Journal Rebird Co. Ltd. Unit 4, Pier wharf Grays, Essex AC4374 LIBRARY S0454 METROPOLITAN BOROUGH OF SOUTHWARK. INTERIM REPORT of the MEDICAL OFFICER OF HEALTH Relative to the work of the Health Services Department during the year. 1944 W. Stott, M.B., B.S., D.P.H. Medical Officer of Health. Health Services Department, walworth Road, S.E.17. Health Services Department, Walworth Road, S.E.17. November, 1945. To His Worship the Mayor, Aldermen and Councillors of the Metropolitan Borough of Southwark. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1944, which in its abridged form is similar to former war-time reports. The health of the population generally has been fairly good, there having been no serious epidemics. During the latter half of the year, however, the civilian population were once more called upon to endure the weight of enemy air attack in the form of flying-bombs and rockets, but whilst the Borough probably did not suffer to the same degree as some of its immediate neighbours, it had a goodly share of this new form of attack, which did considerable damage to houses, the blast effect being much greater than that formerly experienced with high explosive bombs. In spite of these trials however the morale of the inhabitants remained good, although there is no doubt that towards the end of the year people were beginning to feel worse for wear. The birth rate shewed an increase over that recorded for 1943, being 19.4 per 1000 population as against 18.3, and was higher than that for England and Wales and the County of London, the respective rates being 17.6 and 15.0. The infant mortality rate shewed a slight increase over the previous year, rising from 49 to 51 per 1000 live births. The general death rate at all ages and from all causes rose from 18.8 to 21.7 per 1000 population, which was greater than that for the country as a whole 11.6 and also that for the County of London 15.7, but it must be remembered that included in this figure are the deaths of civilians resulting from enemy action. Although the birth rate is higher than that recorded pre-war, nevertheless there has been no natural increase in the population owing to the death rate being still higher. The statistics in relation to infectious diseases are low, but it is extremely difficult to assess the value of these figures or to obtain a true view-point with a floating and diminished population and with only a few schools functioning. The figures in respect of the notification of diphtheria are noteworthy in the fact that there were only 24 cases during the whole year with one death attributable to this disease. The interesting point is that in all the cases save four, the children had not been immunised, and vhilst parents stated that these four children had been immunised during the time they were evacuated, I have been unable to obtain proof of this fact, so that it is extremely doubtful if any of the notified cases had been protected against diphtheria. The number of cases of scabies remained heavy, but as I forecast in my 1943 report, I felt that the climax had been reached; this year there was a drop of nearly 3000 attendances for this condition at the Treatment and Bathing Station. The Sanitary Inspectors Department became seriously depleted in numbers, which unfortunately, it has not been possible to make good, the Ministry of Health having disapproved of any -1- further appointments being made, owing to both the shortage of sanitary inspectors and the present depleted state of the Southwark population. I have much pleasure in tendering my best thanks for their support and co-operation, to the Chairman and Members of the Committees on which I serve, to the Chief Officers of the Council and to the whole of my staff. I am, Mr. Mayor, Ladies and Gentlemen, Yours obediently, W. STOTT. Medical Officer of Health. -2- VITAL STATISTICS, 1944, ESTIMATED CIVILIAN POPULATION - 67,220. LIVE BIRTHS Males Females Total Legitimate 627 573 1200 Illegitimate 56 49 105 683 622 1305 Live Birth Rate:-19.4 per 1000 population. STILL-BIRTHS