Ac43 Sou 55 METROPOLITAN BOROUGH OF SOUTHWARK. ANNUAL (A bridged) REPORT of the MEDICAL OFFICER OF HEALTH Relative to the work of the Health Services Department during the year 1945. 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. October, 1946. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Southwark. Mr. Mayor, Ladies and Gentlemen, The year under review has seen a change from war to peace and many difficulties have arisen in consequence, particularly the shortage of houses and suitable accommodation for people returning from reception areas and from the Armed Forces. There is no doubt that the housing difficulty will have to be faced for some little time to come, an inevitable fact in a Borough which has been so badly damaged and devastated as the result of enemy action. In spite of the war and the difficulties which presented themselves in the latter half of the year, the health of the Borough has been particularly good. The Infant Mortality Rate is noteworthy in that it has fallen to 39 per 1000 births, which is the lowest figure ever recorded in the Borough. Forty years ago the infant mortality figure was in the neighbourhood of 200 per 1000 births. Infectious diseases have been slight and only one death occurred as - result thereof and that was due to cerebro-spinal meningitis. The throe nurseries maintained by the Ministry of Health were carried on throughout the year, although a serious handicap was the recruitment of suitable staff. At no time was there a complete staff at all the nurseries, although the children's accommodation was full. In conformity with the request of the Ministry of Health a drive was made to obtain Homo and Domestic Helps, but in spite of the efforts made by the Authority with the co-operation of the Ministry of Labour the campaign was unsuccessful. The X-ray unit installed during the year in the Tuberculosis Clinic has enabled the medical staff to produce chest pictures of more detail and accuracy than in the past, and there is every hope that it will materially assist in the nation-wide fight against Tuberculosis, I have much pleasure in tendering ray best thanks for their support and co-operation to the Chairmen 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. - 1 - VITAL STATISTICS, 1945. ESTIMATED CIVILIAN POPULATION- 71,160. LIVE BIRTHS Males Females Total Legitimate 613 557 1170 Illegitimate 77 58 135 690 615 1305 Live Birth Rate - 18.3 per 1000 population. STILL-BIRTHS Males Females Total Legitimate 10 23 33 Illegitimate 2 - 2 12 23 35 DEATHS Males Females Total 645 502 1147 Death Rate:- 16.1 per 1000 population. MATERNAL DEATHS Deaths Live & Still Births Rate per 1000 From puerperal sepsis Nil Nil Other puerperal causes 1 0.75 INFANT DEATHS Death Rate. All infants - per 1000 live births 39 Legitimate infants - per 1000 live legitimate births 43 Illegitimate infants - per 1000 live illegitimate births 7 OTHER DEATHS Deaths Measles (all ages) Nil Cancer (all ages) 194 Whooping Cough (all ages ) Nil Diarrhoea (under 2 years) 10 - 2 - CLASSIFICATION OF DEATHS. The causes of deaths (645 males and 502 females ) were as follows:- Cerebro-spinal fever 1 Tuberculosis of the respiratory system 89 Other forms of tuberculosis 8 Syphilitic dideases 13 Influenza 7 Acute infective encephalitis 1 Cancer 194 Diabetes 7 Intra-cranial vascular lesions 89 Heart diseases 260 Other diseases of the circulatory system 55 Bronchitis 109 Pneumonia 71 Other respiratory diseases 9 Ulcer of stomach or duodenum 17 Diarrhoea 10 Appendicitis 3 Other digestive diseases 20 Nephritis 15 Maternal Causes (other than puerperal sepsis) 1 Premature Birth 17 Congenital malformations and birth injuries 14 Suicide 7 Road Traffic accidents 11 Other violent causes 50 All other cruses 69 Total deaths all ages 1147 Age Groups. Under l. 1 to 4. 5 to 14. 15 to 44. 45 to 64. 65 & over. Total. Males. 30 12 6 68 179 350 645 Females. 21 4 8 52 119 298 502 51 16 14 120 298 648 1147 Infant Mortality. The total number of deaths of infants under one year of age was Fifty One, the causes of death being as follows:- Syphilitic Diseases 1 Pneumonia 7 Diarrhoea 8 Premature birth 17 Congenital malformations and birth injuries 13 Other violent causes 4 All other causes 1 Total. 