — — — — — — — — „ 12 1 3 6 2 4 13 — — — — — — — — — „ 19 — — — 2 6 12 — — — — — — — — — „ 26 1 3 12 1 1 5 — — — — — — — — — June 2 — — „ 9 ] 4 12 — — — — — — — — — — — — „ 16 1 1 3 2 5 14 — — — — — — — — — „ 23 — — — 1 4 12 — — — — — — — — — „ 30 — — — — — — — — — — — — — — — Crd. fwd. 6 17 51 23 64 194 1 2 12 1 1 3 1 1 2 52 TABLE 22—Continued. 1923. Scarlet Fever. Diphtheria. Small Pox. Other Diseases, &c. Verminous Persons. Week Ending. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. No. of Families. No. of Persons. No. of Days. Brt. frwd. 6 17 51 23 64 194 1 2 12 1 1 3 1 1 2 July 7 1 2 4 1 2 4 — — — — — — — — — „ 14 — — — — — — — — — — — — — — — „ 21 — — — — — — — — — — — — — — — „ 28 — — — 1 5 15 — — — — — — — — — Aug. 4 — — — — — — — — — — — — — — — „ 11 — — — — — — — — — — — — — — — „ 18 1 3 12 — — — — — — — — — — — — „ 25 — — — 1 6 18 — — — — — — — — — Sept. 1 — — — 2 2 4 — — — — — — — — — „ 8 — — — — — — — — — — — — — — — „ 15 — — — 2 2 5 — — — — — — — — — „ 22 3 9 24 — — — — — — — — — — — — „ 29 1 2 6 1 5 10 — — — — — — — — — Oct. 6 — — — 1 2 6 — — — — — — — — — „ 13 1 4 12 1 2 6 — — — — — — — — — „ 20 — — — — — — — — — — — — — — — „ 27 1 4 8 1 2 6 — — — 1 1 1 — — — Nov. 3 — — — — — — — — — — — — — — — „ 10 — — — — — — — — — — — — — — — „ 17 — — — — — 21 — — — — — — — — — „ 24 — — — 2 6 — — — — — — — — — — Dec. 1 — — — — — — — — — — — — — — — „ 8 — — — — — — — — — — — — — — — „ 15 1 6 18 — — — — — — — — — — — — „ 22 — — — — — — — — — — — — — — — „29 — — — — — — — — — — — — — — — Total 15 47 135 36 98 289 1 2 12 2 2 4 1 1 2 53 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 14,936. Of this number 2,201 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, as against 3,696 rooms in 1922. 10,458 periodical sprayings of rooms occupied by Phthisical patients were also carried out during the year. 680 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 728 in 1922. Among the total number of disinfections (14,936) it was found necessary to strip 505 rooms. Of these 394 were in relation to the notifiable diseases, 110 after the termination of cases of Phthisis, and 1 was verminous. TABLE 23. The Locality of Rooms Disinfected and Stripped after the occurrence of Infectious Disease. St. Mary's Ward. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. AllSaints Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Disinfected 279 194 242 176 206 215 260 224 225 78 102 2201 Stripped 64 42 42 45 35 44 35 38 38 11 10 394 1,597 sprayings of Offices and Rooms at the Town Hall were also carried out during the year. TABLE 24. The Locality of the Rooms Disinfected and Stripped after the occurrence of Phthisis. St.Mary's Ward. St. Paul's Ward. St.Peter's Ward. St. John's Ward. Trinity Ward. All Saints Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. ChristChurch Ward. St. Saviour's Ward. Total. Disinfected 1136 1157 1056 1154 810 1051 1225 821 1087 481 480 10,458 Stripped 19 13 11 13 8 12 14 8 10 2 — 110 54 TABLE 25. Bedding, &c., disinfected and destroyed after the occurrence of Infectious Disease during the Year 1923. Articles. No. Disinfected. No. Destroyed. Beds 1,439 49 Palliasses 1,213 47 Bolsters 667 9 Pillows 1,416 28 Cushions 260 6 Blankets 1,792 4 Sheets 1,357 6 Quilts 990 6 Articles of Clothing, &c. 2,246 101 Books 74 — Total 11,454 256 3 tons 18 cwt. 3 qrs. 12 lbs. of horse hair and 34 satchels were also disinfected at the Depots. 1 chair was destroyed. PHTHISIS. TABLE 26. A summary of the cases notified and other particulars in connection therewith during the year 1923. Notified cases remaining in district at end of 1922. Cases notified during 1923. Old cases returned home from Infirmary. Visits paid at the homes of patients. Cases removed to Infirmary. Cases removed from Southwark or which died at home. Notified cases remaining in Southwark at end of 1923. Rooms periodically sprayed and otherwise disinfected. Booms stripped on termination of cases. 1,141 424 269 12,309 425 519 890 10.458 110 55 TABLE 27. Showing the Number and Sex of Verminous or Scabious Children treated at the Council's Station, King James Street, during 1923, and the Schools from which they were sent. These 3,439 Children received 4,904 baths during 1923. Name of School. Verminous. scabious. Boys. Girls. Boys. Girls. Total. Archbishop Sumner — 4 — — 4 Addington street — 53 — 2 55 All Saints' 1 50 1 — 52 Archbishop Temple — — — — — Archbishop Tenison — 29 — — 29 Archbishop Tait — 14 — — 14 Blackfriars 1 71 3 5 80 Beresford street 2 38 — — 40 Charles Dickens 9 130 3 5 147 Christchurch 1 48 2 — 51 Crampton street 4 45 2 — 51 English Martyrs 2 56 — 1 59 Faunce street 7 29 3 1 40 Flint street 1 116 1 1 119 Heygate street — 11 3 5 19 Holy Trinity 2 28 — — 30 Harper street 8 102 5 8 123 Hatfield street 1 49 1 — 51 Holland street 5 102 — — 107 Johanna street 1 97 — 8 106 John Buskin — 24 1 — 25 King and Queen street 5 113 — — 118 Lollard street 2 99 5 9 115 Mina road 3 39 — — 42 Michael Faraday 3 45 — 1 49 Newcomen Foundation — — — — — Orange street 5 112 — 3 120 Penrose street 4 66 1 2 73 Friar street 6 219 3 — 228 Rockingham street 21 178 — 1 200 St. George's R.C. 5 25 — — 30 Carried forward 99 1,992 34 52 2,177 56 Name of School. Verminous. Scabious. Boys. Girls. Boys. Girls. Total. Brought forward 99 1,992 34 52 2,177 St. George's, Earl street — 62 2 — 64 