Males Females Total Legitimate 10 20 30 Illegitimate - 3 3 10 23 33 Still-birth Rate:- 24.7 per 1000 total births. DEATHS Males Females Total 822 638 1460 Death Rate:- 21.7 per 1000 population. MATERNAL DEATHS Rate per 1000 Deaths Live & Still Births. From puerperal sepsis 1 0.75 Other puerperal causes - 0.00 INFANT DEATHS Death Rate All infants - per 1000 live births 51 Legitimate infants - per 1000 live legitimate births 51 Illegitimate infants - per 1000 live illegitimate births 57 OTHER DEATHS Deaths Measles (all ages) 1 Cancer (all ages) 208 Whooping Cough (all ages) 5 Diarrhoea (under 2 years) 11 - 3 - CLASSIFICATION OF DEATHS The causes of death (822 males and 638 females) were as follows:- Cerebro-spinal fever 2 Whooping Cough 5 Diphtheria 1 Tuberculosis of the respiratory system 111 Other forms, of tuberculosis 9 Syphilitic diseases 23 Influenza 11 Measles 1 Acute infective encephalitis 2 Cancer 208 Diabetes 7 Intra-cranial vascular lesions 86 Heart diseases 315 Other diseases of the cirulatory system 78 Bronchitis 99 Pneumonia 75 Other respiratory diseases 9 Ulcer of stomach or duodenum 20 Diarrhoea 11 Appendicitis 5 Other digestive diseases 20 Nephritis 26 Puerperal sepsis 1 Premature Birth 13 Congenital malformations and birth injuries 17 Suicide 5 Road Traffic accidents 11 Other violent causes 196 All other causes 93 Total deaths at all ages 1460 Age Groups Under 1 1 to 4 5 to 14 15 to 44 45 to 64 65 and over Total Males 43 11 9 96 245 418 822 Females 24 6 13 82 170 343 638 67 17 22 178 415 761 1460 Infant Mortality. The total number of deaths of infants under one year of age was sixty-seven, the causes of death being as follows -4- Cerebro - spinal fever 1 Whooping Cough 4 Influenza 1 Measles 1 Bronchitis 1 Pneumonia 12 Diarrhoea 10 Other digestive diseases 1 Premature birth 13 Congenital malformations and birth injuries 14 Other violent causes 7 All other causes 2 Total deaths of infants under one year of age 67 MATERNAL MORTALITY. The death of one woman due to puerperal sepsis was recorded. Maternal Mortality Rate:- 0.78 per 1000 live and still births. HOME NURSING. During the year the nursing of sick children and home confinement cases and infectious disease was under taken by the Catholic Nursing Association and the Southwark, Newington and Walworth District Nursing Association. District nursing of similar cases was also commenced by the Ranyard Nurses on the 1st July, 1944. The number of visits made by these associations were as follows:- Catholic Nursing Association 293 Southwark, Newington and Walworth District Nursing Association 983 Ranyard Nurses (as from 1st July) 124 Total visits 1400 The method of payment in respect of this visiting was made on a ‘capita’ basis in lieu of an annual grant made in former years. HOME VISITING. The Health Visitors made visits to the homes of expectant mothers, infants and toddlers, as follows:- Villa Street Manor Place Lorrimore Hall (From 14.2.44) Larcom Street. Pocock Street Crossways Lambeth Road Guy's Hospital Total. First Visits Expectant Mothers 198 155 314 158 185 40 157 290 1497 Infants under 1x 230 188 272 227 168 87 112 74 1358 Revisits Expectant Mothers 82 219 403 148 116 70 161 449 1648 Infants under 1 2228 1509 2385 2438 2030 310 873 565 12338 Children 1-5 3309 1469 3187 3319 2317 250 1126 3282 38259 Total 6047 3540 6561 6290 4816 757 2429 4660 35100 x - includes 28 visits in respect of still-births. -5- WELFARE CENTRE ATTENDANCE. Owing to there-commencement of enemy air attack during daylight, the attendances at the infant welfare centres in the middle of the year fluctuated very considerably for a while, but became more stable towards the end of the year. The attendances were as follows:- Villa Street Manor Place Lorrimore Hall (From 14.2.44) Larcom Street Pocock Street Crossways Lambeth Road Guy's Hospital Total Infants under 1. 3297 1464 2095 1336 1543 1063 1186 1121 13605 Children 1-5. 