51 MATERNAL MORTALITY. The death of one women due to causes other than puerperal sepsis was recorded during the year. -3- MATERNITY AND CHILD WELFARE CENTRES VILLA STREET MANOR PLACE LORRIMORE HALL LARCOM STREET POCOCK STREET CROSSWAY LAMBETH ROAD GUY'S [###/]TOTAL Showing the Attendance at the Several Centres and visits paid to the homes of Mothers and Children by Health Visitors. TABLE Number of Births notified during the year 222 101 277 277 194 138 108 133 1450 Number of individual children attending the Centres during the year. 393 244 585 457 370 328 415 273 3065 Number of Sessions held during the year 99 50 106 100 98 49 94 96 692 Number of children 1-5 age group attending during the year Number of new cases attending the Centres during the year 241 172 380 273 223 205 239 188 1921 (1) Expectant Mothers (Ante Natal Clinics) 446 154 49 472 1121 (2) Post Natal Cases (Including Ante-Natal Clinics) 206 1 194 266 48 — 171 129 1015 (3) Infants under 1 year 199 96 229 231 166 170 92 102 1285 (4) Seen by Doctor 199 96 229 231 166 170 92 102 1285 (5) Children 1 to 5 years 61 23 62 66 33 46 48 33 372 (6) Seen by Doctor 61 23 62 66 33 46 48 33 372 Method of feeding (a) Breast 135 41 132 140 52 107 59 75 741 (b) Breast and bottle 20 12 34 23 9 19 6 9 132 (c) Bottle 52 25 41 57 53 27 19 16 290 (d) Ordinary diet 53 41 84 77 85 63 56 35 494 Total number of attendances during the year:- (1) Expectant Mothers (Ante Natal Clinics) seen by Doctor 1384 582 157 3092 5215 (2) Post Natal Cases (including Ante-natal Clinics) 206 1 197 272 48 _ 181 129 1034 (3) Infants under 1 year 2563 1296 3389 2799 2038 1761 1450 1299 16595 (4) Children 1 to 5 years 1048 690 1335 1065 882 702 1527 935 8184 Average number of attendances (Infants under 1) 26.0 26.0 31.9 28 .0 20.8 35.8 15.4 13.5 " " " " (Children 1-5) 10.6 13.8 12.6 10.60 9.0 14.3 16.2 9.6 (5) Infants seen by Doctor during the year 1154 403 741 1297 920 766 859 637 6777 (6) Children 1 to 5 seen by Doctor during the year 497 201 394 437 428 388 844 559 3748 (7) Number of weighings recorded (children) 3491 1901 4654 399 3 3506 2997 2789 2319 25650 Total number of first visits paid by Health Visitors to homes of (1) Expectant Mothers 293 123 312 213 241 170 152 188 1692 (2) Infants under 1 year 222 101 277 277 194 138 108 133 1450 Total number of re-visits paid by Health Visitors to homes of (1) Expectant Mothers 59 198 505 137 174 135 154 327 1689 (2) Infants under 1 year 2227 917 2406 2459 2233 961 923 600 12726 (3) Children 1 to 5 years 3369 1169 3182 2922 2336 3022 1366 2185 19551 NOTIFICATION OF BIRTHS. Mothers confined. Live Births. Still Births. Total. BORN AT HOME AND ATTENDED BY Midwives. 389 386 7 393 Private Doctors. 1 1 - 1 BORN AT HOSPITALS In the Borough. 122 125 1 126 Outside the Borough. 927 916 12 928 BORN AT OTHER ADDRESSES. 2 2 — 2 TOTALS. 1441 1430 20 1450 HOME NURSING. During the year, the nursing of sick children and home confinement cases and infectious disease was undertaken by the Catholic Nursing Association, Southward, Newington and Walworth District Nursing Association and Renyard Nurses. The number of visits rade by these associations were as follows:- Catholic Nursing Association. 501 Southwork, Newington and Walworth District Nursing Association. 992 Ranyard Nurses. 445 Total Visits. 1938 PREMATURE INFANTS. The number of premature babies notified during 1945 was as follows:- Born at Home. 16 Born in Hospital. 32 Total. 48 BORN AT HOME Nursed entirely at home 13 Died during the first 24 hours Survived at end of first month 12 BORN IN HOSPITAL Died during the first 24 hours 1 Survived at end of first month 29 HOME HELPS. There were three part-time Home Helps on the register, and 20 cases were helped during the year under review. WOMEN'S COUNTRY HOLIDAY FUND. Nine women and nine children were sent for convalescent treatment under this scheme. - 5 - DAY NURSERIES. There are three Day Nurseries under the control of the Council in the Borough, and the following is a summary of the average daily attendances during the years:- Jan. Feb. Mar. Apl. May. Jun. Jul. Aug. Sep. Oct. Nov. Dec. Bishop's House. 