Sayer street 4 94 8 7 113 St. Saviour's — 27 — 4 31 St. Agnes 6 51 — — 57 St. Paul's, Sutherland square 2 32 2 — 36 Surrey square 4 42 — — 46 Sandford row 14 66 5 1 86 Springwell house — — — — — St. John's, Larcom street — 24 — 4 28 St. Patrick's 1 45 — 2 48 St. John's, Waterloo road 4 43 1 — 48 St. Alban's 1 10 — — 11 St. Andrew's — 33 — — 33 St. Mary, Newington 4 99 1 — 104 St. Jude's — 45 — — 45 St. Joseph's 1 94 2 2 99 St. Mary, Lambeth 2 39 — — 41 St. Peter's 1 9 — — 10 St. Phillip's — — — — — Victory place 2 42 — 1 45 Westminster Bridge road 11 94 2 1 108 Walnut Tree walk 6 79 — 1 86 West square — 19 — — 19 Waterloo road 7 64 — — 71 Westmoreland road — 31 1 — 32 Webber street — — 1 — 1 Totals 169 3,136 59 75 3,439 57 CLEANSING OF PERSONS ACT, 1897. Adults sent from Lodging-houses and other places in the Borough to be cleansed during 1923. TABLE 28. Address. Male. Female. Total. 83, Blackfriars road 1 1 112, Barlow street 2 — 2 Salvation Army Shelter, Blackfriars road 264 — 264 90, Camberwell road 12 — 12 7, Dorritt street — 8 8 86, Gravel lane 24 — 24 12, Gray street 3 — 3 3, Quilp street 3 — 3 Rowton house 14 — 14 St. Olave Chambers 23 — 23 112, Southwark Bridge road 22 — 22 67, Union street — 8 8 78, Camberwell road — 4 4 12, Lombard street — 6 6 Morning Post Home, New Kent road 5 — 5 8, Great Charlotte street 9 — 9 YM.C.A. Huts 312 — 312 19, Belvedere crescent — 5 5 Other addresses 13 21 34 Total 706 53 759 58 Cleansing of Verminous Rooms and their Contents. During the year 1923 the number of verminous rooms with the bedding and other articles cleansed and disinfected in accordance with the requirements of Sections 19-21 of the London County Council (General Powers) Act, 1904, has decreased in comparison with 1922. I append a table shewing the number of notices served upon the owners or occupiers of the several premises in question, and the number of verminous rooms stripped and cleansed by the owners, and fumigated by the Council's disinfecting staff, respectively. I also submit tables showing the number of articles dealt with at the disinfecting stations. TABLE 29. Verminous Rooms Cleansed. Ward. No. of Intimation Notices served. No. of Statutory Notices served. Police Court proceedings taken. Verminous rooms treated. (a) by Owners of Premises. (b) by the Council's Disinfect ing Staff. St. Mary 45 13 — 56 48 St. Paul 16 4 — 24 26 St. Peter 32 12 — 41 29 St. John 91 34 — 112 37 Trinity 154 65 — 206 213 All Saints 99 30 — 115 57 St. Michael 103 64 — 131 107 St. Jude 65 20 — 85 54 St. George 87 35 — 114 59 Christchurch 12 4 — 14 20 St. Saviour 14 8 — 16 30 Houses let in Lodgings (No. 1 District). 11 5 — 12 — Houses let in Lodgings (No. 2 District). 26 8 — 40 — Total 755 302 — *966 680 *Note:—These 966 rooms were stripped by the owners. 59 TABLE 30. Verminous Bedding, &c., Disinfected at the Council's Stations during 1923. Articles. Disinfected. Destroyed. Beds 136 4 Palliasses 84 1 Bolsters and Pillows 299 1 Cushions 84 — Blankets 672 — Sheets 164 — Quilts 172 — Articles of Clothing, &c. 13,442 48 Total 15,053 54 1 bag of feathers and 1 dust-sheet were also disinfected at the Depots. 3 boxes and 5 bags of old clothes and rubbish were destroyed. VERMINOUS PERSONS CLEANSED DURING 1923. During the year 4,198 persons were cleansed at the station in King James Street. Under our agreement with the London County Council, 3,439 children were cleansed. One cleansing was found to be sufficient in verminous cases, except when the cases were associated with impetigo, when two or three cleansings had to be given. Many of the children treated were suffering from Scabies. In every case the treatment at our Station was thoroughly efficacious, and no recurrence of the trouble was experienced. 759 adults sent from the various common lodging houses and other places in our borough were cleansed during the year, as against 626 dealt with under the provisions of the Cleansing of Persons Act, 1897, in 1922. 60 MORTUARIES. TABLE 31. During the year 416 bodies were received into the Mortuaries:— Reasons bodies were brought to Mortuary. Collier's Rents Mortuary. Manor Place Mortuary. Total. Bodies brought in upon which Inquests were held 138 140 278 Bodies brought in for convenience 8 127 135 Bodies brought in in cases where death had occurred from Infectious Disease 1 2 3 Total 147 269 416 61 SANITARY WORK. ST. MARY'S WARD. House to house inspections were carried out in the following localities:— Alberta street, Berryfield road, Cavour street, Chapter road, Danson road, Delverton road, Faunce street, Gaza street, Horse and Groom court, Kennington Park road, Manor place, New street, Penton place, St. Paul's road, Suffield road. Tarver road. st. paul'S ward. Aldred road, Alpha square, Avenue cottages, Beresford buildings, Beresford street, Chapter road, Farmer's road, Grosvenor park, Grosvenor terrace, Royal terrace, Sturgeon road, Sutherland place, Sutherland square, Sutherland street. ST. PETER'S WARD. Aylesbury road, Beckford place, Blackwood street, Boundary lane, Bronti place, Burton street, Date street, Doctor street, East street, Elizabeth street. Faraday street, Inville road, Pinelp street, Saltwood grove, South strent, Wooler street, Worth grove. ST. JOHN'S WARD Bedford street, Browning street, Charleston street, Content street, Deacon street, Gloucester