72 588 723 797 748 710 1499 912 6698 Infants seen by doctor 990 493 569 847 628 353 737 472 5089 Children 1-5 seen by doctor 362 207 277 376 335 247 862 512 3178 ANTE-NATAL CLINICS. Ante-natal examinations (including post-natal examinations) were conducted at two municipal and two voluntary clinics during the year. 842 expectant mothers made 4281 attendances. 907 women attended for post-natal examination. PREMATURE INFANTS . Following upon the receipt of a Circular from the Ministry of Health arrangements were made for one of the Council's Health Visitors to receive special training in the care of premature infants, and to meet the need for proper care of these infants after discharge from hospital, special equipment was purchased, and provision for the supply of expressed breast milk was made with one of the London hospitals. Notification of birth cards were withdrawn from midwives and doctors, and amended to include the birth weight of infants in cases where this was 5½ lbs, or less. All local hospitals were requested to notify me immediately upon the discharge from hospital of premature infants. Notifications in respect of 10 infants under 5½ 1bs. weight were received, but information was not available in many instances where children were born outside the London area. CHILD LIFE PROTECTION. At the end of the year there were 11 foster mothers and 11 foster children on the Council's register. Seven women were registered as foster mothers during the year. One foster mother and child returned to the Borough after being evacuated. Four instances came to light where children were being kept illegally without registration, but in each case it was satisfactorily proved that the omission to register was due to ignorance of the law and not to wilful contravention. In -6- one case it was necessary for a foster child to be removed to an Institution as the parent was unable to continue payments to the foster mother. In another case a foster child was found in a common lodging house and was subsequently removed to the care of a foster mother in another Borough. The names of three foster mothers were removed from the register. Several foster children were evacuated but subsequently returned to the district. In accordance with the Ministry of Health's request that the Council should consider the introduction of a guaranteed payment scheme to foster mothers in respect of children under 5 years of age, this was commenced during the year, but although wide publicity through the medium of the press, labour exchanges and infant welfare centres, was given to* the scheme, only one application for registration was received. Such a poor response to the Council's appeal for foster-mothers was undoubtedly due to the prevailing demand for female labour in industry, women preferring to obtain employment outside the home at wages much higher than they would obtain as foster mothers, rather than accept responsibility for the care of children by night and day in their own homes. Generally, the health of foster children remained good and some 170 visits were paid to them by the Child Life Protection visitor, HOME HELPS. Despite the many difficulties in obtaining suitable women willing to work as Home Helps, it was possible in 20 cases to provide this service. An application was made early in the year to the Ministry of Labour for women who were prepared to undertake these duties, but none were available from this source. In a few instances it was not possible to provide home helps, but this was generally due to late application for assistance by the patient. WAR-TIME NURSERIES. At the close of the year there were three war-time nurseries in Southwark, one of which was operated by the London County Council in conjunction with its Rest Centre Service. Owing to the small attendance of children at the Evelina Nursery, Southwark Bridge Road, and to a request from the Governors of the Hospital for possession of that part of the hospital used as a nursery, it was closed dcwn, with the approval of the Ministry of Health on 30th September, the staff being transferred to a nursery at Trimdon near Durham. The health of the children at the nurseries was generally good and a