Borough of Southwark ANNUAL REPORT of the Medical Officer of Health for the YEAR 1928 HORACE WILSON, M.D., B.S.Lond., D.P.H., L.R.C.P., M.R.C.S., Medical Officer of Health. Administrative Tuberculosis Officer, Administrative Officer for Maternity and Child Welfare. London: J. J. Keliker & Co., Limited, Southwark, S E. i. INDEX. A. Page Acute Influenzal Pneumonia 88 Acute Primary Pneumonia 88 Ambulance Services 6 Ante-Natal Clinic 101 „ Statistics 106-107 Area of Borough 5,11 Bag Makers 43 Bakehouses 71 Births 11, 18 ,, Illegitimate 5 Birth-rate 5,12,13 Births Tables 13, 18 Black Smoke 41 Butter and Margarine Factories 72 C. Cancer Deaths 19 Caseous Lymphadenitis 64-65 Census 5 Cerebro-spinal Fever 87 Childbirth Deaths 5, 9 Cleansing of Persons Act, 1897 48 Clinics 6 Closet Accommodation 32 Cowsheds 71 Customs and Inland Revenue Act, 1890 46 D. Day Nurseries 7 Deaths 14,17,18,24 „ Causes of, Table 19 „ Infants 20 Tables 13, 14, 15, 16, 24 ii. D— contd. Page Deaths in Wards 13, 16 „ Table 13 „ Zymotic Mortality 24, 25 Death Rate 5, 14, 15 Density 11 Diarrhœa and Enteritis, Deaths 5, 83-84 Table 19 Diphtheria 81 „ Prevention 82 „ Schick Test 81-82 „ Anti-toxin 81 Disinfection 94 „ of Rooms, Table 94 „ of Articles, Table 95 „ Summary of work done 94 Dried Milk 77 E. Eating Houses 44 Encephalitis Lethargica 87-88 Enteric Fever 82-83 F. Factories 42 Table 42 „ Inspections of 42 „ Defects found in 42 Families 5 Food and Drugs, Tables of Samples 73, 75-77 ,, ,, Prosecutions 74, 79 Food, Supervision of 55-66, 67-78 Fried Fish Shops 44 Food Inspection and Tables 56-66 G. Graded Milk 68,69 iii H. Page Health Week 108, 109 „ Services, Children's Hospitals 6 „ Visitors, Summary 105, 106, 107 Heart Disease Deaths 24 House-to-house Inspections 27, 28 Housing 29,34,35,53-54 Housing Representations 52,53,54 ,, and Town Planning Act 46 Houses let in Lodgings 35-41 Home Workers, Table 43 I. Ice Cream 44 Infant Mortality 5,20,21 Of Illegitimates 5 „ Rates for 30 years, Table 20 Table 21 „ in Wards 13 Infant Welfare Centres 6, 102-104 Infectious Diseases, Control of 80 „ Deaths, Table 89 Number of Cases 89 Tables 89,90,91 Nursing 8-9 Influenza 84-87 Inhabited Dwellings 5 Invalid Children's Aid Association 101 L. Laboratory Work 110 Laundries 44 Legal Proceedings 36, 37, 38, 39, 40 London Birth, Death and Mortality Rates 26 M. Maternity and Nursing Homes 9 Maternal Mortality 9 Measles 5 „ Visits of Health Visitors to 105 iv M.— contd. Page Meat 55 Metropolitan Boroughs-Birth, Death and Mortality Rates 26 Midwives 9 Milk and Dairies (Amendment) Act, 1922 67, 68 Milksellers 70 Mortality Statistics 19, 24 Mortuary Report 52 O. Offensive Trades 71 Ophthalmia Neonatorum 87 Orthopœdic Clinics 7 Overcrowding 33 P. Paratyphoid B. Fever 82,89, 90, 91 Pneumonia 88 Population 5, 10, 11 „ in Wards 11 Poliomyelitis 87 Professional Nursing 8, 9 Puerperal Fever 88 „ Pyrexia 88 „ Sepsis, Deaths 5 Fever, Visits 105 Public Health Officers 8 „ „ (Condensed Milk) Regulations, 1923 and 1927) 77 „ „ (Dried Milk) Regulations, 1923 and 1927) 77 „ „ (Preservatives in Food) Regulations, 1925 110 „ „ (Meat) Regulations, 1924 55 Pulmonary Tuberculosis Deaths 98, 99 R. Rag Flock Acts, 1911 and 1928 70 Rateable Value 5 Rats and Mice (Destruction) Act 45 Reception House, Families Admitted 92, 93 Remedy of Sanitary Defects 32-35 Rheumatic Fever 19 V S. Page St. Thomas's Hostel 101 Sanitary Administration 27, 28 „ Inspectors' Work 27-35 Tables 27.35 Scabies 49-50, 51 Scarlet Fever 80-81 Schick Test and Inoculation against Diphtheria 81, 82 School Clinics 7 Slaughterhouses 55 Smoke Abatement 41 Smallpox 80 Social Conditions 5 Separate Occupiers 5 Sputum, Examinations of 95 Sunlight Treatment 7 Southwark Invalid Kitchens Society 101 T. Tuberculosis 95 „ Care Committee, Secretary's Report 118 „ Contacts 116 „ Deaths 98 „ Dispensary Scheme 7,95 „ New Cases 115 „ Notifications and Deaths 119 „ Non-Pulmonary 99 Notifications Table 96-97 U. Underground Rooms 11 „ Sleeping Rooms 40 „ Bakehouses 72 Unfit Dwelling Houses 52 Unsound Food 56-65 Ultra-Violet Rays Centre 7 vi V. Page Venereal Disease Clinics 7 Verminous Children 49, 50 „ Rooms and Bedding 47, 51 Vital Statistics, Summary of 5 Table 22, 23 W. Water Supply 46 Wearing Apparel 43 Whooping Cough, Deaths 5,84 Workshops, Table 42,44 „ and Workplaces 42,44 Table 42 „ „ „ and H.M. Inspector 44 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, I have the honour of presenting my Annual Report of the work of the Public Health Department for the past year. The year 1928 was characterised by one or two outstanding features. In its earlier part an outbreak of Small-pox occurred, a thing unknown in the Borough for over twenty years. Fortunately, the cases were of a mild type. The disease originated in one of the Institutions where seven cases occurred, and spread by direct contact to other parts of the Borough. Cases also occurred in the Newington Institution and in Rowton House, noticeably chiefly among the unvaccinated, or those in whom a long period had elapsed since vaccination. Owing to prompt measures being taken the epidemic was kept under control. Unfortunately I myself was away on sick leave at the time and the Council acting on the suggestion of the Ministry of Health, appointed Dr. Sims, the Assistant Medical Officer for Maternity and Child Welfare, to take over the duties of Deputy Medical Officer of Health in case of the absence or illness of the Medical Officer of Health. This duty had previously been undertaken by arrangement with the Medical Officer of Health of a neighbouring Borough, but it was obvious that in a case of a serious epidemic a more permanent arrangement was necessary. Another noteworthy feature of the year was the holding of a Health Week and Exhibition. This was a most successful venture, which it is hoped has stimulated the interest of the inhabitants of the Borough in Public Health matters, and that it will ultimately result in an improvement in the general health and conditions in the Borough. 2 The exhibits and lectures were of a high order and everyone did their utmost to make the Health Week worthy of the Borough. During the early part of the year, whilst a site at the Corner of Red Cross and Union Streets was being excavated, a number of human remains was unearthed, skulls and limb bones predominating. They were found six feet below the surface, and descended to a depth of ten feet. These bones were of considerable antiquity and were those of persons from 25 years of age and upwards. They were carefully placed and had undoubtedly been moved here at some former period from another part of the site and re-interred in this excavation and covered over at the time with a layer of lime concrete several inches in thickness, in which some of the skulls and bones were embedded, proving that the concrete had been put there for the definite purpose of covering them in. Wherever excavation was made bones were found, and the quantity actually brought to the surface would represent about forty persons, and a greater number still remain. The site on which these bones were found is described on old maps of the district as the Crossbones Burial Ground, which was of considerable extent, and covered a larger area than the present vacant site. A licence was applied for to the Home Office to remove the said remains, which was duly granted. They were accordingly placed in wooden shells and re-interred in the Church of England Ground, Brookwood Cemetery. Later in the year human remains from under the Wesleyan Chapel in Hankey Place were removed under licence of the Home Office by the London County Council, under my supervision, to the Camberwell New Cemetery at Honor Oak. The actual work was overlooked by Inspector Ede, who paid in all 52 visits to the chapel and saw every coffin or shell before removal. He also visited the cemetery. The Vaults were below the entrances and chancel and were found to contain lead coffins from which the wood coffins had fallen away. In some cases the coffins had to be re-soldered. The instructions of the Home Office were that each coffin should be put into a pitch pine shell and surrounded by four inches of charcoal, and these directions were carefully carried out. 3 Where possible, records were obtained of the names of those interred and dates of interment, which records are in the possession of the London County Council. In all 372 exhumations were made. The Housing question though still acute, shows definite signs of improvement, but years must elapse before overcrowding is finally a thing of the past. Overcrowding in this district, which has so few facilities for building, can only be overcome by deportation. The central position and amenities for travelling away from it to work are so great that residents naturally do not want to leave the Borough, and if they do, not infrequently return. A further development of the Council's activities was the purchase of Sutherland House for the purpose of extending the Maternity and Child Welfare scheme, and at which premises the scope of the Maternity and Child Welfare work can be expanded. The Centres of St. Mary's and St. Paul's districts were transferred to these premises during the year. In Southwark, with its wharves and warehouses, Borough Market, and colony of street traders, Food is naturally a question which calls for much attention and supervision, and a large amount of work is done in regard to this, which is set out in the body of the Report. In addition to the supervision of imported foods there is also the question of the export of manufactured food products to foreign countries. Each country has its own regulations, but these products have to be examined by the Inspector and certified by myself before they can be admitted to a foreign country, and as I am appointed Certifying Officer for the U.S.A., Canada, Philippine Islands, Turkey, and other countries, the food products sent to these countries must be accompanied by a certificate signed by myself, and during the year £88 15s. 6d. has been received by the Council for such certificates. An unusually high tide with an easterly wind caused severe flooding at the north end of the Borough, chiefly affecting the basement dwellings of the riverside houses. Fortunately no epidemic broke out, though considerable damage and inconvenience was inflicted on the inhabitants. The mere fact of flooding with water would not in itself cause sickness (other than that caused by dampness), but should drainage 4 be defective and the soil polluted with sewage such a contingency might easily occur. Arrangements were made for the cleansing of affected premises and for drying the damaged goods and effects of the persons whose houses were flooded, and every assistance was given to them. During the year 320 persons were medically examined with a view to employment as permanent or temporary members of the Council's Staff, and 35 employees were examined and reported on as a result of accident or illness. Fifty specimens were taken from the throats of children prior to their admission to Convalescent Homes and submitted by me to the Borough Analyst for examination. Detailed reports of the varied work undertaken by the Council's Public Health Department will be found under the various headings. Yours faithfully, HORACE WILSON, Medical Officer of Health. 5 NATURAL AND SOCIAL CONDITIONS OF THE AREA. Estimated population (1928) 181,300 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 £5,880 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 3,312 Illegitimate 164 Total 3,476 Birth Rate, 19.2 Deaths 2,310 Death Rate, 12.7 Number of women dying in, or in consequence of childbirth— From sepsis 6 Other causes 5 Deaths of infants under 1 year of age per 1,000 births 70 Legitimate 225 Illegitimate 18 Total 243 Deaths from Measles (all ages) 72 Do. Whooping Cough (all ages) 26 Do. Diarrhoea under 2 years of age 28 6 GENERAL PROVISION OF HEALTH SERVICES. Hospitals.— Southwark is fortunately situated as regards hospital accommodation of all descriptions, and hospitals for infectious diseases are provided by the Metropolitan Asylums Board, whilst Tuberculosis cases are accommodated by the London County Council. 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)— Sutherland House, Sutherland Square. (St. Mary's). Sutherland House, Sutherland Square. (St. Paul's). Boys' 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. 7 (2) DAY NURSERIES.— There are 4 in the Borough. One is Municipal, and is situated at 63, Kennington Park Road. This accommodates 45 children and is supervised by a Committee of Nursery Managers, a Sub-Committee 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) SCHOOL CLINICS.— 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. (4) ORTHOPDIÆC CLINICS.— This is undertaken by the London County Council and the General Hospitals in the Borough. (5) ARTIFICIAL LIGHT TREATMENT.— The treatment of children from 1 to 5 years of age has been carried out at Guy's Hospital by arrangement with the Borough Council by which these children are treated at the cost of 1/- per sitting. I am in constant touch with the Hospital and the progress of the cases is watched and reported on by the Hospital from time to time. The system is working well and a large proportion of the children have the maximum number of attendances to their credit, though there are others who for various domestic reasons do not attend a full course of sittings. During the year 1928, there were 1,475 attendances and the number tends to increase. The result of treatment varies; it is, however, most beneficial in cases of rickets, but in other diseases less progress is made and the effect is not so lasting. The treatment, however, as a substitute for actual sunshine and fresh air has undoubted value. (6) TUBERCULOSIS DISPENSARY.— The Municipal Dispensary is at 82 and 84, Newington Causeway. A special report is included concerning the same. (7) VENEREAL DISEASE CLINICS.— These are held at the General Hospitals, they are free and are conducted under conditions of secrecy. The times of attendances may be obtained on application to the Medical Officer of Health, and they are also displayed in the Public Conveniences. 8 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. C. Sims, M.D., Ch.B., D.P.H., Deputy Medical Officer of Health and Assistant Medical Officer of Health, Maternity and Child Welfare. John T. Crowe, L.S.A., L.M.S.S.A., Tuberculosis Officer. Sanitary Inspectors. ‡ || G. Fisher (Senior Inspector). || J. R. Findley. § ‡ || J. C. Nicholson (Food & Drugs Inspector). ‡ || H. S. Steele. ‡ || J. A. Syms. ‡ || F. J. Bryant. ‡ || A. C. White. ‡ || W. H. Banham. ‡ || F. Mayhew. ‡ || A. Ede. ‡ || S. Bowers. ‡ || H. E. Hattersley. ‡ || G. H. Duffield sistant Food Insnector). || Margaret Burrows (Women's Workshops). Health Visitors. † * a Jane Holland (Superintendent). * a Florence Adair, † * a Hilda Johnson. † * a Mary Freeth. a ¶ Annie Rogers. † a Mary George, † * a Clare Cottrill, † * a Annie Kingsmill. * a Winifred Sayer. ¶ * Winifred Cleverley. Helena Onions (From Jan. 11th to May 12th, 1928.) 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 IN THE HOME. General Nursing is carried out by the Ranyard Nurses, the Benson Nursing Association (which is subsidised by the Newington Charities to the extent of £400 per annum), and the Catholic Nursing Home, 60, Lambeth Road. A few parishes also have their own private nurses. || Cert. Sanitary Inspector. J Meat and other Foods. § Ist Class Engineer (Board of Trade). a Cert. Health Visitor. ¶ Cert. Sanitary Inspector. * C.M.B. † Nursing. 9 Infectious diseases are not nursed in their own homes, neither are cases of Measles, but cases of Puerperal Pyrexia are nursed at home if necessary by arrangement with one of the above Associations. MATERNITY AND NURSING HOMES. Southwark being so well supplied with Maternity Wards in the General Hospitals (and Children's Hospitals), and in addition, having the General 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. MATERNAL MORTALITY. Maternal deaths are investigated by the Medical Officer of Health and reported on fully to the Maternal Mortality Committee of the Ministry of Health. Puerperal Fever cases are sent direct to Hospital. Arrangements have been made for consultations in cases of Puerperal Fever or Puerperal Pyrexia where it is considered necessary with the obstetric physicians of Guy's Hospital, but during 1928 it was not necessary to enlist their services. In the year 1928, childbirth was directly responsible for 11 deaths, but it is hoped by increasing our antenatal teaching and clinics to diminish this number in the future, although too much must not be expected of this, as the causes of maternal deaths cannot as a rule be foreseen, and are more frequently from post natal than antenatal reasons. No midwives are employed by, or subsidised by, the Borough Council. ACTS AND BYE-LAWS ADMINISTERED BY THE PUBLIC HEALTH DEPARTMENT. Drainage bye-laws. Closing and filling up of cesspools and privies. Removal and disposal of house and other refuse. Removal of faecal and offensive matter by road. Water closets, earth closets and privies. Receptacles for dung. Conveyance of carcases of dead horses through streets. Regulations as to Dairies, Cowsheds and Workshops. Fish Curers. Offensive trades. Fried fish shops. 