Sou 48 Borough of Southwark ANNUAL REPORT of the Medical Officer of Health for the YEAR 1927. Horace Wilson, H.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.1. TABLE OF CONTENTS. Page. Natural and social conditions of the area 6 Physical features and general character of the area 6 Vital statistics 6 General provision of health services 7 Clinics and treatment centres 7-8 Public Health officers 8-9 Nursing, chemical work, Acts and Byelaws 9 Population, Births, Deaths and Infantile Mortality 10-13 Births and birth-rates for the last 30 years 11-12 Infantile mortality and zymotic rate 13 Deaths and death-rates for the last 30 years 14-15 Death-rates for the various wards for the last 15 years 16 Deaths occurring in public institutions in the Borough 17 Births and deaths registered in the sub-districts of the Borough 18 Principal causes of and ages at death during the year 19 Deaths of infants under one year of age during the last 30 years 20 Infantile mortality (under one year) for the Borough 21 Vital statistics for separate localities (wards) 22-23 Deaths from principal zymotic diseases in the wards 24 Zymotic mortality, showing the localities where the deaths occurred 25 London and the Metropolitan Boroughs birth and death-rates and infantile mortality rates 26 Sanitary Circumstances of the Area 27 Sanitary work 27-28 Inspections and re-inspections (Housing Acts) 29 Do. do. (Public Health Act) 30-31 Sanitary works completed Do. 32-33 Do. do. (Housing Acts) 34-35 Proceedings taken under the Public Health and other Acts, with results 36-39 Smoke abatement and black smoke 40 Houses let in lodgings 40 Factories, workshops, &c., and outworkers 41-43 Bats and Mice (Destruction) Act, 1919 44 Customs and Inland Revenue Act, 1890 45 Certificates for exemption (Housing, Town Planning, Act, 1909) 45 Water Supply—Public Health (London) Act, 1891 (Section 48) 45 Sanitary Circumstances of the Area—continued. Page. Water Supplies to tenemented houses—L.C.C. (General Powers) Act, 1907 45 Verminous rooms and contents cleansed 46 Cleansing of Persons Act, 1897 :— Adults 47 Children 48-49 Bedding 50 Mortuaries 51 Housing 51-53 Inspection and Supervision of Food— Public Health (Meat) Regulations, 1924 (visits made) 54 Slaughterhouses 54 Examination of food 55-67 Milk and Dairies (Amendment) Act, 1922 68-70 Milksellers 70 Noxious trades 71 Cowsheds 71 Bakehouses 71-72 Butter and margarine factories 72 Sale of Food and Drugs Acts 73-78 Do. do. (Proceedings taken) 79 Infectious Disease 80-87 Reception House—Families admitted 88-89 Disinfection 90 91 Tuberculosis Schemes 91 Notifications 92-93 Deaths 94-95 Removals and Disinfection 96 Maternity and Child Welfare 97-100 Visits made by Health Visitors 101 Attendances at Centres 102-103 Appendix:— Report of the Tuberculosis Officer 106-114 BOROUGH OF SOUTHWARK. Public Health Department Town Hall, Walworth Road, S.E. To His Worship the Mayor, Aldermen and Councillors, Dear Sir, Ladies and Gentlemen, In, presenting my Report for the year 1927, the questions of the cold and wet summer and general meteorological depression have had a definite influence on the types of illness prevailing as the annexed tables show, there having been a marked diminution of cases of illness and resulting deaths from diseases which occur, as a rule, during hot summer months and an increase of catarrhal and pulmonary complaints, The population as estimated by the returns of the Registrar General has declined by 4,350 to a total of 184,250. The death rate is 13.4, an increase over 1926 of .7, and the birth rate has again declined being 19.0 as against 20.9 in 1926. I am pleased to report a further fall in the infantile mortality rate, which is only 61 per thousand births, as against 70 in 1926, and an average of 69 during the last five years. There has been a general decline of mortality from infectious disease with the exception of whooping cough, which disease was probably influenced by the climate in common with other pulmonary complaints. During the year there was a change in the staff of the Maternity and Child Welfare Organisation, Miss C. Sims, M.B., B.Ch., D.P.H., being appointed whole time Medical Officer and Dr. Stevens taking part time work at the Surrey Square Centre and relinquishing her post as a whole time Officer. The following new Regulations came into force in 1927, and are being carried out by your staff. (1) Preservatives in Pood. (2) Milk. 5 The work of the Maternity and Child Welfare and Tuberculosis Departments has shown good results and are the subjects of special report. It is satisfactory to note that both the number of newly notified cases and of deaths from Tuberculosis in the Borough have both decreased. I have to report a great improvement in the condition of the butchers shops and stalls under the Meat Regulations. A large amount of work has been done under the Food and Drugs Act and the Milk Regulations, the latter have caused a considerable increase in the work necessary to carry them out owing to the system now in force of licensing Graded Milks. The Municipal Creche continues popular and the improvement in the children even after a short stay is quite noticeable. The staff take great interest in their work and are well liked by the Children. 292 men were examined for employment in the Borough Engineer's department. My thanks are due to the whole staff for their loyal assistance, their whole time being fully occupied. I should also like to record my appreciation of the consideration of the Public Health and Maternity Committees, and of the earnest work they have carried out to improve the hygiene and social conditions in Southwark. Yours faithfully, HORACE WILSON, Medical Officer of Health. 6 NATURAL AND SOCIAL CONDITIONS OF THE AREA. Estimated population (1927) 184.250 Population (Census, 1921) 184,404 Area (acres) 1,131 Number of inhabited houses (1921) 19,050 Number of families or separate occupiers (1921) 46,727 Rateable value £1,446,164 Sum represented by penny rate £5,861 SOCIAL CONDITIONS. The district is chiefly a residential working class one, with a number of factories, business premises, warehouses and wharves. VITAL STATISTICS. Births—Legitimate 3,359 Illegitimate 119 Total 3,508 Birth Rate, 19.0. Deaths 2,465 Death Rate, 13.4. Number of women dying in, or in consequence of childbirth — Prom sepsis 7 Other causes 2 Deaths of infants under 1 year of age per 1,000 births, 61. Legitimate 197 Illegitimate 18 Total 215 Deaths from Measles (all ages) 27 Do. Whooping Cough (all ages) 30 Do. Diarrhæa under 2 years of age 26 7 GENERAL PROVISION OF HEALTH SERVICES. Hospitals.— No hospitals are provided by the Local Authority for Tuberculosis, Fevers, or general ailments, as these matters are amply provided for by the London County Council, the Metropolitan Asylums Board or the general Hospitals. The following general Hospitals are within the area :— Guy's Hospital. Evelina Hospital for Children. St. George's Hospital for diseases of the Eye. The Hospitals available but beyond the borders are : — St. Thomas's Hospital. King's College Hospital. Royal Waterloo Hospital. General Lying-in Hospital, York Road. The Belgrave Hospital for Children. Ambulance Services are provided by the Metropolitan Asylums Board for Infectious and Poor Law cases, and the London County Council provides Ambulances for accidents, also for the transit of parturient women to Hospitals. CLINICS AND TREATMENT CENTRES. (1) Maternity and Child Welfare.— There are in all fourteen Centres which may be classified as follows:— Municipal Centres (Eight) — St. Mary's Hall, Kennington Park Road. St. Paul's Parochial Hall, Lorrimore Street. Boy's Club, Villa Street. All Saints Parish Room, Surrey Square. Lady Margaret Parish Room, Chatham Street. Lansdowne Place Mission Hall. St. George's Dispensary, Pocock Street. St. Mary's Girls' Club, Union Street. Partly Municipal, Partly Voluntary (Three)— Crossways Mission, New Kent Road. Welfare Centre, 56, Lambeth Road. St. George's Welfare Centre, 86, Borough Road. Wholly Voluntary (Three)- St. John's Institute, Larcom Street. Roman Catholic Centre, 148, New Kent Road. Salamon's Centre, Newcomen Street. 8 (2) Day Nurseries— There are 4 in the Borough. One is Municipal, and is situated in Kennington Park Road. This accommodates 45 children and is supervised by a Committee of Nursery Managers, a SubCommittee of the Maternity and Child Welfare Committee. Guy's Hospital have in connection with their Maternity scheme a day nursery which is used by children from Southwark and Bermondsey. Southwark makes an annual grant towards its upkeep of £75 per annum. Crossways Mission, New Kent Road, have a day nursery accommodating 40 children, and All Hallows Mission, Union Street, have a small one accommodating 8 to 10 children. (3) Tuberculosis Dispensary —The Municipal Dispensary is at 82 and 84, Newington Causeway. A special report is included concerning the same. (4) Venereal Diseases are dealt with at the special clinics at the general hospitals. 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. D. F. M. Rose, M..B., Ch.B., Asst. M.O.H., &c. (from Nov. 6th, 1926, to April 19th, 1927, Temporary). C. Sims, M.B., Ch.B., D.P.H., Assistant Medical Officer of Health, Maternity and Child Welfare (from April 20th, 1927). John T. Crowe, L.S.A., L.M.S.S.A., Tuberculosis Officer. Sanitary Inspectors. ‡ || G. Fisher (Senior Inspector). * ‡ || J. C. Nicholson (Food & Drugs Inspector.) ‡ || J. A. Syms. ‡ || A. C. White. ‡ || W. H. Banham. ‡ || A. Ede. ‡ || H. E. Hattersley. || Margaret Burrows (Women's Workshops). || J. R. Findley. ‡ || H. S. Steele. || F. Mayhew. ‡ || S. Bowers. ‡ || G. H. Duffield (Assistant Food Inspector.) || F.J. Bryant. || Cert. Sanitary Inspector. ‡ Meat and other Foods. * 1st Class Engineer (Board of Trade) 9 Health Visitors. †*|| Jane Holland (Superintendent). †* || Hilda Johnson. * Lilian Hartley. || ‡ Annie Rogers. †* || Clare Cottrill. * || Winifred Saver. || Cert. Health Visitor. * || Florence Adair. † * || Mary Freeth. † || Mary George. † * || Annie Kingsmill. † M. Southward (Tempy. 8/4/1927 to 2/1/1928.) ‡ Cert. Sanitary Inspector. * C.M.B. † Nursing. Part Time Officers. Dorothy Shepherd, M.B., Ch.B., Maternity and Child Welfare Clinic. Arabella C. Stevens, M.B., B.Ch., B.A.O. do. do. NURSING. Professional home nursing is not undertaken by the Borough Council, but the Benson Home for Nurses provides nursing in the Newington district, and the sum of £400 per annum is granted towards their funds. In other districts the Ranyard Nurses cover a large area, while several parishes have their own private nurse. No special Nurses are employed for infectious diseases, nor are midwives subsidised or employed by the Borough Council. The General Lying-in Hospital, York Road the Obstetric Wards at Guy's, and King's College Hospitals, and the wards of Southwark Hospital, are sufficient to meet the requirements of the district without the necessity of a local Maternity Home. CHEMICAL WORK. The Analytical work and Chemical work under the Food and Drugs Act and various Milk Regulations, the Bacteriological work for Infectious Diseases and Tuberculosis, are carried out by the Borough Analyst, whose report is incorporated with the Public Health report. ACTS AND BYE LAWS. There are no local Acts, but the London County Council Bye-laws are enforced (as also are local Bye-laws concerning Underground rooms, Houses Let in Lodgings and others). No midwives are employed by, or subsidised by the Borough Council, 10 POPULATION. Daring the year 1927 the estimated population as supplied by the Registrar-General has decreased by 4,350, being 184,250 as against 188,600 in the previous year. All the rates in my report are calculated on the former figure. It will be seen from the subjoined table that the greater decrease in population has taken place in the Newington District, with a lesser decrease in St. George's District, and Christchurch and St. Saviour's Wards The population of the several divisions of the Borough at each Census since 1841, and also the estimated population for 1922, 1.923,1924, 1925, 1926, 1927, and 1928, are as follows:— Newington. St. George's. St. Saviour's and Christchurch. 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 53,652 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 1924 117,500 52,610 17,604 1925 118,300 52,980 17,720 1926 118,120 52,750 17,720 1927 115,500 51,650 17,100 11 The Ward distribution was as follows :— TABLE 1. WARD. Area in Acres Population. Persons to the Acre. Males. Females. Total. St. Mary 127 11,156 11,442 22,598 178 St. Paul 133 9,179 9,921 19,100 144 St. Peter 90 8,310 8,894 17,204 191 St. John 85 9,198 9,879 19,077 224 Trinity 109 8,019 8,155 16,174 148 All Saints 89 10,304 11,043 21,347 240 St. Michael 93 10,070 10,194 20,264 218 St. Jude 97 6,371 7,295 13,666 141 St. George 98 8,622 9,098 17,720 181 Christchurch 77 4,177 4,006 8,183 106 St. Saviour 133 4,089 4,828 8,917 67 Whole Borough 1,131 89,495 94,755 184,250 163 BIRTHS. The number of Births registered in the Borough during 1927 was 3,065, of which 1,618 were males, and 1,447 females. This represents a birth-rate of 16.6 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:—Newington, 1,708; St. George the Martyr, 740; Christchurch and St. Saviour's, 617. Of the 3,065 births registered in the Borough 239 were transferred away, the permanent residence of the parents being outside the Borough. 682 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 239 "outward" transfers are deducted 12 and the 682 "inward" transfers are added to the 3,065 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 3,508. This gives a corrected birth-rate of 19.0. 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. 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 1924 22.0 23.6 22.4 22.5 1925 20.1 23.9 21.1 21.2 1926 19.9 21.6 18.1 20.2 1927 18.6 20.6 17.4 19.0 13 TABLE 2. Number of Births and Deaths belonging to each Ward, with the Birth and Death Rates, also the Infantile Mortality Rate, 1927. WARD. Births. Infantile Mortality. Deaths. Males. Females. Total. Birth-rate. Males. Females. Total. Death-rate. St. Mary 187 186 373 16.5 67 180 124 304 13.5 St. Paul 194 166 360 18.8 50 132 111 243 12.7 St. Peter 151 121 272 15.8 74 100 86 186 10.8 St. John 224 200 424 22.2 42 137 122 259 13.6 Trinity 181 156 337 20.8 36 150 111 261 16.1 All Saints 200 181 381 17.8 81 136 111 247 11.6 St. Michael 239 195 434 21.4 46 160 135 295 14.6 St. Jude 129 136 265 19.4 87 103 117 220 16.1 St. George 195 169 364 20.5 77 125 98 223 12.6 Christchurch 78 77 155 18.9 52 57 52 109 13.3 St. Saviour 73 70 143 16.0 84 65 53 118 13.2 Borough 1851 1657 3508 19.0 61 1345 1120 2465 13.4 14 DEATHS. 1,773 deaths were registered in the sub-districts of the Borough during 1927. 10 of these deaths were of persons residing in other sanitary districts, but who died in our streets or on the way to hospitals. 920 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 411 belonging to Southwark and 509 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 1,211. When the 519 deaths of those persons who were non-parishioners but who died in our Borough, have been deducted, and the 1,211 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 2,465 of which number 1,345 were males and 1,120 females. The death-rate when calculated on this "corrected" number is 13.4 per 1,000 inhabitants for the whole Borough for the year 1927, as against a rate of 12.7 for 1926. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 49.1. The principal localities in which the "outlying" deaths occurred are as follows :— Southwark Hospital 759 Mental Hospitals 86 Metropolitan Asylums Board Hospitals 50 St. Thomas's Hospital 60 Lambeth Hospital 20 Belgrave Hospital 12 King's College Hospital 25 Royal Waterloo Hospital 15 In the Street and other Institutions 184 Total 1211 15 TABLE 3. Death Rates for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's, Christchurch and St. Saviour's. Whole Borough 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 1906 17.8 18.5 17.5 18.0 1907 17.6 19.3 16.4 18.0 1908 161 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 1924 13.5 15.3 15.1 14.2 1925 12.4 13.8 15.5 13.1 1926 12.3 13.3 14.1 12.7 1927 13.0 14.3 13.3 13.4 16 TABLE 4. Death Rates for the various Wards for the last Fifteen Years. Ward. 1913. 1914. 1915. 1916. 1917. 1918. 1919. 1920. 1921. 1922. 1923. 1924. 1925. 1926. 1927. St. Mary 15.4 15.3 18.1 17.4 18.6 25.1 15.7 16.4 15.0 16.0 14.6 14.4 12.8 12.2 13.5 St. Paul 14.2 15.5 19.9 15.7 17.2 22.0 14.5 12.9 14.9 15.6 12.3 14.5 12.7 12.0 12.7 St. Peter 15.5 14.2 16.4 14.0 17.4 21.7 11.3 13.1 11.4 13.8 10.0 12.0 11.9 12.3 10.8 St. John 15.9 16.7 18.7 17.0 18.0 21.0 14.0 14.2 14.3 16.5 12.8 14.0 13.8 13.0 13.6 Trinity 20.5 19.6 21.0 17.5 17.8 26.1 17.3 14.5 14.6 16.9 13.1 14.8 11.7 13.4 16.1 All Saints 18.4 18.0 22.1 17.4 16.6 21.8 15.0 15.2 15.4 12.8 10.4 11.8 11.2 10.9 11.6 St. Michael 20.7 20.1 24.1 19.1 19.1 23.1 15.4 14.4 15.7 17.4 14.2 16.7 15.6 14.2 14.6 St. Jude 18.4 17.8 23.0 17.7 20.0 24.9 18.0 15.8 14.0 15.3 14.3 15.4 12.9 12.6 16.1 St. George 20.3 20.3 23.0 17.9 19.8 23.7 15.7 14.1 13.8 15.1 12.4 13.5 12.4 12.9 12.6 Christchurch 23.7 21.1 25.6 19.7 20.8 25.1 16.9 14.5 14.4 17.9 16.0 19.2 18.2 16.6 13.3 St. Saviour 16.8 20.2 18.5 15.2 15.2 21.1 14.1 11.3 11.9 13.0 11.7 11.3 12.9 11.8 13.2 17 TABLE 5. Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1927. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter. In 4th Quarter. During Year. Newington Institution 94 40 43 61 238 Christchurch Institution 1 1 — — 2 Evelina Hospital 18 13 9 8 48 Guy's Hospital 168 144 138 151 601 Bethlem Hospital 6 8 8 5 27 60, Lambeth Road 2 - 1 - 3 (Catholic Nursing Home) Royal Eye Hospital - - - 1 1 Total 289 206 199 226 920 18 TABLE 6. Births and Deaths Registered in the Sub-Districts of the Borough in 1927. For the First Quarter of 13 weeks ending 2nd April. For the Second Quarter of 13 weeks ending 2nd July. Sub-Districts. Births. Deaths. Births. Deaths. Male. Female. Male. Female. Sub-Districts. Male. Female. Male. Female. Newington 237 212 145 144 Newington 227 183 79 83 St. George the Martyr, West 111 74 71 64 St. George the Martyr, West 97 109 44 35 Christchurch and St. Saviour 72 68 119 80 Christchurch and St. Saviour 84 76 97 60 Totals 420 354 335 288 Totals 408 368 220 178 For the Third Quarter of 13 weeks ending 1st October. For the Fourth Quarter of 14 weeks ending 31st December. Newington 234 219 69 64 Newington 210 186 91 92 St. George the Martyr, West 106 79 32 20 St. George the Martyr, West 85 79 30 31 Christchurch and St. Saviour 80 78 94 53 Christchurch and St. Saviour 75 84 106 70 Totals 420 376 195 137 Total 370 349 227 193 Births. Deaths. M. F. M. F. In 1st Quarter 420 354 335 288 In 2nd Quarter 408 368 220 178 In 3rd Quarter 420 376 195 137 In 4th Quarter 370 349 227 193 Total 1618 1447 977 796 19 TABLE 7. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1927. Causes of Death. All Ages. AGES. Localities of Deaths. Institutions. 0- 1- 2- 5 15- 25- 45- 65- 75- St. Mary. St. Paul. St. Peter. St. John. Trinity. All Saints. St. Michael. St. Jude. St. George. Christchurch- St. Saviour. All Causes. (1) Enteric Fever 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... (2) Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (3) Measles 27 9 12 4 1 1 ... ... ... ... 4 6 3 4 1 2 1 2 1 ... 3 ... (4) Scarlet Fever 1 ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 (5) Whooping Cough 30 13 8 8 1 ... ... ... ... ... 6 1 2 ... 4 4 5 4 2 ... 2 1 (6) Diphtheria 21 2 7 4 7 ... 1 ... ... ... 1 1 1 1 2 2 3 2 2 4 2 ... (7) Influenza 44 1 ... 1 ... ... 5 20 12 5 4 3 2 4 6 3 6 4 7 2 3 1 (8) Encephalitis Lethargica 4 ... 1 ... ... 1 2 ... ... ... 1 ... ... 1 ... 1 1 ... ... ... ... 2 (9) Meningococcal Meningitis 4 2 1 1 ... ... ... ... ... ... ... 1 ... ... 2 1 ... ... ... ... ... 3 (10) Tuberculosis (Respiratory System) 197 1 1 1 3 53 64 61 11 2 94 23 7 27 21 18 21 22 20 7 7 22 (11) Other Tubercular Diseases 33 4 4 4 7 3 7 1 3 ... 5 3 3 4 3 1 8 2 2 ... 9 20 (12) Cancer 260 ... ... ... 2 2 29 129 70 28 35 28 23 35 30 21 29 21 21 11 6 118 (13) Rheumatic Fever 5 ... ... ... 3 1 ... ... 1 ... ... 3 ... 1 ... ... ... ... ... ... 1 3 (14) Diabetes 14 ... ... ... ... 2 3 2 6 1 2 1 3 1 1 2 2 1 1 ... ... 7 (15) Cerebral Hæmorrhage 109 ... ... ... ... ... 2 41 39 27 11 11 7 11 13 13 13 10 12 4 4 48 (16) Heart Disease 437 ... ... 1 7 13 34 141 125 116 57 36 43 43 52 43 53 35 34 19 22 130 (17) Arterio Sclerosis 105 ... ... ... ... ... 1 23 36 45 11 10 7 10 12 13 13 10 11 4 4 47 (18) Bronchitis 201 12 3 2 ... 1 6 56 59 62 26 93 15 12 20 22 26 29 18 6 4 68 (19) Pneumonia (all forms) 219 38 27 20 4 3 24 56 32 15 33 16 18 27 20 25 25 17 9 11 18 65 (20) Other Respiratory Diseases 22 ... ... ... 1 1 1 14 8 8 3 2 2 2 3 2 1 1 4 1 1 7 (21) Ulcer of Stomach and Duodenum 29 ... ... ... ... 1 5 22 1 ... 2 3 ... ... 1 3 3 1 7 6 3 14 (22) Diarrhæa 36 19 7 4 ... ... 2 2 1 1 4 1 3 3 4 4 4 5 4 1 3 11 (23) Appendicitis and Typhlitis 8 ... ... 2 1 2 ... 2 ... 1 ... ... 2 2 1 1 1 ... ... ... 1 12 (24) Cirrhosis of Liver 8 ... ... ... ... ... ... 7 1 ... 2 1 1 ... 1 ... 1 1 ... ... 1 6 (25) Acute and Chronic Nephritis 104 ... ... ... 1 3 9 40 30 21 15 13 4 17 11 10 13 4 9 7 1 56 (26) Puerperal Sepsis 7 ... ... ... ... 2 4 1 ... ... 1 ... ... 2 1 ... 1 2 ... ... ... 2 (27) Other Accidents 2 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 (28) Congenital Debility, etc. (prem. birth) 77 76 ... ... ... 1 ... ... ... ... 7 11 9 7 2 7 7 6 11 5 5 27 (29) Suicide 32 ... ... ... 1 9. 10 16 3 ... 3 5 2 2 3 5 3 2 9 3 2 6 (30) Other Deaths from Violence 82 4 2 3 8 6 12 28 8 11 12 5 6 8 12 6 12 3 8 5 5 65 (31) Other Defined Diseases 344 34 6 7 14 11 44 101 52 75 35 34 22 35 35 38 42 35 37 13 18 176 (32) Ill-defined Causes 2 ... 1 1 ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... Totals 2465 215 80 64 61 110 267 763 493 412 304 243 186 259 261 247 295 220 223 109 118 920 20 DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 61 during the year 1927. The deaths under one year of age to 1,000 births for the last thirty years were as follows :— 1898 190 1913 115 1899 199 1914 123 1900 192 1915 132 1901 168 1916 98 1902 166 1917 111 1903 148 1918 124 1904 174 1919 95 1905 148 1920 86 1906 144 1921 90 1907 142 1922 79 1908 131 1923 68 1909 119 1924 71 1910 115 1925 77 1911 145 1926 70 1912 105 1927 61 The average number of Infantile deaths for the last thirty years is 123. 21 TABLE 8. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1927. 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. I 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. All causes Certified 48 8 9 2 67 35 38 39 34 213 Uncertified 1 ... ... ... 1 ... ... 1 ... 2 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 3 6 9 Diphtheria ... ... ... ... ... ... ... 1 1 2 Whooping Cough ... ... ... ... ... 2 1 6 4 13 Diarrhæa ... ... ... ... ... 2 9 4 4 19 Enteritis ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever ... ... ... ... ... ... 1 ... 1 2 Phthisis ... ... ... ... ... ... 1 ... ... 1 Tuberculous Meningitis ... ... ... ... ... ... 2 ... 1 3 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculosis ... ... ... ... ... ... ... ... 1 1 Congenital Malformations 6 2 3 ... 11 4 2 1 1 19 Premature Birth 32 2 3 1 38 5 1 ... ... 44 Atrophy, Debility and Marasmus 3 ... ... ... 3 2 3 2 1 11 Atelectasis 1 ... ... ... 1 1 ... ... ... 2 Erysipelas ... ... ... ... ... 1 ... ... ... 1 Syphilis ... ... ... ... ... 1 ... ... 1 2 Rickets ... ... ... ... ... ... ... ... ... ... Meningitis ... ... ... ... ... 1 1 2 1 5 Laryngitis ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... 1 1 Gastritis ... ... ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... ... ... ... ... Dentition ... ... ... ... ... ... ... ... ... ... Dermatitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... 1 1 3 3 3 2 12 Pneumonia ... ... ... ... ... ... 1 2 1 4 Broncho-Pneumonia 1 ... ... ... 1 9 9 10 5 34 Pleuro Pneumonia ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) ... 1 ... ... 1 ... 1 ... ... 2 Accident (other) 1 1 ... ... 2 ... ... ... ... 2 Nephritis, Acute ... ... ... ... ... ... ... ... ... ... Icterus Neonatorum ... ... ... ... ... ... ... ... ... ... Septic Pyaemia ... ... ... ... ... ... ... ... ... ... Otitis and Mastoiditis ... ... ... ... ... ... ... ... ... ... Other causes not classified above 5 2 3 ... 10 4 3 6 3 26 49 8 9 2 68 35 38 40 34 215 Nett Deaths in the year Legitimate 3,359 Illegitimate 149 Nett Deaths in the year of Legitimate Infants 197 Illegitimate Infants 18 22, 23 TABLE 9 Vital Statistics of Separate Localities in 1927 and previous years. BOROUGH OF SOUTHWARK Names of Localities. 1. St. Mary'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 year. 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 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 1924 22.992 461 330 31 19,479 396 282 34 17,502 326 210 29 19,364 498 271 31 16,451 418 243 26 21,712 485 256 33 1925 23,154 440 298 35 19,561 363 248 21 17,619 329 210 27 19,538 451 269 46 16,566 354 194 26 21,862 441 244 30 1926 23,119 417 283 34 19,532 399 235 30 17,592 308 217 14 19,509 446 253 20 16,541 358 222 15 21,827 420 239 33 Averages of Years 1917 to 1926 21,815 472 346 42 18,833 398 279 32 17,274 385 231 29 19,496 523 294 47 15,656 413 247 35 19,794 524 273 40 1927 22,598 373 304 25 19,100 360 243 18 17,204 272 186 20 19,077 424 259 18 16,174 337 261 12 21,347 381 247 31 7. St. Michael's Ward. 8. St. Jude's Ward. 9. St. George's Ward. 10. Christchurch Ward. 11. St. Saviour's Ward. 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 ... ... ... ... 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 ... ... ... ... 1924 20,644 442 345 42 13,912 342 214 19 18,045 458 244 31 8,424 207 162 13 9,180 187 104 14 ... ... ... ... 1925 20,788 468 324 44 14,018 334 181 18 18,174 463 227 34 8,478 197 154 15 9,242 177 119 13 ... ... ... ... 1926 20,702 425 294 39 13,961 311 176 25 18,097 405 234 34 8,480 170 141 13 9,240 151 109 8 ... ... ... ... Averages of Years 1917 to 1926 20,831 487 343 48 13,271 302 213 30 17,386 503 264 42 8,628 183 154 15 9,149 199 122 15 ... ... ... ... 1927 20,264 434 295 20 13,666 265 220 23 17,720 364 223 28 8,183 155 109 8 8,917 143 118 12 ... ... ... ... 24 TABLE 10. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various wards for 1927. WARD. Cerebro Spinal Fever. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhæa. Phthisis. Pneumonia & Bronchitis. Heart Disease. Influenza. Polio Myelitis. Encephalitis Lethargica. St. Mary - 4 - 1 6 - 4 24 59 57 4 - 1 St. Paul 1 6 1 1 1 - 1 23 39 36 3 1 - St. Peter - 3 - 1 2 - 3 7 33 43 2 - - St. John - 4 - 1 - - 3 27 39 43 4 - 1 Trinity 2 1 - 2 4 - 4 21 40 52 6 - - All Saints 1 2 - 2 4 - 4 18 47 43 3 - 1 St. Michael - 1 - 3 5 - 4 21 51 53 6 - 1 St. Jude - 2 - 2 4 1 5 22 46 35 4 - - St. George - 1 - 2 2 - 4 20 27 34 7 - - Christchurch - - - 4 - - 1 7 17 19 2 - - St. Saviour - 3 - 2 2 - 3 7 22 22 3 - - Borough 4 27 1 21 30 1 36 197 420 437 44 1 4 25 TABLE 11. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1927. Showing the localities where the deaths occurred. Locality. PolioMyelitis. Encephalitis Lethargica. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhæa. Cerebrospinal Fever. Influenza. Total. The Borough ... 1 9 ... 1 8 ... 6 ... 32 57 Southwark Hospital ... 1 5 ... ... 6 ... 21 ... 6 39 Met. Asylums Board Hospitals ... 1 12 1 18 14 ... 1 1 ... 48 Newington Institution ... 1 ... ... ... ... ... 1 ... 1 3 Evelina Hospital ... ... ... ... ... 1 ... 1 1 1 4 Guy's Hospital ... ... ... ... ... ... ... 3 1 ... 4 St. Thomas's Hospital 1 ... ... ... 1 ... 1 2 ... ... 5 Royal Waterloo Hospital ... ... 1 ... ... ... ... ... ... ... 1 King's College Hospital ... ... ... ... 1 1 ... 1 1 ... 4 Various Mental Hospitals ... ... ... ... ... ... ... ... ... 2 2 Lambeth Hospital ... ... ... ... ... ... ... ... ... 2 2 Total 1 4 27 1 21 30 1 36 4 44 169 26 TABLE 12. London and the Metropolitan Boroughs. Birth and Death Rates and Infantile Mortality Rate, &c. Boroughs. Estimated Population, 1926. Birth Rate. Death Bate. Infantile Mortality Bate. Deaths from Enteric Fever. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhsea and Enteritis (under 2 years). LONDON 4,605,400 161 11.9 59 27 179 63 546 387 552 West. Paddington 146,700 15.2 12.8 78 1 5 3 38 11 16 Kensington 179,800 14.8 13.1 65 ... 1 ... 14 10 28 Hammersmith 134,400 15.4 12.5 58 ... 2 1 4 10 24 Fulham 164,300 14.9 11.0 67 2 ... 1 8 12 22 Chelsea 64,820 13.2 13.5 74 1 3 ... 6 4 14 City of Westminster 138,400 9.9 11.7 67 2 1 1 7 7 12 North. St. Marylebone 105,800 13.0 11.5 59 1 9 1 11 12 13 Hampstead 87,530 11.7 11.6 49 ... 2 1 4 2 7 St. Pancras 216,400 15.2 11.9 61 2 5 2 35 6 27 Islington 339,200 17.3 12.0 55 ... 30 10 46 23 42 Stoke Newington 53,080 13.8 11.8 64 ... 1 ... 5 5 2 Hackney 228,500 15.5 11.3 64 1 4 4 28 25 35 Central. Holborn 43,200 11.7 12.0 38 ... ... ... 5 1 5 Finsbury 77,550 18.6 12.8 51 ... 3 2 17 5 11 City of London 13,230 8.6 11.5 96 ... ... 1 ... 1 ... East. Shoreditch 107,400 20.4 12.2 73 1 8 3 25 12 22 Bethnal Green 119,600 19.7 11.1 57 1 3 4 27 16 23 Stepney 255,400 18.0 11.4 66 2 10 4 45 21 60 Poplar 169,000 19.6 11.5 66 ... 9 2 31 17 37 South. Southwark (1927) Pop. 184,250 19.0 13.4 61 1 27 1 30 21 26 Bermondsey 123,100 19.6 12.6 61 ... 11 ... 12 13 13 Lambeth 311,000 16.0 12.2 54 3 24 2 30 31 33 Battersea 171,900 16.3 11.8 53 ... 1 3 16 25 7 Wandsworth 342,100 13.6 11.2 51 4 3 5 28 23 19 Camberwell 275,400 15.4 11.1 52 1 14 5 30 23 24 Deptford 115,700 16.5 11..1 58 1 ... 2 12 14 8 Greenwich 103,300 16.2 10.7 54 1 ... 2 16 11 9 Lewisham 187,800 15.2 10.8 45 2 2 3 6 16 8 Woolwich 141,900 15.3 10.3 43 ... 1 ... 10 10 5 27 SANITARY WORK. ST. MARY'S WARD. House to house inspections were carried out in the following localities:— Alberta street, Ambergate street, Clock place, Danson road, Delaune street, Deverton road, Doddington grove, Faunce street, Harmsworth street, Kennington park place, New street, St. Gabriel street, Sharsted street. ST. PAUL'S WARD. Alpha square, Beresford street, Beresford buildings, Carter street, Finchley road, Goschen street, Grosvenor terrace, Horsman street, Lorrimore street, Otto street, Sutherland street. ST. PETEE'S WARD. Aylesbury road, Boundary lane, Boyson road, Bronti place, Date street, Doctor street, East street, Elizabeth street, Phelp street, Sandford row, St. Edmunds house. ST. JOHN'S WARD. Albert House, Chatteris square, Cotham street, King and Queen street, Lock square, North row, Nursery row, Paragon row, Revesby street, Rodney place, Sayer street, Vowler street, Wansey street. TRINITY WARD. Avonmouth street, Falmouth chambers, Bockingham street, Tiverton street. ALL SAINTS' WARD. Alfreton street, Aylesbury road, Brockley terrace, Claremont terrace, Hopwood street, Inville road, Jesmond street, Kinglake street, Namur terrace, Northampton place, Northampton court, Salisbury row, South street, South street buildings, Surrey square, Thurlow street, Williams grove. 