satisfactory attendance was maintained. The greatest difficulty experienced was in connection with staffing, but this was by no means local in character, the same problems being met in most of the other London Boroughs. The following is a summary of the average daily attendances at nurseries under the control of the Council:- Jan. Feb. Mar . Apl . May Jun. Jul. Aug. Sep. Oct. Nov. Dec. Crossways 46 39 35 34 40 31 15 16 23 37 40 39 Bishops House 67 71 63 61 69 57 36 30 35 49 58 58 Evelina 34 40 36 36 43 29 10 5 - - - - -7- WOMEN'S COUNTRY HOLIDAY FUND. Eleven women and eleven children were sent for convalescent treatment under this scheme. SOLARIUM - HEALTH SERVICES DEPARTMENT. During the year 364 children under the age of five years received treatments in the Solarium at the request of the Council's Medical Officers. The total attendance was 1736. The treatments given were principally in respect of general debility, vitamin deficiency, bronchitis following teething, debility after infectious disease and cases where general progress was poor. EXTRA NOURISHMENT. The Invalid Kitchens of London under arrangements made with the Council supplied 218 dinners to children, necessitous, expectant and nursing mothers upon the reommendation of the Council's Medical Officers. DENTAL CLINIC. There was a good attendance of patients at the Dental Clinic although renewed enemy activity was considerable in the latter part of the year. There were some 106 new patients who made a total of 516 attendances. VACCINATION. The total number of certificates and copies of certificates of successful primary vaccination received during the year 1944 was Northern Division 341 Southern Division 508 849 SANITARY CIRCUMSTANCES OF THE AREA. A considerable amount of sanitary work was carried out during the year and nuisances as they arose were dealt with by the sanitary inspectors. A number of nuisances were directly attributable to enemy action, the Borough having received a fair amount of damage in the fly-bomb attacks. ??? visits to air raid shelters were also carried out by the inspectors and disinfestation work arranged in instances where verminous ??? were found. SANITARY WORK House to House inspections 6 Member of inspections upon complaint 2,834 Number of miscellaneous inspections 1,222 Number of ??? shelters 1,626 Number of inspections of war damaged property 2,841 Inspections of factories 1,391 -8- SANITARY WORK (continued) Number of visits to outworkers 219 Inspections of shops 19 Visits re billeting 206 Inspections of common lodging houses 71 Inspections of bedding stores 10 Revisits 12,051 Intimation notices served 1,555 Statutory notices served 557 Defects found and remedied 4,042 PUBLIC HEALTH (LONDON) ACT, 1956 - Section 122. Action was taken in one instance under this Section of the Act for the purpose of the removal and destruction of verminous and offensive articles to health, HOUSING. From June onwards when the enemy commenced fly-bom and rocket attacks, many families who had returned to the Borough from reception areas, again hastily departed, and in consequence a number of them, who were badly overcrowded, lost the opportunity of accepting offers of re-accommodation made by the London County Council. In consequence only 7 families were rehoused on the grounds of overcrowding, involving 55 persons in all. Twelve families were re-housed by the London County Council on urgent medical grounds. Many other medical cases had the misfortune to have their homes damaged and were re-housed by the Billeting Officer, Apart from the cases already mentioned a considerable number of cases were dealt with under Ministry of Health Circular 2845 and were passed to the Billeting Officer for rehousing, HOUSING ACT, 1936-Section 9. Action was taken under the above Section in respect, of the following properties:- 11, 15, 15, 17, 19, 21, 25, 25, 27, 29, 51, 55 and 55 Gaywood Street. HOUSING ACT, 1956-Section 12. Closing Orders in respect of underground rooms and parts of buildings were made under this Section as regards the following premises:- 