10 Dressers of fish skins. Dressers of fur skins. Rag and bone dealers. Underground dwellings. Bye-laws with respect to houses divided into separate tenements. Fouling of footway by dogs. (1929). POPULATION. The population of Southwark to the middle of 1928 has been estimated by the Registrar-General as 181,300. This estimate has been based on the adjusted 1921 figures, after allowing for the varying rate of natural increase as evidenced by the births and deaths, and of migration as indicated from other sources, such as the changes in the numbers on the Parliamentary Register, and the migration returns from the Board of Trade. The population of the several divisions of the Borough at each Census since 1841, and also the estimated population for 1922, 1923, 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 58,652 31,628 1891 115,663 59,740 27,116 1901 121,863 60,998 23,319 1911 116,819 55,782 19,316 1921 114,987 52,114 17,303 1922 116,683 52,996 17,541 1923 117,200 52,690 17,574 1924 117,500 52,610 17,604 1925 118,300 52,980 17,720 1923 118,120 52,760 17,720 1927 115,500 51,650 17,100 1928 113,850 50,730 16,720 11 The Ward distribution was as follows:— TABLE 1. WARD. Area in Acres Population. Persons to the Acre. Males. Females. Total. St. Mary 127 10,996 11,278 22,274 175 St. Paul 133 9,047 9,780 18,827 142 St. Peter 90 8,192 8,768 16,960 188 St. John 85 9,068 9,738 18,806 221 Trinity 109 7,904 8,038 15,942 146 All Saints 89 10,156 10,885 21,041 237 St. Michael 93 9,891 10,012 19,903 214 St. Jude 97 6,258 7,265 13,523 139 St. George 98 8,468 8,836 17,304 177 Christchurch 77 4,084 3,916 8,000 104 St. Saviour 133 3,998 4,722 8,720 66 Whole Borough 1,131 88,062 93,238 181,300 160 BIRTHS. The number of Births registered in the Borough during 1928 was 3,028, of which 1,553 were males, and 1,475 females. This represents a birth-rate of 16.7 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:— Newington, 1,655; St. George the Martyr, 773; Christchurch and St. Saviour's, 600. Of the 3,028 births registered in the Borough 226 were transferred away, the permanent residence of the parents being outside the Borough. 674 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 226 "outward" transfers are deducted 12 and the 674 "inward" transfers are added to the 3,028 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 3,476. This gives a corrected birth-rate of 19.2. Birth-Rate for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George St. Saviour and Christchurch. Whole Borough. 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 1928 18.0 21.1 19.4 19.2 13 table Number of Births and Deaths belonging to each Ward, with the Birth and Death Rates, also the Infantile Mortality Rate, 1928. WARD. Births. Infantile Mortality. Deaths. Males. Females. Total. Birth-rate. Males. Females. Total. Death-rate. St. Mary 218 209 427 19.2 56 188 117 305 13.7 St. Paul 131 145 276 14.7 76 112 111 223 11.8 St. Peter 138 121 259 15.3 73 87 79 166 9.1 St. John 226 188 414 22.0 85 138 114 252 13.4 Trinity 159 143 302 18.9 63 121 91 212 13.3 All Saints 179 191 370 17.6 62 138 105 243 11.5 St. Michael 214 190 404 20.3 69 151 141 292 14.7 St. Jude 155 135 290 21.4 72 107 74 181 13.4 St. George 224 186 410 23.7 76 118 87 205 11.8 Christchurch 77 75 152 19.0 99 81 51 132 16.5 St. Saviour 93 79 172 19.7 41 51 48 99 11.4 Borough 1,814 1,662 3,476 19.2 70 1,292 1,018 2,310 12.7 14 Deaths. 1,696 deaths were registered in the sub-districts of the Borough during 1928. 9 of these deaths were of persons residing in other sanitary districts, but who died in our streets or on the way to hospitals. 932 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 424 belonging to Southwark and 508 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 1,131. When the 517 deaths of those persons who were non-parishioners but who died in our Borough, have been deducted, and the 1,131 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 2,310 of which number 1,292 were males and 1,018 females. The death-rate when calculated on this "corrected" number is 12.7 per 1,000 inhabitants for the whole Borough for the year 1928, as against a rate of 13.4 for 1927. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 49.0. The principal localities in which the outlying deaths occurred are as follows:— Southwark Hospital 680 Mental Hospitals 62 Metropolitan Asylums Board Hospitals 54 St. Thomas's Hospital 44 Lambeth Hospital 23 Belgrave Hospital 7 King's College Hospital 20 Royal Waterloo Hospital 13 In the street, and other Institutions 228 Total 1131 15 TABLE 3. Death Rates for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George. Christchurch and St. Saviour. Whole Borough. 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 16.1 17.2 14.3 16.3 1909 15.8 18.6 16.6 16.7 1910 15.9 15.6 16.5 15.9 1911 17.3 19.7 21.1 18.4 1912 15.8 18.5 17.4 16.8 1913 16.5 20.0 20.2 17.9 1914 16.5 19.6 20.7 17.8 1915 19.3 23.4 22.0 20.8 1916 16.5 18.4 17.3 17.1 1917 17.9 19.5 17.9 18.3 1918 22.9 23.7 23.1 23.2 1919 14.6 16.1 15.5 15.1 1920 14.4 14.6 12.9 14.4 1921 14.3 14.6 13.1 14.3 1922 15.2 16.1 15.4 15.5 1923 12.2 13.6 13.7 12.8 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 1928 12.3 13.4 13.8 12.7 16 TABLE 4. Death Rates for the various Wards for the last Fifteen Years. WARD. 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 St. Mary 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 13.7 St. Paul 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 11.8 St. Peter 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 9.1 St. John 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 13.4 Trinity 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 13.3 All Saints 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 11.5 St. Michael 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 14.7 St. Jude 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 13.4 St. George 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 11.8 Christchurch 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 16.5 St. Saviour 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 11.4 17 TABLE 5. Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1928. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter. In 4th Quarter. During Year. Newington Institution 84 59 47 52 242 Christchurch Institution — — — — — Evelina Hospital 24 15 21 11 71 Guy's Hospital 164 135 143 141 583 Bethlem Hospital 9 7 8 8 32 60, Lambeth Road (Catholic Nursing Home) 2 1 — 1 4 Royal Eye Hospital — — — — — Total 283 217 219 213 932 18 TABLE 6. Births and Deaths Registered in the Sub-Districts of the Borough in 1928. For the First Quarter of 13 weeks ending 31st March. For the Second Quarter of 13 weeks ending 30th June. Sub-Districts. Births. Deaths. Sub-Districts. Births. Deaths. Male. Female. Male. Female. Male. Female. Male. Female. Newington 222 235 126 122 Newington 211 214 109 77 St. George the Martyr, West 114 102 60 48 St. George the Martyr, \\ est 112 103 45 33 Christchurch and St. Saviour 84 85 133 63 Christchurch and St. Saviour 71 60 92 65 Totals 420 422 319 233 Totals 394 377 246 175 For the Third Quarter of 13 weeks ending 29th September. For the Fourth Quarter of 13 weeks ending 29th December. Newington 203 186 62 67 Newington 191 193 80 76 St. George the Martyr, West 98 92 27 41 St. George the Martyr, West 82 70 43 32 Christchurch and St. Saviour 68 76 65 65 Christchurch and St. Saviour 97 59 99 66 Totals 369 354 154 173 Totals 370 322 222 174 Births. Deaths. M. F. M. F. In 1st Quarter 420 422 319 233 In 2nd Quarter 394 377 246 175 In 3rd Quarter 369 354 154 173 In 4th Quarter 370 322 222 174 Total 1553 1475 941 755 19 TABLE 7. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1928. 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 1 — — — — — — 1 — — — — — — — 1 — — — — — — (3) Measles 72 15 37 17 3 — — — — — 4 2 6 6 8 8 12 9 9 4 4 3 (4) Scarlet Fever 3 — — 2 1 — — — — — 1 — 1 — 1 — — — — — — — (5) Whooping Cough 26 11 10 5 — — — — — — 4 — 2 4 2 4 2 2 4 1 1 — (6) Diphtheria 13 2 1 5 4 1 — — — — 2 2 2 2 — 2 2 — 1 — — 2 (7) Influenza 29 1 1 — 1 — 5 10 9 2 4 4 4 3 2 3 2 5 — 1 1 4 i(8) Encephalitis Lethargica 2 — — — — 1 1 — — — — — — 2 — — — — — — — 3 (9) Meningococcal Meningitis 3 1 — — 1 1 — — — — — 1 — — — 1 1 — — — —- 7 (10) Tuberculosis (Respy System) 194 1 2 — 6 37 68 71 7 2 23 22 8 18 21 21 32 14 17 9 9 21 (11) Other Tubercular Diseases 36 3 5 7 11 5 3 1 — 1 3 3 5 4 5 4 5 1 2 2 2 37 (12) Cancer 252 — — — — — 17 135 71 29 33 27 22 28 24 26 25 20 23 11 13 102 (13) Rheumatic Fever 9 — — — 4 3 1 1 — — 1 1 — — 1 — 1 1 3 — 1 6 (14) Diabetes 19 — — — — 1 — 10 5 3 2 2 2 2 1 4 3 2 — 1 — 6 (15) Cerebral Hæmorrhage 86 — — — — — — 27 28 31 7 7 7 9 8 7 10 4 12 9 6 40 (16) Heart Disease 437 — — 1 10 17 31 123 126 129 59 51 29 49 42 35 57 34 29 30 22 114 (17) Arterio Sclerosis 97 — — — — — 1 18 27 51 19 15 6 14 11 11 6 10 2 2 1 25 (18) Bronchitis 133 13 2 — — — 5 42 30 41 11 8 7 13 14 19 21 9 14 10 7 63 (19) Pneumonia (all forms) 191 43 20 11 2 3 29 34 36 13 24 13 14 18 14 28 25 18 17 12 8 106 (20) Other Respiratory Diseases 27 3 2 — — — 4 11 5 2 7 1 2 3 3 4 2 1 3 — 1 4 (21) Ulcer of Stomach & Duodenum 27 — — — — 1 5 16 3 2 5 2 2 3 1 4 4 — 4 2 — 19 (22) Diarrhæa 31 26 2 1 — — — 1 1 — 3 — 2 3 2 3 6 4 5 2 1 23 (23) Appendicitis and Typhlitis 7 — — 1 — — 1 2 3 — 1 1 — 1 — 1 2 1 — — — 17 (24) Cirrhosis of Liver 8 — — — — 1 — 5 1 1 1 1 3 2 — 1 — — — — — 4 (25) Acute and Chronic Nephritis 97 1 — — — 2 18 34 26 16 12 8 4 9 8 13 12 6 11 6 8 60 (26) Puerperal Sepsis 6 — — — — — 5 1 — — 1 1 1 — — 1 — 2 — — — 3 (27) Other Accidents 5 — — — — 1 4 — — — — 2 — — — — 2 1 — — — 3 (28) Congenital Deb., &c. (Prem. Birth) 90 90 — — — — — — — — 9 14 7 13 6 6 11 8 9 4 3 42 (29) Suicide 22 — — — — 2 6 8 4 2 3 1 1 4 1 2 1 3 3 2 1 8 (30) Other Deaths from Violence 84 3 3 6 12 10 7 18 17 8 9 7 5 8 11 4 9 11 9 10 1 71 (31) Other Defined Diseases 298 30 5 3 10 10 35 76 61 68 55 26 24 34 26 30 38 14 28 14 9 138 (32) Ill-defined Causes 4 — 3 — — — — 1 — — 1 1 — — — — 1 1 — — — 1 Totals 2310 243 93 59 65 96 246 647 460 401 305 223 166 252 212 243 292 181 205 132 99 932 20 DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 70 during the year 1928. The deaths under one year of age to 1,000 births for the last thirty years were as follows :— 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 1913 115 1928 70 The average number of Infantile deaths for the last thirty years is 119. 21 TABLE 8. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1928. Nett Deaths from stated causes at various ages under 1 Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 Year. All causes Certified 62 7 9 6 84 48 34 43 34 243 Uncertified — — Scarlet Fever Measles — — — — — — — 8 7 15 Diphtheria 1 — 1 — 2 Whooping Cough 4 2 2 3 11 Diarrhœa 1 8 12 5 26 Enteritis Influenza — — — — — 1 — — — 1 Cerebro-Spinal Fever 1 1 Phthisis Tuberculous Meningitis 1 2 3 Abdominal Tuberculosis Other Tuberculosis Congenital Malformations 8 — — — 8 7 2 — — 17 Premature Birth 39 1 4 1 45 5 — — — 50 Atrophy, Debility and Marasmus 1 1 1 1 4 b 8 6 1 23 Atelectasis 4 — — — 4 — — — — 4 Erysipelas Syphilis — 1 — — 1 1 — — — 2 Rickets — — Meningitis 1 1 Laryngitis — — Convulsions 1 — — — 1 2 1 2 — 6 Gastritis — — — — — — — — — — Intussusception — — — — — — — — — — Dentition — — — — — — — — — — Dermatitis — — 1 — 1 — — — — 1 Bronchitis 2 1 2 — 5 5 1 — 2 13 Pneumonia — — — — — — 1 — 2 3 Broncho-Pneumonia — 2 1 2 5 12 7 9 7 40 Pleuro-Pneumonia — — — — — — — — — — Suffocation (overlying) — — — 1 1 — — — — 1 Accident (other) — — — — — — — — — — Nephritis, Acute — — — — — — — — 1 1 Icterus Neonatorum — — — — — — — — — — Septic Pyaemia — — — — — — — — — — Otitis and Mastoiditis — — — — — — — — — — Other causes not classified above 7 1 — 1 9 4 3 4 2 22 62 7 9 6 84 48 34 43 34 243 Nett Births in the year ... Legitimate ... ... ... 3,312 Illegitimate ... ... 164 Nett Deaths in the year of Legitimate Infants ... 225 Illegitimate Infants ... 18 22 23 TABLE 9 Vital Statistics of Separate Localities in 1928 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. 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 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 Averages of Years 1918 to 1927 22,111 466 340 40 19,013 394 271 29 17,375 373 221 28 19,535 514 286 43 15,861 409 248 32 20,224 514 269 38 1928 22,274 427 305 24 18,827 276 223 21 16,960 259 166 19 18,808 414 252 35 15,942 302 212 19 21,041 370 243 23 7. St. Michael's Ward. 8. St. Jude's Ward. 9. St. George's Ward. 10. Christchurch Ward. 11. St. Saviour's Ward. 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 — — — — 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 — — — — Averages of Years 1918 to 1927 20,861 484 335 44 13,436 300 211 27 17,569 494 255 40 8,607 183 147 15 9,174 194 120 15 — — — — 1928 19,903 404 292 28 13,523 290 181 21 17,304 410 205 13 8,000 152 132 15 8,720 172 99 7 — — — — 24 TABLE 10. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various Wards for 1928. WARD. Cerebro-Spinal Fever. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Phthisis. Pneumonia & Bronchitis. Heart Disease. Influenza. Polio-Myelitis. Encephalitis Lethargica. St. Mary — 4 1 2 4 1 3 23 35 59 4 — — St. Paul 1 2 — 2 — — — 22 21 51 4 — — St. Peter — 6 1 2 2 — 2 8 21 29 4 — — St. John — 6 — 2 4 — 3 18 31 49 3 — 2 Trinity — 8 1 — 2 — 2 21 28 42 2 — — All Saints 1 8 — 2 4 — 3 21 47 35 3 — — St. Michael 1 12 — 2 2 — 6 32 46 57 2 — — St. Jude — 9 — — 2 — 4 14 27 34 5 — — St. George — 9 — 1 4 — 5 17 31 29 — — Christchurch — 4 — — 1 — 2 9 22 30 1 — St. Saviour — 4 — — 1 — 1 9 15 22 1 — — Borough 3 72 3 13 26 1 31 194 324 437 29 — 2 25 table 11. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1928. Showing the localities where the deaths occurred. Locality. Smallpox. Encephalitis Lethargica. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Cerebrospinal Fever. Influenza. Total. The Borough — — 19 — — 9 — 4 — 23 55 Southwark Hospital — — 16 — 1 9 — 10 — 3 39 Met. Asylums Board Hospitals 1 1 32 3 12 8 -— 1 1 — 59 Newington Institution — 1 — — — — — — — 1 2 Evelina Hospital — — — — — — — 2 — — 2 Guy's Hospital — — — — — — — 8 1 1 10 St. Thomas's Hospital .. — — — — — — — 4 — — 4 Royal Waterloo Hospital — — — — — — — 1 — — 1 King's College Hospital — — — — — — — — — — — Various Mental Hospitals — — 1 — — — — — — 1 9 Lambeth Hospital — — 1 — — — — — — 1 Other Addresses — — 3 — — — 1 1 1 — 6 Total 1 2 72 3 13 26 1 31 3 29 181 26 TABLE 12. London and the Metropolitan Boroughs. Birth and Death Rates and Infantile Mortality Rate, &c. Boroughs. Estimated Population, 1927. Birth Rate. Death Rate. Infantile Mortality Rate. Deaths from Enteric Fever. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhoea and Enteritis (under 2 years). LONDON 4,541,000 15.9 11.6 67 45 1355 78 396 388 738 West. Paddington 142,700 15.3 12.8 84 1 71 4 12 6 22 Kensington 176,500 14.5 12.7 86 1 59 2 10 15 20 Hammersmith 132,800 17.0 11.4 67 — 23 3 5 5 29 Fulham 161,900 14.7 10.8 77 1 15 1 14 14 59 Chelsea 63,690 12.6 13.2 48 1 3 — 2 4 1 City of Westminster 136,500 9.9 10.7 57 5 5 1 3 13 13 North. St. Marylebone 103,500 12.7 11.6 77 1 37 1 10 11 17 Hampstead 86,160 11.6 11.3 54 1 9 1 — 3 7 St. Pancras 212,800 15.5 12.1 79 1 125 1 24 12 46 Islington 334,300 17.4 12.3 64 2 158 8 24 22 66 Stoke Newington 52,130 14.9 11.8 59 — 7 — 5 1 2 Hackney 224,700 15.5 11.2 68 2 28 7 11 27 37 Central. Holborn 42,209 11.2 12.3 55 8 — 4 2 6 Finsbury 75,500 19.5 14.1 83 — 52 1 19 9 12 City of London 13,010 6.3 10.6 73 — — — — 1 — East. Shored itch 105,700 19.8 12.8 76 — 59 3 4 13 24 Bethnal Green 117,900 18.1 11.0 73 — 44 2 11 9 33 Stepney 250,880 18.0 11.4 72 4 99 6 27 27 72 Poplar 167,000 19.3 11.3 71 3 57 2 17 24 42 South. Southwark (1928) Pop 181,300 19.2 12.7 70 1 72 3 26 13 28 Bermondsey 121,000 18.8 12.4 78 1 87 4 28 16 15 Lambeth 307,700 16.3 11.7 61 3 61 6 37 23 33 Battersea 169,000 16.2 11.3 62 1 36 5 13 26 26 Wandsworth 342,700 13.5 10.8 50 4 37 3 10 15 31 Camberwell 271,000 15.3 11.2 61 2 105 4 27 21 35 Deptford 113,800 16.1 11.7 76 1 30 2 15 14 20 Greenwich 101,920 16.7 11.0 54 2 26 1 8 14 11 Lewisham 188,600 16.1 10.3 52 5 33 3 14 14 22 Woolwich 140,770 15.7 10.7 50 2 9 4 16 14 9 27 SANITARY WORK. ST. MARY'S WARD. House-to-house inspections were carried out in the following localities :— Alberta Street, Berryfield Road, Borrett Road, Cavour Street, Clock Place, Manor Place, Marsland Road, Penton Place, St. Gabriel Street, Stopford Road, Suffield Road, Tarver Road. ST. PAUL'S WARD. Chapter Road, Chapter Terrace, Cook's Road, Frederick Road, Goschen Street, Grosvenor Terrace, Horsman Street, St. Paul's Road, Sturgeon Road. ST. PETER'S DISTRICT. Aycliffe House, Blewitt Street, Boyson Road, Faraday Street, Inville Road, Mann Street, Merrow Street, Portland Street, Runham Street, Villa Street, Westmoreland Road. ST. JOHN'S DISTRICT. Ash Street, Deacon Street, Eltham Street, Gurney Street, Henshaw Street, Ladysmith Dwellings, Sayer Street, Weymouth Dwellings. TRINITY WARD. Avonmouth Street, Causeway Place, Deverell Street, Nebraska Street, Parel Place, Rockingham Street, Tabard Street. ALL SAINTS' DISTRICT. Akers Street, Alvey House, Barlow Street, Beckway Street, Darwin Street, East Street, Elsted Street, Flint Street, Flora Terrace, Hemp Row, Henshaw Street, High Park Crescent, Huntsman Street, Osborne Street, Rossett Place, Salisbury Row, Sandringham Buildings, Surrey Grove. 28 ST. MICHAEL'S WARD. Aster Place, Bittern Street, Clenham Street, Dodson Street, Friar Street, Gable Cottages, Gilbert Buildings, Goodwin Buildings, Gray Street, Ilfracombe Buildings, Lant Street, Library Mansions, Little Suffolk Street, Little Surrey Street, Marshall Buildings, Milcote Street, Monarch Buildings, Nelson Place, Priory Buildings, Quilp Street, St. George's Buildings, St. George's Mansions, Sturge Street, Sussex House, Toulmin Street, Tower Street, Westminster Bridge Road. ST. JUDE'S WARD. Brook Street, Burman Street, Hayles Buildings, Lambeth Road, London Road, St. George's Buildings, Southwark Bridge Road. ST. GEORGE'S WARD. Cardol Place, Chapel Court, Chaucer House, Crosslet Street, Devonshire House, Harbledown House, Lansdowne Place, Law Street, McBean's Buildings, Madron Street, Mermaid Court, Mina Road, Prioress Street, Rochester House, Westcott Street. CHRISTCHURCH WARD. Bear Lane, Boddy's Bridge, Burrell Street, Charles Street, Dolben Street, Nelson House, Scoresby Street, Stamford Street, Surrey Row, Upper Ground Place, Union Street. ST. SAVIOUR'S WARD. Elizabeth Place, Emerson Place, Emerson Street, Great Guildford Street, Ladd's Court, Mander Place, Mowbray Buildings, Moss Alley, Noah's Ark Alley, Peabody Buildings, Skin Market Place, Stanhope Buildings, Taylor's Yard, Townsend Yard, White Hind Alley. 29 TABLE 13. Summary of Original Inspections, etc., made under the Housing Acts during the Year, 1928. WARD or DISTRICT. Housing. Houses Let in Lodgings. Number of Inspections. Number of Re-Inspections. Number of Inspections. N umber of Re-Inspections. St. Mary (Mr. Syms) 250 600 50 182 St. Paul (Mr. Mayhew) 177 386 18 93 St. Peter (Mr. Banham) 95 298 24 123 St. John (Mr. White) 53 125 45 197 Trinity (Mr. Findley) 391 1396 26 135 All Saints (Mr. Steele) 212 927 40 272 St. Michael (Mr. Hattersley) 368 1284 103 231 St. Michael (Mr. Hattersley) 1 1 — — St. Jude (Mr. Bryant) 155 949 18 39 St. George (Mr. Ede) 277 791 36 254 Christchurch No. 2 (Mr. Bowers) 62 197 45 62 St. Saviour No. 2 (Mr. Bowers) 69 309 5 25 2110 7263 410 1613 30 31 TABLE 14. Summary of Original Inspections, etc., made in the several Wards during the year 1928. 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) 836 1 1999 637 1914 146 5 194 132 33 7.2 17.3 St. Paul (Mr. Mayhew) 725 29 2316 273 1 543 107 83 286 167 88 5.1 13.0 St. Peter (Mr. Banham) 474 10 1400 726 — 1203 99 53 135 120 36 5.4 11.2 St. John (Mr. White) 800 20 1711 241 — 435 153 53 191 143 96 5.0 9.7 Trinity (Mr. Findley) 691 3 2633 70 1 558 75 25 281 311 337 5.5 18.7 All Saints (Mr. Steele) 689 6 2500 443 1 1282 149 133 296 131 84 5.8 18.8 St. Michael (Mr. Hattersley) 554 34 1720 506 1 1452 110 65 196 354 112 7.2 17.6 St. Michael (Mr. Hattersley) 27 3 8 — — — 25 7 6 — — St. Jude (Mr. Bryant) 671 53 2666 392 1 846 95 79 268 278 190 5.6 17.4 St. George (Mr. Ede) 845 45 2701 218 — 633 127 59 263 184 76 5.9 16.6 Christchurch No. 1 (Mr. Fisher and Mr. Duffield) — — — — — — — — — — — — — Christchurch No. 2 (Mr. Bowers) 216 1 509 126 — 273 39 30 52 186 41 2.4 3.9 St. Saviour No. 1 (Mr. Fisher and Mr. Duffield) — — — — — — — — — — — — — St. Saviour No. 2 (Mr. Bowers) 192 1 479 285 — 563 56 44 61 266 83 3.1 5.3 Women's Wkshps. (Miss Burrows) — — — — — — — — — *2447 960 8.6 3.4 Bakehouses, &c. (Mr. Nicholson) — — — — — — — — — 2283 — — — Slaughterhouses (Mr. Fisher and Mr. Duffield) — — — — — — — — — 96 — — — Total 6720 206 20642 3917 5 9702 1181 636 2229 7098 2136 — — 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. * 1,607 of these were inspections of public conveniences for women. 32 33 TABLE . 5. Summary of Sanitary Works Completed under the Public Health Act during the year 1928. 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, &c. Water Supply to upper floors. Draw Tap on Main. New Water Supply. Roof and Gutters repaired. Paving repaired. Dampness abated. Rooms cleansed. Sub-Floor Ventilation. Basement concreted. Staircase Ventilated. Dust-bin provided. Overcrowding abated. Miscellaneous IS uisances abated. St. Mary (Mr. Syms) 1121 480 1142 27 23 16 47 14 21 9 106 95 70 35 2 — — 372 46 51 1842 5 9 — 161 4 455 St. Paul's (Mr. Mayhew) 675 390 777 15 35 12 24 14 5 10 36 101 32 46 1 — — 330 59 126 1035 1 — — 158 3 463 St. Peter's (Mr. Banham) 697 358 745 22 14 18 9 18 6 7 58 82 79 69 1 12 1 309 44 68 1526 8 1 — 153 — 608 St. John's (Mr. White) 703 328 680 8 26 9 17 13 4 3 44 70 59 28 — — — 230 45 30 1058 1 — — 99 1 333 Trinity (Mr. Findley) 741 524 924 32 53 19 76 42 7 30 104 135 97 80 10 17 — 522 149 143 1381 25 1 — 127 14 725 All Saints' (Mr. Steele) 900 270 950 12 . 26 7 42 47 3 5 50 111 26 64 — 1 — 475 90 81 1045 — — — 206 2 588 St. Michael's (Mr. Hattersley) 730 335 834 8 22 6 46 2 3 8 72 78 35 56 1 1 — 247 60 50 1443 2 — 3 125 — 295 St. Michael's (Mr. Hattersley) 18 — 12 — 1 — — — — — 1 1 — — — — — 1 — — 4 — — — — — 5 St. Jude's (Mr. Bryant) 836 351 818 32 53 16 86 33 29 27 59 204 114 105 1 — — 374 121 44 1249 10 7 9 156 4 827 St. George's (Mr. Ede) 764 333 821 11 20 4 34 10 30 23 76 114 87 37 — — — 273 52 65 1411 — — — 143 — 494 Christchurch No. 2 (Mr. Bowers) 228 187 244 5 8 — 7 2 3 8 13 28 14 9 — — — 73 13 4 487 — — — 31 1 114 St. Saviour's No. 2 (Mr. Bowers) 240 209 285 3 3 1 4 1 2 1 4 14 5 10 — — — 66 11 5 601 1 — — 30 — 168 Women's Workshops (Miss Burrows) 48 20 46 — — — 4 — — 2 9 36 1 3 — — — 6 — 1 164 — 1 — 4 2 88 Milkshops, &c. (Mr. Nicholson) 43 — 39 — 1 — 2 — — 1 — 1 2 — — — — 2 5 — 54 — — 1 20 — 23 Meat Regulations (Mr. Duffield) \ 7 — 7 — — — 1 — — — — — — — — — — 2 9 — 44 — — — 5 — 30 Total 7751 3785 8324 175 285 108 399 196 113 134 6 632 1070 621 542 16 31 1 3282 704 668 13344 53 19 13 1418 31 5216 34 35 TABLE 16. Sanitary Works completed under the Housing Acts during the year 1928. Ward or District. 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. Separation of Sexes and Overcrowding. Cleansing by Tenants and Lodgers. 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) 240 — 276 13 13 12 43 231 46 7 23 39 — 114 67 19 15 1 41 — — — — — — — — 318 11 St. Paul's (Mr. Mayhew) 173 — 164 4 35 44 102 58 58 7 8 23 — 1 49 5 7 1 12 — — — — — — — — 61 5 St. Peter's (Mr. Banham) 93 — 122 9 27 35 23 43 30 10 17 21 — 33 61 12 7 1 14 — — — — — — — — 112 — St. John's (Mr. White) 52 — 49 3 4 22 21 8 44 2 — 14 — 3 42 11 1 1 40 — — — — — — — — 186 — Trinity (Mr. Findley) 384 — 424 79 75 105 128 158 135 63 30 130 2 169 147 71 18 9 28 — — — — — — — — 95 — All Saints' (Mr. Steele) 210 — 207 26 16 14 42 32 30 13 13 39 3 14 103 33 1 — 29 — — — — — — — — 117 — St. Michael's (Mr. Hattersley) 368 — 366 24 10 23 232 87 116 102 10 80 1 8 171 49 9 — 78 — — — — — — — — 189 — St. Michael's (Mr. Hattersley) 2 — — — — — — — — —— — — — — — — — — — — — — — — — — — — — St. Jude's (Mr. Bryant) 155 — 202 35 32 36 108 226 72 80 48 98 — 90 82 28 15 8 11 — — — — — — — — 24 — St. George's (Mr. Ede) 277 — 192 5 — 1 44 122 43 15 25 86 — — 137 52 — — 29 — — — — — — — — 195 — Christchurch No. 2 (Mr. Bowers) 62 — 50 1 2 — 14 10 11 11 1 12 — 22 15 3 1 — 38 — — — — — — — — 209 — St. Saviour's No. 2 (Mr. Bowers) 69 — 61 1 5 4 8 13 8 7 6 15 4 14 39 6 1 — 4 — — — — — — — — 13 — Total 2085 — 2113 200 219 296 765 988 593 317 181 557 10 468 913 289 75 21 324 — — — — — — — — 1519 16 36 PROCEEDINGS TAKEN UNDER THE PUBLIC HEALTH AND OTHER ACTS. 22 summonses were taken out during the year 1928, 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. WARD OR DISTRICT. 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 3 3 1 1 1 5 2 6 — — — 22 The above summonses had reference to the following :— Ordinary Nuisances 20 Nuisance caused by Animals 1 Closing Order (Housing Act) 1 22 TABLE 18. These proceedings resulted as follows :— Summonses withdrawn (with costs), the Council's requirements having been complied with 18 Magistrates' Orders made with costs 3 Closing Order Made 1 Total 22 37 TABLE 19. Proceedings taken under the Public Health and Other Acts. Defendant. Cause of Proceedings. Result. G. O. Davies, Marlborough Road, Wealdstone. Neglecting to amend defective roof at 5, Friar Place. Summons withdrawn, work done,with 10/6 costs. Kate Fowles, 37, Northfield Road, N. Neglecting to amend defective roof at 88, East Street. Ordered to do work within 14 days, with £1 1s. 0d. costs; in consequence of Mrs. Fowle's disobedience to this Order she was compelled to pay a further 9/-. John Ray, 104, St. George's Road, S.E. Neglecting to amend defective roof, and to cleanse the dirty premises at 5, Sutherland Street. This Summons was heard on the 24th November, 1927, when Mr. Ray was ordered to do the work within 14 days, with 10/6 costs; in consequence of Mr. Ray's disobedience to this Order he was fined £1 with £2 2s. 0d. costs. E. J. Springate, Pollard Road, Mitcham Neglecting to amend defective drain at 83, Carter Street. Summons withdrawn, work done, with 10/6 costs. Messrs. Dickins & Son, 3/4, George Street, Croydon. Neglecting to provide suitable means of ventilation to the ground floor front room at 62, Morecambe Street. Summons withdrawn, work done, with 10/6 costs. 38 TABLE 19. Defendant. Cause of Proceedings. Result. Mrs. G. Cottrell, 11, Horsall Road, Highbury. Neglecting to unstop choked drain, and to cleanse dirty rooms at 17, Alberta Street. Ordered to do work within 14 days, with £1 1s. 0d. costs. Stewart M. Brace, 7, King's Terrace, Chingford. Neglecting to amend defective roof gutters, and to cleanse verminous rooms at 43, Tarn Street. Summons withdrawn, work done, with 10/6 costs. Henry Warman, 497, Commercial Road, E. Neglecting to disconnect rain-water pipe from sewer at 63, Pocock Street. Summons withdrawn, work done, with 13/6 costs. R. L. W. Spurrett, 7, Hopwood Street, S.E.17. Neglecting to provide a sufficient ash-pit at 2, Hopwood Street. Summons withdrawn, ash-pit provided with 10/6 costs. R. L. W. Spurrett, 7, Hopwood Street, S.E.17. Neglecting to abate nuisance caused by dampness at 2, Hopwood Street. Summons withdrawn, nuisance abated, with 10/6 costs. William Abbott, 25, Gale Street, Bow, E. Neglecting to unstop choked drain at 4, Amery Place. Summons withdrawn, work done, with 10/6 costs. William Abbott, 25, Gale Street, Bow, E. Neglecting to amend defective water closet, roof, and sink waste pipe at 4, Amery Place. Ordered to do work within 7 days, with £1 1s. 0d. costs. 39 TABLE 19. Defendant. Cause of Proceedings. Result. William Good, 7, Sedgemoor Place, Camberwell. Neglecting to amend defective roof gutter, and top floor back ceiling at 7, Horsman Street. Summons withdrawn, work done, with 10/6 costs. R. Holliday, 28, Lower Kennington Lane, S.E. 11. Neglecting to amend defective water closet hinges, and door fastenings at 18, Barbel Street. Summons withdrawn, work done, with 10/6 costs. R. Holliday, 28, Lower Kennington Lane, S.E. 11. Neglecting to amend defective drain, roof and rain-pipe at 22, Barbel Street. The owner, Mr. Gough Cook paid £20 towards the cost of repairing these drains. R. Holliday, 28, Lower Kennington Lane, S.E. 11. Neglecting to amend defective drain, and to abate nuisance caused by dampness at 24, Barbel Street. The summonses were accordingly withdrawn. R. Holliday, 28, Lower Kennington Lane, S.E. 11. Neglecting to amend defective roofs, paving and yard door sill at 32, Barbel Street. Summons withdrawn, work done, with 10/6 costs. S. Bounds, 4, Gaza Street, S.E. Neglecting to amend defective roof, and abate nuisance caused by dampness at 6, Gaza Street. Ordered to do work within 14 days, with 10/6 costs. S. Bounds, 4, Gaza Street, S.E. Neglecting to abate nuisance caused by dampness at 8, Gaza Street, Ordered to do work within 14 days, with 10/6 costs. 40 TABLE 19. Defendant. Cause of Proceedings. Result. Mrs. Thurley, 101, Faraday Street, S.E. Neglecting to abate nuisance, caused by the keeping of cats at 101, Faraday Street. Ordered to abate nuisance within 14 days, with £1 1s. 0d. costs; in consequence of Mrs. Thurley's disobedience to the Order, she was fined 10/- and £l 1s. 0d. costs. John Phillips Mead, 2, King's Bench Walk, E.C. Neglecting to amend defective ventilating shaft to drain, roof gutters, and to cleanse dirty scullery and lobby walls at 7, Colnbrook Street. Summons withdrawn, work done, with £1 3s. 0d. costs. Walter James Nash, 88, Borough Road, S.E.1. Notice of a Closing Order under the Housing Act, 1925, prohibiting the use of a certain room at 88, Borough Road, as a sleeping place contrary to the provisions of the said Act. Closing Order made for compliance by the Magistrate. 41 SMOKE ABATEMENT. There is not, on the whole, a great amount of pollution from local factories or works. The chief cause can be attributed to the use of coal fires for heating purposes in the numerous tenements and small dwellings, and as this Borough is built on low-lying land there is a tendency to an increase of fog, which causes much of the bronchial troubles so prevalent in the district, and increases the heavy mortality from this type of case. Southwark lies to the south and south-west of the most smoky districts of London, and with a north-east wind it gets its share of their pollution also. BLACK SMOKE. During the year 1928, three complaints were received at the Public Health Office from persons other than the Council's Inspectors. TABLE 20. Showing the Number of Observations, etc., in regard to Smoke Nuisances made by the several Ward Inspectors during 1928. St. Mary's Ward. St. Paul's Ward. St. Peter's District. St. John's District. Trinity Ward. All Saints' District. 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 — — 6 1 — — — 2 1 — 11 Number of nuisances observed — — — 3 1 — — — 1 1 — 6 No. of Intimation Notices served — — — 1 1 — — — — 1 — 3 No. of Statutory Notices served — — — — — — — — — 1 — 1 No. of Summonses taken out — — — — — — — — — — — — During the year 1927, three complaints were received at the Public Health-Office, 4 observations were made, and two nuisances were observed. HOUSES LET IN LODGINGS. Under the definition of Houses Let in Lodgings, so many of our houses are included, that it is a work of time to get a Register to cover all the ground, but progress is being made by including the most obvious cases as they occur. Notices are sent to those concerned to proceed with the cleansing each April, and from time to time leaflets are distributed to tenants and lodgers, drawing their attention to their obligations under these Regulations. NUMBER OF HOUSES ON REGISTER AT END OF 1928. St. Mary 37 St. Michael 59 „ Paul 19 „ Jude 16 „ Peter 33 „ George 56 „ John 22 Christchurch & St. Saviour 60 Trinity 13 — All Saints 36 Total 351 42 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) 421 78 — Workshops (including Workshop Laundries) 564 97 — Workplaces 5651 323 — Homeworkers' Premises (including Out-workers) 361 3 — Total 6997 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 296 302 — — Want of Ventilation 29 20 — — Overcrowding 2 2 — — Want of drainage of floors — — — — Other nuisances 424 458 — — Sanitary accommodations : Insufficient 1 1 — — Unsuitable or defective 43 41 — — Not separate for sexes ... 