28 ST. MICHAEL'S WARD. Aster place, Collinson street, Dodson street, Florence house, Gerridge street, Gray street, Jubilee dwellings, Little Surrey street, Miniver street, New Winchester buildings, Philemon house, Pocock street, St. Georges house, Sturge street, Sumption buildings, Tupman place, Valentine place, Valentine row, Youngs buildings. ST. JUDE'S WARD. Austral street, Borough road, Gaywood street. Gladstone street, Hayles street, King Edward street, Lancaster street, Newington causeway, Orient street, Pineapple buildings, Temple street, Westminster bridge road, White Horse yard. ST. GEORGE'S WARD. Ackworth street, Chaucer house, Collier's rents, Dover buildings, Dover House, Gordon house, Graham house, Haddon house, Lansdowne place, Prioress street, Stewart house, Trinity buildings, Waleran buildings, Wolseley house, Weston street. CHRISTCHURCH WARD. Boundary row, Cavan terrace, Gray street, Great Charlotte street, Holmwood buildings, Jane street, New cut, Norfolk street, Ponsonby buildings, Ufford street. ST. SAVIOUR'S WARD. Burleigh buildings, Canvey street, Cromwell buildings, Hopetoun place, Mowbray buildings, Nelson buildings, New buildings, Park street, Red Cross street, Stanhope buildings, Streets buildings, Whitehill houses, Winchester buildings, Zoar street. 29 TABLE 13. Summary of Original Inspections, &c., made under the Housing Acts during the Year 1927. WARD or DISTRICT. Housing. Houses Let in Lodgings. Number of Inspections. Number of Re.Inspections. Number of Inspections. Number of Re-Inspections. St. Mary (Mr. Syms) 277 751 72 94 St. Paul (Mr. Hatteraley & Mr. Mayhew) 186 618 18 — St. Peter (Mr. Banham) 152 406 19 2 St. John (Mr. White) 211 260 — 1 Trinity (Mr. Findley) 374 1063 23 43 All Saints (Mr. Steele) 157 513 63 173 St. Michael (Mr. Mayhew & Mr. Hattersley) 234 481 100 17 St. Michael (Mr. Mayhew & Mr. Hatteraley) 1 2 — — St. Jude (Mr. Bryant) 186 856 16 95 St. George (Mr. Ede) 268 828 42 217 Christchurch No. 2 (Mr. Bowers) 95 358 56 61 St. Saviour No. 2. (Mr. Bowers) 81 335 21 — 2222 6471 430 703 30 31 TABLE 14 Summary of Original Inspections, &c., made in the several Wards during the year 1927. Ward or District. Complaints. Including houses in which deaths have occurred.) House to House. Principal Infectious Diseases. Factories, Workshops Workplaces and Outworkers. Number of Original Inspections made daily. Number of Reinspections made daily. 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. St. Mary (Mr. Syms) 1041 11 2857 436 ... 1676 128 15 199 246 81 7.6 19.6 St. Paul (Mr. Hattersley and Mr. Mayhew) 626 55 2196 391 1 1620 77 46 128 134 25 5.0 15.9 St. Peter (Mr. Banham) 465 17 1535 529 ... 1181 98 42 201 121 46 4.8 11.7 St. John (Mr. White) 732 21 2008 467 1 1097 132 51 198 130 61 5.8 12.6 Trinity (Mr. Findley) 634 8 2458 148 ... 443 127 39 303 231 190 5.3 15.6 All Saints (Mr. Steele) 692 13 2345 552 2 1518 119 100 155 92 120 5.8 16.7 St. Michael (Mr. Mayhew and Mr. Hattersley) 618 20 2239 355 16 1256 133 82 256 350 270 6.2 15.7 St. Michael (Mr. Mayhew and Mr. Hattersley) 31 8 89 ... ... 1 24 18 17 ... 1 0.2 0.4 St. Jude (Mr. Bryant) 638 40 2606 355 6 1215 111 86 262 254 227 5.4 18.3 St. George (Mr. Ede) 823 35 2875 301 1 612 153 82 237 170 49 6.1 16.7 Christchurch No. 1 (Mr. Fisher and Mr. Duffield) ... ... ... ... ... ... ... ... ... ... ... ... ... Christchurch No. 2 (Mr. Bowers) 201 35 759 329 ... 828 44 35 78 184 83 3.2 7.5 St. Saviour No. 1 (Mr. Fisher and Mr. Duffield) ... ... ... ... ... ... ... ... ... ... ... ... ... St. Saviour No. 2 (Mr. Bowers) 157 49 779 347 ... 736 67 54 79 259 79 3.2 7.0 Women's Wkshps. (Miss Burrows) ... ... ... ... ... ... ... ... ... *2538 998 8.8 3.5 Bakehouses, &c Mr. Nicholson) ... ... ... ... ... ... ... ... ... 2350 ... ... ... Slaughterhouses . (Mr. Fisher and Mr. Duffield) ... ... ... ... ... ... ... ... ... 88 ... ... ... Total 6658 312 22744 4210 27 12183 1213 650 2113 7147 2230 ... ... Mr. Fisher supervised the wharves and landing places in the Borough, and also the Borough Market, making a large number of inspections during the year in relation to the food dealt with at those places. * 1,836 of these were inspections of public conveniences for women. 32 33 TABLE 15 Summary of Sanitary Works Completed under the Public Health Act, 1927. Ward, or District. Intimation Notices served. Statutory Notices served. Sanitary Works completed. Drain reconstructed. Drain repaired. Drain Intercepted and Ventilated. Drain Unstopped. Gullies provided. Soilpipe provided or repaired Closet provided. Closet Pan and Trap. Water apparatus repaired. Sink, Lav. and Waste Pipes. Rain Water Pipes repaired, &o. Water Supply to upper floors Draw Tap on Main. New Water Supply. Roof and Gutters repaired. Paving repaired. Dampness abated. Booms cleansed. Sub-Floor Ventilation. Basement concreted. Staircase Ventilated. Dust-bin provided. Overcrowding abated. Miscellaneous Nuisances abated. St. Mary's (Mr. Syms) 1210 432 1198 95 35 70 47 29 18 12 122 87 112 70 1 10 1 444 62 79 2734 4 6 1 112 6 392 St. Paul's (Mr. Hattersley and Mr. Mayhew) 730 290 695 7 20 11 26 12 1 ... 33 49 30 66 ... 6 ... 375 59 62 1208 2 ... 5 141 ... 192 St. Peter's (Mr. Banbam) 704 312 729 8 24 21 16 2 7 39 79 89 81 64 ... 22 ... 262 62 69 1429 5 1 ... 147 3 526 St. John's (Mr. White) 858 345 883 58 31 19 18 26 11 12 104 94 66 52 ... 17 ... 336 47 31 1554 4 ... ... 133 2 422 Trinity (Mr. Findley) 809 376 955 17 50 27 74 17 20 11 64 135 108 97 ... 43 3 470 124 128 1222 30 2 1 125 30 596 All Saints' (Mr. Steele) 910 248 1008 22 48 24 53 16 8 4 56 87 30 98 ... 24 1 548 92 76 1198 8 ... ... 171 8 738 St. Michael's (Mr. Mayhew and Mr. Hattersley) 759 323 803 12 20 14 34 8 11 13 53 92 49 63 1 15 ... 254 60 43 1030 ... 1 1 124 1 518 St. Michael's (Mr. Mayhow and Mr. Hattersley) 10 2 9 ... ... ... ... ... ... ... 3 1 ... ... ... ... ... 2 ... 1 5 ... ... ... ... ... ... St. Jude's (Mr. Bryant) 822 370 923 32 61 42 115 67 22 16 75 130 125 104 6 10 3 345 93 71 1327 14 4 10 109 21 1021 St. George's (Mr. Ede) 663 228 718 58 32 39 54 22 10 41 49 89 47 34 1 2 ... 252 61 42 1243 ... 1 ... 143 ... 375 Christchurch No. 2. (Mr. Bowers) 312 195 312 5 4 11 7 16 4 17 16 38 37 14 2 5 1 82 30 8 526 1 ... ... 63 ... 119 St. Saviour's No. 2 (Mr. Bowers) 229 134 280 24 6 17 6 16 5 21 19 29 16 5 ... 3 5 50 20 3 527 ... ... 5 24 7 102 Women's workshops (Miss Burrows) 29 18 38 ... ... 2 3 1 1 1 1 17 6 1 1 ... 1 11 3 1 120 ... ... ... 5 1 98 Milkshops, &c. (Mr. Nicholson) 38 4 43 ... ... 2 ... ... ... 1 1 3 ... ... ... ... ... 2 2 ... 57 ... ... ... 1 ... 15 Meat Regulations Mr. Duffield) ... ... 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... 56 ... ... ... 1 ... 28 Total 8083 3277 8602 338 331 299 453 232 118 188 675 940 707 668 12 157 15 3435 717 614 14236 68 15 23 1299 79 5142 34 35 TABLE 16. Sanitary Works completed under the Housing Acts, 1927. Ward. Housing Acts. Houses Let in Lodgings. Intimation Notices served. Statutory Notices served. Works completed. Chimney flues repaired. Brickwork and Pointing repaired. Window reveals and sills. Window sash repaired. New Sash Lines. Doors and woodwork reprd. Stair Treads and Risers repaired. Handrail and Balusters repaired. Floors repaired. Provision of ventilated food Storage. Plaster repaired. Stove and Fireplace repaired. Copper repaired Stone Steps repaired. Skylight repaired and new Cords. Intimation Notices served. Statutory Notices served. Works completed. Separation of Sexes and Overcrowding. Cleansing by Tenants and Lodgere. Cleansing of Bed Linen. Cleansing of Receptacles. Removal of Refuse Daily. Ventilation of Rooms by Lodgers. Animals in Tenements. Rooms cleansed. General. St. Mary's (Mr. Syms) 263 ... 324 20 15 40 44 265 74 11 23 42 ... 123 77 32 16 1 62 25 21 ... ... ... ... ... ... ... 117 32 St. Paul's (Mr. Mayhew & Mr. Hattersley) 186 ... 173 11 6 26 91 132 49 33 39 32 ... 7 59 24 7 ... 21 ... 13 ... ... ... ... ... ... ... 26 ... St. Peter's (Mr. Banham) 133 ... 105 6 20 31 30 43 27 11 12 11 ... 23 31 10 1 1 19 ... 12 ... ... ... ... ... ... ... 24 ... St. John's (Mr. White) 92 ... 98 4 11 42 46 49 54 5 3 14 ... 3 62 22 2 ... 7 ... 7 ... ... ... ... ... ... ... 21 ... Trinity (Mr. Findley) 369 ... 369 28 85 107 88 89 112 20 26 63 2 67 155 63 16 4 28 ... 27 1 ... ... ... ... ... ... 115 14 All Saints' (Mr. Steele) 152 ... 165 25 11 17 33 20 47 12 8 33 ... 5 74 29 5 1 70 ... 36 ... 3 ... ... ... ... ... 196 25 St. Michael's (Mr. Mayhew & Mr. Hattersley) 232 ... 180 4 6 35 79 102 84 19 13 50 ... 4 81 4 5 2 95 ... 62 ... ... ... ... ... ... ... 120 ... St. Michael's (Mr Mayhew & Mr. Hattersley) 1 ... 1 ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... St. Jude's (Mr. Bryant) 186 ... 182 34 13 21 61 198 89 37 47 65 2 11 43 16 20 ... 15 ... 14 ... ... ... ... ... ... ... 99 ... St. George's (Mr. Ede) 268 ... 200 1 ... 4 23 93 31 11 9 55 1 1 78 47 2 ... 43 ... 14 ... ... ... ... ... ... ... 145 18 Christchurch, No. 2 (Mr. Bowers) 95 ... 87 2 5 8 11 25 5 1 ... 21 ... 27 45 5 3 2 55 ... 13 ... 9 ... ... ... ... ... 60 15 St. Saviour's, No. 2 (Mr. Bowers) 81 ... 85 1 3 2 12 25 '2 1 3 19 ... 12 43 9 2 ... 9 ... 9 ... ... ... ... ... ... ... 18 ... Total 2058 ... 1969 136 175 333 518 1041 576 161 183 405 5 283 748 261 79 11 425 25 228 1 12 ... ... ... ... ... 941 104 36 PROCEEDINGS TAKEN UNDER THE PUBLIC HEALTH AND OTHER ACTS. 22 summonses were taken out during the year 1927, in respect to offences, particulars of which are set out below. The following table shows the number of summonses taken out in each of the several Wards:— TABLE 17. WARDS. Total. St. Mary's. St. Paul's. St. Peter's. St. John's. Trinity. All Saints' St. Michael's. ' St. Jude's. St. George's. Christchurch. St. Saviour's. Number of Summonses taken out 1 5 – — 6 3 — 2 2 2 1 22 The above summonses had reference to the following:— Ordinary Nuisances 20 Unsound Chocolate 2 22 TABLE 18. These proceedings resulted as follows:— Summonses withdrawn (with costs), the Council's requirements having been complied with 16 Magistrates' Orders made with costs 4 Fines inflicted 2 Total 22 37 TABLE 19. Proceedings taken under the Public Health and Other Acts. Defendant. Cause of Proceedings. Result. James Walden, 367, London road, Thornton Heath Neglecting to amend defective roofs, window sashes and headings at 116, St. Georges road Ordered to do work within 14 days, with £1 1s. 0d. costs James Pusser, 1, Kinglake street Neglecting to amend defective roofs and top floor front ceiling at 62, Alvey street Ordered to do work within 21 days, with 21/- costs Messrs. Gale, Heath & Sneath 15, New Bridge street Neglecting to provide sufficient ash-pit at 22, Jane street Summons withdrawn, ash-pit provided, with 10/6 coats Rebecca Benabo, 240, Mile End road, E.l Neglecting to amend and cleanse dirty and defective walls and ceilings at 13. Shorncliffe road Summons withdrawn, work done, with 10/6 costs Bebecca Benabo, 240, Mile End road, E.l Neglecting to amend defective sink waste pipe at 15, Shorncliffe road Summons withdrawn, work done, with 10/6 costs Thomas G. By all, 182, Kennington road, S.E. Neglecting to provide sufficient ash-pit at 76, Gravel Lane Summons withdrawn, ash-pit provided William Glasier, 19, Surrey street, W.C. Neglecting to amend defective drains at 214, Union street Summons withdrawn, work done, with 10/6 costs 38 Defendant. Cause of Proceedings. Result. E. Holliday, 28, Lower Kennington Lane, S.E. Neglecting to amend defective W.C. and roof, and to cleanse dirty rooms at 6, Barbel st. Ordered to do work within 14 days, with 21/- costs Messrs. W. & G. Schilling, 74, Beresford street Neglecting to securely fix the ventilating pipe at 51, Thurlow street Summons withdrawn, work done, with 12/6 costs John Ray, 33, Grange Road, Bermondsey Neglecting to amend defective roof and to cleanse staircase and landing at 5. Sutherland street Ordered to do work within 14 days, with 10/6 costs Emil, Draps & Co., 22/26, Paul street, E.C Selling to B.Matthews, of 51, Newington Causeway, 16 boxes of unsound chocolate Fined £10 and £5 5s. 0d. costs Bernard Matthews, 51,Newington Causeway Found deposited on the premises 16 boxes of unsound chocolate Fined £5. George Kennett, 160, Tulse Hill, S.W. Neglecting to amend defective roof and gutters, and to cleanse rooms at 36. Cavour street Summons withdrawn, work done. 10/6 costs T. H. Brown. Parkfield Avenue, Harrow Neglecting to amend defective roof, gutter and walls at 6, Horsman street Summons withdrawn, work done. 10/6 costs T. H. Brown, Parkfield Avenue, Harrow Neglecting to amend defective paving and to cleanse the premises at 31, Horsman street Summons withdrawn, work done. 10/6 costs Rebecca Benabo, 240, Mile End road, E. Neglecting to amend defective roof and r.w.p. and ceilings at 10, Chapter terrace. Summons withdrawn, work done. 10/6 costs 39 Defendant. Cause of Proceedings. Result. Rebecca Benabo, 240, Mile End road, E. Neglecting to amend defective roof at 11, Chapter terrace Summons withdrawn, work done 10/6 costs D. Dolin, 53, Whitechapel rd., E.1 Neglecting to amend defective sink waste pipe at " A " Block, Silvester buildings. Summons withdrawn, work done. 10/6 costs D. Dolin, 53, Whitechapel rd., E.1 Neglecting to amend defective flushing apparatus at " A " Block, Silvester buildings Summons withdrawn, work done. 10/6 costs D. Dolin. 53, Whitechapel rd., E.l Neglecting to amend defective range at 5b, Silvester buildings Summons withdrawn, work done. 10/6 costs D. Dolin, 53, Whitechapel rd., E.l Neglecting to amend defective floor and range, and to cleanse dirty tenement at lib, Silvester buildings Summons withdrawn, work done. 10/6 costs Messrs. A. Bulmer, 141, Boro' High street Neglecting to amend defecting flushing apparatus and to cleanse wash-house at 4, Amery place Summons withdrawn, work done. 10/6 costs 40 SMOKE ABATEMENT. The tendency to adopt gas cooking must in time minimise the amount of solid carboniferous particles in the atmosphere, but owing to the partiality for a coal fire for warming purposes there is still great pollution of the atmosphere with resulting lung irritation and bronchitis. BLACK SMOKE. During the year 1927 three complaints were received at the Public Health Office from persons other than the Council's Inspectors. TABLE 20 Showing the Number of Observations, &c., in regard to Smoke Nuisances made by the several Ward Inspectors during 1927. 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 for Borough. Number of observations made by the inspectors 1 — 1 1 1 — — — — — 4* Number of nuisances observed — — 1 — 1 — — — — — — 2 No. of Intimation Notices served — 1 — 1 — — — — — — 2 No. of Statutory Notices served — — — — 1 — — — — — — 1 No. of Summonses taken out — — — — — — — — — — — — During the year 1926, three complaints were received at the Public Health Office, 8 observations were made, and one nuisance was observed. HOUSES LET IN LODGINGS. The new regulations have involved an entire revision of the houses on our registers, and under these regulations a large proportion of the houses in the Borough will ultimately come under this heading. NUMBER OF HOUSES ON REGISTER AT END OF 1927. St. Alary 37 „ Paul 19 „ Peter 33 „ John 22 Trinity13 All Saints 38 St. Michael 59 „ St. Jude 16 „ St. George 55 Christ Church (St. Saviour) 331 Total 623 41 TABLE 21 Factories, Workshops, Laundries, Workplaces and Homework. 