45, Dolben Street 59, West Square. INSPECTION AND SUPERVISION OF FOOD. Constant attention was given to inspection of food in the Borough, Large quantities of foodstuffs are now being handled at the riverside wharves, all of which received regular attention. Food factories, dairies, eating houses and other food premises were visited throughout the year and instructions given where necessary. On a number of occasions arrangements have been made for the -9- disposal of sound food which for various reasons became unsaleable in the shops. Such food was directed for use in canteens or for manufacturing purposes. All food found to be unsound was disposed of to the best advantage of the community. The total quantity found to be unsound was 105 tons, 18 cwts. and 2 1b3. The Department continued to work in friendly co-operation with the Salvage Department of the Ministry of Pood and with the Southwark Food Control Committee. MORTUARY AND CORONER'S COURT. The following is a statement of the work of the Mortuary and Coroner's Court during the year 1944, which was nearly 50% greater than in the previous year:- Post-mortems conducted without inquest 648 Post-mortems conducted with inquest 235 Inquests held - Post-mortems conducted elsewhere 71 Bodies accommodated for convenience 6 Total 960 COMMON LODGING HOUSES . There are 4 lodging houses for women in Southwark with a total of 252 beds but one has been so extensively damaged by enemy action that it is temporarily closed. Two others were badly damaged but continued to take in some lodgers while repairs were being effected. A new licence was granted to one common lodging house allowing two more beds than the previous number. In two of the lodging houses the standard of cleanliness and lighting were poor, tut notices were served and defects remedied. 64 visits were paid during the year. There are also two large men's lodging houses in the Borough with a bed capacity of 776, which during the year were periodically visited by the male sanitary inspectors, a fair standard of sanitary condition being maintained at each. FACTORIES ACT, 1957. The factories in the Borough, many of which were engaged upon work of national importance, were visited at frequent periods to ensure that a good standard of cleanliness and hygienic condition was adhered to, particularly as many factories were working upon extended hours and, in a number of instances, on night work. Generally the sanitary condition of the factories was good, but where this was not up to standard, notices were served and conditions improved. In those cases where the inspectors noted a lack of the welfare provisions, and other offences under the Act, due notice was sent to H.M. Inspector of Factories drawing attention thereto. With few exceptions, female labour was employed at all the factories and 733 visits by the Council's Woman Health Officer were made to each such factory, who served some 49 notices in respect of nuisances. This officer also paid 219 visits to the homes of outworkers in the Borough. Other visits to factories made by district sanitary inspectors numbered 658. RODENT DESTRUCTION. In the early part of the year following upon a Direction made under the Infestation Order, 1943, and served on the Council by the Ministry of Pood, requiring the Council to undertake the wholesale destruction of rats and mice in the Borough, a scheme was prepared and put into -10- operation, which involved the appointment of a number of temporary staff and the careful planning of infested areas. VERMINOUS PERSONS. During the year there was a total attendance of 13,766 persona for bathing and treatment. Of this number 5,915 treatments were given to school-children in accordance with the Council's Agreement with the London County Council. 