house, Havelock cottages, Heygate street, Ladysmith dwellings, Larcom street, Lestock place, Lion street, Lt. Trafalgar place, Morecambe street, Munton road, Palatinate, Sayer street, Townley street, Victory place, Wadding street, Walcorde avenue. TRINITY WARD. Arch street, Arcadia, Bath house. Bideford court, Borough High street, Britannia chambers, Devonshire house, Edinburgh buildings, Falmouth chambers, Foston place, Globe buildings, Gt. Dover street, Harmer's buildings, Harper street, Linwood place, Meadow row, Ralph street, Rockingham buildings, Silvester buildings, Tiverton flats, Trinity square, Trinity house, Union square, Uxhridge place, Uxbridge street. ALL SAINTS' WARD. Alfreton street, Amery place, Aylesbury road, Brockley terrace, Claremont terrace, Hopwood street, Innis place, Inville road, Jesmond 62 street, Kinglake street, Mann street, Namur terrace, Northampton place, South street, South street buildings, Surrey square, Thurlow street, Williams grove. ST. MICHAEL'S WARD. Belvedere buildings, Bittern street, Borough High street, Brigade house, Clapton buildings, Clenham street, Collinson street, Foundry yard, Friar street, Gerridge street, Gray street, Ilfracombe buildings, King James street, Lant street, Library mansions, Library street, Marshall buildings, Miniver street, Monarch buildings, Nelson place, Peabody square, Priory buildings, Queen's court, Quinn square, Queen's buildings, Collinson street, Queen's buildings, Red Cross street, Rodney street, St. George's mansions, Scovell road, Southwark Bridge road, Sturge street, Sumptions buildings, Toulmin street, Union street, Valentine place, Webber row, Young's buildings. ST. JUDE'S WARD. Barbel street, St. George's buildings, West square. ST. GEORGE'S WARD. Amicable row. Angel place, Borough High street, Brook's cottages, Chaucer house, Cleghorn street, Congreve street, Cornbury street, Crosby row Delph street, Devonshire house, Dobbs cross, East street Falstaff yard, Gordon house, Hankey place, Hendie road, Henshaw street, Imperial chambers, Kinglake street, Lansdowne place, Law street, Layton's buildings, Layton's grove, Mailing place, Marcia road, Massinger street, Mina road, Minnow street, New Kent road, Preston buildings, Prioress street, Searles road, Shorncliffe road, Smyrks road, Stannage, Staple street, Surrey place, Surrey terrace, Surrey villas, Swan buildings, Upper Grange road, Upper Mill, Warner street, Wolseley house. CHRISTCHURCH WARD. Albert Institute, Collingwood street, Colombo court, Hatfield street, Isabella street, Jane street, Milton house, Nelson house, New cut, Norfolk street, Ponsonby buildings, Short street. ST. SAVIOUR'S WARD. Emerson place, Emerson street, Gt. Guildford street, Lizette place, Mowbray buildings, Noah's Ark alley, Peabody buildings, Orange street, St. Margaret's court, Stanhope buildings, Street's buildings, Sumner street, Wagstaff buildings, Winchester cottages, Winchester buildings. 63 TABLE 32. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made and details of work carried out during the year 1923. WARD. Number of Premises Inspected. Number of Re-inspections made. Premises Rat Infested. Premises where steps were taken to destroy Rats and Mice. Rat Proofing. Rat Holes and Runs stopped. Defective Drains Amended. Defective Sewers Amended. Notices. Poisons used. Wire Traps. Breakback Traps. Other Traps. Varnish. Cats or Dogs. Ferrets. St. Mary 47 279 32 78 21 117 — 11 5 — — 8 1 — 3 St. Paul 93 726 82 115 23 155 1 11 18 — — 28 9 2 15 St. Peter 52 137 28 20 6 27 — 4 4 — 2 18 8 — 6 St. John 43 174 31 18 8 27 — 1 6 — — 12 6 — 11 Trinity 50 552 43 81 47 130 1 2 11 — — 14 4 — 21 All Saints' 66 380 51 13 15 44 — 1 8 — 1 18 7 1 12 St. Michael 37 280 24 21 12 34 — 7 4 1 1 7 2 — 13 St. Jude 44 341 23 32 14 56 — 1 8 — 1 10 7 1 5 St. George 47 346 25 35 16 43 — — 6 — — 18 1 — 9 Christchurch 25 75 13 2 — 4 — 2 — — 1 6 2 3 5 St. Saviour 25 102 18 22 5 19 — — 9 — — 5 4 1 1 Total 529 .1392 370 437 167 656 2 40 79 1 6 144 51 8 101 Number of Eats and Mice destroyed 568 Eats, 30 Mice. 64 REGISTERED HOUSES LET IN LODGINGS During the year 1923, one house was placed upon the Register, viz., 13, Rockingham Street. 12 houses were removed from the Register, 9 of these having been demolished. At the end of the year the number of houses upon the Register was 1,302. They were situate as follows:— In No. 1 district (St. Michael St. George, Christchurch and St. Saviour's Wards) 875 houses In No. 2 District (St. Mary, St. Paul, St. Peter, St. John, Trinity, All Saints and St. Jude's Wards) 127 „ 1,302 houses TABLE 33. Table showing the locality (in Wards) of the Houses Let in Lodgings on the Register at the end of 1923. WARDS. St. Mary St. Paul St. Peter St. John Trinity . All Saints' St. Michael St. Jude St. George Christchurch St. Savicur Total. Number of Houses upon the Register at the end of 1922 35 48 32 51 56 128 336 79 357 111 80 1313 Number of Houses placed upon the Register during the year 1923 — — — — 1 — — — — — — 1 35 48 32 51 57 128 336 79 357 1ll 80 1314 Number of Houses removed from the Register during the year 1923 — — — 3 — — 1 — 8 — — 12 Total number of Registered Houses at end of 1923 35 48 32 48 57 128 335 79 349 1ll 80 1302 65 HOUSES LET IN LODGINGS. No. 1 District. House to house inspections were carried out in the following localities:— Queen's Arms court, Hankey place, Bear lane, Cardol place, Little Surrey street, Stamford street, King James street, Milcote street, Dodson street, Surrey row, Union street, Boddy's bridge, Upper Ground place, Prioress street, Redcross street, Friar street, Belvedere buildings, Mermaid court, Tabard street, Gilbert's buildings, Paris gardens, Sussex house, Weston street, Park street, Valentine place, Gray street. During the year 461 inspections and 1,847 re-visits were made of the various registered houses by Miss Burrows. 