45 50 55 62 66 68 63 63 62 67 66 68 Crossways. 35 39 30 38 45 44 43 39 43 44 42 41 St. George's. - - - - - - - - 19 26 25 25 Early in July the London County-Council intimated that it would cease to control the St. George's Nursery, Westminister Bridge Road, on the 31st August, 1945. The Ministry of Health, however, stated that arrangements had been made for the Requisition Notice under which the premises were held by the London County Council, to be transferred to this Authority and requested the Council to assume authority for the management of the Nursary on behalf of the Ministry, as from the 1st, September, 1945, and that in future the number of nursery places would be increased from 25 to 60. SOLARIUM -HEALTH SERVICES DEPARTMENT. During the year 334 children under the age of five years received treatments in the Solarium at the request of the Council's Medical officers. The total number of attendances was 1779. extra nourishment. The Invalid Kitchens of London, under arrangements made with the Council, supplied 201 dinners to children, necessitous, expectant and nursing mothers upon the recommendation of the Council's Medical Officers. DENTAL CLINIC. There was a considerable increase in the number of now patients compared with the previous year due in a largo measure to the decrease in enemy air activity. The attendances wore as follows:- New Cases. Expectant Mothers 79 Nursing Mothers 35 Pre-school children 87 199 The total number of attendances was 1056. VACC INAT ION. The total number of certificates and copies of certificates of successful primary vaccinations received during the year 1945 was:- Northern Division 322 Southern Division 608 TOTAL. 930 - 6 - % child life protection. At the end of the year there were 14 registered Foster Mothers caring for 15 Poster Children. Early in the year the only Foster Mother who was under the guaranteed payment Scheme had to give up the care of the Foster Child because of domestic reasons. No other applications from Foster Mothers were received during the year although many were received from persons wanting Foster Mothers. Several of the Foster Mothers are not receiving payment as they do not come within the scope of the guaranteed payment scheme because the Mother is not resident in Southwark. Three unregistered mothers were found and one who had returned to Southwark from evacuation without notifying her change of address. No proceedings were taken. Six new Foster Mothers were registered, and four names were removed from the register. Although the conditions in most of the homos wore poor, the health and well being of the children has been generally satisfactory. 170 visits were paid, SANITARY CIRCUMSTANCES OF THE AREA. Summary of work carried out under the public Health and Factory Act during the year:- Inspections upon complaints being received. 3988 Miscellaneous Inspections. 1787 Inspections of Air Raid Shelters. 356 Inspections of War damaged properties. 1413 Inspections of Factories. 1086 Visits to Outworkers 421 Re-housing visits. 434 Inspections of Shops. 51 Inspections of Common Lodging Houses. 45 Inspections of Bedding Stores, 1 Re-visits. 12393 Intimation Notices served, 1421 Statutory Notices served, 417 Defects found and remedied. 3999 PUBLIC HEALTH ACT, 1936 - LEGAL PROCEEDINGS. A summons was obtained in one instance against an owner of property for failure to abate a nuisance, and was withdrawn on the payment of £1.1,0. costs, owing to the fact that the necessary work had been carried out prior to the hearing. PUBLIC HEALTH ACT, 1945 - SECTION 122. A certificate was issued under the above Section for the destruction of bedding in such a filthy, dangerous and unwholesome condition that health was endangered thereby, and that the destruction of such bedding was necessary to prevent the rick of infectious disease. PUBLIC HEALTH ACT, 1936 - SECTION 224. A certificate was issued under the above Suction for the removal of an aged and infirm women to a hospital or other suitable place. PUBLIC HEALTH ACT, 1936 - SECTION 95. Certificates as to habitability were issued in respect of 76, newly