1.—Inspection (including Inspections made by Sanitary Inspectors). Premises. Number Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 366 76 ... Workshops (including Workshop Laundries) 617 107 ... Workplaces 5764 316 ... Homeworkers' Premises (including Outworkers) 400 2 ... Total 7147 501 ... 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. * Nuisances under the Public Health Acts:— Want of Cleanliness 270 284 1 ... Want of Ventilation 22 12 ... ... Overcrowding 2 1 ... • •• Want of drainage of floors — — ... ... Other nuisances 452 490 ... ... Sanitary accommodations: Insufficient 13 9 ... ... Unsuitable or defective 34 25 ... ... Not separate for sexes 6 5 ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (SS. 97-100) ... ... ... ... Other offences 107 107 ... ... Total 906 933 ... ... Including those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts. 42 TABLE 22. 3.—Home Work. Nature of Work. Outworkers' Lists, Section 107. Number of Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, S. 108. Outwork in Infected Premises, Sections 109-10. Lists received from Employers. Nos. of Addresses of Outworkers received from other Councils. Nos. of Addresses of Outworkers forwarded to other Councils. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made. (S. 110). Prosecutions. (Ss. 109, 10). Twice in the year Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Wearing Apparel— (1) Making, &c. 84 76 79 79 338 735 ... ... 254 12 1 ... 3 ... ... (2) Cleaning and washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery 2 3 2 6 1 1 ... ... 3 1 ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... Umbrellas ... ... ... ... 8 ... ... ... 6 ... ... ... 1 ... ... Paper Bags and Boxes 10 12 10 24 3 17 ... ... 58 6 1 ... ... ... ... Brushmaking 8 14 8 10 4 9 ... ... 21 ... ... ... ... ... ... Stuffed Toys 1 4 1 20 ... 22 ... ... 20 1 ... ... 1 ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro Plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and Chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and Grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart Gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, Latches and Keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Miscellaneous 10 15 10 20 22 19 ... ... 33 2 1 ... ... ... ... Total 115 124 110 159 376 803 ... ... 400 22 3 ... 5 ... ... 43 TABLE 23 4.—Registered Workshops. Workshops, Workplaces, &c., on the Register (S. 131) at the end of the year. Number. Bakehouses 98 Factory Bakehouses 5 Bating houses and places where food is prepared for sale 346 Ice Cream Shops 139 Laundries 34 Dressmakers, Milliners, &c. 36 Tailoring 25 Brushmakers 10 Miscellaneous 1949 Total number of Workshops, Workplaces, &c., on Register 2642 5.—Other Matters. Class. Number. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 2 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5): Notified by H.M. Inspector 22 Reports (of action taken) sent to H.M. Inspectors ... 20 Other ... Underground Bakehouses (S. 101):— Certificates granted during the year 8 In use at end of the year 32 44 TABLE 24. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made during the year 1927. WARD. Inspections. Re-inspections. Premises where Rats were found. Action taken. Probable Source. Notices. By Council's Official. By Occupiers. By Inspectors By Rat Officer. By Inspectors By Rat Officer. Baits laid by Rat Officer with poison Wire Traps Set. Breakback Traps Set. Cats or Dogs. Ferrets. Rat Runs and Holes. Defective Drains. Defective Sewers. St. Mary 43 53 33 450 49 2327 151 496 6 – 13 – – 13 St. Paul 57 81 22 386 43 1326 57 261 11 – 26 4 – 3 St. Peter 59 52 33 177 43 610 43 176 6 – 25 2 – 6 St. John 68 81 69 455 50 1812 40 381 6 – 35 2 – 1 Trinity 61 74 130 253 56 876 62 169 8 – 47 5 – 27 All Saints' 37 50 134 638 60 2322 130 472 10 – 31 8 – 9 St. Michael 19 39 6 179 19 596 17 117 1 – 16 1 – 9 St. Jude 70 60 157 122 56 279 19 59 3 – 25 7 1 7 St. George 69 92 51 479 48 1563 44 423 7 – 23 7 1 2 Christchurch 26 21 29 149 18 661 29 200 – – 9 – – 4 St. Saviour 25 44 67 325 16 1690 93 464 1 – 5 4 – 1 Total 534 647 731 3613 458 14062 685 3218 59 – 255 40 2 82 Number of Rats destroyed 1,840 Number of Mice destroyed 68 45 CUSTOMS AND INLAND REVENUE ACT, 1890. No Certificate for exemption from Inhabited House Duty was granted during the year 1927. HOUSING, TOWN PLANNING, Etc., ACT, 1909. No certificate for exemption from Inhabited House Duty in respect to lodging houses for working classes was granted during the year. WATER SUPPLY. PUBLIC HEALTH (LONDON) ACT, 1891. Section 48. Certificates in regard to water supply have been granted in respect of the undermentioned (new) houses during the year. Premises. Certificates granted to. Manciple Street (4 shops and 4 workshops) Messrs. Rowley Bros., Tottenham. 34, 36, 38, Walworth Road Mr. J. Parsons, 190-192, Waterloo Road. Palmerston Arms (Grosvenor Terrace) Messrs. Miller & Lumsden, Holborn. 2 to 18a, Liverpool Street (18 Flats) Messrs. Cluttons, 5, College Street, S.W. 1 to 8 St. Edmunds House Messrs. A. S. & J. C. Soutar, 1 to 4 Bailie House 16 flats 8, King William Street, 1 to 4 Strathcona House Strand. WATER SUPPLIES TO TENEMENTED HOUSES. London County Council (General Powers) Act, 1927. 27 additional water supplies were provided to houses during the year, 1926. 46 Cleansing of Verminous Rooms and their Contents. During the year 1927 the number of verminous rooms with the bedding and other articles cleansed and disinfected in accordance with the requirements of the London County Council (General Powers) Act, 1904 and 1922, has decreased in comparison with 1926. 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 25. 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. (ft) by the Council's Disinfecting Staff. St. Mary 49 35 – 70 56 St. Paul 23 12 – 28 25 St. Peter 35 29 – 55 25 St. John 85 32 – 115 40 Trinity 126 116 1 177 166 All Saints 41 19 – 53 68 St. Michael 83 53 – 121 103 St. Jude 47 23 – 69 79 St. George 76 41 – 117 32 Christchurch 22 16 – 39 16 St. Saviour 13 10 – 17 17 Total 600 386 1 *861 627 *Note:—These 861 rooms were stripped by the owners. 47 CLEANSING OF PERSONS ACT, 1897. Adults sent from Lodging-houses and other places in the Borough to be cleansed during 1927. TABLE 26. Address. Male. Female. Total. 8, Quilp street 21 – 21 76, Blackfriars road 1 – 1 12, Marshalsea road 7 – 7 Salvation Army Shelter, Blackfriars road 681 – 681 90, Camberwell road 21 – 21 7, Dorritt street – 22 22 86, Gravel lane 6 – 6 12, Gray street 25 – 25 56, Newington Causeway 4 — 4 Rowton house 57 – 57 St. Olave Chambers 77 — 77 112, Southwark Bridge road 22 — 22 128, Walworth road 4 — 4 78, Camberwell road — 2 2 12, Lombard street — 16 16 Morning Post Home, New Kent road 6 –— 6 8, Great Charlotte street 2 – 2 Y.M.C.A. Huts – – – 19, Belvedere crescent – 1 1 Other addresses 59 33 92 Total 993 74 1,067 48 TABLE 27. Showing the Number and Sex of Verminous or Scabious Children treated at the Council's Station, King James Street, during 1927, and the Schools from which they were sent. These 3,443 Children received 5,417 baths during 1927. Name of School. Verminous. Scabious. Total. Boys. Girls. Boys. Girls. Archbishop Sumner — 14 – 1 15 Addington street 13 43 1 1 58 All Saints' 5 45 — — 50 Archbishop Temple — — — — — Archbishop Tenison – 1 – — 1 Archbishop Tait 1 2 — – 3 Blackfriars 3 105 2 — 110 Beresford street — — 1 1 2 Charles Dickens 28 100 2 3 133 Christchurch 7 53 – – 60 Crampton street 6 44 5 2 57 English Martyrs 11 89 — 2 102 Faunce street 1 — — 2 3 Flint street 23 65 — 1 89 Heygate street 6 14 – 2 22 Holy Trinity 2 40 – 1 43 Harper street 37 111 1 1 150 Hatfield street 7 82 2 — 91 Holland street 4 59 — — 63 Johanna street 62 188 9 — 259 John Ruskin 18 38 — 3 59 King and Queen street 17 88 2 2 109 Lollard street 11 4 — — 15 Mina road – – – – – Michael Faraday 6 31 — — 37 Newcomen Foundation — 7 — — 7 Orange street 14 109 — – 123 Penrose street 27 79 9 4 119 Friar street 24 192 2 2 220 Rockingham street 33 86 — — 119 St. George's R.C. 26 71 – – 97 Carried forward 392 1,760 36 28 2,216 49 Name of School. Verminous. Scabious. Total. Boys. Girls. Boys. Girls. Brought forward 392 1,760 36 28 2,216 St. George's, Earl street 14 42 — — 56 Sayer street 11 91 — — 102 St. Saviour's 9 43 — — 52 St. Agnes 2 11 4 — 17 St. Paul's, Sutherland square 6 20 — — 26 Surrey square – — — — — Sandford row 11 47 1 2 61 Springwell house – – – – – St. John's, Larcom street 4 25 — — 29 St. Patrick's 7 48 — — 55 St. John's, Waterloo road 8 38 — 1 47 St. Alban's 7 15 — — 22 St. Andrew's 12 43 – 1 56 St. Mary, Newington 17 143 2 2 164 St. Jude's 13 31 — — 44 St. Joseph's 12 107 — 2 121 St. Mary, Lambeth 4 — — 1 5 St. Peter's 5 5 1 — 11 St. Phillip's — 4 — — 4 Victory place 14 39 2 1 56 Westminster Bridge road 17 92 — — 109 Walnut Tree walk — 4 — 1 5 West square 18 35 — 1 54 Waterloo road 5 67 3 — 75 Westmoreland road — 34 — 2 36 Webber street — 3 — — 3 Boundary Lane — — — — — Other schools 8 7 2 – 17 Totals 596 2,754 51 42 3,443 50 TABLE 28. Verminous Bedding, &c., Disinfected at the Council s Stations during 1927. Articles. Disinfected. Destroyed. Beds 185 – Palliasses 56 – Bolsters and Pillows 273 –— Cushions 55 – Blankets 1219 – Sheets 272 – Quilts 57 – Articles of Clothing, &c. 15,939 – Total 18,056 – VERMINOUS PERSONS CLEANSED DURING 1927. During the year 4,510 persons were cleansed at the station in King James Street. Of these under our agreement with the London County Council, were 3,443 children. 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. 1,067 adults sent from the various common lodging houses and other places in our borough were cleansed during the year, as against 1,045 dealt with under the provisions of the Cleansing of Persons Act, 1897, in 1926. 51 MORTUARIES. table 29. During the year 328 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 151 16 167 Bodies brought in for convenience 2 158 160 Bodies brought in in cases where death had occurred from Infectious Disease 1 — 1 Total 154 174 328 HOUSING. Housing conditions show a slight improvement, and overcrowding is not quite so bad as in 1926. 122 families have been accommodated on the London County Council Estates, and others have obtained accommodation elsewhere. There have been fewer applications for houses than in 1926, and the pressure is diminishing. Many applicants are not in a position to take up Council houses even if more were available. This is chiefly due to the large families and small incomes, and it is practically impossible to rehouse families living under these conditions. Every effort is made to provide accommodation for those who are suitable tenants and who are able to live in the districts where houses are provided. 52 TABLE 30. 9.—Housing. Number of new houses erected during the year:— (a) Total (including numbers given separately under (6) 37 (b) With State assistance under the Housing Acts: None. (i) By the Local Authority None. (ii) By other bodies or persons 37 1. Unfit dwelling houses:— Inspection—(1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 10,523 (2) Number of dwelling houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 4,210 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 10,499 2. Remedy of Defects without Service of formal Notices :— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers included in above 1-4 3. Action under Statutory Powers :— A. Proceedings under Section 3 of the Housing Act, 1925:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 5 (2) Number of dwelling houses which were rendered fit after service of formal notices — (a) by owners — (b) by Local Authority in default of owners 53 table 30—continued. (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil B. Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 10,499 (2) Number of dwelling houses in which defects were remedied after service of formal notices : 10,710 (a) by owners 10,710 (b) by Local Authority in default of owners — C. Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925:— (1) Number of representations made with a view to the making of Closing Orders Nil (2) Number of dwelling houses in respect of which Closing Orders were made Nil (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit Nil (4) Number of dwelling houses in respect of which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil 54 table 31. VISITS MADE UNDER THE PUBLIC HEALTH (MEAT) REGULATIONS, 1924. 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. Stalls and Shops visited 147 78 652 587 55 53 68 30 170 64 25 1929 SLAUGHTERHOUSES. The supervision of the various Slaughterhouses was carried out during the year by Mr. Fisher and Mr. Duffield. There are four 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 70, Union Road Sidney John Waghorn 244, Walworth Road Messrs. Chalk & Cox, Ltd. 283-5, Walworth Road William Charles Brady 88 inspections were made during the year. One nuisance was discovered. Each Slaughterhouse was limewashed every three months during the year. 55 Table 32. Inspections of Pood at Wharves, Markets, and other places where food is stored, and the action taken by the officials during the year 1927. INSPECTION OF WHARVES, Ac. FOOD EXAMINED, &c. WARD. Inspections of Wharves and Warehouses. Inspections of Markets, Inspections of Shops or Street Stalls. Total. Parcels of Food Examined. Parcels of Food Stopped. Parcels of Food Released. Parcels of Food destroyed by consent of owner. Parcels of food seized by Inspector. Parcels of food condemned by Magistrate. Summonses taken out. St. Mary's — 317 84 401 442 — — — — — — St. Paul's 29 — 11 40 15 — — 3 — — — St. Peter's — 1463 134 1597 1645 — — 3 — — — St. John's — 77 3 8O 80 — — 4 — — — Trinity 1 56 32 89 98 — — 1 1 1 1 All Saints' — 23 1 24 24 — — 1 — — — St. Michael's 11 597 12 620 696 — — 2 — — — St. Jude's 1 87 2 90 97 — — — — — — St. George's 1 573 8 582 673 — — — — — — Christchurch 475 123 1 599 982 1 3 49 — — — St. Saviour's 660 — — 660 1068 — — 224 — — — By M.O.H — — — — — — — — — — Brought to Town Hall — — 13 13 10 — — 14 — — — Total 1178 3316 301 4795 5830 1 3 301 1 1 1 56 57 EXAMINATION OF FOOD. TABLE 33. Showing the quantity of Foodstuffs examined during the year 1927 by the several Inspectors throughout the Borough (The amount shown in this table is in addition to the total shown in Table 34.) Foodstuffs Examined. Quantity and Weight found Unsound. Surrendered by Owners. Seized by Inspector. Remarks. Foodstuffs. Quantity. Weight. Quantity. Weight. Quantity. Weight. Quantity. Weight. T. C. Q. L. T. C. Q. L. T. C. Q. L. T. C Q. L. Apricots 40 bottles - - - 20 Destroyed at Council's Depot. Apples 24 packages - 6 0 12 8 boxes — 2 3 16 8 boxes — 2 3 16 Asparagus, tinned 1 case - - 1 20 1 case - - 1 20 1 case - - 1 20 — — Destroyed at Council's Depot. Apricots 15 crates - 1 2 0 15 crates - 1 2 0 15 crates — 1 2 0 — — Destroyed at Council's Depot. Apricot pulp 45 tins - 16 0 23 Bacon Bales, sides, &c. 82 4 3 27 — — 9 1 10 — — 9 1 10 — — 6 cwt. 2 qrs. 14 lbs. were released for soap boiling and 2 cwt. 2 qrs. 24 lbs. were destroyed at the Council's Depot. Beef Joints, &c. 81 15 3 6 18 pieces - 2 1 8 18 pieces - 2 1 8 — — Destroyed on premises where found. Blackcurrants 48 baskets _ 5 2 24 Beef paste 6 gross - 2 0 0 Bananas 142 crates 3 1 1 0 100 crates 