4 4 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97100) — — — — Other offences 92 92 — — Total 891 920 — — * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts. 43 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. J Instances. Notices served. J 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. 78 70 73 74 382 309 — — 275 13 1 — — — — (2) Cleaning and washing — — — — — — — — — — — — — — — Lace, lace curtains and nets — — — — — — — — — — — — — — — Furniture and Upholstery 1 2 1 2 2 1 — — 4 — — — — — — Fur pulling.. — — — — — — — — — — — — — — — Umbrellas — — — — 7 — — — 7 1 1 — — — — Paper Bags and Boxes 8 22 8 21 14 11 — — 29 5 1 — — — — Brushmaking 8 9 8 11 — 5 — — 9 1 1 — — — — Stuffed Toys 1 6 1 4 — 3 — — 6 — — — — — — File making — — — — — — — — — — — — — — — Electro Plate — — — — — — — — — — — — — — — Cables and Chains — — — — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — — — — Locks, Latches and Keys — — — — — — — — — — — — — — — Miscellaneous 7 18 8 16 15 32 — — 31 4 1 — — — — Total 103 127 99 128 420 361 — — 361 24 5 — — — — 44 TABLE 23. 4.—Registered Workshops. Workshops, Workplaces, &c., on the Register (S. 131) at the end of the year. Number. Bakehouses 102 Factory Bakehouses 5 Eating-houses and places where food is prepared for sale 342 Ice Cream Shops 150 Laundries 34 Dressmakers, Milliners, &c. 24 Tailoring 22 Brushmakers 9 Miscellaneous 1918 Total number of Workshops, Workplaces, &c., on Register 2606 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 45 Reports (of action taken) sent to H.M. Inspectors 23 Other — Underground Bakehouses (S. 101) :— Certificates granted during the year — In use at end of the year 24 45 TABLE 24. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made during the year 1928. WARD OR DISTRICT. 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 37 40 52 556 25 2478 149 888 1 - 14 2 - 11 St. Paul 46 60 14 507 41 1875 100 418 6 - 18 12 - 3 St. Peter 36 39 13 129 15 580 44 155 8 - 15 4 - 1 St. John 68 70 35 504 42 1720 66 445 7 - 20 5 - 1 Trinity 42 40 96 360 55 1273 59 373 6 - 44 2 - 36 All Saints 48 55 113 606 52 2064 33 529 15 - 34 3 - 5 St. Michael 48 55 22 222 30 890 48 182 4 - 25 8 - 7 St. Jude 78 65 211 200 45 631 11 137 2 - 29 5 2 22 St. George 45 46 20 209 31 567 15 158 1 - 23 7 1 1 Christchurch 33 25 22 166 18 760 34 236 - - 10 2 - 3 St. Saviour 20 17 29 241 15 1333 25 387 — - 4 1 — 2 Total 501 512 627 3700 369 14171 584 3908 50 - 236 51 3 92 Number of Rats destroyed 1827 Number of Mice destroyed 127 46 CUSTOMS AND INLAND REVENUE ACT, 1890. No Certificate for exemption from Inhabited House Duty was granted during the year 1928. 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. 1 to 12, Carlyle House (12 tenements) The Lansdowne Building Co., 15/17, Lansdowne Rd., S.W.8. Officers' Quarters, Salvation Army Messrs. H. & j. Taylor, Hostel, Blackfriars Road. 177, Lewisham Road, S.E.13. la to lb, Horsley Street Messrs. J. Marsland & Son, 42a to 42f, Queen's Row (12 tenements) 56, South Molton Street, W.l. WATER SUPPLIES TO TENEMENT HOUSES. London County Council (General Powers) Act, 1907. 16 additional water supplies were provided to houses during the year, 1928. 47 Cleansing of Verminous Rooms and their Contents. During the year 1928 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) Acts, 1904 and 1922, has increased in comparison with 1927. I append a table showing 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 OR DISTRICT. No. of Intimation Notices served. No. of Statutory Notices served. Police Court proceedings taken. Verminous rooms treated. (a) by Owners of Premises. (b) by the Council's Disinfecting Staff. St. Mary 47 26 — 59 63 St. Paul 62 31 — 70 53 St. Peter 24 11 — 39 11 St. John 34 16 — 76 38 Trinity 102 60 1 139 155 All Saints 28 6 36 62 St. Michael 33 11 — 50 81 St. Jude 75 31 — 100 66 St. George 49 25 — 64 36 Christchurch 9 8 — 21 25 St. Saviour 14 10 16 49 Total 477 235 1 *670 639 * Note.—These 670 rooms were stripped by the owners. 48 CLEANSING OF PERSONS ACT, 1897. Adults sent from Lodging-houses and other places in the Borough to be Cleansed during 1928. TABLE 26. Address. Male. Female. Total. 3, Quilp Street 7 7 76, Blackfriars Road 4 — 4 12, Marshalsea Road 2 — 2 Salvation Army Shelter, Blackfriars Road 497 — 497 90, Camberwell Road 25 — 25 7, Dorrit Street — 24 24 86, Gravel Lane 7 — 7 12, Gray Street 17 — 17 56, Newington Causeway 16 — 16 Rowton House 89 — 89 St. Olave Chambers 73 — 73 112, Southwark Bridge Road 30 — 30 128, Walworth Road 3 — 3 78, Camberwell Road — 2 2 12, Lombard Street — 14 14 Morning Post Home, New Kent Road 4 — 4 8, Great Charlotte Street 11 — 11 52, Lambeth Road — 4 4 19, Belvedere Crescent — — — Other addresses 69 30 99 Total 854 74 928 49 TABLE 27. Showing the Number and Sex of Verminous or Scabious Children treated at the Council's Station, King James Street, during 1928, and the Schools from which they were sent. These 3,191 Children received 5,307 Baths during 1928. Name of School. Verminous. Scabious. Total. Boys. Girls. Boys. Girls. Archbishop Sumner — 10 — — 10 Addington Street 21 36 2 — 59 All Saints 3 46 — 1 50 Archbishop Temple - - - - - Archbishop Tenison — — — — — Archbishop Tait — 3 2 2 7 Blackfriars 11 98 — 2 111 Beresford Street - - - - - Charles Dickens 26 106 — — 132 Christchurch 2 55 — — 57 Crampton Street 19 53 3 7 82 English Martyrs 11 78 — 1 90 Faunce Street - - - - - Flint Street 5 45 — 1 51 Heygate Street 2 9 — — 11 Holy Trinity 9 20 - — 29 Harper Street 21 74 — — 95 Hatfield Street 18 69 — — 87 Holland Street 3 46 — — 49 Johanna Street 61 159 3 2 225 John Ruskin 22 23 1 — 46 King and Queen Street 27 114 2 3 146 Lollard Street — 4 2 1 7 Mina Road 1 — — — 1 Michael Faraday 8 30 — — 38 Newcomen Foundation — 13 — — 13 Orange Street 20 89 — — 109 Penrose Street 32 70 2 1 105 Friar Street 9 144 4 4 161 Rockingham Street 28 103 — 2 133 St. George's R.C. 20 68 — 1 89 Carried forward 379 1565 21 28 1993 50 Name of School. Verminous. Scabious. Total. Boys. Girls. Boys. Girls. Brought forward 379 1565 21 28 1993 St. George's, Earl Street 10 48 3 1 62 Sayer Street 25 114 5 1 145 St. Saviour's 6 32 — 1 39 St. Agnes - - - - - St. Paul's, Sutherland Square 4 24 1 3 32 Surrey Square 1 — — — 1 Sandford Row 5 39 — — 44 Stowey House 2 2 1 4 9 St. John's, Larcom Street 3 9 — 4 16 St. Patrick's 4 40 — — 44 St. John's, Waterloo Road 9 45 1 — 55 St. Alban's 10 14 — 2 26 St. Andrew's 7 31 — — 38 St. Mary, Newington 23 140 6 2 171 St. Jude's 3 11 1 1 16 St. Joseph's 19 99 — 6 124 St. Mary, Lambeth - - - - - St. Peter's 5 3 — — 8 St. Phillip's - - - - - Victory Place 6 42 2 4 54 Westminster Bridge Road 23 72 — — 95 Walnut Tree Walk 2 5 2 - 9 West Square 5 19 — — 24 Waterloo Road 14 95 4 — 113 Westmoreland Road 11 40 1 2 54 Webber Street — 4 — 1 5 Boundary Lane — — - — — Other Schools — 9 1 4 14 Totals 576 2502 49 64 3191 51 TABLE 28. Verminous Bedding, etc., Disinfected at the Council's Stations during 1928. Articles. Disinfected. Destroyed. Beds 194 — Palliasses 98 — Bolsters and Pillows 203 - Cushions 81 - Blankets 778 - Sheets 842 - Ouilts 58 - Articles of Clothing, &c. 17,432 - Total 19,686 - VERMINOUS PERSONS CLEANSED DURING 1928. During the year 4,119 persons were cleansed at the station in King James Street. Of these under our agreement with the London County Council, were 3,191 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. 928 adults sent from the various common lodging houses and other places in our borough were cleansed during the year, as against 1,067 dealt with under the provisions of the Cleansing of Persons Act, 1897, in 1927. 52 MORTUARIES. TABLE 29. During the year 426 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 174 16 190 Bodies brought in for convenience 7 224 231 Bodies brought in in cases where death had occurred from Infectious Disease 4 1 5 Total 185 241 426 HOUSING. During the year 1928, the number of houses granted to families from Southwark by the London County Council amounted to 133, they were distributed as follows:— Downham 59 Barnes 6 Hendon 39 Tottenham 1 Becontree 27 Tabard Street 1 The Hatfield Street and Paris Gardens district which I represented in 1926, is being proceeded with, and the slum area thereon has been cleared, alternative accommodation having been provided for the tenants by the London County Council. The scheme for the clearance of a considerable area in Hard Street and Townley Street was put forward, and progress was made during the year concerning the preliminary steps. 53 table 30. 9.—Housing. Number of new houses erected during the year :— (a) Total (including numbers given separately under (b)) 24 (b) With State assistance under the Housing Acts: (i) By the Local Authority — (ii) By other bodies or persons 24 1. Unfit Dwelling Houses:— Inspection—(1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 14,338 (2) Number of dwelling houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 3,917 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (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 9,349 2. Remecly 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 2,113 3. Action under Statutory Powers:— A. Proceedings under Section 3 of the Housing Act, 1925:— Nil (1) Number of dwelling houses in respect of which Notices were served requiring repairs Served during 1927 (2) Number of dwelling houses which were rendered fit after service of formal Notices— 5 (a) by Owners 5 (b) by Local Authority in default of owners Nil 54 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 5,545 (2) Number of dwelling houses in which defects were remedied after service of formal notices: (a) by owners 6,180 (b) by Local Authority in default of owners Nil 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 1 (2) Number of dwelling houses in respect of which Closing Orders were made 1 (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 D. Proceedings under Sec. 18 of the Housing Act 1925:— (1) Closing Order made prohibiting the use of an underground room as a sleeping place 1 55 table 31. VISITS MADE UNDER THE PUBLIC HEALTH (MEAT) REGULATIONS, 1924. St. Mary's Ward. St. Paul's Ward. St. Peter's District. St. John's District. Trinity Ward. All Saint's District. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Stalls and Shops visited 123 46 438 330 45 39 62 28 98 64 20 1293 SLAUGHTERHOUSES. The supervision of the various Slaughterhouses was carried but during the year, and 298 oxen and 2,019 sheep were slaughtered, under the supervision of 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 96 inspections were made during the year. One nuisance was discovered. Each Slaughterhouse was limewashed every three months during the year. 56 57 EXAMINATION OF FOOD. table 32. Showing the quantity of Foodstuffs found unsound during the year 1928 by the several Inspectors throughout the Borough. The amount shown in this table is in addition to the total shown in Table 33. Foodstuffs. Quantity and Weight found Unsound. Surrendered by Owner Seized by Inspector. Remarks. Quantity. Weight Quantity. Weight. Quantity. Weight. T. C. Q. L. T. C. Q. L. T. C. O. L. Apples 116 cases 2 4 2 20 116 cases 2 4 (v 2 20 — — Destroyed at the Council's Depot. Bacon 11 cases, 21 pieces - 16 2 20 11 cases, 21 pieces — 16 2 20 — — 11 cwts. were released for soap boiling, and 5 cwts. 2 qrs. 20 lbs. were destroyed at the Council's Depot. Bananas 30 crates - 15 0 0 30 crates - 15 0 0 — — Destroyed at Council's Depot. Beef 13 pieces, 11 clods - 5 2 27 13 pieces, 11 clods - 5 2 27 — — 4 cwts. 4 lbs. were destroyed at the Council's Depot, and 1 cwt. 2 qrs. 23 lbs. were released for soap boiling. Beef Cubes A quantity 2 9 3 0 A quantity 2 9 3 0 — — Destroyed at the Council's Depot. Beef Extract A quantity 3 0 1 19 A quantity 3 0 1 19 — — Destroyed at the Council's Depot. Beef Powder A quantity 10 16 0 7 A quantity 10 16 0 7 — — Destroyed at the Council's Depot. Beef, tinned 69 tins - 3 2 11 69 tins — 3 2 11 - — Destroyed at the Council's Depot. Carrots 39 half-bags 1 0 0 0 39 half-bags 1 0 0 0 — — Destroyed at the Council's Depot. Cherries 19 chips - - 3 11 19 chips - — 3 11 - — Destroyed at the Council's Depot. Chocolates 8 boxes - - — 7 8 boxes - — — 7 — — Destroyed at the Council's Depot. Condensed Milk 3 cases, etc. - 1 3 5 3 cases, etc. - 1 3 5 — — Destroyed at the Council's Depot. Cream, canned 5 cases - 2 0 24 5 cases - 2 0 24 — — Destroyed at the Council's Depot. Figs 3 boxes - - - 6 3 boxes - - - 6 — — Destroyed on premises where found. Fruit, tinned 7 cases - 4 3 0 7 cases - 4 3 0 — — Destroyed at the Council's Depot. Haddocks 1 box - - 2 0 1 box - - 2 0 — — Destroyed at the Council's Depot. Hams, tinned 2 tins - - - 27 2 tins - - 27 — — Destroyed on premises where found. Carried forward 22 2 1 16 22 2 1 16 58 Foodstuffs. Quantity and Weight found Unsound. Surrendered by Owner. Seized by Inspector. Remarks. Quantity. Weight. Quantity. Weight. Quantity. Weight. Brough forward T. C. Q. L. T. C. Q. L. T. C. Q. L. 22 2 1 16 22 2 1 16 Heads, Pigs 4,380 heads 21 14 1 18 4,380 heads 21 14 1 18 — — 21 tons 14 cwts. 1 qr. 8 lbs. were released for soap boiling and 10 lbs. were destroyed on premises where found. Herrings 1½ boxes - 1 9 0 1½ boxes - 1 2 0 — — Destroyed at the Council's Depot. Kippers 3 boxes - — 2 0 3 boxes - - 2 0 — — Destroyed at the Council's Depot. Mussels 1 bag - 1 0 0 1 bag - 1 0 0 — — Destroyed at the Council's Depot. Mutton 1 piece - - - 7 1 piece - — - 7 — — Destroyed on premises where found. Offal — 2 3 25 - 2 3 25 — — 2 cwts. 3 qrs. 22 lbs. were destroyed at the Council's Depot and 3 lbs. were released for soap boiling. Oranges 1 box - 1 0 0 1 box - 1 0 0 — — Destroyed at the Council's Depot. Pears 29 barrels - 5 1 12 29 barrels - 5 1 12 — — Destroyed at the Council's Depot. Pineapple 14 cases - 4 0 0 14 cases - 4 0 0 — — Destroyed at the Council's Depot. Plaice 2 boxes - - 3 5 2 boxes - - 3 5 — — Destroyed on premises where found. Plums, preserved 1 case - — 3 12 1 case — - 3 12 — — Destroyed at the Council's Depot. Pork 376 carcases, etc. 21 6 0 3 376 carcases, etc. 21 6 0 3 — - 21 tons 5 cwts. 2 qrs. 11 lbs. were released for soap boiling, and 1 qr. 20 lbs. were destroyed at the Council's Depot. Potatoes 17 bags - 17 0 0 17 bag - 17 0 0 — - Destroyed at the Council's Depot. Roes, Herrings 14 boxes - 7 2 6 14 boxes - 7 2 6 — — Destroyed on premises where found. Shallots 32 bags - 16 0 0 32 bags - 16 0 0 — — Destroyed at the Council's Depot. Skate 1 box - — 2 14 1 box - - 2 14 — — Destroyed on premises where found. Tomatoes 145 bundles 2 11 0 14 145 bundles 2 11 0 14 — — Destroyed at the Council's Depot. Tomatoes, tinned .. 2 cases — 1 0 8 2 cases — 1 0 8 —' — Destroyed at the Council's Depot. Turnips 20 half-bags - 10 0 0 20 half-bags - 10 0 0 — — Destroyed at the Council's Depot. Veal 1 calf - - 1 15 1 calf — — 1 15 — — Destroyed at the Council's Depot. Total 71 4 2 15 71 4 2 15 59 60 TABLE 33 J able showing the quantity of Foodstuffs examined at the wharves during the year 1928, the quantity found to be unsound, the notices served and the method of disposal of unsound portion. 