479 intimation and 227 statutory notices were served. 561 sanitary works were carried out. The following nuisances have been abated:— Blocked drains unstopped 7 Closet apparatus reinstated 41 Water supply reinstated 3 New closet pans provided 1 Yards paved or paving amended 54 Roofs repaired 120 New dust bins provided 53 Foul rooms cleansed 1,970 Cases of overcrowding abated 14 Miscellaneous nuisances (other than those above specified) abated 964 66 HOUSES LET IN LODGINGS. No. 2 District. House to house inspections were carried out in the following localities:— Runham street, St. Gabriel street, Gurney street, Elsted street, Halpin place, Kingston street, Brandon street, Beckway street, East street, Larissa street, Chatham street, Rodney road, Barlow street, Causeway place, Flint street, Lamlash street, Alvey house, Townley street, Empress street, Goschen street, Horsman street. During the year 362 inspections and 1,511 re-visits were made of the various registered houses by Miss Burrows. 395 intimation and 181 statutory notices were served. 425 sanitary works were carried out. The following Nuisances have been abated:— Blocked drains unstopped 6 Closet apparatus reinstated 33 Yards paved or paving amended 41 New closet pans provided 5 Roofs repaired 90 New dustbins provided 37 Foul rooms cleansed 1,527 Cases of overcrowding abated 7 Miscellaneous nuisances (other than those above specified) abated 187 67 ICE CREAMS. TABLE 34. Showing the Number of Inspections made of the Shops or other Premises where Ice Cream is made or stored during 1923. WARDS. Original Inspections. Re-inspections. Premises found satisfactory on Inspection. Premises found defective on Inspection. Intimation Notices served. Statutory Notices served. Proceedings taken. St. Mary's 13 — 13 — — — — St. Paul's 32 19 28 4 4 4 — St. Peter's 14 32 7 7 7 5 — St. John's 29 26 21 8 8 6 — Trinity 18 17 14 4 4 2 — All Saints' 18 37 9 9 9 3 — St. Michael's 12 6 9 3 3 1 — St. Jude's 11 14 8 3 3 1 — St. George's 17 12 10 7 10 2 — Christchurch 1 4 — 1 4 — — St. Saviour's — — — — — — — Total 165 167 119 46 52 24 — 68 EATING HOUSES. During the year the Eating Houses and other places where food is prepared for sale were periodically inspected. The following table shows the number of inspections, &c., made during the year. TABLE 35 Showing the number of Inspections made of the Eating Houses, &c., during 1923. WARDS. Original Inspections. Re-inspections. Premises found satisfactory on Inspection. Premises found defective on Inspection. Intimation Notices served. Statutory Notices served. Proceedings taken. St. Mary's 137 33 121 16 17 5 — St. Paul's 53 18 47 6 6 1 — St. Peter's 75 5 69 6 6 — — St. John's 144 104 111 33 34 13 — Trinity 156 106 132 24 24 4 — All Saints' 69 23 61 8 10 1 — St. Michael's 164 37 141 23 25 8 — St. Jude's 83 51 61 22 26 3 — St. George's 135 27 115 20 20 3 — Christchurch 133 37 113 20 23 2 — St. Saviour's 176 39 157 19 19 4 — Total 1325 480 1128 197 210 44 — 102 103 TABLE 50. Sanitary Works completed during 1923 and also in Fourteen preceding Years, 1909-22. Year. Intimation Notices served. Statutory Notices served. Sanitary Works completed. Drain reconstructed. Drain repaired. Interceptor, die. Blocked Drains unstopped. New Soilpipe provided. Closet app. or repaired. Closet provided. Water supply. Closet Pan and Trap. Yards, Ac., paved. Paving repaired. Gullies provided. Sinks trapped. Rain Pipes disconnected. Boofs, Gutters, &c. Dust-bin provided. Basement concreted. Foul rooms cleansed. Floor ventilation. House ventilated. Draw tap from Main. Overcrowding abated. Additional Water Supplies provided. Surface Drains. Miscellaneous Nuisances from Urinals, Manure, Animals, &c., abated. 1923 11299 4304 11570 171 336 40 309 43 918 69 103 410 9 953 162 421 10 21)88 1667 1 20371 84 4 23 92 10 — 13613 1909 13532 4628 13604 233 160 59 539 47 2072 66 502 445 204 1018 164 198 22 1714 1307 20 24728 114 56 365 444 165 6 4403 1910 14484 4634 14508 164 171 32 589 36 1731 35 383 441 182 1406 158 532 21 1792 1377 28 24763 122 101 317 444 251 25 5646 1911 15386 4975 15350 317 184 40 568 37 1986 53 265 585 88 1307 204 539 6 1655 1516 8 23873 124 78 250 442 129 5 5629 1912 15197 4903 16041 288 192 30 589 35 2205 23 57 569 81 1143 181 281 19 1818 1615 8 21980 87 88 67 417 100 6 6274 1913 14967 4578 15673 303 166 16 555 36 2057 18 90 545 79 888 152 369 23 1314 1439 8 22805 57 101 122 494 68 10 6908 1914 12974 4551 12942 271 181 25 495 71 1806 18 127 780 68 926 241 591 11 1138 1253 8 22537 71 52 219 295 42 — 5726 1915 10541 4183 11063 96 107 6 462 37 1430 38 114 491 40 634 103 368 8 2381 1210 22 18078 71 53 184 229 32 4 563£ 1916 8513 3705 8562 94 62 18 373 17 1070 22 54 199 17 411 50 125 1 1476 984 5 12882 50 57 31 207 17 23 4313 1917 9233 4597 8337 36 50 10 342 33 