erected premises. - 7 - inspection and supervision of food and food premises. Systematic inspection of the food supplies in the Borough was made during the year, The riverside wharves received regular visits and large quantities of food were examined. Cold Storago Depots were also visited and considerable quantities of meat and bacon were inspected both during landing at the rivor3ido and at routine examinations. Promises where food is prepared or deposited for the purpose of sale wore visited during the year, including food factories, eating houses and dairies. Directions to remedy defects were given in several cases. Arrangements were made for the use of a number of parcels of food, found unsuitable for retail trade, in canteens and for nonufac turing purposes. Food found to be unfit for human consumption amounted to 60 tons, 3 cwts and 46 lbs. This was disposed of for the most suitable use. The Department continued to work in full co-operation with the Ministry of Food Salvage Department, 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 1945:- Post-mortems conducted without inquest. 571 Post-mortem conducted with inquest. 309 Inquest hold - Post-mortem conducted elsewhere. 80 Bodies accommodated for convenience. 1 961 COMMON LODGING HOUSES . There are six Common Lodging Houses in the Borough, four being women's and two men's. The women's Houses provide for 252 beds and the men's 776, Three of the Houses which were badly damaged by enemy action, were still not weatherproof at the end of 1945, although repairs had been effected. the standard of cleanliness was generally improved during the year, and although it was necessary to serve several Notices under the Public Health Act, the defects were remedied promptly. Forty-five inspections were made during the year. FACTORIES ACT, 1937. Regular routine visits were paid to all factories in the Borough and more frequent interim visits where necessary. Many minor defects were remedied after verbal notice was given, but where more serious defects were found Notices were served and Licences issued. The general standard was good, and in most cases the defects were duo to War damage and the difficulty of obtaining labour and materials for repair and maintenance. There were many instances of friendly co-operation between the Council's Officers and H.M. Inspector of Factories, With few exceptions, female labour was employed at all the factories, and 391 vists were made by the Council's Women Health Officer, who served some 20 Notices in respect of nuisances. This Officer also paid 1.43 visits to the homes of outworkers in the Borough. Other visits to factories made by the District Sanitary Inspectors numbered 69. and 278 visits wero made to the homes of outworkers. -8- RODENT CONTROL. DOMESTIC DWELLINGS. BUSINESS PREMISES. VISITS. Rodent Officer. 64 236 Investigators. 319 1165 Operatives. 2841 2588 Drains tested. 259 64 Drains found defective. 106 22 Drains repaired. 50 9 Drains opened up for examination. 43 2 Other preventive work. 1 3 Premises reported infested. 611 17 6 Premises freed of rodents. 341 12 6 Pre-baits. Poison Baits. Totals . Bodies recovered. Business Premises 27046 7636 34682 1271 Domestic Dwellings. 187 3663 3850 123 BLOCK SCHEME. The northern part of the Borough has been surveyed end divided into areas end the treatment carried out has been in accordance with the formula laid down by the Ministry of Pood. Areas A and B consist of that part of the Borough bounded on the north by the river. On the east by the Blackfriars Road, on the south by the Cut, and on the west by Hotfields and Br or dwell. Area C is bounded on the north by Bankside, on the west by the Blackfriars Road, on the oast by Southwark Bridge Road, and on the south by Union Street. The following resume indicates the work done:- 1. Promises treated and cleared. 68 2. Promises inspected and found free. 246 3. Premises empty. 104 4. Pre-baits laid. 9087 5. Poison Baits laid. 2567 Work on Area D commenced on December 3rd. This Area includes the Borough Market. 