2 10 1 0 100 crates 2 10 1 0 — — Destroyed at Council's Depot. Brussel sprouts 34 bags — 7 1 4 34 bags — 7 1 4 34 bags — 7 1 4 — — Destroyed at Council's Depot. Beef, tinned 167 tins - 11 1 13 144 tins - 6 1 23 144 tins — 6 1 23 — — Destroyed at Council's Depot. Beef powder 126 cases 3 7 2 0 Beef extract 478 cases 14 15 1 0 Casings, Sheeps' 6 barrels — 13 2 0 Condensed milk 21 cases, &c. - 10 0 5 170 tins - 3 3 5 170 tins — 3 3 5 — — Destroyed at Council's Depot. Crabs 2 barrels - 2 0 0 2 barrels - 2 0 0 2 barrels - 2 0 0 — — Destroyed at Council's Depot. Cherries 15 sieves, &c. - 3 2 8 15 sieves - 3 2 8 15 sieves - 3 2 8 — — Destroyed at Council's Depot. Cauliflowers 46 crates 1 1 1 20 46 crates 1 1 1 20 46 crates 1 1 1 20 — — Destroyed at Council's Depot. Carried forward 190 6 0 14 5 11 1 2 5 11 1 2 58 59 Foodstuffs Examined. Quantity and Weight found Unsound. Surrendered by Owners. Seized by Inspector. ks. Foodstuffs. Quantity. Weight. Quantity. Weight. Quantity, Weight. Quantity Weight. T. C. Q. L. T. C. Q. L. T. C. Q. L. Brought forward 190 6 0 14 5 11 1 2 5 11 1 2 T. C. Q. L. Currants, Red 50 baskets _ 4 1 24 Chocolate 16 boxes - - 2 8 16 boxes - - 2 8 — — 16 boxes - - 2 8 See page 38. Egg Liquid 6 casks 1 16 0 0 Fruit, tinned 3 cases. &c. - 2 2 24 77 tins - 1 1 20 77 tins — 1 1 20 — — Destroyed at Council's Depot. Fish, tinned 199 tins - 1 1 0 199 tins - 1 1 0 199 tins - 1 1 0 — — Destroyed at Council's Depot. Fowls 12 fowls _ — 2 4 French beans 30 cases - 15 0 0 Gooseberries 144 packages 1 12 1 20 34 packages - 6 0 0 34 packages - 6 0 0 — — Destroyed at Council's Depot. Grape fruit 10 boxes - 10 0 0 Ginger 6 barrels – 6 0 0 Heads, pigs' 38,100 184 4 0 10 3,276 heads 15 14 3 3 3276 heads 15 14 3 3 — — Released for soap boiling. Hams 1,625, &c. 22 16 0 23 12 hams - 1 1 19 12 hams - 1 1 19 — — Released for soap boiling. Haddocks 5 boxes. &c. - 5 0 8 5 boxes - 5 0 0 5 boxes - 5 0 0 — — Destroyed at Council's Depot. Heads, sheeps' 18 heads _ - 3 6 Loganberries 40 baskets - 1 0 8 Marmalade 50 pots - 1 0 0 - Mutton Joints, &c. 18 2 0 5 6 pieces - - - 20 6 pieces — — — 20 — — Destroyed on premises where found. Mussels 1 bag - 1 0 0 1 bag - 1 0 0 1 bag - 1 0 0 — — Destroyed at Council's Depot. Offal — 16 3 3 11 — - 3 2 1 — - 3 2 1 — — Destroyed at Council's Depot. Pork Carcases, joints, &c. 272 16 0 27 226 carcases 13 16 0 23 226 carcases 13 16 0 23 — — Released for soap boiling. Potatoes 16 bags - 10 0 0 8 bags - 8 0 0 8 bags - 8 0 0 — — Destroyed at Council's Depot. Plums 15 baskets - 1 2 12 Pears 15 packages - 2 0 0 15 packages - 2 0 0 15 packages - 2 0 0 — — Destroyed at Council's Depot. Plaice 1 box, 120 plaice - 1 0 12 1 box - - 3 0 1 box - - 3 0 — — Destroyed at Council's Depot. Rabbits 6 boxes, 412 rabbits - 12 3 7 6 boxes - 5 0 19 6 boxes - 5 0 19 — — Destroyed at Council's Depot. Roe 12 boxes - 2 2 0 4 boxes - - 2 0 4 boxes - - 2 0 — — Destroyed on premises where found. Raspberries 70 baskets - 8 1 24 Carried forward 712 4 3 23 36 19 0 3 36 18 1 23 - - 2 8 60 61 Foodstuffs Examined. Quantity and Weight found Unsound. Surrendered by Owners. Seized by Inspector. Remarks. Foodstuffs. Quantity. Weight, Quantity. Weight. Quantity. Weight. Quantity. Weight. T. C. Q. L. T. C. Q. L. T. C. Q. L. T. c. Q. L. Brought forward 712 4 3 23 36 19 0 3 36 18 1 23 — — 2 8 Sprats ½ bushel — — _ 20 Spinach 210 cases 5 11 0 0 180 cases 4 16 0 0 180 cases 4 16 0 0 — — Destroyed at Council's Depot. Salmon, tinned 6 cases — 2 2 24 31 tins — — — 16 31 tins — — — 16 — — Destroyed on Council's Depot. Strawberries 166 baskets — 8 3 4 Tongues, Ox — 6 5 0 18 Tomatoes 23 bundles, 26 boxes — 17 0 8 22 bundles — 16 3 22 22 bundles — 16 3 22 — — Destroyed at Council's Depot. Tallow 1 cask — 3 0 0 Tongues, calves' 1 cask — 2 1 7 1 cask — 2 1 7 1 cask — 2 1 7 — — Released for soap boiling. Tongues, tinned 18 tins - - - 18 Turkeys 350 turkeys 2 1 i 22 1 turkey - — — 20 1 turkey — — — 20 — Released for soap boiling. Veal Carcases, pieces — 19 2 13 3 bags — 1 2 19 3 bags - 1 2 19 — — Released for soap boiling. Watercress 12 baskets — 3 0 0 Total 728 19 1 17 42 16 1 3 42 15 2 23 — — 2 8 62 63 TABLE 34 Table showing the total quantity of Foodstuffs examined at the wharves during the year 1927, the quantity found to be unsound, the notices served and the method of disposal of the unsound portion. Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. 1 Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention. (b) Release T. C. Q. L. T. C. Q. L. Apricots, tinned 1,306 cases 30 19 3 2 - 19 1 4 Yes — 4 — Destroyed at Council's Depot. Apples 178 boxes 3 14 0 12 — — — — — — Asparagus, tinned 665 cases 14 4 3 20 - 1 1 4 Yes — 1 — Destroyed at Council's Depot. Apricots, dried 276 boxes 3 6 3 12 — — — — — — Apricot pulp 50 cases 2 9 0 12 — — — — — — Apple juice... 84 tins 1 1 0 0 1 1 0 0 Yes — 1 — Destroyed at Council's Depot. Apples, tinned 602 cases 9 11 2 22 — — — — — — Apricots 3,250 crates 33 0 3 4 4 0 0 8 Yes — 11 — Destroyed on premises where found. Beef, tinned 4,828 cases 155 18 0 20 17 3 1 18 Yes — 38 3 13 tons 16 cwt 3 qrs. 2 lbs. were destroyed at the Council's Depot and 3 tons 6 cwt. 2 qrs. 16 lbs. were released for soap boiling and pig feeding. Beef 3,945 joints, 577 bags 134 13 1 18 12 17 1 6 Yes — 7 1 12 tons 14 cwt 3 qrs. 6 lbs. were released for soap boiling and 2 cwt. 2 qrs. were destroyed at Manor Place Depot. Bacon 2,188 bales, 65 boxes 242 3 0 0 — — — 2 — — Beans, tinned 42 cases 1 2 2 0 — — — — — — Blackcurrant pulp 337 cases 9 0 2 4 — — — — — — Beef, salted 6 barrels — 10 2 24 — — — — — — Blackcurrants 700 packages 7 10 0 0 — — 3 12 Yes — 1 — Destroyed on premises where found. Beef fat 50 boxes — 12 2 0 — — — — — — Butter 18 tubs — 18 0 0 — — — — — — Condensed milk 6,170 cases, 3 barrels 109 0 0 26 33 7 3 14 Yes — 51 — 27 tons 18 cwt. 1 qr. 20 lbs. were released for soap boiling, and 5 tons 9 cwt. 1 qr. 22 lbs. were destroyed at the Council's Depot. Cheese 1,268 crates 56 11 3 6 17 12 1 2 Yes — 4 3 Destroyed at Council's Depot. Crayfish, tinned 30 cases — 12 3 12 - 9 0 0 Yes — 1 1 Destroyed on premises where found. Crab, tinned 288 cases 6 1 2 3 — — — — — — Cherries, tinned 375 cases 10 10 3 6 — — — — — — Caviare 1 barrel, 10 casks — 7 0 0 - 2 0 0 Yes — 1 — Destroyed at Council's Depot. Currants 158 boxes 1 19 2 0 — — — — — — Cherries 350 billots 3 10 1 20 — 3 0 6 yes — 3 — Destroyed on premises where found. Capsicum 1 crate - - - 24 - - - 24 Yes — 1 — Destroyed on premises where found. Casings, hog 24 casks 4 16 0 0 — — — — — — Ducks 60 boxes, 113 cases 2 18 3 4 — — — — — Dates 56 boxes - 11 0 0 — — — — — — Egg liquid, frozen 3,876 cases, &c. * 1181 14 2 6 — — — 2 — *1,169 tons still under " stop." Eggs 189 cases 18 14 0 0 6 8 0 0 Yes — 10 — Destroyed at Council's Depot. Egg liquid 4,299 casks 448 4 2 0 4 2 2 0 Yes — — — Released to Hamburg for cattle feeding. Carried forward 2496 13 1 5 98 8 0 14 138 8 64 65 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention. (b) Release T. C. Q. L. T. C. Q. L. Brought forward. 2496 13 1 5 98 8 0 14 138 8 Egg albumen 6 cases _ 12 0 0 _ 1 0 0 Yes – 1 – Destroyed at Council's Depot. Egg yolk ... 6 casks 1 12 0 16 1 12 0 16 Yes – 1 — Destroyed at Council's Depot. Fowls 2,168 boxes and crates 39 0 1 2 1 10 2 4 Yes — 5 1 Released to Smithfield Animal Products Co. for soap boiling. Fruit, assorted 1,761 cases 39 7 3 18 9 14 2 24 Yes – 25 2 Destroyed at Council's Depot. Flour 335 bags 18 15 0 0 – 17 0 0 Yes – — — Released for animal food. Figs 45 bags - 5 2 14 — — – — – — Gooseberries, tinned 58 cases 1 11 0 8 — — – — — — Gooseberry pulp 40 cases 1 1 1 20 — — – — — — Greengages 250 packages 2 13 2 16 – – 2 16 Yes — 1 — Destroyed on premises where found. Grapes 1 billot — – – 12 – – – 12 Yes – 1 – Destroyed on premises where found. Herrings, tinned 236 cases 5 1 3 22 – – – – – — Hams 258 boxes 54 9 1 10 – – – 2 2 — Heads, Ox 30 heads _ 5 1 12 – – — – — Ice Cream mixture 48 tins _ 3 1 20 _ 3 1 20 Yes – 1 – Destroyed at Council's Depot. Lard 659 boxes 16 12 3 20 – – – — — — Loganberries, tinned 352 cases 9 7 2 16 – 18 0 24 Yes — 3 — Destroyed at Council's Depot. Lobster, tinned 66 cases — 18 0 4 — — – — — — Lemons 40 boxes 1 10 0 0 — — – — — — Mutton Carcases, &c. 1074 7 2 17 66 15 3 22 Yes – 12 5 Released to the Smithfield Animal Products Co. for soap boiling. Mutton, tinned 48 cases 1 10 3 12 – — — — — — Offal – 88 3 0 9 14 1 3 7 Yes – 7 – Released for soap boiling. Oranges 675 boxes 19 13 0 20 3 4 0 4 Yes — 3 1 Destroyed on premises where found. Peaches, tinned 985 cases 26 10 1 27 1 0 1 12 Yes — 2 Destroyed at Council's Depot. Pineapple, tinned 1,214 cases 32 6 1 0 2 4 3 16 Yes – 6 Destroyed at Council's Depot. Pork 792 carcases 27 19 1 12 _ _ 2 12 Yes – 1 – Released for soap boiling. Prunes, dried 494 boxes 6 1 1 12 — 1 Released for sorting. Pears, tinned 780 cases 20 14 2 8 – 1 0 8 Yes 1 – Destroyed at Council's Depot. Pork and Beans, tinned 51 cases _ 18 2 8 – 4 1 4 Yes – 2 — Destroyed at Council's Depot. Plums, tinned 438 cases 11 15 1 16 _ 3 2 0 Yes — 2 — Destroyed on premises where found. Peas, tinned 84 cases 1 17 2 0 — — – — — — Pork, salted 1 barrel _ 1 3 4 — – — — — Plums 1,318 packages 12 16 3 14 _ 16 3 14 Yes — 10 — Destroyed on premises where found. Peaches 270 packages 2 19 0 0 _ 1 2 26 Yes — 3 — Destroyed on premises where found. Babbits 2,102 crates 57 15 0 18 2 1 1 26 Yes — 4 — Released for soap boiling. Raspberry pulp 2,228 cases 60 0 2 4 18 13 1 16 Yes — 3 2 Destroyed at Council's Depot. Raspberries, tinned 554 cases 15 1 1 10 — — — — — — Raisins, dried 130 boxes 1 12 2 0 — — 1 0 Yes — 1 — Destroyed at Council's Depot. Redcurrants 25 boats _ 5 1 12 — — i 24 Yes — 1 — Destroyed on premises where found. Salmon, tinned 2,124 cases 45 19 1 26 5 14 0 12 Yes — 22 2 Destroyed at Council's Depot. Soup, tinned 114 cases 2 0 0 2 1 3 1 22 Yes — 10 — Destroyed at Council's Depot. Carried forward 4200 11 1 26 229 13 3 9 269 23 66 67 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention. (b) Release. T. C. Q. L. T. C. Q. L. Brought forward 4200 11 1 26 229 13 3 19 269 23 Strawberry pulp 82 cases 2 3 3 20 - 17 0 16 Yes — 1 — Destroyed at Council's Depot. Sardines, tinned 368 cases 8 1 2 2 - 12 2 0 Yes — 1 — Destroyed on premises where found. Strawberries, tinned 42 cases 1 2 2 0 — — — — — — Sausages, tinned 40 cases — 17 0 16 — — — — — — Strawberries 4 baskets — — — 16 — — — 16 Yes — 1 — Destroyed on premises where fouud. Turkeys 377 cases 11 6 2 0 — — — — — — Tomatoes, tinned 540 cases 14 13 2 16 1 2 0 8 Yes — 1 — Destroyed on premises where found. Tallow 245 casks 58 15 0 0 58 15 0 0 Yes — 3 — Released for export. Tongues, tinned 886 cases 28 8 1 3 — 15 0 0 Yes — 1 — Released for soap boiling. Tongues, ox 442 bags 11 8 2 8 — — — — — — Tunnyfish 40 cases — 17 0 16 — — — — — — Tomato puree 114 cases 4 9 2 16 — — — — — — Tripe, tinned 113 cases 2 6 1 20 — 2 0 16 Yes — 1 — Destroyed at Council's Depot. Total 4345 3 3 19 291 17 3 19 278 23 CASEOUS LYMPHADENTITIS IN SHEEP. In July it was found that in sheep imported from Patagonia and Chili, a number were suffering from the above disease, and that a large amount of this mutton was in cold storage in this district. On August 5th, Sir Gordon Campbell and representatives from Patagonia and Chili met at the cold store to see the method of examination. It was found that 40,000 carcases were still in store. These had to be partly defrosted and each carcase examined by cutting to expose the glands Additional help being provided, these carcases were examined under the super- vision of Mr. Duffield at the rate of 2,000 a day. A total of 41,086 carcases were examined of which 2,600 proved to be diseased. The latter were released to the Smithfield Animal Products Co., Stratford, for commercial purposes. 68 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER. At the end of the year 1926 the number of milksellers on the Registers were as follows:— Retail 356 names 347 premises Wholesale 39 „ 39 „ During the year 1927, 68 applications respecting 67 premises were received for registration as Retail Milksellers. Four applications respecting four premises were received for registration as Wholesale Milksellers. These were entered in the respective Registers. Retail Register. Entered in Register. Removal from Register Not Registered. (Unsuitable, &c.) Total Applications. Names. Premises. Names. Premises. Names. Premises. Names. Premises 68 67 67 66 — — 68 67 The sale of milk was started afresh at 18 premises The sale of milk was discontinued at 17 „ Total number of Milksellers on Retail Register at end of 1927 357 Total number of Milksellers' premises „ „ 348 Wholesale Registeb. Entered in Register. Removal from Register Not Registered. (Unsuitable, &c.) Total Applications. Names. Premises. Names. Premises. Names. Premises. Names. Premises 4 4 4 4 — — 4 4 The sale of milk by wholesale was newly started during 1927 at 1 premises Do do discontinued at 1 do 69 Total number of Wholesale Milksellers on Register at end of 1927 39 Total number of Wholesale Premises „ 39 There are two premises licensed to bottle "Grade A (Tuberculin Tested) " milk and at these premises two samples of " Grade A (Tuberculin Tested) " milk were procured and submitted to the Public Analyst for Bacteriological Examination. These were certified by the Public Analyst to be in accordance with the requirements of the Milk (Special Designations), Order, 1923. Total number of Licences to sell graded Milk 39 Licences to sell "Graded" Milk. During the year 37 applications for licences to sell "graded" milk were received from various firms, as under :— (1) 28 applications from Messrs. R. Higgs and Sons Dairies, Ltd., of Nos. 2, 4, 6, Canterbury Road, Brixton, to sell (a) "Certified,'' (b) "Grade A," (c) "Grade A (Tuberculin Tested)" and (d) " Pasteurised " milk at each of their undermentioned premises: No. 8, Alvey Street. No. 91, Southwark Bridge Road „ 62, Borough High St. „ 18, Villa Street. „ 64, Camberwell Rd. „ 38, Westmoreland Road. „ 1/3. New Street. (2) Three applications from Mr. A. R. Ash, of No. 41, Alvey Street, Walworth, to sell (a) "Certified," (b) "Pasteurised," and (c) to bottle and sell " Grade A (Tuberculin Tested) " milk at No. 41, Alvey Street. (3) Two applications from Messrs. The Express Dairy Co., Ltd., of No. 26, Tavistock Place, W.C.I, to sell (a) "Certified" and (b) " Grade A (Tuberculin Tested) " milk at No. 12, St. George's Road, Southwark. (4) One application from Messrs. B. Jones & Son, of 16, Pilgrimage Street, to bottle and sell "Grade A (Tuberculin Tested) "milk at No. 16, Pilgrimage Street. 70 (5) One application from Mr. John Jones, of 3, Old Kent Road, to sell '-Grade A (Tuberculin Tested)" milk at No. 3, Old Kent Road. (6) One application from Mr. Dan Evans, of 227, Union Street, to sell "Grade A (Tuberculin Tested)" milk at No. 227, Union Street. (7) One application from Mr. D. C. Griffiths, of 25, Deacon Street, "Grade A (Tuberculin Tested)" milk at No, 25, Deacon Street. Inquiries were duly made, and it was found that the Producers who supplied the milk in question were holders of the necessary corresponding licences. The 37 licences applied for were accordingly issued by the Council. The following work of supervision was carried out by Mr. Nicholson during the year:— MILKSELLERS. 