1311 19 84 174 23 363 60 124 2 1661 1026 2 12436 74 22 19 126 12 — 4046 1918 10233 5047 10091 22 84 23 428 14 1486 22 88 239 11 587 21 169 2 2237 1163 10 15140 59 19 17 168 6 2 5594 1919 11570 5495 12007 93 172 18 364 17 1499 37 42 292 18 811 50 208 1 2512 1656 2 23359 63 34 14 103 — — 7709 1920 13566 6811 13140 106 384 47 318 35 1444 88 386 385 14 1155 121 305 1 2986 2638 7 30107 205 114 13 49 1 — 10027 1921 13377 6030 13853 128 319 48 324 31 1659 70 100 420 20 1404 123 325 2485 2485 7 31056 197 55 23 51 20 — 12113 1922 13028 5215 13212 165 315 48 324 33 1379 122 103 428 40 1137 78 306 6 2836 2134 3 25040 84 38 22 77 23 — 12815 104 TABLE 51 Summary of Original Inspections, &c., made during 1923 and in Fifteen preceding Years, 1908-1922. Year. Complaints (including houses in which deaths have occurred). House to House. Infectious Diseases. Factories, Workshops and Workplaces, Ac. Number of Inspections made. Number of drains tested. Number of Reinspections made. Number of Inspections made. Number of drains tested. Number of Reinspections made Number of Inspections made. Number of drains | tested. Number of Reinspections made. Number of Inspections made. Number of Reinspections made. 1923 6403 309 20880 6975 183 181S0 2589 1232 3823 5614 2203 1908 13099 4871 26506 11324 3718 30530 1550 1550 2285 6614 7113 1909 14954 3595 25370 11426 2943 26389 1507 1507 2087 5002 4846 1910 16557 2350 29051 7729 1338 22182 1269 1269 16i8 5066 4915 1911 14325 1827 30052 9825 1561 24277 1878 1878 2261 5491 4783 1912 13437 2425 29128 10234 2354 24476 1822 1822 2053 6133 5432 1913 14225 2046 29278 9921 2125 21372 2399 2399 2778 6451 4773 1914 13678 1732 28512 7913 1954 19808 2626 2626 3589 6114 4532 1915 11776 1102 23691 7245 1325 20025 2077 2077 2717 5762 3822 1916 8326 388 18394 6905 580 16363 1571 718 1894 5528 3538 1917 7225 203 18499 6994 85 18494 1678 599 2538 5016 4044 1918 9101 238 26251 7361 58 23762 1942 673 3866 5355 4515 1919 8272 296 24165 7605 87 25271 1787 825 3078 5300 3896 1920 8932 301 27876 8582 141 27388 1803 1033 2901 5044 3212 1921 8648 752 24638 8517 409 27494 2175 1821 3703 6105 3984 1922 7650 376 22843 7435 145 20190 3927 1696 6165 6308 3558 105 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER. At the end of the year 1922 the number of milksellers on the Registers were as follows :— Retail 264 names 255 premises Wholesale 38 „ 37 „ During the year 1923, 115 applications for registration as Retail Milksellers were received. Of these 111 were registered and 4 wer3 found to be unsuitable for registration. 9 applications for registration as Wholesale Milksellers were received and were duly registered. Retail Register. Entered in Register. Removal from Register. Not Hegistered. (Unsuitable, &c.) Total Applications. Names. Premises. Names. Premises. Ill 101 57 52 4 115 The sale of milk was started afresh at 17 premises The sale of milk was discontinued at 9 „ Total number of Milksellers on Retail Register at end of 1923... 318 Total number of Milksellers' premises ,, 304 Wholesale Register. Entered in Register. Removal from Register. Not Registered. (Unsuitable, &c.) Total Applications. Names. Premises. Names. Premises. 9 9 9 8 — 9 The sale of milk-by wholesale was newly started during 1923 at 5 premises The sale of milk by wholesale was discontinued „ 5 ,, 106 Total number of Wholesale Milksellers on Register at end of 1923 38 Total number of Wholesale Premises „ 38 During the year seven applications for licences to sell milk as " Certified," and one application to sell milk as " Grade A (Tuberculin Tested)" at or from various addresses in the Borough were received from Messrs. R. Higgs <fc Sons Dairies, Ltd., of 2, 4, 6, Canterbury Road, Brixton. The eight licences were duly granted by the Council as under:— To sell " Certified " milk at No. 64, Camberwell Road. No. 1/3, New Street. ,, 62. Borough High Street. ,, 38, Westmoreland Road. ,, 8, Alvev Street. ,, 91, Southwark Bridge Road. ,, 18, Villa Street. To sell " Grade A (Tuberculin Tested) " milk at No. 64, Camberwell Road. 107 The following work of supervision was carried out by Mr. Nicholson during the year:— MILKSELLERS. 1,617 inspections of the various milkshops were made. The following nuisances were discovered, in respect to which 46 intimation and 9 statutory notices were served :— Dirty milkshops 17 cases Dirty milkstores 8 cases Dirty floors 8 casos Defective floors 3 cases Defective walls 6 cases Utensils improperly stored and defective 3 cases Defective paving 4 cases Milk improperly stored 1 case Other insanitary conditions 18 cases Unsuitable premises 2 cases Paraffin sold 1 case Total 71 cases All the above nuisances were remedied. NOXIOUS TRADES. There are two premises in the Borough upon which noxious businesses or trades are carried on. The following are the premises :— Situation of Premises. Description of Business. Name of Occupiers. 