89 Stands and shops were treated and cleared, and 3 premises inspected and found free. 166 Notices were served on occupiers. SEWERS. Half-yearly maintenance treatment of sowers was carried out in Juno and November with the following results;- June. November. 1. Manholes Poison-baited. 677 7 27 2. Manholes not baited for technical reasons. 81 104 3. Estimated kill. 10356 9213 - 9 - TREATMENT &. BATHING CENTRE, KING- JAMES STREET. During the year there has been a slight drop in the number of actual cases occurring among adults resident in the Borough. The routine visiting of cases and contacts who have failed to attend for treatment has been maintained and the Health Visitor made 451 original visits. The incidence of scabies among L.C.C. School children showed a slight increase during the year. The routine methods of treatment, other than those controlled by the L.C.C., Education Department, have been Benzyl Benzoate treatments, followed by medical examination seven days or more after the date of the last treatment. In this connection, 54 medical sessions were held at the Centre and. 1087 cases were examined. These were either discharged or referred back for further treatment. Secondary ailments incident to Scabies have been successfully treated before discharge or sent for hospital treatment. Disinfection of the personal clothing of all cases is carried out by moans of electrical sterilization. TREATMENT OF VERMINOUS PERSONS. There has been a steady increase among the male patients and a reduction in the number of female patients and school children. The following figures indicate the principal sources from which verminous cases were received:MALES. Rowton House. One in Southwark and one in Lambeth. 215. Salvation Army Hostel - Southwark only. 205 Casuals. 68 A.R.P. Shelters. 20 Marshalsea Road Common Lodging House. 20 Morning Post Home. 4 Embankment Fellowship, Lambeth. 4 FEMALES AND YOUNG CHILDREN. 83, Blackfriars Road, Common Lodging House. 14 78, Camberwell Gate. 8 Cecil House. 12 Elizabeth Baxter Hostel. 7 Church Army Hostel. 5 A.R.P. Shelters. 5 INFECTIOUS DISEASE. Owing to the inadequate staffing of the L.C.C., Fever Hospitals, admission of cases of Scarlet Fever and Measles were restricted to cases where serious complications had arisen or whore the home conditions were unsuitable. It is interesting to note that despite this change of the general policy in regard to Scarlet Fever there has been no evidence of dissemination of the disease. Fifty eight cases of Scarlet Fever were treated at home. The return of Service personnel from overseas ports where Small-pox was prevalent led to cases occurring on H.M. Transports. The Local Authority of the district is responsible for keeping in touch with the various contacts, who were allowed to proceed to their home address for the full period of incubation. 57 visits wore made in this connection. GENERAL DISINFECTION AND DISINFESTATION. Disinfestation of verminous premises was carried out at the request of the District Sanitary Inspector and re-housing Officer. In general it may be stated that bug infestations were remarkably low and that the bad cases occurred in rooms occupied by aged and infirm persons who were not receiving adequate care and attention. Towards the end of the year the Council was able to obtain a supply of D.D.T. Insecticides. The introduction of this method of vermin repression gave rise to changes in general procedure. Formerly a contact insecticide was used and results were judged by the actual kill. D.D.T. has a delayed action value extending over a period of many months; the kill is not instantaneous. It is not possible, therefore, at the present time, to offer any conclusive evidence of its effectiveness. -10- treatment and bathing station king james street. annual report for year ending 29th december 1945. treatment of scabies. lambeth. southwark. total. men. women. men women. 1st: Quarter. 177 695 217 618 1707 2nd: quarter 131 509 150 505 1295 3rd. quarter . 124 478 137 493 1232 4th. quarter . 162 513 165 663 1503 totals. 594 2195 669 2279 5737 number of actual cases . men. women. total. lambeth residents. 321 1196 1517 south wark residents. 345 1098 1443 TOTALS. 666 2294 2960 l.c.c. school children. 1st. quarter. 849 2nd: quarter. 