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. Apricots, tinned 893 cases 23 11 3 6 2 10 1 12 Yes - 11 Destroyed at the Council's Depot. Apricots, dried 504 boxes 8 12 2 11 2 2 1 11 Yes - 1 1 15 cwt. released for export and 2 tons 2 cwts. 1 qr. 11 lbs. were released for re-conditioning. Apples, dried 151 cases 3 0 2 0 — - - - - Apples 424 cases 10 19 1 16 - 11 1 12 Yes - 1 - Destroyed on premises where found. Apricot pulp 60 cases 3 0 0 0 — - - — - Apricots 312 crates 3 5 3 14 - 10 2 24 Yes - 7 - Destroyed on premises where found. Asparagus, tinned 286 cases 5 14 0 0 - 2 0 16 Yes - 1 - Destroyed at the Council's Depot. Apples, tinned 448 cases 5 18 1 6 - 2 2 8 Yes - 1 - Destroyed at the Council's Depot. Beef 1,507 quarters, etc. 147 1 0 6 - - 3 14 Yes - 3 - 2 qrs. were released to the Smithfield Animal Products Company, and 1 qr. 14 lbs. were released for soap boiling. Beef, tinned 3,641 cases, etc. 99 5 0 22 11 4 3 12 Yes - 32 2 6 tons 7 cwts. 3 qrs. 4 lbs. were destroyed at the Council's Depot, and 4 tons 17 cwts. 8 lbs. were released for cattle food and soap boilirg. Bacon 4,146 bales, etc. 515 6 3 24 - 1 0 20 Yes - 1 - 3 qrs. 24 lbs. were released for soap boiling, and 24 lbs. were destroyed at the Council's Depot. Butter 3,164 cases 66 19 2 24 — - - - - - Beef, salted 16 casks 3 9 3 20 — - - - - - Blackcurrants, tinned 76 cases 2 0 2 24 — - - - - - Blackcurrants 50 crates — 9 3 8 — - - - - - Condensed Milk 4,877 cases, etc. 89 13 0 22 33 11 2 2 Yes - 40 -i 26 tons 19 cwts. 3 qrs. 10 lbs. were released for pig and poultry feeding, and 6 tons 11 cwts. 2 qrs. 20 lbs. were destroyed at the Council's Depot. Cereals A quantity 17 5 2 25 16 1 0 9 Yes - — - Released for pig feeding. Crab, tinned 249 cases 5 5 3 8 — - - - - - Cheese 259 crates, etc. 26 1 1 0 — 3 0 0 Yes - 1 — Destroyed at the Council's Depot. Cherries, tinned 171 cases 4 11 2 12 — - - - - - Currants 121 boxes 1 19 1 0 — - - - - - Casings, sheep 3 kegs - 4 2 0 - 4 2 0 Yes - 1 - Destroyed at the Council's Depot. Casings, ox 28 casks, etc. 6 8 0 0 — - - — - - Casings, hog 7 casks - 14 0 0 — - - — - - Cherries, glazed 40 boxes — 5 0 0 — - - — - - Ducks 236 boxes 3 19 1 0 — - - - - - Dates 518 cases 9 17 1 12 — - - - - - Dripping 36 tierces 10 16 0 0 — - - — - - Eggs 47 cases 4 14 0 0 1 0 0 0 Yes - — - Destroyed at the Council's Depot. Egg liquid 100 casks 15 0 0 0 — - - — - — Carried forward 1095 10 3 8 68 6 2 0 100 3 61 62 Foodstuffs. Quantity and Weight Examined. Weigh found to be unsoud. 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 1095 10 3 8 68 6 2 0 100 3 Egg liquid, frozen 5,652 tins, etc.* 1276 10 1 2 177 11 3 10 Yes - 3 2 1,169* tons under "stop" from 1927. Of this amount 991 tons 15 cwts. 2 qrs. 18 lbs. were found to be sound, 177 tons 4 cwts. 1 qr. 10 lbs. were released for leather dressing, and 7 cwts. 2 qrs. were released for pig feeding. Fowls 603 cases, etc. 48 19 3 25 — — 3 20 Yes - - 1 qr. 8 lbs. were released for soap boiling and 2 qrs. 12 lbs. were destroyed on premises where found. Fruit, tinned 1,354 cases 33 2 0 24 4 4 3 24 Yes - 8 — Destroyed at the Council's Depot. Fruit salad, dried 2,832 cases 19 12 3 4 — — - — — — Flour 300 bags 13 4 1 4 — — - — — — Figs 45 bags - 12 1 0 — — - — - - Gooseberries, tinned 85 cases 2 5 2 4 — — - — — — Game 44 cases 2 4 0 0 — — - — — — Grape fruit, tinned 45 cases 1 3 2 8 — — - — — — Hams 1,097 boxes 256 14 2 0 1 5 0 0 Yes - 1 — Released for soap boiling. Heads, pigs 11 casks 2 1 0 0 — — - — — — Herrings, tinned 36 cases — 15 1 20 — — - — — — Hams, tinned 6 boxes, etc. 3 3 0 14 — 1 0 14 Yes - — — Destroyed at the Council's Depot. Hares 100 crates 2 11 3 4 — — - — — — Ice Cream mixture 8 cases — 3 1 20 — 3 1 20 Yes - 1 — Destroyed at the Council's Depot. Jam pulp 156 cases 4 2 2 0 — — - — — — Jam, tinned 190 tins — 18 3 20 — 2 3 12 Yes - 1 - Destroyed at the Council's Depot. Lard 883 boxes 22 4 2 0 — — - — — — Lobster, tinned 38 cases 1 0 1 12 — — - — — — Loganberries, tinned 267 cases 7 3 3 16 — 8 0 0 Yes - 1 — Destroyed at the Council's Depot. Mutton Carcases, etc. 1554 12 3 22 66 19 0 0 Yes - 7 24 Released for animal food and technical purposes. Mutton, tinned 80 cases 2 11 1 20 - - - — — - Mincemeat 10 kegs — 2 3 22 — 2 3 22 Yes - 2 — Destroyed on premises where found. Nuts, assorted 234 bags 11 10 0 18 — — -- — — — Offal 6,188 bags, etc. 243 1 0 22 96 15 2 18 Yes - 5 12 96 tons 13 cwts. 12 lbs. were released for soap - boiling, and 2 cwts 2 qrs. 6 lbs. were destroyed at - the Council's Depot. Onions 1,600 bags 77 10 0 0 66 3 0 0 Yes - 1 1 Destroyed on premises where found. Peaches, tinned 896 cases 25 0 2 4 3 9 2 16 Yes - 7 — Destroyed at the Council's Depot. Pears, tinned 613 cases 16 10 0 0 — — - — — — Pineapple, tinned 1,115 cases 29 9 0 26 1 13 2 2 Yes — 5 1 Destroyed at the Council's Depot. Prunes 2,506 cases 39 0 1 21 9 8 2 2 Yes — 6 4 Destroyed at the Council's Depot. Pork 125 cases, etc. 16 12 0 16 — 5 1 6 Yes — 1 1 Released for soap boiling. Peaches, dried 95 boxes 1 8 1 9 — — — — — — Plums, tinned 162 cases 4 6 3 4 — — — — — — Prunes, tinned 84 cases 2 4 0 4 — 12 3 12 Yes — 2 — Destroyed at the Council's Depot. Pork and beans, tinned 136 cases 2 18 1 4 — — — — — — Carried forward 4821 3 2 12 497 15 0 0 151 48 63 64 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 .. 4821 3 2 12 497 15 0 10 151 48 Pig's feet 10 casks, etc. 1 0 0 0 - - — - — Plums 3 baskets — — 2 16 - — 2 16 Yes - - - Destroyed on premises where found. Raisins 381 boxes 7 2 0 1 - - - - — Rabbits 839 crates 21 13 2 16 — 4 1 4 Yes - 1 - Released for soap boiling. Raspberries, tinned 216 cases 5 14 2 4 - - — - - Salmon, tinned 1,510 cases 31 14 0 16 2 14 3 2 Yes - 19 - Destroyed at the Council's Depot. Soup, tinned 35 cases - 12 0 12 - 12 0 12 Yes - 7 - Destroyed at the Council's Depot. Sardines, tinned 192 cases 3 17 1 23 - - - - - Sultanas 225 boxes 3 6 1 18 - - - - - Swedish bread 44 cases _- 11 0 0 - 11 0 0 Yes - 1 - Destroyed at the Council's Depot. Strawberries, tinned 40 cases 1 1 1 20 - - - - - Spinach, tinned 26 cases - 14 1 4 - - - - - Tongues, tinned.. 917 cases, etc. 34 5 3 24 10 1 4 Yes - 3 1 Destroyed at the Council's Depot. Tallow 337 casks 62 8 0 0 31 12 0 0 Yes - 2 - Released for export. 30 tons 16 cwts. still under "stop." Tripe, tinned 138 cases 2 16 1 4 — 3 1 20 Yes - 1 — Destroyed at the Council's Depot. Turkeys 102 cases, etc. 3 15 0 12 16 3 24 Yes - 1 1 Released for soap boiling. Tongues, ox 40 boxes, etc. 1 19 3 12 - - - - - Tomatoes, tinned 351 cases 9 8 0 4 12 1 8 Yes - 1 1 Destroyed at the Council's Depot. Tongues, sheep 441 bags 13 1 1 0 - - 4 - Veal 50 carcases etc 22 16 0 0 - 2 2 - Walnuts 35 boxes - 17 2 0 — - - 1 1 - Total 5050 0 1 2 535 12 3 16 190 58 CASEOUS LYMPHADENITIS IN SHEEP. During 1928 the above disease was still found to exist in large quantities of mutton imported from abroad. A much larger number of carcases were examined than was necessary in 1927. The amount of disease, however, was less in proportion, from which it may be assumed that more careful supervision is being exercised before these carcases are shipped to this country. 65 66 TABLE 34. Inspections of Food at Wharves, Markets, and other places where Food is stored, and the action taken by the officials during the year 1928. INSPECTION OF WHARVES, &c. FOOD EXAMINED, &c. WARD OR DISTRICT. 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 237 57 294 343 - - 2 - - - St. Paul's 10 — 16 26 38 - - 1 - — - St. Peter's — 1183 136 1319 1407 - - 2 — — - St. John's — 382 8 390 392 - - 4 — — - Trinity — 24 34 58 63 - - 4 — — - All Saints' — 1 2 3 4 - - - - - St. Michael's 10 622 14 646 650 - - 4 - - - St. Jude's — 79 16 95 89 - - 1 - - - St. George's 5 523 3 531 557 - - 1 - - - Christchurch 498 68 1 567 867 - 2 21 - - - St. Saviour's 600 - - 600 978 - - 201 - - - By M.O.H — - - - - - - - - - - Brought to Town Hall — - 11 11 11 - - 10 - - - Total 1123 3119 298 4540 5399 4 2 251 - - - 67 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER. At the end of the year 1927 the number of milksellers on the Registers were as follows:— Retail 357 names 348 premises Wholesale 39 „ 39 „ During the year 1928, 62 applications respecting 62 premises were received for registration as Retail Milksellers. Two applications respecting two 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. 62 62 55 55 — — 62 62 The sale of milk was started afresh at 19 premises The sale of milk was discontinued at 12 „ Total number of Milksellers on Retail Register at end of 1928.. 364 Total number of Milksellers' premises „ „ .. 355 Wholesale Register. Entered in Register. Removal from Register. Not Registered. (Unsuitable, &c.) Total Applications. Names. Premises. Names. Premises. Names. Premises. Names. Premises. 2 2 4 4 — — 2 2 The sale of milk by wholesale was newly started during 1928 at 1 premises Do. do. discontinued at 3 „ 68 Total number of Wholesale Milksellers on Register at end of 1928 37 Total number of Wholesale Premises „ 37 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. One of these samples did not comply with the requirements of the Order. Total number of Licences to sell graded Milk 31 viz.:—Certified 5 premises. Grade A (TT) 11 „ Grade A 3 „ Pasteurised 9 „ Supplementary 2 „ (Certified & Grade A (TT). Licences to sell "Graded "Milk. During the year 31 applications to sell "graded" milk were received from various firms, as under:— (1) Two applications from the Express Dairy Company, Ltd., of 26, Tavistock Place, W.C.1, to sell (a) "Certified" and (b) " Grade A (Tuberculin Tested)" milk at or from No. 12, St. George's Road, Southwark. (2) Seventeen applications from the United Dairies (London), Ltd., to sell (a) "Grade A," (b) "Certified," (c) "Grade A (Tuberculin Tested) " milk at or from each of their premises : No. 62, Borough High St. No. 64, Camberwell Road. „ 1/3, New Street, and (d) to sell " Pasteurised " milk at or from each of their premises: No. 62, Borough High St. No. 207, Newington Butts. „ 64, Camberwell Road. „ 91, Southwark BridgeRd. „ 262, East Street. „ 18, Villa Street. „ 1/3, New Street. „ 38, Westmoreland Road. (3) Three applications from Messrs. E. Ash and Son, of 41 and 41a, Alvey Street, Walworth, to sell (a) "Pasteurised," (b) " Certified" and (c) to bottle and sell "Grade A (Tuberculin Tested)” milk at or from their premises: No. 41, Alvey Street, Walworth. 69 (4) One application from Mr. D. C. Griffiths, of 25, Deacon Street, Walworth, to sell "Grade A (Tuberculin Tested)" milk at or from his premises : No. 25, Deacon Street, Walworth. (5) One application from Mrs. M. E. Jones, of 16, Pilgrimage Street to bottle and sell "Grade A (Tuberculin Tested)" milk at or from her premises: No. 16, Pilgrimage Street. (6) One application from Mr. John Jones, of 3, Old Kent Road to sell "Grade A (Tuberculin Tested)" milk at or from his premises: No. 3, Old Kent Road. (7) One application from Mr. Daniel Jones, of 224, Southwark Bridge Road, to sell " Grade A (Tuberculin Tested) " milk at or from his premises : No. 224, Southwark Bridge Road. (8) One application from Mr. J. R. Lewis, of 150, Blackfriars Road, to sell "Grade A (Tuberculin Tested)" milk at or from his premises: No. 150, Blackfriars Road. (9) One application from Mr. Evan Jones, of 120, Trafalgar Street, Walworth, to sell "Grade A (Tuberculin Tested)" milk at or from his premises: No. 120, Trafalgar Street, Walworth. (10) One application from Mr. G. O. Wynne, of 16, Pilgrimage Street, to bottle and sell "Grade A (Tuberculin Tested)" milk at or from his premises: No. 16, Pilgrimage Street. (11) Two applications from Mr. J. J. Rowling, of 52a, Walnut Tree Walk, Lambeth, for supplementary licences to sell (a) "Certified" and (b) "Grade A (Tuberculin Tested)" milk from his vehicles in the Borough of Southwark. Inquiries were duly made, and it was ascertained that the Producers who supplied the milk in question were holders of the necessary corresponding licences. The 31 licences applied for were accordingly issued by the Council. 70 MILKSELLERS. 1,783 inspections of the various milkshops, dairies, etc., were made. The following nuisances were discovered, in respect to which 9 intimation notices were served:— Dirty condition of walls 7 cases Dirty condition of ceilings 7 cases Dirty condition of floors 2 cases Defective paving 1 case Defective utensils 2 cases Defective ceiling 1 case Total 20 cases Of the 355 Retail Milksellers' premises, 292 are Dairies. In 52, milk is sold in containers, as received by the seller, and in 11 the milk is sold for consumption on the premises only. RAG FLOCK ACTS, 1911 and 1928. There are several premises in the Borough where Rag flock is used in the course of the manufacture of bedding, etc., which have been visited from time to time, but no specimens were taken during 1928 for analysis. 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 Fat melters J. Ewen & Son. Harrow Street Skin Dressers Messrs. Leeding & Co. Wansey Street Works Soap Boilers J. Lewman. Eleven 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 449 inspections were made of the various bakehouses and factories. The following defects were discovered and 33 intimation notices were served in order to obtain the abatement of the nuisances complained of:— Dirty ceilings 21 cases Dirty walls 21 cases Dirty floors 1 case Food or flour store dirty 8 cases Dirty dressing room 2 cases Defective walls 2 cases Defective floors 4 cases Food improperly stored 1 case Defective ceilings 3 cases Dog in bakehouse 1 case Other insanitary conditions 28 cases Total 92 cases All the above-mentioned nuisances were remedied. Each bakehouse was limewashed or the walls washed as required. 72 PARTICULARS OF BAKEHOUSES. Position. Good. Fair. Not satistactory. Not in use. Totals. Above ground 11 33 3 14 61 Underground 11 16 1 8 36 Factories 3 2 - - 5 Totals 25 51 4 22 102 One Bakehouse was demolished during the year. BUTTER AND MARGARINE FACTORIES, &c. 14 Inspections of the Butter Factories were made, and 1 intimation notice was served "To unstop drain." The cleansing was carried out as required. 25 Samples of Butter were procured and submitted to the Public Analyst for analysis. 3 were certified to be "Not genuine." 25 Inspections were made of Wholesale Dealers in Margarine, and the list brought up to date. Two new Dealers were registered. TOTAL INSPECTIONS DURING 1928. Premises. No. of Inspections. Notices. Intimation. Statutory Milkshops 1783 9 - Bakehouses 449 33 — Tripe Boilers 4 — — Fat Melters 6 — — Butter Factories 14 1 — Skin Dresser 1 — — Wholesale Dealers in Margarine 25 — — Total 2282 43 — 73 SALE OF FOOD AND DRUGS ACTS. During the year ending December 29th, 1,354 "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 District. St. John's District. Trinity Ward. All Saints' District. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Number of Samples taken 155 130 143 136 120 127 143 109 152 79 60 1354 27 of these samples were certified as adulterated a percentage of 2.0. Compared with the previous year, the percentage is the same. 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 1928. The following able 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 District. St. John's District. Trinity Ward. All Saints' District. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. Total. Number of Summonses taken out — — 3 1 2 — — 2 1 — - 9 The proceedings taken before the Magistrates resulted as follows:— Summonses. Convictions obtained on 4 Dismissed on payment of costs 5 Total 9 75 FOOD AND DRUGS ACTS. TABLE 37. Return of Official Samples for the Year ending 29th December, 1928, showing the number taken, and the percentage of adulterated Samples for the year. Article. Number of Samples taken. Adulterated. Milk 504 3 Ground Ginger 1 — Flour 1 — Tea Dust 2 — Coffee 7 — Alum 1 — Bismuth 2 — Cocoa 19 — Sugar 55 — Butter 126 11 Margarine 96 — Dripping 32 1 Lard 58 — Cooking Fat 1 — Beef Suet and Flour 5 — Cake 11 — Cheese 6 — Self-raising Flour 39 — Pea Soup Flour 13 1 Gofa 1 — Cornflour 10 — Bun Flour 6 — Rice 29 — Tapioca 26 — Oatmeal 4 — Carraway Seeds 1 — Sago 2 — Pearl Barley 22 1 Arrowroot 4 — Rolled Oats 5 — Crushed Linseed 6 1 Mixed Spice 3 — Soup 2 — Dough Nuts 1 — Prepared Groats 1 — Milk Pudding 2 — Borax 1 — Celery Salt 1 — Carried forward 1106 18 Percentage of adulterated samples for the year-2.0. 76 Article. Number , of Samples taken. Adulterated. Brought forward 1106 18 Cheese Cakes 4 — Table Jelly 20 — Ground Cinnamon 1 — Custard Powder 7 — Blanc Mange 7 — Lemonade Powder 6 - Curry Powder 4 — Ox Tail Soup 4 — Chicken and Ham Roll 1 — Whisky 8 2 Gin 4 2 Rum 4 1 Brandy 3 — Thick Gravy 7 — Bisto 13 — Mustard 13 — Salt 10 — Pepper 2 — Semolina 2 — Grape Nut 1 — Jam Sandwich 7 — Sweets 3 — Corned Beef 2 — Brawn 10 1 Breakfast Sausage 11 1 Fish Paste 15 — Sausages 4 1 Bicarbonate of Soda 1 — Boracic Powder 3 — Figs 4 — Prunes 7 — Muscatels 1 — Olive Oil 1 — Eucalyptus Oil 1 — Jelly Crystals 1 — Liquorice Powder 1 — Citrate of Magnesia 1 — Oil of Turpentine 1 — Camphorated Oil 1 — Liquid Paraffin 1 — Gravy Salt 8 — Sponge Cake 9 — Cakeoma 4 — Desiccated Soup 1 — Carried forward 1325 26 77 Article. Number of Samples taken. Adulterated. Brought forward 1325 26 Quinine 1 — Raisins 8 1 Sultanas 3 — Fruit Salad 1 — Candied Peel 1 — Glycerine 1 — Condensed Milk, Sweetened (Machine Skimmed) 2 — Apricots 1 — Mixed Fruits 2 — Ground Mace 1 — Currants 2 — Port 3 — Sherry 1 — Ginger Wine 1 — Roast Pork and Stuffing 1 — Total 1,354 27 PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 and 1927. 2 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 and 1927. 