24 and 25, Great Suffolk Street Tripe boilers J. Martin 5, Hatfield Street Fat melters J. Ewen & Son The Inspector made 8 inspections of these premises during the year. No nuisance was discovered. The periodical process of limewashing and cleansing was duly carried out. 108 COWSHEDS. No cows are being kept in the Borough at the present time. BAKEHOUSES. During the year 622 inspections were made of the various bakehouses and factories. The following defects were discovered by the Inspector, who found it necessary to serve 60 intimation and 13 statutory notices in order to obtain the abatement of the nuisances complained of Dirty utensils 23 cases Dirty ceilings 50 cases Dirty walls 52 cases Dirty floors 30 cases Food or flour store dirty 7 cases Oven front defective 1 case Defective walls 3 cases Defective floors 2 cases Defective roofs 4 cases Defective ceilings 3 cases Defective troughs 2 cases Animals in bakehouse 2 cases Unsuitable premises 1 case Damp walls 1 case Defective paving 1 case Other insanitary conditions 25 cases Total 207 cases All the above-mentioned nuisances were remedied. Each bakehouse was limewashed or the walls washed as required. Certificates have been granted during the year to the undermentioned bakehouses:— Above Ground Bakbhouses, 386, Walworth Road. 176, East Street. 61, Westmoreland Road. 63, Finchley Road. Underground Bakehouses. 34, Portland Street. 42, New Kent Road. 119, Walworth Road. 68, Alvey Street. 109 FACTORY BAKEHOUSE. 61, Webber Street. 11, Stamford Street. 195/201, Union Street. BUTTER AND MARGARINE FACTORIES. Seven inspections of these premises were made. No nuisance was discovered. SLAUGHTERHOUSES. The supervision of the various Slaughterhouses was carried out during the year by Mr. Fisher. There are five licensed Slaughterhouses in the Borough. The following are the premises and the licensees: — Situation of Premises. Name of Licensee. 129, Hillingdon Street Frederick George Jacques 3, Lucas Road Reginald Stanley Taylor 70, Union Road Sidney John Waghorn 244, Walworth Road Messrs. Chalk & Cox, Ltd. 283-5, Walworth Road William Charles Brady 55 inspections were made during the year. No nuisance was discovered. Each Slaughterhouse was limewashed every three months during the year. SALE OF FOOD AND DRUGS ACTS. During the year ending 29th December, 1923, 1,482 "official" samples were taken by the Inspector. The following Table shows the localities in which these samples wi-rn taken :— TABLE 52. Showing the number of samples taken in each Ward of the Borough during the year. St. Mary's Ward. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. All Saints' Ward. 1 St. Michael's Ward. | St. Jude's W^ard. , St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Number of Samples taken 158 161 139 148 139 143 132 127 154 95 86 1482 110 58 of those samples were certified as adulterated, a percentage of 3.9. Compared with the percentage for the previous year a decrease of 0.6 is shown. Particulars of the samples taken together with the results of the analyses are given in table 55. POLICE COURT PROCEEDINGS TAKEN UNDER THE FOOD AND DRUGS ACTS. 24 summonses were taken out during the year 1923. The following table shows the number of summonses in each ward: - TABLE 53. Showing the Wards in which proceedings were taken under the Food and Drugs Act. St. Mary's W ard. St. Paul's Ward. St. Peter's Ward. St. John's Ward. Trinity Ward. All Saints' Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Number of Summonses taken out — 1 — 4 0 2 4 1 2 4 1 24 The proceedings taken before the Magistrates resulted as follows Summonses. Convictions obtained on 16 Withdrawn (duplicates) 1 Dismissed on warranties 1 Dismissed on payment of costs 6 Total 24 111 INFORMAL SAMPLES. In addition to the samples taken under the Food and Drugs Acts as shown in table 55, 496 samples were purchased informally by the Inspector through his several agents. The whole of these samples were submitted to the Public Analyst for analysis, with the following result:— TABLE 54. Article. No. of samples purchased by Agents. Result of Analysis. Percentage of adulterated samples. Genuine. Adulterated. Butter 294 288 6 2.0 Milk 87 65 22 25.3 Unstamped Margarine 48 48 — — Golden Syrup 16 16 — — Vinegar 36 35 1 2.8 Dripping 2 — 2 100.0 Lard 2 1 1 50.0 Cornflour 1 1 — — Beef Sausage 1 — 1 100.0 Ginger Beer Powder 1 1 — — Boracic Ointment 4 4 — — Zinc Ointment 4 4 — — Total 496 463 33 6.7 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. One sample of Preserved Cream was taken by the Inspector during the year which was found to be genuine. 112 113 FOOD AND DRUGS ACTS. table 56 Return of Official Samples for the Year ending 29th December 1923, showing the number taken, and sthe percentage of adulterated Samples for the year. Article. Number of Samples taken. Adulterated. Percentage of Adulterated Samples. Article. Number of Samples taken. Adulterated. Percentage of Adulterated Samples. Article. Number of Samples taken. Adulterated. Percentage of Adulterated Samples. Milk 505 27 53 Brought forward 1230 43 - Brought forward 1395 45 ... Separated Milk 1 ... ... Cairaway Seeds 3 ... ... Sweets 10 ... ... Tea 24 ... ... Mixed Spice 2 ... ... Chocolates 6 ... ... Tea Siftings 2 ... ... Ground Ginger 4 ... ... Corned Beef 8 ... ... Coffee 16 ... ... Crystalized Ginger 1 ... ... Brawn 9 1 11.1 Preserved Cream 1 ... ... Desiccated Cocoanut 3 ... ... Breakfast bausage 4 ... ... French Coffee 3 ... ... Prepared Groats 2 ... ... Fish Paste 8 6 75.0 Cocoa 35 ... ... Lentils 1 ... ... Salmon & Shrimp raste 1 1 100.0 Cocoa Essence 1 ... ... Lemonade Crystals 2 ... ... Rum 7 1 14.3 Sugar 45 ... ... Jelly Crystals 6 ... ... Brandy 3 ... ... Butter 106 ... ... Jelly Cuttings 1 ... ... Whisky 9 3 33.3 