1,878 inspections of the various milkshops, dairies, &c., were made The following nuisances were discovered, in respect to which 11 intimation, and 3 statutory notices were served:— Dirty milkshops or dairy 15 cases Defective floor paving 1 case Dirty condition of utensils 1 case Unsuitable receptacles 2 cases Total 19 cases Of the 348 Retail Milksellers premises, 298 are Dairies. In 40, milk is sold in the closed bottles, as received by the seller, and in 11 the milk is sold for consumption on the premises only. 71 NOXIOUS TRADES. There are four 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 & 25, Gt. Suffolk St Tripe boilers J. Martin 5, Hatfield Street Pat melters J. Ewen & Son Harrow Street Skin Dressers Messrs. Leeding & Co. Wansey Street Works Soap Boilers J. Lewnian (not being used at present). Eight inspections of these premises were made during the year. No nuisance was discovered. The periodical process of limewashing and cleansing was duly carried out. COWSHEDS. No cows are being kept in the Borough at the present time. BAKEHOUSES. During the year 454 inspections were made of the various bakehouses and factories. The following defects were discovered and 27 intimation and 1 statutory notices were served in order to obtain the abatement of the nuisances complained of:— Dirty utensils 3 cases Dirty ceilings 18 cases Dirty walls 17 cases Dirty floors 5 cases Pood or flour store dirty 26 cases Dirty baking room 4 cases Defective walls 1 case Defective floors 2 cases Defective utensils 1 case Defective ceilings 3 cases Defective paving 1 case Other insanitary conditions 26 cases Total 107 cases All the above-mentioned nuisances were remedied. Each bakehouse was limewashed or the walls washed as required. 72 The following bakehouses were reported as being in a satisfactory condition:— 386, Walworth Road Above ground 4 times 61, Westmoreland Road do. 3 do. 176, East Street do. 4 do. 63, Finchley Road do. 3 do 146, Old Kent Road do. 3 do. 34, Portland Street Underground 4 do. 68. Alvey Street do. 4 do. The Maltina Bakeries, Ltd., 61, Webber Street Factory 4 do. J. Sainsbury, 11, Stamford Street do. 4 do. Particulars of Bakehouses:— Position of. Total Number. Not in use. Reported satisfactory. Above ground 62 16 0 Underground 36 6 2 Factories 5 — 2 Total 103 22 9 One Bakehouse was demolished during the year. BUTTER AND MARGARINE FACTORIES, &c. 8 inspections were made, and no nuisances were discovered. The limewashing and cleaning was carried out as required. There are 2 Butter Factories in the Borough. 6 samples of Butter were procured and submitted to the Public Analyst, who certified them as genuine. Two inspections were made of Wholsale Dealers in Margarine premises. One new Dealer was registered, and one discontinued. TOTAL INSPECTIONS DURING 1927. Premises. No. of Inspections. Notices. Intimation. Statutory. Milkshops 1878 11 3 Bakehouses 454 27 1 Tripe Boilers 4 — — Fat Melters 4 — — Butter Factories 10 — — Total 2350 38 4 73 SALE OP FOOD AND DRUGS ACTS. During the year ending 31st December, 1927, 1,416 " official " samples were taken by the Inspector. The following Table shows the localities in which these samples were taken:— table 35. 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. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Number of samples taken 150 150 152 181 121 132 136 98 140 72 84 1416 28 of these samples were certified as adulterated a percentage of 2.0. 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 37. 74 POLICE COURT PROCEEDINGS TAKEN UNDER THE FOOD AND DRUGS ACTS. 9 summonses were taken out during the year 1927. The following table shows the number of summonses in each ward TABLE 36. Showing the Wards in which proceedings were taken under the Food and Drugs Act. 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. Number of Summonses taken out 1 — — 2 1 — 2 1 2 — — 9 The proceedings taken before the Magistrates resulted as follows:— Summonses. Convictions obtained on 3 Dismissed on payment of costs 6 Total 9 75 FOOD AND DRUGS ACTS. TABLE 37. Return of Official Samples for the Year ending 31st December, 1927, showing the number taken, and the percentage of adulterated Samples for the year. Article. Number of Samples taken. Adulterated. Milk 462 12 Ground Ginger 1 ... Tea 8 ... Tea Dust 10 ... Coffee 17 ... Preserved Cream 1 ... Cream 4 ... Cocoa 37 ... Sugar 69 ... Butter 117 ... Margarine 74 ... Dripping 37 ... Lard 89 ... Cooking Fat 1 ... Beef Suet and Flour 5 ... Cake 18 4 Cheese 7 ... Self-raising Flour 52 ... Pea Soup Flour 14 ... Cakeflour 1 ... Cornflour 16 ... Bun Flour 8 ... Rice 38 ... Tapioca 26 ... Oatmeal 2 ... Carraway Seeds 4 ... Sago 4 ... Pearl Barley 22 5 Arrowroot 5 ... Rolled Oats 2 ... Crushed Linseed 9 2 Mixed Spice 6 . . . Soup 2 ... Yorkshire Pudding Powder 1 ... Prepared Groats 5 ... Milk Pudding 2 ... Borax 1 ... Dessicated Cocoanut 4 ... Carried forward 1181 23 Percentage of adulterated samples for the year—2.0. 76 Article. Number of Samples taken. Adulterated. Brought forward 1181 23 Cheese Cakes 2 ... Table Jelly 12 ... Raspberry Powder 1 ... Custard Powder 24 ... Blanc-Mange 3 ... Lemonade Powder 4 ... Curry Powder 7 ... Ox Tail Soup 2 ... Veal and Ham Loaf 1 ... Whisky 15 2 Gin 7 1 Rum 9 1 Brandy 5 1 Thick Gravy 6 ... Bisto 4 ... Mustard 20 ... Salt 14 ... Pepper 4 ... Semolina 3 ... Sponge Mixture 2 ... Jam Sandwich 7 ... Sweets 6 ... Corned Beef 1 ... Brawn 2 ... Breakfast Sausage 3 ... Fish Paste 17 ... Sausages 6 ... Bicarbonate of Soda 5 ... Boracic Powder 7 ... Crystalised Fruit 1 ... Lemon Crystals 1 ... Glauber Salts 1 ... Raspberry Crystals 1 ... Black Pudding 1 ... Jelly Crystals 5 ... Liquorice Powder 1 ... Citrate of Magnesia 1 ... Preserved Ginger 2 ... Preserved Pineapple 1 ... Oxbif 1 ... Gravy Salt 1 ... Sponge Cake 6 ... Cakeoma 1 ... Desiccated Soup 1 ... Carried forward 1405 28 77 Article. No. of Samples taken. Adulterated. Brought forward 1405 28 Allspice 1 ... Raisins 2 ... Sultanas 1 ... Fruit Salad 1 ... Candied Peel 1 ... Condensed Milk (Sweetened Fullcream) 2 ... Do do (Machine Skimmed) 2 ... Do do (Unsweetened Fullcream) 1 ... Total 1416 28 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 AND 1917. 4 samples of Cream and 1 sample of Preserved Cream were purchased under the above Regulations, and were certified by the Public Ayalyst as genuine. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923. 5 samples have been purchased under the above Regulations during the year and submitted to the Public Analyst, who certified them as genuine. PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923. Dried Milk does not appear to be on sale at the shops in the Borough. 78 INFORMAL SAMPLES. In addition to the samples taken under the Food and Drugs Acts as shown in table 39, 524 samples were purchased informally by the Inspector through his several agints. The whole of these samples were submitted to the Public Analyst for analysis, with the following result:— TABLE 38. Article. No. of samples purchased by Agents. Result of Analysis. Percentage of adulterated samples. Genuine. Adulterated. Butter 292 285 7 2.4 Milk 137 131 6 4.4 Margarine 29 29 — — Sausages 66 44 22 33.3 Total 524 489 35 6.7 79 TABLE 39. 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. George Cowell, 54, Upper Bland street Milk 1338 5 per .cent, deficient in Milk Fat Ordered to pay £1/1/0 costs Robert Cruttenden, 53, Long lane Milk 26 13 do do do Fined 10s. and £1/1/0 costs George Hughes, 14, Haddon Hall street Milk 36 5 do do do Fined 5s. and £1/1/0 costs George Cooke, 57, West Square Milk 42 13 do do do Ordered to pay £3/3/0 costs George Hope, 81, East street Crushed Linseed 123 20 do do in Oil Ordered to pay 10s. 6d. costs Daniel MacCarthy, 42. Little Surrey street Whisky 853 37.3 degrees under proof Ordered to pay £2 2s. 0d. costs William Morton, 124, Blackfriars Road Whisky 862 41.5 do do Ordered to pay £5 5s. 0d. costs Alice Knapman, 14, Saver street Rum 903 42.0 do do Ordered to pay £5 5s. 0d. costs Edward Evans, 181, Manor Place Pearl Barley 984 20 per .cent, groats Fined £1 and £2 2s. 0d. costs 80 INFECTIOUS DISEASE. General.—All homes are visited by a Sanitary Inspector and an Enquiry Officer, who arranges for isolation or Hospital treatment, and investigates the possible source of infection, and deals with the schools and contacts. SMALL POX. There was no case of Small Pox during 1927, nor in the preceding five years. During the present year I visited a few suspected cases which were found to be chicken pox. SCARLET PEYER. Although 21 more cases were notified during the year the number of deaths diminished by 2. This fact points to the decreasing virulence of the disease. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1923 409 4 1924 534 10 1925 741 8 1926 519 3 1927 540 1 DIPHTHERIA. There was a diminution of notified cases amounting to 171, and a decreased mortality of 11. Probably this was partly due to the climatic conditions, but is very satisfactory in view of the prevalence of this disease in Southwark. The Schick Test has not been utilised, but I have made the following report to the Council in November last: — "A few years ago Dr. Bela Schick, of Vienna, published results of experiments by which he showed that injection of a certain substance into the skin produced a slight red spot in cases where the person was liable to contract Diphtheria, but no reaction occurred when the person was immune. By this test, named after him the "Schick Test" he was enabled to divide persons into two classes; those susceptible to the infection of Diphtheria and those who were not. Following on this, he found it possible by giving the susceptible persons three injections of 81 what may be called an antidote to render them immune from Diphtheria for a period of six to seven years, and the practical application of his discoveries is to immune susceptible persons by these injections so that they will not contract the disease, even if in contact with virulent cases, and this is done nowadays universally in the case of nurses employed in diphtheria wards. The preliminary test can be omitted in very young children up to four years of age. as practically all children to that age are liable to contract the disease, the liability decreasing as age advances. These young children should all be immunised by the three injections without undergoing the preliminary test, and also if such older ones who are found susceptible by the "Schick Test" were immunised the disease would be well on its way to extermination. The application to the "Schick Test" requires some experience and practical knowledge to interpret the results successfully, but immunisation without preliminary testing can be done without special knowledge and at considerably less expense, and as mentioned above the preliminary test of children up to four years of age is not necessary. The cost of " Schick Test " is 2s. 3d. a phial for material, the other expenses being regulated by the administrative method employed ; the cost for immunisation only is about 3s. per child for material and no special experienced administrator would need engagement for the purpose. The outlay for syringes and other necessities would be covered by about £5, and record keeping outfit and office expenses would amount to about £10. For a capital outlay therefore of about £15 (if the work were carried out by our present staff) and a running charge of about 3s. 6d. per child the infant population could be immunised. Two hundred children would cost £35. This number would be possible and would be the commencement of a movement that in the future would probably stamp out the disease with the exception of imported susceptible persons, and as the knowledge spread among the parents, and as their confidence increased in this method of the prevention of Diphtheria the numbers would grow. The annual number of deaths from this disease in the Borough has averaged over 40 during the last five years and enormous expense is incurred in treating other cases for a long period in isolation hospitals who recover from the disease, these average over 800 per annum for the last five years, at a cost to the country which is estimated at £30 per case. 82 The scheme of immunisation of the very young without preliminary testing is worthy of institution in this Borough, and I recommend it to the Committee for their serious consideration." Antitoxin is supplied free of charge, and 60 Phials of 4,000 units have been supplied to Medical Practitioners in the Borough during the year. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1923 770 49 1924 791 49 1925 905 31 1926 945 32 1927 774 21 ENTERIC FEVER. Ten cases were notified during the year with 1 death. Of the above cases 5 which occurred in Southwark can be traced to a common source, and 3 other cases from a neighbouring borough also. These were all treated at St. Thomas's Hospital. The original case was a baby aged 4, and the suspected source ice cream. Of these 8 cases 2 died. Direct personal infection could be traced in several instances. Two families were involved, 1 living in Lambeth and the other in two different addresses in Southwark. Through the courtesy of Dr Tidy of St. Thomas's Hospital who kindly furnished notes on these cases it was possible to connect this small outbreak and to trace the epidemic back to the original case. Only the original case appears to have been due to food infection, the other cases having been transmitted from person to person. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1923 18 2 1924 12 1 1925 6 - 1926 10 3 1927 10 1 83 MEASLES. The bad cases of this disease are now admitted to the infectious wards of the Metropolitan Asylums Board Hospitals. There was a diminished mortality of 24 during the year. Deaths from Measles during the last 5 years. 1923 13 1926 51 1924 77 19 27 27 1925 28 DIARRHŒA. Owing to the mild summer there was a decrease in the mortality of 25 from this disease. Deaths from Diarrhoea during the last 5 years. 1923 61 1926 61 1924 49 1927 36 1925 58 26 of these deaths occurred in infants under 2 years of age. WHOOPING COUGH. The mortality from this disease has increased during the present year. The number of fatal cases during the last 5 years were as follows:— 1923 27 1926 5 1924 17 1927 30 1925 51 INFLUENZA. Influenza, although occurring was of mild type and bad cases were chiefly in old people. The number of deaths being 19 in excess of the previous year. Deaths during the last 5 years. 1923 25 1926 24 1924 62 1927 43 1925 25 84 OPHTHALMIA NEONATORUM. 21 cases of this disease occurred, as against 21 in 1926. These cases were all visited by the lady Assistant Medical Officer and Health Visitors. An analysis of the cases will be found hereunder. Notified. Cases treated. Vision unimpaired. Vision impaired. Total Blindness. Deaths At home. Hospital. 21 4 17 21 — — — 2 cases born in Lambeth Institution and treated there. CEREBRO-SPINAL FEVER, ENCEPHALITIS LETHARGICA AND POLIO MYELITIS. 6 cases of Cerebro-Spinal Fever were notified during the year, four of which died. Deaths during the last 5 years. 1923 4 1926 3 1924 3 1927 4 1925 1 9 cases of Encephalitis Lethargica were notified with 4 deaths. Deaths during the last 5 years. 1923 6 1926 3 1924 9 1927 4 1925 5 2 cases of Polio-Myelitis and 3 cases of Polio-Encephalitis were notified during the year. One case of Polio-Encephalitis died. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. 310 cases were notified during the year. 262 of these were removed to hospital or infirmary. There were 89 deaths of these notified cases. PUERPERAL FEVER. 