7,851 treatments were given to persons sent by various local practitioners, hospitals, and common lodging houses. The following amount of work was undertaken:- Scabies Men Women Children Total 1st Quarter 541 1681 988 3210 2nd Quarter 290 1161 761 2212 3rd Quarter 273 905 593 1771 4th Quarter 438 1373 874 2685 Total 1542 5120 3216 9878 Cleansing of Verminous Persons Men Women Children Total 1st Quarter 81 59 734 874 2nd Quarter 109 44 539 692 3rd Quarter 138 524 791 1453 4th Quarter 139 95 635 869 Total 467 722 2699 3888 The following table shows the classification of adults whose treatments are included above Scabies Vermin Cases Treatments Cases Treatments Southwark residents 1544 3097 586 607 Lambeth residents 1799 3565 127 138 Government Evacuation Scheme 444 cases received preventive treatment. VERMINOUS PREMISES. The Council's disinfecting staff treated the following premises in the Borough, consequent upon verminous conditions being found:- 1st Q. 2nd Q. 3rd Q. 4th Q.  Number of rooms treated 148 455 330 95 1028. Premises found to be infested 515 (1028 rooms) Premises disinfested 515 (1028 rooms) L.C.C. dwellings found infested 4 (7 rooms) L.C.C. dwellings disinfested 4 (7 rooms) Borough Council dwellings found infested 2 (5 rooms) Borough Council dwellings disinfested 2 (5 rooms) Apart from a peculiar prevalence of fleas during the summer months the year was not marked as one when insect infestation was abnormally heavy. -11- VERMINOUS BEDDING DISINFESTED. Disinfested Destroyed Beds 107 18 Palliasses 2105 17 Bol sters 51 8 Pillows 2590 41 Cushions 336 14 Blankets 13367 6 Sheets 142 2 Quilts 111 2 Pieces of clothing etc. 83015 427 Total 101824 535 In addition 20 cwts, of household effects and 2 cwts, of rubbish were destroyed. DISINFECTION. The total number of disinfections of rooms during the year was 290. Of this number 269 were disinfected after the occurrence of the ordinary notifiable infectious diseases and 21 after cases of pulmonary tuberculosis. DISINFECTION OF DEEDING - INFECTIOUS. Disinfected Destroyed Beds 86 Palliasses 103 2 Bolsters 69 Pillows 329 2 Cushions 48 Blankets 380 Sheets 167 Quilts 146 Articles of Clothing 537 3 Books 145 - Total 2010 7 POOD & DRUGS ACT, 1938 - ANALYSIS OP SAMPLES Samples Examined Adulterated Formal Informal Formal Informal Milk and Milk Products 288 30 3 1 Oils , Fats , etc. 67 95 1 Meat and Meat Products 39 100 3 7 Canned and Potted Poods 19 97 2 3 Fruit and Vegetables, Canned etc. 20 29 2 Preserves, Jams, Jellies, etc. 47 11 Cereals and Cereal Preparations 87 99 3 5 Bread, Flour and Confectionery 84 16 3 2 Wines, Spirits and Boverages 69 59 3 8 Condiments, Spices, Sauces, etc. 84 147 7 8 Drugs and Medical Preparations 29 121 1 5 Miscellaneous Samples 38 79 1 Total 871 1030 25 40 Percentage of samples adulterated - 3.42. -12- FOOD & DRUGS ACT, 1933 - LEGAL PROCEEDINGS. Defendant Cause of Proceedings. Result. Batger & Co. Ltd., 566 Cable Street, E.1. Selling Plum Jam containing 30 parts per million excess of sulphur dioxide. Discharged P.O.A. Lewis Selwood, ''Queen Elizabeth" Public House, 42 Merrow Street, S.E.17. Selling Gin 38 degrees under proof. Fined £2, and 2 guineas costs. Albert G. Turner, "Duke of Clarence" Public House, 154 Manor Place, S.E.17. Selling Gin 37 degrees under proof. Fined £2. and 5 guineas costs. Evan J. Davies, “Duke of Clarence” Pub1ic House, 154 Manor Place, S.E.17. Selling Gin 37 degrees under proof. Fined £2. F. H. Gill & Sons, 22 Bronti Place, S.E.17. Selling Vinegar 22% deficient in acetic acid. Discharged P.O.A. 5 guineas costs. MILKSELLERS. At the close of the year there were 185 registered, retailers and wholesalers in the Borough, whilst the number of retailers and wholesalers purveying milk in the Borough but registered elsewhere was 43. MILK (SPECIAL DESIGNATIONS) ORDERS, 1956-43. -1 Applications were received and Dealers Licenses were granted authorising the use of the special designation "Pasteurised" in 22 cases whilst Dealers Licenses authorising the use of the special designation "Tuberculin Tested" wore granted to 8 applicants. Ten supplementary licenses in respect of "Pasteurised" milk and seven in respect of "Tuberculin Tested" milk were granted to dealers selling from premises outside the Borough, principal licenses having been issued by the appropriate licensing authorities in each