Margarine 109 *5 4.6 Table Jelly 8 ... ... Gin 4 ... ... Dripping 54 1 1.9 Jelly Powder 1 ... ... Alum 1 ... ... Lard 50 ... ... Milk Pudding 1 ... ... Bicarbonate of Soda 2 ... ... Cooking Fat 5 ... ... Cream Custard 1 ... ... Boracic Powder 2 ... ... Beef Suet and Flour 10 ... ... Custard Powder 42 ... ... Borax 2 1 50.5 Cake 14 6 42.9 Blanc-Mange Powder 8 ... ... Camphorated Oil 1 ... ... Cream Cheese 1 1 100.0 Lemonade Powder 1 ... ... Castor Oil 1 ... ... Cheese 13 ... ... . Curry Powder 3 ... ... Olive Oil 1 ... ... Dutch Cheese 3 ... ... Desiccated Soup 1 ... ... Oil of Eucalyptus 1 ... ... Self-raising Flour 38 ... ... Ox Tail Soup 3 ... ...... Glycerine 1 ... ... Pea Soup Flour 13 ... ... Tomato Soup 1 ... ... Liquorice Powder 2 ... ... Pea Flour 5 ... ... Soup 1 ... ...... Tartaric Acid 1 ... ... Cornflour 20 1 5.0 Oxo Cubes 1 ... ... Cream of Tartar 1 ... ... Cake Mixture 2 ... ... Gravy Salt 6 ... ... Sulphate of Quinine 1 ... ... Bun Flour 4 l 25.0 Thick Gravy 5 ... ... Epsom Salts 1 ... ... Eice 9 l 11.1 Gravo 1 ... ....w. Flaked Rice 7 ... ... Bisto 3 ... ... Grouud Rice 15 ... ... Mustard 21 ... ...... Tapioca 26 ... ... Mustard Condimeut 3 ... ...... Tapioca Flakes 3 ... ... Salt 13 ... ...... Oatmeal 25 ... ... Pepper 6 ... ... Semolina 9 ... ... Cakeoma 2 1 100.0 Sago 9 ... ... Fruit Cake 1 ... ... Pearl Barley 17 ... ... Sponge Mixture 1 1 25.0 Arrowroot 11 ... ... Jam Sandwich 4 ... ... Rolled Oats 7 ... ... Swiss Roll 1 ... ... Crushed Linseed 12 ... ... Sponge Cake 1 ... ... Carried forward 1230 43 - Carried forward 1395 45 - Total 1482 58 3.9 * These 5 samples consisted of genuine margarine, sold in unmarked wrappers. 114: t—» Or TABLE 56. SALE OF FOOD AND DRUGS AND OTHER ACTS. PROCEEDINGS TAKEN, WITH THE RESULTS. Name and Address of Vendor. Sample and Number. Result of Analysis. Result of Proceedings. Emily Goodwin, 20. Avonmouth street Margarine 1060 Sold in an unmarked wrapper Fined £1 and 17/6 costs Susan Davies, 79, Tower street Margarine 1059 Sold in an unmarked wrapper Fined 10/- and 10/- costs Benedetto Panzeri, 225, Borough High street Milk 1108 14 per cent, added water Fined 10/6 and 12/6 costs Douglas Card, 40. Harper street Dripping 1267 24 per cent, water Fined £1 and 10/- costs Herbert Jones, 21, Globe street Margarine 1278 Sold in an unmarked wrapper Fined £1 and 17/6 costs Emily Adams, 32, King & Queen street Margarine 1277 Sold in an unmarked wrapper Fined £1 and 17/6 costs David Jenkins Waters, 12, St. George's road Milk 1327 65 per cent, abstraction of milk fat Fined £5 5/- and £2 2/- costs Albert Sanders, 80, Southwark street Whisky 1431 37.7 degrees under proof Fined £2/2/0 costs Madeline Clark, 173, Blackfriars road Whisky 1437 36.5 degrees under proof Fined £1 1/- and £1 1/- costs Madeline Clark, 173, Blackfriars road Whisky 1438 42.5 degrees under proof Fined £2 2/- and £1 1/- costs Madeline Clark, 173, Blackfriars road Rum 1441 37.7 degrees under proof Fined £1 1/- and £1 1/- costs Name and Addreis of Vendor. Sample and Number. Result of Analysis. Result of Proceedings. Michael McCarthy, 40. Friar street Margarine 1472 Sold in an unmarked wrapper Fined 17/6 costs Edith Johnson, 74, Chatham street Margarine 1474 {Sold in an unmarked wrapper Fined 1/- and 10/- costs Jenkin Jones, 284, East street Margarine 1473 Sold in an unmarked wrapper Fined 1/- and 10/- costs Rebecca Hutton, 74, Park street Milk 81 4 per cent, added water Fined £2/0/0 costs Arthur Mager, 171, New Kent road Cream Cheese 195 14 per cent, deficient of fat Fined £2 and £2/2/0 costs Stanislas, Brino, 6, Orb street Milk 311 3.5 partsper 1.000,000 Formaldehyde preservative Fined 1/- Marion Jones, 15, Gt. Suffolk street Milk 363 3.0 parts per 1,000,000 Formaldehyde preservative Dismissed on payment of £2 2/- costs Sarah Tucker, 284, Waterloo road Milk 474 25 per cent, deficient of milk fat Dismissed on payment of £1 1/- costs Benjamin Jones, 17, Sutherland square Milk 477 9.4 per cent, added water Warranty was put in but not proceeded with. Dismissed on point Albert Gilder, 67, Long lane Milk 608 5 per cent, added water of law Fined £1/1/0 Albert Gilder, 67, Long lane Milk 608 5 per cent, added water Withdrawn. Cost of this summons included in the above £1/1/0 Thomas Hughes. 25, Deacon street Milk 719 7 parts per 1,000,000 Formaldehyde preservative Fined £2 and £2/2/0 costs James Birchard, 7, Saver street Milk 722 12 parts per 1,000,000 Formaldehyde preservative Fined £1/1/0 costs Public Health Office. Town Hall, Southwark. HORACE WILSON, Medical Officer of Health. APPENDIX. Borough of Southuuai*k ANNUAL REPORT of the Tuberculosis Medical Officer fob the YEAR 1923. Horace Wilson, M.D., B.S.Lond., D.P.H., L.R.C.P., M.R.C.S., Medical Officer of Health. Administrative Tuberculosis Officer, Administrative Officer for Maternity and Child Welfare. 118 BOROUGH OF SOUTHWARK. Southwabk Tubbrculosis Dispensary, 82-84, Newington Causeway, S.E To the Mayor, Aldermen and Councillors of the Borough of Southivark. Sir, Ladies and Gentlemen, I have pleasure in presenting my report for the year 1923. The Dispensary has been actively carried on during 1923 and the results of the work has shown very satisfactory returns. The number of primary notifications has been very low, being over two hundred less than any year during the war period. The number of deaths recorded is fewer than any previous year, being about 150 a year less than any during the war period. On my appointment as Acting Medical Officer of Health in July, Dr. K. Hamilton was appointed as Acting Tuberculosis Officer. He filled the office with great industry and ability, and the successful issue of the year is largely due to his energy and interest in the work. The general conduct of the work has not varied from previous years. 