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 37) 578 samples were purchased informally by the Inspector through his several agents. The whole of these samples were submitted to the Public Analyst for analysis, with the following result:— TABLE 38. Article. No. of Samples purchased by Agents. Result of Analysis. • Percentage of Adulterated Samples. Genuine. Adulterated. Butter 287 267 20 7.0 Milk 135 127 8 5.9 Vinegar 114 114 — — Sausages 6 4 2 33.3 Brawn 25 23 2 8.0 Beer 6 6 — — Cyder 2 2 — — Ginger Beer 3 3 — — Total 578 546 32 5.5 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. Walter James Wilcox, 190, Old Kent Road. Butter 1,129 30 per cent foreign fat and boracic compounds. Fined £25 and £5 5s. 0d. costs. Rosa Zeigermacher, 143, East Street. Milk 9 8 per cent deficient in milk fat Ordered to pay £1 1s. 0d. costs. Frank Holman, 11/13, Camberwell Road: Sausages 673 300 parts per 1,000,000 sulphur dioxide. Fined 10/- and 10/6 costs. Frank Holman, 11/13, Camberwell Road. Breakfast Sausage 674 90 parts per 1,000,000 sulphur dioxide. Fined 5/- and 10/6 costs. Frank Holman, 11/13, Camberwell Road. Brawn 675 70 parts per 1,000,000 sulphur dioxide. Fined 20/- and £1 1s. 0d. costs. James William Howe, 27, Austral Street. Rum 844 37 degrees under proof. Ordered to pay £2 2s. 0d. costs. Rebecca Mills, 56, West Square. Gin 848 40 degrees under proof. Ordered to pay £2 2s. 0d. costs. H. C. Hay & Co., 16, Great Dover Street. Margarine Found in Butter Factory. Summonses dismissed under the First Offenders' Act, with £10 10s. 0d. costs. H. C. Hay & Co., 16, Great Dover Street. 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. The year 1928 was not a good one in Southwark as regards Infectious Disease, for in addition to an outbreak of Smallpox in which 19 people were attacked, with one death, there was a considerable rise in incidence and mortality from Measles and Scarlet Fever, likewise Summer Diarrhœa. Diphtheria the most prevalent disease in the district showed a slight decline. Southwark is so situated as to be peculiarly liable to have infectious disease brought into the Borough, as tramway and omnibus services from all the suburbs or crowded districts have to pass through it, converging to the Elephant and Castle, before again diverging to cross the various bridges in order to reach their ultimate destination. Again a very large proportion of our poorer inhabitants go annually to the hop fields, where they frequently contract some infectious complaint. Further information as to the prevalence of infectious diseases will be found under each heading. SMALLPOX. There were 19 cases of Smallpox notified during 1928. A small outbreak of this disease occurred in the early part of the year which apparently broke out in the wards of Southwark Hospital. As a result 19 cases were notified with one death, the type was mild on the whole. Eight cases directly occurred in Southwark Hospital and a cleaner from the hospital spread the disease in Chaucer House, Tabard Street, 5 cases being notified from these buildings. Two cases occurred in Rowton House, one in Newington Institution, and one in St. Olave ChambersOne contracted the disease while hopping, and the cause of the other was untraced. All infected premises were disinfected and vaccination offered to all contacts. The epidemic died down during the summer months. SCARLET FEVER. It will be seen by the accompanying table that Scarlet Fever was more prevalent in our district during the year under consideration than since 1925. 133 more cases being notified. The Dick Test has not been utilised. 81 The number of cases notified, and the number of deaths during the last five years were as follows:— Notified. Deaths. 1924 534 10 1925 741 8 1926 519 3 1927 540 1 1928 673 3 DIPHTHERIA. There was a diminution of notified cases amounting to 106 during the year under consideration. Antitoxin is supplied free of charge, and 34 phials of 4,000 units have been supplied to Medical Practitioners in the Borough during the year. The number of cases of Diphtheria notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1924 791 49 1925 905 31 1926 945 32 1927 774 21 1928 668 13 In regard to the Schick Test I submitted a report to the Council in November, 1927, which was printed in my Annual Report for that year. In November, 1928, I submitted a further report in which was embodied a scheme for the establishment of a centre for immunisation against Diphtheria, which scheme was approved and adopted by the Borough Council, and forwarded to the Ministry of Health for their sanction and approval. The scheme as submitted was as follows:— "I beg to submit herewith the details of a scheme for the inauguration of a centre for children and others desirous of taking advantage of the recent introduction of the "Schick" test and immunisation against Diphtheria irrespective of their age, as recommended by the Council at their last meeting. As the testing and immunisation is entirely voluntary on the part of the patient, propaganda through the schools and welfare centres will be necessary to secure success. Posters should be put in prominent 82 places, and leaflets setting out the advantages and objects of immunisation freely distributed. To carry out the actual scheme it will be necessary to utilise a room for the purpose one afternoon a week, and have a medical session of two hours. The Council have a room in Sutherland House on the ground floor admirably suited for the purpose, provided the Ministry of Health will permit its use, and if their sanction is given no expense would be incurred for rent. The services of a doctor with previous experience is essential, and such can be obtained at a fee of 1½ guineas per session. The services of a part-time nurse would also be required. The Ministry of Health state that no "extensive" use should be made of the services of Health Visitors, although in other Boroughs the Ministry allows the services of a Health Visitor for this purpose. A large proportion of the children are sent from the Welfare Centres. The cost of the necessary medical equipment would amount to about £10, and the office equipment to another £10, as certain record cards, etc., would have to be printed. Should the Ministry of Health agree to the use of the room in Sutherland House, and to the scheme as set out above, it would be possible to deal with about 600 cases yearly, for the sum of about £300. I would suggest that if this scheme meets with the approval of the Public Health Committee, it should be submitted to the Ministry of Health for their approval." ENTERIC FEVER. There were two notified cases of Enteric Fever during the year, one of which died. In neither case did investigation succeed in tracing the cause of the disease. Five cases of Paratyphoid occurred but none were fatal. One of these cases, a pupil of St. Olave's School, contracted the disease when visiting Calais. Other cases notified in Birmingham are reported to have contracted it from the same source. 83 The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1924 12 1 1925 6 - 1926 10 3 1927 10 1 1928 2 1 MEASLES. The mortality from Measles was considerably higher than the three previous years, but this was not peculiar to Southwark, as the same increase was common to nearly all the London Boroughs. The severe cases were sent to the hospitals of the Metropolitan Asylums Board. All cases are visited by a Health Visitor who gives advice and instruction, and if necessary, visits them subsequently, but no definite nursing of Measles is undertaken by the Borough Council, as in a previous epidemic no great benefit accrued from adopting this course, and the much better plan is for the children themselves to have proper hospital accommodation and skilled attention. The number of cases notified during the year was 2,431, of these 1,462 were under five years of age, 385 cases were removed to hospital. The number of Deaths from Measles during the last five years were as follows:— Deaths. 1924 77 1925 28 1926 51 1927 27 1928 72 DIARRHŒA. In spite of the hot summer there was less summer diarrhœa than in previous years, and the deaths only amounted to 31, as against 36 in 1927, and 61 in 1926. In Southwark, Summer Diarrhœa is notifiable during the months of July, August and September, and in these three months 92 cases were 84 notified, of which 12 were fatal. Twenty-seven of these cases were admitted to hospital. The increased incidence in the hotter weather is attributable to the decomposition of food, infection carried by flies, and the consumption of contaminated milk and other articles of diet. Much of this is preventable and the teaching at our Welfare Centres should take a great part in continuing to reduce this mortality. Deaths from Diarrhœa during the last five years:— Deaths. 1924 49 1925 58 1926 61 1927 36 1928 31 Twenty-eight of these deaths occurred in infants under two years of age. WHOOPING COUGH. Although the deaths from this disease have diminished during the year 1928 the number is still far too high, and is in a great measure due to the fact that parents do not realise the contagiousness of the disease and the necessity for isolation where possible. They also do not hesitate to take their children in conveyances, or to crowded thoroughfares. Few of them realise the possibly fatal result, in which case they do not take the disease sufficiently seriously in its early stages, and thus prevent serious complications. Seventy-five cases were removed to the M.A.B. hospitals during the year. The number of fatal cases during the last five years were as follows:— Deaths. 1924 17 1925 51 1926 5 1927 30 1928 26 INFLUENZA. The deaths from Influenza during the last five years:— 1924 62 1925 25 1926 24 1927 43 1928 29 85 The deaths from Influenza were fewer than in 1927, there was no great variety in the type, but the after results may be serious and long lasting, particularly in cases of cardiac and nervous complications. The after results are more serious as regards inability to follow employment and invalidism than the primary attack, and this being the case it is essential to take measures to prevent an epidemic whenever possible, and in this connection I have issued the following pamphlet in order that its infectious nature should be more generally understood by the inhabitants of the Borough. INFLUENZA. HINTS AND PRECAUTIONS. We do not know for certain what Influenza is due to, but the infection is readily conveyed from the sick to the healthy. It enters the body through the mouth or nose, and quickly sets up a state of fever. Influenza is particularly infectious during its early stages and while a person who has contracted it is still able to follow his vocation and to mix with other people. Almost everybody, therefore, is exposed to infection at one stage or another of an epidemic. No certain safeguard against the disease is as yet known to exist, and it is important to give attention to the following points during an epidemic wave. PREVENTION. Infection may be guarded against by:— (a) Healthy and regular habits, and avoidance of:— (i) Fatigue, (ii) Chill, (iii) Alcoholic excess, (iv) Crowded meetings and hot rooms, (v) Unnecessary travelling. (b) Good ventilation in working and sleeping rooms. (c) Warm clothing. (d) Gargling from a tumbler of warm wafer to which has been added enough permanganate of potash to give the liquid a pink colour. Use as a mouth wash and gargle the throat night and morning, and specially on returning home after exposure to infection in any crowd or after travelling. (e) Vaccination.—A vaccine against Influenza is available, and any person who wishes to be vaccinated should apply to his medical attendant. The purpose of the vaccine is prevention, 86 and therefore to obtain its value it should be used before an epidemic occurs. It cannot be guaranteed that the vaccine will necessarily protect from attack, but there is reason to believe that, if an attack occurs, vaccination will lessen the risk of complications. Influenza is dangerous mostly because of what may follow it The after effects are often serious and complicated. CURE. In the event of an attack of Influenza, the patient is advised to adopt the following measures with a view to securing a speedy return to health, and the avoidance of relapses and dangerous complications:— (a) At the first feeling of illness, or immediately on a rise of temperature, the patient should leave off work, go home and go to bed, keep warm, and send for the doctor. He should stay in bed till after all fever has gone. (b) On convalescence, the patient should avoid meeting-places and places of entertainment for at least one week after his temperature has become normal. Chill and overexertion during convalescence are fruitful of evil consequences. (c) Recovery should be fully established before return to work. PERSONS NURSING INFLUENZA. (a) The patient should, if possible, occupy a separate bedroom or a bed screened off from the rest of the room. This rule should be observed until the temperature is normal. (b) The patient should be kept warm. (c) All curtains and other articles which prevent free circulation of the air about the patient's bed should, as far as possible. be removed. (d) Inhalation of the patient's breath should be avoided. (e) A handkerchief or other screen should be held before the mouth, and the head should be turned aside while the patient is coughing or sneezing. 87 (f) The hands should be washed at once after contact with the patient. EMPLOYERS. Workers who are obviously ill should be sent or taken home at once. Their continuance at work is bad for them and dangerous to others. OPHTHALMIA NEONATORUM. Twenty-five cases of this disease occurred, as against 21 in 1927. 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. 25 5 20 25 — — — One case was born in St. Thomas's Hospital and treated there. CEREBRO-SPINAL FEVER, ENCEPHALITIS LETHARGICA AND POLIO MYELITIS. Five cases of Cerebro-Spinal Fever were notified during the year, three of which died. Deaths during the last five years:— 1924 3 1925 1 1926 3 1927 4 1928 3 88 Four cases of Encephalitis Lethargica were notified with 2 deaths. Deaths during the last five vears:— 1924 9 1925 5 1926 3 1927 4 1928 2 No cases of Polio-Myelitis or Polio-Encephalitis were notified during the year. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. 334 cases were notified during the year. 203 of these were removed to hospital or infirmary. There were 57 deaths of these notified cases. PUERPERAL FEVER. Ten cases were notified during the year, with 6 deaths. In each case of death the circumstances were investigated by myself and the full facts reported to the Maternal Mortality Committee of the Ministry of Health in accordance with their instructions. All the 10 cases were removed to hospital. PUERPERAL PYREXIA. Fifty-eight cases have been notified. Forty-six were removed to hospital and 12 kept at home. 89 TABLE 40. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1928. Disease. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Males. Females. Total. Cases admitted to Hospital. Total Deaths. Scarlet Fever 5 220 264 107 24 22 25 6 - - - - - 327 346 673 654 3 *Smallpox — 1 — 2 4 3 — — 5 3 — 1 — 15 4 19 19 1 Diphtheria 17 261 224 83 31 21 23 6 2 - — — — 312 356 668 666 13 Memb. Croup 1 1 1 — — - - - - - - - - 2 1 3 3 — Enteric Fever - - 1 - - - 1 - - - - - - 2 — 2 2 1 Paratyphoid — — 1 — 1 2 — — 1 - — — — — 5 5 5 — Puerperal Fever - - - - - 1 4 5 - - - - - — 10 10 10 6 Puerperal Pyrexia — — — — 2 15 29 11 1 - - - - - 58 58 46 Cerebro-Spinal Fever 2 1 1 — 1 - - - - - - - - 1 4 5 5 3 Measles 164 1298 894 51 11 5 5 — 3 - — — — 1177 1254 2431 385 72 Malaria - - — — - - 1 — — - — - — 1 — 1 - - Dysentery - - - - - - 1 - - 1 - - - 2 — 2 1 - Epidemic Diarrhœa 45 44 3 - - - - - - - - - - 55 37 92 27 12 Encephalitis Lethargica — — 1 1 - 1 1 — — - — — — 1 3 4 2 2 Pneumonia 24 69 36 16 17 25 31 46 27 19 20 4 - 222 112 334 203 57 Ophthalmia Neonatorum 25 — — - - - - - - - - - - 10 15 25 5 — Erysipelas 6 3 4 5 7 1 9 18 18 13 5 1 — 45 45 90 — 3 Totals 289 1898 1430 265 98 96 130 92 57 36 25 6 — 2172 2250 4422 2033 173 *The Registrar-General's figure for this disease is 21, but 2 cases were returned as not Smallpox. 90 TABLE 41. CASES OF INFECTIOUS DISEASES. Notified to the Medical Officer of Health for Southwark, during each week of the year 1928. Week Ending. Scarlet Fever Diphtheria. Membranous Croup. Enteric Fever. Cerebrospinal Fever. Small pox. Erysipelas. Puerperal Fever. Malaria. Ophthalmia Neonatorum. Phthisis. Other forms of | Tuberculosis. Measles. Encephalitis Lethargica. Epidemic Diarrhœa. Pneumonia. Dysentery. Puerperal Pyrexia. PolioEncephalitis. Total. 