12 cases were notified during the year, with 3 deaths. PUERPERAL PYREXIA. 69 cases have been notified. 47 were removed to hospital and 22 kept at home. 85 TABLE 40. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1927. Disease 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Males Females Total Oases admitted to Hospital Total Deaths Scarlet Fever 6 182 229 55 28 26 11 2 1 — — — — 240 300 540 528 1 Small-Pox — — — — — — — — — — — — — — — — — — Diphtheria 19 277 255 100 36 33 30 7 6 2 — — — 366 399 765 763 21 Memb. Croup 3 4 2 — — — — — — — — — — 4 5 9 9 — Enteric Fever — 2 1 3 2 — 2 — — — — — — 6 4 10 10 1 Puerperal Fever — — — — — 5 5 2 — — — — — — 12 12 12 3 Puerperal Pyrexia — — — — 2 17 33 15 2 — — — — — 69 69 47 4 Cerebro-Spinal Fever 2 2 — — — — 1 1 — — — — — 4 2 6 6 4 Measles 82 595 455 14 5 2 1 4 — — 1 — — 590 569 1159 274 27 Polio-Encephalitis — — 1 1 — — — 1 — — — — — 3 — 3 3 1 Polio-Myelitis — 2 — — — — — — — — — — — 2 — 2 2 — Epidemic Diarrhsea 18 16 1 — 1 — — — — — — — — 24 12 36 9 26 Encephalitis Lethargica — 1 — 1 1 1 1 2 2 — — — — 4 5 9 5 4 Pneumonia 19 94 27 11 17 11 19 30 44 15 22 1 — 171 139 310 262 89 Ophthalmia Neonatorum 21 — — — — — — — — — — — — 8 13 21 7 — Erysipelas 3 4 3 3 11 2 11 18 19 16 13 1 — 46 58 104 — — Totals 173 1179 974 188 103 97 114 82 74 33 36 2 — 1468 1587 3055 1937 181 86 TABLE 41. Cases of Infectious Disease. Notified to the Medical Officer of Health for Southwark, during each week of the year 1927. 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 Diarrhoea. Pneumonia. PolioMyelitis. Pueperal Pyrexia. PolioEncephalitis. Total. 1927 Jan. 8 8 16 ... ... 1 ... ... ... ... ... 8 2 2 1 ... 14 ... 2 1 55 „ 15 8 18 ... ... ... ... 1 ... ... ... 2 ... 2 ... ... 17 ... 1 ... 49 „ 22 13 21 ... ... ... ... 4 ... ... ... 4 2 ... ... ... 19 ... 2 ... 65 „ 29 14 20 ... 1 ... ... 1 ... ... 2 4 1 1 1 ... 15 ... 1 ... 61 Feb. 5 5 13 ... ... ... ... 5 ... ... 1 5 2 2 ... ... 20 ... 4 1 59 „ 12 7 12 ... ... ... ... ... ... ... ... 10 1 ... l ... 14 ... 1 ... 46 „ 19 8 12 ... ... ... ... 1 ... ... ... 9 2 3 l ... 8 ... 3 ... 47 „ 26 10 22 ... 1 ... ... ... ... ... 1 12 1 3 ... ... 6 ... 1 ... 57 March 5 12 23 ... ... ... ... 4 ... ... ... 14 2 13 ... ... 5 ... ... ... 76 „ 12 8 23 ... ... ... ... 1 ... ... ... 7 4 7 ... ... 6 ... ... ... 56 „ 19 8 12 ... 1 ... ... 3 ... ... ... 9 2 3 ... ... 8 ... 2 ... 50 „ 26 3 15 ... ... ... ... 2 ... ... ... 3 2 6 ... ... 6 ... 4 ... 41 April 2 14 21 ... 1 ... ... 3 ... ... ... 7 2 7 ... ... 5 ... ... ... 60 „ 9 7 11 ... ... ... ... 1 ... ... ... 9 7 4 ... ... 5 ... 2 ... 47 „ 16 5 2 ... ... ... ... 1 ... ... 1 6 2 5 ... ... 1 ... 1 ... 24 „ 23 6 13 ... ... ... ... ... ... ... 1 9 3 7 ... ... 2 ... 1 ... 42 „ 30 5 14 ... ... ... ... 1 ... ... ... 12 3 2 1 ... 5 ... 1 ... 45 May 7 7 9 ... ... ... ... 1 ... ... ... 6 3 6 1 ... 3 ... 2 ... 39 „ 14 15 9 ... ... ... ... 1 ... ... ... 3 3 3 ... ... 5 ... 3 ... 42 „ 21 12 12 ... ... ... ... 2 ... ... ... 11 3 14 ... ... 3 ... 1 ... 58 „ 28 12 12 ... ... ... ... 2 1 ... 1 8 4 14 ... ... 8 ... 3 ... 65 June 4 5 14 ... ... ... ... ... ... ... ... 7 1 24 ... ... ... ... ... ... 51 „ 11 2 10 ... ... ... ... 1 ... ... 1 5 1 15 ... ... 6 ... ... ... 42 „ 18 8 17 ... 1 ... ... 2 ... ... 1 9 4 27 ... ... 3 ... ... ... 72 „ 25 13 8 ... 1 ... ... 6 ... ... ... 7 1 18 ... ... 6 ... 2 ... 62 July 2 10 15 1 1 ... ... 1 ... ... 1 5 1 23 ... ... 2 ... 2 ... 62 „ 9 10 15 ... ... ... ... 3 ... ... ... 4 4 25 l 3 3 ... ... ... 68 „ 16 10 9 ... 1 ... ... 1 ... ... ... 3 ... 21 ... 5 3 ... 2 ... 55 „ 23 13 16 ... ... ... ... 4 ... ... 2 7 1 23 ... 2 1 ... 1 ... 71 „ 30 15 8 ... ... ... ... 2 ... ... ... 7 ... 10 ... 1 1 ... 2 ... 46 Aug. 6 14 12 ... ... ... ... 3 ... ... ... 3 2 18 ... 6 5 ... 2 ... 65 „ 13 13 12 ... ... ... ... 5 ... ... ... 8 2 20 ... 4 7 ... ... ... 72 „ 20 7 11 ... ... ... ... ... ... ... ... 4 3 10 ... 2 ... ... 2 ... 39 „ 27 6 14 ... ... ... ... ... ... ... ... 12 ... 10 ... 4 2 ... 3 ... 51 SeDt. 3 7 16 ... ... ... ... 2 ... ... ... 6 1 7 ... 1 2 ... ... ... 42 10 8 16 ... ... ... ... 4 ... ... 2 9 2 4 ... 4 4 ... 1 ... 54 „ 17 5 11 ... ... ... ... 1 ... ... ... 6 3 12 ... 2 1 ... ... ... 42 „ 24 17 24 ... ... ... ... 1 ... ... ... 6 1 6 ... 2 4 ... 2 ... 65 Oct. 1 13 20 ... 1 ... ... 1 ... ... ... 5 1 20 ... ... 3 ... 2 ... 67 „ 8 16 21 1 1 ... ... 1 1 ... ... 5 ... 23 ... ... 1 ... ... ... 70 „ 15 11 15 ... ... ... ... 2 2 ... ... 6 1 45 ... ... 3 ... ... ... 85 ., 22 20 12 ... ... ... ... 3 ... ... ... 11 4 28 ... ... 10 ... 2 ... 90 „ 29 11 12 2 ... ... ... 2 ... ... ... 4 4 57 ... ... 5 ... 2 ... 99 Nov. 5 15 25 ... ... ... ... 3 ... ... 2 10 1 47 ... ... 7 ... 2 ... 112 „ 12 10 9 1 ... ... ... 2 ... ... ... 4 4 35 ... ... 7 ... 2 ... 74 ,, 19 19 20 ... ... ... ... 3 2 ... ... 3 1 40 ... ... 6 ... 1 ... 95 „ 26 22 11 1 ... ... ... 5 ... ... 2 3 3 72 ... ... 8 ... ... ... 128 Dec. 3 13 21 ... ... ... ... 3 ... ... 1 6 5 78 ... ... 9 ... 1 ... 137 „ 10 11 19 1 ... ... ... 1 ... ... ] 6 ... 72 ... ... 4 ... ... ... 116 „ 17 11 14 ... ... ... ... 4 ... ... 1 7 1 86 ... ... 10 ... 1 ... 135 „ 24 9 18 ... ... ... ... 1 ... ... ... 3 2 88 ... ... 5 ... 1 ... 127 „ 31 9 10 ... ... ... ... 3 ... ... ... 4 ... 91 ... ... 7 ... 1 ... 125 Total 540 765 9 10 6 ... 104 12 ... 21 343 105 1159 9 36 310 2 69 3 3503 88 TABLE 42 Return of Families Admitted into the Council's Reception House during the tear 1927. 1927. 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. 8 — — — 3 10 30 — — — — — — — — — 15 — — — 1 3 9 — — — — — — — — — 22 — — — 1 3 12 — — — — — — — — — 29 1 3 9 — — — — — — — — — — — — Feby. 5 — — — — — — — — — — — — — — — 12 1 2 6 — — — — — — — — — — — — „ 19 — — — 1 2 8 — — — — — — — — — 26 — — — — — — — — — — — — — — — March 5 1 4 16 1 4 12 — — — — — — — — — 12 — — — 2 4 10 — — — — — — — — — 19 — — — 2 5 18 — — — — — — — — — „ 26 — — — — — — — — — — — — — — — April 2 — — — — — — — — — — — — — — — 9 1 3 9 — — — — — — — — — — — — 16 2 5 15 1 1 3 — — — — — — — — — „ 23 — — — — — — — — — — — — — — — 30 — — — — — — — — — — — — — — — May 7 — — — 3 4 10 — — — — — — — — — 14 1 2 6 — — — — — — — — — — — — 21 — — — — — — — — — — — — — — — 28 — — — 1 7 21 — — — — — — — — — June 4 — — — — — — — — — — — — — — — 11 1 1 4 1 3 6 — — — — — — — — — 18 1 3 9 2 5 15 — — — — — — — — — 25 — — — 1 4 8 — — — — — — — — — Crd. fwd. 9 23 74 20 55 162 — — — — — — — — — 89 TABLE 42—Continued. 1927. 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. 9 23 74 20 55 162 — — — — — — — — — July 2 — — — 1 2 6 — — — — — — — — — „ 9 — — — 1 2 6 — — — — — — — — — „ 16 2 5 13 — — — — — — — — — — — — „ 23 — — — 1 4 12 — — — — — — — — — „ 30 — — — 2 5 12 — — — — — — — — — Aug. 6 — — — 1 3 9 — — — 1 2 16 — — — „ 13 — — — — — — — — — — — — — — — „ 20 — — — 1 5 20 — — — — — — — — — „ 27 — — — 2 5 15 — — — — — — — — — Sept. 3 — — — 2 4 12 — — — — — — — — — „ 10 — — — 4 14 45 — — — — — — — — — „ 17 — — — — — — — — — — — — — — — „ 24 — — — 1 3 9 — — — — — — — — — Oct. 1 — — — 2 5 17 — — — — — — — — — „ 8 — — — 3 6 20 — — — — — — — — — „ 15 — — — 2 4 12 — — — — — — — — — „ 22 — — — — — — — — — — — — — — — „ 29 — — — 1 4 12 — — — — — — — — — Nov. 5 — — — — — — — — — — — — — — — „ 12 1 2 8 — — — — — — — — — — — — „ 19 1 3 6 1 5 15 — — — — — — — — — „ 26 2 6 19 — — — — — — — — — — — — Dec. 3 1 3 9 — — — — — — — — — — — — „ 10 2 9 30 — — — — — — — — — — — — „ 17 — — — — — — — — — — — — — — — „ 24 — — — 1 2 6 — — — — — — — — — „ 31 2 7 21 1 3 9 Total 20 58 180 47 131 399 — — — 1 2 16 — — — 90 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 5,634. Of this number 2,576 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, as against 3,009 rooms in 1926. 3,058 periodical sprayings of rooms occupied by Phthisical patients were also carried out during the year. 627 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 637 in 1926. Among the total number of disinfections (5,634) it was found necessary to strip 239 rooms. Of these 181 were in relation to the notifiable diseases and 58 after the termination of cases of Phthisis. TABLE 43. 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. All Saints Ward. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Disinfected 317 201 252 353 211 230 258 236 273 94 151 2576 Stripped 22 13 19 25 12 30 14 9 20 6 11 181 91 TABLE 44. Bedding, &c., disinfected and destroyed after the occurrence of Infectious Disease during the Year 1927. Articles. No. Disinfected. No. Destroyed. Beds 1,293 43 Palliasses 612 45 Bolsters 645 12 Pillows 2,115 27 Cushions 253 16 Blankets 1,645 12 Sheets 1,067 9 Quilts 863 7 Articles of Clothing, &c. 2,128 335 Books 32 — Total 10,653 506 55 cases, 1 bag, 1 box and 8 samples of horsehair weighing 3 tons 11 cwt. 11 lbs. (for which fees were paid to the amount of £16 15s. 8d ), 1 parcel of flock was destroyed. TUBERCULOSIS SCHEMES. The Municipal Tuberculosis Dispensary is situated near the Elephant and Castle Underground Railway and convenient for all buses and trams. This central position renders one Dispensary adequate for the district as it can be reached from all parts without difficulty to the patients. A detailed account of the work done at the Tuberculosis Dispensary is tabulated at the end of my report. 92 TABLE 45. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 2nd January, 1927, to the 31st December, 1927, in the Metropolitan Borough of Southwark. Age-periods Notifications on Form A. Total Notifications on Form A. Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. 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 — 3 4 2 18 27 22 49 38 24 12 199 234 — — — — 99 155 „ Females — — 7 10 19 20 40 23 7 5 4 135 170 — — — — 64 73 Non-Pulmonary Males 1 10 14 12 9 2 5 2 1 1 — 57 61 — — 1 — 1 3 45 „ Females 1 6 8 6 5 2 2 3 — 3 — 36 41 — 2 1 — 3 3 27 Primary Notifications relate to patients who have not previously been notified in this or former years, either on Form A or on Form B, in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is to be regarded as duplicate. (Note—No primary notifications should be made on Form C.) A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of Tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Form C. Eelates to patients admitted to Sanatoria or Poor Law Institutions. 93 TABLE 46. SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from the 2nd January, 1927, to the 31st December, 1927, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 40 to 55 55 to 65 65 and upwards Total Cases Pulmonary Males — — — — — — 2 3 1 — — 6 ,, Females — — — — 1 1 — — 1 — — 3 Non-pulmonary Males 1 1 — — — — 1 — — — 3 ,, Females — 2 — 1 1 — 1 — — — — 5 Note—New cases first coming to knowledge otherwise than by formal notification may in some instances afterwards be formally notified on Form A or Form B. Such cases should be included in the appropriate columns of the Summary of Notifications overleaf and not in the Supplemental Return, unless the formal notification in any of such cases was improperly made, e.g., after death of the person, in which event the case should appear in the Supplemental Return. No case should be included both in the Summary of Notifications and the Supplemental Return. 94 DEATHS FROM PULMONARY TUBERCULOSIS. TABLE 47. Shewing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions. 1927. 0- 1- 2- 5- 15- 25- 45- 65- 75- All Ages. Males Females Total Number of patients who died at home ... ... ... 2 26 22 23 4 50 27 77 Number of patients who died in hospitals, &c. 1 1 1 1 27 42 38 7 2 78 42 120 1 1 1 3 53 64 61 11 2 128 69 197 Of the total number of deaths from Pulmonary Tuberculosis 60.9 per .cent, occurred in hospitals or other institutions. 95 TABLE 48. TUBERCULOSIS. Age Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. 0 — 3 1 4 1 3 19 1 4 5 11 24 1 4 10 12 21 3 4 15 58 15 25 3 20 48 4 28 1 25 64 8 28 2 35 75 6 36 1 45 47 1 38 4 55 29 4 23 3 65 and upwards. 16 — 13 3 Total 343 105 197 33 (1) The ratio of non-notified deaths to notified cases is 1 to 66. Notification is carried out efficiently, but frequently too late to be of any service. There has been no need to take action on grounds of wilful neglect or refusal to notify. (2) Tuberculosis is not marked in any special occupation if the varying numbers employed in these trades is considered and the proportions adjusted. 96 PHTHISIS. TABLE 49. A summary of the cases notified and other particulars in connection therewith during the year 1927. Cases notified during 1927. 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. Rooms periodically sprayed and otherwise disinfected. Rooms stripped on termination of cases. 343 239 4,792 246 133 3.058 58 TABLE 50. 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 389 323 307 376 207 298 349 227 296 139 147 3,058 Stripped 7 11 1 13 2 7 5 7 3 1 1 58 97 MATERNITY AND CHILD WELFARE. There are in the Borough 10 Municipal Centres, Voluntary and partly Voluntary and partly Municipal for the attendance of mothers and children under 5 years of age. Sessions are also held for ante-natal work amongst expectant mothers. There is an assistant doctor to the Medical Officer of Health for maternity work and three part time doctors attached to other centres. There is also a Superintendent Health Visitor and 10 Health Visitors. The district being so well supplied with Maternity Wards in general Hospitals and childrens' Hospitals, and also having the York Road Lying-in Hospital extending its excellent work into the district, there is no need for the Borough to undertake a Maternity Home or Hospital for babies on its own account. Ante-natal sessions are held every week at two Municipal Centres and the same is also done at the Maternity Centre of Guy's Hospital. Orthopædic Treatment.—This is undertaken by the London County Council and the General Hospitals in the Borough. The voluntary societies co-ordinating are the Invalid Childrens Aid Society, and the Southwark Invalid Kitchens Society, which both do good work. As all the children attending the centres are under 5 years of age there is no connection with the school medical service until they are transferred to school. Under an arrangement with Guy's Hospital for applying Artificial Sunlight to delicate children, 125 received treatment, and on the whole were considerably benefited. It is not possible in all cases to ensure that the full number of attendance is carried out as the treatment is often interrupted by illness or home circumstances. The Artificial Sunlight has not been found of universal benefit, but some cases have done remarkably well. 98 MATERNITY AND CHILD WELFARE CENTRES. Assistant Medical Officer of Health (Maternity and Child Welfare) Dr. D. F. M. Rose. (Temporary from Nov. 6th, 1926, to April, 19th 1927). Assistant Medical Officer of Health (Maternity and Child Welfare) Dr. C. Sims. (from April 20th, 1927). 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. E. M. Saxton. 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. Rose and Dr. Sims. Health Visitor Miss L. F. Hartley and Mrs. Southward (from April 8th). 99 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. Stevens. and Dr. McNair. 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 10.0 — 12. 2. 0—4.30. Medical Officer Dr. Rose and Dr. Sims. 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—4.30. 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. Rose and Dr. Sims. Health Visitor Miss F. N. Adair. 