11 patients were referred to Guy's Hospital for X-ray diagnosis, and 28 certificates were granted for artificial pneumothorax refils. The huts lent out by the Dispensary have been all in use during the year and have been appreciated. Overcrowding and lack of accommodation for isolating the patient is still our greatest difficulty. The disinfection is a difficult problem which received considerable attention and is being more thoroughly carried out. Owing to the length of the disease and the fact that the patient goes from one room to another during the day the whole house gets infected to some degree and necessarily the disinfection is inadequate. To counterbalance this the personal precautions taken by the patient received special attention from our visitors, and sputum flasks and leaflets of instructions are issued to the patient. The whole staff has worked well and assiduously, and I wish to put on record an appreciation of their loyal assistance and co-operation. I append statistical tables setting out details of the work carried out during the year. I am. Sir, Ladies and Gentlemen, Your obedient Servant, HORACE WILSON, Tuberculosis Officer. 119 TABLE A. Total number of persons examined for the first time, 1,103 :— Insured Persons 442 Males 281 Females 161 Non-Insured Persons 661 Males 30 Females 168 Children 463 Total 1,103 TABLE B. Patients found to be suffering from Pulmonary Tuberculosis, 248: — Insured Persons 152 Males 116 Females 36 Non-Insured Persons 96 Males 21 Females 45 Children 30 Total 248 TABLE C. Patients suffering from Non-Pulmonary Tuberculosis, 55:- Insured Persons 11 Males 7 Females 4 Non-Insured Persons 44 Males 4 Females 2 Children 38 Total 55 TABLE D. Cases (including contacts) found Non-Tuberculous, 759:— Insured Persons 259 Males 147 Females 112 Non-Insured Persons 500 Males — Females 116 Children 384 Total 759 120 TABLE E Total attendances of patients:— Insured Persons 3,621 Non-Insured Persons 2,342 Total 5,963 TABLE F. Number of examinations of patients:— Insured Persons 1,166 Non-Insured Persons 1,110 Total 2,276 TABLE G. The following cases were recommended to the London County Council for treatment (Insured Persons):— Sanatorium 96 Hospital 19 Home for Advanced Cases 28 Hospital for observation 8 Farm Colony 2 Total 153 TABLE H. The recommendations to the County Council for Institutional treatment were as follows (Non-insured Persons):— Sanatorium 100 Hospital 12 Open Air School 1 Country and Convalescent Homes 3 Home for Advanced Cases 4 Hospital for observation 4 Treatment and Training 1 Total 125 TABLE 1. The Nurses visited the homes of the following cases and advised the patients on the questions of environment and preventive measures:— Insured Persons 1,614 Non-Insured Persons 1,206 Total 2,820 121 TABLE J. Patients discharged during the year :— Insured. Non-Insured Cured — 15 Arrested 6 12 Improved 6 4 " In statu quo" 11 8 Moved away 20 7 Transferred to other districts. 6 2 Ceased attending 16 8 Transferred to Domiciliary treatment 16 3 Transferred to Institutions 3 — Non-Tubercular 145 126 Open Air School — 2 School Supervision — 4 Refused Treatment 2 ... Totals 231 191 TABLE K. Statistics of cases dealt with by the Tuberculosis Care Committee Children— New Cases 69 Sent to Sanatoriums or Hospitals by L.C.C. 61 Do. do. do. I.C.A.A. 9 Referred to Poor Law 2 Returned from Institutions 59 Reports on progress of patients 217 Adults— New Cases 127 Sent to Sanatorium or Hospital by L.C.C. 115 Died 11 Visits for Hospitals 45 TABLE L. Death-rate from Pulmonary Tuberculosis for Southwark compared with the year 1922 :— 1922. Southwark 1.33 per 1000 1923. Southwark 1.23 per 1000 122 TABLE M. Notification of fresh cases of Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923[/##] 911 775 653 634 639 685 579 494 415 430 444 424 TABLE N. Deaths from Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923[/##] 345 359 330 388 391 392 381 311 243 262 249 231 TABLE O. Cases referred to Hospitals :— Insured. Non-insured. Infirmary 3 5 South London 1 — Guy's Hospital — 2 King's College Hospital — 3 St. Bartholomew's Hosp. — 1 Charing Cross Hospital 1 — Totals 5 11 TABLE P. Sexes of new cases of Pulmonary Tuberculosis :— Males 150 Females 98 248 TABLE Q Patients still attending the Dispensary on December 31st, 1923: — Insured Persons 375 Non-Insured Persons 275 650 123 TABLE R. Sources of cases:— Insured. Non-insured Doctors 103 36 Hospitals 21 25 School Medical Officer — 3 War Pensions 19 3 Patients — — Nurses — 3 Contacts 3 17 Returned from Institutions — 4 Returned from Sanatoriums 6 12 Invalid Children's Aid Society — 7 Care Committee — — London County Council 3 7 Transferred from other Dispensaries 1 11 Guardians — — Own Account 7 11 Infant Welfare — 2 British Red Cross Society 1 — Totals 164 141 TABLE S Contacts examined:— Found Tuberculous 21 Found Non-Tuberculous 499 Total 520