1928 Jan. 7 15 24 1 - - - 2 - - - 7 - 157 - - 6 - - - 212 „ 14 11 19 1 - - - 2 - - - 5 3 99 - - 15 - 1 - 156 „ 21 10 16 - - - - 1 - - - 8 1 80 2 - 7 - 2 - 127 „ 28 10 23 - - - 4 — 1 - 1 11 3 85 — - 4 - 1 - 143 Feb. 4 7 24 - - - 4 4 - - - 7 3 106 1 - 3 - 2 - 161 „ 11 9 21 - 1 - 2 3 - - - 5 — 102 — - 3 - — - 146 „ 18 15 23 - - - 4 4 - - - 4 2 85 — - 5 - — - 142 „ 25 17 23 - - - - 4 1 - 3 9 1 135 — - 5 - 6 - 204 March 3 12 21 - - - - 1 - - 1 6 6 103 - - 12 - - - 162 „ 10 16 6 - - 1 - — - - 2 5 4 135 — - 15 - 2 - 186 „ 17 9 14 - - - - 1 - - — 8 1 89 - - 5 - 1 - 128 „ 24 6 13 - - - - 1 1 - - 8 3 105 - - 10 - — - 147 „ 31 12 14 - - - - - - - 1 6 2 113 — - 11 - 1 - 160 April 7 7 12 - - - - 1 - - — 6 — 73 — - 8 - 1 - 108 „ 14 16 11 - 1 1 - 3 - - — 6 — 97 - - 12 - 2 - 149 „ 21 15 5 - - - - 3 - - 1 9 1 52 - - 8 - - - 94 „ 28 17 11 - - - - - - - - 8 1 59 - - 4 - 2 - 102 May 5 6 4 - - - - 1 - - - 4 1 39 - - 7 - 3 - 65 „ 12 17 9 - - - - 3 1 - 2 9 2 54 - - 12 - 1 - 110 „ 19 14 9 - - - - 1 - - - 11 - 39 - - 11 - 1 - 86 „ 26 8 10 - - 1 1 2 - - — 2 3 43 - - 3 - 3 - 76 91 June 2 10 7 — — — — 1 — — 1 4 4 48 — — 11 — — — 86 „ 9 14 10 1 — — 2 1 — — 1 3 1 70 — — 5 — 1 — 109 „ 16 18 5 — — — 1 2 — 1 2 9 4 61 — — 5 — 3 — 111 „ 23 14 6 — — — — 2 — — 2 7 1 38 — — 2 — 2 — 74 „ 30 12 6 — — — — — — — — 5 1 31 — —. 4 — 1 — 60 July 7 22 10 — — 1 — 1 2 — — 3 3 33 — 2 5 1 — — 83 „ 14 15 15 — — — — 1 — — 1 2 4 27 — 3 9 — — — 77 „ 21 13 10 — — — — — — — — 9 3 20 — 2 4 — 1 — 62 „ 28 12 20 — — — — 1 — — — 8 2 30 — 2 8 — 4 — 87 Aug. 4 10 8 — — — — — 1 — 1 6 1 11 — 4 3 — 1 — 46 „ 11 11 4 — — — — — — — — 4 4 11 — 6 4 — 1 — 45 „ 18 12 4 — — — — 1 — — — 5 1 8 — 1 3 — — — 35 „ 25 8 10 — — — — 2 1 — — 6 2 5 — 14 — — 1 — 49 Sept. 1 12 3 *(1) — — 3 — — — 8 1 6 — 8 4 — — — 46 „ 8 13 12 — *(2) — — 1 — — — 5 2 10 — 9 3 —• 2 — 59 „ 15 20 15 — *(1) — — 2 — — 1 6 — 6 1 12 3 — 2 — 69 „ 22 14 15 — — — — 2 — — — 3 1 6 — 15 2 — — — 58 „ 29 20 14 — — 1 — 2 1 — 1 5 3 4 — 14 4 — 1 — 70 Oct. 6 12 12 — — — 1 3 — — — 9 1 7 — — 9 1 — — 55 „ 13 17 9 — — — — 5 — — — 5 6 8 — — 12 — — — 62 „ 20 17 17 — — — — 6 — — — 5 1 8 — — 9 — 1 — 64 „ 27 22 13 — — — — — — — — 12 2 17 — — 2 — 3 — 71 Nov. 3 10 11 — — — — 5 — — — 2 2 12 — — 7 — 1 — 50 „ 10 15 16 — *(1) — — 4 — — 2 5 — 13 — — 8 — — — 64 „ 17 13 16 — — — — 2 — — 1 7 1 8 — — 5 — — — 53 „ 24 10 20 — — — — 2 1 — — 1 4 7 — — 2 — — — 47 Dec. 1 11 18 — — — — — — — — 7 3 18 — — 3 — — — 60 „ 8 14 10 — — — — 1 — — — 4 3 9 — — 3 — 3 — 47 „ 15 11 16 — — — — 1 — — — 9 — 11 — — 4 — — — 52 „ 22 16 9 — — — — — — — 1 9 5 18 — — 12 — 1 — 71 „ 29 6 15 — — — — 2 — — — 2 — 20 — — 13 — — — 58 Total 673 668 3 7 5 19 90 10 1 25 319 103 2431 4 92 334 2 58 — 4844 *Paratyphoid cases. TABLE 42. Return of Families Admitted into the Council's Reception House during the Year 1928. 1928. Scarlet Fever. Diphtheria. Smallpox. 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 Daw. No. of Families No. of Persons No. of Days. Jan. 7 1 3 6 — — — — — — — — — — — — „ 14 — — — — — — — — — — — — — — — „ 21 1 5 15 1 2 8 — — — — — — — — — „ 28 — — — 1 2 6 — — — — — — — — — Feb. 4 — — — 2 5 15 2 7 35 — — — — — — „ 11 — — — — — — — — — — — — — — — „ 18 1 3 9 — — — — — — — — — — — — „ 25 1 2 6 — — — 1 4 60 — — — — — — March 3 — — — — — — — — — — — — — — — „ 10 1 4 12 — — — — — — — — — — — — „ 17 — — — — — — — — — — — — — — — „ 24 2 7 21 — — — — — — — — — — — — „ 31 — — — 1 3 9 — — — — — — — — — April 7 2 7 25 — — — — — — — — — — — — „ 14 1 3 9 — — — — — — — — — — — — „ 21 3 5 12 — — — — — — — — — — — — „ 28 — — — — — — — — — — — — — — — May 5 — — — — — — — — — — — — — — — „ 12 2 5 15 — — — — — — — — — — — — „ 19 — — — — — — — — — — — — — — — „ 26 1 5 15 1 3 12 — — — — — — — — — June 2 1 2 6 2 6 18 — — — — — — — — — „ 9 1 2 6 — — — — — — — — — — — — „ 16 — — — 1 2 6 — — — — — — — — — „ 23 „ 30 — — — 1 5 15 — — — — — — — — — Crd. fwd. 18 53 157 10 28 89 3 11 95 — — — — — — 92 TABLE 42—continued. 1928. Scarlet Fever. Diphtheria. Smallpox. 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. fwd. 18 53 157 10 28 89 3 11 95 - - - - - - July 7 1 3 9 - - - - - - - - - - - - „ 14 - - - - - - - - - - - - - - - „ 21 3 7 15 - - - - - - - - - - - - „ 28 — - — 1 2 6 - - - - - - - - - Aug. 4 - - - - - - - - - - - - - - - „ 11 - - - - - - - - - - - - - - - „ 18 - - - - - - - - - - - - - - - „ 25 1 2 8 - - - - - - - - - - - - Sept. 1 1 5 15 2 6 18 - - - - - - - - - „ 8 1 2 6 - - - - - - - - - - - - „ 15 2 7 21 1 3 9 - - - - - - - - - „ 22 1 3 6 1 2 6 1 3 6 - - - - - - „ 29 1 3 9 - - - - - - - - - - - - Oct. 6 — — — 1 4 8 1 8 40 - - - - - - „ 13 — — — 2 5 17 - - - - - - - - - „ 20 1 5 15 - - - - - - - - - - - - „ 27 — — — 1 3 9 1 3 9 - - - - - - Nov. 3 — — — — - - - - - - - - - - - „ 10 — — — 1 3 6 - - - - - - - - - „ 17 1 3 12 - - - - - - - - - - - - „ 24 — — — 1 2 4 - - - - - - - - - Dec. 1 — — — 2 9 23 - - - - - - - - - „ 8 1 3 6 1 3 9 - - - - - - - - - „ 15 — — — 1 4 12 - - - - - - - - - „ 22 — — — 2 5 15 - - - - - - - - - „ 29 - - - - - - - - - - - - - - - Total 32 96 279 27 79 231 6 25 150 - - - - - - 93 94 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 6,467. Of this number 3,136 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, as against 2,576 rooms in 1927. 2,692 periodical sprayings of rooms occupied by Phthisical patients were also carried out during the year. 639 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 627 in 1927. Among the total number of disinfections (6,467) it was found necessary to strip 76 rooms. Of these 39 were in relation to the notifiable diseases and 37 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 District. St. John's District. Trinity Ward. All Saints' District. St. Michael's Ward. St. Jude's Ward. St. George's Ward. Christchurch Ward. St. Saviour's Ward. J Total. Disinfected 425 255 272 410 253 334 393 244 280 129 141 3136 Stripped 1 4 3 4 3 10 8 2 3 — 1 39 95 TABLE 44. Bedding, etc., Disinfected and Destroyed after the occurrence of Infectious Disease during the Year 1928. Articles. No. Disinfected. No. Destroyed. Beds 1301 69 Palliasses 669 43 Bolsters 663 21 Pillows 2152 69 Cushions 251 70 Blankets 1055 13 Sheets 797 6 Quilts 671 4 Articles of Clothing, &c. 2234 77 Books 45 — Total 9838 372 40 Cases of Horsehair weighing 2 tons 14 cwts. 3 qrs. 10 lbs. were also disinfected at the Depots. 1 Hamper of Shaving Brushes was destroyed. TUBERCULOSIS SCHEMES. The Borough Council has for some years carried out a scheme for dealing with Tuberculosis, and the cases in Southwark are visited by a staff of specially trained nurses from the Municipal Dispensary, which also is a centre for the treatment of out-patients, and for the examination of suspects or contacts. Through this dispensary also pass all cases who are admitted and discharged from Hospital or Sanatoria. Arrangements are made for the examination of Sputa, X-ray examination and treatment by artificial pneumothorax or ultra-violet rays. The dispensary is under the charge of a Tuberculosis Medical Officer, who is a whole-time officer of the Council. The general supervision of all the notified cases, whether attending the dispensary or not, is carried out by the Public Health Department where the Statutory Register and records of all notified cases are kept. It is interesting to note that since the inauguration by the Borough Council of the above scheme, the notification of new cases and the number of deaths occurring from Phthisis have each diminished by exactly one half. The whole of the above work is under the supervision of the Medical Officer of Health as Administrative Tuberculosis Officer. 96 TABLE 45. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 1st January, 1928, to the 29th December, 1928, 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 — 1 7 5 17 27 36 28 40 21 9 191 239 — 1 — 1 1 112 153 „ Females — 1 2 5 19 19 28 24 10 5 — 113 139 — — — — — 66 81 Non-Pulmonary Males 2 9 11 11 8 3 2 5 2 4 2 59 69 — — 2 2 2 18 22 „ ,, Females 1 10 7 7 4 — 3 3 1 — 1 37 44 — — — — — 9 16 Primary Notifications relate to patients who have not previously been notified in this or former vears, 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 previouslv been notified. Form C. Relates to patients admitted to Sanatoria or Poor Law Institutions. 97 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 1st January, 1928, to the 29th December, 1928, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Cases. Pulmonary Males — — — 1 — 1 3 2 2 — — 9 „ Females — — 1 — 1 — 3 — — — — 5 Non-pulmonary Males 2 — — — — — 1 — — 1 — 4 „ ,, Females — — — — — 1 — — — — — 1 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. 98 DEATHS FROM PULMONARY TUBERCULOSIS. TABLE 47. Showing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions, 1928. 0- 1- 2- 5- 15- 25- 45- 65- 75- All Ages. Males. Females. Total. Number of patients who died at home — — — 2 15 21 31 3 2 46 28 74 Number of patients who died in hospitals, &c. 1 2 — 4 22 47 40 4 — 80 40 120 1 2 — 6 37 68 71 7 2 126 68 194 Of the total number of deaths from Pulmonary Tuberculosis 61.9 per cent. occurred in hospitals or other institutions. 99 TABLE 48. TUBERCULOSIS. Age Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. 0 — 5 1 3 1 2 19 2 12 5 11 18 6 11 10 11 20 — — 15 37 12 37 5 20 47 4 — — 25 70 6 68 3 35 54 8 — — 45 52 3 71 1 55 26 5 — — 65 and upwards 9 3 9 1 Total 319 103 194 36 (1) The ratio of non-notified deaths to notified cases is 1 to 84. Notification, however, still is frequently deferred until the cases are too advanced for beneficial treatment. This, however, is frequently due to the patients themselves not attending the doctor until the disease has progressed too far, or in other cases, particularly in elderly people, the disease is masked by accompanying bronchitis and is not detected until the sputum is examined. All doubtful cases or chronic cases of bronchitis should occasionally have their sputum sent for examination for they may be carriers of the disease and infect others even though they themselves are not too advanced for cure. 100 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. It was not found necessary to take any action under these Regulations during the year. PHTHISIS. TABLE 49. A summary of the cases notified and other particulars in connection therewith during the year 1928. Cases notified during 1928. 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. 319 271 4,430 270 166 2,692 37 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 District. St. John's District. Trinity Ward. All Saints' District. St. Michael's Ward. St. Jude's Ward. St. George's W ard. Christchurch Ward. St. Saviour s Ward. Total. Disinfected 336 295 278 316 184 253 347 218 227 105 133 2,692 Stripped 3 3 1 4 3 6 5 3 4 1 4 37 101 MATERNITY AND CHILD WELFARE. There are in the Borough 8 Municipal Centres, 3 Voluntary and 3 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 Visiter and 9 Health Visitors. 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. The Ante-natal work at the centres is steadily growing and is of great importance, as timely advice is given to expectant mothers as to their own health, the preparations for the coming confinement, and the care of the newly-born infant. This work will greatly expand in future, and special sessions will have to be set aside for it. Hitherto it has been taken as part of the ordinary work of the centres which has limited its scope both as regards the number of patients and the time given to their instruction. An arrangement was entered into between the Borough Council and the Invalid Children's Aid Association, by which the Council undertook part payment for children under 5 years of age sent to Convalescent Homes by the Invalid Childrens' Aid Association, and 67 children were thus assisted to have the necessary treatment and fresh air to restore them to health. During the year 7 children were treated for dietetic diseases at St. Thomas's Hostel, under the arrangement entered into with them. Five children were referred to the Guardians for convalescence. Fifty-seven mothers and babies were sent away for holiday from the Mayor's Fund. Several cases were referred to the Southwark Invalid Kitchens Society for dinners. 102 MATERNITY AND CHILD WELFARE CENTRES. Assistant Medical Officer of Health (Maternity and Child Welfare) Dr. C. Sims. 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). Sutherland House, Sutherland Square. 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). Sutherland House, Sutherland Square. 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. C. Sims. Health Visitor Miss H. Onions (from January 11th to May 12th). Miss W. F. Cleverley (from May 14th). 103 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. 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. C. 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. C. Sims. Health Visitor Miss F. N. Adair. 104 5 CENTRE (partly Municipal and partly Voluntary). 56, Lambeth Road. District served by Centre:—A part of St. Jude's and St. Michael's Wards. Sessions held every Monday and Friday, 2—4.30. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss McCurdy. 6a CENTRE (Municipal). St. George's Dispensary, Pocock Street. District served by Centre:—Christchurch Ward and a part of St. Michael and St. Jude's Wards. Sessions held every Tuesday 10.0—12. 2.0—4.30. Medical Officer Dr. C. 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 Officer Dr. C. 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. 105 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 1928. TABLE 51. Original Visits. Revisits. Visits to AnteNatal Cases. Visits to PostNatal Cases. Visits to Delicate Infants. Visits to Cases of Diarrhoea and Sick Children. Attendances at Welfare Centres. Visits where Mothers were found to be out. Special Visits, &c. Puerperal Pyrexia. Total. Births. Measles. Ophthalmia Neonatorum. Births. Measles. Ophthalmia Neonatorum Mrs. Holland — — — — — — — — — — 386 — 6 — 392 Mrs. Kingsmill 391 456 5 3328 20 — 242 2 — — 105 56 1 6 4612 Miss Johnson 305 258 — 2606 31 — 134 7 — 1 98 198 2 7 3657 Miss Cleverley (from May 14th) 262 283 4 2495 16 120 — — 8 93 384 26 3 3694 Miss Rogers 316 180 4 2387 19 — 95 — — 5 101 306 1 4 3418 Miss Cottrill 335 318 3 2893 41 — 86 3 — 1 99 33 6 5 3823 Miss Saver 256 371 2 2317 280 — 37 — — 11 93 268 35 8 3678 Miss Adair 256 246 4 4013 15 — 140 4 — — 100 8 — 9 4795 Miss Freeth 360 450 5 3020 38 — 135 — — 23 85 73 3 12 4204 Mrs. George 249 361 1 2619 54 — 99 1 — 18 102 196 3 4 3707 Mrs. George (home help) 392 — 45 — 437 Total 2730 2923 28 25678 514 — 1088 17 — 67 1654 1522 128 58 36407 106 107 MATERNITY AND CHILD WELFARE CENTRES. Showing the Attendances at the several Centres and Visits paid to the homes of Mothers and Children by Health Visitors. TABLE 52. St. John. la. St. Mary. lb. St. Paul. 2a. St. Peter. 2b. All Saints. 3a. Lady Margaret. 3b. Crossway. 4a. St. Stephens. 4b. St. Jude. 5. St. Michael. 6a. St. Saviour. 6b. St. George. 6c. Guy's. 7. TOTAL. N umber of Births notified during the year 431 427 275 272 287 299 262 222 314 368 239 130 46 3572 Number of individual Children attending the Centre during year 572 606 455 309 233 280 381 269 427 409 283 90 65 4379 Number of Sessions held during the year 94 94 94 94 94 94 94 92 90 94 88 45 94 1161 Number of new cases attending the Centres during the year:— (1) Expectant Mothers 140 30 132 203 28 30 2 11 49 35 26 1 984 1671 (2) Infants under 1 year 262 424 337 209 189 224 244 155 277 274 223 81 65 2964 (3) Seen by Doctor 256 304 176 120 120 134 176 136 212 186 160 81 65 2126 (4) Children 1 to 5 years 310 182 118 100 44 56 137 114 150 135 60 9 — 1415 (5) Seen by Doctor 42 34 27 26 13 29 40 58 96 51 12 9 — 437 Method of Feeding—(a) Breast 222 330 270 168 170 173 211 128 209 226 199 62 62 2430 (b) Breast and bottle 12 19 23 11 5 27 13 9 32 15 5 8 2 181 (c) Bottle 28 76 43 31 12 19 18 11 30 38 20 10 1 337 (d) Ordinary diet 48 181 119 99 46 61 139 121 156 130 59 10 — 1169 Total number of attendances at the Centres during the year— (1) Mothers 6331 6810 4654 2991 3628 3622 5505 3294 5385 4956 4299 1918 — 53393 (2) Expectant Mothers 379 103 290 448 98 73 26 122 238 123 225 1 3177 5303 (3) Infants under 1 year 3589 4652 2820 1786 2317 2330 2751 1790 2004 2937 2740 1172 886 31774 (4) Children 1 to 5 years 2358 2032 1480 942 1232 1226 2273 1655 1675 1572 1378 1018 697 19538 (1) Average number of attendances 67.4 72.4 49.5 31.8 38.6 38.5 58.6 35.8 59.8 52.7 48.9 42.6 — — (2)„ „ „ 4.0 1.1 3.1 4.8 1.0 0.8 0.3 1.3 2.6 1.3 2.6 — 33.8 — (3) „ „ „ 38.2 49.5 30.0 19.0 24.6 24.8 29.3 19.5 22.3 31.2 31.1 26.0 9.4 — (4) „ „ „ 25.1 21.6 15.7 10.0 13.1 13.0 24.2 18.0 18.6 16.7 15.7 22.6 7.4 — (5) Total number of attendances of Infants seen by Doctor during the year 1051 1844 1076 743 1264 1113 1067 1072 1097 1327 1209 596 886 14345 (6) Total number of attendances of children 1 to 5 years seen by Doctor during the year 346 752 634 372 762 625 678 858 869 735 540 496 695 8362 (7) Total number of Expectant Mothers seen by Doctor 140 31 182 371 23 49 23 30 49 58 28 1 984 1969 (8) Children weighed 4783 6144 4090 2694 3322 3248 5023 2981 3247 4397 3750 2085 1581 47345 (9) Post-natal cases 1402 1547 1424 717 697 1375 837 927 1841 292 1051 315 461 12886 Total number of first visits paid by Health Visitors to homes of— (1) Expectant Mothers 140 181 105 95 70 86 34 138 236 115 77 45 933 2255 (2) Infants under 1 year 466 391 305 262 316 335 256 256 365 360 249 118 35 3714 (3) Children 1 to 5 years 51 — — — — — — — 4 — — 11 — 66 Total number of revisits paid by Health Visitors to homes of— (1) Expectant Mothers 284 61 29 25 25 — 3 2 187 20 22 113 911 1682 (2) Infants under 1 year 1641 1454 1165 996 757 1422 902 2030 1471 1330 1067 1209 603 16047 (3) Children 1 to 5 years 3377 1874 1441 1499 1630 1471 1415 1983 2445 1690 1552 2781 1446 24604 Sewing Classes were held during the year at No. 5 Centre, with a total attendance of 87. „ „ „ under the direction of Mrs. Holland with a total attendance of 441. „ „ „ at No. la Centre, with a total attendance of 373. 