case. PHARNACY & POIS0NS ACT, 1933. During the year visits were made to the various premises listed by the Council for the sale of Part 2 Poisons under the above Act. Instructions were given when necessary and the requirements of the Act were carried out. There were 46 names of persons on the Council's List of Sellers of Part 2 Poisons at the end of the year. -13- NOTIFICATION OF INFECTIOUS DISEASES. The notifications of infectious diseases received during the year numbered 1273, 596 being males and 677 females. The total number of cases admitted to the London County Council's fever hospitals was 386. Males Females Total Admitted to Hospitals. Scarlet Fever 87 72 159 131 Diphtheria 11 13 24 24 Paratyphoid 1 1 1 Puerperal Fever 3 3 3 Puerperal Pyrexia 10 10 10 Cerebro-spinal Fever 3 1 4 4 Scabies 227 286 513 Measles 74 82 156 61 Whooping Cough 108 128 236 66 Malaria 5 - 5 2 Dysentery 13 15 28 28 Epidemic Diarrhoea 12 7 19 16 Pneumonia 40 35 75 22 Ophthalmia Neonatorum 3 8 11 2 Erysipelas 13 15 28 15 Polio-encephalitis - 1 1 1 Total 596 677 1273 386 There were 8 deaths from infectious diseases as follows:Cerebro-spinal fever 1; Whooping Cough 5; Diphtheria l; Measles 1. DIPHTHERIA IMMUNISATION. Immunisation against diphtheria was carried out in the Council's Clinics and by general practitioners in accordance with the Council's scheme for doctors. The total number of children who completed a course of preventive injections during the year was 511 of whom 423 were under the age of 5 years. TUBERCULOSIS. Primary Notifications. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Total including duplicate notifications. Pulmonary Males - 4 3 2 9 15 13 14 14 17 11 - 102 113 Pulmonary Females - 3 2 3 17 22 18 6 5 2 5 - 83 99 Non-Pulm, Males - - 2 3 - 2 1 2 - - - - 10 11 Non-Pulm, Females - - - 1 2 2 1 1 - 2 - - 9 10 Total - 7 7 9 28 41 33 23 19 21 16 - 204 233 New Cases and Deaths. New Cases Deaths Age Group Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary 0- — - - - 1- 8 - 1 - 5- 10 6 2 - 15- 74 8 10 1 25- 43 2 17 - 35- 28 3 12 - 45- 23 - 25 - 55- 23 2 22 - 65- 21 - 25 - Total 230 21 114 1 TREATMENT OP TUBERCULOSIS. 1. Number of cases on Dispensary Register 1st January 1944 1001 2. Number of cases transferred from other areas and cases returned after discharge under head 3 in previous years 28 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of." 53 4. Cases written off during the year as dead (all causes) 70 5. Number of attendances at Dispensary (including contacts) 7013 6. Number of consultations with medical practitioners: (a) Personal (b) Others 76 517 7. Number of visits by Tuberculosis Officers to homes (including personal consultations) 35 8. Number of visits by nurses or health visitors to homes for dispensary purposes 2022 9. Number of (a) specimens of sputum etc. examined (b) X-ray examinations made in connection with dispensary work (i) Screenings ) (ii) Films ) 628 2964^1 10. Number of "recovered" cases restored to Dispensary Register and including A (a) and A (b) in following table - 11. Number of "T.B. Plus" cases on Dispensary Register on 31st December 1944 453. -15- TREATMENT OP TUBERCULOSIS. 1944. DIAGNOSIS PULMONARY. NON-PULMONARY TOTAL GRAND TOTAL. Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A. New cases examined during the year (excluding contacts) (a) Definitely tuberculous 51 54 7 6 2 5 3 - 53 59 10 6 128 (b) Diagnosis not completed 39 28 13 4 - 1 - 1 39 29 13 5 86 (c) Non-tuberculous 113 78 7 17 — - - - 113 78 7 17 215 B. Contacts examined during the year (a) Definitely tuberculous 6 2 - 1 - 6 2 1 9 (b) Diagnosis not completed 11 7 7 6 - - _ - 11 7 7 6 31 (c) Non-tuberculous 48 79 32 42 •* ! 48 79 32 42 201 C. Cases written off the Dispensary Register as (a) Recovered 6 — _ 3 2 1 4 — 8 1 4 3 16 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 1 - 1 - - - - - 1 - 1 - 2 D. Number of cases on Dispensary Register on 31st December. l i ; (a) Definitely tuberculous 517 407 71 65 27 23 6 5 544 430 77 70 1121 (b) Diagnosis not completed 50 35 20 10 - 1 2 1 50 36 22 11 119