697 3rd. quarter. 647 4th. QUARTER . 1532 total. 3725. treatment of verminous persons. lambeth. southwark. total. men. women. MEN. women . 1st. quarter. 24 36 156 41 257 2nd. quarter. 17 26 137 46 226 3rd. QUARTER. 16 39 130 76 261 4th. quarter. 2 38 112 55 207 TOTALS. 59 139 535 218 951 number OF actual cases. 53 124 535 210 922 L.C.C. SCHOOL CHILDREN VERMINOUS. 1st. QUARTER. 528 2nd. QUARTER. 502 3rd . QUARTER . 426 4 th. QUARTER . 519 total. 1975 SUMMARY OF TREATMENTS. SCABIES VERMINOUS. TOTAL. MEN. (Lambeth & Southwark). 1263 594 1857 WOMEN. do. 4474 357 4831 l.c.c. school children. 3725 1975 5700 TOTALS. 9462 2926 12388 TREATMENT OF VERMINOUS BEDDING & EFFECTS. QUARTER . bed. PALL. BOLS . PILL. CUSH. blankts. sheets. QUILTS pieces. 1st. 98 500 30 591 75 2567 48 60 22218 2nd. 31 572 12 197 12 1097 20 20 17534 3rd. 15 33 5 44 7 1963 18 9 15745 4th. 11 86 15 79 6 65 8 4 19813 totals. 155 1191 62 911 100 5692 94 93 75310 destroyed 17 11 5 14 3 2 - - 131 4 Rugs & 10 cwts of household effects. TREATMENT OF INFECTIOUS BEDDING & EFFECTS . 1st. 14 33 4 58 4 118 19 14 116 2nd. 13 35 9 79 13 82 32 27 66 5rd. 16 31 11 65 6 81 31 27 103 4 th. 8 12 4 60 - 75 38 30 47 totals. 51 111 28 262 23 356 120 98 332 destroyed 1 1 Public Library Books Disinfected 100 TREATMENT OF VERMINOUS rooms. Sulphured & Sealed 10 Sprayed with Insecticide 930 Total Rooms treated 940 L.C.C. PREMISES FOUND TO BE VERMINOUS 4 ROOMS TREATED 5 SOUTHWARK COUNCIL ESTATE FOUND VERMINOUS 5 ROOMS TREATED 7 -11- FOOD & DRUGS ACT, 1938 - ANALYSIS OF SAMPLES. Samples Examined. Adulterated. Formal Informal Formal Informal. Milk. 278 26 2 Condensed Milk. 8 Dried Milk. 1 Graded Milk. 22 Butter 23 14 Cheese. 4 6 Margarine. 13 15 Lard. 15 14 Tea. 18 2 Coffee. 8 Coffee Mixture & Essences. 14 13 Cocoa. 13 14 1 Sugar. 14 5 Meat & Meat Products. 30 127 1 4 Canned & Potted Foods. 30 176 5 Fruit & Vegetables (canned etc). 44 45 1 Preserves, Jellies , Jams etc. 45 22 1 Cereals & Cereal preparations. 84 157 5 13 Bread, Flour & Confectionery. 97 160 3 6 Wines, Spirits & Beverages. 10 40 1 2 Condiments, Spices, Sauces etc. 133 230 6 6 Drugs & Medical Preparations. 10 62 2 6 Miscellaneous Samples. 12 37 1 Total. 896 1195 20 46 Percentage of adulterated samples - 3.16. FOOD & DRUGS ACT, 1938 - LEGAL PROCEEDINGS. DEFENDANT. CAUSE OF PROCEEDINGS. result . Eastern Provision Co, Ltd. 5/9, The Highway, E.D. Selling Liver Sausage containing sulphur dioxide 250 parts per million. Withdrawn on payment of £2-2-0 costs. David Jones, 1, Stead Street, S.E. l7. Soiling vinegar 16 por cent deficient in Acetic Acid. Dismissed under p.o.A. on payment of £2-2-0 costs. J. Green's Beatall Food Products, 55a, Yeldham Road, HAMMERSMITH, W.6. Selling self-raising flour 49 por cent deficient in available Carbon Dioxide. . Withdrawn# Andrew Lawrence, 157, New Kent Road, S.E.1. Selling vinegar 15* per cent deficient in Acetic Acid. Pined £3. Ernest E. Burford, 4, Montpelier Road, Peckham, S.E.15. Selling vinegar 8.5. per cent deficient in Acetic Acid. Fined £1 and £1-1-0 costs. Seven cautionary letters were sent in respect of other non-genuine samples. - 12 - BAKEHOUSES . There are 43 bakehouses In use in Southwark, of which 16 are underground bakehouses. During the War the following underground bakehouses were closed owing to damage by enemy action 126, Southwark Bridge Road. 17, St. Georges Road. 195, Great Dover Street. 80/82, Old Kent Road. 55, Rodney Road. MILK (SPECIAL DESIGNATIONS) REGULATIONS, 1936 - 1943. Dealers licences were granted authorising the use of the special designation "Pasteurised" In 25 cases, and Dealers Licences authorising the use of the special designation "Tuberculin Tested" were granted in 9 cases. 8 Supplementary Licences in respect of "Pasteurised Milk" and 5 in respect of " Tuberculin Tested" Milk were granted to dealers selling from premises outside the Borough, the principal licences having been issued by the appropriate licencing authority in each case. During the year, 23 samples of graded milks were taken and submitted to the Public Analyst for bacteriological examination and chemical analysis. MILKSELLERS. At the close of the year, there were 184 registered retailers and wholesalers - in the Borough, whilst the number of retailers and wholesalers purveying milk in the Borough but registered elsewhere was 43. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1925 & 1927. 10 samples of Condensed Milk were purchased under the above Regulations for analysis. They were all certified by the Public Analyst to comply with the said Regulations. PHARMACY & POISONS ACT, 1933. During the year 73 visits were paid to the various premises listed by the Council for the sale of Part II Poisons under the above Act. There are 51 names of persons on the Council's List of Sellers of Part II Poisons. -15- INFECTIOUS DISEASES - 1945. GENERAL. Notifications of Infectious Disease generally revealed a slight decrease on the 1944 figures, the only important variations being for Whooping Cough - which was only about 25 per cent of the previous year's total- and Measles, which showed a considerable increase, due to the, fact that 1945 was a Measles epidemic year, also that the 1944 total for this disease was exceptionally low, Hospital accommodation remained seriously restricted, and only cases of particular clinical severity or unsuitable home nursing conditions were removed. It is, therefore, especially gratifying to record that only one death occurred from infectious disease during the year under review. The gradual return of Service personnel from abroad who had been in contact with cases of Smallpox and Typhus during their journey home, or where, owing to the speed of air travel, symptoms might not have been apparent at the time of their arrival, necessitated the examination of all such contacts returning to the Borough., No cases of smallpox or Typhus were reported in Southwark during the year. NOTIFICATIONS OF INFECTIOUS DISEASE. The notifications of Infectious Diseases during the year totalled 1971, of which 449 wore removed to the London County Council's fever .hospitals. The total number of cases of Infectious Disease, after correction of diagnosis, was 1862. Disease. Total, after correction of diagnosis Admitted to Hospital. Males. Females. Total. Scarlet Fever. 73 66 139 93 Diphtheria. 19 19 38 38 Pneumonia. 34 34 58 7 Erysipelas. 9 24 33 16 Dysentery 18 11 29 29 Ophthalmia Neonatorum 10 2 12 2 Puerperal Fever. - 3 3 3 Puerperal Pyrexia. - 17 17 17 Enteritis. 5 10 15 15 Food Poisoning. 1 - 1 - Scabies. 201 294 495 - Measles. 538 427 965 217 Whopping-Cough. 20 37 57 7 Totals. 928. 934. 1862. 449. One death only, from Cerebro Spinal Meningitis, was discovered on post-mortem examination. tuberculosis . Primary Notifications. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Total including duplicate notifications Pulmonary Males. - 5 4 3 5 10 11 21 17 15 11 - 102 113 Pulmonary Females. - 3 4 2 17 19 11 7 4 5 2 - 74 85 Non-Pulm Males. - - 1 2 3 1 2 2 - 1 - - 12 12 Non-Pulm Females. - 2 1 2 - 2 5 - - - - - 12 12 Totals. - 10 10 9 25 32 29 30 21 21 13 - 200 222 -14- RETURN RELATING TO THE WORK OF THE DISPENSARY DURING THE YEAR ENDING 31ST DECEMBER, 1945. 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. (1) Number of definite cases of Tuberculosis on the Dispensary Register at the beginning of year. 273 262 49 46 16 25 3 3 289 287 52 49 677 (2) Transfers from other Authorities during the Year. 12 10 1 - - - - - 12 10 1 - 23 (3) Lost eight of cases returned during the year. - - - - - - - - - - - - - B. Number of New Cases diagnosed as tuberculosis during the year. -- (1) Class T.B. minus 38 30 8 12 - - - - 38 30 8 12 88 (2) Class T.B. plus 30 28 - - — - - — 30 28 - - 58 (3) Non-pulmonary — — — - 2 4 2 3 2 4 2 3 11 C. Number of cases included in A & B written off the Dispensary Register during the year as:- (1) Recovered. 10 3 - 3 - - 1 - 10 3 1 3 17 (2) Dead (all causes). 34 21 - — — 1 - - 34 22 - - 56 (3) Removed to other Areas 17 4 1 1 1 2 1 - 18 6 2 1 27 (4) For other reasons. — "" — - - - - - - - - - - D. Number of definite cases of tuberculosis on the Dispensary Register at the end of the year. 292 302 57 54 17 26 3 6 309 328 60 60 757 A.P. Refills 1737. Total Attendances 7079. X-Ray Exams 3339. Home visits by Health Visitors 2336. i i—! I