108 HEALTH WEEK—OCTOBER 18th to 25th. A successful Health Week was held in the Borough from 18th to 25th October. An Exhibition was also held at Manor Place Baths and opened by His Worship the Mayor of Southwark (Councillor W. F. Castle, J.P.) During the week, lectures and demonstrations were held at the Schools and Welfare Centres, whilst the Centres, Creche, Analytical Department and Tuberculosis Dispensary were thrown open to the public and well attended. The visitors showed great interest, and displayed a desire for knowledge that was gratifying to those who had worked hard to make these branches interesting. The Public Analyst's Department, in particular, had a well-arranged and interesting series of exhibits, and it was visited by 375 persons. The Creche was visited by 36 persons, whose comments in the Visitor's Book were highly favourable. At the Exhibition in Manor Place Baths lectures were given and films shown on various health topics by Dr. King Brown, late Medical Officer of Health of Bermondsey, Dr. Thompson, Medical Officer of Health of Deptford, Professor Leonard Hill, Dr. Crowe, Dr. M. Brodie, Dr. E. Foley, Dr. E. B. Turner, Mr. Fisher and Mr. Syms (Sanitary Inspectors) and myself. The lectures were so well attended that the small hall was insufficient to accommodate the audiences, and many people had to be turned away. The accompanying cinematograph films added to the popularity of the lectures. Cookery demonstrations were given each day at intervals by various bodies, which were highly instructive. The Main Hall of Manor Place Baths was occupied by an Exhibition of interest and educational value, which consisted of Health stalls and Trade stalls. The trade exhibits were all of a high order, and the stalls well set out. The Health exhibits were interesting, and great care had been displayed in equipping them. The Sanitary Inspectors' Infant Welfare and Tuberculosis Departments worked well to provide exhibits, and produced results of the greatest credit. The Model House of Inspectors Mayhew and Ede, the house "as it should not be" of Mr. Bowers, attracted great attention and interest; the attractive models were all well finished, whilst the exhibits and demonstrations by Mr. Syms on flies, Mr. Duffield on diseased meat, and Mr. Banham on smoke, all drew large numbers of people. Great interest was also evinced in the other instructive exhibits shown on the Inspectors' stall. 109 The Tuberculosis Dispensary Staff had made a model which formed the chief exhibit on their stall, showing three rooms for habitation of consumptive patients, a "good" room, a "bad" room, and "making the best of it." Many excellent photographs kindly lent by Sir Henry Gauvain and Dr. Watts were keenly examined, and samples of sputum appliances and paper handkerchiefs were shown. In connection with this exhibit, the "Spero" leather works for tuberculosis soldiers showed some highly finished and excellent work in the shape of bags, purses, etc., whilst the Open Air School for tubercular children at Stowey House had a stall, showing fresh vegetables and flowers grown by them. The Health Visitors' stall was most instructive and the results of competitions for needlework, etc., were displayed there. Some of the articles entered for competition being excellent in quality, and others most original, including several articles made by school children. The fathercraft exhibits were very creditable and considerable originality was shown in fashioning cradles from banana crates, and chairs for children from disused perambulators, model furniture and home-made cots. On Thursday, 25th October, the Countess of Birkenhead officially opened the new Welfare Centre at Sutherland House. The Exhibition was a very successful one, over 27,000 persons, including 300 school children daily, visited it, and great credit is due to the Chairman and Members of the Public Health and Maternity and Child Welfare Committees, the organiser, Dr. Sims, and the helpers from the various departments by whose effort the success of the Heath Week was accomplished. 110 BACTERIOLOGICAL SPECIMENS. Number of specimens examined by the Public Analyst 2,708 Positive results 414 PRESERVATIVES IN FOOD. 1936 Samples of Foods and Drugs, both formal and informal, have been examined by the Public Analyst. Nearly all these samples have been tested for preservatives, as the practice in the Public Analyst's department is to examine for preservatives all articles of food which experience has shown are liable to contain them. Details of the above matters are given in full in the reports sent by the Public Analyst to the Ministry of Health in each quarter of the year. Cyril Dickinson, Public Analyst. APPENDIX. Borough of Southward. ANNUAL REPORT of the Tuberculosis Medical Officer for the YEAR 1 928. J. T. CROWE, L.S.A., L.M.S.S.A. (London), Tuberculosis Medica Officer 112 BOROUGH OF SOUTHWARK. Tuberculosis Dispensary, 82-84, Newington Causeway, S.E.I. 11th March, 1929. 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 1928. The work of the Dispensary has been carried on on the same lines as in previous years. The Staff remains the same, viz.:—a Secretary-Dispenser and three Nurses; to all of whom I would like to give a word of praise for their enthusiasm and devotion to duty. During the year 222 patients were recommended for Sanatorium treatment under the London County Council Scheme and 60 doubtful cases were recommended for admission to Brompton and other hospitals for observation. The two Open Air Schools for Tuberculous Children, viz., Nightingale House, Bermondsey, and Springwell House, Clapham Common, are still taking a large number of the children from our Borough and are doing splendid work. We still make great use of the Contact (children of Tuberculous infectious cases living at home) Scheme of the London County Council by boarding-out either in the country or in convalescent homes, the Scheme being worked by the Invalid Children's Aid Association in conjunction with the London County Council. The Ministry of Pensions New Regulations are working well, and very close relationship is maintained between myself and the Area Deputy Commissioner of Medical Services. Twenty-eight pensioners were recommended for Sanatorium treatment, besides a considerable number recommended for treatment at home by private practitioners, and also a large number attended the Dispensary regularly. 113 Tuberculin has again been used in a number of cases of a surgical nature with very fair results. A certain number of cases have been sent for Artificial Sunlight treatment to the Guy's Hospital Light Centre under the arrangement between our Council, the L.C.C. and the Guy's Hospital Authorities, but I am sorry to say the results have not come up to expectations, as owing to the poor food and bad accommodation at their homes, the patients do not get the advantages of the light treatment which they would do if they were in Residential Institutions ; as this form of treatment was only being tried experimentally for two years, I am given to understand it will cease on and from 31st March, 1929. But the special form of Finsen Light is to continue for cases of Lupus. Under a new Scheme of the L.C.C., all patients now going to Sanatorium are given a free Railway Voucher for their fare, and if they stay as long as the L.C.C. wish them to do and they do not discharge themselves against the advice of the Medical Officer of the Institution, they receive a Voucher for their railway fare home, whereas previously the majority of the cases had to pay their own fares except in a few cases where the patients were so badly off that they could not possibly afford it. A number of doubtful cases (29) of Tuberculosis have been sent to Guy's Hospital for X-Ray examination, which has been very useful as a help to diagnosis. Several patients attend Brompton Hospital for the purposes of refills for Artificial Pneumothorax and are making very good progress. 452 specimens of sputum were examined by the Borough Analyst's Department. Extra nourishment was granted to 55 patients. The Nurses paid 3,795 visits to the patients' houses, and have done a great amount of propaganda work. The Invalid Children's Aid Association has, as in previous years, been most helpful to us in arranging for Convalescent Treatment for delicate children and for working the aforesaid Contact Scheme in conjunction with the L.C.C. The Charity Organisation Society has also given us great help in the way of getting adult delicate (non-Tuberculous) patients into 114 Convalescent Homes, and providing clothing for patients going to Sanatoria. The Red Cross Society and the United Service Fund have also given us very great assistance in numerous ways. During the year the Borough Health Week and Exhibition was held at the Manor Place Baths and the Dispensary had a stall which was one of the centres of attraction during the week, where also a great amount of propaganda work was done by the Nurses, who worked very hard for its success. Lectures were also given and Films shown. The relationship between the London County Council, the Ministry of Pensions, the private practitioners and the Hospitals has been most cordial. I append Tables and Statistics of the work done during the year. 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 Sanitary Inst.), S.R.N. F. C. Rogers (C.M.B.), S.R.N. F. K. Jay (C.M.B.), S.R.N. 115 TABLE A. Total number of persons examined for the first time, 820 — Insured Persons 353 Males 218 Females 135 Non-Insured Persons 467 Males 25 Females 116 Males 178 Females 148 Total 820 TABLE B. Patients found to be suffering from Pulmonary Tuberculosis, 196:— Insured Persons 143 Males 98 Females 45 Non-Insured Persons 53 Males 7 Females 35 Males 7 Females 4 Total 196 TABLE C. Patients suffering from Non-Pulmonary Tuberculosis, 37:— Insured Persons 6 Males 1 Females 5 Non-Insured Persons 31 Males 5 Females 2 Males 16 Females 8 Total 37 116 TABLE D. Cases (including contacts) found Non-Tubcrculous, 535:— Insured Persons 183 Males 109 Females 74 Non-Insured Persons 352 Males 12 Females 69 Males 141 % Females 130 Total 535 TABLE E. Total attendances of patients:— Insured Persons 3,334 Non-Insured Persons 1,712 Total 5,046 TABLE F. Number of examinations of patients:— Insured Persons 860 Non-Insured Persons 722 Total 1,582 TABLE G. The following cases were recommended to the London County Council for treatment (Insured Persons):— Sanatorium 161 Hospital 36 Home for Advanced Cases 2 Hospital for observation 26 Convalescence 3 Total 228 117 TABLE H. The recommendations to the County Council for Institutional treatment were as follows (Non-insured Persons):— Sanatorium 61 Hospital 19 Open Air School 34 Convalescence 11 Home for Advanced Cases 6 Hospital for observation 34 Total 165 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 2,133 Non-Insured Persons 1,662 Total 3,795 TABLE J. Patients discharged during the year:— Insured. Non-Insured. Cured 33 50 Arrested 25 32 Guardians 2 1 "In statu quo" . . 17 13 Moved away 32 16 Transferred to other districts 22 12 Ceased attending 24 20 Transferred to Domiciliary treatment 59 Transferred to Institutions 6 13 Non-Tubercular 186 354 Open Air School — 14 School Supervision — 6 Refused Treatment 3 — Too ill to attend 1 — Private Practitioner — 9 Totals 410 540 118 TUBERCULOSIS CARE COMMITTEE. The work of the Tuberculosis Care Committee is to see all people recommended by the Tuberculosis Officer to the L.C.C. for Sanatorium or Hospital treatment, and such other people attending the Borough Tuberculosis Dispensary who need special help or advice. In 1928, 235 adults and 92 children were recommended to the L.C.C. for Institutional treatment. In the case of ex-service men, discharged from the Army or Navy with pensions for Tuberculosis, they are provided for by the Ministry of Pensions or referred to the Red Cross and they do not come before the Committee. Our Committee has no funds except a fund for extra nourishment, granted by the Ministry of Health, so when help is needed it has to be obtained from various societies with whom we co-operate closely. During 1928 the United Service Fund helped 36; Soldiers' and Sailors' Help Society 28; Charity Organisation Society 18. Many of the cases were receiving Poor Law Relief. In 7 cases the Guardians supplied these people with clothes. The Society for Relief of Distress helped 5; Society of St. Vincent de Paul 1; Royal Naval Benevolent Trust 3; and various Regimental Societies 9; Church Army 1. Help was obtained in 5 cases from private individuals. Some of the forms of help given are clothes to wear during the period of treatment. Provision for the care of children when the mother is away. Allowances to families when the father is away. Pocket money for people with no resources going to Sanatoria. Invalid dinners on their return and temporary allowances while looking for work. All cases are visited on their return home. When their means allow it, the heads of families are asked to contribute towards the cost of treatment. These contributions are collected in adult cases by the Hon. Organiser, and in children's cases by the two Branches of the I.C.A.A., with whom we co-operate closely. During 1928 the relations of 69 adults and 29 children contributed weekly sums, varying from 1/6 to 20/-. If any change occurs in the circumstances of the contributor during the time of treatment, the L.C.C. is at once communicated with and the contributions excused or altered. 119 TABLE L. Death rate from Pulmonary Tuberculosis for Southwark compared with the year 1927:— 1927. Southwark 1.06 per 1,000 1928. Southwark 1.07 TABLE M. Notification of fresh cases of Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1189 1919 911 775 653 634 639 685 579 494 1920 1921 1922 1923 1924 1925 1926 1927 1928 415 430 444 424 427 336 363 343 319 TABLE N. Deaths from Pulmonary Tuberculosis:— 1912 1913 1914 1915 1916 1917 1918 1919 345 359 330 388 391 392 381 311 1920 1921 1922 1923 1924 1925 1926 1927 1928 243 262 249 231 260 192 199 197 194 TABLE O. Cases referred to Hospitals:— Insured. Non-insured. South London Hospital 1 3 Guy's Hospital 12 10 Royal Waterloo Hospital — 2 St. Thomas's Hospital — 4 Brompton Hospital 1 — Charing Cross Hospital — 1 Southwark Hospital 27 13 Totals 41 33 Number of Patients sent to Hospital for Special Treatment:— X-Ray 29 Light Treatment 7 Artificial Pneumo-Thorax 3 Total 39 120 TABLE P. Sexes of new cases of Pulmonary Tuberculosis:— Males 112 Females 84 196 TABLE Q. Patients still attending the Dispensary on December 31st, 1928:— Insured Persons 361 Non-Insured Persons 182 543 TABLE R. Sources of cases:— Insured. Non-insured. Doctors 98 17 Hospitals 15 9 School Medical Officer — 2 Nurses 2 15 Contacts 2 5 Returned from Institutions 2 3 Returned from Sanatoriums 3 11 Invalid Children's Aid Society — 2 London County Council 7 6 Transferred from other Dispensaries 10 2 Own Account 10 11 Infant Welfare — 1 Totals 149 84 TABLE S. Contacts examined:— Found Tuberculous 8 Found Non-Tuberculous 353 Total 361