100 5 CENTRE (Partly Municipal and partly Voluntary). 56, Lambeth Road. District served by Centre:—A pare of St. Jade'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. Rose and Dr. Sims. 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 Officcr Dr. Rose and Dr. Sims. Health Visitor Mrs. M. E. George. 6c CENTRE (Partly Municipal and partly Voluntary). 86, Borough Road. 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. 101 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 1927. TABLE 51. Original Visits. Revisits. Visits to AnteNatal Cases. Visits to PostNatal Cases. Visits to Delicate Infants. Visits to Cases of Diarrhæa and Sick Children. Attendances at Welfare Centres Visits where Mothers were found to be out. Special Visits, &c. Puerperal 1 yrexia. Total. Births. Measles. Ophthalmia Neonatorum Births. Measles. Ophthalmia Neonatorum Mrs. Holland - - - - - - - - - - 368 - - - 368 Mrs. Kingsmill 419 274 2 4,310 15 - 228 1 - 1 111 6 6 9 5,382 Miss Johnson 380 107 1 3,099 36 - 141 18 — — 90 215 6 5 4,098 Miss Hartley 277 258 3 2,495 22 129 28 18 5 85 61 — 4 3,385 Miss Rogers 262 89 2 2,812 18 - 114 2 — 1 99 254 3 4 3,660 Miss Cottrill 302 197 5 3,250 2 - 65 3 5 8 85 15 3 5 3,945 Miss Sayer 262 229 2 3,148 136 - 51 3 6 2 98 190 9 9 4,145 Miss Adair 238 88 1 4.447 1 - 177 32 29 50 100 12 — 1 5,176 Miss Freeth 383 165 4 4,197 34 - 163 10 — 7 104 137 16 11 5,231 Mrs. George 234 97 1 4,172 39 - 88 — — 17 91 221 6 8 4,974 Mrs. Newman, to April 7th, Mrs. George, from April 8th (home help) - - — — — — — — — — 238 — 70 — 308 Total 2757 1504 21 31,930 303 - 1156 97 58 91 1,469 1,111 119 56 40,672 102 103 MATERNITY AND CHILD WELFARE CENTRES. Showing the Attendances at the several Centres and Visits paid by Health Visitors. TABLE 51. St. John. la. St. Mary. 1b. St. Paul. 2a. St. Peter. 2b. All Saints. 3a. Lady Margaret 3b. Crossway. 4a. St. Stephens. 4b. St. Jude. 5. St. Michael. 6a. St. Savionr. 6b. St. George. 6c. Guy's. 7. TOTAL. Number of Births notified daring the year 437 387 379 290 267 265 305 226 284 385 248 124 58 3655 Number of individual children attending the Centre during year 604 670 418 308 243 424 372 312 439 440 330 157 50 4767 Number of Sessions held during the year 94 92 94 94 96 96 92 96 94 94 86 46 94 1168 Number of new cases attending the Centres during the Year— (1) Expectant Mothers 132 40 112 108 8 16 — 9 67 21 47 — 950 1510 (2) infants under 1 year 391 439 287 217 159 288 226 162 262 304 233 108 50 3126 (3) Seen by Doctor 239 302 205 125 117 115 160 112 213 248 160 68 50 2114 (4) Children 1 to 5 years 213 231 131 91 14 136 146 150 177 136 97 49 — 1571 (5) Seen by Doctor 40 75 37 30 8 43 58 58 121 59 18 8 — 555 Method of Feeding (a) Breast 318 359 230 159 113 229 186 147 213 264 195 77 49 2539 (b) Breast and bottle 24 29 32 34 2 31 16 8 22 17 13 13 1 242 (c) Bottle 38 59 46 23 18 31 24 10 25 28 26 21 — 349 (d) Ordinary diet 224 223 110 92 40 133 146 147 179 131 96 46 — 1567 Total number of attendances at the Centres during the year— (1) Mothers 6491 6667 4737 3770 3833 4103 4744 4401 5261 5527 4259 1924 — 55717 (2) Expectant Mothers 293 120 170 198 75 37 13 81 291 90 198 — 3326 4898 (3) Infants under 1 year 3744 4162 2964 2325 2387 2776 2353 2058 1897 3393 2265 1149 1205 32678 (4) Children 1 to 5 years 2443 2131 1546 1236 1188 1190 2064 2329 4108 1579 1646 916 790 23166 (1) Average number of attendances 69.0 72.5 50.4 40.1 39.9 42.7 51.6 45.8 56.0 58.8 49.5 41.8 — — (2) do. do. 31 1.3 1.9 2.0 0.8 0.4 0.1 0.8 3.1 1.0 2.3 — 35.4 — (3) do. do. 39.8 45.2 31.5 24.7 24.9 28.9 25.6 21.4 20.2 36.1 26.3 25.0 12.8 — (4) do, do. 26.0 23.2 16.4 13.1 12.4 12.4 22.4 24.3 43.7 16.8 19.1 19.9 8.4 - (5) Total number of attendances of Infants seen by Doctor during the year 1088 1647 1127 993 1203 1196 1023 1171 1079 1670 1114 513 1186 15010 (6) Total number of attendances of children 1 to 5 years seen by Doctor during the year 408 774 612 480 581 545 801 1080 981 652 599 433 786 8732 (7) Post-natal cases 1496 1581 1670 551 1224 1656 1082 1163 1738 1670 1058 297 354 15540 (8) Children weighed 4953 5763 4164 3360 3443 3710 4357 3806 3140 4907 3717 2051 1995 49366 Total number of first visits paid by Health Visitors to homes of— (1) Expectant Mothers 125 223 93 120 85 65 34 174 220 142 60 35 943 2319 (2) Infants under 1 year 441 419 380 277 262 302 262 238 280 383 234 128 63 3669 (3) Children 1 to 5 years 76 - - - - - - - 3 - - 5 — 84 Total number of revisits paid bY Health Visitors to homes of— (1) Expectant Mothers 296 5 48 9 29 - 17 3 168 21 28 109 826 1559 (2) Infants under 1 year 1809 1692 1337 940 1073 1618 1296 2211 1220 1763 1074 1272 876 18181 (3) Children 1 to 5 years 4145 2618 1762 1555 1739 1632 1852 2236 2147 2434 2098 2840 1553 28611 Sewing Classes were held during the year at No. 5 Centre, with a total attendance of 173. do. do. do. under the direction of Mrs. Holland with a total attendance of 462. do. do. do. at No. la Centre, with a total attendance of 304. APPENDIX. Boroagh of Southwark annual report of the Tuberculosis Medical Officer for the YEAR 1927. J. T. Crowe, L.S.A., L.M.S.S.A. (London), Tuberculosis Medical Officer 106 BOROUGH OF SOUTHWARK. Southwark Tuberculosis Dispensary, 82-84, Newington Causeway, S.E To the Mayor, Aldermen and Councillors of the Borough of Southwark. Sir, Ladies and Gentlemen, I have pleasure in presenting my Annual Report for the year 1927. The work of the Dispensary has progressed on similar lines as in previous years. The Staff still consists of a Secretary-Dispenser and three Nurses. The General Practitioners are making good use of the Dispensary, for although Notifications are less, the attendances have increased in numbers. During the year 431 Patients were recommended to Sanatoria through the City Council, and doubtful cases to Brompton Hospital for observation. The arrangement for sending children away within a few hours of their cases being diagnosed instead of having to wait for a vacancy, still holds good with the L.L.C. A New Open-Air School for tuberculous children has recently been opened at Fort Road, Bermondsey, and a number of children from this Borough have been admitted, this is in addition to the older OpenAir School at Springwell House, Clapham Common, where already a fair number of children from the Borough are attending ; arrangements are made now that children living on the Kennington side of the Borough are recommended for Springwell House, and on the other side to Fort Road. The L.C.C. are also dealing with the contacts (Children) of Tuberculous Patients living at home, by sending them away either by Boarding-Out in the Country or to Convalescent Homes. 107 During the year New Ministry of Pensions Regulations have come into force dealing with treatment allowances, and most of the pensioners have been examined by Special Medical Boards, and their pensions have either been put on a permanent basis or have been stabilised. Closer relations are now maintained between the Area Deputy Commissioner of Medical Services and myself, and personal consultations are held between us on any case, which is in need of admission to a Sanatorium or any other special treatment. I am still using Tuberculin in a number of cases, especially of a Surgical nature, and find that together with extra nourishment and Artificial Sunlight treatment, very good results are obtained. I have also a number of Patients being treated with Tuberculin ointment in-unction for enlarged glands, and again I find that this, together with Artificial Sunlight Treatment, gives good results. Cases are still sent for Artificial Sunlight to the Guy's Hospital Light Centre as arranged between the Council and the L.C.C. and Guy's Hospital. Several of our patients are undergoing Artificial Pneumothorax treatment by Special arrangements with Brompton Hospital, and are doing very well under it. Doubtful cases of tuberculosis are sent to the X-Ray Department of Guy's Hospital by special arrangement, which I feel is very useful in conjunction with the physical examination, as it gives a more complete survey of the case. 527 specimens of sputum were examined by the Borough Analyst during the year. The Nurses have paid 3,429 visits to the patients' houses, and have done a great amount of propaganda work in the homes, besides giving lectures to the patients and their relatives at the dispensary. I, myself, also gave a series of lectures to the patients and their friends during the year. The Care Committee meets at the Town Hall weekly, an account of their work is appended. The Invalid Children's Aid Association has been very helpful in sending away to Convalescent Homes a number of delicate nontuberculous children; and the Charity Organisation Society has also done 108 a good deal for us in the way of sending away to Convalescent Homes delicate non-tuberculous adults, and by supplying clothing to patients going to Sanatoria. The United Services Fund and the British Red Cross Society have also been a very great help to us. The Council still have three shelters and eight beds in constant use at the homes of patients. Extra nourishment has been given to 45 patients. The relationship with the L.C.C., the Ministry of Pensions, and the Local Practitioners has been most cordial. I append tables and statistics of the work done during the year. I am, Sir, Ladies and Gentlemen, Yours faithfully, J. T. CROWE, Tuberculosis Officer. Staff of the Tuberculosis Dispensary to whose Salary contribution is made— Tuberculosis Officer : J. T. Crowe, l.s.a., l.m.s.s.a. Secretary and Dispenser: F. Nightingale (Certificate of the Society of Apothecaries, London). Tuberculosis Nurses : M. E. Bennett (Cert. Royal San. Inst.), S.R.N. F. C. Rogeks (C.M.B.), S.R.N. F. Jay (C.M.B.), S.R.N. 109 table a. Total number of persons examined for the first time, 816:— Insured Persons 372 Males 225 Females 147 Non-Insured Persons 474 Males 23 Females 108 Males 192 Females 151 Total 846 table b. Patients found to be suffering from Pulmonary Tuberculosis, 188:— Insured Persons 131 Males 94 Females 37 Non-Insured Persons 57 Males 11 Females 31 Males 6 Females 9 Total 188 table c. Patients suffering from Non-Pulmonary Tuberculosis, 63 Insured Persons 7 Males 5 Females 2 Non-Insured Persons 56 Males 2 Females 7 Males 31 Females 16 Total 63 table d. Cases (including contacts) found Non-Tuberculous, 440:— Insured Persons 154 Males 85 Females 69 Non-Insured Persons 286 Males 7 Females 53 Males 126 Females 100 Total 440 110 table e. Total attendances of patients:— Insured Persons 4,103 Non-Insured Persons 1,440 Total 5,543 table f. Number of examinations of patients:— Insured Persons 1,092 Non-Insured Persons 806 Total 1,898 table g. The following cases were recommended to the London County Council for Institutional treatment (Insured Persons):— Sanatorium 163 Hospital 37 Hospital for observation 28 Hospital for Advanced Cases 5 Treatment and training combined 1 Total 234 table h. Recommendations to the County Council for Institutional treatment (Non-insured Persons):— Sanatorium 104 Hospital 15 Open Air School 37 Hospital for observation 25 Home for Advanced Cases 1 Convalescent Treatment 15 Total 197 111 table i. The Nurses visited the homes of the following cases and advised the patients on the questions of environment and preventive measures:— Insured Persons 1,923 Non-Insured Persons 1,506 Total 3,429 table j. Patients discharged during the year:— Insured. Non-Insured. Cured — 2 Arrested — 1 Taken off Register 12 30 "In statu quo" 12 24 Removed 43 22 Transferred to other districts. 15 11 Ceased attending 30 13 Transferred to Domiciliary treatment 53 - Transferred to Institutions 2 18 Non-Tuberculous 156 288 Open Air School — 3 School Supervision — 4 Guardians 5 — Discharged to private doctor 1 9 Special School — 1 Totals 329 426 table k. Report of the work of the Borough Tuberculosis Care Committee:— Our Committee has met weekly to consider the circumstances of people recommended for Institutional Treatment under the London County Council whether they can contribute towards the cost, or if they require help for themselves or their families, to enable them to accept 112 the treatment offered and keep them free from anxiety while they are away. During 1927, 347 adults and 106 children have been recommended for Institutional Treatment. Of these 49 adult cases have been assessed for contributions, ranging from 2s. to 15s. a week, and 50 children's cases, contributing 2s. to 10s. Our Committee has no funds except a grant from the Ministry of Health for extra nourishment. This is administered by our Tuberculosis Officer as part of the medical treatment and reported to Committee. Other help required is various, such as allowances to families while the bread winner is away. Fit clothes to go away in, bedding for beds lent from the dispensary to enable people when ill to sleep alone, fares for visits to relations at sanatoria, and other wants which may arise. To obtain these we refer the people to various charitable agencies. During 1927, 33 have been referred to the Charity Organisation Society, 27 to the United Service Fund, 9 to Soldiers' and Sailors' Help Society, 2 to Invalid Kitchens, 2 to Society for Belief of Distress, 9 to the Guardians, who kindly supplied clothes, 6 to Regimental or Naval Funds, 2 to Churches, 2 to Hospitals, 4 to Dr. Jane Walker for employment, one got too ill, one was received for further treatment, but may be given work later. Work was obtained for two. We work in close conjunction with the I.C.A.A., who deal with all the children's cases, collect contributions and supervise the needs of the families apart from visits paid by the Dispensary Staff, and families under the care of the I.C.A.A. Every family of adult patients is visited from the Hon. Organisers Office before going to sanatorium, and after return. At every Committee time is given to deal with special cases who have not of necessity been recommended for Institutional Treatment, but who need visits for help or advise. Our greatest difficulty and one which we cannot cope with is finding work for discharged patients fit for light work. table: Death-rate from Pulmonary Tuberculosis for Southwark compared with the year 1926:— 1926. Southwark l.06 per 1000 1927. Southwark 1.06 per 1000 113 table m. Notification of fresh cases of Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 i 1923 1924 1925 1926 1927 911 775 653 634 639 685 579 494 415 430 444 : 424 427 336 363 343 table n. Deaths from Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 345 359 330 388 391 392 381 311 243 262 249 231 260 192 199 197 table o. Cases referred to Hospitals:— Insured. Non-insured Southwark Hospital 45 15 Westminster — 1 Guy's Hospital 18 9 Royal Waterloo Hospital — 2 South London Hospital for Women 4 1 Totals 67 28 table p. Sexes of new cases of Pulmonary Tuberculosis:— Males 111 Females 77 188 table Q Patients still attending the Dispensary on December 31st, 1927:— Insured Persons 358 Non-Insured Persons 177 535 114 table r. Sources of cases:— Insured. Non-insured. Doctors 100 24 Hospitals 11 11 War Pensions 5 2 Nurses 2 22 Contacts 2 6 Returned from Hospitals 5 1 Returned from Sanatoria 5 10 Invalid Children's Aid Society — 5 School Medical Officer — 2 London County Council 5 21 Transferred from other Dispensaries - 3 Own Account 1 5 Infant Welfare — 4 Guardians 1 — Councillors 1 — Totals 138 116 table s. Contacts examined:— Found Tuberculous 8 Found Non-Tuberculous 357 Total 365